Biliary tract cancer (BTC) is highly malignant, with curative surgical resection being the only potentially definitive treatment. Due to its frequently asymptomatic onset, most patients are diagnosed at an advanced stage, precluding the opportunity for curative surgery. Conversion therapy offers the potential to downstage initially unresectable tumors, thereby making R0 resection possible, providing patients with surgical opportunities, and potentially extending survival. This approach has shown promising results in various advanced cancers. However, the application of conversion therapy in BTC is still in its nascent stages, with unresolved issues related to patient selection, treatment strategies, and the timing of conversion surgery. In this context, this article reviews conversion therapy strategies for advanced BTC,drawing on clinical experience and recent research from our institution and aiming to provide valuable insights and guidance for the field.
To investigate the expression of guanine nucleotide-binding protein gamma 4 (GNG4) and its clinicopathological and prognostic significance in gastrointestinal stromal tumors(GIST).
Methods
A total of 112 surgically resected GIST samples in Nantong First People's Hospital from January 2016 to December 2019 were systematically collected, and the expression of GNG4 in these tissue samples were detected by immunohistochemistry. The correlations between the expression of GNG4 and clinicopathological parameters were analyzed, and the prognostic value of GNG4 for GIST patients was evaluated by Kaplan-Meier curve as well as the univariate and multivariate Cox regression analysis.
Results
The positive signals of GNG4 protein expression were mainly located in the cytoplasm of GIST cells, and the positive rate of its expression was 59.8% (67/112). Compared with the negative expression group, patients with positive expression of GNG4 had higher mitotic index (χ2=5.630, P=0.018) and the proportion of moderate and high risk group (P=0.022). Kaplan-Meier curves showed that the 3-year disease free survival (DFS) rates were 51.8% and 82.9% for patients with positive and negative expression of GNG4, respectively, with a statistically significant difference (P=0.020). Subgroup analysis revealed that the positive expression of GNG4 was significantly correlated with worse prognosis of GIST patients at moderate and high risk, and the 3-year DFS rates were 31.1% and 73.8%, respectively (P=0.009).Univariate and multivariate Cox analysis suggested that AFIP risk stratification (HR=2.177, 95% CI:1.036-4.578, P=0.040) and the expression of GNG4 (HR=2.551, 95% CI: 1.081-6.021, P=0.033) were independent prognostic factors for GIST patients.
Conclusion
The positive expression of GNG4 may reflect the malignant potential of GIST, and it can be used as an independent prognostic biomarker to further identify high-risk populations.
To explore the correlation between the expression level of serum insulin-like growth factor binding protein 1 (IGFBP1) and clinicopathological features and its diagnostic value in patients with gastric cancer.
Methods
A total of 192 patients with gastric cancer diagnosed and treated in Affiliated Hospital of Yan'an University from January 2021 to December 2023 were retrospectively selected as the gastric cancer group and 192 patients with benign gastric lesions as the control group. Serum IGFBP1 expression levels of the subjects were detected by enzyme-linked immunosorbent assay (ELISA). General data and clinicopathological features of patients were collected and sorted out, differences in serum IGFBP1 expression levels of patients with different data and clinicopathological features were analyzed, and receiver operating characteristic curve (ROC) was drawn to evaluate the diagnostic value of serum IGFBP1 expression levels in gastric cancer.
Results
The proportions of patients with Helicobacter pylori infection, family history of gastric cancer, drinking and high-salt spicy diet in gastric cancer group were significantly higher than those in control group (all P＜0.05). The serum IGFBP1 expression level in gastric cancer group was significantly higher than that in control group (P＜0.001). The serum IGFBP1 expression level in patients with low differentiation, stageⅢ-Ⅳ, depth of invasion stage T4, lymph node metastasis and remote metastasis was significantly higher than that in patients with high/moderate differentiation, stage I-Ⅱ, depth of invasion stage T1-T3, no lymph node metastasis and no remote metastasis (all P＜0.001). The proportion of patients with low differentiation, stage Ⅲ-Ⅳ, T4 stage of infiltration, lymph node metastasis and remote metastasis in serum IGFBP1 high expression group was significantly higher than that in low expression group (all P＜0.001).ROC analysis results showed that the AUC of serum IGFBP1 expression level was 0.800, and when the cut-off value was 40.755, the sensitivity was 0.656 and the specificity was 0.964.
