Risk factors and prediction model for inpatient surgical site infection after elective abdominal surgery

BACKGROUND Surgical site infections(SSIs) are the commonest healthcare-associated infection. In addition to increasing mortality, it also lengthens the hospital stay and raises healthcare expenses. SSIs are challenging to predict, with most models having poor predictability. Therefore, we developed a prediction model for SSI after elective abdominal surgery by identifying risk factors.AIM To analyse the data on inpatients undergoing elective abdominal surgery to identify risk factors and develop predictive models that will help clinicians assess patients preoperatively.METHODS We retrospectively analysed the inpatient records of Shaanxi Provincial People’s Hospital from January 1, 2018 to January 1, 2021. We included the demographic data of the patients and their haematological test results in our analysis. The attending physicians provided the Nutritional Risk Screening 2002(NRS 2002)scores. The surgeons and anaesthesiologists manually calculated the National Nosocomial Infections Surveillance(NNIS) scores. Inpatient SSI risk factors were evaluated using univariate analysis and multivariate logistic regression. Nomograms were used in the predictive models. The receiver operating characteristic and area under the curve values were used to measure the specificity and accuracy of the model.RESULTS A total of 3018 patients met the inclusion criteria. The surgical sites included the uterus(42.2%), the liver(27.6%), the gastrointestinal tract(19.1%), the appendix(5.9%), the kidney(3.7%), and the groin area(1.4%). SSI occurred in 5% of the patients(n = 150). The risk factors associated with SSI were as follows: Age;gender;marital status;place of residence;history of diabetes;surgical season;surgical site;NRS 2002 score;preoperative white blood cell, procalcitonin(PCT), albumin, and low-density lipoprotein cholesterol(LDL) levels;preoperative antibiotic use;anaesthesia method;incision grade;NNIS score;intraoperative blood loss;intraoperative drainage tube placement;surgical operation items. Multivariate logistic regression revealed the following independent risk factors: A history of diabetes [odds ratio(OR) = 5.698, 95% confidence interval(CI): 3.305-9.825, P = 0.001], antibiotic use(OR = 14.977, 95%CI: 2.865-78.299, P = 0.001), an NRS 2002 score of ≥ 3(OR = 2.426, 95%CI: 1.199-4.909, P = 0.014), general anaesthesia(OR = 3.334, 95%CI: 1.134-9.806, P = 0.029), an NNIS score of ≥ 2(OR = 2.362, 95%CI: 1.019-5.476, P = 0.045), PCT ≥ 0.05 μg/L(OR = 1.687, 95%CI: 1.056-2.695, P = 0.029), LDL < 3.37 mmol/L(OR = 1.719, 95%CI: 1.039-2.842, P = 0.035), intraoperative blood loss ≥ 200 mL(OR = 29.026, 95%CI: 13.751-61.266, P < 0.001), surgical season(P < 0.05), surgical site(P < 0.05), and incision grade I or Ⅲ(P < 0.05). The overall area under the receiver operating characteristic curve of the predictive model was 0.926, which is significantly higher than the NNIS score(0.662).CONCLUSION The patient’s condition and haematological test indicators form the bases of our prediction model. It is a novel, efficient, and highly accurate predictive model for preventing postoperative SSI, thereby improving the prognosis in patients undergoing abdominal surgery.

Application of Pelvic Peritoneum Closure Combined with Extraperitoneal Colostomy in Laparoscopic Surgery for Low Rectal Cancer

