A new method for predicting SIRS after percutaneous transhepatic gallbladder drainage.

The occurrence of systemic inflammatory response after percutaneous transhepatic gallbladder drainage brings great risks to patients and is one of the challenges faced by clinicians. Therefore, it is of great significance to find a suitable prediction method for clinicians to intervene early and reduce the transformation of serious complications. Easy-to-obtain and objectively measured clinical features were screened, and logistic regression was used to construct a prediction model. The predictive ability of the model was evaluated by using the receiver operating characteristic curve and the decision curve in the validation set and the training set, respectively. Nine clinical features (CRP, Fever, DBIL, Obstruction, Bile properties, PCT, Length, Width, and Volume factor) were used to construct the prediction model, and the validation results showed that the prediction model had good performance in the training set (AUC = 0.83) and the validation set (AUC = 0.81). The decision curve also showed that the predictive ability of the model incorporating nine clinical features is better than that of a single clinical feature. The model we constructed can accurately predict the occurrence of SIRS, which can guide clinicians to take treatment measures and avoid the deterioration of complications.

Application of laparoscopic backtracking full-thickness continuous everting suture for non-AOSC choledocholithiasis.

BACKGROUND: Based on the current trend of increasing incidence of choledocholithiasis, it is of great significance to explore the closure method of the common bile duct during laparoscopic choledocholithotomy. METHODS: Backtracking full-thickness continuous everting suture was selected for primary closure of the common bile duct suture, while traditional T-tube drainage was selected for the control group. Propensity score matching (PSM) was used to reduce baseline differences between the two groups. RESULT: The intraoperative blood loss, operation time, postoperative recovery speed, postoperative bleeding, postoperative pancreatitis, recurrence rate of bile duct stones, and hospitalization time in the primary closure group were all less than those in the T-tube drainage group. CONCLUSION: Under certain conditions, backtracking full-thickness continuous everting suture could benefit patients with choledocholithiasis compared with traditional T-tube drainage.

Nutritional deficiencies in low-sociodemographic-index countries: a population-based study.

Background: We aimed to estimate the burden of nutritional deficiency according to sex and age in countries with a low sociodemographic index (SDI). Methods: Following the methods of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019, estimated annual percentage changes (EAPCs) were calculated to determine trends in the age-standardized rates of incidence and disability-adjusted life-years (DALYs) of nutritional deficiency and its main subcategories from 1990 to 2019 in low-SDI countries. Findings: From 1990 to 2019, the age-standardized incidence and DALY rates of nutritional deficiency showed decreasing trends, with EAPCs of -0.90 [95% confidence interval (CI), 1.06 to -0.75] and -3.20 (95% CI, -3.29 to -3.10), respectively, in low-SDI countries. In 2019, of the subcategories analyzed, vitamin A deficiency had the highest age-standardized incidence rate and protein-energy malnutrition had the highest age-standardized DALY rate. From 1990 to 2019, the greatest decrease in the age-standardized incidence rate was observed for vitamin A deficiency and the greatest decrease in the age-standardized DALY rate was observed for protein-energy malnutrition. At the national level, from 1990 to 2019, the greatest increase in the age-standardized incidence rate of overall nutritional deficiency was observed in males in Afghanistan (EAPC: 0.28; 95% CI, 0.07 to 0.49). Of the age groups analyzed, the highest incidence and DALY rates of overall nutritional deficiency and dietary iron deficiency were observed in children aged 1-4 years. Interpretation: The age-standardized incidence and DALY rates of nutritional deficiency decreased significantly from 1990 to 2019, especially for vitamin A deficiency and protein-energy malnutrition. Overall nutritional deficiency and dietary iron deficiency occurred primarily in children aged 1-4 years.

[Data-mining-revealed Regularities of Application of Meridian Acupoints for Coronary Heart Disease in Ancient Chinese Medical Literature].

OBJECTIVE: To analyze the regularities of selection of meridian acupoints for coronary heart disease (CHD) recorded in the ancient Chinese medical literature, in order to provide a reference for clinical application of meridian acupoint recipes to treat CHD nowadays. METHODS: Papers were retrieved from 1 156 ancient Chinese medical books collected in "Encyclopedia of Traditional Chinese Medicine" (Fifth Edition) by using key words "Xin Tong"(cardiac pain), "Zhen Xin Tong"(true heart pain), "Jue Xin Tong"(precordial pain with cold limbs), "Xiong Bi" (obstruction of qi in the chest), "Zheng Chong"(severe palpitation), "Xin Ji"(palpitation), followed by establishment of a database. Then, the association analysis data mining technology was used to analyze the characteristics and regularities of application of meridian acupoints in the treatment of CHD. RESULTS: A total of 347 items of ancient document data were collected, containing acupoints of the 12 regular meridians, Conception Vessel and Governor Vessel, with a frequency of usage being 625 times. Among the involved meridians, the Conception Vessel was most frequently used, followed by the Pericardium Meridian. Zhongwan (CV 12) was the most frequently used acupoint, and Rangu (KI 2) and Taixi (KI 3), CV 12 and Shangwan (CV 13), and Quze (PC 3) and Daling (PC 7) were the top 3 frequently used auxiliary acupoint pairs. CONCLUSION: In ancient China, in the treatment of CHD, the main acupoints of the Conception and Pericardium Meridian, and the auxiliary acupoints i．e., five-shu points are most frequently used. PC 3 and PC 7 combination is suitable for the treatment of CHD with negative emotion.

