Purpose To investigate the expression of pro-tein of relevant evolutionary and lymphoid interest domain-con-taining 1(PRELID1)in gastric cancer tissues and to analyze its effect on prognosis,and the mechanism of influencing the prolif-eration and invasion ability of gastric cancer cells.Methods Using TCGA data and clinical data of 111 patients with gastric cancer,we analyzed the relationship between the expression of PRELID1 and clinicopathological parameters and the impact on clinical prognosis.The biological function of PRELID1 was pre-dicted by bioinformatics,and further verified by in vitro and in vivo experiments.Lentivirus was applied to regulate the level of PRELID 1 in gastric cancer cell line(MGC803)in vitro,and its effect on the proliferation,migration,and invasion of gastric cancer cells was observed.The nude mouse subcutaneous tumor-igenesis was used to observe the effect of PRELID1 on the growth of gastric cancer tissue in vivo.Results The expression of PRELID1 was significantly higher in gastric cancer tissues than that in the adjacent tissues(P＜0.001)and was positively cor-related with the cell proliferation indicator Ki67(P＜0.001).Cox regression model analysis showed that the high expression of PRELID 1 was an independent risk factor affecting the 5-year survival rate after radical gastrectomy(HR=2.336;95％CI=1.354-4.029).Gene enrichment results showed that the func-tion of PRELID1 was related to proliferation and JAK/STAT sig-naling.CCK-8 and Transwell experiments found that up-regula-tion of PRELID1 promoted the proliferation(P=0.016),mi-gration(P=0.016)and invasion(P=0.025)of gastric cancer cells,while down-regulation inhibited the proliferation(P=0.026),migration(P=0.048)and invasion(P=0.029).Subcutaneous tumor formation experiments in nude mice found that up-regulation of PRELID1 promoted the growth of gastric cancer tissue(P=0.047),while down-regulation was the oppo-site(P=0.005).Western blot detecting gastric cancer cells and gastric cancer tissues found that up-regulation of PRELID1 promoted the expression of JAK and STAT proteins(all P＜0.05),while down-regulation inhibited them(all P＜0.05).Conclusion The high expression of PRELID1 associated with poor prognosis may regulate the proliferation,migration and in-vasion of gastric cancer cells by up-regulating JAK/STAT signa-ling in gastric cancer.

Objective This study was to develop a"Spleen Deficiency Certificate Scale for County Residents"and test its reliability.It was then developed as an objective tool for Chinese medicine evidence and symptoms for the prevention and control of chronic diseases among county residents.Methods The scale was compiled based on the team's previous foundation.The reliability of the scale was evaluated using internal consistency reliability and split-half reliability,while its validity was evaluated using structural validity,content validity,calibration validity,and discriminant validity.Results The study included 213 adults from Lanxi,of whom 155 were tested for intestinal flora.Seven scale entries were identified:Fatigue,fear of cold,bland mouth,loss of appetite,diarrhea,weak bowel movements,and tooth-marked tongue.In the reliability test,Cronbach's alpha coefficient was 0.828 and McDonald's ω coefficient was 0.825.The"stomach pain"and"bloating"entries did not meet the inclusion requirements and were recommended to be deleted.The Spearman-Brown coefficient was 0.839.The exploratory factor analysis of the two common factors explained 61.6%of the cumulative variance.The calibration validity indicated that the ratio of salivary amylase activity before and after acid stimulation was 0.826±0.253 in the group with spleen deficiency.Significant differences(P<0.05)in the genera Dialister,Shigella,Leuconostoc,Photobacterium,Trabulsiella,and Parvimonas between the spleen deficiency group and the non-spleen deficiency group.Conclusion The Spleen Deficiency Scale for County Residents demonstrates good reliability and validity.

Objective To investigate the value of T2 mapping sequence combined with apparent diffusion coefficient(ADC)values in identifying benign and malignant breast lesions.Methods Ninety-two patients with breast mass were retrospectively selected,all patients received MRI examination,T2 mapping sequence and ADC values were selected for image analysis,and all patients underwent surgical biopsy and pathological diagnosis,the clinical value of T2 mapping sequence combined with ADC values in differential diagnosis of benign and malignant breast lesions was observed.Results After pathological examination,52 patients were diagnosed as malignant breast lesions and the remaining 40 were diagnosed as benign breast lesions.Among 52 patients with malignant lesions,51 were diag-nosed as malignant and 1 was diagnosed as benign by ADC values.Among the 40 cases of benign lesions,16 were diagnosed as malig-nant and 24 were diagnosed as benign by ADC values.The difference between the mean T2 values of benign breast lesions and malig-nant breast lesions was not significant(P＞0.05);but the coefficient of variation(CV)of T2 values of malignant breast lesions was significantly higher than that of benign breast lesions,and the difference was significant(P＜0.05),and the diagnostic efficacy of T2 mapping and ADC value single examination was lower than that of the combined examination(P＜0.05).Conclusion T2 mapping sequence and ADC value in MRI have the ability to diagnose and distinguish benign and malignant breast,especially the value of the joint application of the two is more prominent,improve the diagnostic accuracy,sensitivity and specificity,and can provide more accurate reference information for clinical practice,which is worth popularizing.

