Background and Aims:Mucinous adenocarcinoma of the colorectum(MAC)is a distinct histologic subtype of colorectal cancer characterized by high malignancy and low diagnostic accuracy of preoperative biopsy,posing challenges for clinical decision-making.Given the critical role of the inflammatory microenvironment in tumor progression,this study aimed to develop and validate a nomogram model integrating preoperative systemic inflammatory indicators and clinical features to improve the preoperative diagnosis of MAC.Methods:Clinical data of 293 patients with colorectal cancer who underwent radical resection between June 2017 and June 2022 at the First Affiliated Hospital of the University of South China were retrospectively analyzed.Based on postoperative pathology,patients were classified into the mucinous adenocarcinoma(MAC)group and the non-specific adenocarcinoma(AC)group.Propensity score matching(PSM,1∶1)was used to balance age,T stage,and N stage.Differences in preoperative inflammatory indices were compared between groups.Univariate and multivariate logistic regression analyses were performed to identify independent predictors of MAC,which were incorporated into a diagnostic nomogram.The model's discrimination,calibration,and clinical utility were evaluated using the area under the receiver operating characteristic curve(AUC),calibration plots,and decision curve analysis(DCA).Results:Among the 293 patients,46 had MAC and 247 had AC,with a preoperative colonoscopic diagnostic rate of 54%for MAC.After PSM(43 pairs),platelet count,platelet lymphocyte ratio(PLR),systemic immune inflammation index(SII),inflammation related prognostic index(IPI),and systemic inflammation score(SIS)were significantly higher in the MAC group,while lymphocyte monocyte ratio(LMR)was lower(all P<0.05).Multivariate analysis identified tumor location,maximum tumor diameter,and preoperative IPI as independent predictors.The AUCs of the nomogram in the training(n=206)and validation(n=87)cohorts were 0.759(95%CI=0.662-0.856)and 0.776(95%CI=0.649-0.903),respectively.Calibration plots showed good agreement between predicted and observed probabilities,and DCA demonstrated satisfactory clinical applicability.Conclusion:A nomogram model integrating tumor location,tumor size,and preoperative IPI was successfully developed and validated for preoperative diagnosis of colorectal MAC.This model provides a practical,quantitative tool with good predictive performance to assist clinicians in individualized treatment planning,particularly for patients ineligible for surgical biopsy.

Background and Aims:Mucinous adenocarcinoma of the colorectum(MAC)is a distinct histologic subtype of colorectal cancer characterized by high malignancy and low diagnostic accuracy of preoperative biopsy,posing challenges for clinical decision-making.Given the critical role of the inflammatory microenvironment in tumor progression,this study aimed to develop and validate a nomogram model integrating preoperative systemic inflammatory indicators and clinical features to improve the preoperative diagnosis of MAC.Methods:Clinical data of 293 patients with colorectal cancer who underwent radical resection between June 2017 and June 2022 at the First Affiliated Hospital of the University of South China were retrospectively analyzed.Based on postoperative pathology,patients were classified into the mucinous adenocarcinoma(MAC)group and the non-specific adenocarcinoma(AC)group.Propensity score matching(PSM,1∶1)was used to balance age,T stage,and N stage.Differences in preoperative inflammatory indices were compared between groups.Univariate and multivariate logistic regression analyses were performed to identify independent predictors of MAC,which were incorporated into a diagnostic nomogram.The model's discrimination,calibration,and clinical utility were evaluated using the area under the receiver operating characteristic curve(AUC),calibration plots,and decision curve analysis(DCA).Results:Among the 293 patients,46 had MAC and 247 had AC,with a preoperative colonoscopic diagnostic rate of 54%for MAC.After PSM(43 pairs),platelet count,platelet lymphocyte ratio(PLR),systemic immune inflammation index(SII),inflammation related prognostic index(IPI),and systemic inflammation score(SIS)were significantly higher in the MAC group,while lymphocyte monocyte ratio(LMR)was lower(all P<0.05).Multivariate analysis identified tumor location,maximum tumor diameter,and preoperative IPI as independent predictors.The AUCs of the nomogram in the training(n=206)and validation(n=87)cohorts were 0.759(95%CI=0.662-0.856)and 0.776(95%CI=0.649-0.903),respectively.Calibration plots showed good agreement between predicted and observed probabilities,and DCA demonstrated satisfactory clinical applicability.Conclusion:A nomogram model integrating tumor location,tumor size,and preoperative IPI was successfully developed and validated for preoperative diagnosis of colorectal MAC.This model provides a practical,quantitative tool with good predictive performance to assist clinicians in individualized treatment planning,particularly for patients ineligible for surgical biopsy.