Elevated expression of KLK8 predicts poor prognosis in colorectal cancer.

KLK8, also known as neuropsin, is one of fifteen members of the human kallikrein-related peptidase (KLK) gene family, which consists of enzymes with serine protease enzymatic activity. Aberrant KLK8 expression has been reported in several malignancies. However, the clinicopathological significance and prognostic value of KLK8 expression in colorectal cancer (CRC) are unknown. Therefore, analysis of public datasets, quantitative real-time PCR and western blot analysis were performed to assess KLK8 expression in CRC at both the mRNA and protein level. KLK8 expression was also assessed by immunohistochemistry in a tissue microarray containing 124 CRC specimens. We observed that KLK8 was overexpressed in CRC tissues and was significantly associated with TNM stage, vascular invasion, differentiation and AJCC stage. Univariate and multivariate Cox analyses confirmed that KLK8 is a significant independent prognostic factor for both DFS and OS. Cell function assays also indicated that KLK8 could facilitate CRC cell proliferation, migration and invasion in vitro. In conclusion, elevated KLK8 expression was correlated with the progression of CRC and is a potential independent prognostic indicator for CRC.

Zinc protoporphyrin IX enhances chemotherapeutic response of hepatoma cells to cisplatin.

AIM: To investigate the effect of zinc protoporphyrin IX on the response of hepatoma cells to cisplatin and the possible mechanism involved. METHODS: Cytotoxicity was determined using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. Apoptosis was determined by a flow cytometric assay. Western blotting was used to measure protein expression. Heme oxygenase (HO)-1 activity was measured by determining the level of bilirubin generated in isolated microsomes. Reactive oxygen species (ROS) production was monitored by flow cytometry. Caspase-3 activity was measured with a colorimetric assay kit. Mice were inoculated with 1 × 10(7) tumor cells subcutaneously into the right flanks. All mice were sacrificed 6 wk after the first treatment and tumors were weighed and measured. RESULTS: Overexpression of HO-1 in HepG2 cell line was associated with increased chemoresistance to cis-diaminedichloroplatinum (cisplatin; CDDP) compared to other cell lines in vitro. Inhibition of HO-1 expression or activity by zinc protoporphyrin IX (ZnPP IX) markedly augmented CDDP-mediated cytotoxicity towards all liver cancer cell lines in vitro and in vivo. In contrast, induction of HO-1 with hemin increased resistance of tumor cells to CDDP-mediated cytotoxicity in vitro and in vivo. Furthermore, cells treated with ZnPP IX plus CDDP exhibited marked production of intracellular ROS and caspase-3 activity, which paralleled the incidence of cell apoptosis, whereas hemin decreased cellular ROS and caspase-3 activity induced by CDDP. CONCLUSION: ZnPP IX increases cellular sensitivity and susceptibility of liver cancer cell lines to CDDP and this may represent a mechanism of increasing ROS.

[Nuclear factor-kappaB expression in peripheral blood polymorphonuclear leukocytes of patients with acute pancreatitis and the preventive effectiveness of pyrrolidine dithiocarbamate on NF-kappaB in vitro].

OBJECTIVE: To investigate the expression of NF-kappaB in peripheral blood polymorphonuclear leukocyte (PMN) of acute pancreatitis (AP) and to assess the preventive effectiveness of pyrrolidine dithiocarbamate (PDTC) on NF-kappaB in vitro. METHODS: Nineteen patients and 16 healthy individuals as control were enrolled in this study. The expression of NF-kappaB in PMNs was determined by gel electrophoretic mobility shift assay (EMSA). Routine clinical examination results and computed tomography findings of AP were recorded in all patients. RESULTS: The PMNs from the patients with AP showed higher levels of NF-kappaB activities than those from control subjects (P < 0.01), severe acute pancreatitis (SAP) group showed much higher than mild acute pancreatitis (MAP) group (P < 0.05). In vitro, PDTC could reduce the NF-kappaB activity in PMNs of patients with AP, and its effectiveness at 2 mmol/L was stronger than at 1 mmol/L (P < 0.05). The PMNs from control subjects pretreated with 2 mmol/L PDTC before stimulation with the plasma from patients with SAP showed lower levels of NF-kappaB activities than did those untreated (P < 0.05). CONCLUSION: The NF-kappaB activation in peripheral blood PMNs participate in the course of acute pancreatitis and can be inhibited by PDTC in vitro.