Background:In the treatment of colorectal cancer,laparoscopic surgery has seen a significant amount of success.Reducing the risk of postoperative complications and improving patients’quality of life can be accomplished by appropriately employing pelvic peritoneal repair and sigmoid colostomy when appropriate.Objective:To compare fusion closure of pelvic peritoneum combined with extraperitoneal colostomy with non-closure of pelvic peritoneum combined with intraperitoneal colostomy in patients with low rectal cancer who had permanent colostomy.Methods:Low rectal cancer patients admitted to Hengshui People’s Hospital for permanent colostomy were evaluated.The participants were divided into two groups:an observation and a control group.All 30 cases in the observation group underwent pelvic peritoneum closure and extraperitoneal colostomy,while the other 30 cases in the control group underwent intraperitoneal colostomy.The C-reactive protein(CRP)levels of the participants in both groups were evaluated for 6 months to 2 years(24 h before,24 h after,48 h after,96 h after surgery).Results:Comparing the colostomy operative time,time to first passage of flatus postoperatively,time to first defecation postoperatively,length of hospital stay,laboratory indicators,stoma-related complications,colostomy function,etc.,the colostomy operative time significantly differed between the two groups(P<0.05);the observation group did considerably better than the control group in terms of stoma-related complications and bowel movement control 6 months after surgery(P<0.05);and although serum CRP levels increased in both groups 48 h after surgery,the difference was significant(P<0.05).Conclusion:Extraperitoneal colostomy can improve the quality of life of patients with permanent stoma and reduce the occurrence of stoma-related complications.Thus,this technique is worthy of promotion in clinical practice.

Retrospective Analysis of the Effect of Auricular Acupuncture on Pain and Gastrointestinal Motility Recovery After Laparoscopic Surgery for Colorectal Cancer

Objective:To investigate the effect of auricular acupuncture on postoperative pain and gastrointestinal motility recovery after laparoscopic surgery for colorectal cancer.Methods:The clinical data of patients who underwent laparoscopic radical surgery for colorectal cancer in our hospital from April 2020 to December 2021 were collected.Based on the inclusion and exclusion criteria,76 patients were included in the retrospective analysis.Depending on whether they received auricular acupuncture or not,the patients were divided into two groups:46 patients in the experimental group(auricular acupuncture)and 30 patients in the control group.The differences between the two groups were analyzed.Results:The time to first flatus of the experimental group was significantly shorter than that of the control group(52.2±7.36 h versus 66.3±7.83 h;P<0.001).Similarly,the time to first defecation of the experimental group was significantly shorter than that of the control group(76.3±7.76 h versus 86.1±10.79 h;P<0.001).The time to first fluid intake of the auricular group was significantly shorter than that of the control group(90.4±8.92 h versus 107.3±9.66 h,P<0.001).Compared with the control group,the experimental group scored significantly lower on the visual analogue scale on postoperative days 2 and 3(P<0.001).Conclusion:Auricular acupuncture is an effective traditional Chinese medicine external treatment method.It can promote gastrointestinal motility recovery in patients after laparoscopic radical surgery for colorectal cancer and also reduce postoperative pain and discomfort.Furthermore,this therapy is easy to operate and well-accepted by patients.Therefore,it should be strongly promoted in clinical practice.

Establishment and validation of a predictive model for peripherally inserted central catheter-related thrombosis in patients with liver cancer