AIM To investigate the effects of dried extract powder of Qingre Xiaoyanning on a mouse model of rhinovirus (RhV) infection.METHODS Ninety-six BALB/c mice,half males and half females,were randomly divided into the normal group,the model group,the ribavirin group (60 mg/kg) and the low,medium and high dose groups of dried extract powder of Qingre Xiaoyanning (8.72,17.44,34.89 g/kg) for the administration of the corresponding doses of drugs once daily for 7 days.Except for those of the normal group,the mice of the other groups were intranasally instilled with VR-1187 RhV on the fourth day of the administration.On the second day to the day of the last administration,the mice had their left bronchus and left lung procured for pathological examination;their right lung taken for PCR detection of viral load;their levels of inflammatory factors TNF-α,IL-1β,IL-4,VCAM-1 and IFN-γ in alveolar lavage fluid detected by ELISA;their levels of macrophages,NK cells and lymphocytes detected by flow cytometry;and their pulmonary protein expressions of TLR4,MYD88,IKK-β,IκB and p-IκB detected by Western blot.RESULTS Compared with the model group,the group intervened with high dose dried extract powder of Qingre Xiaoyanning displayed decreased viral load (P<0.01);decreased levels of IL-4,VCAM-1 and IL-1β in bronchoalveolar lavage fluid (P<0.05,P<0.01);decreased proportion of pulmonary macrophages (P<0.01);increased proportion of lymphocytes and NK cells (P<0.05);and decreased protein expressions of TLR4,MYD88,IκB,p-IκB and ratio of p-IκB/IκB in lung tissue (P<0.05).Additionally,the medium dose group of dried extract powder of Qingre Xiaoyanning shared decreased pulmonary IKK-β protein expression (P<0.05).CONCLUSION The dried extract powder of Qingre Xiaoyanning can reduce the inflammatory reaction in mice to protect their lung tissue because of its obvious anti-RhV effect in vivo by inhibiting the RhV replication via TLR4/MYD88/NF-κB signaling pathway.

AIM To establish the HPLC-CAD characteristic chromatograms of Qingzhi Huayu Formula,and to determine the contents of rhamnose,fructose,mannitol,D-anhydrous glucose,sucrose and raffinose.METHODS The analysis was performed on a 35 ℃ thermostatic Dikma Polyamino HILIC column (4.6 mm×250 mm,5 μm),with the mobile phase comprising of acetonitrile-water flowing at 0.8 mL/min in a gradient elution manner.RESULTS There were 14 common peaks in the characteristic chromatograms of 15 batches of samples with the similarities of more than 0.90.Six carbohydrates showed good linear relationships within their own ranges ( r>0.9950 ),whose average recoveries were 93.34％-105.64％ with the RSDs of 0.5％-2.6％.CONCLUSION This accurate,reliable,sensitive and reproducible method can be used for the quality control of carbohydrates in Qingzhi Huayu Formula.

