OBJECTIVE: To establish the mode of anterior cervical surgery in outpatient setting, and evaluate its preliminary effectiveness. METHODS: A clinical data of patients who underwent anterior cervical surgery between January 2022 and September 2022 and met the selection criteria was retrospectively analyzed. The surgeries were performed in outpatient setting ( n=35, outpatient setting group) or in inpatient setting ( n=35, inpatient setting group). There was no significant difference between the two groups ( P>0.05) in age, gender, body mass index, smoking, history of alcohol drinking, disease type, the number of surgical levels, operation mode, as well as preoperative Japanese Orthopaedic Association (JOA) score, visual analogue scale score of neck pain (VAS-neck), and visual analogue scale score of upper limb pain (VAS-arm). The operation time, intraoperative blood loss, total hospital stay, postoperative hospital stay, and hospital expenses of the two groups were recorded; JOA score, VAS-neck score, and VAS-arm score were recorded before and immediately after operation, and the differences of the above indexes between pre- and post-operation were calculated. Before discharge, the patient was asked to score satisfaction with a score of 1-10. RESULTS: The total hospital stay, postoperative hospital stay, and hospital expenses were significantly lower in the outpatient setting group than in the inpatient setting group ( P<0.05). The satisfaction of patients was significantly higher in the outpatient setting group than in the inpatient setting group ( P<0.05). There was no significant difference between the two groups in operation time and intraoperative blood loss ( P>0.05). The JOA score, VAS-neck score, and VAS-arm score of the two groups significantly improved at immediate after operation when compared with those before operation ( P<0.05). There was no significant difference in the improvement of the above scores between the two groups ( P>0.05). The patients were followed up (6.67±1.04) months in the outpatient setting group and (5.95±1.90) months in the inpatient setting group, with no significant difference ( t=0.089, P=0.929). No surgical complications, such as delayed hematoma, delayed infection, delayed neurological damage, and esophageal fistula, occurred in the two groups. CONCLUSION The safety and efficiency of anterior cervical surgery performed in outpatient setting were comparable to that performed in inpatient setting. Outpatient surgery mode can significantly shorten the postoperative hospital stay, reduce hospital expenses, and improve the patients' medical experience. The key points of the outpatient mode of anterior cervical surgery are minimizing damage, complete hemostasis, no drainage placement, and fine perioperative management.
Humans ; Treatment Outcome ; Cervical Vertebrae/surgery* ; Outpatients ; Retrospective Studies ; Blood Loss, Surgical ; Spinal Fusion ; Neck Pain

