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BACKGROUND & AIMS: Mild and moderate dysplasia are major premalignant lesions of esophageal squamous cell carcinoma (ESCC); however, evidence of the progression risk in patients with these conditions is extremely limited. We aimed to assess the incidence and risk factors for advanced neoplasia in patients with mild-moderate dysplasia. METHODS: This prospective cohort study included patients with mild-moderate dysplasia from 9 regions in rural China. These patients were identified from a community-based ESCC screening program conducted between 2010 and 2016 and were offered endoscopic surveillance until December 2021. We estimated the incidence of advanced esophageal neoplasia, including severe dysplasia, carcinoma in situ, or ESCC, and identified potential risk factors using the Cox regression model. RESULTS: The 1183 patients with mild-moderate dysplasia were followed up over a period of 6.95 years. During follow-up evaluation, 88 patients progressed to advanced neoplasia (7.44%), with an incidence rate of 10.44 per 1000 person-years. The median interval from the progression of mild-moderate dysplasia to advanced neoplasia was 2.39 years (interquartile range, 1.58-4.32 y). A total of 74.47% of patients with mild-moderate dysplasia experienced regression to nondysplasia, and 18.09% showed no lesion progression. Patients with mild-moderate dysplasia who had a family history of esophageal cancer and were age 55 years and older showed 97% higher advanced neoplasia yields than all patients with mild-moderate dysplasia. CONCLUSIONS: In a country with a high incidence of ESCC, patients with mild-moderate dysplasia showed an overall risk of advanced neoplasia progression of 1.04% per year. Patients with mild-moderate dysplasia would be recommended for endoscopic surveillance during the first 2 to 3 years.
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Carcinoma de Células Escamosas , Neoplasias Esofágicas , Carcinoma de Células Escamosas do Esôfago , Lesões Pré-Cancerosas , Humanos , Pessoa de Meia-Idade , Neoplasias Esofágicas/diagnóstico , Carcinoma de Células Escamosas/patologia , Estudos Prospectivos , Lesões Pré-Cancerosas/patologia , Esofagoscopia , HiperplasiaRESUMO
BACKGROUND: The postoperative length of hospital stay (PLOS) is an important indicator of surgical quality. We identified perioperative factors that affect prolonged PLOS (PPLOS) after laparoscopic colorectal cancer resection, which is the preferred surgical approach for colorectal cancer, the third most common cancer. METHODS: This study was a secondary analysis of a randomized trial (clinicaltrials.gov ID: NCT03160144) that included 280 patients who underwent laparoscopic colorectal cancer resection. The primary outcome was a PPLOS, defined as a PLOS that was longer than the median PLOS. Baseline, anesthetic, surgical, and postoperative management factors were included in the univariate and multivariate analyses to identify factors influencing PPLOS. RESULTS: The median PLOS was 10 days, and 117 patients had a PPLOS. We identified six influencing factors for PPLOS: preoperative pulse oxygen saturation < 96% (odds ratio [OR], 3.09 [95% confidence interval (CI) 1.38-6.92]; P = 0.006), distant tumor metastasis (OR, 0.34 [95% CI 0.13-0.91]; P = 0.031), the Miles procedure or left hemicolectomy (OR, 4.51 [95% CI 1.67-12.18]; P = 0.003), perioperative surgical events (OR, 2.44 [95% CI 1.25-4.76]; P = 0.009), postoperative albumin infusion (OR, 2.19 [95% CI 1.14-4.19]; P = 0.018), and postoperative early ambulation (OR, 0.35 [95% CI 0.18-0.68]; P = 0.002). Further stratified analysis showed that postoperative albumin infusion might be a risk factor for PPLOS, even in patients with a preoperative albumin level < 40 g/L (OR, 2.29 [95% CI 0.98-5.34]; P = 0.056) or duration of surgery ≥ 3 h (OR, 2.52 [95% CI 1.08-5.87]; P = 0.032). CONCLUSIONS: A low preoperative pulse oximetry reading, complex surgical procedures, perioperative surgical events, and postoperative albumin infusion may be risk factors for PPLOS after laparoscopic colorectal cancer resection, whereas distant tumor metastasis and postoperative early ambulation might be protective factors. The association between postoperative albumin infusion, a modifiable factor, and PLOS or clinical outcomes warrants further investigation.
