ObjectiveTo observe the clinical efficacy of Shentong Zhuyutang combined with Dilongtang in the treatment of lumbar disc herniation （LDH） with Qi stagnation and blood stasis syndrome， and its effect on nucleus pulposus reabsorption and immune-inflammatory factors， exploring its therapeutic mechanism from the perspective of reabsorption. MethodsA total of 120 patients with LDH from the Fourth Clinical Medical College of Guangzhou University of Chinese Medicine， treated between June 2020 and January 2023， were randomly divided into the control group （52 cases， with 8 dropouts） and the observation group （49 cases， with 11 dropouts） according to a random number table. The control group received routine treatment， while the observation group was treated with Shentong Zhuyutang combined with Dilongtang in addition to routine treatment. Visual Analogue Scale （VAS）， Oswestry Disability Index （ODI）， Japanese Orthopaedic Association （JOA） score， and traditional Chinese medicine （TCM） syndrome score were measured before treatment and after 3 courses of treatment. Venous blood samples were collected for the determination of serological indexes. MR examination was performed during the 6-month follow-up to calculate the absorption rate. ResultsAfter treatment， both groups showed significant reductions in VAS， ODI， TCM syndrome score， serum tumor necrosis factor （TNF）-α， matrix metalloproteinase （MMP）-9， and vascular endothelial growth factor （VEGF） levels， and a significant increase in JOA score compared with pre-treatment values （P<0.05）. Compared with the control group， the observation group showed significantly lower VAS， ODI， TCM syndrome score， serum TNF-α， MMP-9， and VEGF levels， and a significantly higher JOA score （P<0.05）. The proportion of nucleus pulposus reabsorption in the observation group was 57.14% （28/49）， significantly higher than 21.15% （11/52） in the control group （χ²=6.161， P<0.05）. ConclusionShentong Zhuyutang combined with Dilongtang can effectively relieve pain， improve lumbar function， and alleviate TCM clinical symptoms in LDH patients with Qi stagnation and blood stasis syndrome. Imaging findings suggest that the treatment promotes the reabsorption of nucleus pulposus protrusion， while laboratory testing shows reduced serum levels of TNF-α， MMP-9， and VEGF， which contribute to the rehabilitation of patients.

Objective To investigate the clinical value of tumor-stroma ratio (TSR) in combination with KRAS, BRAF, NRAS, and microsatellite status for prognostic assessment of patients with colorectal cancer. Methods A total of 51 colorectal cancer cases meeting the inclusion and exclusion criteria were enrolled in this study. TSR levels were evaluated through optical microscopy. The KRAS/NRAS/BRAF mutation profiles and microsatellite status were determined in accordance with genetic testing results. Clinical data, pathological characteristics, and survival outcomes were systematically recorded. Results Among the 51 patients with colorectal cancer, 19 (37.3%) were categorized into the low stromal group and 32 (62.7%) into the high stromal group. Statistically significant differences were observed between the two groups in drug resistance, M stage, TNM stage, neural invasion, and microsatellite status (P<0.05). Compared with patients exhibiting high TSR, those with low TSR demonstrated significantly increased recurrence rates (5 vs. 21 cases, P=0.007), shortened disease-free survival (34.21 vs. 14.34 months, P=0.001), and reduced overall survival (38.79 vs. 23.09 months, P=0.021). Multivariate Cox regression analysis identified N stage, M stage, TNM stage, neural invasion, lymphovascular invasion, and TSR as independent risk factors for disease-free survival. N stage, M stage, neural invasion, lymphovascular invasion, and TSR emerged as independent prognostic factors for overall survival (P<0.05). Although the combined models of TSR with KRAS, NRAS, BRAF, and microsatellite status, respectively, demonstrated overall statistical significance (P<0.05), none of the dummy variables in these models reached individually statistical significance (P>0.05), and therefore cannot be considered independent prognostic factors. Conclusion TSR serves as an independent predictor of poor prognosis in advanced colorectal cancer, with patients exhibiting low TSR demonstrating a significantly higher risk of recurrence and metastasis than those with high TSR. For patients with colon cancer undergoing first-line palliative chemotherapy after postoperative recurrence, histopathological assessment of TSR in primary tumor sites holds prognostic value and may serve as a relevant factor for evaluating treatment resistance in clinical management.