Objective:To investigate the clinical efficacy of neoadjuvant chemotherapy for the resectable locally advanced adenocarcinoma at the gastroesophageal junction.Methods:A retrospective cohort study was conducted to analyze 86 patients with resectable locally advanced Siewert type Ⅱ and Ⅲ adenocarcinoma at the gastroesophageal junction (T 3-4N +M 0) who were admitted to the Panzhihua Central Hospital of Sichuan Province from January 2013 to January 2016. All the patients were divided into the neoadjuvant chemotherapy group [preoperative XELOX regimen (oxaliplatin + capecitabine) adjuvant chemotherapy + surgery + postoperative XELOX regimen adjuvant chemotherapy, 46 cases] and non-neoadjuvant chemotherapy group (surgery + postoperative XELOX regimen adjuvant chemotherapy, 40 cases) according to whether neoadjuvant chemotherapy was performed before surgery. The total gastrectomy + Roux-en-Y esophagojejunostomy + D 2 lymphadenectomy or proximal subtotal gastrectomy + esophageal gastric remnant anastomosis + D 2 lymphadenectomy were applied to patients by the same team of doctors. The observation indicators included treatment situations, results of postoperative pathological examination and prognosis in the two groups. Results:In the neoadjuvant chemotherapy group, 25 patients (54.3%) had partial remission (PR), 21 patients (45.7%) had stable disease (SD), the clinical response rate was 54.3% (25/46), tumor control rate was 100.0% (46/46), and clinical stage reduction rate was 37.0% (17/46). Compared with the non-neoadjuvant chemotherapy group, the neoadjuvant chemotherapy group had a higher R 0 resection rate [100.0% (46/46) vs. 80.0% (32/40), χ2 = 4.024, P = 0.045], and in the neoadjuvant chemotherapy group, the pathological complete remission [tumor regression grade (TRG) 0] rate was 13.0% (6/46), and the overall pathological response (TRG 1 + TRG 0) rate was 56.5% (26/46). The postoperative pathological examination showed that the neoadjuvant chemotherapy group and the non-neoadjuvant chemotherapy group had statistically significant differences in the longest tumor diameter, vessel carcinoma embolus, perineural invasion, and pathological TNM staging (all P < 0.05). However, there was no statistical difference in the total humber of lymph nodes, the number of positive lymph nodes, pathological T stage, N stage, and human epidermal growth factor receptor 2 (HER2) expression in specimens (all P > 0.05). In the neoadjuvant chemotherapy group, 6 patients had grade 3 adverse reactions, and chemotherapy was suspended or the dose was adjusted. Adverse reactions in the blood system included the red blood cells reduction, white blood cells reduction and thrombocytopenia. Other adverse reactions included nausea, vomiting, and decreased appetite. There were no deaths related to radiotherapy. In the neoadjuvant chemotherapy group, the median tumor-free survival time was 20 months (5-36 months), and the 1-year and 3-year tumor-free survival rates were 89.5% and 52.4%, respectively; the median postoperative overall survival time was 20 months (9-36 months), and the 1-year and 3-year overall survival rates were 91.0% and 48.0%, respectively; 12 patients had tumor recurrence. In the non-neoadjuvant chemotherapy group, the median tumor-free survival time was 19 months (10-35 months), and the 1-year and 3-year tumor-free survival rates were 87.3% and 30.0%, respectively. The median postoperative overall survival time was 20 months (10-35 months), the 1-year and 3-year overall survival rates were 87.0% and 18.6%, respectively; 14 patients had tumor recurrence. There was a statistical difference in the tumor-free survival between the two groups ( χ2 = 4.522, P = 0.03), and there was no statistical difference in the overall survival between the two groups ( χ2 = 3.717, P > 0.05). Conclusions:XELOX regimen neoadjuvant chemotherapy is safe and effective for patients with resectable locally advanced Siewert type Ⅱ and Ⅲ adenocarcinoma at the gastroesophageal junction. It can decrease the tumor clinical stage and increase the R 0 resection rate and tumor-free survival rate.

Objective To investigate the high risk factors for children with Mycoplasma pneumonia infection complicated with heart failure.Methods Retrospective analysis was utilized to analyze the clinical data of the 33 children who were hospitalized at Pediatric Intensive Care Unit of Fujian Provincial Maternity and Children's Hospital due to Mycoplasma pneumonia infection complicated with heart failure between January 2014 and October 2017 (the case group),male 15,female 18,aged from 3 month to 8 years old.A total of 66 concurrent children with Mycoplasma pneumonia infection without complications were selected as a control group,male 32,female 34,aged from 1 month to 8 years old.The overall data and laboratory findings in the case group and the control group were compared,and high risk factors for heart failure in children with Mycoplasma pneumoniae infection were analyzed by multivariate Logistic regression analysis.Results (1)There was no significant difference in gender,age,duration of fever,white blood cell,platelet count,the proportions of cough,fever,pulmonary rales,large shadow of lung,abnormal electrocardiographic pattern between 2 groups (all P ＞ 0.05).(2) Compared to the control group,the children with Mycoplasma pneumonia infection complicated with heart failure were more prone to longer time intervals from the onset to the application of macrolide drugs (5.27 d vs.4.09 d),lower hemoglobin and prealbumin,higher C-reactive protein,lactate dehydrogenase and MB isoenzyme of creatine kinase (CK-MB)(all P ＜ 0.05),there were significant differences in the proportions of co-infection of 2 or more noxae between 2 groups (45.5 ％ vs.18.1％,x2 =8.250,P =0.004).(3) Logistic regression multifactor analysis showed hemoglobin(OR =0.875,95％ CI:0.793-0.965,Wald x2 =7.167,P ＜ 0.01),prealbumin (OR =0.567,95％ CI:0.372-0.863,Wald x2 =6.998,P ＜ 0.01),lactate dehydrogenase (OR =1.030,95％ CI:1.010-1.051,Waldx2 =8.651,P ＜0.01) were associated with children with mycoplasma pneumonia infection complicated with heart failure.Conclusion Hemoglobin,prealbumin and lactate dehydrogenase are risk factors related to Mycoplasma pneumonia infection complicated with heart failure.