Conclusion
Serum IGFBP1 expression level is significantly increased in patients with gastric cancer, and it is closely related to clinicopathological features, especially in patients with low differentiation, advanced stage, high infiltration depth and metastasis, the expression level is higher, which has potential diagnostic value in gastric cancer.
To research the influence of carcinoembryonic antigen associated cell adhesion molecule 19 antibody (CEACAM19) gene on the pathogenesis and prognosis of gastric cancer by regulating PI3K/AKT signaling pathway, and then provide reference for clinical diagnosis and prognosis judgment of gastric cancer.
Methods
Immunohistochemical (IHC) staining technique was used to detect the expression levels of CEACAM19 and AKT protein in gastric cancer tissues and corresponding adjacent tissues of patients with gastric cancer. At the same time, the mRNA expression levels of CEACAM19 and AKT were detected by fluorescence quantitative PCR. The relationships between the expression of CEACAM19 and AKT and the clinicopathological features of gastric cancer patients were analyzed and compared, and the relationship between them and their influence on prognosis was explored by Pearson and Spearman correlation analysis and Kaplan-Meier survival curve analysis.
Results
The positive expression rates of CMACAM19 and AKT protein in gastric cancer tissues were significantly higher than those in adjacent tissues (78.75% vs. 17.50%, 76.25% vs. 15.00%, P＜0.05). The expression levels of CEACAM19 and AKT mRNA in gastric cancer tissues were significantly higher than those in adjacent tissues (P＜0.05). The positive expressions of CEACAM19 and AKT were significantly different in TNM stage, differentiation degree, infiltration degree and lymph node metastasis (P＜0.05). CEACAM19 was positively correlated with the protein and mRNA expression of AKT (r=0.715, P=0.000; r=0.557,P=0.000). Kaplan-Meier survival analysis showed that the overall survival and disease-free survival of patients with positive expression of CEACAM19 and AKT were lower than those with negative expression,and the differences were statistically significant by Log-rank test (χ2=8.054, 8.660, 7.815, 8.721, P=0.005,0.003, 0.005, 0.003).
Conclusion
CEACAM19 gene and its regulated PI3K/AKT signaling pathway play an important role in the occurrence and development of gastric cancer. CEACAM19 and AKT protein may be used as biomarkers for the progress of gastric cancer and play an important role in promoting the invasion and malignant progress of gastric cancer.
To investigate the effect of multislice spiral CT (MSCT) combined with serum microRNA-17 (miR-17) detection in predicting the risk of lymph node metastasis in gastric cancer.
Methods
A total of 110 patients diagnosed with gastric cancer in Jiangsu Province People's Hospital Suqian Hospital from January 2023 to February 2024 were retrospectively selected as the study objects,and were divided into metastatic group (n=47) and non-metastatic group (n=63) according to whether lymph node metastasis occurred. All patients underwent MSCT examination and blood samples were collected to isolate serum, and real-time fluorescence quantitative PCR was used to detect serum miR-17 levels. MSCT measurement parameters [blood volume in the lesion area (BV), mean transit time of contrast agent (MTT), surface permeability (PS), and bleeding flow (BF)] were compared between the two groups. Pearson correlation analysis was used to analyze the correlation between MSCT measurement parameters and serum miR-17 level. Using pathological examination results as the gold standard, the application value of MSCT and MSCT combined with serum miR-17 detection in the diagnosis of lymph node metastasis of gastric cancer was evaluated.
