Objective To construct the risk model for healthcare-associated infection (HAI)with multidrug-re-sistant organisms(MDROs)in intensive care unit (ICU).Methods 836 patients who were admitted to ICU for more than 48 hours between October 2012 and September 2015 were analyzed retrospectively,logistic regression model of HAI was constructed,the model was conducted goodness of fit tests and the area under ROC curve analysis. Results Among 836 patients,incidence of HAI with MDROs was 14.23%(n=119).15 variables that were statis-tically significant in univariate analysis were included in logistic multivariate analysis,the results showed that the following variables entered into logistic regression equation:length of ICU stay (OR,2.493 [95%CI ,1 .816 -3.494]),underlying diseases (OR,1 .536 [95%CI ,1 .243 - 1 .898 ]),hypoproteinemia (OR,87.211 [95%CI , 36.165-210.304]),ventilator days (OR,1 .723 [95%CI ,1 .399-2.121 ]),fever(OR,20.639 [95%CI ,3.462 -123.043]),and primary pulmonary infection (OR,0.295 [95%CI ,0.133 -0.664]).Evaluation of model effect:sensitivity 95%,specificity 87.9%,the area under ROC curve 0.973.Conclusion Logistic regression model has a high goodness of fit in predicting HAI among ICU patients.

In recent years,the application of immune checkpoint blockades has brought dramatical revolution to the treatment of malignant tumors,which not only significantly increase the clinical benefits of partial advanced lung cancer,but also gradually change the landscape of available treatment options for patients with local advanced and early-staged lung cancer.But problems of immunotherapy about efficacy and safety follows.It is urgent to find dynamic biomarkers to identify the patients who are most likely to benefit from immunotherapy and to monitor tumor-specific immune responses.Several dynamic biomarkers have been identified,we will review some of lung cancer-related biomarkers,such as PD-L1 、TMB 、ctDNA 、TILs and peripheral blood biomarkers.

Objective:To investigate the effect of serum 25 hydroxyvitamin D (25OHD) levels in early pregnancy on glucose and lipid metabolism indicators and pregnancy outcomes in women with polycystic ovary syndrome (PCOS).Methods:A prospective study was conducted on 132 pregnant women with PCOS admitted to the Yanda Hospital in Hebei from January 2021 to June 2022. They were divided into four groups based on serum 25OHD levels: severe vitamin D deficiency group (12 cases with 25OHD<10 ng/ml), vitamin D deficiency group (28 cases with 25OHD: 10-<20 ng/ml), vitamin D deficiency group (55 cases with 25OHD: 20-<30 ng/ml), and vitamin D sufficient group (37 cases with 25OHD≥30 ng/ml). Four groups of serum glucose and lipid metabolism indicators [total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), fasting blood glucose (FPG), fasting insulin (FINS), insulin resistance index (HOMA-IR)] and poor pregnancy outcomes were compared.Results:As the degree of vitamin D deficiency worsens in early pregnancy, serum levels of TC, TG, LDL-C, FPG, FINS, and HOMA-IR gradually increased (all P<0.05), while serum levels of HDL-C gradually decreased (all P<0.05). The serum 25OHD level in early pregnancy of PCOS pregnant women was negatively correlated with serum TG, FINS levels, and HOMA-IR levels ( r=-0.523, -0.612, -0.354, all P<0.05), and positively correlated with serum HDL-C levels ( r=0.484, P<0.05). There was no significant correlation with serum TC, LDL-C, and FPG levels (all P>0.05). The incidence of adverse pregnancy outcomes in the vitamin D sufficient group was significantly lower than the other three groups [8.11%(3/37) vs 34.55%(19/55), 46.43%(13/28), 8/12, P<0.05], while the incidence of adverse pregnancy outcomes in the vitamin D insufficient group was significantly lower than that in the vitamin D severely deficient group (34.55% vs 8/12, P<0.05). Conclusions:With the decrease of serum 25OHD levels in early pregnancy, the disorder of glucose and lipid metabolism in PCOS pregnant women gradually worsens, and the incidence of adverse pregnancy outcomes gradually increases.