Objective To investigate the predictive value of C-reactive protein/albumin(CRP/Alb)ratio on early small or medi-um-sized coronary artery aneurysm(CAA)of children with Kawasaki disease(KD).Methods The clinical data of 116 children with KD admitted to the First Affiliated Hospital of Xinxiang Medical University from September 2018 to December 2021 were retrospectively analyzed,and they were divided into CAA group(n=34)and non-CAA group(n=82).The general conditions,clinical characteris-tics and laboratory indicators were compared between the two groups.Univariate analysis was used to screen the related factors of early small or medium-sized CAA of children with KD,and multivariate Logistic regression analysis was used to estimate the independent risk factors of early small or medium-sized CAA of children with KD.Then the receiver operating characteristic(ROC)curve was plotted to evaluate the predictive value of CRP/Alb ratio on early small or medium-sized CAA of children with KD.Results Univariate analysis showed that compared with the non-CAA group,the proportion of males in CAA group was higher,the incidence of pleomorphic rash was higher,CRP,fibrinogen and CRP/Alb ratio were significantly increased,and the differences were statistically significant(P＜0.05).The multivariate logistic regression analysis showed that male,fibrinogen and CRP/Alb ratio were the independent risk factors for early small or medium-sized CAA of children with KD.The ROC curve analysis showed that CRP/Alb ratio had a good predictive value for early small or medium-sized CAA of children with KD,with the best cut-off value of 1.4,with sensitivity of 82％,specificity of 66％,and the area under the ROC curve of 0.811.Conclusion CRP/Alb ratio can be used as a marker of predict the early small or medium-sized CAA of children with KD.

The update of multi-omics technology is a key means to promote the rapid development of accurate health model in the whole life cycle.It can formulate dynamic and accurate nursing measures and provide massive data information from the perspective of nursing biology of health and disease.At present,clinical nursing research faces many challenges such as insufficient application and transformation ability of multi-omics technology.This paper introduces the multi-omics technology,reviews the application status of multi-omics technology in cancer nursing,maternal and child nursing,chronic metabolic disease nursing and symptom management,and puts forward the cross integration and prospect of multi-omics technology and nursing research,so as to strengthen the information mining ability of nurses at different levels of health and disease,and provide an important basis for accelerating the clinical transformation of precision nursing.

【Objective】 To investigate the efficacy and safety of double-sheath vacuum suction microchannel percutaneous nephrolithotomy (MPCNL) in the treatment of complex renal stones. 【Methods】 The clinical data of 139 patients with complicated renal stones who received MPCNL during Aug. 2019 and Jul.2020 were retrospectively analyzed. According to the operation modes, the patients were divided into the double-sheath vacuum suction group (dsVS group, n=72) and conventional nephrostomy sheath group (cNS group, n=67). The perioperative indexes and the first-stage stone clearance rate of the two groups were compared. 【Results】 In the dsVS group and cNS group, the mean operation time was (46.72±9.55) min and (57.22±11.31) min, respectively (P<0.05). The first-stage stone clearance rate was 83.33% and 70.15%, respectively (P<0.05). The BUN value was (5.07±1.65) mmol/L and (5.75±1.83) mmol/L, respectively (P<0.05). The WBC value was (9.45±2.46)×10⁹/L and (10.71±3.14)×10⁹/L, respectively (P<0.05). The incidence of postoperative fever was 1.39% and 11.94%, respectively (P<0.05). There was no significant difference in other clinical data between the two groups (P>0.05). 【Conclusion】 The double-sheath vacuum suction MPCNL is safe and effective to manage complex renal stones, which can shorten the operation time, reduce postoperative complications, and improve the stone clearance rate.

Objective:To explore the efficacy and safety of laparoscopy for acute appendicitis (AA)in kidney transplant(KT)recipients.Methods:From May 2016 to December 2022, retrospective review is conducted for 99 AA patients operated at Tianjin First Central Hospital.They are assigned into two groups of observation(kidney transplant recipients, 33 cases)and control(normal renal function patients, 66 cases). Laparoscopic perioperative data of white blood cell(WBC), neutrocyte percentage(NEUT%), C-reactive protein(CRP), procalcitonin(PCT), operative duration, intraoperative blood loss, postoperative drainage volume, postoperative hospitalization length, total hospitalization expense and morbidity of postoperative complications are compared.Results:After propensity score matching, no statistically significant inter-group difference existed in clinical profiles.WBC and NEUT% pre-operation are lower in observation group than those in control group[11.85(9.54~13.99)×10 9/L vs 13.74(12.42~14.66)×10 9/L, Z=-3.908, P<0.01; 85.00(73.65~89.60)% vs 88.20(83.85~90.20)%, Z=-2.522, P=0.012]. No significant inter-group difference existed in preoperative CRP/PCT(all P>0.05). No significant inter-group differences existed in WBC, NEUT, CRP or PCT at Day 3 post-operation(all P>0.05). No significant difference existed in creatinine level in observation group before and after operation( P>0.05). As compared with control group, operative duration was longer[86(74~99)vs 62(57~68)min, Z=-6.290, P=0.020], intraoperative blood loss greater[25(20~33)vs 15(15~20)ml, Z=-6.104, P<0.01], postoperative drainage volume larger[75(65~85)vs 35(25~36)ml, Z=-8.103, P<0.01], postoperative hospitalization time longer[7(6~9)d vs 5(4~5)d, Z=-7.064, P<0.01]and total hospitalization expense higher[(1.98±0.22)vs (1.73±0.22)ten thousand yuan, t=5.401, P<0.01]. No significant inter-group differences existed in time of postoperative passage of flatus( P=0.669). No significant inter-group difference existed in morbidity of postoperative complications( P=0.893). Conclusions:The efficacy of laparoscopic appendectomy in patients post-KT is basically comparable to that in counterparts with normal renal function.