The aim of this study was to investigate the pattern of distribution of mating type (MAT) genes of Tuber indicum in ectomycorhizosphere soils from natural T. indicum-producing areas and cultivated truffle orchards and ascocarp samples from different regions. Quantitative real-time PCR and multiplex PCR were used to weight the copy numbers of MAT1-1-1 and MAT1-2-1 in natural truffle soils and cultivated orchard soils. The effect of limestone on the pattern of truffle MAT genes and the correlation between soil properties and the proportion of MAT genes were also assessed. These results indicated that an uneven and nonrandom distribution of MAT genes was common in truffle-producing areas, cultivated truffle orchards, and ascocarps gleba. The competition between the two mating type genes and the expansion of unbalanced distribution was found to be closely related to truffle fructification. Limestone treatments failed to alter the proportion of the two mating type genes in the soil. The content of available phosphorus in soil was significantly correlated with the value of MAT1-1-1/MAT1-2-1 in cultivated and natural ectomycorhizosphere soils. The application of real-time quantitative PCR can provide reference for monitoring the dynamic changes of mating type genes in soil. This study investigates the distributional pattern of T. indicum MAT genes in the ectomycorhizosphere soil and ascocarp gleba from different regions, which may provide a foundation for the cultivation of T. indicum.
Calcium Carbonate ; Multiplex Polymerase Chain Reaction ; Phosphorus ; Polymerase Chain Reaction ; Real-Time Polymerase Chain Reaction ; Soil

Objective To investigate the association between body mass index (BMI), waist circumference (WC), waist?to?height ratio (WHtR), and the incidence risk of type 2 diabetes mellitus (T2DM). Methods In total, 20 194 participants≥18 years old were selected randomly by cluster sampling from two township (town) of the county in Henan province from July to August of 2007 and July to August of 2008 and the investigation included questionnaires, anthropometric measurements, fasting plasma glucose,and lipid profile examination were performed at baseline; 17 236 participants were enrolled in this cohort study. 14 720 (85.4%) were followed up from July to August 2013 and July to October 2014. Finally, 11 643 participants (4 301 males and 7 342 females) were included in this study. Incidence density and Cox proportional hazards regression models were used to evaluate the risk of T2DM associated with baseline BMI, WC, WHtR, and their dynamic changes. Results After average of 6.01 years following up for 11 643 participants, 613 developed T2DM and the incidence density was 0.89 per 100 person?years. After adjusted for baseline sex, age, smoking, drinking, family history of diabetes, as well as the difference of fasting plasma?glucose (FPG), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL?C), systolic blood pressure (SBP), diastolic blood pressure (DBP) between baseline and follow?up, Cox Proportional?Hazards regression analysis indicated that T2DM risk of baseline BMI overweight group, BMI obesity group, abnormal WC group and abnormal WHtR group were significantly higher than that of the corresponding baseline normal groups , and the incidence risk of T2DM reached the highest for those whose baseline BMI, WC and WHtR were all abnormal, the corresponding HR (95%CI) were 2.05 (1.62-2.59), 3.01 (2.33-3.90), 2.34 (1.89-2.90), 2.88 (2.21-3.74), 3.32 (2.50-4.40), respectively. Whether baseline BMI/WC was normal or not, T2DM risk increased if baseline WHtR was abnormal, and the HR (95%CI) of baseline normal BMI/abnormal WHtR group, baseline abnormal BMI/abnormal WHtR group, baseline normal WC/abnormal WHtR group, baseline abnormal WC/abnormal WHtR group were 1.88 (1.29-2.74), 3.08 (2.34-4.05), 2.15 (1.53-3.00), 3.22 (2.45-4.23), respectively. The analysis for dynamic changes of BMI, WC, and WHtR indicated that in baseline normal WC or WHtR group, T2DM risk increased when baseline normal WC or WHtR developed abnormal at follow?up, and the corresponding HR (95%CI) were 1.79 (1.26-2.55), 2.12 (1.32-3.39), respectively. In baseline abnormal WC or WHtR group, T2DM risk decresed when baseline abnormal WC or WHtR reversed to normal at follow?up, and the corresponding HR (95%CI) were 2.16 (1.42-3.29), 2.62 (1.63-4.20), respectively. Conclusion BMI, WC, and WHtR were associated with increased T2DM risk. The more abnormal aggregation of BMI, WC, and WHtR presents, the higher T2DM risk was. T2DM risk could be decreased when abnormal WC or WHtR reversed to normal.