Objective To investigate the clinical effect of jinweijing decoction combined with dachengqi decoction on treatment of patients with pulmonary infection after thoracoscopic surgery.Methods Totally 160 patients with pulmonary infection after thoracoscopic surgery were randomly divided into control group and observation group.The control group was treated with conventional treatment,while the observation group was treated with the combination of jinweijing decoction and dachengqi decoction on the basis of routine treatment.The therapeutic effect,serum PCT,IL-6,TNF-α and hs-CRP were compared.At the same time,the disappearance time of fever,cough and hospitalization as well as satisfaction degree were compared.Results The observation group was significantly higher in efficiency than the control group (P ＜ 0.05).After treatment,the levels of PCT,IL-6,TNF-α and hs-CRP decreased significantly,and the four indicators of the observation group were significantly lower than the control group (P ＜ 0.05).The observation group had shorter disappearance time of fever,cough and hospitalization than the control group (P ＜ 0.05).The satisfaction degree of the observation group was significantly higher than that of the control group (P ＜ 0.05).Conclusion Jinweijing decoction combined with dachengqi decoction is effective in treatment of patients with pulmonary infection after thoracoscopic surgery.

Objective To investigate the clinical effect of jinweijing decoction combined with dachengqi decoction on treatment of patients with pulmonary infection after thoracoscopic surgery.Methods Totally 160 patients with pulmonary infection after thoracoscopic surgery were randomly divided into control group and observation group.The control group was treated with conventional treatment,while the observation group was treated with the combination of jinweijing decoction and dachengqi decoction on the basis of routine treatment.The therapeutic effect,serum PCT,IL-6,TNF-α and hs-CRP were compared.At the same time,the disappearance time of fever,cough and hospitalization as well as satisfaction degree were compared.Results The observation group was significantly higher in efficiency than the control group (P ＜ 0.05).After treatment,the levels of PCT,IL-6,TNF-α and hs-CRP decreased significantly,and the four indicators of the observation group were significantly lower than the control group (P ＜ 0.05).The observation group had shorter disappearance time of fever,cough and hospitalization than the control group (P ＜ 0.05).The satisfaction degree of the observation group was significantly higher than that of the control group (P ＜ 0.05).Conclusion Jinweijing decoction combined with dachengqi decoction is effective in treatment of patients with pulmonary infection after thoracoscopic surgery.

Objective To establish a study cohort of chronic hepatitis B (CHB) in Qidong and evaluate its baseline characteristics. Methods CHB outpatients of the Third People's Hospital of Qidong were invited to participate in baseline survey from January 1, 2016, including questionnaire survey, liver function detection, serum detection of HBV infection and upper abdomen ultrasound detection. Anticipated sample size was at least one thousand. Baseline data were inputted by EpiData 3.1 software and then cleaned and analyzed by SAS 9.3 software. Results As of 18 July, 2016, a total of 1006 participants had been enrolled into the current study, including 615 males with an average age of (44.26±9.97) years and 391 females with an average age of (46.66±11.17) years. The difference in family history of liver disease was not significant between males and females (P>0.05), while the differences in other key information, such as age, education level, tobacco consumption, alcohol drinking, tea consumption, and antiviral intervention, were significant between males and females (P<0.05). Among the key clinical parameters, such as ALT, HBeAg, HBsAg, HBV DNA, albumin, and width of splenic vein and portal vein, only the abnormal rates of ALT and total bilirubin levels were higher in males than in females, the difference was significant (P<0.05). Conclusion Outpatient department-based CHB cohort was established successfully in Qidong, and sub-cohort could be divided according to the differences on baseline characteristics.

