Objective : To analyze the expression and immune infiltration levels of the BMP7 gene ( BMP7) in e- sophageal squamous cell carcinoma(ESCC) ． Methods : Initially，in 274 cases of ESCC and 242 cases of normal tissues，the level of BMP7 was verified by immunohistochemistry ，and the relationship between the expression difference and the survival cycle and clinical pathological characteristics of patients with ESCC was explored，and BMP7 overexpression plasmid transfection of ESCC cells was established，and the effect of BMP7 on the biological behavior of ESCC cells was examined by CCK-8，Clone，and Transwell. Results : BMP7 expression in normal e- sophageal tissues was higher than that of ESCC(P＜0. 001) ，the expression level of BMP7 was correlated with the degree of differentiation of patients(P = 0. 006) and TNM staging(P ＜0. 001) ，and the survival of patients with high expression of BMP7 exceeded that of patients with low BMP7 (P = 0. 041) ，and the experiments of CCK-8 and Clone showed that the proliferation effect of cells in the overexpressed BMP7 group was lower than that of the control group．Transwell experiments confirmed that the cell invasion migration capacity of the overexpressed BMP7 group was less than that of the control one．The immune infiltration results showed that BMP7 was positively correlated with macrophages(P = 0. 008) and negatively correlated with γ-δT cells(P = 0. 028) ． Conclusion BMP7 is low in ESCC and associated with poor prognosis and immune infiltration levels in patients.

Objective:To explore the influences of different lying positions on vital signs and comforts in patients with tracheal intubation removed after intestinal fistula surgery.Methods:From October 2018 to June 2019, convenience sampling was used to select 150 patients with intestinal fistula surgery after general anesthesia in Intensive Care Unit of the General Hospital of Eastern Theater Command were selected as the research object. After waiting for the patient to wake up from anesthesia, the tracheal intubation was removed, and the lying position was changed after normal spontaneous breathing through the nose. Patients were randomly divided into 5 groups, 30 cases in each group. Group A was in the supine position; group B was in the lying position with the head of the bed raised by 15°; group C was in the lying position with the head of the bed raised by 30°; group D was in the lying position with the head of the bed raised by 45°; group E was in the lying position with the head of the bed raised by 15° to 45 °. At the beginning, the head of the bed was shaken to 15 °; and after two hours, the head of the bed was shaken to 30 °, and after another two hours, the head of the bed was shaken to 45 °. After 5 groups of patients fixed the angle of the lying position, when the patient complained of discomfort or the body position changed spontaneously, the patient changed the lying position. The duration of the lying position, uncomfortable symptoms and pain degree of abdominal incision were compared among 5 groups.Results:Patients with tracheal intubation removed after intestinal fistula surgery had a longer persistence in the 15° and 30° lying positions within 6 hours, respectively (72.27±12.41) min and (69.37±9.10) min. There were statistically significant differences in the persistence time of 5 different lying positions ( P<0.01) . The number of patients in group B and C with waist pain was less, and there were more patients with painless incisions, and there were statistically significant differences among 5 groups ( P<0.05) . Conclusions:Among patients with tracheal intubation removed and normal spontaneous breathing through the nose after intestinal fistula surgery, the 15° to 30° lying position within 6 hours after the operation can prolong the patient's adherence to the lying position, reduce the incidence of abdominal incision pain and waist pain, and reduce the probability of dizziness, nausea and vomiting.

OBJECTIVETo explore the efficacy of over-the-scope clip (OTSC) in the treatment of gastrointestinal fistula.

METHODSClinical data of 12 gastrointestinal fistula patients, including 3 internal fistula and 9 external fistula treated with OTSC in our institute from March 2015 to May 2016 were retrospectively analyzed. OTSC was performed when pus was drained thoroughly and intra-abdominal infection around gastrointestinal fistula was controlled, and each patient received one clip to close fistula.

RESULTSThere were 6 female and 6 male patients with mean age of (50.1±12.6) years. The successful rate of endoscopic closure was 100% without complications including bleeding and intestinal obstruction during and after OTSC treatment. According to comprehensive evaluation, including drainage without digestive juices, no recurrence of intra-abdominal infection, no overflow of contrast medium during digestive tract radiography, and CT examination without intra-abdominal abscess, clinical gastrointestinal fistula closure was 91.7%(11/12). There was no recurrence of gastrointestinal fistula during 3 months of follow-up in 11 patients. In the remaining 1 case, the gastric fistula after laparoscopic sleeve gastrectomy recurred one week after OTSC treatment because of intra-abdominal infection surrounding fistula, and was cured by surgery finally.

CONCLUSIONThe endoscopic closure treatment of OTSC for gastrointestinal fistula is successful and effective, and control of intra-abdominal infection around fistula with adequate drainage is the key point.

Adult ; Digestive System Fistula ; complications ; drug therapy ; surgery ; Drainage ; Endoscopy, Gastrointestinal ; instrumentation ; methods ; Female ; Humans ; Intraabdominal Infections ; etiology ; therapy ; Male ; Middle Aged ; Recurrence ; Retrospective Studies ; Suppuration ; therapy ; Surgical Fixation Devices

OBJECTIVETo investigate the risk factors of surgical site infection (SSI) in definitive surgery of intestinal fistulas.

METHODSPatients with gastrointestinal fistula undergoing definitive operation during November 2011 to November 2013 in Jinling Hospital were prospectively enrolled in the study. Risk factors of SSI were analyzed. Patients' characteristics, surgery-related data and fistula-related data were prospectively collected. Risk factors of SSI were analyzed.

