Objective:To investigate the application value of double contrast-enhanced ultrasonography (DCEUS) combined with serum pepsinogen (PG) in the diagnosis of early gastric cancer(EGC).Methods:Eighty-two patients suspected of EGC from July 2020 to July 2022 in the People′s Hospital of Guangxi Zhuang Autonomous Region, and preoperative DCEUS examination and PG test were performed, and the patients were divided into benign lesion group(13 cases), early gastric cancer group(57 cases) and progressive gastric cancer group(12 cases) using postoperative pathology as the gold standard. Parameters for comparison included time to peak (TTP), peak intensity (PI), enhanced intensity (EI), serum pepsinogen Ⅰ (PGⅠ), serum pepsinogenⅡ (PGⅡ) and their ratio (PGⅠ/PGⅡ). The sensitivity, specificity, and accuracy of DCEUS and PG alone and in combination for the diagnosis of EGC were analyzed by plotting the ROC curve, and its diagnostic value was compared.Results:In the comparison of DCEUS parameters, PI and EI values were higher in the malignant group than in the benign lesion group and TTP was the opposite, with statistically significant differences (all P<0.05). In the comparison of PG detection, PGⅠ and PGⅠ/PGⅡ were lower in the malignant group than in the benign lesions, and lower in the progressive gastric cancer than in the EGC, while PGⅡ was the opposite, with statistically significant differences (all P<0.05). As shown by the ROC curve results, the sensitivity of DCEUS and PG alone and in combination for the diagnosis of EGC was 80.7%, 73.7% and 87.7%, respectively; the specificity was 76.0%, 72.0% and 80.0%, respectively; and the accuracy was 79.3%, 73.2% and 85.4%, respectively. The area under curve (AUC) of the two modalities alone and combined were 0.784 (95% CI=0.669-0.898), 0.728 (95% CI=0.606-0.850) and 0.839 (95% CI=0.734-0.943), respectively, and the combined diagnosis had a higher diagnostic value than the single diagnostic modality. Conclusions:The combined diagnostic modality of DCEUS and PG can further improve the diagnostic efficacy of EGC and reduce its underdiagnosis rate, which has good application value.

OBJECTIVE: To explore the valuable predictors for evaluating progression-free survival (PFS) in patients with lung adenocarcinoma, we analyzed the potential roles of standardized uptake value (SUV)-derived parameters from ¹⁸F-FDG PET/CT, combining with the gene mutation states of epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK), and other clinical characteristics. METHODS: Data of 84 lung adenocarcinoma patients pre-treated, who underwent ¹⁸F-FDG PET/CT scans, EGFR gene mutations test, ALK rearrangement assay and other relative tests, were retrospectively collected. Then a series of clinical parameters including EGFR/ALK mutation status and SUV-derived features [maximum standardized uptake value (SUVmax), average of standardized uptake value (SUVmean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG)] were evaluated. Best possible cutoff points for all measuring parameters were calculated using receiver operating characteristic curve (ROC) analysis. Survival analysis was performed using Cox proportional hazards model to determine the prognostic markers for progression-free survival (PFS). Survival curves were obtained through Log-rank test and Kaplan-Meier curve. RESULTS: The median follow-up period was 31 months (24 to 58 months). It was found that SUVmax (≥3.01), SUVmean (≥2.25), MTV (≥25.41 cm³), and TLG (≥55.02) of the primary tumors were significantly associated with PFS in univariate Cox proportional hazards regression. Then regardless of age, gender, co-morbidity, EGFR/ALK mutation status, and treatment program, TLG (≥ 55.02, HR=4.965, 95%CI: 1.360-18.133), TNM stage (Ⅲ/Ⅳ, HR=7.811, 95%CI: 2.977-20.489), pro-gastrin releasing peptide (proGRP) (≥45.65 ng/L, HR=4.070, 95%CI: 1.442-11.487), tissue polypeptide antigen (TPA) (≥68.20 U/L, HR=6.996, 95%CI: 1.458-33.574), alkaline phosphatase (ALP) (≥82.50 IU/L, HR=4.160, 95%CI: 1.416-12.219) and ratio of activated partial thromboplastin time (aPTTR) (≥1.16: HR=4.58, 95%CI: 1.913-10.946) showed the independently relevant to PFS through multivariate Cox proportional hazards analysis. The EGFR mutant (P=0.343) and ALK rearrangement (P=0.608) were not significant either in survival analysis. CONCLUSION High SUV-derived parameters (SUVmax, SUVmean, MTV and TLG) might provide prognostic value to some extent. Especially, TLG, and other clinical features [TNM stage, proGRP, TPA, ALP, and aPTTR] could be independently and significantly associated with PFS of lung adenocarcinoma patients. However, EGFR/ALK gene status could not be effectively relevant to PFS in lung adenocarcinoma patients.
Adenocarcinoma of Lung/genetics* ; Anaplastic Lymphoma Kinase/genetics* ; ErbB Receptors/genetics* ; Fluorodeoxyglucose F18 ; Genes, erbB-1 ; Humans ; Lung Neoplasms/genetics* ; Mutation ; Positron Emission Tomography Computed Tomography ; Prognosis ; Radiopharmaceuticals ; Retrospective Studies ; Tumor Burden

