The workup and surveillance strategies for infant hydronephrosis (HN) vary, although this could be due to grade-dependent differences in imaging intensity. We aimed to describe the frequency of imaging studies for HN within the first year of life, stratified by initial HN grade, within a large regional healthcare system.

. Retrospective cohort using Intermountain Healthcare Data Warehouse. Inclusion criteria (1) birth between 1/1/2005 and 12/31/2013, (2) CPT code for HN, and (3) ultrasound (U/S) confirmed HN within four months of birth.

. Grade of HN on initial postnatal U/S; number of HN-associated radiologic studies (renal U/Ss, voiding cystourethrograms (VCUGs), and diuretic renal scans); demographic and medical variables.

. Sum of radiologic studies within the first year of life or prior to pyeloplasty.

. Multivariate poisson regression to analyze association between the primary outcome and the initial HN grade.

Of 1,380 subjects (993 males and 387 females), 990 (72%), 230 (17%), and 160 (12%) had mild, moderate, and severe HN, respectively. Compared with those with mild HN, patients with moderate (RR 1.57; 95% CI 1.42-1.73) and severe (RR 2.09; 95% CI 1.88-2.32) HN had a significantly higher rate of imaging use over 12 months (or prior to surgery) after controlling for potential confounders.

In a large regional healthcare system, imaging use for HN is proportional to its initial grade. This suggests that within our system, clinicians treating this condition are using a risk-stratified approach to imaging.

In a large regional healthcare system, imaging use for HN is proportional to its initial grade. This suggests that within our system, clinicians treating this condition are using a risk-stratified approach to imaging.

Sepsis is a severe complication in patients following major hepatobiliary and pancreatic surgery. The purpose of this study was to develop and validate a nomogram based on inflammation biomarkers and clinical characteristics.

Patients who underwent major hepatobiliary and pancreatic surgery between June 2015 and April 2017 were retrospectively collected. Multivariate logistic regression was used to identify the independent risk factors associated with postoperative sepsis. A training cohort of 522 patients in an earlier period was used to develop the prediction models, and a validation cohort of 136 patients thereafter was used to validate the nomograms.

Sepsis developed in 55 of 522 patients of the training cohort and 19 of 136 patients in the validation cohort, respectively. In the training cohort, one nomogram based on clinical characteristics was developed. The clinical independent risk factors for postoperative sepsis include perioperative blood transfusion, diabetes, operative time, direct bilirubk estimation of sepsis for patients following major hepatobiliary and pancreatic surgery.Poor adherence to treatment instructions may play an important role in the failure of Helicobacter pylori eradication. The aim of this study was to evaluate the effects of telephone-based reeducation on 14-day quadruple H. pylori eradication therapy. In total, 162 patients were randomly assigned (1  1) to either the intervention group (patients received telephone-based reeducation on the 4th, 7th, and 10th days of the course) or the control group (patients received instructions only at the time of getting the prescriptions). All patients received a 14-day quadruple H. pylori eradication therapy. The primary outcome was the H. pylori eradication rate. The secondary outcomes included the symptom relief rates and the incidence rates of adverse events. Seventy-five patients in the reeducation group and 74 patients in the control group completed the follow-up. The H. pylori eradication rate in the reeducation group was statistically higher than that in the control group (intention-to-treat 72.8% vs. 50.6%, P = 0.006; per-protocol 78.7% vs. 55.4%, P = 0.003). However, the symptom relief rates and the adverse event rates in these two groups were not significantly different. Overall, the results from this study suggest that telephone-based reeducation can be potentially applied to improve the H. pylori eradication rate in clinical practice, without significantly increasing the adverse effects.

Intraoperative fluid (IOF) administration plays an important role during major abdominal surgery although increased fluid intake can adversely influence postoperative outcomes. However, the effect of the IOF rate on the outcomes of pancreatoduodenectomy (PD) is unclear.

151 patients, who underwent PD at Binzhou Medical University Hospital between January 2010 and May 2017, were categorized into three groups according to IOF rates (ml/kg/hr) restricted (<10,

= 47), standard (10-15,

= 76), and liberal (>15,

= 28).

The overall postoperative morbidity was 56.95%. The incidence of postoperative pancreatic fistula (POPF) was 11.26%. The in-hospital mortality rate was 7.28% with the most common cause being grade C POPF and secondary intra-abdominal infections. The patients in the liberal group had significantly higher incidences of POPF (25%) and respiratory complications (21.43%). The other outcome parameters such as recovery of bowel function, hospital stay, and postoperative daily drainage were similar among the groups. Multivariable analysis confirmed the IOF rate to be most strongly associated with POPF (odds ratio 5.195, confidence interval 1.142-23.823,

= 0.023) and respiratory complications (odds ratio 7.302, confidence interval 0.676-58.231,

= 0.025).

The IOF rate significantly affects the incidence of POPF and respiratory complications after PD. Careful patient-oriented fluid therapy may help to prevent these complications.

The IOF rate significantly affects the incidence of POPF and respiratory complications after PD. Careful patient-oriented fluid therapy may help to prevent these complications.

Tripartite motif protein 36 (TRIM36) plays a tumor-suppressive role in prostate cancer. However, there is little information on the clinical relevance of TRIM36 expression in esophageal cancer (ESCA).

TRIM36 expression was analyzed by using The Cancer Genome Atlas (TCGA) ESCA dataset as well as by quantitative real-time polymerase chain reaction (PCR) and immunohistochemical (IHC) staining on samples from our hospital.

