Objective:To explore the characteristics of endothelial function in children with incomplete Kawasaki disease (IKD) of different ages and its relationship with coronary artery lesion (CAL).Methods:A total of 200 children with IKD admitted to the Affiliated Hospital of Jining Medical University from February 2020 to May 2022 were selected as the IKD group, and another 200 healthy children who underwent physical examinations during the same period were selected as the control group. According to the age of children with IKD, infants ( n=78) were classified as those under 1 year old, infants ( n=62) were classified as those between 1-3 years old, and preschool children ( n=60) were classified as those over 3-6 years old. The endothelial function characteristics of IKD children in different age groups and normal control group children were analyzed and compared. In addition, IKD patients were divided into CAL group ( n=110) and nCAL group ( n=90) based on whether CAL was merged. The age, carotid intima-media thickness (IMT), flow-mediated-dilation (FMD), carotid stiffness index (SI), nitroglycerin-mediated dilation (NMD), tumor necrosis factor α (TNF-α), C-reactive protein (CRP), brachial artery endothelial dependent dilation function (EDD) and other clinical data were compared between the two groups. Cox proportional hazards model was used for univariate and multivariate analysis to identify the risk factors for CAL in IKD patients. A column chart prediction model was constructed and evaluated. Results:There were statistically significant differences in FMD, NMD, SI, IMT, reactive congestion index (RHI), and EDD between IKD patients and normal control group children (all P<0.05). There were statistically significant differences in FMD, NMD, SI, IMT, RHI, and EDD among three groups of IKD children of different ages (all P<0.05). There were statistically significant differences in the proportion of children aged ≤3 years, TNF-α, CRP, SI, IMT, EDD, FMD, and NMD between the nCAL and CAL groups (all P<0.05). Age ≤3 years, elevated levels of TNF-α, CRP, SI, IMT, and EDD, as well as decreased levels of FMD and NMD, were independent risk factors for CAL in children with IKD (all P<0.05). The column chart prediction model had high discrimination, and the area under the curve for predicting CAL occurrence in children with IKD was 0.868 and 0.830, respectively. Conclusions:There are significant differences in endothelial function among children with IKD of different ages, and endothelial function is closely related to the occurrence of CAL. When endothelial function is abnormal, CAL is more likely to occur.

Objective To investigate the effect of early glucose metabolism abnormality on skeletal muscle content of young men.Methods 88 males who underwent physical examinations in our hospital from September 2020 to September 2021 were divided into normal blood glucose group(NGT,n=47)and IGR group(n=41),according to their FPG and 2 hPG levels.FPG,FIns and visceral fat area(VFA)were measured.HOMA-IR,HOMA-β,skeletal muscle index(SMI)and body fat ratio(BFR)were calculated.Results Compared with NGT group,the males in IGR group showed elevated BMI,WC,FPG,2 hPG,HOMA-IR and VFA(P＜0.05),but decreased HDL-C and SMI(P＜0.05).Pearson correlation analysis showed that SMI was negatively correlated with BMI,WC,FPG,2 hPG,HOMA-IR,VFA and BFR in young men(P＜0.05 or P＜0.01).Logistic regression analysis showed that BMI was the influencing factor of FPG,while SMI was the influencing factor of 2 hPG.Conclusions In young men with abnormal glucose metabolism,the postprandial blood glucose significantly increase with the decrease of skeletal muscle content,and fasting blood glucose is mainly affected by BMI.