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Neoplasias Colorretais , Laparoscopia , Humanos , Tempo de Internação , Laparoscopia/métodos , Neoplasias Colorretais/cirurgia , Neoplasias Colorretais/patologia , Colectomia/métodos , Fatores de Risco , Complicações Pós-Operatórias/etiologiaRESUMO
Limited literatures report the management of congenital left atrial appendage aneurysm (LAAA) which is extremely rare. Chest X-ray firstly showed an enlarged left cardiac silhouette for a 3-year-old patient with pneumonia. Echocardiography and magnetic resonance imaging confirmed a large cyst attached to the left atrium. Aneurysmectomy was performed through lateral thoracotomy using step-by-step method and under the guidance of transoesophageal echocardiography. We aim to show the safety and efficacy of this approach applied to children associated with congenital LAAA.
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Apêndice Atrial , Procedimentos Cirúrgicos Cardíacos , Aneurisma Cardíaco , Apêndice Atrial/diagnóstico por imagem , Apêndice Atrial/cirurgia , Pré-Escolar , Ecocardiografia , Aneurisma Cardíaco/diagnóstico por imagem , Aneurisma Cardíaco/cirurgia , Humanos , ToracotomiaRESUMO
In orange-spotted grouper, androgen can promote the development of testis and spermatogenesis, but the effect of androgen on testis development is unclear. Forkhead box L 3 (Foxl3) is important in the development of fish testis. Rec8 and fbxo47 are involved in meiosis, which impacts spermatogenesis. The present study investigated the plausible role of testis development through the Foxl3 transcriptional regulation of rec8 and fbxo47. The results of tissue distribution showed that rec8 and fbxo47 are highly expressed in gonad. In addition, the highest expression of foxl3, rec8, and fbxo47 was in the testis and intersex compared with the other stages of gonadal development, suggesting that foxl3, rec8, and fbxo47 are important in testis development. In addition, by using dual-luciferase assays, we found that the androgen can increase foxl3 promoter activity and Foxl3 can upregulate rec8 and fbxo47 promoter activity. Furthermore, the addition of ß-testosterone significantly increased foxl3, rec8, and fbxo47 promoter activity. Together, these results suggest that foxl3 plays a decisive role in testis development by regulating the expression of rec8 or fbxo47 and imply that AR-foxl3-rec8/fbxo47 affects the testis development pathway.
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Androgênios/farmacologia , Bass/metabolismo , Proteínas de Ciclo Celular/metabolismo , Fatores de Transcrição Forkhead/metabolismo , Receptores Androgênicos/metabolismo , Testículo/crescimento & desenvolvimento , Fatores de Transcrição/metabolismo , Animais , Bass/genética , Proteínas de Ciclo Celular/genética , Proteínas de Peixes/genética , Proteínas de Peixes/metabolismo , Fatores de Transcrição Forkhead/genética , Regulação da Expressão Gênica no Desenvolvimento/efeitos dos fármacos , Células HEK293 , Humanos , Masculino , Regiões Promotoras Genéticas/genética , Testículo/citologia , Testículo/efeitos dos fármacos , Testículo/metabolismo , Testosterona/farmacologia , Distribuição Tecidual/efeitos dos fármacos , Fatores de Transcrição/genéticaRESUMO
BACKGROUND: Idiopathic hyper eosinophilic syndrome (HES) is a rare disease characterized by a sustained increase in eosinophilia. Heart involvement is called Loffler endocarditis. Loffler endocarditis is a serious complication of hyper eosinophilia syndrome, which is characterized by a special type of fibrotic endocarditis. Loffler endocarditis is an inflammatory cardiac condition characterized by eosinophilic infiltration in the heart. The overall prognosis for patients with Loffler endocarditis is very poor. METHODS: In this article we report an 8-year-old girl who was diagnosed as having Loffler endocarditis in thrombotic phase and was successfully treated with surgery. RESULTS: Our patient had a good prognosis during the half-year follow-up. She had no symptoms of heart failure and echocardiography findings were normal. CONCLUSION: The cardiac damage occurred in a three-stage process: the necrotic, thrombotic, and fibrotic stages. This unusual but sometimes life-threatening disease is often detected in the late phase, resulting in no curative strategy available to reverse the disease process. The overall prognosis of patients with Loffler endocarditis is very poor. Current treatments include anticoagulation and anti-eosinophils therapy, and surgery only in selected cases. Surgical treatment of HES in adolescents is very rare. The present case illustrates that with well-controlled peripheral eosinophilia, proper surgical treatment in selected patients can improve their prognosis in the near future but long-term follow-up is necessary.
