Objective:To investigate whether intestinal rehabilitation therapy (IRT)could optimize the effectiveness of IRT in patients with short bowel syndrome (SBS) caused by acute mesenteric ischemia (AMI) with chronic multivessel lesions.Methods:Clinical data of 18 hospitalized patients diagnosed with AMI leading to SBS and undergoing IRT at the Eastern Theater General Hospital of the People's Liberation Army from Jan 2012 to Oct 2023 was retrospectively analyzed.Result:Following IRT, the revascularization group showed significantly greater increases in ASMI and grip strength compared to the control group [(0.28±0.26) kg/m 2vs. (0.02±0.21) kg/m 2, P=0.033, and (0.97±0.33) kg vs. (0.48±0.34) kg, P=0.007, respectively]. Similarly, the increase in EN intake was significantly higher in the revascularization group compared to the control group [(572.5±93.6) ml/d vs. (375.2±176.3) ml/d, P=0.012], accompanied by a greater improvement in intestinal nitrogen absorption rate [(25.06±14.06)% vs. (13.84±4.62)%, P=0.034] and a more substantial decrease in GSRS scores [(-15.88±3.94) vs. (-6.33±5.13), P=0.030]. Moreover, there were significant differences in the composition of EN formulations between the two groups after IRT ( P=0.046). Additionally, SF-36 scores at discharge were significantly higher in the revascularization group than that in the control group for five indicators including BP, GH, VT, SF, and MH ( P<0.05). Conclusions:For patients with SBS resulting from AMI by chronic multivessel lesions, revascularization therapy may not leading to higher growth in weight and hematological nutritional indicators during IRT, but it is beneficial for improving muscle function, improving EN absorption, increasing the likelihood of PN independence, relieving gastrointestinal symptoms, and enhancing overall quality of life.

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 dietary fiber in the intestinal rehabilitation for patients with ultra-short bowel syndrome.Methods:This study included 34 inpatients diagnosed with ultra-short bowel syndrome in the General Surgery Department of the Eastern Theater General Hospital of the People's Liberation Army from January 2012 to October 2023. Patients were grouped based on whether they received intestinal rehabilitation and whether dietary fiber was added to the treatment plan, and were divided into three groups: nutritional therapy group (11 cases), growth hormone + glutamine intestinal rehabilitation treatment group (10 cases) and growth hormone injection + glutamine + dietary fiber intestinal rehabilitation treatment group (13 cases). The therapeutic regimen and its changes, pre- and post-treatment parameters of hematology, nutrition, intestinal absorption, fecal consistency, and quality of life were recorded and compared, and the impact of different treatment regimens on clinical outcomes was analyzed.Results:Compared with nutrition treatment group and growth hormone + glutamine intestinal rehabilitation treatment group, growth hormone injection + glutamine + dietary fiber intestinal rehabilitation treatment group, the increase of enteral nutritional fluid, the decrease of parenteral nutritional energy, the increase of intestinal moisture absorption, the decrease of defecation times and the appreciation of hemoglobin were significantly increased, and the difference was statistically significant ( P<0.05). At the same time, the levels of insulin-like growth factor 1 and insulin-like growth factor binding protein were significantly increased after treatment ( P<0.01). Conclusions:Nutritional support combined with intestinal rehabilitation can significantly improve the nutritional status and intestinal absorption rate of ultra-short bowel syndrome patients. The use of dietary fiber in the intestinal rehabilitation regimen for ultra-short bowel syndrome patients yields more significant benefits, as evidenced by improved clinical outcomes.

This paper investigates the current situation of fallout sample collection and preparation as well as radioactivity measurement methods in the Environmental Radiation Monitoring Network in China, analyzes the radioactivity levels of fallout nationwide in recent years, summarizes the problems in fallout measurement, and puts forward suggestions for improving fallout monitoring.

Objective : To explore the effect of LncRNA MEG3 in temozolomide (TMZ) resistance of glioma cells. Methods : TMZ⁃resistant glioma cells U87(U87/TMZ) were constructed,qRT⁃PCR was used to detect the LncRNA MEG3 expression level, and MTT was used to detect the cell proliferation ability. The LncRNA MEG3 in U87/TMZ was overexpressed by liposome method (pcDNA⁃MEG3 group), the empty vector was transfected as the empty vector group ( pcDNA group), and the conventionally cultured U87/TMZ was used as the blank group ( Control group),then treated with 10 μg/ml TMZ. The plasmid transfection effect was analyzed by qRT⁃PCR. The expression of LncRNA MEG3⁃related protein was confirmed by Western blot. The cell cloning experiment detects the effect of LncRNA MEG3 on cell proliferation. The effect of LncRNA MEG3 on cell invasion was tested by Transwell. The effect of LncRNA MEG3 on cell apoptosis was detected by flow cytometry. And mouse transplant tumoranimal model was constructed for in vivo experiments. Results : Compared with U87, the expression level of Ln cRNA MEG3 in U87/TMZ was lower (P < 0. 01), and the cell viability of U87/TMZ was higher than that of U87 (P < 0. 01) . After overexpression of MEG3 combined with TMZ, compared with the Control group and the pcDNA group, the pcDNA⁃MEG3 group up⁃regulated the expression of MEG3 mRNA and p53 protein, and down⁃regulated the expression of MDM2 protein, and the proliferation and invasion ability of the pcDNA⁃MEG3 group decreased while the apoptosis ability increased (P < 0. 01) . The construction of mouse transplant tumor animal model showed that the tumor volume and mass of the pcDNA⁃MEG3 group were reduced compared with the pcDNA group (P < 0. 01) . Conclusion Overexpression of LncRNA MEG3 can attenuate the drug resistance of TMZ⁃resistant glioma cells.