OBJECTIVE To explore the relationship between laryngeal morphology and clinical function after partial laryngectomy for glottic laryngeal cancer,as assessed by CT.METHODS This study included 90 patients with glottic laryngeal cancer who underwent partial laryngectomy between March 2020 and March 2023(observation group).Postoperative follow-up included CT scans,measuring glottal area(GA),glottal width(GW),glottal depth(GD),subglottic area(SGA),and hyoid-cricoid distance(HCD).Postoperative respiratory,phonation,and swallowing functions were recorded.The study compared CT morphological parameters and voice acoustic parameters between the observation group and 50 healthy volunteers(control group)and analyzed the correlation of laryngeal CT morphological parameters with decannulation time,swallowing function grading,and voice acoustic parameters.RESULTS All 90 patients were decannulated at follow-up,with decannulation times ranging from 7 to 22(14.35±3.67)days.Laryngoscopy showed that 58 patients had complete glottal closure while phonating/i:/,whereas 32 had incomplete closure.At follow-up,all patients were able to eat orally.Swallowing function assessment results were:grade 0 in 62 cases(68.89％),grade 1 in 23 cases(25.56％),and grade 2 in 5 cases(5.55％).Postoperative laryngeal CT in the observation group revealed varying degrees of structural deficiencies in the vocal cords,laryngeal ventricle,and ventricular band.Glottal morphology appeared as'V','U'shaped,or irregularly abnormal,with some patients showing slight enlargement or deviation of the glottal slit.CT morphological parameters GA,GW,GD,SGA,HCD in the observation group were all smaller than those in the control group(P＜0.05).Those in the observation group with complete glottal closure during/i:/phonation had larger GA,GW,GD,SGA,HCD than those with incomplete closure(P＜0.05).Voice acoustic analysis revealed that postoperative F0,MPT were lower in the observation group compared to the control group(P＜0.05),while Jitter and Shimmer were higher(P＜0.05).Spearman correlation analysis showed a negative correlation between postoperative laryngeal CT morphological parameters GA,GW,GD,SGA,HCD and swallowing function grading in the observation group(P＜0.05).Pearson correlation analysis showed a positive correlation of these parameters with F0,MPT(P＜0.05),and a negative correlation with decannulation time,Jitter and Shimmer(P＜0.05).CONCLUSION Laryngeal CT morphological parameters GA,GW,GD,SGA,HCD are closely related to respiratory,phonation,and swallowing functions in patients after vertical partial laryngectomy for glottic laryngeal cancer.These parameters can be helpful in guiding clinical treatment and rehabilitation training.

Objective:To evaluate the safety of double and a half layered esophagojejunal anastomosis in radical gastrectomy.Methods:This prospective, multi-center, single-arm study was initiated by the Affiliated Cancer Hospital of Zhengzhou University in June 2021 (CRAFT Study, NCT05282563). Participating institutions included Nanyang Central Hospital, Zhumadian Central Hospital, Luoyang Central Hospital, First Affiliated Hospital of Henan Polytechnic University, First Affiliated Hospital of Henan University, Luohe Central Hospital, the People's Hospital of Hebi, First People's Hospital of Shangqiu, Anyang Tumor Hospital, First People's Hospital of Pingdingshan, and Zhengzhou Central Hospital Affiliated to Zhengzhou University. Inclusion criteria were as follows: (1) gastric adenocarcinoma confirmed by preoperative gastroscopy;(2) preoperative imaging assessment indicated that R0 resection was feasible; (3) preoperative assessment showed no contraindications to surgery;(4) esophagojejunostomy planned during the procedure; (5) patients volunteered to participate in this study and gave their written informed consent; (6) ECOG score 0–1; and (7) ASA score I–III. Exclusion criteria were as follows: (1) history of upper abdominal surgery (except laparoscopic cholecystectomy);(2) history of gastric surgery (except endoscopic submucosal dissection and endoscopic mucosal resection); (3) pregnancy or lactation;(4) emergency surgery for gastric cancer-related complications (perforation, hemorrhage, obstruction); (5) other malignant tumors within 5 years or coexisting malignant tumors;(6) arterial embolism within 6 months, such as