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Procedimentos Cirúrgicos Cardíacos/métodos , Ecocardiografia/métodos , Endocardite/cirurgia , Eosinofilia/cirurgia , Criança , Endocardite/diagnóstico , Eosinofilia/diagnóstico , Feminino , HumanosRESUMO
Design of underwater acoustic (UWA) modems for compact-sized, underwater platforms such as autonomous underwater vehicles (AUVs) is challenging because of the practical requirement to keep an engineering balance between the performance and the system overhead. Considering this type of mobile communication scenario, Doppler spread as well as the multipath draws substantial attention in implementing the system's design and engineering. Specifically, for a small AUV, the large computational complexity of real-time resampling for the classic Doppler correction poses significant difficulty for the limited capability of the low-cost processor. In this paper, by adopting an adjustable AD (analog-to-digital) sampling rate, a Doppler compensation approach is proposed to enable low-complexity hardware implementation. Based on this, a direct sequence spread spectrum (DSSS) acoustic modem is designed for a low-cost, small-sized AUV. Meanwhile, the performance evaluation of this acoustic modem is conducted in terms of the robustness upon varying Doppler as well as AUV integration. Finally, experimental results performed on a commercial, small-sized AUV under different speeds are reported to verify the effectiveness of the proposed acoustic modem.
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Herein we present a new, readily functionalized AAA-DDD hydrogen bond array. A novel AAA monomeric unit (3a-b) was obtained from a two-step synthetic procedure starting with 2-aminonicotinaldehyde via microwave radiation (overall yield of 52-66%). 1H NMR and fluorescence spectroscopy confirmed the complexation event with a calculated association constant of 1.57 × 107 M-1. Likewise, the usefulness of this triple hydrogen bond motif in supramolecular polymerization was demonstrated through viscosity measurements in a crosslinked supramolecular alternating copolymer.
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A high frequency acoustic experiment was conducted in the northern portion of the Gulf of Mexico in August 2016 to examine the operating range, data rates, and performance of acoustic communication systems at the carrier frequency of 85 kHz. The received signal-to-noise ratios, channel coherence, and impulse responses were reported between two 85 kHz transducers and a five-element hydrophone array over multiple ranges up to 1500 m. Channel estimation based decision feedback equalizers (DFEs) were applied to process the communication measurements. A data rate of 27.2 kb/s was achieved for four tested ranges with a uniform set of receiver parameters.
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OBJECTIVES: The aim of this study was to evaluate the results following surgeries for the treatment of coarctation of the aorta in Chinese paediatric patients and to compare the surgery outcomes between simple and complex coarctation procedures. METHODS: Between January 2006 and December 2011, 107 consecutive paediatric patients with coarctation of the aorta underwent surgery. Forty-four patients (41.12%) were classified as having simple coarctations (group A), and 54 patients (50.47%) were classified as having complex coarctations (group B). Echocardiography and the resting systolic blood pressure were evaluated prior to the operation, at one month following the operation, and then once annually. RESULTS: Follow-up was 93.5% complete (100 patients), without significant differences between the two groups. Arch hypoplasias and bicuspid aortic valves were initially present in 10 (9.35%) and 11 (10.28%) of 107 patients, respectively. There were no deaths among the group A patients and three (5.56%) early deaths among the group B patients. There was a significant difference in the restenosis incidence rate between the two groups during the most recent follow-up consultations (p<0.05). Additionally, only 10 of 43 group A and 10 of 51 group B patients had persistently abnormal blood pressures during the annual follow-up consultations. CONCLUSIONS: The postoperative restenosis ratio was increased in the complex coarctation group compared with the simple coarctation group. Additionally, the complex coarctation patients who did not have restenosis at follow-up had a lower proportion of hypertension.
