Objective The study aimed to investigate the effect of Shen-Fu injection on the clinical efficacy and prognosis of gas-trointestinal dysfunction in patients with septic shock.Methods Patients diagnosed with septic shock in the Department of Critical Care Medicine of the First Hospital of Lanzhou University from September 2021 to April 2024 were enrolled and divided into the Shen-Fu group and the conventional treatment group according to the treatment plan.The propensity score matching(PSM)was used for 1∶1 matc-hing.Clinical data of patients in both groups at enrollment,the main gastrointestinal symptoms(vomiting,diarrhea,abdominal disten-sion,abnormal bowel sounds,gastric retention),blood lactic acid(Lac),interleukin(IL)-6,procalcitonin(PCT),white blood cell(WBC),neutrophil percentage(NEUT％),the ratio of lactic acid to creatinine(Lac/SCr)before and 5days after treatment,and the mortality rate 28days after discharge were recorded.Results Compared with conventional treatment group(35.06％),the total effective rate(66.23％)of gastrointestinal efficacy in Shen-Fu group 5days after treatment was significantly higher(x2=14.964,P＜0.05).The levels of Lac,WBC and Lac/SCr in Shen-Fu group was higher than that in conventional treatment group(P＜0.05).There was no significant difference in IL-6,PCT and NEUT％(P＞0.05).Compared with pre-treatment,the levels of IL-6,Lac,Lac/SCr de-creased after 5days of treatment in Shen-Fu group(P＜0.05),while there was no significant difference in PCT,WBC and NEUT％(P＞0.05).There was no statistically significant difference in mortality rate between the two groups at 28 days after discharge(P＞0.05).Conclusion Shen-Fu Injection can improve gastrointestinal dysfunction in patients with septic shock,alleviate gastrointestinal symptoms,suppress inflammatory responses,enhance gastrointestinal tissue perfusion,and can improve the short-term prognosis of pa-tients with septic shock to some extent.

Objective To analyze the clinical characteristics and interventional treatment effects of pa-tients with renal arteriovenous fistula in this hospital over the past 10 years.Methods A retrospective analy-sis was conducted on the clinical and imaging data of 40 patients with renal arteriovenous fistula who were treated in this hospital from October 2012 to October 2022.After classifying the fistula type using digital sub-traction angiography(DSA),an individualized embolization plan was developed by a vascular surgery team.Postoperatively,the embolization materials,embolization success rate,clinical success rate,perioperative renal function changes and complications were analyzed.Results A total of 29 cases(72.5%)had acquired renal arteriovenous fistula,while 11 cases(27.5%)had non-acquired renal arteriovenous fistula.Forty-three super-selective transcatheter arterial embolization(TAE)procedures were performed,achieving a technical success rate of 100.0%(40/40)and a clinical success rate of 95.0%(38/40).The mean serum creatinine levels after TAE were(91.39±23.72)mmol/L in the non-acquired group and(105.94±35.51)mmol/L in the acquired group.No statistically significant difference was observed in perioperative serum creatinine changes between the two groups(P=0.095).No severe complications such as renal function deterioration occurred postopera-tively in any patient.Conclusion Gross hematuria serves as the primary clinical manifestation of renal arterio-venous fistula,with abdominal pain being more prevalent in non-acquired renal arteriovenous fistula.The em-bolization approach combining coils with polyvinyl alcohol particles demonstrates favorable safety and efficacy in treating renal arteriovenous fistula.

Objective The study aimed to investigate the effect of Shen-Fu injection on the clinical efficacy and prognosis of gas-trointestinal dysfunction in patients with septic shock.Methods Patients diagnosed with septic shock in the Department of Critical Care Medicine of the First Hospital of Lanzhou University from September 2021 to April 2024 were enrolled and divided into the Shen-Fu group and the conventional treatment group according to the treatment plan.The propensity score matching(PSM)was used for 1∶1 matc-hing.Clinical data of patients in both groups at enrollment,the main gastrointestinal symptoms(vomiting,diarrhea,abdominal disten-sion,abnormal bowel sounds,gastric retention),blood lactic acid(Lac),interleukin(IL)-6,procalcitonin(PCT),white blood cell(WBC),neutrophil percentage(NEUT％),the ratio of lactic acid to creatinine(Lac/SCr)before and 5days after treatment,and the mortality rate 28days after discharge were recorded.Results Compared with conventional treatment group(35.06％),the total effective rate(66.23％)of gastrointestinal efficacy in Shen-Fu group 5days after treatment was significantly higher(x2=14.964,P＜0.05).The levels of Lac,WBC and Lac/SCr in Shen-Fu group was higher than that in conventional treatment group(P＜0.05).There was no significant difference in IL-6,PCT and NEUT％(P＞0.05).Compared with pre-treatment,the levels of IL-6,Lac,Lac/SCr de-creased after 5days of treatment in Shen-Fu group(P＜0.05),while there was no significant difference in PCT,WBC and NEUT％(P＞0.05).There was no statistically significant difference in mortality rate between the two groups at 28 days after discharge(P＞0.05).Conclusion Shen-Fu Injection can improve gastrointestinal dysfunction in patients with septic shock,alleviate gastrointestinal symptoms,suppress inflammatory responses,enhance gastrointestinal tissue perfusion,and can improve the short-term prognosis of pa-tients with septic shock to some extent.