BACKGROUND Peripherally inserted central catheters(PICCs)are commonly used in hospitalized patients with liver cancer for the administration of chemotherapy,nutrition,and other medications.However,PICC-related thrombosis is a serious complication that can lead to morbidity and mortality in this patient population.Several risk factors have been identified for the development of PICC-related thrombosis,including cancer type,stage,comorbidities,and catheter characteristics.Understanding these risk factors and developing a predictive model can help healthcare providers identify high-risk patients and implement preventive measures to reduce the incidence of thrombosis.AIM To analyze the influencing factors of PICC-related thrombosis in hospitalized patients with liver cancer,construct a predictive model,and validate it.METHODS Clinical data of hospitalized patients with liver cancer admitted from January 2020 to December 2023 were collected.Thirty-five cases of PICC-related thrombosis in hospitalized patients with liver cancer were collected,and 220 patients who underwent PICC placement during the same period but did not develop PICC-related thrombosis were randomly selected as controls.A total of 255 samples were collected and used as the training set,and 77 cases were collected as the validation set in a 7:3 ratio.General patient information,case data,catheterization data,coagulation indicators,and Autar Thrombosis Risk Assessment Scale scores were analyzed.Univariate and multivariate unconditional logistic regression analyses were performed on relevant factors,and the value of combined indicators in predicting PICC-related thrombosis in hospitalized patients with liver cancer was evaluated using receiver operating characteristic(ROC)curve analysis.RESULTS Univariate analysis showed statistically significant differences(P<0.05)in age,sex,Karnofsky performance status score(KPS),bedridden time,activities of daily living impairment,parenteral nutrition,catheter duration,distant metastasis,and bone marrow suppression between the thrombosis group and the non-thrombosis group.Other aspects had no statistically significant differences(P>0.05).Multivariate regression analysis showed that age≥60 years,KPS score≤50 points,parenteral nutrition,stage III to IV,distant metastasis,bone marrow suppression,and activities of daily living impairment were independent risk factors for PICC-related thrombosis in hospitalized patients with liver cancer(P<0.05).Catheter duration of 1-6 months and catheter duration>6 months were protective factors for PICC-related thrombosis(P<0.05).The predictive model for PICC-related thrombosis was obtained as follows:P predictive probability=[exp(Logit P)]/[1+exp(Logit P)],where Logit P=age×1.907+KPS score×2.045+parenteral nutrition×9.467+catheter duration×0.506+tumor-node-metastasis(TNM)staging×2.844+distant metastasis×2.065+bone marrow suppression×2.082+activities of daily living impairment×13.926.ROC curve analysis showed an area under the curve(AUC)of 0.827(95%CI:0.724-0.929,P<0.001),with a corresponding optimal cut-off value of 0.612,sensitivity of 0.755,and specificity of 0.857.Calibration curve analysis showed good consistency between the predicted occurrence of PICC-related thrombosis and actual occurrence(P>0.05).ROC analysis showed AUCs of 0.888 and 0.729 for the training and validation sets,respectively.CONCLUSION Age,KPS score,parenteral nutrition,TNM staging,distant metastasis,bone marrow suppression,and activities of daily living impairment are independent risk factors for PICC-related thrombosis in hospitalized patients with liver cancer,while catheter duration is a protective factor for the disease.The predictive model has an AUC of 0.827,indicating high predictive accuracy and clinical value.

Predicting prolonged postoperative ileus in gastric cancer patients based on bowel sounds using intelligent auscultation and machine learning

BACKGROUND Prolonged postoperative ileus(PPOI)delays the postoperative recovery of gastrointestinal function in patients with gastric cancer(GC),leading to longer hospitalization and higher healthcare expenditure.However,effective monitoring of gastrointestinal recovery in patients with GC remains challenging because of AIM To explore the risk factors for delayed postoperative bowel function recovery and evaluate bowel sound indicators collected via an intelligent auscultation system to guide clinical practice.METHODS This study included data from 120 patients diagnosed with GC who had undergone surgical treatment and postoperative bowel sound monitoring in the Department of General Surgery II at Shaanxi Provincial People's Hospital between January 2019 and January 2021.Among them,PPOI was reported in 33 cases.The patients were randomly divided into the training and validation cohorts.Significant variables from the training cohort were identified using univariate and multivariable analyses and were included in the model.RESULTS The analysis identified six potential variables associated with PPOI among the included participants.The incidence rate of PPOI was 27.5%.Age≥70 years,cTNM stage(Ⅰ and Ⅳ),preoperative hypoproteinemia,recovery time of bowel sounds(RTBS),number of bowel sounds(NBS),and frequency of bowel sounds(FBS)were independent risk factors for PPOI.The Bayesian model demonstrated good performance with internal validation:Training cohort[area under the curve(AUC)=0.880,accuracy=0.823,Brier score=0.139]and validation cohort(AUC=0.747,accuracy=0.690,Brier score=0.215).The model showed a good fit and calibration in the decision curve analysis,indicating a significant net benefit.CONCLUSION PPOI is a common complication following gastrectomy in patients with GC and is associated with age,cTNM stage,preoperative hypoproteinemia,and specific bowel sound-related indices(RTBS,NBS,and FBS).To facilitate early intervention and improve patient outcomes,clinicians should consider these factors,optimize preoperative nutritional status,and implement routine postoperative bowel sound monitoring.This study introduces an accessible machine learning model for predicting PPOI in patients with GC.