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Coartação Aórtica/epidemiologia , Coartação Aórtica/cirurgia , Estenose da Valva Aórtica/epidemiologia , Doenças das Valvas Cardíacas/epidemiologia , Adolescente , Aorta Torácica/cirurgia , Coartação Aórtica/classificação , Estenose da Valva Aórtica/etiologia , Povo Asiático , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Criança , Pré-Escolar , China/epidemiologia , Feminino , Seguimentos , Doenças das Valvas Cardíacas/etiologia , Humanos , Lactente , Masculino , Estudos RetrospectivosRESUMO
OBJECTIVE: The aim of this study was to investigate the association between sleep duration and muscle quality index (MQI) in middle-aged and older age groups, as limited evidence exists on this topic. METHODS: In order to assess the relationship between sleep duration and MQI, a cross-sectional study was undertaken, utilizing data from the National Health and Nutrition Examination Survey (NHANES) acquired during the period from 2011 to 2014. The study comprised a total of 4598 participants aged 20 years and above. To examine the association between sleep duration and MQI, sophisticated weighted multivariate linear regression models were employed. Additionally, smooth curve fitting techniques were applied to examine the possibility of any non-linear relationship between the two variables. RESULTS: The average age of the adults who were enrolled in the study was 38.48±11.69 years, and 46.75% of them were female. The results of the multivariable linear regression models showed that sleep duration had a positive correlation with MQI. However, when subgroup analysis was conducted, it was found that this positive correlation only existed among women (ß = 0.09, 95% CI: 0.014 to 0.167). To further confirm the differences between sexes in the relationship between sleep duration and MQI, a weighted generalized additive model (GAM) was used. CONCLUSIONS: This research study provides evidence that there is a positive correlation between the duration of sleep and MQI specifically in females, while no such association was observed in males. These findings shed light on the existence of gender disparities in the connection between sleep duration and MQI.
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Inquéritos Nutricionais , Sono , Humanos , Feminino , Masculino , Adulto , Estudos Transversais , Sono/fisiologia , Pessoa de Meia-Idade , Fatores Sexuais , Adulto Jovem , Idoso , Caracteres Sexuais , Músculo Esquelético/fisiologia , Fatores de Tempo , Modelos Lineares , Duração do SonoRESUMO
BACKGROUND: The impact of repeated influenza vaccination on vaccine effectiveness has been a topic of debate. Conducting more multinational, multicenter studies in different influenza seasons is crucial for a better understanding of this issue. There is a lack of comprehensive related research reports in China. METHODS: Using the Regional Health Information Platform, we conducted a test-negative case-control study to evaluate the impact of repeated vaccination on the prevention of laboratory-confirmed influenza in individuals aged 60 and above in Ningbo during four influenza seasons from 2018-19 to 2021-22. Influenza-positive cases and negative controls were matched in a 1:1 ratio based on the visiting hospital and the date of influenza testing. Propensity score adjustment and multivariable logistic regression were used to estimate risk and address confounding effects. RESULTS: During the study period, a total of 30,630 elderly patients underwent influenza virus nucleic acid or antigen testing. After exclusions, we included 1976 cases of influenza-positive and 1976 cases of influenza-negative controls. Multivariable logistic regression analysis revealed that individuals receiving the vaccine in two consecutive seasons did not exhibit a significantly increased risk of influenza illness compared to those receiving the vaccine only in the current season (adjusted odds ratio: 1.22, 95% confidence interval: 0.94-1.58). However, the risk of influenza illness was found to be elevated in individuals who received the vaccine only in the previous season (adjusted odds ratio: 1.56, 95% confidence interval: 1.15-2.10) and even further elevated in those who had not received the vaccine in either of the consecutive two seasons (adjusted odds ratio: 3.39, 95% confidence interval: 2.80-4.09). CONCLUSIONS: Regardless of the vaccination history in the previous season, receiving the current season influenza vaccine is the best choice for the elderly population. Our study supports the initiative to vaccinate elderly individuals against influenza annually.