Objective: To investigate the occurrence of suspected adverse events following immunization (AEFI) in Wuyi County, Zheijang Province from 2018 to 2021, so as to provide insights into safety assessment of vaccination. Methods The AEFI data in Wuyi County from 2018 to 2021 were collected from the AEFI Information Management System and Immunization Information Management System of National Immunization Information Management System in China. The reported incidence of AEFI and epidemiological characteristics of cases with AEFI were analyzed in Wuyi County from 2018 to 2021 using a descriptive epidemiological method. Methods: The AEFI data in Wuyi County from 2018 to 2021 were collected from the AEFI Information Management System and Immunization Information Management System of National Immunization Information Management System in China. The reported incidence of AEFI and epidemiological characteristics of cases with AEFI were analyzed in Wuyi County from 2018 to 2021 using a descriptive epidemiological method. Results: A total of 870 007 vaccine doses had been administered in Wuyi County from 2018 to 2021, and a total of 482 AEFI were reported, with annual mean reported incidence of 55.40/105. The incidence of AEFI associated with vaccines included in the national immunization program was significantly higher than those not included in the national immunization program (67.75/105 vs. 44.00/105; χ2=20.334, P<0.001). There were 435 individuals with general reactions (50.00/105 incidence), with high fever, local redness and swelling and solid nodes; 39 cases with abnormal reactions (4.48/105 incidence), including 87.18% allergic reactions; 7 cases with coincident syndrome and one case with psychogenic reaction; however, no vaccine quality or vaccination events were reported. The five vaccines with the greatest incidence of AEFI included 13-valent pneumococcal polysaccharide conjugate vaccine (269.11/105), diphtheria and tetanus toxoids and acellular pertussis, inactivated poliovirus and Haemophilus b conjugate vaccine (204.23/105), 23-valent pneumococcal polysaccharide vaccine (175.85/105), tetanus, diphtheria, acellular pertussis vaccine (128.39/105) and combined live vaccine for measles, mumps and rubella (124.36/105). The reported incidence rates of AEFI were 10.89/105, 49.88/105, 56.07/105 and 57.78/105 following oral, intradermal, subcutaneous and intramuscular administrations, respectively. In addition, AEFI were predominantly found to occur in patients at ages of 0 to <2 years (333 cases, 69.09%), and AEFI predominantly occurred <1 day following immunization (336 cases, 69.71%). Conclusions General reactions were predominant types of AEFI following vaccination in Wuyi County from 2018 to 2021, and the reported incidence of AEFI associated with vaccines included in the national immunization program was significantly higher than those not included in the national immunization program. AEFI mainly occurred among children under 2 years of age.