Present situation of minimally invasive surgical treatment for early gastric cancer

Minimally invasive surgery is a kind of surgical operation,which is performed by using professional surgical instruments and equipment to inactivate,resect,repair or reconstruct the pathological changes,deformities and wounds in human body through micro-trauma or micro-approach,in order to achieve the goal of treatment,its surgical effect is equivalent to the traditional open surgery,while avoiding the morbidity of conventional surgical wounds.In addition,it also has the advantages of less trauma,less blood loss during operation,less psychological burden and quick recovery on patients,and these minimally invasive techniques provide unique value for the examination and treatment of gastric cancer patients.Surgical minimally invasive surgical techniques have developed rapidly and offer numerous options for the treatment of early gastric cancer(EGC):endoscopic mucosal resection(EMR),underwater EMR(UEMR),endoscopic submucosal dissection(ESD),endoscopic full-thickness resection(EFTR),endoscopic submu-cosal excavation(ESE),submucosal tunnel endoscopic resection,laparoscopic and endoscopic cooperative surgery(LECS);Among them,EMR,EFTR and LECS technologies have a wide range of applications and different modific-ations have been derived from their respective surgical operations,such as band-assisted EMR(BA-EMR),conven-tional EMR(CEMR),over-the-scope clip-assisted EFTR,no-touch EFTR,the inverted LECS,closed LECS,and so on.These new and improved minimally invasive surgeries are more precise,specific and effective in treating different types of EGC.

Application of stapling devices in liver surgery: Current status and future prospects

The liver is a vascular-rich solid organ. Safe and effective dissection of the vessels and liver parenchyma, and control of intraoperative bleeding are the main concerns when performing liver resection. Several studies have confirmed that intraoperative blood loss and postoperative transfusion are predictors of postoperative morbidity and mortality in liver surgery. Various methods and instruments have been developed during hepatectomy. Stapling devices are crucial for safe and rapid anastomosis. They are used to divide hepatic veins and portal branches, and to transect liver parenchyma in open liver resection. In recent years, laparoscopic liver surgery has developed rapidly, and is now preferred by many surgeons. Stapling devices have also been gradually introduced in laparoscopic liver surgery, from dividing vascular and biliary structures to parenchymal transection. This may be because staplers make manipulation more simple, rapid and safe. Even in single incision laparoscopic surgery, which is recognized as a new minimally invasive technique, staplers are also utilized, especially in left lateral hepatectomy. For safe application of stapling devices in liver surgery, more related designs and modifications, such as application of a suitable laparoscopic articulating liver tissue crushing device, a staple line reinforcement technique with the absorbable polymer membrane or radiofrequency ablation assistance, are still needed. More randomized studies are needed to demonstrate the benefits and find broader indications for the use of stapling devices, to help expand their application in liver surgery.

Solitary thyroid gland metastasis from rectal cancer:A case report and review of the literature

BACKGROUND Metastatic carcinoma of the thyroid gland is a rare encounter in clinical practice, but autopsy series showed that it is not so rare. Thyroid metastasis from colorectal cancer(CRC) is rare and has a poor prognosis. We herein report a rare case of solitary thyroid metastasis from rectal cancer combined with needle tract implantation after fine-needle aspiration(FNA) of the thyroid nodule and review the relevant literature.CASE SUMMARY A 54-year-old woman with a history of TNM stage Ⅲ CRC presented a 1.3 cm × 1.0 cm mass in the left thyroid gland. FNA and histological examination of the left thyroid lobe surgical specimen confirmed the diagnosis of isolated metastatic adenocarcinoma from the rectum. Needle tract implantation was observed in the neck 11 mo after the FNA examination. The 2.5-cm seeding lesion was successfully removed by surgery, and the patient recovered well. The literature relevant to this clinical condition, the diagnostic workup, spread pathway, and surgical management of these rare lesions is reviewed.CONCLUSION For a patient with a thyroid mass and a history of CRC, metastatic thyroid carcinoma should be considered even if the patient has no evidence of other organ metastasis from CRC. FNA cytological examination of the thyroid mass is useful in the differential diagnosis between primary thyroid disease and metastatic thyroid carcinoma. Thyroid lobectomy of the gland containing the metastatic tumor is suggested in patients with metastatic carcinoma of the thyroid.