AIM To investigate the effects of dried extract powder of Qingre Xiaoyanning on a mouse model of rhinovirus (RhV) infection.METHODS Ninety-six BALB/c mice,half males and half females,were randomly divided into the normal group,the model group,the ribavirin group (60 mg/kg) and the low,medium and high dose groups of dried extract powder of Qingre Xiaoyanning (8.72,17.44,34.89 g/kg) for the administration of the corresponding doses of drugs once daily for 7 days.Except for those of the normal group,the mice of the other groups were intranasally instilled with VR-1187 RhV on the fourth day of the administration.On the second day to the day of the last administration,the mice had their left bronchus and left lung procured for pathological examination;their right lung taken for PCR detection of viral load;their levels of inflammatory factors TNF-α,IL-1β,IL-4,VCAM-1 and IFN-γ in alveolar lavage fluid detected by ELISA;their levels of macrophages,NK cells and lymphocytes detected by flow cytometry;and their pulmonary protein expressions of TLR4,MYD88,IKK-β,IκB and p-IκB detected by Western blot.RESULTS Compared with the model group,the group intervened with high dose dried extract powder of Qingre Xiaoyanning displayed decreased viral load (P<0.01);decreased levels of IL-4,VCAM-1 and IL-1β in bronchoalveolar lavage fluid (P<0.05,P<0.01);decreased proportion of pulmonary macrophages (P<0.01);increased proportion of lymphocytes and NK cells (P<0.05);and decreased protein expressions of TLR4,MYD88,IκB,p-IκB and ratio of p-IκB/IκB in lung tissue (P<0.05).Additionally,the medium dose group of dried extract powder of Qingre Xiaoyanning shared decreased pulmonary IKK-β protein expression (P<0.05).CONCLUSION The dried extract powder of Qingre Xiaoyanning can reduce the inflammatory reaction in mice to protect their lung tissue because of its obvious anti-RhV effect in vivo by inhibiting the RhV replication via TLR4/MYD88/NF-κB signaling pathway.

AIM To establish the HPLC-CAD characteristic chromatograms of Qingzhi Huayu Formula,and to determine the contents of rhamnose,fructose,mannitol,D-anhydrous glucose,sucrose and raffinose.METHODS The analysis was performed on a 35 ℃ thermostatic Dikma Polyamino HILIC column (4.6 mm×250 mm,5 μm),with the mobile phase comprising of acetonitrile-water flowing at 0.8 mL/min in a gradient elution manner.RESULTS There were 14 common peaks in the characteristic chromatograms of 15 batches of samples with the similarities of more than 0.90.Six carbohydrates showed good linear relationships within their own ranges ( r>0.9950 ),whose average recoveries were 93.34％-105.64％ with the RSDs of 0.5％-2.6％.CONCLUSION This accurate,reliable,sensitive and reproducible method can be used for the quality control of carbohydrates in Qingzhi Huayu Formula.

To explore the efficacy and value of personalized surgical schemes in the repair of maxillary sinus perforation and maxillary sinus fistula based on the size of the maxillary sinus perforation and maxillary sinus fistula. A total of 28 patients with maxillary sinus perforation and maxillary sinus fistula who were admitted to the Department of Oral and Maxillofacial Surgery, Stomatology Hospital of Kunming Medical University from July 2017 to May 2020 were included to conduct a prospective case clinical study. After the inflammation in the maxillary sinus was controlled, a proper surgical repair method was selected according to the size of the perforation and fistula based on the double-layer closure technique. The diameter of the perforation and fistula was measured with the assistance of cone-beam CT. After that, the platelet rich fibrin (PRF) repair was performed on the perforation and fistula with 3 mm≤diameter<7 mm in size in 14 patients. The PRF repair and buccal flap repair were performed on the perforation and fistula with 7 mm ≤diameter<15 mm in size in 7 patients. The adjacent buccal pad repair, palatine flap repair, and buccal flap repair were performed on the perforation and fistula with 15 mm≤ diameter<25 mm in size in 4 patients. The nasolabial axial flap repair and nasolabial free flap repair were performed on the perforation and fistula with a diameter ≥25 mm in size in 3 patients. The medical follow-up was conducted in all patients in the 1st, 2nd, and 4th week after surgery, with an overall success rate reaching 96.4% (27/28) after the initial intervention. The relapse of disease occurred in one patient (4.6%) with diabetes and a smoking history in the 2nd week after surgery. Identifying a proper surgical repair method according to the size of the oral and maxillary sinus perforation and maxillary sinus fistula based on the double-layer closure technique can improve the one-time cure rate in these patients under the premise that the inflammation in the maxillary sinus can be controlled.
Fistula/surgery* ; Humans ; Inflammation ; Maxilla ; Maxillary Sinus/surgery* ; Oroantral Fistula/surgery*