RESULTSA total of 191 cases were enrolled and 51 cases developed SSI. Univariate analysis showed that patients with risk index category (RIC)≥2, length of abdominal incisions>15 cm, and duration of drainage tubes>10 days had significantly higher incidence of SSI (P<0.05). Multivariate Logistics analysis demonstrated that RIC and duration of drainage tube were independent risk factors for SSI (P=0.02, P=0.01, respectively).

CONCLUSIONSRIC≥2 and duration of drainage tubes>10 days are independent risk factors for development of SSI.

Humans ; Incidence ; Intestinal Fistula ; Multivariate Analysis ; Risk Factors ; Surgical Wound Infection

Objective To investigate the risk factors of surgical site infection (SSI) in definitive surgery of intestinal fistulas. Methods Patients with gastrointestinal fistula undergoing definitive operation during November 2011 to November 2013 in Jinling Hospital were prospectively enrolled in the study. Risk factors of SSI were analyzed. Patients'characteristics, surgery-related data and fistula-related data were prospectively collected. Risk factors of SSI were analyzed. Results A total of 191 cases were enrolled and 51 cases developed SSI. Univariate analysis showed that patients with risk index category (RIC)≥2, length of abdominal incisions > 15 cm, and duration of drainage tubes > 10 days had significantly higher incidence of SSI(P<0.05). Multivariate Logistics analysis demonstrated that RIC and duration of drainage tube were independent risk factors for SSI (P=0.02, P=0.01, respectively). Conclusions RIC≥2 and duration of drainage tubes > 10 days are independent risk factors for development of SSI.

Objective To investigate the risk factors of surgical site infection (SSI) in definitive surgery of intestinal fistulas. Methods Patients with gastrointestinal fistula undergoing definitive operation during November 2011 to November 2013 in Jinling Hospital were prospectively enrolled in the study. Risk factors of SSI were analyzed. Patients'characteristics, surgery-related data and fistula-related data were prospectively collected. Risk factors of SSI were analyzed. Results A total of 191 cases were enrolled and 51 cases developed SSI. Univariate analysis showed that patients with risk index category (RIC)≥2, length of abdominal incisions > 15 cm, and duration of drainage tubes > 10 days had significantly higher incidence of SSI(P<0.05). Multivariate Logistics analysis demonstrated that RIC and duration of drainage tube were independent risk factors for SSI (P=0.02, P=0.01, respectively). Conclusions RIC≥2 and duration of drainage tubes > 10 days are independent risk factors for development of SSI.

Stem cell niche is a specialized microenvironment crucial to self-renewal. The testis in Drosophila contains two different types of stem cells, the germline stem cells and the somatic cyst stem cells that are sustained by their respective niche signals, thus is a good system for studying the interaction between the stem cells and their hosting niche. The JAK-STAT and BMP pathways are known to play critical roles in the self-renewal of different kinds of stem cells, but the roles of several other pathways have emerged recently in a complex signaling network in the testis niche. Reports of independent observations from three research groups have uncovered an important role of Hedgehog (Hh) in the Drosophila testis niche. In this review, we summarize these recent findings and discuss the interplay between the Hh signaling mechanisms and those of the JAK-STAT and BMP pathways. We also discuss directions for further investigation.
Adult Germline Stem Cells ; metabolism ; Animals ; Bone Morphogenetic Proteins ; metabolism ; Drosophila ; cytology ; metabolism ; Drosophila Proteins ; metabolism ; Female ; Hedgehog Proteins ; metabolism ; Janus Kinases ; metabolism ; Male ; Ovary ; metabolism ; STAT Transcription Factors ; metabolism ; Signal Transduction ; Stem Cell Niche ; Testis ; cytology ; metabolism ; Transcription Factors ; metabolism

Objective To discuss the frequency of ventilator pipe replacement in ICU ward for reducing the frequency of VAP occurrence caused by bacterial colonization in ventilator-line. Methods 30 patients hospitalized to ICU ward from Janurary,2008 to June, 2009 who had mechanical-ventilation above 48h were randomly divided into group A, B and C with 30 patients in each group, then bacteria culture and strain analysis were employed for the pipeline sample of ventilator inspiratory side at the time point to be use and used mechanical ventilation for 1 day, 3 days and 7 days. Results There was no bacteria grew after ventilator-line sterilization, and positive ratio of bacterial culture in 1d, 3d and 7d were 46.66%,53.33% and 100.00%, respectively. Conclusions The frequency of ventilator pipe replacement should be shortened in patients with abdominal infection, to replace every 3 days is suitable in ICU where infectious patients gathered.

Thymosin ?1 is a multiple peptide of hormone and protein isolated from thymus gland,and it has many biological functions.It has been reported that it plays an important role in immune response,neuroendocrine modulation and gene expression.The article is to review the progress of thymosin ?1 and its mechanisms.

The etiology of Crohn's disease is not clear as yet,many evidences has shown that the dysfunction of the immune system is the internal cause of inflammation and tissue damage.It is identified that many immune diseases can be anticipated,monitored and therapeutic through detecting some specified serological markers.To identify some high specific sensitive and predictable markers and groups,the research of searching an ideal and non-incursive method for differentiating inflammatory bowel diseases from other disease is still undergoing.The current research of five serum immune markers that are usefulness in the diagnosis and management of Crohn's disease are summarized.