Compatibility mechanism of Chinese medicine formula:state of the art and perspectives

Traditional Chinese medicine(TCM)has been practiced in China and surrounding countries for thousands of years and has gradually attracted the attention of Western countries.After reasonable compatibility,TCMs could play the key role of enhancing efficacy and reducing toxicity,which has significant therapeutic advantages in the treatment of complex diseases in clinical practice.While the TCM compatibility is not the simple addition of drugs.Under the appropriate dosage ratio,multiple TCMs can play a synergistic role to realize the overall regulation of TCM treatment.Therefore,it is of critical essential to study the compatibility of TCM formula to promote TCM modernization,new drug development and clinical application.Recently,under the guidance of TCM theory,many researches on the composition,pharmacodynamic activity and pharmacokinetic properties of TCM formula have emerged by integrating new technologies and new methods,revealing the scientific connotation of the compatibility of TCM formula from different perspectives and levels.This paper introduces the research progress of compatibility rules from different levels of compatibility,compatibility for synergistic enhancement and detoxification,and application of cutting-edge technology,with representative cases,in order to provide ideas and references for further study on TCM compatibility.

Partial splenectomy using a laparoscopic bipolar radiofrequency device:A case report

We report a 51-year-old female patient with a solitary lymphangioma located in the upper splenic pole which was managed successfully with laparoscopic partial splenectomy.Surgery lasted 170 min and did not require blood transfusions.The patient recovered well post-operatively and was asymptomatic at the 3-mo follow-up.She had a normal platelet count and no recurrence on ultrasonography or computed tomography.Laparoscopic partial splenectomy is a safe,minimally invasive technique for the treatment of solitary splenic lymphangiomas in the splenic pole.We performed the procedure using the HabibTM 4X device.This laparoscopic bipolar radiofrequency device ensured a "bloodless" splenic parenchymal resection.

Radiofrequency ablation for incidentally identified primary intrahepatic cholangiocarcinoma

Cholangiocarcinoma is the second most common primary hepato-biliary malignancy. The majority of patients with primary hepatic tumors are not suitable candidates for resection, due to advanced stage of the disease at presentation, anatomic limitations and medical comorbidities. At present, radiofrequency ablation (RFA) may offer an alternative, feasible and safe therapy for selected patients with hepatic tumors, who are not otherwise candidates for hepatic resection. Herein, we present the case of successful RFA in a patient with a solitary, primary intrahepatic cholangiocarcinoma. The patient remained free of disease 24 mo after the procedure, and is still followed up. This is the first report of RFA application inthe treatment of primary intrahepatic cholangiocarcinoma.

Repair of bile duct defect with degradable stent and autologous tissue in a porcine model

AIM： To introduce and evaluate a new method to re- pair bile duct defect with a degradable stent and au- tologous tissues. METHODS： Eight Ba-Ma mini-pigs were used in this study, Experimental models with common bile duct （CBD） defect （0,5-1,0 cm segment of CBD resected） were established and then CBD was reconstructed by duct to duct anastomosis with a novel degradable stent made of poly [sebacic acid-co-（1,3-propanediol）-co- （1,2-propanediol）]. In addition, a vascularized greater omentum was placed around the stent and both ends of CBD. Cholangiography via gall bladder was per- formed for each pig at postoperative months 1 and 3 to rule out stent translocation and bile duct stricture. Complete blood count was examined pre- and post- operatively to estimate the inflammatory reaction. Liver enzymes and serum bilirubin were examined pre- and post-operatively to evaluate the liver function. Five pigs were sacrificed at month 3 to evaluate the healing of anastomosis. The other three pigs were raised for one year for long-term observation. RESULTS： All the animals underwent surgery success- fully. There was no intraoperative mortality and no bile leakage during the observation period, The white blood cell counts were only slightly increased on day 14 and month 3 postoperatively compared with that before operation, the difference was not statistically significant （P = 0.652）. The plasma level of alanine aminotrans- ferase on day 14 and month 3 postoperatively was also not significantly elevated compared with that before operation （P = 0.810）. Nevertheless, the plasma level of y-glutamyl transferase was increased after opera- tion in both groups （P = 0.004）, especially 2 wk after operation. The level of serum total bilirubin after opera- tion was not significantly elevated compared with that before operation （P = 0.227）, so did the serum direct bilirubin （P = 0.759）. By cholangiography yia gall blad- der, we found that the stent maintained its integrity of shape and was stillin situ at month 1, and it disap- peared completely at month 3. No severe CBD dilation and stricture were observed at both months 1 and 3. No pig died during the 3-too postoperative observation period. No sign of necrosis, bile duct stricture, bile leak- age or abdominal abscess was found at reoperation at month 3 postoperatively. Pigs had neither fragments of stent nor stones formed in the CBD. Collagen deposit was observed in the anastomosis by hematoxylin and eosin （HE） and Masson＇s trichrome stains. No severe cholestasis was observed in liver parenchyma by HE staining. Intestinal obstruction was found in a pig 4 mo after operation, and no bile leakage, bile duct stricture or biliary obstruction were observed in laparotomy. No sign of bile duct stricture or bile leakage was observed in the other two pigs. CONCLUSION： The novel method for repairing bile duct defect yielded a good short-term effect without postoperative bile duct stricture. However, the long- term effect should be further studied.

