Objective:Based on " the surveillance, epidemiology, and end results" (SEER) database, we constructed a nomogram model for predicting cancer-specific survival time (CSST) in patients with T2 stage gallbladder cancer.Methods:Clinical data on 486 patients with T2 stage gallbladder cancer between 2018 and 2020 were retrospectively collected from the SEER database. The cohort comprised 147 male and 339 female patients with the age at diagnosis of (70±13) years. Clinical information including age, gender, tumor size, tumor stage, surgical type, number of lymph node dissection, postoperative treatment, and patients prognosis were extracted from the SEER database. We analyzed the factors influencing CSST in patients with T2 stage gallbladder cancer using Cox risk-proportional regression. The nomogram model was constructed based on independent risk factors obtained from multivariate Cox regression analysis, and the area under curve (AUC) of receiver operating characteristic curves (ROC) were used to evaluate the predictive accuracy of the nomogram model, while calibration plots, decision curve analysis, and clinical impact curves were used to evaluate the model's practicality and effectiveness.Results:The results of multivariate Cox regression analysis showed that patients with tumor size ≥30 mm ( HR=1.775, 95% CI: 1.123-2.806), AJCC stage ⅢB ( HR=6.083, 95% CI: 2.961-12.495), 1-3 lymph node dissection ( HR=6.139, 95% CI: 2.876-13.106), no postoperative chemotherapy ( HR=1.743, 95% CI: 1.096-2.771) had a higher risk of short CSST (all P<0.05). A nomogram model for predicting CSST was constructed based on the above risk factors, and the AUC of the ROC of which for predicting 1-year and 2-year CSST in patients with T2 stage gallbladder cancer was 0.778 and 0.696, respectively. Calibration plots demonstrated excellent collinearity between predicted and actual probabilities. Decision curve analysis and clinical impact curves confirmed high net benefit and clinical validity of the nomogram model. Conclusions:The tumor size ≥30 mm, AJCC stage ⅢB, 1-3 lymph node dissection and no postoperative chemotherapy are risk factors for short CSST in patients with T2 gallbladder cancer. The nomogram model based on the above risk factors have excellent performance in predicting CSST in patients with T2 stage gallbladder cancer.

Objective:Based on " the surveillance, epidemiology, and end results" (SEER) database, we constructed a nomogram model for predicting cancer-specific survival time (CSST) in patients with T2 stage gallbladder cancer.Methods:Clinical data on 486 patients with T2 stage gallbladder cancer between 2018 and 2020 were retrospectively collected from the SEER database. The cohort comprised 147 male and 339 female patients with the age at diagnosis of (70±13) years. Clinical information including age, gender, tumor size, tumor stage, surgical type, number of lymph node dissection, postoperative treatment, and patients prognosis were extracted from the SEER database. We analyzed the factors influencing CSST in patients with T2 stage gallbladder cancer using Cox risk-proportional regression. The nomogram model was constructed based on independent risk factors obtained from multivariate Cox regression analysis, and the area under curve (AUC) of receiver operating characteristic curves (ROC) were used to evaluate the predictive accuracy of the nomogram model, while calibration plots, decision curve analysis, and clinical impact curves were used to evaluate the model's practicality and effectiveness.Results:The results of multivariate Cox regression analysis showed that patients with tumor size ≥30 mm ( HR=1.775, 95% CI: 1.123-2.806), AJCC stage ⅢB ( HR=6.083, 95% CI: 2.961-12.495), 1-3 lymph node dissection ( HR=6.139, 95% CI: 2.876-13.106), no postoperative chemotherapy ( HR=1.743, 95% CI: 1.096-2.771) had a higher risk of short CSST (all P<0.05). A nomogram model for predicting CSST was constructed based on the above risk factors, and the AUC of the ROC of which for predicting 1-year and 2-year CSST in patients with T2 stage gallbladder cancer was 0.778 and 0.696, respectively. Calibration plots demonstrated excellent collinearity between predicted and actual probabilities. Decision curve analysis and clinical impact curves confirmed high net benefit and clinical validity of the nomogram model. Conclusions:The tumor size ≥30 mm, AJCC stage ⅢB, 1-3 lymph node dissection and no postoperative chemotherapy are risk factors for short CSST in patients with T2 gallbladder cancer. The nomogram model based on the above risk factors have excellent performance in predicting CSST in patients with T2 stage gallbladder cancer.

Objective:To investigate the clinical significance and possible mechanisms of elevated homocysteine(Hcy) levels in peripheral blood of children with sepsis.Methods:The clinical data of 51 children with sepsis (sepsis group) admitted to PICU at Xuzhou Children′s Hospital from January 2019 to December 2019 were analyzed, and the levels of Hcy in plasma were compared with 50 non-septic children (common infection group) and 50 healthy children (healthy control group) during the same period.The possible mechanism of metabolic disorders about Hcy was analyzed by detecting the levels of the key rate-limiting enzymes cystathionine-β-synthase(CBS) and cystathionine-γ-lyase(CSE), which were in the downstream of metabolism in septic mouse model induced by lipopolysaccharide.Results:The level of Hcy in plasma was (12.62±5.46)μmol/L in sepsis group, which was significantly higher than those in common infection group[(9.42±2.28) μmol/L] and healthy control group[(8.14±1.60) μmol/L]( P<0.05). The level of Hcy in plasma of 12 children with acute kidney injury in sepsis group was significantly higher than that of 39 children without acute kidney injury in sepsis group[(16.48±5.87)μmol/L vs.(11.62±4.74) μmol/L, P<0.05]. The level of Hcy in plasma of six children with acute liver failure in sepsis group was significant higher than that of 45 children without acute liver failure in sepsis group[(18.35±7.10) μmol/L vs.(11.84±4.78) μmol/L, P<0.05]. The level of Hcy in serum significantly increased in septic mouse models ( P<0.01). The transcription and protein expression levels of key rate-limiting Hcy transcription enzymes CBS and CSE in liver and kidney tissues of septic mouse were significantly down-regulated ( P<0.05). Conclusion:The level of Hcy in peripheral blood of children with sepsis increases, which is more obviously in children with acute kidney injury or acute liver injury.When patients developed sepsis, the expression of CBS and CSE will be restrained, leading to disorders related to transsulfuration metabolism and elevated level of Hcy in peripheral blood.