| Objective: To investigate the gene expression and significance of HoxD-13 in the terminal rectal tissue of children with congenital anorectal malformation(CAM) and its relationship with incision infection after operation. Method(s): 71 children with CAM from June 2015 to June 2019 were selected as the observation group, and 12 children without CAM were selected as the control group. Real-time fluorescent PCR(RT-PCR) was used to detect the HoxD-13 gene expression of terminal rectum tissue. The case data of the observation group as gender, age, weight, clinical type of CAM, other system combined malformations, operation mode, shaping times and postoperative incision infection were recorded, and the differences of Hoxd-13 gene expression levels in the above cases were analyzed. Analysis of the relationship between clinical type of CAM with other combined malformations or Hoxd-13 gene expression levels were done according to linear regression. The related factors of postoperative incision infection were observed, and then the risk factors of incision infection were investigated by single factor analysis and binary logistic analysis. Result(s): The relative expression level of HoxD-13 in the terminal rectal tissue of children with CAM was significantly lower than that of the control group (P<0.05). The relative expression of Hoxd-13 in children with other combined malformations was significantly lower than that in children without other malformations (P<0.05). In children with middle and high cam, the prevalence of other combined malformations was significantly higher than that in children with low cam (72.09% vs. 21.43%) (P<0.05), and the relative expression of Hoxd-13 was significantly lower than that in children with low cam (P<0.05), and according to the linear regression, the relative expression of Hoxd-13 was the main factor affecting clinical type (t=4.714, P=0.000). The single factor analysis of incisional infection indicated that there were statistical differences in clinical type, other combined malformations and the relative expression of Hoxd-13 in terminal rectal tissue between the children with postoperative incisional infection and those without incisional infection (P<0.05), and the binary logistic analysis showed that the relative expression of Hoxd-13 was a risk factor for postoperative incision infection (Wald χ2=7.440, P=0.006). Conclusion(s): The low expression of Hoxd-13 in the terminal rectum tissue of children with CAM may be the main factor of clinical type of CAM and other combined malformations, and may be the risk factor of incision infection after operation, so it has certain clinical value to detect the expression of Hoxd-13 gene in fetus of children. |