Objective To investigate the clinical data, risk factors for bleeding following endoscopic treatment of colorectal polyps (diameter ≥ 1.0 cm) and feature analysis for carcinogenesis of adenomatous polyps. Method It was analyzed retrospectively that the clinical data, endoscopic characteristics, risk factors for bleeding and features for carcinogenesis of adenomatous polyps in 741 patients with a total of 884 colorectal polyps (diameter ≥ 1.0 cm) of our hospital from January 1, 2014 to January 1, 2016, which were resected under endoscope. Result Univariate analysis of colorectal polyps resected under endoscope on intraoperative and delayed bleeding, we found that gender (P = 0.017), location (P = 0.011), size (P = 0.004), lobulated or not (P = 0.010), resection methods under endoscope (P = 0.029) were statistically significant deviation between the two groups; taking the polyp as observation unit,multivariate Logistic regression analysis of their clinical data and endoscopic characteristics, we found gender (P = 0.012, OR^ = 2.671, 95% CI = 1.246 ~ 5.728) was an independent risk factor, men are more prone to bleeding than women; it was a protective factor for the location of polyps is sigmoid colon compared to rectum (P = 0.011, OR^ = 0.348, 95% CI = 0.154 ~ 0.786), and it was a risk factor for the polyps whose diameters ≥ 3.0 cm compared to among 1.0 ~ 1.9 cm. Univariate analysis of the features for carcinogenesis of colorectal adenomatous polyps, we found that surface lobulated or not (P = 0.001), surface smooth or not (P = 0.017), Yamada classification (P = 0.008) were statistically significant deviation, and the logistic regression analysis identified surface lobulation (P = 0.001, OR^ = 6.556, 95% CI = 2.326 ~ 18.475) was an independent risk factor for carcinogenesis of adenomatous polyps. Conclusion Resection of colorectal polyps under endoscope is a safe treatment method. Taking the polyp as observation unit, gender is an independent risk factor of colorectal polyps resected under endoscope on intraoperative and delayed bleeding, men are more prone to bleeding than women; the larger the diameters of polyps are, the higher the bleeding rates could be. Surface lobulation of colorectal adenomatous polyps are more likely lead to carcinogenesis.

Aim To study the effect of cobra venom nerve growth factor ( NGF) on inducing the apoptosis of LX2 cells, the key cells of hepatic fibrosis , through Akt signaling pathway and its underlying mechanism .Methods CCK-8 method was used to detect the pro-liferation of LX2 cells at different concentrations of NGF and LY294002 .Flow cytometry was applied to detect the effect of NGF on the apoptosis of LX 2 cells. Western blot was used to study the effects of NGF and LY294002 respectively , and their combination on the p-Akt protein level .Results NGF could decrease the survival rate of LX2 cells, and the minimum effective concentration was 1mg· L-1; it increased the apopto-sis rate of LX2 cells within the rise of concentration un-der a certain of range and decreased the expression level of p-Akt, but it had no significant effect on the ex-pression of Akt .Conclusions NGF may promote the apoptosis of LX2 cells by inhibiting the activation of PI3K/Akt signaling pathway in a concentration-de-pendent manner .The study of the pathogenesis of liver fibrosis is significant for the clinical treatment of liver fibrosis.