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Vacinas contra Influenza , Influenza Humana , Vacinação , Eficácia de Vacinas , Humanos , Vacinas contra Influenza/imunologia , Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Influenza Humana/imunologia , Idoso , Estudos de Casos e Controles , Feminino , Masculino , China/epidemiologia , Pessoa de Meia-Idade , Estações do Ano , Idoso de 80 Anos ou mais , Modelos LogísticosRESUMO
Based on the observed biological activity of 1,2,4-triazin-5-one derivatives and their cyclic analogues, a novel series of 7H-thiazolo[3,2-b]-1,2,4-triazin-7-one derivatives that contain ester moiety compounds 3a-3g, carboxylic acid moiety compounds 4a-4g and piperazine amide moiety compounds 5a-5k at position-3 of the thiazolotriazinone scaffold were synthesized. The intermolecular cyclization occurred regioselectively at N2-position of 1,2,4-triazine ring was characterized by X-ray single-crystal diffraction analysis. The in vitro biological activities of the target compounds were assayed against some bacterial strains. Compared with ciprofloxacin, compounds 3g and 4g exhibited more excellent antibacterial activity, especially the activity against Staphylococcus aureus and Escherichia coli, showing that the fluorine at the para position of the benzyl group would be the best choice. In addition, compounds 4e-4g with carboxylic acid moiety can enhance the antibacterial activity. Compounds 5g-5k containing bulky 1-(substituted phenyl)piperazine moiety were found with slightly less biological activity. Similar to ciprofloxacin, the docking result of target compounds with DNA topoisomerase II indicates the carboxyl group of the target compounds with carboxylic acid moiety has a crucial salt bridge interaction with Mg2+ in the protein.
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Aerobic glycolysis is involved in the pathogenesis of pulmonary hypertension (PH). The mechanisms by which glycolysis is increased and how it contributes to pulmonary vascular remodelling are not yet fully understood. In this study, we demonstrated that elevated lipocalin-2 (LCN2) in PH significantly enhances aerobic glycolysis in human pulmonary artery smooth muscle cells (PASMCs) by up-regulating LDHA expression. Knockout of Lcn2 or having heterozygous LDHA deficiency in mice significantly inhibits the progression of hypoxic PH. Our study reveals that LCN2 stimulates LDHA expression by activating Akt-HIF-1α signalling pathway. Inhibition of Akt or HIF-1α reduces LDHA expression and proliferation of PASMCs. Both Akt and HIF-1α play critical roles in the development of PH and are suppressed in the pulmonary vessels of hypoxic PH mice lacking LCN2. These findings shed light on the LCN2-Akt-HIF1α-LDHA axis in aerobic glycolysis in PH.
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Background: Leveraging well-established DNA-level drug resistance mechanisms, whole-genome sequencing (WGS) has emerged as a valuable methodology for predicting drug resistance. As the most effective second-line anti-tuberculosis (anti-TB) drugs, fluoroquinoloness (FQs) are generally used to treat multidrug-resistant tuberculosis (MDR-TB, defined as being resistant to resistant to rifampicin and isoniazid) or rifampicin-resistant tuberculosis (RR-TB). However, FQs are also commonly used in the management of other bacterial infections. There are few published data on the rates of FQs resistance among rifampicin-susceptible TB. The prevalence of FQs resistance among TB patients who are rifampicin-susceptible has not been studied in Zhejiang Province, China. The goal of this study was to provide a baseline characterization of the prevalence of FQs resistance, particularly among rifampicin-susceptible TB in Zhejiang Province, China. Methods: Based on WGS, we have investigated the prevalence of FQs resistance among rifampicin-susceptible TB in Zhejiang Province. All pulmonary TB patients with positive cultures who were identified in Zhejiang area during TB drug resistance surveillance from 2018 to 2019 have enrolled in this population-based retrospective study. Results: The rate of FQs resistance was 4.6% (32/698) among TB, 4.0% (27/676) among rifampicin-susceptible TB, and 22.7% (5/22) among RR-TB. According to WGS, strains that differ within 12 single-nucleotide polymorphisms (SNPs) were considered to be transmission of FQ-resistant strains. Specifically, 3.7% (1/27) of FQs resistance was caused by the transmission of FQs-resistant strains among the rifampicin-susceptible TB and 40.7% (11/27) of FQs resistance was identified as hetero-resistance. Conclusion: The prevalence of FQs resistance among TB patients who were rifampicin-susceptible was severe in Zhejiang. The emergence of FQs resistance in TB isolates that are rifampicin-susceptible was mainly caused by the selection of drug-resistant strains. In order to prevent the emergence of FQs resistance, the WGS-based surveillance system for TB should be urgently established, and clinical awareness of the responsible use of FQs for respiratory infections should be enhanced.
