Objective To investigate the value of cranial CT cisternal grading combined with D-dimer(D-D)and Glasgow Coma Scale(GCS)score in predicting the short-term postoperative prog-nosis of patients with severe traumatic brain injury.Methods A total of 165 patients with severe trau-matic brain injury who were treated in the hospital from January 2019 to May 2024 were selected as study subjects,all underwent craniotomy surgery.Postoperative follow-up was conducted for 3 months to analyze the differences in clinical data and preoperative indicators such as cranial CT cisternal grad-ing,D-D levels,and GCS scores between patients with poor and good prognosis.The value of cranial CT cisternal grading,D-D levels,and GCS scores in predicting short-term postoperative poor prognosis in patients with severe traumatic brain injury was also analyzed.Results Compared with patients with good prognosis,patients with poor prognosis had higher proportion of age,cranial CT cisternal grading of Ⅰ to Ⅱ,D-D levels,and GCS scores＜6(P＜0.05).There were no statistically significant differences in C-reactive protein,prothrombin time,activated partial thromboplastin time,international normalized ratio,total cholesterol,triglycerides,high-density lipoprotein cholesterol,and low-density lipoprotein cholesterol levels between patients with poor and good prognosis(P＞0.05).Cranial CT cisternal grading,D-D levels,and GCS scores were influencing factors for short-term postoperative poor prognosis in patients with severe traumatic brain injury(P＜0.05).The area under the curve for poor prognosis by three indicators in combination was 0.941(95％CI,0.906 to 0.975),which was higher than the area under the curve for the individual predictions of cranial CT cisternal grad-ing,D-D levels,and GCS scores(P＜0.05).Conclusion The influencing factors for short-term postoperative prognosis in patients with severe traumatic brain injury include cranial CT cisternal grading,D-D levels,and GCS scores.The model based on these three indicators has certain appli-cation value in predicting patient prognosis.

Objective To investigate the relationships of serum microRNA-9-3p(miR-9-3p),microRNA-27b-3p(miR-27b-3p),with brain glioma(BG)grading and their impacts on prognosis.Methods A total of 172 BG patients admitted in Suqian Hospital of Jiangsu Provincial People's Hos-pital from May 2020 to May 2023 were enrolled and divided into high-grade group(grade Ⅲ to Ⅳ,n=101)and low-grade group(grade Ⅰ to Ⅱ,n=71)according to the World Health Organization(WHO)classification of central nervous system tumors.Additionally,85 healthy individuals of the same age range during the same period were selected as control group.General information,serum levels of miR-9-3p,and miR-27b-3p were compared among the three groups.The correlations of pre-treatment serum levels of miR-9-3p and miR-27b-3p with BG grading were analyzed.The prognosis of BG patients one year after treatment was recorded,and clinical data were compared between the poor prognosis group and the good prognosis group.Factors influencing poor prognosis in BG patients as well as the value of pretreatment serum miR-9-3p and miR-27b-3p in predicting poor prognosis were analyzed.Conventional factors influencing poor prognosis were used to establish a conventional prediction mod-el,and model combined with pretreatment serum miR-9-3p and miR-27b-3p levels was used as a new prediction model.The value of these two models in predicting poor prognosis in BG patients was compared.Results Before treatment,serum levels of miR-9-3p and miR-27b-3p were lower in the high-grade group than those in the low-grade and control groups,and lower in the low-grade group than those in the control group(P＜0.05).Correlation analysis showed that pretreatment serum levels of miR-9-3p and miR-27b-3p were negatively correlated with BG grading(r=-0.573,P＜0.001;r=-0.498,P＜0.001),and serum miR-9-3p level was positively correlated with miR-27b-3p level in BG patients(r=0.509,P＜0.05).Before treatment,the poor prognosis group had a higher proportion of patients with WHO grade Ⅲ to Ⅳ,low differentiation,Karnofsky Performance Scale(KPS)＜70,and higher serum interleukin-17(IL-17)levels compared to the good prognosis group,while serum levels of miR-9-3p and miR-27b-3p were lower(P＜0.05).Logistic regression analysis showed that pretreatment WHO grading,differentiation,KPS,serum IL-17,miR-9-3p,and miR-27b-3p levels were all influencing factors of poor prognosis in BG patients(P＜0.05).Receiver operating characteristic(ROC)curves showed that the areas under the curve(AUCs)for pretreatment serum miR-9-3p and miR-27b-3p alone in predicting poor prognosis in BG patients were 0.714 and 0.720,respectively,with no statistically significant difference(Z=0.086,P=0.413).The AUC of the conventional prediction model for predicting poor prognosis in BG patients was 0.829,and the AUC of the new prediction model was 0.926(P＜0.05).Conclusion Serum levels of miR-9-3p and miR-27b-3p are negatively correlated with BG grading and are factors influ-encing poor prognosis,demonstrating certain value in predicting poor prognosis.