Objective To discuss the clinical effects of Zhuang medicine tendons method with Zhuang herbal medicine inunction after ironing therapy in the nursing of knee osteoarthritis. Methods From February 2014 to December 2015, a total of 80 patients from the Orthopaedics Department and the Zhuang Medical Clinic of the First Affiliated Hospital of Guangxi University of Chinese Medicine were selected, and divided into observation group and control group by random number table method, with 40 cases in each group. The patients in the control group received routine Zhuang herbal medicine inunction and ironing therapy, while the patients in observation group received Zhuang medicine tendons method on the basis of the treatment of the control group. The Japanese Orthopedic Association (JOA) scores and the effects of the two groups were compared before and after the intervention. Results After 2 weeks of intervention, the JOA scores of the observation group and the control group were (91.1±4.3) and (63.2±4.2) respectively, and the difference was statistically significant (P< 0.01). Additionally, the effective rates of the observation group and the control group were 100.0% and 87.5% respectively. It was significantly higher in the observation group than in the control group (P< 0.05). Conclusions Zhuang medicine tendons method with Zhuang herbal medicine inunction after ironing therapy can improve the score of clinical symptoms and theraputic effects in knee osteoarthritis patients

Objective To investigate the relationship between serum 25-hydroxycholecalciferol [25(OH)D3] deficiency and the risk of peritoneal dialysis associated peritonitis.Methods Baseline clinical data (before the peritoneal dialysis catheter insertion) of peritoneal dialysis patients treated with CAPD in the First Affiliated Hospital of Guangxi Medical University from May 1,2013 to February 1,2016 were retrospective analyzed.All the patients were followed-up until July 31,2016.According to the baseline serum 25(OH)D3 levels,patients were divided into deficiency group (25(OH)D3 ＜ 15 ng/ml) and non deficiency group (25(OH)D3 ≥ 15 ng/ml),the baseline clinical data of the two groups were also analyzed.Kaplan-Meier method was used to compare the time-to-peritonitis of two groups.Cox proportional hazard model was used to analyze the relationship between the 25(OH)D3 deficiency and the risk of peritonitis.ROC curve was used to analyze the predictive value of the baseline serum 25(OH)D3 for the risk of PDAP in peritoneal dialysis patients.Results Compared with the 25(OH)D3 non deficiency group,25(OH)D3 deficiency group had a significant increase incidence of peritonitis,high diastolic blood pressure and mean arterial pressure,but serum albumin,total serum protein decreased significantly (P ＜ 0.05).Kaplan-Meier survival analysis showed that,compared with 25(OH)D3 non deficiency group,the time-to-peritonitis episode of patients with 25(OH)D3 deficiency were shorter (P ＜ 0.05).Cox proportional hazard model showed that after adjusting for age,sex,hemoglobin,serum albumin,C-reactive protein,total Kt/V,eGFR,diabetes or not,25(OH)D3 deficiency is the independent risk factor of peritoneal dialysis associated peritonitis (HR 5.247,95％CI 1.180-23.340,P ＜ 0.05).ROC curve showed the area under the curve that baseline serum 25(OH)D3 deficiency predict the occurrence of PDAP was 0.714,and the best cut-off point of baseline serum 25(OH)D3 was 11.35 ng/ml (sensitivity 75％,specificity 63％).Conclusions Peritoneal dialysis associated peritonitis occurred earlier in peritoneal dialysis patients whose baseline serum 25(OH)D3 deficiency.Baseline serum 25(OH)D3 deficiency is the independent risk factor of peritoneal dialysis associated peritonitis,which may predict the incidence of peritoneal dialysis associated peritonitis.

Objective To observe the patients hemodynamic reactions to the different stimula-tions under different blood concentrations of propofol with remifentanil.Exerting the response surface methodology,the half of the maximum effective concentration of propofol and the interaction index of propofol with remifentanil were calculated.Methods A total of 120 patients for scheduled abdominal surgery,randomly divided into 12 groups(n = 10).TCI 12 different concentration combinations of propofol with remifentanil,also the the hemodynamic reactions to harmful stimulations of intubation and incising were observed.The data were analyzed by responding surface analysis.Results The in-teraction index of propofol and remifentanil under intubation was 0.523 0±0.223 7,that under inci-sing 0.361 3±0.148 4,half of the maximum effective concentration of propofol for intutation and in-cising was (6.878 7 ± 1.832 1 ) μg/ml and (4.41 1 6 ± 0.902 5 ) μg/ml respectively. Conclusion Propofol and remifentanil have a synergistic inhibitory effect on harmful cardiovascular reaction among Chinese.During the endotracheal intubation,the requirements of half of the maximum effective concentration of propofol and intensity of the synergy with remifentanil are greater than those during the incising.

