Effect of screening colonoscopy frequency on colorectal cancer mortality in patients with a family history of colorectal cancer

BACKGROUND Colorectal cancer is a common malignant tumor in China,and its incidence in the elderly is increasing annually.Inflammatory bowel disease is a group of chronic non-specific intestinal inflammatory diseases,including ulcerative colitis and Crohn’s disease.We included the clinicopathological and follow-up data of patients with colorectal cancer who underwent laparoscopic colectomy or open colectomy at our Gastrointestinal Department between January 2019 and December 2022.Surgical indicators,oncological indicators,and survival rates were compared between the groups.The results of 104 patients who met the above criteria were extracted from the database(laparoscopic colectomy group=63,open colectomy group=41),and there were no statistically significant differences in the baseline data or follow-up time between the two groups.RESULTS Intraoperative blood loss,time to first ambulation,and time to first fluid intake were significantly lower in the laparoscopic colectomy group than in the open colectomy group.The differences in overall mortality,tumor-related mortality,and recurrence rates between the two groups were not statistically significant,and survival analysis showed that the differences in the cumulative overall survival,tumor-related survival,and cumulative recurrence-free rates between the two groups were not statistically significant.CONCLUSION In elderly patients with colorectal cancer,laparoscopic colectomy has better short-term outcomes than open colectomy,and laparoscopic colectomy has superior long-term survival outcomes compared with open colectomy.

Kawasaki disease with peritonsillar abscess as the first symptom:A case report

BACKGROUND Kawasaki disease(KD),also known as mucocutaneous lymph node syndrome,is an acute,self-limiting vasculitis of unknown aetiology that mainly involves the medium and small arteries and can lead to serious cardiovascular complications,with a 25%incidence of coronary artery aneurysms.Periton–Sillar abscesses are a rare symptom of KD and is easily misdiagnosed at its early stages.CASE SUMMARY A 5-year-old boy who presented to a community hospital with a 3-d fever,difficulty in opening his mouth,and neck pain and was originally treated for throat infection without improvement.On the basis of laboratory tests,ultrasound of submandibular and superficial lymph nodes and computed tomography of the neck,the clinician diagnosed the periamygdala abscess and sepsis that did not resolve after antibiotic therapy.On the fifth day of admission,the child developed conjunctival congestion,prune tongue,perianal congestion and desquamation,and slightly stiff and swollen bunions on both feet.A diagnosis of KD was reached with complete remission after intravenous immunoglobulin treatment.CONCLUSION Children with neck pain,lymph node enlargement,or airway obstruction as the main manifestations are poorly treated with intravenous broad-spectrum antibiotics.Clinicians should not rush invasive operations such as neck puncture,incision,and drainage and should be alert for KD when it cannot be explained by deep neck space infection and early treatment with aspirin combined with gammaglobulin.

Ercao Qinggan decoction regulates apoptosis of hepatocytes in mice with acute liver failure via the TLR4-mediated PI3K/Akt/GSK3βsignal pathway

Background:To clarify the inhibitory effect of Ercao Qinggan decoction(EQD)on acute liver failure(ALF)and its related mechanisms.Methods:HL-7702 hepatocytes were pretreated with TLR4 inhibitor CLI-095,glycogen synthase kinase 3β(GSK3β)inhibitor LiCl and different doses of EQD for 2 hours,and lipopolysaccharide(LPS)(10μg/mL)for 24 hours.Cell apoptosis,TNF-αand IL-6 and GSK3βwere detected by flow cytometry,immunofluorescence,quantitative polymerase chain reaction.After mice were gavaged with different concentrations of EQD for 12 days,ALF mouse models were established intraperitoneal injection of D-Gal/LPS.After 24 hours,the mice were euthanized and the liver tissue was stained with hematoxylin and eosin.Liver cell apoptosis,the serum levels of aspartate aminotransferase,alanine aminotransferase,TNF-αand IL-βwere detected by terminal transferase-mediated dUTP nick end-labelling,enzyme linked immunosorbent assay,quantitative polymerase chain reaction,and Western blotting,respectively.These methods were also used to test the mRNA expression of Bax,Bcl-2 and the protein expression of GSK3β,p-Akt/Akt in livers.Results:CLI-095,LiCl,and EQD significantly inhibited apoptosis induced by LPS,the mRNA expression of IL-6,TNF-αand the nuclear translocation of GSK3βin HL-7702 hepatocytes.EQD dose-dependently inhibited hepatocyte apoptosis,the serum concentration of aspartate aminotransferase and ALT,the expression of TNF-αand IL-β,the ratio of p-GSK3β/GSK3β,p-Akt/Akt in alanine aminotransferase mice.Conclusion:EQD can inhibit hepatocyte apoptosis in ALF mice through regulating TLR4/PI3K/Akt/GSK3βsignaling pathway.