Objective: To investigate the incidence and treatment of perioperative anemia in patients with gastrointestinal neoplasms in Hubei Province. Methods: The clinicopathological data of 7 474 patients with gastrointestinal neoplasms in 62 hospitals in 15 cities (state) of Hubei Province in 2019 were collected in the form of network database. There were 4 749 males and 2 725 females. The median age of the patients was 62 years (range: 17 to 96 years). The hemoglobin value of the first time in hospital and the first day after operation was used as the criterion of preoperative anemia and postoperative anemia. Anemia was defined as male hemoglobin <120 g/L and female hemoglobin <110.0 g/L, mild anemia as 90 to normal, moderate anemia as 60 to <90 g/L, severe anemia as <60 g/L. The t test and χ² test were used for inter-group comparison. Results: The overall incidence of preoperative anemia was 38.60%(2 885/7 474), and the incidences of mild anemia, moderate anemia and severe anemia were 25.09%(1 875/7 474), 11.37%(850/7 474) and 2.14%(160/7 474), respectively. The overall incidence of postoperative anemia was 61.40%(4 589/7 474). The incidence of mild anemia, moderate anemia and severe anemia were 48.73%(3 642/7 474), 12.20%(912/7 474) and 0.47%(35/7 474), respectively. The proportion of preoperative anemia patients receiving treatment was 26.86% (775/2 885), and the proportion of postoperative anemia patients receiving treatment was 14.93% (685/4 589). The proportions of preoperative anemia patients in grade ⅢA, grade ⅢB, and grade ⅡA hospitals receiving treatment were 26.12% (649/2 485), 32.32% (85/263), and 29.93% (41/137), and the proportions of postoperative anemia patients receiving treatment were 14.61% (592/4 052), 22.05% (73/331), and 9.71% (20/206). The proportion of intraoperative blood transfusion (16.74% (483/2 885) vs. 3.05% (140/4 589), χ²=434.555, P<0.01) and the incidence of postoperative complications (17.78% (513/2 885) vs. 14.08% (646/4 589), χ²=18.553, P<0.01) in the preoperative anemia group were higher than those in the non-anemia group, and the postoperative hospital stay in the preoperative anemia group was longer than that in the non-anemia group ((14.1±7.3) days vs. (13.3±6.2) days, t=5.202, P<0.01). Conclusions: The incidence of perioperative anemia in patients with gastrointestinal neoplasms is high. Preoperative anemia can increase the demand for intraoperative blood transfusion and affect the short-term prognosis of patients. At present, the concept of standardized treatment of perioperative anemia among gastrointestinal surgeons in Hubei Province needs to be improved.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anemia/epidemiology* ; Blood Transfusion ; Female ; Gastrointestinal Neoplasms/surgery* ; Humans ; Length of Stay ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult

Aim To investigate the effect of Exendin4 on proliferation, migration, adhesion and senescence of endothelial progenitor cells (EPCs) in type I diabetic mice and its possible mechanism. Methods EPCs from 6-month diabetic mice were isolated and cultured by density gradient centrifugation. Cells were treated with different concentrations of Exendin-4 (1, 5, 10, 25 μmol · L