Results
There were statistically significant differences in tumor size, TNM stage and differentiation degree between the two groups (all P＜0.05). Compared with the non-metastatic group, BV and PS were significantly decreased in the metastatic group, while MTT, BF and serum miR-17 levels were significantly increased (all P＜0.001). Pearson correlation showed that BV(r=-0.361) and PS (r=-0.194) were significantly negatively correlated with serum miR-17 level, while MTT (r=0.424) and BF (r=0.250) were significantly positively correlated with serum miR-17 level (all P＜0.05). MSCT examination results showed that 43 patients with gastric cancer lymph node metastasis.There were 52 cases without metastasis, 4 cases were misdiagnosed and 11 cases were missed. MSCT combined with serum miR-17 showed 45 cases of gastric cancer with lymph node metastasis. There were 60 cases without metastasis, 2 cases were misdiagnosed and 3 cases were missed. MSCT diagnosis of lymph node metastasis in gastric cancer: the accuracy was 86.36% (85/110), the sensitivity was 91.49%(43/47), the specificity was 82.54% (52/63), the positive prediction rate was 79.63% (43/54), the negative prediction rate was 92.86% (52/56), and the Cohen's Kappa value of the pathological examination results was 0.727. After further combination with serum miR-17: the accuracy was 95.45% (105/110), the sensitivity was 95.74% (45/47), the specificity was 95.24% (60/63), the positive prediction rate was 93.75% (45/48), the negative prediction rate was 96.77% (60/62), and the Cohen's Kappa value of the pathological examination results was 0.907.
Conclusion
MSCT combined with serum miR-17 detection can significantly improve the prediction accuracy and diagnostic efficiency of lymph node metastasis risk of gastric cancer, and it is in high consistency with pathological diagnosis.
To study the application value of endoscopic narrow-band imaging (NBI)in the diagnosis of early gastric cancer under the background of Helicobacter pylori (Hp) infection.
Methods
A total of 82 patients with early gastric cancer admitted to Jiaozhou Central Hospital of Qingdao from January 2022 to December 2022 were retrospectively selected and divided into Hp infection group (n=54) and Hp eradication group (n=28) according to Hp detection results. All patients underwent white light endoscopy and NBI examination, the white light endoscopy and NBI findings of patients with early gastric cancer in Hp infection group and Hp eradication group were compared, the image quality scores of white light endoscope and NBI were compared, the receiver's working curve (ROC) was drawn to analyze the diagnostic value of endoscopy in Hp eradicated early gastric cancer, and the diagnostic results of white light endoscopy and NBI in patients with early gastric cancer under different Hp conditions were compared.
Results
The rates of white light endoscope diffused redness and lesion depression in Hp infection group were significantly higher than those in Hp eradication group, the rate of boundary ambiguity in Hp infection group was significantly lower than that in Hp eradication group, there were statistically significant differences (P＜0.05); there were no statistically significant differences in the rates of boundary irregularity and shrinkage between the two groups (P＞0.05). The diagnostic rate of early gastric cancer in the Hp eradication group was lower than that in the Hp infection group (P＜0.05), and the diagnostic rate of early gastric cancer in the NBI group was higher than that in the white light endoscope group (P＜0.05). The microvascular morphology, gastric fovea morphology and lesion contour scores of NBI were significantly higher than those of white light endoscopy (P＜0.05). ROC analysis showed that the areas under the curve of white light endoscopy and NBI for the diagnosis of early gastric cancer in the Hp eradication group were 0.571 and 0.657, with specificity of 74.41% and 90.52% and sensitivity of 78.54% and 97.45%.
Conclusion
NBI can improve the diagnosis of early gastric cancer under the background of Hp infection, and Hp eradication can affect the endoscopic diagnosis of early gastric cancer.
To construct a predictive model of postoperative metabolic acidosis in patients with colorectal cancer and evaluate its application value.
Methods
A total of 271 patients with colorectal cancer admitted to Shuyang Hospital Affiliated to Nanjing University of Traditional Chinese Medicine from January 2020 to December 2022 were included. According to the occurrence of postoperative metabolic acidosis, the patients were divided into occurrence group and non-occurrence group. The clinical data of the two groups were compared, and the related factors affecting postoperative metabolic acidosis in patients with intestinal cancer were summarized by Logistic multivariate regression model. Based on the risk factors, the Nomogram prediction model was established and applied to the prediction of postoperative metabolic acidosis in 115 patients (evaluation group) admitted from January 2023 to March 2024. Receiver operating characteristic curve (ROC) was used to evaluate the application efficiency of the prediction model.