Objective:To explore the clinicopathological and genetic characteristics of sporadic medullary thyroid carcinoma (MTC) and new therapeutic targets for sporadic MTC.Methods:Based on family and personal disease history, we identified 32 sporadic MTC who underwent surgical resection from Jan 2010 to Dec 2022. Clinicopathological and immunohistochemical features were analyzed in all patients, while 6 of them were subject to the whole exome sequencing (WES).Results:Compared with those of low-grade sporadic MTC, patients with high-grade tumors were more likely to have lymph node metastasis at presentation ( χ2=4.428, P=0.040); less likely to be cured by biochemical treatment ( χ2=4.072, P=0.044). Pathological grading scheme, biochemical cure, and TNM stage were independent risk factors of disease free survival. WES was performed on 6 pairs of normal tissues. We screened RET and RAS as driver mutations, and the mutation ratio was 3/6 respectively. Patients with RET or RAS mutations had no recurrence. In addition, we detected PDGFRA somatic mutation, with a mutation ratio of 1/6. Conclusions:For sporadic MTC cases, the pathological grading system has important prognostic value, and RET and RAS somatic mutations are the main driver mutations. PDGFRA are potential therapeutic targets for sporadic MTC.

Diabetes mellitus with ketoacidosis and combined with coma are acute critical complications, which can be complicated with acute abdomen, such as acute pancreatitis, mesenteric thrombosis, small intestine necrosis, etc. There is no report of massive intestine necrosis in the previous literature. We present an overview and aim to improve the diagnosis of acute complications in diabetes mellitus combined with acute abdomen.

Objective:To investigate the effect of post-traumatic pain on post-traumatic stress disorder (PTSD).Methods:A prospective trial was conducted with the recruitment of patients referred to the Emergency Center of Affiliated Hospital of Xuzhou Medical University for acute trauma from January 2018 to June 2019, with the exclusion criteria: age < 18 years, severe eye injury, severe craniocerebral injury and other critical conditions. The clinical data and written informed consent were collected at admission, the post-traumatic pain was assessed by VAS scores and the trauma severity was assessed by ISS score. APACHEⅡ score were evaluated within 24 h after admission. One month after trauma, patients with history of mental illness, or history of major psychogenic trauma within one year or drug addiction were further excluded. Accordingly, 64 eligible patients were evaluated by VAS, and the PCL-5 scale was used to evaluated their PTSD symptoms. The patients were divided into the PTSD group and non-PTSD group according to PCL-5 score≥ 38, and the difference between the two groups in post-traumatic VAS scores was compared. Logistic regression analysis was used to analyze the risk factors of PTSD. Spearman correlation analysis was adopted to establish the correlation between VAS score at admission and PCL-5 score at one month after trauma. The receiver operator characteristic (ROC) curve was used to analyze the predictive value of traumatic pain intensity for PTSD onset.Results:Sixty-four patients were selected and defined as the PTSD group ( n=19) and non-PTSD group ( n=45). The VAS score at admission was significantly higher in the PTSD group than that in the non-PTSD group ( P=0.006). There was no significant difference in VAS scores and VAS variations at 1 month, and in ISS scores at admission and APACHEⅡ scores within 24 h after admission between the two groups. Traumatic pain was an independent risk factor for PTSD ( P=0.043). VAS score at admission was positively correlated with PCL-5 score at 1 month post-traumatically ( r=0.355, P=0.004). In addition, ROC curve analysis showed that VAS score > 8 at admission had predictive value for PTSD (sensitivity=100%, specificity=33%, P=0.000 2). Conclusions:Post-traumatic severe pain is an independent risk factor for PTSD, which requires prompt medical intervention.

BACKGROUND: How to locate pulmonary ground-glass nodules in thoracoscopic surgery is an important clinical topic in minimally invasive thoracic surgery. There is no unified localization method at present. This study intends to investigate the accuracy and security of body surface theodolitic puncture localization method in video-assisted thoracoscopic surgery for pulmonary ground-glass nodules. METHODS: The clinical data of 41 patients from August 2018 to December 2019 were analyzed retrospectively, including 28 males and 13 females. After anesthesia, the patient was located by body surface theodolitic puncture, and then partial lobectomy was performed under video-assisted thoracoscopy. The distance from the nodule to the marked suture and the distance from the nodule to the incisal margin were measured, and the accuracy of localization, the rate of complication and the success rate of surgical resection were calculated. RESULTS: A total of 51 nodules in 41 patients were located by body surface theodolitic puncture localization method. The accuracy rate was 96.1%, and the average location time was 8.3 min. Puncture bleeding occurred in 5 cases (12.2%), all of which were successfully stopped by video-assisted thoracoscopy, and there were no other complications. All patients underwent thoracoscopic partial lobectomy, including 33 cases of anatomical segmentectomy and 8 cases of wedge lobectomy. All the patients in operation process smoothly. The distance between nodule and incisal margin was measured, and all specimens were more than 2 cm, reaching a safe distance. The success rate of surgical resection was 100.0%. CONCLUSIONS In video-assisted thoracoscopic surgery for ground glass nodules of lung, the body surface theodolitic puncture localization method can be accurate, safe and simple.

