Objective:We aimed to develop a novel visualized model based on nomogram to predict postoperative overall survival.Methods:This was a multicenter, retrospective, observational cohort study, including participants with histologically confirmed gastric and colorectal cancer who underwent radical surgery from 11 medical centers in China from August 1, 2015 to June 30, 2018. Baseline characteristics, histopathological data and nutritional status, as assessed using Nutrition Risk Screening 2002 (NRS 2002) score and the scored Patient-Generated Subjective Global Assessment, were collected. The least absolute shrinkage and selection operator regression and Cox regression were used to identify variables to be included in the predictive model. Internal and external validations were performed.Results:There were 681 and 127 patients in the training and validation cohorts, respectively. A total of 188 deaths were observed over a median follow-up period of 59 (range: 58 to 60) months. Two independent predictors of NRS 2002 and Tumor-Node-Metastasis (TNM) stage were identified and incorporated into the prediction nomogram model together with the factor of age. The model's concordance index for 1-, 3- and 5-year overall survival was 0.696, 0.724, and 0.738 in the training cohort and 0.801, 0.812, and 0.793 in the validation cohort, respectively.Conclusions:In this study, a new nomogram prediction model based on NRS 2002 score was developed and validated for predicting the overall postoperative survival of patients with gastric colorectal cancer. This model has good differentiation, calibration and clinical practicability in predicting the long-term survival rate of patients with gastrointestinal cancer after radical surgery.

Objective To investigate the role of Toll-like receptor 4(TLR4)in hepatocyte regeneration after acet-aminophen(APAP)-induced injury in human normal liver cell(L02)and its possible mechanism.Methods L02 cells were cultured in vitro,and cell viability was detected by CCK-8 assay.The optimal concentration and duration of APAP and the concentration of TLR4 inhibitor(TAK-242)were determined.The protein expression levels of nu-clear factor-κB(NF-κB),microtubule-associated protein light chain 3(LC3),p62,receptor interacting protein kinase 1(RIP1),receptor interacting protein kinase 3(RIP3),signal transducer and activator of transcription 3(STAT3),phosphorylation of STAT3(p-STAT3),proliferating cell nuclear antigen(PCNA)and Cyclin D1 were detected by Western blot.The mRNA expression levels of TLR4,NF-κB,tumor necrosis factor-α(TNF-α),inter-leukin-6(IL-6),interleukin-1 β(IL-1 β),PCNA,Cyclin D1 and Ki67 were detected by qRT-PCR.Results Ac-cording to the results of CCK-8,L02 cells were treated with 5 mmol/L APAP for 24,36,48 h to simulate liver in-jury and regeneration model in vitro,and TAK-242 100 nmol/L was pretreated 2 ht before APAP to inhibit TLR4.Compared with the control group,the protein levels of NF-κB,RIP1,p-STAT3,PCNA,Cyclin D1 and the mRNA levels of TNF-α,IL-1 β and PCNA increased in the APAP 24 h group;the protein levels of NF-κB,RIP1,RIP3,p-STAT3,PCNA,Cyclin D1 and the mRNA levels of TLR4,NF-κB,TNF-α,IL-1 β,PCNA and Cyclin D1 in-creased in the APAP 36 h group;the protein levels of NF-κB,RIP1,p-STAT3,PCNA,Cyclin D1 and the mRNA levels of TLR4,NF-κB,TNF-α,IL-1β,IL-6,PCNA,Cyclin D1 and Ki67 increased in the APAP 48 h group.The protein levels of NF-κB,RIP1,RIP3,p-STAT3,PCNA,Cyclin D1 and the mRNA levels of TLR4,NF-κB,TNF-α,IL-1β,IL-6,PCNA,Cyclin D1,Ki67 significantly decreased in APAP+TAK-242 24 h and 48 h group than the APAP group at the same time point;the protein levels of NF-κB,PCNA and the mRNA levels of TLR4,NF-κB,TNF-α,IL-1β,IL-6,PCNA and Ki67 in APAP+TAK-242 36 h group were also significantly lower than those in APAP 36 h group.Compared with the control group,autophagy was activated in the APAP group,while autophagy was inhibited in the APAP+TAK-242 group.Conclusion TLR4 may affect the TLR4/NF-κB pathway,up-regulate the levels of inflammatory factors and autophagy,and promote hepatocyte regeneration after APAP-in-duced liver injury in L02 cells.