angina pectoris, myocardial infarction, and cerebrovascular accident; and (7) comorbidities or mental health abnormalities that could affect patients' participation in the study. Patients were eliminated from the study if: (1) radical gastrectomy could not be completed; (2) end-to-side esophagojejunal anastomosis was not performed during the procedure; or (3) esophagojejunal anastomosis reinforcement was not possible. Double and a half layered esophagojejunal anastomosis was performed as follows: (1) Open surgery: the full thickness of the anastomosis is continuously sutured, followed by embedding the seromuscular layer with barbed or 3-0 absorbable sutures. The anastomosis is sutured with an average of six to eight stitches. (2) Laparoscopic surgery: the anastomosis is strengthened by counterclockwise full-layer sutures. Once the anastomosis has been sutured to the right posterior aspect of the anastomosis, the jejunum stump is pulled to the right and the anastomosis turned over to continue to complete reinforcement of the posterior wall. The suture interval is approximately 5 mm. After completing the full-thickness suture, the anastomosis is embedded in the seromuscular layer. Relevant data of patients who had undergone radical gastrectomy in the above 12 centers from June 2021 were collected and analyzed. The primary outcome was safety (e.g., postoperative complications, and treatment). Other studied variables included details of surgery (e.g., surgery time, intraoperative bleeding), postoperative recovery (postoperative time to passing flatus and oral intake, length of hospital stay), and follow-up conditions (quality of life as assessed by Visick scores).Result:[1] From June 2021 to September 2022,457 patients were enrolled, including 355 men and 102 women of median age 60.8±10.1 years and BMI 23.7±3.2 kg/m2. The tumors were located in the upper stomach in 294 patients, mid stomach in 139; and lower stomach in 24. The surgical procedures comprised 48 proximal gastrectomies and 409 total gastrectomies. Neoadjuvant chemotherapy was administered to 85 patients. Other organs were resected in 85 patients. The maximum tumor diameter was 4.3±2.2 cm, number of excised lymph nodes 28.3±15.2, and number of positive lymph nodes five (range one to four. As to pathological stage,83 patients had Stage I disease, 128 Stage II, 237 Stage III, and nine Stage IV. [2] The studied surgery-related variables were as follows: The operation was successfully completed in all patients, 352 via a transabdominal approach, 25 via a transhiatus approach, and 80 via a transthoracoabdominal approach. The whole procedure was performed laparoscopically in 53 patients (11.6%), 189 (41.4%) underwent laparoscopic-assisted surgery, and 215 (47.0%) underwent open surgery. The median intraoperative blood loss was 200 (range, 10–1 350) mL, and the operating time 215.6±66.7 minutes. The anastomotic reinforcement time was 2 (7.3±3.9) minutes for laparoscopic-assisted surgery, 17.6±1.7 minutes for total laparoscopy, and 6.0±1.2 minutes for open surgery. [3] The studied postoperative variables were as follows: The median time to postoperative passage of flatus was 3.1±1.1 days and the postoperative gastrointestinal angiography time 6 (range, 4–13) days. The median time to postoperative oral intake was 7 (range, 2–14) days, and the postoperative hospitalization time 15.8±6.7 days. [4] The safety-related variables were as follows: In total, there were 184 (40.3%) postoperative complications. These comprised esophagojejunal anastomosis complications in 10 patients (2.2%), four (0.9%) being anastomotic leakage (including two cases of subclinical leakage and two of clinical leakage; all resolved with conservative treatment); and six patients (1.3%) with anastomotic stenosis (two who underwent endoscopic balloon dilation 21 and 46 days after surgery, the others improved after a change in diet). There was no anastomotic bleeding. Non-anastomotic complications occurred in 174 patients (38.1%). All patients attended for follow-up at least once, the median follow-up time being 10 (3–18) months. Visick grades were as follows: Class I, 89.1% (407/457); Class II, 7.9% (36/457); Class III, 2.6% (12/457); and Class IV 0.4% (2/457).Conclusion:Double and a half layered esophagojejunal anastomosis in radical gastrectomy is safe and feasible.