Objective To study the changes of endotoxin in blood,Escherichia coli,lactobacillus,bifidobacterium,enterococci in feces of HCC patients.Methods Real-time fluorescence quantitative PCR was used to detect the difference between HCC group and normal group in the expression in bifidobacterium,lactobacillus,enterococcus and Escherichia coli,and the difference of endotoxin level.Results The expression levels of Escherichia coli and enterococcus in HCC group were significantly higher than those in normal control group (P＜ 0.05).Bifidobacterium and lactobacillus in primary liver cancer group significantly decreased compared with the normal group (P ＜ 0.05).The serum endotoxin level in HCC group was significantly higher than that in normal control group (P ＜ 0.05).Bifidobacterium and lactobacillus increased in HCC group.Enterococcus and escherichia coli decreased in HCC group.There was a significant positive correlation between endotoxin content and tumor number and tumor diameter in HCC patients.Conclusion Bifidobacterium,lactobacillus decreased,enterococcus and Escherichia coli increased in HCC patients.These changes along with the increase of endotoxin may relate to the development of HCC.

Objective: To investigate the clinical characteristics, therapy modality and prognosis of primary breast diffuse large B-cell lymphoma(PB-DLBCL). Methods: A total of 68 patients with PB-DLBCL treated in Tianjin Medical University Cancer Institute and Hospital were enrolled between January 1, 2004 and January 31, 2017. Clinicopathological data were retrospectively analyzed. 67 patients were female and only one male. The median age was 56 years old. 46 patients had Ann Arbor clinical stageⅠ~Ⅱ disease, and the other 22 were stage Ⅲ~Ⅳ. The patients with and without B symptom were 11 and 57, respectively. Kaplan-Meier method was used for univariate analysis to calculate the 5-year overall survival (OS) rate and 5-year progress-free survival (PFS) rate, compared using the log rank test. Cox regression analysis was used for multivariate analysis. Results: The 1, 3, 5-year OS rate were 84.0%, 78.0% and 73.0%, and 1, 3, 5-year PFS rate were 80.0%, 71.0% and 51.0%, respectively. Univariate analysis indicated that eastern cooperative oncology group (ECOG) score, Ann Arbor clinical stage, international prognostic index (IPI) score, risk stratification, B symptom, β2-microglobulin(β2-MG) level, size of the tumor and cycles of chemotherapy were prognostic factors for OS (all P<0.05), and Ann Arbor clinical stage, IPI score, risk stratification and B symptom were prognostic factors for PFS (all P<0.05). Multivariate analysis indicated that Ann Arbor clinical stage was independent prognostic factor for OS(P=0.029) and B symptom was independent prognostic factor for PFS(P=0.028). Conclusions Prognosis of PB-DLBCL was relatively good. Ann Arbor clinical stage and B symptom were independent prognostic factors for OS and PFS, respectively.

Objective To investigate the clinical characteristics, therapy modality and prognosis of primary breast diffuse large B?cell lymphoma ( PB?DLBCL). Methods A total of 68 patients with PB?DLBCL treated in Tianjin Medical University Cancer Institute and Hospital were enrolled between January 1, 2004 and January 31, 2017. Clinicopathological data were retrospectively analyzed. 67 patients were female and only one male. The median age was 56 years old. 46 patients had Ann Arbor clinical stageⅠ～Ⅱdisease, and the other 22 were stage Ⅲ～Ⅳ. The patients with and without B symptom were 11 and 57, respectively. Kaplan?Meier method was used for univariate analysis to calculate the 5?year overall survival (OS) rate and 5?year progress?free survival (PFS) rate, compared using the log rank test. Cox regression analysis was used for multivariate analysis. Results The 1,3,5?year OS rate were 84.0%, 78.0% and 73.0%,and 1,3,5?year PFS rate were 80.0%,71.0% and 51.0%, respectively. Univariate analysis indicated that eastern cooperative oncology group ( ECOG) score, Ann Arbor clinical stage, international prognostic index (IPI) score, risk stratification, B symptom, β2?microglobulin(β2?MG) level, size of the tumor and cycles of chemotherapy were prognostic factors for OS (all P＜0.05), and Ann Arbor clinical stage, IPI score, risk stratification and B symptom were prognostic factors for PFS (all P＜0.05). Multivariate analysis indicated that Ann Arbor clinical stage was independent prognostic factor for OS(P＝0.029) and B symptom was independent prognostic factor for PFS(P＝0.028). Conclusions Prognosis of PB?DLBCL was relatively good. Ann Arbor clinical stage and B symptom were independent prognostic factors for OS and PFS, respectively.