Objective    To analyze the expression of cold-induced RNA-binding protein (CIRBP) in lung adenocarcinoma and its clinical significance based on bioinformatics, in order to provide a new direction for the study of therapeutic targets for lung adenocarcinoma. Methods    The CIRBP gene expression data and patient clinical information data in lung adenocarcinoma tissues and adjacent tissues were downloaded from The Cancer Genome Atlas and Gene Expression Omnibus databases. The expression of CIRBP in lung adenocarcinoma was analyzed. Furthermore, its relationship with clinicopathological features and prognosis in patients with lung adenocarcinoma was analyzed. GO and KEGG enrichment analysis were carried out for the screened genes. The CIRBP protein interaction network was constructed by STRING, and the correlation analysis was carried out using the GEPIA online website. Results    The expression level of CIRBP gene in lung adenocarcinoma tissues was significantly lower than that in adjacent tissues (P<0.01), and its expression level was correlated with T stage and N stage in clinicopathological features. The prognosis of patients with high CIRBP expression in lung adenocarcinoma was significantly better than that with low CIRBP expression. Univariate and multivariate Cox regression analysis showed that CIRBP was an independent prognostic factor in patients with lung adenocarcinoma. GO functional annotation showed its enrichment in organelle fission, nuclear fission, chromosome separation, and DNA replication, etc. KEGG analysis showed that it was mainly involved in cell cycle and DNA replication. Protein interaction network and GEPIA online analysis showed that the expression level of CIRBP  was negatively correlated with the expression level of cyclin B2. Conclusion    CIRBP gene is down-regulated in lung adenocarcinoma tissues, and its expression level is closely related to patient prognosis. CIRBP gene may be a potential therapeutic target and prognostic marker for lung adenocarcinoma.

Objective:To explore the characteristics of T lymphocyte subsets and cytokines in hyperlipidemia-induced acute pancreatitis (HLAP) and its prognostic value.Methods:This study included 184 patients with acute pancreatitis (AP) admitted to the First Affiliated Hospital of Xiamen University from January 2018 to May 2021. Based on disease etiology, there were 92 HLAP cases and 92 non-hyperlipidemia-induced AP (NHLAP) cases. Stratified by disease severity according to 2012 Atlanta classification criteria, the patients were divided into the severe subgroup (SAP) and non-severe subgroup (NSAP). Peripheral venous blood samples were taken from all patients on day 1, 3, and 5 after admission. T lymphocyte subsets were determined by flow cytometry, and cytokines were detected by flow fluorometry. The number of CD4 +% and CD8 +% and the expression of cytokines were compared by Student’s t test or Mann-Whitney U analysis. Logistic regression analyses were performed to identify risk factors for severe AP, and a receiver operating characteristic (ROC) curve was constructed to predict severe AP. Statistical significance was taken as P<0.05. Results:Compared with the NHLAP group, patients in the HLAP group had lower CD4 +%, while higher levels of IL-2 on day 1 ( P<0.05), and had also lower CD4 +%, while higher levels of IL-4, IL-6, and IL-10 on day 3 ( P<0.05). Furthermore, IL-6 and IL-10 levels of the HLAP group were significantly increased compared to the NHLAP group on day 5 ( P<0.05). IL-10 levels in the SAP subgroup were significantly higher than those in the NSAP subgroup on day 1 ( P<0.05). Compared with the NSAP subgroup, the SAP subgroup had elevated levels of IL-2, IL-4, IL-6, IL-10 and IFN-γ on day 3 (all P<0.05), and had lower CD4 +%, while increased levels of IL-6 and IL-10 on day 5 (all P<0.05). Multivariate Logistic regression analysis showed that IL-10 was an immune indicator of independent risk factor for severe AP in the HLAP group on day 1 ( OR=1.139, 95% CI: 1.038-1.251, P<0.05). Finally, ROC analysis showed that the area under the curve of IL-10 to assess HLAP with severe AP was 0.772, and the best cut-off value for predicting severe AP was 5.6 pg/mL, with a sensitivity of 83.3% and a specificity of 68.8%. Conclusions:Changes of CD4 +% and cytokines are different between the HLAP and NHLAP groups. IL-10 can be used as a predictor of early disease severity in patients with HLAP.