Objective    To investigate the use of opioid analgesics during the postoperative hospitalization in patients undergoing lung resection and analyse its influencing factors. Methods    The clinical data of 450 patients undergoing lung resection in Sichuan Cancer Hospital among a multicenter symptom research database (CN-PRO-Lung 1) between November 2017 and January 2020 were analyzed. There were 248 males and 202 females with an average age of 54.7±10.3 years. Results    A total of 448 (99.6%) patients used opioid analgesics. The average daily morphine equivalent dose during the postoperative hospitalization was 48.9 mg. There were statistical differences in postoperative morphine equivalent dose across patients with different sex, age, highest level of education, Charlson Comorbidity Index score, surgical approach, surgical type, operative time, postoperative hospital stay and grade of postoperative complications (all P<0.05). Multivariate analysis showed that sex, surgical approach and postoperative hospital stay were independent influencing factors for morphine use during the postoperative hospitalization in patients undergoing lung resection (all P<0.05). Conclusion    In clinical practice, attention should be paid to postoperative pain for male patients, as well as to promote the application of minimally invasive surgery, and to shorten the length of postoperative hospital stay, in order to ultimately reduce the use of opioids.

Objective To analyze the short- and long-term effect of chemoradiotherapy combined with rhAd-p53 on locally advanced cervical cancer (LACC). Methods A total of 51 patients with stage ⅡA-ⅣA LACC were divided into experimental group (chemoradiotherapy+rhAd-p53 gene therapy, RCT-p53) and control group (chemoradiotherapy, RCT). Short-term effect, long-term effect and early side-effect were evaluated. Results ORR of RCT-p53 group and RCT group were 91.7% and 62.9%, respectively (P=0.037); CR rates were 66.7% and 40.7%, respectively. There was no significant difference of early side-effects between two groups, in terms of hematologic toxicity, digestive toxicity, hepatotoxicity or renal toxicity. Five-year PFS of RCT-p53 group and RCT group were 79.8% and 51.3%, respectively (P=0.028); 5-year OS were 81.6% and 60.3%, respectively (P=0.061). Conclusion rhAd-p53 treatment has better short-term effect and long-term effect than concurrent chemoradiotherapy, without increasing early side effects.

Objective: Short-course neoadjuvant radiotherapy (SCRT) combined with delayed surgery seems to be safer than SCRT in combination with immediate surgery. However, the clinical efficacy between SCRT and long-course neoadjuvant radiotherapy (LCRT) combined with delayed surgery has not been compared. Therefore, this meta-analysis was performed to compare the safety and efficacy between SCRT and LCRT followed by delayed surgery in patients with locally advanced rectal cancer. Methods: Relevant literatures were searched using relevant databases. Baseline characteristics and treatment results of patients were extracted. The included studies were subject to bias risk assessment. Evidence assessment and data analysis were conducted. Results: A total of 7 studies with 4967 patients were included. Meta-analysis results illustrated no statistical significance between two groups in terms of sphincter preservation rate, R₀ resection rate, postoperative complications, local recurrence rate (LRR), distant metastasis, recurrence-free survival (RFS), overall survival (OS), length of hospital stay and acute radiotherapy toxicity (all P>0.05). Compared with SCRT with delayed surgery, LCRT with delayed surgery was associated with a significant increase in the tumor downstaging rate (RR=0.84, 95%CI=0.76-0.93, P<0.05) and a considerable increase in pathologically complete remission rate (RR=0.46, 95%CI=0.34-0.61, P<0.05). Conclusions SCRT with delayed surgery is as effective as LCRT with delayed surgery in terms of sphincter preservation rate, R₀ resection rate, postoperative complications, LRR, RFS, OS, grade Ⅲ-Ⅳ acute toxicity and length of hospital stay. However, LCRT in combination with delayed surgery enhances the tumor downstaging rate and pathologically complete remission rate.

Objective To evaluate the efficacy and safety of bronchoalveolar lavage( BAL) in the treatment of neonatal atelectasis with fiberoptic bronchoscopy under ultrasound monitoring. Methods From June 2018 to December 2018,29 children were diagnosed as atelectasis by lung ultrasound. After conventional mechanical vibration and sputum ineffective,BAL was treated with fiberoptic bronchoscopy. All patients be-fore operation were monitored by ultrasound to find the lung segment where the atelectasis was located. 0. 9%NaCl solution was injected by fibrobronchoscope(1～2 ml/kg),and then sucked to ensure the recovery rate of the lavage fluid was more than 50%. After each lavage,ultrasound was immediately used to monitor the recovery of atelectasis to determine whether or not to continue the lavage. One course of treatment could be continuously performed BAL 1 to 3 times a day,1 course per day,and up to 3 courses of lavage. We analyzed the efficacy,adverse reactions and complications of BAL in the treatment of neonatal atelectasis under ultra-sound monitoring. Results Twenty-nine patients underwent BAL treatment with fiberoptic bronchoscopy,25 cases (86. 2%) were cured,3 cases (10. 3%) were effective,and 1 case (3. 4%) was ineffective. All chil-dren had stable vital signs during treatment. Among them,11 cases (37. 9%) had transient hypoxemia, 3 ca-ses (10. 3%) had tracheal mucosal injury, and 2 cases (6. 9%) had hoarseness. There were no serious com-plications such as pulmonary hemorrhage,pneumothorax,and cardiac arrest. Conclusion BAL treatment of atelectasis under lung ultrasound monitoring has obvious effect,easy to operate,no radiation,no obvious ad-verse reactions and complications,which is worthy of clinical application.