Results
Among 271 patients in the construction group, 130 patients developed metabolic acidosis after operation, the incidence rate was 47.97%. Among 115 patients in the evaluation group, 52 patients developed metabolic acidosis after operation, the incidence rate was 45.22%. Logistic multivariate regression analysis showed that hypoproteinemia, malnutrition/risk, operation time ≥180 min and preoperative urea nitrogen ≥7 mmol/L were independent risk factors for postoperative metabolic acidosis in patients with colorectal cancer, while body mass index≥18.5 kg/m2 and rehydration speed ≥11 mL·kg-1·h-1 were protective factors (P＜0.05). The C-index of Nomogram model for predicting postoperative metabolic acidosis in patients with colorectal cancer was 0.862 (95% CI: 0.811-0.925), and the consistency curve of Nomogram model for predicting postoperative metabolic acidosis had a high degree of fit with the 45° diagonal line. Taking the total score ≥185 as the cutoff value, the AUC predicted by Nomogram model for postoperative metabolic acidosis in 115 patients of evaluation group was 0.851, and its sensitivity, specificity and accuracy were 88.49%, 90.48% and 89.57%, respectively.
Conclusion
The incidence of postoperative metabolic acidosis in patients with colorectal cancer is high, which is related to nutritional status, rehydration speed, operation time and glomerular filtration function. The Nomogram based on the above factors can provide more accurate reference for the prediction of postoperative metabolic acidosis in patients.
To investigate the relationship between the expression of SPOC domain protein-1 (SPOCD1) in colorectal cancer (CRC) tissues, clinicopathological features and postoperative recurrence and metastasis.
Methods
A total of 150 CRC patients who underwent radical CRC operation in Shangluo Hospital of Traditional Chinese Medicine from April 2018 to April 2022 were retrospectively selected. The R language was used to extracted and analyzed the expression of SPOCD1 mRNA in CRC tumor tissues and normal tissues in TCGA colorectal cancer data and GSE110224 data sets. The expression of SPOCD1 in cancer tissues and adjacent tissues was detected by immunohistochemistry. The clinicopathological features of patients were summarized, and the clinicopathological features of CRC patients with different SPOCD1 protein expression were explored. According to the 2-year follow-up results, all patients were divided into recurrence and metastasis group (n=72) and non-recurrence and metastasis group (n=78), and the expression of SPOCD1 in cancer tissues of the two groups was compared.Kaplan-Meier curve was used to analyze the effect of SPOCD1 expression on the risk of postoperative recurrence and metastasis of CRC, and univariate and multivariate COX regression were used to analyze the influencing factors of postoperative recurrence and metastasis of CRC.
Results
The expression level of SPOCD1 mRNA in cancer tissues was higher than that in adjacent tissues, the high expression rate of SPOCD1 protein in cancer tissues (59.33% vs. 35.33%) was higher than that in paracancer tissues(P＜0.001). There were statistically significant differences in TNM stage, differentiation degree, lymph node metastasis and vascular invasion in CRC patients with different SPOCD1 expression in cancer tissues(all P＜0.05). The high expression rate of SPOCD1 protein in recurrence and metastasis group (73.61% vs.46.15%) was significantly higher than that in non-recurrence and metastasis group (P＜0.001).Kaplan-Meier analysis showed that the risk of postoperative recurrence and metastasis was significantly increased in patients with high expression of SPOCD1 in CRC tissues (Log-Rank χ2=15.044, P＜0.001).Stage Ⅲ, low differentiation, lymph node metastasis, and high expression of SPOCD1 in cancer tissue were independent risk factors for postoperative recurrence and metastasis in CRC patients (all P＜0.05).
Conclusion
SPOCD1 is highly expressed in CRC tissues, which is closely related to the pathological features of patients. High expression of SPOCD1 in cancer tissue increases the risk of postoperative recurrence and metastasis in CRC patients and is an independent risk factor for postoperative recurrence and metastasis in CRC patients.
To analyze the correlation and predictive value of serum amyloid A(SAA) and soluble interleukin-2 receptor (sIL-2R) on the severity of pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP).