Objective:To explore the sequential chemotherapy efficacy of different chemotherapeutic regimens in ovarian epithelial carcinoma, fallopian tube carcinoma, and primary peritoneal carcinoma.Methods:A retrospective analysis was conducted on clinical and pathological data of 100 patients with platinum-sensitive ovarian epithelial carcinoma, fallopian tube carcinoma, and primary peritoneal carcinoma treated at Peking University Peopel′s Hospital from January 1992 to January 2019. All patients underwent staging surgery or cytoreductive surgery followed by adjuvant chemotherapy. Based on different postoperative adjuvant chemotherapy regimens, patients were divided into the sequential chemotherapy group (70 cases) and the conventional chemotherapy group (30 cases). Clinical and pathological characteristics, chemotherapy efficacy, adverse reactions, and prognosis were compared between the two groups.Results:(1) Clinical and pathological characteristics: the age, tumor types (including ovarian epithelial carcinoma, fallopian tube carcinoma, and primary peritoneal carcinoma), pathological types, International Federation of Gynecology and Obstetrics (FIGO) stage, postoperative residual disease size, presence of neoadjuvant chemotherapy, and total number of chemotherapy cycles were compared between the sequential chemotherapy group and the conventional chemotherapy group. There were no statistically significant differences observed in these characteristics between the two groups (all P>0.05). (2) Chemotherapy efficacy: the median sum of complete response (CR)+partial response (PR) duration in the sequential chemotherapy group was 80.0 months (range: 39 to 369 months), whereas in the conventional chemotherapy group, it was 28.0 months (range: 13 to 52 months). A statistically significant difference was observed between the two groups ( Z=-7.82, P<0.001). (3) Chemotherapy adverse reactions: in the sequential chemotherapy group, 55 cases (79%, 55/70) experienced bone marrow suppression and 20 cases (29%, 20/70) had neurological symptoms. In the conventional chemotherapy group, these adverse reactions occurred in 11 cases (37%, 11/30) and 2 cases (7%, 2/30), respectively. Statistically significant differences were observed between the two groups for both bone marrow suppression and neurological symptoms (all P<0.05). For the other chemotherapy adverse reactions compared between the two groups, no statistically significant differences were observed (all P>0.05). (4) Prognosis: during the follow-up period, the recurrence rate in the sequential chemotherapy group was 73% (51/70) and in the conventional chemotherapy group was 100% (30/30). The median sum of recurrence-free interval was 70.5 months (range: 19 to 330 months) in the sequential chemotherapy group and 15.0 months (range: 6 to 40 months) in the conventional chemotherapy group. Statistically significant differences were observed between the two groups for both recurrence rate and median recurrence-free interval (all P<0.01).In the sequential chemotherapy group, the median progression-free survival (PFS) time was 84.0 months (range: 34 to 373 months), and the median overall survival (OS) time was 87.0 months (range: 45 to 377 months). In contrast, in the conventional chemotherapy group, the median PFS time was 30.5 months (range: 14 to 60 months), and the median OS time was 37.5 months (range: 18 to 67 months). Statistically significant differences were observed between the two groups for both PFS and OS (all P<0.001). In the sequential chemotherapy group, the 3-year, 5-year, and 10-year OS rates were 100% (70/70), 93% (65/70), and 21% (15/70), respectively. In contrast, in the conventional chemotherapy group, the OS rates were 50% (15/30) at 3 years, 3% (1/30) at 5 years, and 0 at 10 years, respectively. The two groups were compared respectively, and the differences were statistically significant (all P<0.05). Conclusions:Sequential chemotherapy significantly prolongs PFS and OS in patients with ovarian epithelial carcinoma, fallopian tube carcinoma, and primary peritoneal carcinoma. The efficacy is superior to that of the conventional chemotherapy, with manageable adverse reactions. The use of sequential chemotherapy as first-line treatment for patients with ovarian epithelial carcinoma, fallopian tube carcinoma, and primary peritoneal carcinoma is recommended.