Objective:To systematically review the effect of fracture liaison service (FLS) in elderly patients with fragile hip fractures, so as to provide reference for clinical decision-making.Methods:By combining subject terms and free terms, electronic searches were conducted on China National Knowledge Infrastructure, WanFang Data, VIP, China Biomedical Literature Database, PubMed, Embase, Cochrane Library and Web of Science. The included references were manually retrieved using the snowball method. The retrieval time was from the establishment of the database to March 1, 2023. Two researchers screened articles based on inclusion and exclusion criteria, extracted data, and evaluated the quality of articles, using RevMan5.4 software for statistical analysis.Results:A total of 15 articles were included, totaling 4 333 patients with fragile hip fractures, with a follow-up time of ≥3 months. Meta-analysis showed that FLS could improve patient medication compliance [ RR=2.32, 95% CI (1.74, 3.11) , P<0.01] and hip function [ SMD=1.20, 95% CI (0.93, 1.47) , P<0.01] , reduce mortality [ RR=0.70, 95% CI (0.58, 0.84) , P<0.01] and the occurrence of refractures [ RR=0.44, 95% CI (0.32, 0.61) , P<0.01] , with statistical differences. Conclusions:Compared with routine nursing for fragile hip fractures, FLS can improve medication compliance and hip function, decrease mortality and the occurrence of refractures in patients with fragile hip fractures.

Objective:To evaluate the safety of double and a half layered esophagojejunal anastomosis in radical gastrectomy.Methods:This prospective, multi-center, single-arm study was initiated by the Affiliated Cancer Hospital of Zhengzhou University in June 2021 (CRAFT Study, NCT05282563). Participating institutions included Nanyang Central Hospital, Zhumadian Central Hospital, Luoyang Central Hospital, First Affiliated Hospital of Henan Polytechnic University, First Affiliated Hospital of Henan University, Luohe Central Hospital, the People's Hospital of Hebi, First People's Hospital of Shangqiu, Anyang Tumor Hospital, First People's Hospital of Pingdingshan, and Zhengzhou Central Hospital Affiliated to Zhengzhou University. Inclusion criteria were as follows: (1) gastric adenocarcinoma confirmed by preoperative gastroscopy;(2) preoperative imaging assessment indicated that R0 resection was feasible; (3) preoperative assessment showed no contraindications to surgery;(4) esophagojejunostomy planned during the procedure; (5) patients volunteered to participate in this study and gave their written informed consent; (6) ECOG score 0–1; and (7) ASA score I–III. Exclusion criteria were as follows: (1) history of upper abdominal surgery (except laparoscopic cholecystectomy);(2) history of gastric surgery (except endoscopic submucosal dissection and endoscopic mucosal resection); (3) pregnancy or lactation;(4) emergency surgery for gastric cancer-related complications (perforation, hemorrhage, obstruction); (5) other malignant tumors within 5 years or coexisting malignant tumors;(6) arterial embolism within 6 months, such as angina pectoris, myocardial infarction, and cerebrovascular accident; and (7) comorbidities or mental health abnormalities that could affect patients' participation in the study. Patients were eliminated from the study if: (1) radical gastrectomy could not be completed; (2) end-to-side esophagojejunal anastomosis was not performed during the procedure; or (3) esophagojejunal anastomosis reinforcement was not possible. Double and a half layered esophagojejunal anastomosis was performed as follows: (1) Open surgery: the full thickness of the anastomosis is continuously sutured, followed by embedding the seromuscular layer with barbed or 3-0 absorbable sutures. The anastomosis is sutured with an average of six to eight stitches. (2) Laparoscopic surgery: the anastomosis is strengthened by counterclockwise full-layer sutures. Once the anastomosis has been sutured to the right posterior aspect of the anastomosis, the jejunum stump is pulled to the right and the anastomosis turned over to continue to complete reinforcement of the posterior wall. The suture interval is approximately 5 mm. After completing the full-thickness suture, the anastomosis is embedded in the seromuscular layer. Relevant data of patients who had undergone radical gastrectomy in the above 12 centers from June 2021 were collected and analyzed. The primary outcome was safety (e.g., postoperative complications, and treatment). Other studied variables included details of surgery (e.g., surgery time, intraoperative bleeding), postoperative recovery (postoperative time to passing