Supervision of teaching is of great significance to the substantive equivalence of "online" and "offline" teaching. Compared with the conventional supervision of offline teaching, supervision of online teaching has its particularity. The School of Medicine of Shanghai Jiao Tong University has formulated the online teaching supervision program, relying on the constantly improving supervision system in long-term practice and based on the quality control concept of OBE (outcomes-based education) which aims to improve the learning effect of students. The supervision program of online teaching includes full coverage of expert supervision, smooth feedback channels for students, prompt communication and solutions by management supervision, etc. And the effect of online teaching supervision on students' learning effect can be tested in practice. The effect of the online teaching has been investigated by the questionnaire survey. The results show that online teaching expert supervision has higher satisfaction and students learning effect is better, which illustrates that the online supervision program has played a positive role in teaching.

Objective To investigate the health care workers'(HCWs) knowledge and attitude towards perioperative warming as well as patients' warming status, provide reference for warming in perioperative period and reduce surgical site infection(SSI).Methods Convenience sampling was used to select 198 HCWs in surgical department and operating room as well as 160 patients undergoing operation.HCWs were investigated by referring foreign literatures and designing questionnaires, on-site observation method was used to collect information about warming measures implemented for surgical patients.Results The median (quartile range) of scores of HCWs' knowledge and attitude towards patients' perioperative warming were 9 (2.25) and 25 (1.25) respectively.There was no statistical significance in scores of knowledge and attitude among HCWs with different age, education degree and occupation(all P>0.05).The awareness rates of hypothermia, active warming, and passive warming modes were 21.21%, 43.94%, and 30.81% respectively.80.30%, 89.90%, and 86.36% of HCWs thought that it was essential to keep warming before, during and after surgery.68.13% of surgical patients were warmed by covering cotton quilt and shoulder pad during operation.Conclusion HCWs hold positive attitude towards perioperative warming, but they lack sufficient knowledge about perioperative warming, it is necessary to improve facilities of perioperative warming.

Objective To investigate the clinical and MRI characteristics of reversible splenial lesion syndrome (RESLES).Methods The clinical data,MRI features and follow-up results of 18 patients with RESLES were analyzed retrospectively.Results The average age of the patients was younger,and 5 cases were below 1 5 years old.Clinical history and MRI features were characterized.About 67%(12/18)patients had fever,headache,encephalitis,history,without long history of alcohol abuse.MRI revealed that the lesions of splenial of corpus callosum were solitary nodule with clear boundary.The lesions were slightly hyperintensity on T2 WI and obviouslyhyperintensity on FLAIR and DWI,while the they show hypointensity on ADC with the ADC value <1×10-3 mm2/s.No edema or significant enhancement were observed.The lesions may completely disappear or relief on DWI after short treatment.Conclusion RESLES is a rare entity with a broad clinicoradiological spectrum.The MRI features are characteristic,and it will provide helpful information for diagnosis, differential diagnosis and clinical treatment.

OBJECTIVE To study the morphology, immunology, cyto- and molecular genetics of a patient with lymphoplasmacytic lymphoma/Waldenström macroglobulinemia (LPL/WM), deletion of P53 gene and rearrangement of clonal T cell receptors-delta (TCR-delta) gene. METHODS The cell morphology and immunocytochemistry were analyzed by bone marrow testing and biopsy. Cellular immunology was analyzed by flow cytometry. Genetic analysis was carried out by chromosome karyotyping, fluorescent in situ hybridization (FISH) and polymerase chain reaction (PCR). Immunoglobulin M (IgM) in serum and urine was assayed by immunofixation electrophoresis. And the effect of chlorambucil therapy was evaluated. RESULTS Bone marrow biopsy suggested that the patient was of B lymphocyte type and had abnormal increase of lymphocytoid plasma cells, which were CD38 and CD138 positive. The patient had a normal male karyotype. FISH and PCR analysis of peripheral blood samples suggested deletion of P53 gene and rearrangement of TCR-delta gene. Immunofixation electrophoresis has detected IgM-kappa in both serum and urine. The patient showed partial response to chlorambucil. CONCLUSION In addition to typical clinical features, bone marrow examination, flow cytometry, histochemistry and immunophenotyping, testing for P53 gene deletion and lymphocyte gene rearrangement can facilitate the diagnosis and treatment of LPL/WM.
Aged ; Gene Rearrangement, delta-Chain T-Cell Antigen Receptor ; Genes, p53 ; Humans ; In Situ Hybridization, Fluorescence ; Male ; Polymerase Chain Reaction ; Waldenstrom Macroglobulinemia ; drug therapy ; genetics