Role of detection of microsatellite instability in Chinese with hereditary nonpolyposis colorectal cancer or ordinary hereditary colorectal cancer

AIM： To detect microsatellite instability （MSI） in patients with hereditary nonpolyposis colorectal cancer or ordinary hereditary colorectal cancer and to provide criteria for screening the kindreds with hereditary nonpolyposis colorectal cancer at molecular level.METHODS： MSI was detected in the specimens from 20 cases with HNPCC, 20 cases with ordinary hereditary colorectal cancer and 20 cases with sporadic colorectal cancer by means of polymerase chain reaction-single strand conformation polymorphism. RESULTS： The positive rate of MSI was 85% （17/20） in HNPCC group, 40% （8/20） in ordinary hereditary colorectal cancer group and 10% （2/20） in the sporadic colorectal cancer group respectively. The differences were significant. The mean ages of the three groups were 43.6, 52.2, and 61.8 years respectively, which increased gradually. The incidence of right hemicolon cancer was 64.7%, 37.5%, and 0% respectively, which decreased gradually and had significant difference. The expression ratio of BAT26 and BAT25 was 94.1% respectively, which was highest in the 5 gene sites studied. The incidence of poorly differentiated adenocarcinoma was 70.6% in HNPCC group among high frequency microsatellite instability （MSI-H）, which was higher than the other two groups, which had 50% and 50% respectively. CONCLUSION： The incidence of MSI-H is higher in HNPCC group. The detection of MSI is simple and economical and has high correlation with the clinicopathologic feature of HNPCC and can be used as a screening method to detect the germ line mutation of the mismatch repair gene.

Donor safety in adult living donor liver transplantation using the right lobe: Single center experience in China

AIM: To evaluate the safety of donors in adult living donor liver transplantation (LDLT) using the right lobe in a single liver transplantation center in China. METHODS: We investigated retrospectively 52 living donor liver resections performed from October 2003 to July 2006. All patients were evaluated by blood tests and abdominal CT. The mean donor age was 28.2 ± 7.4 years. Residual liver volume was 42.1% ± 4.7%. Mean operative time was 420 ± 76.2 min; mean ICU stay, less than 36 h; mean hospital stay, 16.4 ± 8.6 d; and mean follow-up period, 6 mo. RESULTS: There was no mortality. The overall complication rate was 40% (21 donors). Major complications included biliary leak in two, and pneumonia in 2 donors. Minor complications included mild pleural effusion in 12 donors, transient ascites in 6, mild depression in 4, intra-abdominal collections in 2, and wound infections in 1 donor. Residual liver volume did not affect the complication rate. None required re- operation. Return to pre-donation activity occurred within 5-8 wk. CONCLUSION: Right hemi-hepatectomy can be performed safely with minimal risk in cases of careful donor selection. Major complications occurred in only 7.7% of our series.