In the current study, the analysis of TCGA ESCA dataset suggested the decreased expression of TRIM36 in ESCA tissues. Further analyses on samples from our hospital demonstrated that TRIM36 was significantly downregulated in ESCA tissues than in the noncancerous controls at both the mRNA and protein levels. Moreover, gene set enrichment analysis on TCGA ESCA dataset suggested that TRIM36 expression was inversely correlated with the

-catenin pathway. IHC staining data showed that 66.25% (53/80) and 51.25% (41/80) of ESCA cases had a low expression of TRIM36 and a high expression of

-catenin, respectively. By Fisher’s exact test, we found that TRIM36 protein expression was significantly correlated with tumor size (

= 0.0104), tumor stage (

= 0.0169), lymph node metastasis (

= 0.0021), vital status (

= 0.0443), and

-catenin expression (

= 0.0329). These findings suggest the potential clinical significance of TRIM36 in ESCA. Kaplan-Meier and log-rank test demonstrated that a low expression of TRIM6 and a high expression of

-catenin were associated with poor overall survival of ESCA patients.

Our study provides evidence for the prognostic value of TRIM36 in ESCA.

Our study provides evidence for the prognostic value of TRIM36 in ESCA.

We investigated the prognostic significance of pretreatment systemic inflammation response index (SIRI) in locally advanced pancreatic carcinoma (LAPC) patients treated with concurrent chemoradiotherapy (CRT).

Present retrospective cohort analysis investigated consecutive 154 LAPC patients who received radical CRT. The SIRI was defined as SIRI = neutrophil × monocyte/lymphocyte counts. Ideal SIRI cutoff(s) influencing overall survival (OS) and progression-free survival (PFS) results were sought by using receiver operating characteristic (ROC) curve analysis. The primary endpoint was the interaction between the SIRI and OS results.

The median follow-up, PFS, and OS durations were 14.3 (range 2.9-74.6), 7.9 [%95 confidence interval (CI) 5.7-10.1), and 14.7 months (%95 CI 11.4-18.0) for the entire cohort, respectively. ROC curve analyses determined the ideal SIRI cutoff that exhibiting a significant link with OS and PFS outcomes at the rounded 1.6 point (AUC 74.3%; sensitivity 73.8%; specificity 70.1%).The SIRI <1.6 patients (

= 58) had significantly superior median PFS (13.8 versus 6.7 months;

< 0.001) and OS (28.6 versus 12.6 months;

< 0.001) lengths than SIRI ≥1.6 patients (

= 96), respectively. Although the N0 (versus N1;

< 0.05) and CA 19-9 ≤90 U/mL (versus >90 U/mL) appeared as the other significant associates of better OS and PFS in univariate analyses, yet the results of multivariate analyses confirmed the SIRI <1.6 as the independent indicator of superior OS and PFS (

< 0.001 for each).

Pretreatment SIRI is a novel independent prognosticator that may further enhance the conventional tumor-node-metastases staging system in a more precise prediction of the OS and PFS outcomes of LAPC patients after radical CRT.

Pretreatment SIRI is a novel independent prognosticator that may further enhance the conventional tumor-node-metastases staging system in a more precise prediction of the OS and PFS outcomes of LAPC patients after radical CRT.

Appendicitis is the most common cause of surgery in people under 50. In America, it causes 250,000 cases per year and about 1 million days of hospitalization.

This cross-sectional study was performed on 20 patients under appendectomy with diagnosis of acute appendicitis. The statistical population was divided into two groups, proven appendicitis in pathology and rejection of appendicitis in pathology. Then, 10 patients were assigned into each group.

A total of 20 patients were enrolled in this study, 9 of whom were female (45%) and 11 male (55%). The most common symptom was anorexia. However, there was no statistical difference between the two groups. The lowest level of serum ghrelin was 0.95 and the highest was 16.00 in the study group, which was the mean in people with appendicitis and nonappendicitis 6.24 ± 4.09 and 5.12 ± 4.85, respectively. These values were not significantly different between the two groups (

= 0.45, df = 18,

= 0.65).

This conclusion may be due to the small number of cases introduced into the study, which suggests that further investigation is warranted with a larger sample size.

This conclusion may be due to the small number of cases introduced into the study, which suggests that further investigation is warranted with a larger sample size.

The precise mechanisms of nerve regeneration remain unclear. The potential of facial nerve regeneration and probable mechanisms involved following chronic facial nerve injury should be further studied.

Adult male Wistar rats were used to model either (i) facial nerve injury (axotomy) or (ii) reinjury (chronic axotomy followed by a second axotomy within 5 months). The rats were housed in the animal facility of the Eye and ENT Hospital of Shanghai Medical School, Fudan University (Shanghai, China). Expression of Shh (sonic hedgehog) and growth-associated protein 43 (GAP43, a neuronal marker) was detected in bilateral facial nuclei using reverse transcriptase PCR, western blotting analysis, and immunohistochemistry. The number of surviving motoneurons was quantified, and facial nerve regeneration was examined using transmission electron microscopy.

Reinjury of the facial nerve 12 weeks after the first axotomy resulted in upregulation of GAP43 mRNA and protein expression in neurons ipsilateral to the axotomy; immunohistochemistry revealed that Shh expression was higher compared with control side facial nuclei at the same time point.