flatus and oral intake, length of hospital stay), and follow-up conditions (quality of life as assessed by Visick scores).Result:[1] From June 2021 to September 2022,457 patients were enrolled, including 355 men and 102 women of median age 60.8±10.1 years and BMI 23.7±3.2 kg/m2. The tumors were located in the upper stomach in 294 patients, mid stomach in 139; and lower stomach in 24. The surgical procedures comprised 48 proximal gastrectomies and 409 total gastrectomies. Neoadjuvant chemotherapy was administered to 85 patients. Other organs were resected in 85 patients. The maximum tumor diameter was 4.3±2.2 cm, number of excised lymph nodes 28.3±15.2, and number of positive lymph nodes five (range one to four. As to pathological stage,83 patients had Stage I disease, 128 Stage II, 237 Stage III, and nine Stage IV. [2] The studied surgery-related variables were as follows: The operation was successfully completed in all patients, 352 via a transabdominal approach, 25 via a transhiatus approach, and 80 via a transthoracoabdominal approach. The whole procedure was performed laparoscopically in 53 patients (11.6%), 189 (41.4%) underwent laparoscopic-assisted surgery, and 215 (47.0%) underwent open surgery. The median intraoperative blood loss was 200 (range, 10–1 350) mL, and the operating time 215.6±66.7 minutes. The anastomotic reinforcement time was 2 (7.3±3.9) minutes for laparoscopic-assisted surgery, 17.6±1.7 minutes for total laparoscopy, and 6.0±1.2 minutes for open surgery. [3] The studied postoperative variables were as follows: The median time to postoperative passage of flatus was 3.1±1.1 days and the postoperative gastrointestinal angiography time 6 (range, 4–13) days. The median time to postoperative oral intake was 7 (range, 2–14) days, and the postoperative hospitalization time 15.8±6.7 days. [4] The safety-related variables were as follows: In total, there were 184 (40.3%) postoperative complications. These comprised esophagojejunal anastomosis complications in 10 patients (2.2%), four (0.9%) being anastomotic leakage (including two cases of subclinical leakage and two of clinical leakage; all resolved with conservative treatment); and six patients (1.3%) with anastomotic stenosis (two who underwent endoscopic balloon dilation 21 and 46 days after surgery, the others improved after a change in diet). There was no anastomotic bleeding. Non-anastomotic complications occurred in 174 patients (38.1%). All patients attended for follow-up at least once, the median follow-up time being 10 (3–18) months. Visick grades were as follows: Class I, 89.1% (407/457); Class II, 7.9% (36/457); Class III, 2.6% (12/457); and Class IV 0.4% (2/457).Conclusion:Double and a half layered esophagojejunal anastomosis in radical gastrectomy is safe and feasible.

Objective:To explore the independent prognostic factors of primary osteosarcoma patients under 20 years old after radical surgery, so as to predict the prognosis and survival of patients.Methods:The clinicopathological data of 1 339 patients with primary osteosarcoma diagnosed and registered in the National Cancer Institute Surveillance, epidemiology and outcome database (SEER) from 1984 to 2014 were retrospectively analyzed. Kaplan Meier method was used to calculate the survival rate of patients. Log rank test was used to evaluate the survival difference. Cox multivariate analysis was used to determine the independent prognostic factors of osteosarcoma after radical surgery factor.Results:The results of primary osteosarcoma patients undergoing radical surgery found that 34 cases (2.54%) aged 0-5 years old, 236 cases (17.63%) aged 6-10 years old, and 600 cases (44.81%) aged 11-15 years old and 469 cases (35.02%) aged 16-20 years old. The median survival time was 68 months. Among them, 757(56.53%) were male and 582(43.47%) were female. Among the 1 339 cases, 986 were white (73.64%), followed by black 230(17.18%), and 123 other races (9.18%). Multivariate analysis revealed that males ( HR=1.242; 95% CI:1.024-1.505), axial osteosarcoma ( HR=1.589; 95% CI:1.179-2.166), and regional invasion of osteosarcoma ( HR=1.470; 95% CI:1.156-1.870), distant metastasis ( HR=3.536; 95% CI:2.725-4.589) were independent risk factors for overall survival. Other types of osteosarcoma ( HR=0.471; 95% CI:0.285-0.779) were independent protective factors for overall survival. Conclusions:Based on the SEER database, this study identified independent prognostic factors for patients with primary osteosarcoma under the age of 20 who underwent radical surgery, which will help clinicians formulate individualized medical strategies and predict patients′ prognosis.