Neuroprotective effects of long noncoding RNAs involved in ischemic postconditioning after ischemic stroke

During acute reperfusion,the expression profiles of long noncoding RNAs in adult rats with focal cerebral ischemia undergo broad changes.However,whether long noncoding RNAs are involved in neuroprotective effects following focal ischemic stroke in rats remains unclear.In this study,RNA isolation and library preparation was performed for long noncoding RNA sequencing,followed by determining the coding potential of identified long noncoding RNAs and target gene prediction.Differential expression analysis,long noncoding RNA functional enrichment analysis,and co-expression network analysis were performed comparing ischemic rats with and without ischemic postconditioning rats.Rats were subjected to ischemic postconditioning via the brief and repeated occlusion of the middle cerebral artery or femoral artery.Quantitative real-time reverse transcription-polymerase chain reaction was used to detect the expression levels of differentially expressed long noncoding RNAs after ischemic postconditioning in a rat model of ischemic stroke.The results showed that ischemic postconditioning greatly affected the expression profile of long noncoding RNAs and mRNAs in the brains of rats that underwent ischemic stroke.The predicted target genes of some of the identified long noncoding RNAs(cis targets)were related to the cellular response to ischemia and stress,cytokine signal transduction,inflammation,and apoptosis signal transduction pathways.In addition,15 significantly differentially expressed long noncoding RNAs were identified in the brains of rats subjected to ischemic postconditioning.Nine candidate long noncoding RNAs that may be related to ischemic postconditioning were identified by a long noncoding RNA expression profile and long noncoding RNA-mRNA co-expression network analysis.Expression levels were verified by quantitative real-time reverse transcription-polymerase chain reaction.These results suggested that the identified long noncoding RNAs may be involved in the neuroprotective effects associated with ischemic postconditioning following ischemic stroke.The experimental animal procedures were approved by the Animal Experiment Ethics Committee of Kunming Medical University(approval No.KMMU2018018)in January 2018.

Plasma microRNAs as potential new biomarkers for early detection of early gastric cancer

BACKGROUND Early gastric cancer(EGC), compared with advanced gastric cancer(AGC), has a higher 5-year survival rate. However, due to the lack of typical symptoms and the difficulty in diagnosing EGC, no effective biomarkers exist for the detection of EGC, and gastroscopy is the only detection method.AIM To provide new biomarkers with high specificity and sensitivity through analyzed the differentially expressed microRNAs(miRNAs) in EGC and AGC and compared them with those in benign gastritis(BG).METHODSWe examined the differentially expressed miRNAs in the plasma of 30 patients with EGC, AGC, and BG by miRNA chip analysis. Then, we analyzed and selected the significantly different miRNAs using bioinformatics. Reverse transcription quantitative real-time polymerase chain reaction(RT-qPCR)confirmed the relative transcription level of these miRNAs in another 122 patients, including patients with EGC, AGC, Helicobacter pylori(H. pylori)-negative gastritis(Control-1), and H. pylori-positive atrophic gastritis(Control-2).To establish a diagnostic model for the detection of plasma miRNA in EGC, we chose miRNAs that can be used to determine EGC and AGC from Control-1 and Control-2 and miRNAs in EGC from all other groups.RESULTS Among the expression profiles of the miRNA chips in the three groups in the discovery set, of 117 aberrantly expressed miRNAs, 30 confirmed target prediction, whereas 14 were included as potential miRNAs. The RT-qPCR results showed that 14 potential miRNAs expression profiles in the two groups exhibited no differences in terms of H. pylori-negative gastritis(Control-1) and H. pyloripositive atrophic gastritis(Control-2). Hence, these two groups were incorporated into the Control group. A combination of four types of miRNAs,miR-7641, miR-425-5 p, miR-1180-3 p and miR-122-5 p, were used to effectively distinguish the Cancer group(EGC + AGC) from the Control group [area under the curve(AUC) = 0.799, 95% confidence interval(CI): 0.691-0.908, P < 0.001].Additionally, miR-425-5 p, miR-24-3 p, miR-1180-3 p and miR-122-5 p were utilized to distinguish EGC from the Control group(AUC = 0.829, 95%CI: 0.657-1.000, P =0.001). Moreover, the miR-24-3 p expression level in EGC was lower than that in the AGC(AUC = 0.782, 95%CI: 0.571-0.993, P = 0.029), and the miR-4632-5 p expression level in EGC was significantly higher than that in AGC(AUC = 0.791,95%CI: 0.574-1.000, P = 0.024).CONCLUSION The differentially expressed circulatory plasma miR-425-5 p, miR-1180-3 p, miR-122-5 p, miR-24-3 p and miR-4632-5 p can be regarded as a new potential biomarker panel for the diagnosis of EGC. The prediction and early diagnosis of EGC can be considerably facilitated by combining gastroscopy with the use of these miRNA biomarkers, thereby optimizing the strategy for effective detection of EGC. Nevertheless, larger-scale human experiments are still required to confirm our findings.