Objective To investigate the association between body mass index (BMI), waist circumference (WC), waist?to?height ratio (WHtR), and the incidence risk of type 2 diabetes mellitus (T2DM). Methods In total, 20 194 participants≥18 years old were selected randomly by cluster sampling from two township (town) of the county in Henan province from July to August of 2007 and July to August of 2008 and the investigation included questionnaires, anthropometric measurements, fasting plasma glucose,and lipid profile examination were performed at baseline; 17 236 participants were enrolled in this cohort study. 14 720 (85.4%) were followed up from July to August 2013 and July to October 2014. Finally, 11 643 participants (4 301 males and 7 342 females) were included in this study. Incidence density and Cox proportional hazards regression models were used to evaluate the risk of T2DM associated with baseline BMI, WC, WHtR, and their dynamic changes. Results After average of 6.01 years following up for 11 643 participants, 613 developed T2DM and the incidence density was 0.89 per 100 person?years. After adjusted for baseline sex, age, smoking, drinking, family history of diabetes, as well as the difference of fasting plasma?glucose (FPG), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL?C), systolic blood pressure (SBP), diastolic blood pressure (DBP) between baseline and follow?up, Cox Proportional?Hazards regression analysis indicated that T2DM risk of baseline BMI overweight group, BMI obesity group, abnormal WC group and abnormal WHtR group were significantly higher than that of the corresponding baseline normal groups , and the incidence risk of T2DM reached the highest for those whose baseline BMI, WC and WHtR were all abnormal, the corresponding HR (95%CI) were 2.05 (1.62-2.59), 3.01 (2.33-3.90), 2.34 (1.89-2.90), 2.88 (2.21-3.74), 3.32 (2.50-4.40), respectively. Whether baseline BMI/WC was normal or not, T2DM risk increased if baseline WHtR was abnormal, and the HR (95%CI) of baseline normal BMI/abnormal WHtR group, baseline abnormal BMI/abnormal WHtR group, baseline normal WC/abnormal WHtR group, baseline abnormal WC/abnormal WHtR group were 1.88 (1.29-2.74), 3.08 (2.34-4.05), 2.15 (1.53-3.00), 3.22 (2.45-4.23), respectively. The analysis for dynamic changes of BMI, WC, and WHtR indicated that in baseline normal WC or WHtR group, T2DM risk increased when baseline normal WC or WHtR developed abnormal at follow?up, and the corresponding HR (95%CI) were 1.79 (1.26-2.55), 2.12 (1.32-3.39), respectively. In baseline abnormal WC or WHtR group, T2DM risk decresed when baseline abnormal WC or WHtR reversed to normal at follow?up, and the corresponding HR (95%CI) were 2.16 (1.42-3.29), 2.62 (1.63-4.20), respectively. Conclusion BMI, WC, and WHtR were associated with increased T2DM risk. The more abnormal aggregation of BMI, WC, and WHtR presents, the higher T2DM risk was. T2DM risk could be decreased when abnormal WC or WHtR reversed to normal.

Objective To explore the influence of tranSCription factor FOXC2 in angiogenesis of breast cancer MCF-7 cells and to clarify the action mechanism of FOXC2 in promoting tumor angiogenesis.Methods FOXC2 gene and empty vector gene were transfected into breast cancer of MCF-7 cell line with FOXC2 lentivirus gene transfection technique to obtain stable transfection cell line. The MCF-7 cells were devided into non-transfected group,empty-vector group and over-expression group.Matrigel assay and Transwell chamber test were used to observe the changes of tube formation and migration ability of human umbilical vein endothelial cells (HUVECs)in MCF-7 cells supernatant in various groups. PT-PCR and Western blotting methods were applied to detect the expressions of FOXC2,DLL4 and Notch1 mRNA and protein.Results Compared with non-tranfected group and empty-vector group,the tube formation and the migration number of HUVECs in FOXC2 over-expression group were increased(P<0.05);the expressions of FOXC2,DLL4 and Notch1 mRNA and proteins were significantly increased(P<0.05).Conclusion The FOXC2 over-expression in MCF-7 cells can increase the tube formation ability and migration ability of HUVECs,and its mechanism may be related to Notch signaling pathway.