Methods
A total of 120 patients who underwent ERCP in Norinco General Hospital from January 2019 to January 2024 were selected as the research object, and they were divided into pancreatitis group (n=43) and control group (n=77) according to the occurrence of postoperative pancreatitis, and then the pancreatitis group was divided into mild group and severe group by APACHEⅡ system. The changes of serum SAA and sIL-2R in each group and each subgroup were compared at 6 h, 12 h and 24 h after operation. Pearman was used to analyze the correlation between severity of postoperative pancreatitis and SAA, sIL-2R at 6 h, 12 h and 24 h after operation. The ROC curve was drawn to analyze the predictive value of serum SAA and sIL-2R single and combined detection at different time periods after operation for postoperative pancreatitis.
Results
The levels of serum SAA and sIL-2R in pancreatitis group were significantly higher than those in control group at 6 h, 12 h and 24 h after operation, with statistically significant differences (P＜0.05). There were statistically significant differences on serum SAA and sIL-2R levels at 6 h, 12 h and 24 h after operation among subgroups(P＜0.05). The specificity and sensitivity of serum SAA combined with sIL-2R in the prediction of postoperative pancreatitis were higher than those of single index (P＜0.05).
Conclusion
Serum SAA and sIL-2R levels are related to the severity of pancreatitis after ERCP. The detection of serum SAA combined with sIL-2R after ERCP can be used to predict the risk of pancreatitis after ERCP, and can help the early prevention and control of pancreatitis after ERCP and risk assessment in the clinic.
To analyze the clinical effect of laparoscopic hiatal hernia repair combined with cholecystectomy.
Methods
A total of 36 patients who underwent laparoscopic hiatus hernia repair combined with cholecystectomy in the Department of General Surgery, Affiliated Hospital of Xuzhou Medical University from October 2014 to November 2023 were collected as the observation group, and 36 patients who underwent laparoscopic hiatus hernia repair during the same period were selected as the control group. The clinical indexes, symptom scores (food reflux, chest pain), inflammatory indexes [interleukin-6 (IL-6), interleukin-1β (IL-1β), C-reactive protein (CRP)] and complications of the two groups were analyzed and compared.
Results
There were no differences between the two groups in the amount of intraoperative blood loss and postoperative hospital stay (P＞0.05), and the operative time of the observation group was longer than that of the control group (P＜0.05). Before surgery, there were no differences in the scores of food reflux and chest pain between the two groups (P＞0.05). Symptom scores of the two groups were decreased 3 months after surgery, and the observation group was lower than the control group (P＜0.05). Before operation, there were no differences in IL-6, IL-1β and CRP levels between the two groups (P＞0.05). Three months after operation, the levels of inflammation indexes in two groups were lower than those in control group (P＜0.05). The complication rate of the observation group was 8.33%, lower than that of the control group (27.78%, P＜0.05).
Conclusion
Laparoscopic repair of hiatus hernia combined with cholecystectomy in the treatment of hiatus hernia has significant clinical efficacy,can significantly improve the clinical symptoms of patients, and is safe and feasible in the absence of obvious contraindications.
To explore the predictive value of transabdominal ultrasound submucosal index combined with highly sensitive C-reactive protein (hs-CRP), interleukin (IL)-6, and IL-8 in the early treatment of ulcerative colitis patients.
Methods
Patients with ulcerative colitis treated at the Emeishan People's Hospital from January 1, 2021 to December 31, 2022 were selected as the research objects. The treatment effect was evaluated early after treatment, and the patients were divided into a remission group and an unrelieved group based on the treatment effect. The transabdominal ultrasound results and clinical test indicators were compared between the two groups of patients, and the value of the transabdominal ultrasound combined with test indicators for predicting early treatment effect was evaluated.
