ObjectiveTo conduct an analysis and identify potential risk factors associated with postoperative complications in patients diagnosed with malignant gastrointestinal tumors who underwent laparoscopic surgery. MethodsFrom January 2023 to October 2023, 500 patients with malignant gastrointestinal tumors who underwent laparoscopic surgery at the Department of General Surgery, the First Medical Center of PLA General Hospital were prospectively selected as the research objects. The incidence of postoperative complications (Clavien-Dindo gradeⅡ and higher) was observed, and then 500 patients were divided into a complication group and a non-complication group. The preoperative physical conditions, operative time and bleeding volume related to the operation were compared and analyzed between the two groups. According to the analysis results and clinical experience, appropriate variables were selected to be included in the multivariate binary logistic regression model for analysis, in order to determine the risk factors for postoperative complications in patients with malignant gastrointestinal tumors. ResultsOf the 500 patients, 453 had no postoperative complications (non-complication group), and 47 had postoperative complications (complication group), with an incidence of 9.4%. Univariate analysis showed that there were significant differences between the complication group and the non-complications group in gender, abdominal girth, preoperative hypoalbuminemia, drinking history, protein diet habits, primary diseases, operative time and intraoperative blood loss (P<0.05), while there were no significant differences between the two groups in age, body mass index, preoperative grip strength, 6 m walking test time, preoperative anemia, hypertension, diabetes, cardiovascular and cerebrovascular diseases, smoking history, education level, exercise habits and preoperative NRS 2002 nutritional score (P>0.05). Multivariate binary logistic regression analysis showed that gender, daily protein diet and exercise frequency, operation time >200 min and intraoperative blood loss >150 mL could be used as independent predictors of postoperative complications in patients with malignant gastrointestinal tumors (P<0.05). ConclusionFor female malignant gastrointestinal tumor patients with low daily protein intake, inadequate physical activity, prolonged operation duration, and massive intraoperative bleeding, perioperative management should be taken in advance and the occurrence of postoperative complications should be vigilant.
Objective To investigate the expression and significance of Krüppel-like factor 4 ( KLF4) in the lung tissues of mice with bleomycin-induced pulmonary fibrosis.Methods C57BL/6 mice were randomly divided into a control group and a BLM group. The mice in the BLM group were given a single intratracheal injection of bleomycin ( 2.5 mg/kg) , while those in the control group were injected with isodose physiological saline. The mice were sacrificed at the 12h and on the day 1, 2, 3, 7, 14 and 28, then HE stain and Masson’s trichrome stain were used to detect the architecture of alveolar and the deposition of cellularity and collagen. Real time-polymerase chain reaction ( RT-PCR ) and immunohistochemical technology were performed to investigate the expression of KLF4. Results In the bleomycin-induced pulmonary fibrosis, acute inflammation was observed on the day 1, 2 and 3, the inflammation was exacerbated and the collagen deposition began to be observed on the day 7, the architecture of alveolar was destroyed and the collagen deposition was more obvious on the day 14, while the alveolar structure was nearly recovered to normal, and the inflammation and collagen deposition were attenuated on the day 28. The expression of KLF4 mRNA increased from the day 1, then decreased, arrived at the minimumon the day 3, and then gradually increased until the day 28. The trend of KLF4 protein expression showed roughly the same as the KLF4 mRNA level, which started to increase on the day 1, then decreased, arrived at the minimum on the day 3,then gradually increased until the day 14 and then decreased again. Conclusion The expressions of KLF4 mRNA and protein are dynamically changed in the process of experimental pulmonary fibrosis, suggesting KLF4 may contribute to the pathogenesis of pulmonary fibrosis.