Abstract In order to determine the fasibility of reestablishment of circulation with cryopreserved microvenous allografts (1.0～1.4mm in diameter), 40 rabbits were divided into 2 groups. In the control group, the fresh autografts were used. In the experimental group, 20 rabbitsfemoral vein segments were treated by a two-step freezing procedure. After stored in liquid nitrogen for 48 hours, the segments were implanted into the femoral veins as allografts. The histological as well as the pathological studies were performed with light and electron microscope, and its patency was determined by angiography. The results showed that the preservation of vein was generally good. The rejective response was weak. The patency rates of 1 week and 12 weeks were 90% and 85% respectively, and there was no significant difference with that of the allogenic fresh autografts (Pgt;0.05). It was suggested that clinical use of cryoperserved allogenic microvein grafts instead of fresh autografts was possible.
ObjectiveTo evaluate clinical value of colon leakage score (CLS), a preoperative predictive scoring system, for risk of anastomotic leakage after left-sided colorectal cancer surgery. MethodsThe clinical data of 310 patients who underwent left-sided colorectal cancer surgery from January 2010 to December 2014 were studied retrospectively. Risk factors for postoperative anastomotic leakage were analyzed by univariate analysis. The sensitivity and specificity of CLS system were determined by receiver operating characteristic (ROC) curve analysis. Resultsa total of 14 patients were diagnosed as anastomotic leakage. The point of CLS for the patients with anastomotic leakage was significantly higher than that for the patients without anastomotic leakage (14.21±5.76 versus 4.43±3.36, t=9.474, P=0.000). The results of ROC curve analysis showed that the sensitivity and specificity of the CLS system were 92.9% and 88.6%, respectively. The area under the curve was 0.957 (95% CI 0.924-0.991). The best cut off value of CLS was 10 (The Youden index was 0.867). The results of univariate analysis showed that the age, preoperative hemoglobin level, status of intestinal obstruction, and blood loss were associated with postoperative anastomotic leakage (P<0.05). ConclusionThe preoperative predictive score system CLS could accurately predict occurrence of anastomotic leakage. While large, multicenter prospective randomized controlled trial is still needed to further confirm it.
ObjectiveTo systematically review the diagnostic value of capsule endoscopy and enteroscopy in small intestinal diseases.MethodsPubMed, The Cochrane Library, Web of Science, CNKI, WanFang Data, and VIP databases were electronically searched to collect studies on the diagnosis of intestinal diseases by capsule endoscopy and enteroscopy from inception to August 31st, 2020. Two reviewers independently screened literature, extracted data and assessed risk bias of included studies. Meta-analysis was then performed by using RevMan 5.3 and Meta-DiSc software.ResultsA total of 20 studies were included. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio for capsule endoscopy were 0.86 (95%CI 0.83 to 0.87), 0.81 (95%CI 0.78 to 0.84), 117.07 (95%CI 37.98 to 360.92), 7.20 (95%CI 2.81 to 18.45), 0.11 (95%CI 0.06 to 0.21), and those for enteroscopy were 0.89 (95%CI 0.87 to 0.90), 0.91 (95%CI 0.89 to 0.93), 196.99 (95%CI 72.63 to 534.26), 13.26 (95%CI 5.00 to 35.14), 0.12 (95%CI 0.07 to 0.21). The areas under the working characteristic curve (SROC) of capsule endoscopy and enteroscopy were 0.9692 and 0.9783, respectively.ConclusionsBoth capsule endoscopy and enteroscopy have high specificity and sensitivity in the diagnosis of small intestinal diseases, and enteroscopy has higher clinical value in the diagnosis of some small intestinal diseases than capsule endoscopy. Due to limited quantity and quality of the included studies, the above conclusions are required to be verified by more high-quality studies.
Objective To explore the progress of the relationship between the tumor suppressor gene p53 and oncogene c-erbB-2 and gastric cancer in recent years. Methods Relevant literatures about p53 and c-erbB-2 in gastric cancer were collected and analyzed. Results The mutation of p53 gene and the over-expression of c-erbB-2 gene were a common event in gastric cancer. The mutation of p53 gene was correlated with the location of gastric cancer and its aggressive biological behavior. The over-expression of c-erbB-2 gene could be used as an independent prognostic parameter in gastric cancer. The drugs targeted on p53 and c-erbB-2 gene were being developed. Conclusion Further research on the role of p53 and c-erbB-2 gene in the development of gastric cancer is helpful to understand the biological behavior and provide theoretical basis for gene therapy.
ObjectiveTo investigate the clinical significance of levels of serum salivary Krebs von den Lungen 6 (KL-6) and matrix metalloproteinase-9 (MMP-9) in predicting the prognosis of patients with acute respiratory distress syndrome (ARDS). MethodsFrom January 2020 to December 2023, 100 ARDS patients who received treatment in our hospital were included as the study group, and 59 healthy professionals who underwent health checkup were selected as the control group. And the levels of serum KL-6 and MMP-9 were measured on the day of admission. According to the oxygenation index (OI) results, the study group was separated into mild group (38 cases), moderate group (33 cases), and severe group (29 cases); Based on 28-day intensive care unit (ICU) survival status, the study group was divided into a survival group of 69 cases and a death group of 31 cases. Enzyme-Linked Immunosorbent Assay (ELISA) method was applied to detect the levels of serum KL-6 and MMP-9. Pearson correlation was applied to analyze the correlation between serum KL-6 and MMP-9 levels and OI in the death group. Logistic regression was applied to analyze the influencing factors of prognostic mortality in ARDS patients. Receiver operating characteristic (ROC) curve was applied to analyze the predictive value of serum KL-6 and MMP-9 levels for prognostic mortality in ARDS patients. ResultsCompared with the control group, the levels of serum KL-6 and MMP-9 in the study group were notably increased, and the levels of serum KL-6 and MMP-9 in the severe ARDS group were notably higher than those in the moderate and mild groups. The levels of serum KL-6 and MMP-9 in the moderate group were notably higher than those in the mild group, the OI in the survival group was greatly higher than that in the death group, and the acute physiology and chronic health evaluationⅡ (APACHE II) score, KL-6, and MMP-9 in the survival group were greatly lower than those in the death group (P<0.05). Pearson analysis showed that serum KL-6 and MMP-9 levels were negatively correlated with OI (P<0.05). Logistic analysis showed that APACHE II score, KL-6, and MMP-9 were risk factors for prognostic mortality in ARDS patients (P<0.05). ROC curve showed that the AUC of serum KL-6 and MMP-9 levels in predicting prognostic mortality in ARDS patients was 0.809 and 0.816, respectively, with cutoff value of 510.44 U/ml and 317.15μg/L, respectively. The area under the ROC curve (AUC) predicted by the combination of the two was 0.935, greatly higher than that of KL-6 (Z=2.133, P=0.033) and MMP-9 (Z=2.164, P=0.030) alone. ConclusionsThe levels of serum KL-6 and MMP-9 in ARDS patients are greatly upregulated and increase with the severity of the disease. The combination of the two has certain predictive value for the prognostic mortality of ARDS patients.