Results
A total of 92 patients with ulcerative colitis were included in the study, of which 56 cases (60.87%) were in the remission group and 36 cases (39.13%) were in the unrelieved group. The differences in hs-CRP, IL-8,IL-6 between the remission group and the unrelieved group were statistically significant (P＜0.05).However, there were no statistically significant differences in body mass index, complications, erythrocyte sedimentation rate, white blood cell, hemoglobin, and ulcerative colitis endoscopic severity index (P＞0.05).The differences in submucosal thickness and submucosal index between the two groups were statistically significant (P＜0.05). In terms of intestinal wall thickness, there was no statistically significant difference between the two groups (P＞0.05). The above statistically significant factors were included in the binary multivariate logistic regression, and the results showed that hs-CRP, IL-8, IL-6, and submucosal index were the influencing factors for the early treatment effect of ulcerative colitis (P＜0.05). The ROC curve results showed that hs-CRP, IL-6, and submucosal index alone had a better predictive effect on early treatment of ulcerative colitis patients, with areas under the curve of 0.769, 0.772 and 0.779, respectively. However,IL-8 had a moderate predictive effect, with an area under the curve of 0.678. The accuracy of combining the submucosal index with hs-CRP, IL-8 and IL-6 in predicting early treatment outcomes in patients with ulcerative colitis was high (P＜0.05).
Conclusion
The combination of transabdominal ultrasound submucosal index and hs-CRP, IL-8 and IL-6 has high value in predicting early treatment outcomes in patients with ulcerative colitis.
To analyze the guiding value of submucosal index combined with C-reactive protein/albumin ratio (CRP/ALB), procalcitonin (PCT), interleukin (IL)-6 and IL-8 in the treatment of patients with moderate to severe ulcerative colitis (UC).
Methods
A total of 174 patients with moderate to severe UC in Qionglai Medical Center Hospital from January 2022 to January 2024 were selected, all of them were treated with standardized treatment, and colonoscopy was performed after 2 months of treatment to evaluate the therapeutic effect, and they were divided into remission group and non-remission group according to the curative effect of patients. The differences of submucosal index,CRP/ALB, PCT, IL-6 and IL-8 between the two groups were compared before treatment and 2 months after treatment, and the baseline data of the two groups were compared. Logistic multivariate regression analysis was used to summarize the related factors affecting the treatment effect of patients, and receiver operating characteristic curve (ROC) was used to calculate the efficacy and area under the curve (AUC) of each factor to predict the treatment effect of patients individually and jointly.
Results
After 2 months of treatment, 121 patients reached the effective standard of treatment, and the effective rate was 69.54%.Compared with before treatment, the submucosal index, CRP/ALB, PCT, IL-6 and IL-8 in remission group and non-remission group decreased after 2 months of treatment. Compared with the non-remission group,the submucosal index, CRP/ALB, PCT, IL-6 and IL-8 in the remission group were lower before and after treatment for 2 months (all P＜0.05). Logistic multivariate regression analysis showed that severe UC,submucosal index≥50%, CRP/ALB≥0.55, PCT≥1.44 ng/mL, IL-6≥52.17 ng/L and IL-8≥48.15 ng/L were all independent risk factors affecting the therapeutic effect of patients with moderate to severe UC (all P＜0.05). ROC curve showed that the AUC of UC severity combined with submucosal index, CRP/ALB,PCT, IL-6 and IL-8 was 0.931, and the sensitivity and specificity were 96.69% and 84.91% respectively.
Conclusion
The overall effective rate of moderate to severe UC patients is low, which is related to the patient's condition, submucosal index, laboratory indicators and other factors. Combining the above factors can provide reliable reference for predicting the therapeutic effect of patients.
To analyze the diagnosis and treatment of 14C positive in the population undergoing physical examination and its influencing factors.
Methods
Using single center retrospective cohort study method, data of population undergoing physical examination in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 1, 2021 to December 31, 2022 were collected, the number of 14C positive individuals was counted, and the diagnosis and treatment of 14C positive individuals were followed up. The influencing factors of diagnosis and treatment were explored by univariate analysis and multivariate logistic regression analysis.
Results
A total of 27 356 people were included in this physical examination, of which 9658 (35.25%) were 14C positive. Among the 14C positive population, 6583 (68.16%) received diagnosis and treatment, and 5134 received treatment with the quadruple regimen. Univariate analysis showed that age, education level, residence, marriage, income,smoking history, family history of Helicobacter pylori (Hp) infection, digestive system symptoms, and occupation were related to diagnosis and treatment (P＜0.05). Multivariate logistic regression analysis showed that living in rural areas, annual income less than 100000 yuan, and occupation of manual labor were independent risk factors for 14C positive diagnosis and treatment, while family history of Hp infection and digestive system symptoms were independent protective factors for 14C positive diagnosis and treatment (P＜0.05). Age, education level, marital status, and smoking history were not independent risk factors for 14C positive diagnosis and treatment in the physical examination population (P＞0.05).