Objective To study the clinical effect and application value of micro-plasma beam joint radiofrequency treatment for the striae of pregnancy.Methods 21 female patients with the striae of pregnancy were included in this study,treated from the July 2012 to March 2014,aged 25-37 years;and time of the striae was from 3 months to 7 years.Micro-plasma radiofrequency technology was used to treat the striae,with interval of 30 days each time for total seven months.The total effective rate,satisfaction,and the adverse reaction were evaluated after the treatment.Results 21 patients included grade 4 in 6 cases,grade 6 in 10 cases,grade 2 in 4 cases and grade 1 in 1 case;the total effective rate was 95.2％ (20/21).Satisfactory degree was for the level C in 6 cases,B in 14 cases,and A in 1 case,with total satisfactory rate of 95.2％ (20/21).Adverse reactions included mild pigmentation in 2 patients after scab skin falling off,and disappeared at the end of the treatment course.Conclusions Micro-plasma beam combined with radio frequency in treating the striae of pregnancy has clear curative effect and good clinical application value.

OBJECTIVETo study the relationship between gene p53 codon 72 polymorphism and pathological scar formation occurrence after caesarean section.

METHODSThe method of molecular beacon with real-time PCR was applied to detect gene polymorphism of p53 codon 72 in blood samples taken from 303 pregnant women (within a week after caesarea section). The clinical visits were taken 3 times for 12th to 18th months to ascertain clinical formation of pathological scar and its relationship to genotype of p53. The chi-square method was used to analyze the relationship of p53 gene polymorphism and abnormal scar formation occurrence by statistical software SPSS 13.0.

RESULTSTotal of 303 pregnant women were assayed. 30 patients were found with pathological scar by clinical visit in the total 303 pregnant women. The genotype frequencies of total three types (C/C, C/G and G/G) of p53 gene codon 72 in patients with pathological scar are significantly different from that of normal pregnant woman. The frequency of C/C genotype in patients are higher than that of normal pregnant women (P < 0.01). The frequency of C/C genotype in these patients with pathological scar is higher (46.7%, 14/30) than C/G (33.0%, 10/30, P < 0.01) or G/G (20%, 6/30) genotype (P < 0.01). The C allele frequency in the patients is 63.7%. It is also higher than G allele (36.7%, P < 0.01). The OR value is 2.30. Therefore the C allele of p53 gene codon 72 is a risk factor for pathological scar.

CONCLUSIONSThere was a certain relationship between p53 gene codon 72 C allele and pathological scar formation after caesarean section.

Alleles ; Cesarean Section ; Cicatrix ; genetics ; Codon ; Female ; Gene Frequency ; Genes, p53 ; Genotype ; Humans ; Polymorphism, Genetic ; Pregnancy ; Risk Factors

BACKGROUNDNucleus pulposus of intervertebral discs has proinflammatory characteristics that play a key role in neuropathic pain in lumbar herniated intervertebral disc. One of the most commonly used animal models (the traditional model) of non-compressive lumbar herniated intervertebral disc is created by L4-L5 hemilaminectomy and the application of autologous nucleus pulposus to cover the left L4 and L5 nerve roots in rats. However, such procedures have the disadvantages of excessive trauma and low success rate. We proposed a modified model of non-compressive lumbar herniated intervertebral disc in which only the left L5 dorsal root ganglion is exposed and transplanted with autologous nucleus pulposus following incision of epineurium. We aimed to compare the modified model with the traditional one with regard to trauma and success rate.

METHODSThirty Sprague-Dawley male rats were randomized into three groups: sham operation group (n = 6), traditional group (n = 12), and modified group (n = 12). The amount of blood loss and operative time for each group were analyzed. The paw withdrawal threshold of the left hind limb to mechanical stimuli and paw withdrawal latency to heat stimuli were examined from the day before surgery to day 35 after surgery.

RESULTSCompared with the traditional group, the modified group had shorter operative time, smaller amount of blood loss, and higher success rate (91.7% versus 58.3%, P < 0.05). There was no decrease in paw withdrawal latency in any group. The sham operation group had no decrease in postoperative paw withdrawal threshold, whereas the modified and traditional groups had significant reduction in paw withdrawal threshold after surgery (mechanical hyperalgesia).

CONCLUSIONSTransplantation of nucleus pulposus onto the L5 dorsal root ganglion following incision of epineurium in rats established an improved animal model of non-compressive lumbar herniated intervertebral disc with less trauma and more stable pain ethology.

Animals ; Disease Models, Animal ; Ganglia, Spinal ; pathology ; Intervertebral Disc Degeneration ; pathology ; Intervertebral Disc Displacement ; pathology ; Male ; Random Allocation ; Rats ; Rats, Sprague-Dawley