Objective To explore the clinicopathologic factors impacting recurrence and survival in rectal cancer patients after radical resection.Methods Clinicopathologic data of 1 166 patients with rectal cancer in Changhai Hospital,were recruited between 2005 and 2010.Kaplan-Meier analysis and the logrank test were used to evaluate the effects of the pathology on patients' survival.Cox regression model was used to assess independent factors associated with clinical prognosis.Results The 1,3,5-year overall survival rates were 94.3％,81.2％ and 76.5％,median survival time was 53 months.328 patients had recurrence and metastases,with a median recurrence time of 18 months.The independent prognostic factors for overall survival time were CEA,CA19-9,tumor distance to dentate line,surgical modality,radical operation,tumor invasion,tumor differentiation,lymph node metastasis and postoperative treatment.Surgical treatment,radical operation or not,tumor invasion and lymph node metastasis were statistically significant associated with tumor recurrence and metastases.Conclusions The important factors inffuencing the prognosis of rectal cancer patients were CEA,CA19-9,tumor distance to dentate line,surgical modality,radial operation,tumor in vasion,tumor differentiation,lymph node metastasis,and post operative treatment.

OBJECTIVETo investigate the microRNA101(miR101) expression and its clinical significance in colorectal cancer.

METHODSTissue microarrays containing 56 specimens of normal mucosa, 51 adenoma and 735 colorectal cancer were examined by locked nucleic acid in-situ hybridization(LNA-ISH) for miR101 expression. Relationship between miR101 expression and clinicopathologic parameters and prognosis of colorectal cancer patients were analyzed. Fresh frozen tissues containing 5 specimens of normal mucosa, 5 adenoma and 47 colorectal cancer were examined by RT-PCR to verify the accuracy of LNA-ISH.

RESULTSExpression of miR101 increased gradually from normal mucosa, adenoma to stage I colorectal cancer (all P<0.01), and decreased gradually from stage II(, stage III( to stage IIII( colorectal cancer (all P<0.01). Overexpression of miR101 was related with lower incidence of lymph node metastasis, lower metastasis rate, higher differentiation and lower recurrence rate (all P<0.01). Multivariate survival analysis demonstrated that miR101 expression was an independent prognostic factor of overall survival (HR=0.550, 95% CI: 0.351-0.863) and disease free survival(HR=0.562, 95% CI: 0.397-0.794) in colorectal cancer patients. Overexpression of miR101 predicted a better prognosis in colorectal cancer patients.

CONCLUSIONSExpression of miR101 is associated with the genesis and development of colorectal cancer, and may serve as an independent prognostic factor for colorectal cancer patients.

Adenoma ; Colorectal Neoplasms ; Disease-Free Survival ; Gene Expression Regulation, Neoplastic ; Humans ; Lymphatic Metastasis ; MicroRNAs ; Multivariate Analysis ; Neoplasm Staging ; Prognosis

Objective To examine the effect of teaching surgical nursing using a team-based (TBL) combined with case-based learning (CBL) model on higher vocational students. Methods A total of 227 nursing students were investigated, and they were divided into the experimental group (n=97) and the control group (n=130) by simple random sampling. The TBL and CBL was applied in the experi-mental group, and the traditional 1ecture-based learning (LBL) was used in the control group. After the experiment teaching, a test and questionnaire were used to compare the teaching effect of experimental group and the control group. The data was analyzed by Independent-Samples T test and Chi-square test. Results The 97 students in the experimental group achieved higher mean test scores (89.18 ± 7.808) compared with the other participants' (85.53±11.033) in the control group and the difference was statistically significant (t=2.926, P=0.004). Assessments on participants' abilities, such as indepen-dent thinking, teamwork, communication, problem solving, active learning and so on, were significantly higher in the experimental group compared with the control group students and the difference was sta-tistically significant (P=0.000). Majority of the respondents (91students, 93.82%) noted that case-based, team-based learning was a better learning strategy compared to lecture-based learning. Most of the students (90 students, 92.78%) agreed that more such instruction activity should be organized in the future. Conclusions TBL combined with CBL has enhanced the students' learning achievement and improved their abilities of independent thinking, teamwork, communication, problem solving, autonomous learning and so on, and is welcome by the teachers and students.

Objective To investigate the microRNA101 (miR101) expression and its clinical significance in colorectal cancer. Methods Tissue microarrays containing 56 specimens of normal mucosa, 51 adenoma and 735 colorectal cancer were examined by locked nucleic acid in-situ hybridization (LNA-ISH) for miR101 expression. Relationship between miR101 expression and clinicopathologic parameters and prognosis of colorectal cancer patients were analyzed. Fresh frozen tissues containing 5 specimens of normal mucosa , 5 adenoma and 47 colorectal cancer were examined by RT-PCR to verify the accuracy of LNA-ISH. Results Expression of miR101 increased gradually from normal mucosa, adenoma to stage I colorectal cancer (all P<0.01), and decreased gradually from stageⅡ, stage Ⅲ to stage Ⅳ colorectal cancer (all P<0.01). Overexpression of miR101 was related with lower incidence of lymph node metastasis, lower metastasis rate, higher differentiation and lower recurrence rate (all P<0.01). Multivariate survival analysis demonstrated that miR101 expression was an independent prognostic factor of overall survival (HR=0.550, 95% CI: 0.351-0.863) and disease free survival (HR=0.562, 95% CI: 0.397-0.794) in colorectal cancer patients. Overexpression of miR101 predicted a better prognosis in colorectal cancer patients. Conclusions Expression of miR101 is associated with the genesis and development of colorectal cancer , and may serve as an independent prognostic factor for colorectal cancer patients.