Conclusion
The proportion of 14C positive people receiving diagnosis and treatment in physical examination is 68.16%. Living in rural areas, annual income less than 100 000 yuan, and occupation of manual labor are independent risk factors for 14C positive people to receive diagnosis and treatment, while family history of Hp infection and digestive system symptoms are independent protective factors.
To explore the therapeutic effect of acupoint electrical stimulation combined with traditional Chinese medicine navel hot ironing on post-stroke constipation patients and its impact on the quality of life scale (PAC-QOL) score and constipation symptom score of constipation patients.
Methods
A total of 100 post-stroke constipation patients who visited the Cangzhou City People's Hospital from September 2022 to September 2023 were recruited. They were randomly divided into a treatment group and a control group in chronological order of admission, with 50 cases in each group. The control group received routine treatment, while the observation group received acupoint electrical stimulation combined with traditional Chinese medicine navel hot ironing as an auxiliary treatment on the basis of routine treatment. The clinical efficacy, PAC-QOL score, constipation symptom score, weekly spontaneous bowel movements, gut microbiota, and adverse reactions between two groups were compared.
Results
The total effective rate of the treatment group was 92.00%, significantly higher than the control group's 70.00% (P＜0.05); After treatment, the defecation time, constipation symptom score, and PAC-QOL score of the treatment group were lower than those of the control group, and the defecation frequency was higher than that of the control group (t=3.783, 4.183, 3.295, 5.112, P＜0.05).After treatment, the levels of Escherichia coli and Enterococcus in the treatment group were lower than those in the control group, while the levels of Bifidobacterium and Lactobacillus were significantly higher than those in the control group (t=2.894, 3.146, 3.117, 2.943, P＜0.05). There were no adverse reactions observed during the two treatment periods.
Conclusion
The combination of acupoint electrical stimulation and traditional Chinese medicine navel hot ironing has a clear therapeutic effect on post-stroke constipation patients, which is beneficial for improving constipation symptoms and improving quality of life.
To explore the curative effect of Shenling Baizhu Powder combined with bifidobacterium triplet on functional constipation with spleen deficiency in children.
Methods
A total of 165 children with functional constipation with spleen deficiency treated in First Hospital of Yulin from March 2021 to June 2024 were prospectively selected, and 140 children were finally included as study objects after screening with inclusion and exclusion criteria. The children were divided into control group(bifidobacterium triple viable tablet treatment, n=70) and study group (Shenling Baizhu Powder combined with bifidobacterium triple viable tablet treatment, n=70) by computer random allocation method. The clinical efficacy, main symptom score, traditional Chinese medicine (TCM) syndrome score, serum nitric oxide (NO) and the intestinal neurotransmitter substance P (SP), occurrence of adverse reactions (rash,nausea, vomiting, diarrhea) and recurrence of the two groups were compared.
Results
The total effective rate of the study group (87.14%) was significantly higher than that of the control group (71.43%) (P＜0.05).After treatment, the main disease score and TCM syndrome score of the study group and the control group were significantly decreased, and the decreased of the study group was more significant (P＜0.05). After treatment, NO decreased and SP increased in the two groups, and the changes in the study group were greater (P＜0.05). There was no significant difference in the adverse reaction rate between the study group(12.86%) and the control group (15.71%) (P＞0.05). The recurrence rate of study group (8.57%) was significantly lower than that of control group (18.57%) (P＜0.05).
Conclusion
Shenling Baizhu Powder combined with bifidobacterium triplet has significant therapeutic effect on functional constipation of spleen deficiency type in children, which can effectively improve defecation and gastrointestinal function, reduce the possibility of recurrence, and has good safety, which can be used for clinical promotion and application.
To analyze the relationship between the characteristics of intestinal flora and serum zinc, creatine kinase isoenzyme (CK-MB) and inflammatory factors in children with rotavirus infection-related diarrhea.