Objective To study protective effects of acanthoic acid ( AA) against acute liver injury. Methods Sixty mice were randomly divided into six groups (n=10 each),including normal control group,model control group,positive control group (N-acetyl -L- cysteine,NAC,300 mg·kg-1),and AA at small (50 mg·kg-1),middle (100 mg·kg-1),and high (200 mg·kg-1 ) dose groups. Each group received respective treatment for 3 days and fasted for 16 h before the last dose. All animals except of the normal control group were treated with tacrine (35 mg·kg-1 ) 1 h after the treatments. Hepatic pathological and serum biochemical changes were observed. Results The high-dose of AA significantly reduced the levels of AST (143±46) U·L-1 ,ALT (32±9) U·L-1 ,LDH (1 218±312) U·L-1 ,MDA (3. 24±0. 48) μmol·g-1 ,and GSH (417±15) mg·g-1 compared with the model control group (P<0. 05 or P<0. 01). Liver injury was also ameliorated in AA high dose group.Conclusion AA has a protective effect on acute liver injury in mice.

Objective To investigate the epidemiological characterization , effect of prevention and control measures during an outbreak in a military unit caused by Mycoplasma pneumoniae.Methods All the cases were investigated to learn about their basic characteristics , clinical symptoms and aggregation activities using epidemiological cross-sectional study . Results From May 16 to June 11,2013, forty-nine confirmed cases and thirty-five suspected cases who were all males were found at an attack rate of 7.8%.The epidemic peak period was from May 27 to Jun 2(seven days), and the number of total cases was 66(75.9%).During the outbreak, the attack rate of the 10th cadet team, other cadet teams and a non-student population was 47.5%, 4.5% and 1.2% respectively.The difference was significant (P<0.01).The age of forty-nine confirmed cases ranged from 17 to 26 years old , the attack rate did not differ significantly between different age groups, and no aggregation was found in the place of birth and soldier source .The most frequent clinical symptoms were fever and cough for the confirmed cases , 62.5% of whom showed unilateral or bilateral lung inflammation change , while few positive lung symptoms were present .All the confirmed cases were hospitalized and no severe or critically ill cases were present.The outbreak was controlled effectively after implementation of case surveillance , contact precaution , termination of aggregation activities , dispersed habitation and prescription of azithromycin for disease prevention .Conclusion The confined and crowed environment for learning and training can increase the risk of M.pneumoniae outbreak , making it nec-essary to enhance disease prevention awareness , improve case management , live dispersed , reduce close contact and imple-ment personal hygienic measures .

OBJECTIVE: To evaluate the correlations between p73 G4C14-A4T14 polymorphisms and clinicopathologic characteristics of patients with breast cancer. METHODS: A total of 170 patients with breast cancer were genotyped for p73 G4C14-A4T14 polymorphisms by Sequenom MassArray® iPLEX GOLD System. The correlations between polymorphisms and the age of patients with breast cancer, or tumor size were analyzed by t-test;the correlations between polymorphisms and clinicopathologic characteristics in patients with breast cancer were analyzed by Χ(2) test; and the relation between polymorphisms and the efficacy of chemotherapy for breast cancer was assessed by logistic regression. RESULTS: There was negative correlation between p73 polymorphisms and ser veral clinicopathological characteristics, including age, tumor size, menopausal status, TNM classification, pathological type, axillary lymph node metastasis, estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2, and p53(P>0.05). The frequency of GC/GC genotype in patients with "triple negative" breast cancer (estrogen receptor -negative, progesterone receptornegative, and human epidermal growth factor receptor 2-negative) was higher than that of patients with non-triple negative breast cancer (78.9% vs 57.6%, Χ(2)=5.741, P=0.017). P73 polymorphism was negatively correlated with chemosensitivity for anthracycline-based chemotherapy (P>0.05). CONCLUSION P73 G4C14-A4T14 polymorphisms are positively correlated with triple negative breast cancer, and the patients with breast cancer who carry GC/GC genotype may have bad prognosis.
Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms ; genetics ; metabolism ; pathology ; DNA-Binding Proteins ; genetics ; Female ; Genotype ; Humans ; Middle Aged ; Nuclear Proteins ; genetics ; Polymorphism, Genetic ; Receptor, ErbB-2 ; metabolism ; Receptors, Estrogen ; metabolism ; Receptors, Progesterone ; metabolism ; Tumor Protein p73 ; Tumor Suppressor Proteins ; genetics