Objective    To investigate the prognostic survival status and influence factors for surgical treatment of esophageal squamous cell carcinoma (ESCC) in pathological stage T1b (pT1b). Methods    The patients with ESCC in pT1b undergoing Ivor-Lewis or McKeown esophagectomy in Lanzhou University Second Hospital from 2012 to 2015 were collected, including 78 males (78.3%) and 17 females (21.7%) with an average age of 61.4±7.4 years. Results    The most common postoperative complications were pneumonia (15.8%), anastomotic leakage (12.6%) and arrhythmia (8.4%). Ninety-three (97.9%) patients underwent R0 resection, with an average number of lymph node dissections of 14.4±5.6. The rate of lymph node metastasis was 22.1%, and the incidence of lymph vessel invasion was 13.7%. The median follow-up time was 60.4 months, during which 25 patients died and 27 patients relapsed. The overall survival rate at 3 years was 86.3%, and at 5 years was 72.7%. Multivariate Cox regression analysis showed that lymph node metastasis (P=0.012, HR=2.60, 95%CI 1.23-5.50) and lympovascular invasion (P=0.014, HR=2.73, 95%CI 1.22-6.09) were independent risk factors for overall survival of pT1b ESCC. Conclusion    Esophagectomy via right chest approach combined with two-fields lymphadenectomy is safe and feasible for patients with pT1b ESCC. The progress of pT1b ESCC with lymph node metastasis or lymphovascular invasion is relatively poor.

Objective:To evaluate the efficacy of artificial intelligence assisted pulmonary nodule diagnosis system in detection pulmonary nodule and predicting the malignant probability of pulmonary nodule.Methods:A retrospectively analyze the clinical data of 199 patients with lung nodules in the Thoracic Surgery Department of Lanzhou University Second Hospital from May 2016 to July 2020. The preoperative chest CT was imported into the artificial intelligence system to record the detected lung nodules, to measure nodal diameter and density classification and malignant probability prediction value of each nodule. The detection rate of pulmonary nodules by artificial intelligence system was calculated, and the sensitivity, specificity, positive likelihood ratio and negative likelihood ratio of artificial intelligence system in the differential diagnosis of benign and malignant pulmonary nodules were calculated and compared with manual film reading. and the sensitivity and specificity in the differential diagnosis of benign and malignant pulmonary nodules under the condition of different size and density of pulmonary nodules.Results:A total of 204 pulmonary nodules were pathologically diagnosed by surgical resection, and the detection rate of pulmonary nodules by artificial intelligence system was 100%. The artificial intelligence system can distinguish benign and malignant pulmonary nodules with a sensitivity of 95.83%(95% CI: 0.8967-0.9883), specificity 25.00%(95% CI: 0.1717-0.3425), and a positive likelihood ratio of 1.27(95% CI: 1.14-1.44), negative likelihood ratio 0.17(95% CI: 0.06-0.46), Manual reading for the differentiation of benign and malignant pulmonary nodules has a sensitivity of 87.36%(95% CI: 0.7850-0.9352), specificity 72.17%(95% CI: 0.6214-0.8079), and a positive likelihood ratio of 3.14(95% CI: 2.26-4.37), the negative likelihood ratio is 0.18(95% CI: 0.10-0.31). 5mm≤diameter of pulmonary nodule<10 mm, sensitivity 100%(95% CI: 0.6637-1.0000), specificity 50.00%(95% CI: 0.01258-0.98740), 10 mm≤diameter of pulmonary nodule <20 mm, sensitivity 94.29%(95% CI: 0.8084-0.9930), specificity 29.83%(95% CI: 0.1843-0.4340), 20 mm≤ diameter of pulmonary nodule ≤30 mm, sensitivity 96.15%(95% CI: 0.8679-0.9953), specificity 18.37%(95% CI: 0.0876-0.9953), sensitivity of subsolid lung nodules: 100%(95% CI: 0.9051-1.0000), specificity 20.00%(95% CI: 0.0051-0.7164), solid lung nodule sensitivity 93.22%(95% CI: 0.8354-0.9812), specificity 25.24%(95% CI: 0.1720-0.3476). Conclusion:The artificial intelligence assistant diagnosis system of pulmonary nodules has a strong performance in the detection of pulmonary nodules, but it can not meet the clinical requirements in the differentiation of benign and malignant pulmonary nodules. At present, the artificial intelligence system can be used as an auxiliary tool for doctors to detect pulmonary nodules and assist in the diagnosis of benign and malignant pulmonary nodules.