Risk factors of lymphatic metastasis complement poor radiological detection in gallbladder cancer

AIM: To explore risk factors of lymphatic metastasis (LM) in gallbladder cancer, and their potential to complement unsatisfactory radiological detection.

Flavonoids from Scutellaria baicalensis Georgi are effective to treat cerebral ischemia/reperfusion

Based on previous studies that have shown flavonoids from the stems and leaves of Scutellaria baicalensis Georgi are neuroprotective agents in a naturally senile, D-galactose, aging in vivo model, as well as an in vitro model of oxidative/hypoxic injury, we established a cerebral ischemia/reperfusion model in rats by middle cerebral artery occlusion. The light/electron microscopic observations found significant neuropathological changes including neuron loss or swelling and rough endoplasmic reticulum injury. Moreover, the activities of lactate dehydrogenase Na＋-K＋-ATPase, Ca2＋-ATPase and superoxide dismutase were significantly lowered, and the levels of malonaldehyde increased. In addition, the memory of rats worsened. However, treatment with flavonoids from Scutellaria baicalensis Georgi （35, 70 and 140 mg/kg） for 13 days dramatically improved the above abnormal changes. These results suggest that the ability of flavonoids from Scutellaria baicalensis Georgi in attenuating cerebral functional and morphological consequences after cerebral ischemia/reperfusion may be beneficial for the treatment of ischemic brain disease.

Analysis of the psychological conditions and related factors of breast cancer patients

Sufferers of breast cancer are often plagued by various psychological problems. Mastectomy, which has a serious influence on the female sex characteristics, can bring about especially serious psychological problems. These problems affect not only the patients’ quality of life but also the beginning, development, and end of the disease. This paper reviewed the relationships between the patients’ personal factors, the disease itself, treatment factors, and other socio-psychological factors and psychological conditions so as to provide new ideas for the psychological intervention on breast cancer patients, comprehensive clinical diagnosis and treatment, and prevention and cure.

A novel primary culture method for high-purity satellite glial cells derived from rat dorsal root ganglion

Satellite glial cells surround neurons within dorsal root ganglia. Previous studies have focused on single-cell suspensions of cultured neurons derived from rat dorsal root ganglia. At present, the primary culture method for satellite glial cells derived from rat dorsal root ganglia requires no digestion skill. Hence, the aim of the present study was to establish a novel primary culture method for satellite glial cells derived from dorsal root ganglia. Neonatal rat spine was collected and an incision made to expose the transverse protrusion and remove dorsal root ganglia. Dorsal root ganglia were freed from nerve fibers, connective tissue, and capsule membranes, then rinsed and transferred to 6-well plates, and cultured in a humidified 5% CO_2 incubator at 37°C. After 3 days in culture, some cells had migrated from dorsal root ganglia. After subculture, cells were identified by immunofluorescence labeling for three satellite glial cell-specific markers: glutamine synthetase, glial fibrillary acidic protein, and S100β. Cultured cells expressed glutamine synthetase, glial fibrillary acidic protein, and S100β, suggesting they are satellite glial cells with a purity of > 95%. Thus, we have successfully established a novel primary culture method for obtaining high-purity satellite glial cells from rat dorsal root ganglia without digestion.