PURPOSE: Cancer-associated fibroblasts (CAFs) activated by cancer cells has a central role in development and malignant biological behavior in colorectal cancer (CRC). Adult fibroblasts do not express Snail, but Snail-positive fibroblasts are discovered in the stroma of malignant CRC and reported to be the key role to chemoresistance. However, the reciprocal effect of CAFs expressed Snail to chemoresistance on CRC cells and the underlying molecular mechanisms are not fully characterized. MATERIALS AND METHODS: Snail-overexpressed 3T3 stable cell lines were generated by lipidosome and CT26 mixed with 3T3-Snail subcutaneous transplanted CRC models were established by subcutaneous injection. Cell Counting Kit-8, flow cytometry and western blotting assays were performed, and immunohistochemistry staining was studied. The cytokines participated in chemoresistance was validated with reverse transcriptase-polymerase chain reaction and heatmap. RESULTS: Snail-expression fibroblasts are discovered in human and mouse spontaneous CRCs. Overexpression of Snail induces 3T3 fibroblasts transdifferentiation to CAFs. CT26 co-cultured with 3T3-Snail resisted the impairment from 5-fluorouracil and paclitaxel in vitro. The subcutaneous transplanted tumor models included 3T3-Snail cells develop without restrictions even after treating with 5-fluorouracil or paclitaxel. Moreover, these chemoresistant processes may be mediated by CCL1 secreted by Snail-expression fibroblasts via transforming growth factor β/nuclear factor-κB signaling pathways. CONCLUSION: Taken together, Snail-expressing 3T3 fibroblasts display CAFs properties that support 5-fluorouracil and paclitaxel chemoresistance in CRC via participation of CCL1 and suggest that inhibition of the Snail-expression fibroblasts in tumor may be a useful strategy to limit chemoresistance.
Adult ; Animals ; Blotting, Western ; Cell Count ; Cell Line ; Colorectal Neoplasms* ; Cytokines ; Drug Resistance, Multiple ; Fibroblasts* ; Flow Cytometry ; Fluorouracil ; Humans ; Immunohistochemistry ; In Vitro Techniques ; Injections, Subcutaneous ; Mice ; Paclitaxel ; Snails ; Transforming Growth Factors

To investigate the clinical characteristics,diagnosis and treatment of intrahepatic biliary cystadenoma,a total of 7 patients with intrahepatic biliary cystadenoma admitted in our department from January 2008 to June 2013 were enrolled and the clinical data (i.e.clinical manifestations,imaging features and surgical treatment) were analyzed retrospectively.All the 7 patients were female and diagnosed as intrahepatic biliary cystadenoma.Five cases complained right upper abdominal pain of various severities.Color Doppler ultrasound,CT and MRI confirmed the diagnosis in all patients.The surgery included irregular fight hepatectomy (n =2),left lateral lobe hepatectomy (n =3),and left hepatectomy (n =2).Patients with intrahepatic biliary cystadenoma usually manifest nonspecific clinical symptoms,and thus are prone to be misdiagnosed as simple hepatic cysts.For such patients,surgery is of first choice,and complete resection is the key to avoiding the recurrence and malignancy.

Objective:To investigate the prevalence of post-traumatic stress disorder(PTSD)symptoms in middle school students after Wenchuan earthquake.Methods:The PTSD Checklist-Civilian version( PCL-C),which included three symptom groups(A,B,and C),was used to assess the PTSD symptoms in 1960 middle school students in the disaster region through self-questionnaire.Results:(1)The general positive rate of PTSD symptoms was 78.3%,and that of B group was the highest(68.9%).(2)The rates of general PTSD and three symptom groups of PTSD were higher in girls,high grade students,minority groups,rural students,injured in earthquake and those who lost family property than in boys,low grade students,the Han nationality,urban students,not injured in earthquake and those who did not lost family property[such as,the general positive rate of PTSD symptoms:girls 82.2%,boys 73.9%,P<0.05].(3)The rates of severe PTSD symptoms in girls and rural students were higher than that in boys and urban students(27.9% vs.19.9%,26.7% vs.21.4%,Ps<0.05).Conclusions:PTSD symptoms are common among middle school students in earthquake region.Targeted measures should be taken to protect middle school students from PTSD in earthquake region.

Objective To explore the repair method for refractory diabetic wound. Methods A total of 206 patients with refractory diabetic foot ulcers were treated with proper surgical treatments.Results Of all, 106 patients were treated by skin flap (51.5 % ), with one stage wound healing rate of 85.8%; 122 patients were repaired with split-thickness skin graft ( 59.2% ), with survival rate of the graft for 79.5%. Simple toe amputation was made in 34 patients (46 toes). The high level amputation was performed in 56 patients (27.2%). Of all, 132 patients were followed up for 6-18 months, which showed that ulcer recurred in 12 patients (9.1%). Conclusion Timely and effective treatment as well as flap and skin graft repair could reduce high level amputation rate of diabetic foot ulcer and promote the quality of life.