Objective To explore the clinical characteristics and perioperative treatment of chronic obstructive pulmonary disease (COPD) in patients with non-small-cell lung cancer (NSCLC) in department of thoracic surgery,and to guide the clinical diagnosis and treatment. Methods From January 2013 to December 2016,patients with newly diagnosed NSCLC treated in the thoracic surgical department of Lanzhou University Second Hospital were reviewed retrospectively. The patients were divided into the COPD group and non-COPD group. The clinical data,including the incidence and clinical characteristics of COPD in non-small-cell lung cancer,pulmonary complications after surgery,COPD diagnosis and perioperative pulmonary rehabilitation were analyzed retrospectively. Results A total of 726 NSCLC patients were reviewed,six hundred and seventy-five cases who took the full lung function test were included in the study,of which 95 cases received bronchial diastolic test,86 cases were accorded with COPD diagnosis and were included in incorporated COPD group,and 589 cases were in the non- incorporated COPD group. The proportion of men (69 cases,80. 2%,χ2 = 24. 032), age ≥65 (51 cases,59. 3%,χ2 = 6. 784),smoking history (55cases,64. 0%,χ2 = 29. 474) and a large number of smokers (43 cases,50. 0%,χ2 = 5. 802) and lung squamous cell carcinoma(47 cases,54. 7%,χ2 = 6. 241) in the incorporated COPD group were higher than those in differences were statistically significant (P<0. 05); the incidence of pulmonary complications after radical resection of lung cancer in the incorporated COPD group was 23. 9% (16/ 67),which was significantly higher than that in the unincorporated COPD group(13. 7% (78/568)) (χ2 = 4. 894,P<0. 05). The incidence of pulmonary complications in the lung rehabilitation group was 13. 5% ( 5/37) , lower than that of the non-lung rehabilitation group ( 36. 7% ( 11/30 ) ) (χ2 = 4. 886, P<0. 05);Among the 86 cases (12. 7%) of incorporated COPD,only 6 cases (8. 9 ‰) were diagnosed with COPD at the time of admission, and 23 cases ( 3. 4%) at discharge. No COPD guidelines were given. Conclusion NSCLC often combined wtith COPD,especially in males,elders (≥65 years old) ,smokers, squamous cell carcinoma patients. At present,the diagnosis and treatment of co-morbidity of COPD is seriously inadequate,which needs to be paid much attention to by the thoracic surgeons,in order to improve the diagnosis and treatment of COPD,and improve the prognosis of the patients with NSCLC and COPD.

Objective:To evaluate the effect of postoperative adjuvant therapy on patients with locally advanced pathologic T3N0M0 (pT3N0M0)esophageal squamous cell carcinoma(ESCC).Methods:In this retrospective study,we evaluated patients who underwent esophagectomy at Lanzhou University Second Hospital.Patients were divided into 4 groups:surgery-alone(S),surgery+radiotherapy group(S+RT),surgery+chemotherapy(S+CT),and surgery+chemoradiotherapy(S+CRT)groups.Both the clinicopathologic informa-tion and the long-term follow-up results were analyzed.Results:From January 2010 to April 2014,a total of 177 patients with a medi-an age of 61 years(range 43-78),were enrolled into the study.Among them,79 received surgery alone;the remaining 98 patients re-ceived adjuvant therapy,of whom 28 patients received adjuvant radiotherapy,38 received adjuvant chemotherapy,and 32 received ad-juvant chemoradiotherapy.Overall survival and disease-free survival were better in Group S+Adjuvant than in Group S(P=0.012,P=0.007,respectively).Comparisons among the four groups showed that the overall survival was higher in Group S+CRT than in Group S (P=0.031).Group S+RT was associated with better overall survival and disease-free survival than Group S(P=0.038,P=0.011,respec-tively).Conclusions:Patients with pT3N0M0 ESCC could benefit from adjuvant radiotherapy and chemoradiotherapy,as radiotherapy could help achieve better locoregional control.