Objective To investigate the microRNA101 (miR101) expression and its clinical significance in colorectal cancer. Methods Tissue microarrays containing 56 specimens of normal mucosa, 51 adenoma and 735 colorectal cancer were examined by locked nucleic acid in-situ hybridization (LNA-ISH) for miR101 expression. Relationship between miR101 expression and clinicopathologic parameters and prognosis of colorectal cancer patients were analyzed. Fresh frozen tissues containing 5 specimens of normal mucosa , 5 adenoma and 47 colorectal cancer were examined by RT-PCR to verify the accuracy of LNA-ISH. Results Expression of miR101 increased gradually from normal mucosa, adenoma to stage I colorectal cancer (all P<0.01), and decreased gradually from stageⅡ, stage Ⅲ to stage Ⅳ colorectal cancer (all P<0.01). Overexpression of miR101 was related with lower incidence of lymph node metastasis, lower metastasis rate, higher differentiation and lower recurrence rate (all P<0.01). Multivariate survival analysis demonstrated that miR101 expression was an independent prognostic factor of overall survival (HR=0.550, 95% CI: 0.351-0.863) and disease free survival (HR=0.562, 95% CI: 0.397-0.794) in colorectal cancer patients. Overexpression of miR101 predicted a better prognosis in colorectal cancer patients. Conclusions Expression of miR101 is associated with the genesis and development of colorectal cancer , and may serve as an independent prognostic factor for colorectal cancer patients.

Objective To study the impacts of TBL and LBL teaching methods on the ability of critical thinking among college nursing students. Methods Two classes of nursing students of high vocational school were included. Class 1 ( n=97 ) was set as experimental group which employed TBL teaching method,, and class 2 (n=130) was set as control group which employed LBL teaching method. Students in both groups were tested twice for the critical thinking ability by the questionnaire of critical thinking disposition inventory-Chinese version ( CTDI-CV ) before and after the courses. The scores changing in ability of critical thinking were compared between two groups. Results Score of the critical thinking ability in the experimental group was increased from (242. 80 ± 24. 37) before the course to (252. 55 ± 25. 48) after the course. The difference was statistically significant. (t=2. 636,P<0. 01);92. 78% of the nursing students satisfied with the TLB teaching method. Score of students in the control group was(243. 28 ± 27. 39)before the course and was(239. 45 ± 28. 17) after the course, the difference was not statistically significant (t=1. 070,P>0. 05). Conclusions The TBL teaching method has contributed to the cultivation of the critical thinking ability, and was favored by the college-nursing students.

Colonic pouch can improve fecal continence after low anterior resection in the short-term, but its superiority would disappear in the long-term (2 years after surgery), since fecal continence improves gradually with time in the non-pouch group. Furthermore, the incidence of incomplete defecation increases gradually with time, and a lot of patients would have difficulty in defecation and require long-term use of suppositories and enemas. Pouch enforcement will result in prolonged operation time and increased treatment cost. Therefore, the value of colonic pouch in low rectal anastomosis is being questioned, and its application diminishes gradually. For patients with ulcerative colitis (UC) or familial adenomatous polyposis (FAP) after total colectomy, ileal pouch anal anastomosis (IPAA) can reduce fecal frequency and improve patients' quality of life in both short-term and long-term, by increasing the volume of the neo-rectum and altering intestinal motility. For these reasons, IPAA is the first surgical choice for UC and FAP.
Anal Canal ; surgery ; Anastomosis, Surgical ; methods ; Humans ; Ileum ; surgery ; Rectum ; surgery

Objective To study the attention dysfunction of postoperative glioma patients.Methods Attention network test (ANT),digital span (DS),color trail test Ⅱ (CTT Ⅱ) and stroop test (ST) were used to detect the characteristics of attention function of 45 postoperative glioma patients,admitted to our hospital from January 2010 to January 2012 and 18 healthy controls.The relations of attention dysfunction with tumor localization,malignancy and postoperative recovery time were analyzed.Results As compared with that in the control group,orientation network dysfunction was detected in parietal lobe tumor group,with significant difference (P＜0.05); as compared with patients with low grade rumors (grade Ⅰ-Ⅱ),the patients with high grade tumors (grade Ⅲ-Ⅳ) had significantly lower scores in backward recite test,longer time in digital color connection test and higher word color naming interference value,enjoying significant differences (P＜0.05).No significant relation was observed between postoperative recovery time and attention impairment (P＞0.05); Conclusion The frontal and parietal lobe glioma patients suffer attention dysfunction and the high-grade glioma patients have more seriously impairment in attention,attention switching effect and selective attention ability than the low-grade ones.