Objective To knockout the cell division cycle 25 homolog C(Cdc25C) gene in HeLa human cervical cancer cells and to construct HeLa Cdc25C gene knockout stable strains using clustered regularly interspaced short palindromic repeats(CRISPR)/Cas9 gene-editing system.Methods The sequence of the small guide RNA(sgRNA),which could specifically recognize the first exon of Cdc25C,was designed according to the target-designing rules of CRISPR/Cas9 for construction of eukaryotic recombinant expressional plasmids.After sequencing,the plasmid was transfected into HeLa cells.The stable Cdc25C-knocking out strains were screened through the stress of puromycin,and the knockout effect was detected by Western blotting.The cell cycle was analyzed by flow cytometry.Results The stable Cdc25C-knocking out strains were obtained.Moreover,the gene′s knockout obviously delayed the progression of G2/M phase.Conclusion The HeLa Cdc25C gene knockout stable strain is successfully built using CRISPR/Cas9 system,facilitating studies on the function of Cdc25C and the mechanism of carcinogenesis.

Objective To explore the relationship between the decreased expression of AMP-18 mRNA and different degree of gastric cancer in rats. Methods A total of 20 healthy SD ratswere divided into 4 groups:groups A, B, C and D. A rat model of stomach cancer was established by feeding water with N-Methyl-N′-Nitro-Nitrosoguanidine (MNNG), Tween 20 and vitamin D3. The rats in the four groups were killed respectively at weeks 14, 18, 22 and 24. Then gastric antrum mucosa tissues were detected by using HE staining to observe the pathological changes and by real-time quantitative PCR (Q-PCR) technique to detect the expression of AMP-18 mRNA in rats. Results HE staining section showed that group C developed early gastric cancer, and group D developed progressive gastric cancer. The expression of AMP-18 mRNA in groups C and D wassignificantly lower than that in group A by Q-PCR. Conclusion AMP-18 mRNA expression decreased obviously in early orprogressive gastric cancer.

Objective:To predict the basic physicochemical properties ,structure and function ,and linear B-cell epitopes of the capsid protein VP1 of coxsackievirus A6(CVA6).Methods: The amino acid sequence of the CVA6 VP1 was analyzed using Bioedit software and various online tools including SubLoc ,TargetP and the others from ExPASy Bioinformatics Resource Portal.Results: The CVA6 VP1 protein was a hydrophilic protein with a relative molecular weight of 33.6 kD and an isoelectric point of 7.92.This protein containsed 24 phosphorylation sites , but no signal peptide , transmembrane domains and possible fatty acylation sites.Its secondary structure was characterized by the richest random coils , and 48.52 percent of its amino acid residues exposed at the solution inter-face.Epitope prediction by Bepipred showed a number of potential B cell epitopes in the protein ,the highest antigenicity index among them located in the region of amino acids residue 155-165.Conclusion:The basic physicochemical properties ,structure and function characteristics ,and potential linear B-cell epitopes of CVA 6 VP1 were successfully predicted , which laid foundations for the further study on the protein and the preparation of vaccines and immunological diagnostic reagents for CVA 6 infection.