Objective:To analyze risk factors for duration of small or medium-sized coronary artery aneurysms (CAA) in children with Kawasaki disease (KD) so as to provide clinical guidance for early and full course treatment.Methods:The clinical data of 68 children diagnosed with KD in the Department of Pediatrics, the First Affiliated Hospital of Xinxiang Medical University from January 2018 to January 2021 were retrospectively analyzed.According to duration of CAA, all cases were divided into 2 groups, duration of CAA ≥ 8 weeks group and duration of CAA <8 weeks group.Risk factors associated with CAA duration were screened using univariate analysis, and then independent risk factors for CAA duration in children with KD were analysed using multiple Logistic regression analysis. Results:A total of 68 cases were enrolled in this study.Among these cases, 45 cases (66.18%) were male and 23 cases (33.82%) were female.The onset age was from 3 months to 10 years old, and the median onset age was 1.59 (1.02-3.19). There were 31 cases in the group with CAA duration ≥8 weeks and 37 cases in the group with CAA duration <8 weeks.Univariate analysis showed that patients with the total fever course >10 days[45.16%(14/31 cases) vs.21.62%(8/37 cases)], time of treatment with intravenous immunoglobulin (IVIG)>10 days[54.84%(17/31 cases) vs.16.22%(6/37 cases)], platelet (PLT)>600×10 9/L[32.26%(10/31 cases) vs.10.81%(4/37 cases)], hypersensitive C-reactive protein (HsCRP) >100 mg/L[38.71%(12/31 cases) vs.13.51%(5/37 cases)] (all P<0.05 ) in the group with CAA duration ≥8 weeks were significantly more than those in the group with CAA duration <8 weeks.However, there were no significant differences in gender, age, type of KD, etiology evidence, hormone application, duration of fever before IVIG application, IVIG sensitivity, IVIG application way, urine leukocytes, white blood cells, hemoglobin, percent of neutrophilic granulocyte, erythrocyte sedimentation rate, glutamic-pyruvic transaminase between the 2 groups (all P>0.05). Multivariate Logistic regression analysis showed that the course of IVIG before application >10 days ( OR=6.589, 95% CI: 1.678-25.867, P=0.007)and HsCRP >100 mg/L ( OR=7.949, 95% CI: 1.947-32.461, P=0.004)were independent risk factors for predicting the duration of KD complicated with small and medium-sized CAA ≥8 weeks. Conclusions:The course of IVIG before application >10 days and HsCRP>100 mg/L are independent risk factors for KD complicated with small and medium-sized CAA lasting ≥8 weeks.

Purpose: We aimed to explore whether the prognosis of patients treated with capecitabine and oxaliplatin (XELOX) or S-1 and oxaliplatin (SOX) regimens who received fewer cycles of chemotherapy after D2 radical resection for gastric cancer (GC) would be non-inferior to that of patients who received the standard number of cycles of chemotherapy. Materials and Methods: Data on patients who received XELOX or SOX chemotherapy after undergoing D2 radical resection at Harbin Medical University Cancer Hospital between January 2011 and May 2016 were collected. Results: In patients who received 4, 6, and 8 cycles of chemotherapy, the 5-year overall survival (OS) rates were 59.4%, 64.8%, and 62.7%, respectively. Compared to patients who received 4 cycles of chemotherapy, those who received 6 cycles (hazard ratio [HR], 0.882; 95% confidence interval [CI], 0.599–1.299; P=0.52) or 8 cycles (HR, 0.882; 95% CI, 0.533–1.458; P=0.62) of chemotherapy did not exhibit significantly prolonged OS. The 3-year disease-free survival (DFS) rate of patients who received 4, 6, and 8 cycles of chemotherapy was 62.1%, 67.2%, and 60.8%, respectively. Compared to patients who received 4 cycles of chemotherapy, those who received 6 cycles (HR, 0.835; 95% CI, 0.572–1.221; P=0.35) or 8 cycles (HR, 0.972; 95% CI, 0.606–1.558; P=0.91) of chemotherapy did not show significantly prolonged DFS. However, the 3-year DFS and 5-year OS rates of patients who received 6 cycles of chemotherapy appeared to be superior to those of patients who received 4 and 8 cycles of chemotherapy. Conclusions For patients with stage III GC, 4 to 6 cycles of XELOX or SOX chemotherapy may be a favorable option. This study provides a rationale for further randomized clinical trials.

Objective:To explore the efficacy and safety of laparoscopic colon cancer surgery for patients with end-stage renal disease .Methods:Thirty-one end-stage renal disease patients (continuous hemodialysis) underwent laparoscopic colon cancer surgery from Jan 2014 to May 2019 in Tianjin First Central Hospital compared to 35 colon cancer patients with normal renal function.Result:Compared with the control group, the operation time in laparoscopic group was longer[(187±20) min vs. (174±21) min, t=2.381, P=0.020], the intraoperative blood loss was more[90 (80-110) ml vs. 50(40-60) ml, Z=-6.580, P<0.001], the postoperative drainage volume was more[(417±89) ml vs.(208±67) ml, t=10.858, P<0.001], the postoperative hospitalization time was longer[(13.68±2.10) d vs.(9.09±1.65) d, t=9.918. P<0.001], and the total hospitalization costs were higher[9.2 (8.8-9.6) ten thousand yuan vs. 6.1 (5.8-6.5) ten thousand yuan, Z=-6.976, P<0.001]. There was no significant difference in overall morbidity between the two group (23% vs. 9%, P=0.170). Sixty-one patients (92%) were followed up for a median time of 6 months. One case of liver metastasis was found in each group. Conclusion:Laparoscopic colon cancer surgery can be a safe and effective procedure in patients with end-stage renal disease .