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Objective: To conduct a comprehensive evaluation of the Dengue Fever Surveillance and Early Warning System deployed in Ningbo City during 2023, focusing on its capacity for timely identification and reporting of dengue fever cases, particularly imported cases from endemic regions. Methods: A detailed data of patient clinical features and blood profile trends was collected from clinical records and surveillance reports, focusing on the rapid diagnostic processes and surveillance rigor. This study assessed the effectiveness of the system in identifying and reporting dengue cases and identified the limitations of the existing framework through a basic statistical approach. Results: The system demonstrated timely identification and reporting of dengue fever cases, with a particular emphasis on imported cases. However, several limitations were identified, including the need for more precise monitoring criteria and improved coordination with medical entities. Conclusion: The study underscores the critical role of public health bodies in managing disease outbreaks and advocates for enhanced methodologies to refine epidemic control efforts. The findings contribute to the advancement of early warning mechanisms and the improvement of proactive infectious disease monitoring in metropolitan environments, providing valuable insights for fortifying the Dengue Fever Surveillance and Early Warning System in Ningbo City.
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PURPOSE: A large number of epidemiological studies have shown that myopia is a complex disease involving genetic, environmental, and behavioral factors. The purpose of this study was to explore the role of PAX6 gene methylation in myopia in Chinese adolescents. METHODS: Eighty junior high school students were divided into four groups based on their vision test results: mild myopia, moderate myopia, severe myopia, and non-myopia control. The methylation level of PAX6 gene promoter was detected by bisulfate pyrosequencing. RESULTS: The methylation level of PAX6 gene in myopia group (8.06% ± 1.43%) was slightly but significantly higher than that in non-myopia controls (7.26% ± 1.17%). In addition, PAX6 gene methylation levels presented a decreasing pattern along with the aggravation of myopia. Post-hoc analysis indicated significant inter-group differences for the mild myopia group and other groups (All p < .05). In the subgroup analysis by gender, the methylation level of PAX6 gene promoter in girls was higher than that in boys (p = .023). The ROC curves showed a high accuracy of PAX6 gene methylation to predict mild myopia (AUC (95% CI) = 0.828 (0.709-0.947), p < .001). CONCLUSIONS: The methylation of PAX6 gene might play a role in the onset and progression of myopia in Chinese adolescents. And this could potentially explore the potential molecular mechanisms of juvenile myopia in the future.
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Metilação de DNA , Miopia , Fator de Transcrição PAX6 , Regiões Promotoras Genéticas , Adolescente , Criança , Feminino , Humanos , Masculino , China/epidemiologia , População do Leste Asiático/genética , Miopia/genética , Fator de Transcrição PAX6/genética , Projetos PilotoRESUMO
OBJECTIVE: To compare the efficacy of laparoscopy versus laparotomy in the treatment of transverse colon cancer. METHODS: Data from 100 patients with transverse colon cancer treated in our hospital from January 2018 to December 2020 were retrospectively analyzed in this study. According to the treatment methods, these patients were assigned into two groups: a laparotomy group (n=50) and a laparoscopy group (n=50). The intraoperative parameters, postoperative recovery, incidences of complications, postoperative pain, quality of life (QoL) score, postoperative serum inflammatory cytokine (hs-CRP, TNF-α, and IL-6) levels, and prognostic nutritional index (PNI) were analyzed and compared between the two groups. RESULTS: There was no significant difference in number of resected lymph nodes between the two groups. The operation time and intraoperative bleeding in the laparoscopy group were significantly less than those in the laparotomy group (P<0.05). The hospital stay, duration of gastrointestinal function recovery, and time of first postoperative flatus in the laparoscopy group were significantly shorter than those in the laparotomy group (all P<0.001). Moreover, the incidence of overall complications in the laparoscopy group was significantly lower than that in the laparotomy group (P<0.05). Compared with those in the laparotomy group, the VAS score was obviously lower and the QoL score was significantly higher in the laparoscopy group (all P<0.001). Patients in the laparoscopy group exhibited lower levels of postoperative hs-CRP, TNF-α and IL-6 in contrast to those in the laparotomy group (P<0.05). In additional, there was no significant difference in the PNI level before surgery between two groups. After surgery, the PNI level in the laparoscopy group was obviously higher than that in the laparotomy group (P<0.001). CONCLUSION: Laparoscopy is superior to laparotomy in treatment of transverse colon cancer through achieving better intraoperative outcomes, promoting postoperative recovery, reducing the incidence of complications and inflammatory reactions, alleviating postoperative pain, and improving therapeutic effects.