Objective? To establish a digital protection system for incontinence-associated dermatitis based on earlier prevention to reduce the incidence of incontinence-associated dermatitis. Methods? Based on the informationization of nursing platform, we run the digital protection system module of incontinence-related dermatitis based on the forward moving of the prevention gateway in Zhejiang Provincial People＇s Hospital. Through comparative study, 108 patients with incontinence and incontinence-related dermatitis from January to March 2018 were randomly selected as the pre-operation data, and 108 patients with incontinence and incontinence-related dermatitis from January to March 2019 as the post-operation data. The nurses of the two groups were observed and compared in terms of their assessment accuracy in patients＇ incontinence risk, position and Incontinence Associated Dermatitis Severity(IADS), clinical staging, and implementation of prevention strategies. Meanwhile, the incidence of incontinence-related dermatitis among all inpatients in the hospital from January to March in 2018 was compared with the same period of 2019. Results? After the operation of the digital protection system for incontinence-related dermatitis based on earlier prevention, the nursing staff's accuracy rate in the risk assessment of incontinence (χ2=38.095,P＜0.01), IADS (χ2=64.901,P＜0.01), clinical staging accuracy (χ2=42.424,P＜0.01) and the implementation of protective measures (χ2=50.000, P＜0.01) had significant statistical differences. The incidence of incontinence-related dermatitis in hospitalized patients decreased from 0.35% before operation to 0.06% after operation with statistical significance(χ2=41.031, P＜0.01). Conclusions? The operation of the digital protection system for incontinence-associated dermatitis based on earlier prevention can reduce the incidence of incontinence-associated dermatitis and improve the prevention and management competence of nursing staff.

Objective To explore the effect of practicing Chinese gymnastic Qigong-Yijinjing on the infrared radiant track along meridian course (IRRTM)of Ren Meridian stimulated by moxibustion on CV-8 among dysmenorrhea patients.Methods Twenty dysmenorrhea undergraduate patients were recruied and practiced Chinese gymnastic Qigong-Yijinjing for 3 months.The numbers of patients of mild,moderate and severe symptoms were collected before and after the intervention.The effects of IRRTM stimulated by moxibustion on CV-8 were compared before and after practicing Chinese Gymnastic Qigong-Yijinjing.Results After practicing Chinese Gymnastic Qigong-Yijinjing,symptoms of 15 patients (including 11 with moderate dysmenorrhea and 4 with severe dysmenorrheal)were relieved to different extent.After the practice,all IRRTM of Ren Meridian turn to be more continuous,clear and regular either the Ren Meridian was stimulated with moxibustion or not.The average surface temperature along Ren Meridian rose significantly after the practicing.The conduction time to achieve the best states of IRRTM along Ren Meridian significantly shortened compared to before the intervention.Conclusion Chinese Gymnastic Qigong-Yijinjing can effectively enhance the transmission of IRRTM along Ren Meridian on dysmenorrhea patients,and may have a positive effect on dysmenorrhea treatment.

Objective To study the computed tomography(CT)manifestations of involvement of bridging septa in the perirenal space(BSPS)during acute pancreatitis(AP)and its correlation with extrapancreatic inflam-mation on abdominal computed tomography(EPICT)score. Methods 106 patients with acute pancreatitis were included in this study. Emphasis was placed on CT findings of BSPS and the EPICT score in all the patients. Results The EPICT score was 4 to 7 in 67 patients,and the EPICT score was 0 to 3 in 39 patients. BSPS involve-ment was shown in all the patients. The left or right BSPS involved in 102 patients and 98 patients,respectively. Thickening of the BSPS was shown as strip shadow with slightly higher density and hazy border;fluid collection of the BSPS was shown as liquid density with hazy border. The involvement of BSPS showed a statistically significant association with the EPICT score in the AP patients(r=0. 703,P<0.01). Conclusion BSPS involved by acute pancreatitis is shown as a strip shadow with slightly higher density or as liquid density with hazy border on CT images, reflecting the severity of the acute pancreatitis.

Objective:To analyze PD-L2 expression on monocytes of peripheral blood cells in systemic lupus erythematosus ( SLE) and it′s correlation with the degree of disease activity .Methods:Peripheral blood of 26 cases of SLE patiens and 38 cases of healthy controls were collected .Peripheral blood mononuclear cells ( PBMC) were isolated and realtime PCR was carried on to analyze the PD-L2 gene expression.At the same time flow cytometry was performed to analyze the CD 14 and PD-L2 expression.Results:PD-L2 was significantly up-regulated on monocytes in RA patients than in healthy controls and had correlation with the disease activity and the SLEAI score.Conclusion:These findings help to clarify the function of PD-L2,including its potential role as a biomarker for SLE .