Methods
A total of 200 children with rotavirus infection-related diarrhea admitted to Handan Maternal and Child Health Hospital from January 2018 to December 2023 were divided into mild group (n=141) and moderate severe group (n=59) according to their condition, and 80 children with non-infectious diarrhea were selected and included in the control group. 16SrRNA fluorescence quantitative polymerase chain reaction (PCR) was used to detect the contents of Bifidobacterium, Escherichia coli and Lactobacillus in feces of children in each group, and the serum zinc,CK-MB and inflammatory factors were detected. The characteristics of intestinal flora in children with rotavirus infection-related diarrhea were analyzed, and Pearson correlation analysis was used to calculate the correlation between fecal intestinal flora content and serum zinc, CK-MB and inflammatory factors.
Results
The contents of Bifidobacterium and Lactobacillus in feces of children in mild group were lower than those in control group, and those in moderate and severe group were lower than those in mild group(P＜0.05). The serum zinc content in mild group was lower than that in control group, and CK-MB was higher than that in control group. The serum zinc content in moderate and severe group was lower than that in mild group, and CK-MB was higher than that in mild group, with statistical significance (P＜0.05). The levels of serum IFN-γ, IL-6, IL-10 and TNF-α in mild group were higher than those in control group, and the levels of serum IFN-γ, IL-6, IL-10 and TNF-α in moderate and severe group were higher than those in mild group (P＜0.05). Pearson correlation analysis showed that the contents of Bifidobacterium and Lactobacillus in children with rotavirus infection-related diarrhea were positively correlated with serum zinc content, and negatively correlated with CK-MB, IFN-γ, IL-6, IL-10 and TNF-α content (P＜0.05).
Conclusion
The main feature of intestinal flora in children with rotavirus infection-related diarrhea is the decrease of Bifidobacterium and Lactobacillus, and the decrease of Bifidobacterium and Lactobacillus is more obvious with the progress of the disease, which is accompanied by the decrease of serum zinc content and the increase of CK-MB and inflammatory factors.
To investigate the relationship between serum platelet activating factor(PAF) and soluble thrombomodulin (sTM) levels and the degree of rotavirus enteritis (RVE) and dehydration in children.
Methods
A total of 126 children with acute diarrhea in Xingyuan Hospital of Yulin from January 2020 to January 2023 were retrospectively selected as research objects, and were divided into negative group (n=56) and positive group (n=70) according to RV test results, and the positive group was further divided into moderate and severe group (n=31) and mild group (n=39) according to different degrees of dehydration. The clinical data of the subjects were collected and serum PAF and sTM levels were detected by enzyme-linked immunosorbent assay (ELISA). Spearman was used to analyze the correlation between serum PAF and sTM levels and the degree of dehydration in children with RV enteritis,and Pearson was used to analyze the correlation between serum PAF and sTM levels. Multivariate Logistic regression analysis was used to screen the independent risk factors of RV enteritis in children. Receiver operating characteristic curve (ROC) was plotted to evaluate the predictive value of serum PAF and sTM levels in children with RV enteritis.
Results
There were significant differences in hand cleaning,malnutrition, RV enteritis exposure history and creatine kinase isoenzyme (CK-MB) level between negative group and positive group (all P＜0.05). Serum PAF and sTM levels in positive group were significantly higher than those in negative group, and serum PAF and sTM levels in moderate and severe group were significantly higher than those in mild group (all P＜0.001). The results of correlation analysis showed that serum PAF and sTM levels were significantly positively correlated with the degree of dehydration in children with RV enteritis (P＜0.001). There was also a significant positive correlation between serum PAF and sTM in children with RV enteritis. Logistic regression analysis showed that high CK-MB, high PAF and high sTM levels were independent risk factors for RV enteritis in children (all P＜0.05). ROC results showed that the AUC of serum PAF combined with sTM for predicting pediatric RV enteritis was 0.933(sensitivity 88.57%, specificity 89.29%), which was better than that of serum PAF and sTM alone.
Conclusion
PAF and sTM levels are significantly positively correlated with the degree of dehydration in children with RV enteritis, and their elevated levels are independent risk factors for RV enteritis, and their combined detection has high diagnostic value for children with RV enteritis.