OBJECTIVETo observe the multiple symptom distribution, severity and quality of life of female pelvic floor dysfunction(FPFD) patients with constipation as chief complaint.

METHODSOne hundred FPFD patients with constipation as chief complaint from Speciaty Outpatient Clinic, Pelvic Floor Center of Nanjing Municipal Hospital of Traditional Chinese Medicine between September 2015 and February 2017 were retrospectively enrolled in this study. A comprehensive medical history questionnaire survey and systematical evaluation of severity and quality of life of these patients with constipation was conducted. Constipation scoring system scale (CSS) and patient-assessment of constipation quality of life questionnaire (PAC-QOL) were applied to evaluate the constipation. Other scales included: (1)pain visual analogue scale (VAS) and short form-36 questionnaire (SF-36): if combined with chronic functional anal rectal pain; (2) international consultation on incontinence questionnaire-short form (ICIQ-SF) and urinary incontinence quality of life questionnaires (I-QOL):if combined with urinary incontinence; (3) fecal incontinence severity score scale (Wexner-FIS) and fecal incontinence quality of life questionnaire (FI-QOL):if combined with fecal incontinence.

RESULTSThe mean age of 100 FPFD patients was (57.9±13.9) (24-89) years and the mean disease course was (7.0±8.2)(0.5-40.0) years. Seventy-five cases (75%) were complicated with anal pain, 70 with urinary incontinence, 37 with rectocele, 19 with nocturia, 11 with urinary frequency, 10 with defecation incontinence. Complication with only one symptom was observed in 20 cases (20%), and with two or more symptoms was observed in 80 cases (80%). Pelvic floor relaxation syndrome patients were dominant (58 cases, 58%). The severity of constipation (CSS) was 6-22 (13.89±3.79) points and the quality of life (PAC-QOL) was 45-133 (87.13±18.57) points in FPFD patients. VAS and SF-36 of patients combined with chronic functional anal rectal pain were 1-8 (3.0±1.9) points and 14.4-137.0(71.5±31.4) points respectively. ICIQ-SF and I-QOL of patients combined with urinary incontinence were 1-17 (6.1±3.6) points and 52-110 (90.0±15.8) points respectively. Wexner-FIS and FI-QOL of patients combined with fecal incontinence were 1-11 (4.4±3.0) points and 52-116 (83.4±23.3) points respectively.

CONCLUSIONSThe symptoms of FPFD patients with constipation as chief complaint are complex. They are mainly complicated with anal diseases, then urinary incontinence, and mostly with more than 2 symptoms. Their quality of life is poor.

Adult ; Aged ; Aged, 80 and over ; Constipation ; etiology ; Fecal Incontinence ; etiology ; Female ; Humans ; Middle Aged ; Pelvic Floor ; Pelvic Floor Disorders ; complications ; diagnosis ; Quality of Life ; Retrospective Studies ; Surveys and Questionnaires ; Young Adult