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OBJECTIVE: To investigate the application effect of the county medical community Hospital-Community health service organization-Home (HCH) model in nutritional management of patients with advanced gastrointestinal cancer after surgery. METHODS: This is a retrospective study. A total of 100 postoperative malnutrition patients with advanced gastrointestinal malignant tumors admitted to Lanxi People's Hospital from January 2022 to August 2022 were selected as subjects. All patients were divided into an observation group (n=50) or control group (n=50) according to the different methods of intervention. Patients in the observation group underwent care according to our county medical community HCH model, while those in the control group received routine perioperative nutrition management. The nutritional risk screening scores (NRS2002), Patient-Generated Subjective Global Assessment (PG-SGA) scores, body mass index (BMI), triceps skinfold thickness (TSF), upper arm circumference (AC); a well as levels of serum albumin (ALB), prealbumin (PA), transferrin (TRF), retinol binding protein (RBP), creatinine (Cr) and Free fatty acid (FFA); levels of immunoglobulin G (IgG), immunoglobulin M (IgM) and immunoglobulin A (IgA); and the levels of sodium (Na+), potassium (K+), calcium (Ca+) and lactic acid, and quality of life were recorded and compared between two groups. RESULTS: Compared with those before intervention, NRS2002 scores, PG-SGA score, BMI, TSF and AC after intervention were significantly improved in both groups. Compared with those after intervention in the control group, the NRS2002 score, PG-SGA score, BMI, TSF and AC of the patients in the observation group were significantly improved (all P<0.001). Compared with those before intervention, the levels of ALB, PA, TRF, RBP, Cr, FFA, IgG, IgM and IgA in the two groups were significantly higher after intervention. The levels of ALB, PA, TRF, RBP, Cr, FFA, IgG, IgM and IgA after intervention in the observation group were significantly higher than those in the control group (all P<0.05). Compared with those before management, the levels of Na+, K+ and lactic acid in the two groups were significantly decreased and the level of Ca+ was significantly increased after intervention. Compared with those after intervention in the control group, the patients in the observation group had significantly lower levels of Na+, K+ and lactic acid, and higher levels of Ca+ (all P<0.05). Compared with those before intervention, the scores of mental status, appetite, sleep quality, daily life and family understanding and cooperation in patients from the two groups after intervention were significantly higher. Compared with those after intervention in the control group, the patients in the observation group had significantly higher scores of life quality (P<0.05). CONCLUSION: The county medical community HCH model has a good effect in the nutritional management of patients with advanced gastrointestinal cancer surgery. The HCH model can effectively improve the nutritional status, enhance the immune function, and increase the quality of life. Thus it is worthy of clinical application.
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Objective: The effect of passive smoking exposure on the risk of type 2 diabetes has not been systematically studied. A meta-analysis was conducted to assess the association between passive smoking exposure and the risk of diabetes. Methods: We searched three major databases up to 31 October 2022 to identify relevant prospective cohort studies on the association between passive smoking and the risk of type 2 diabetes. The pooled relative risk (RR) and 95% confidence interval (CI) for the association between passive smoking exposure and the risk of type 2 diabetes were analyzed using a fixed-effect model. Results: Ten prospective cohort studies were included in this meta-analysis, with a total of 251,620 participants involved. The pooled RR showed a significantly positive association between nonsmokers exposed to passive smoking and type 2 diabetes as compared to non-smokers who were not exposed to passive smoking [RR = 1.27; 95% CI (1.19, 1.36); p < 0.001]. Sensitivity analysis indicated that the pooled RR was not substantially affected by any of the individual studies. Conclusion: Exposure to passive smoking increases the risk of type 2 diabetes. This study may have a positive effect on the prevention of type 2 diabetes. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023372532.