Objective To investigate the serum expressions and clinical significance of Dickkopf-1 in patients with rheumatoid arthritis (RA). Methods The clinical data of 139 patients with RA were retrospectively analyzed, including the disease history, tender joint count (TJC), swollen joint count (SJC), platelet, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), anti-nuclear antibody (ANA), antikeratin antibody (AKA), anti-perinuclear factor (APF), anti cyclic citrullinated peptide antibody (anti-CCP), Dickkopf-1 and radiological (X-ray) staging. The disease activity scale (DAS) was evaluated, and the ESR and CRP levels were included. The relationship between Dickkopf-1 and the clinical data of RA, DAS44 score was analyzed. Results The serum level of Dickkopf-1 in patients with RA was (2.70 ± 0.46) μg/L. There was no relationship between serum Dickkopf-1 level and gender, age, course of disease, CRP, platelet, ANA, AKA, APF, RF, radiological staging in patients with RA (P>0.05). The serum Dickkopf-1 level was significantly associated with TJC, SJC, ESR, DAS44-ESR score, DAS44-CRP score and anti-CCP (r = 0.200, 0.291, 0.178, 0.222, 0.199 and 0.278, P = 0.019, 0.001, 0.037, 0.009, 0.028 and 0.012). Conclusions The serum Dickkopf-1 expression level is closely related to the occurrence and development of RA. Dickkopf-1 may contribute to diagnose the disease activity in patients with RA.

Objective To observe the effect of down-regulated CDX2 gene on the migration and invasion abilities of colon cancer cells (SW480 and HT29) and investigate the role and mechanisms of CDX2 gene in occurrence and development of colon cancer metastasis.Methods CDX2 gene in HT29 and SW480 cells was down-regulated using lentivirus RNA interference (RNAi) vector.The interference efficiency of CDX2 was detected by qRT-PCR and Western blotting.The effect of down-regulated CDX2 expression on colon cancer cells'migration and invasion was determined by Transwell and wound heal methods.Then the effects of down-regulated CDX2 on the expressions of epithelial-mesenchymal transition (EMT)-related genes (E-cadherin,ZEB-1,Vimentin,Twist and Snail) were detected by RT-PCR and Western blotting.Results The constructed CDX2 siRNA expression vector could significantly inhibit the expression of CDX2 in HT29 and SW480 cells.Compared with those of the cells transfected with empty vector (LV-NT-shRNA) and non-transfected cells,the migration and invasion abilities of cells transfected with LV-CDX2-shRNA were markedly enhanced (P ＜ 0.05).E-cadherin expression was reduced while expressions of ZEB-1,Vimentin,Twist,and Snail were significantly increased (all P＜0.05).Conclusion Down-regulating the expression of CDX2 can induce the occurrence of EMT,thus enhancing the invasion and migration of colon cancer cells.

OBJECTIVETo observe the short- and long-term efficacy of acupuncture combined with biofeedback in the treatment of functional anorectal pain (FARP).

METHODSClinical data of 142 patients who met the functional gastrointestinal disorders and functional anorectal pain based on criteria of Rome III( undergoing acupuncture with biofeedback therapy from August 2010 to November 2015 in Pelvic Floor Center of The Third Affiliated Hospital of Nanjing University of Chinese Medicine were retrospectively analyzed. Telephone and outpatient clinic recheck were used as standard follow-up. The clinical effect of short-term and long-term data collected from the disease-based database was evaluated with visual analogue pain scale (VAS) (0-10 points), short form health survey questionnaire (SF-36) (0-148 points). The overall satisfaction and effectiveness (VAS was >30%) were evaluated at the end of treatment (short-term) and during follow-up (long-term).

RESULTSThe effective follow-up data were obtained from 71.1%(101/142) of patients and the median follow-up time was 28(3-67) months. The VAS of 101 cases was 6.09±1.78, 1.99±1.89 and 3.55±2.60 before treatment, at the end of treatment and during follow-up respectively. Though the VAS during follow-up was higher than that at the end of treatment, but still significantly lower than that before treatment(P<0.05). The SF-36 score of 31 patients was 82.0±16.9, 94.0±15.1 and 88.1±15.3 before treatment, at the end of treatment and during follow-up respectively. Though the SF-36 score during follow-up was lower compared to at the end of treatment, but still significantly higher compared to before treatment (P<0.05). The effective rates were 85.9%(122/142) at the end of treatment and 75.2%(76/101) during follow-up, and the satisfactory rates were 92.3%(131/142) and 84.2%(85/101), respectively.

CONCLUSIONAcupuncture with biofeedback has significant short-term and long-term efficacy in treating functional anorectal pain, and its degree of satisfaction is high.