Objective To investigate the inhibition of gigantol on corneal neovascularization(CNV)in rats after corneal alkali burn.Methods Animal models of corneal alkali burn were made with SD rats,which were divided into normal control group,model control group,low-concentration gigantol group,high-concentration gigantol group and aflibercept group,with 10 rats in each group.The rats in low-concentration gigantol group,high-concentration gigantol group and aflibercept group were treated with 2.5 mg/0.05 mL gigantol,5 mg/0.05 mL gigantol,and 2 mg/0.05 mL aflibercept by subconjunctival injection after modeling.The CNV,corneal opacity score,and thickness of the cornea were observed and compared on the 3rd,7th,and 14th days after alkali burn.The ratio of CNV area to corneal area was calculated.On the 14th day,all rats were sacrificed.Hematoxylin and eosin staining and immunohistochemistry were used to detect the expression of CD34 and VEGF.The protein expression of VEGF,IL-1β,and TNF-α was detected by ELISA.Results On the 7th and 14th days after alkali burn,the percentages of CNV to total corneal area in low-concentration gigantol group,high-concentration gigantol group and aflibercept group were significantly smaller than those in model control group(all P＜0.05).On the 14th day,the corneal opacity score was lower in high-concentration gigantol group than model control group(P＜0.05).The corneal thickness in model control group and low-concentration gigantol group were significantly greater than that in normal control group(all P＜0.001).However,the corneal thickness in high-concentration gigantol group and aflibercept group were not significantly different from that in normal control group(all P＞0.05).In addition,the protein expression of VEGF,IL-1β,and TNF-α in corneal tissues in low-concentration gigantol group,high-concentration gigantol group and aflibercept group were significantly lower than that in model control group(all P＜0.01).Conclusions Gigantol administration by subconjunctival injection can inhibit the formation of CNV in rats after alkali burn and promote absorption of the corneal edema.

ObjectiveTo investigate the risk factors for liver cancer in patients with chronic hepatitis B （CHB） in the Qidong Chronic Hepatitis B cohort， and to construct a nomogram model for predicting the risk of liver cancer in CHB patients. MethodsA structured questionnaire survey was conducted among the CHB patients， aged ≥18 years， who attended the outpatient service of Qidong Third People’s Hospital from January 1 to December 31， 2016. The onset of liver cancer was defined as the primary outcome， and the outcomes of the cohort were obtained from Qidong Cancer Registry. Baseline clinical features were compared ；between the liver cancer group and the non-liver cancer group. The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups， and the chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups. The Cox regression model was used to analyze the risk factors for liver cancer in CHB patients and calculate their hazard ratio （HR） and 95% confidence interval （CI）； the variables with statistical significance in the univariate Cox regression analysis were included in the LASSO regression analysis， and then the variables obtained were included in the multivariate Cox regression analysis to establish a predictive model. The nomogram was used to visualize the complex model. The receiver operating characteristic （ROC） curve， index of concordance （C-index）， and the calibration curve were used to assess the predictive efficacy of the model， and the decision curve was used to evaluate the clinical practicability of the nomogram. ResultsA total of 1 479 CHB patients were selected， among whom 58 patients with a confirmed diagnosis of liver cancer， 15 with missing data on testing indicators， and 164 with missing data on important information in the questionnaire were excluded， and finally 1 242 subjects were included in the study. Up to December 31， 2023， there were 67 new cases of liver cancer after a median follow-up time of 7.71 years， and the incidence density of liver cancer was 729.78/100，000 person-years. There were significant differences between the liver cancer group and the non-liver cancer group in age， sex， educational level， liver cirrhosis， duration of liver cirrhosis， history of diabetes mellitus， albumin， total bilirubin （TBil）， direct bilirubin， aspartate aminotransferase， aspartate aminotransferase， gamma-glutamyl transpeptidase （GGT）， and alkaline phosphatase （all P<0.05）. The multivariate Cox regression analysis showed that the increase in age （HR=1.07， 95%CI： 1.05‍ ‍—‍ ‍1.10， P<0.001）， a relatively high level of TBil （HR=1.98， 95%CI： 1.15‍ ‍—‍ ‍3.42， P=0.014）， a relatively high level of GGT （HR=2.41， 95%CI： 1.43‍ ‍—‍ ‍4.08， P=0.001）， and a long duration of liver cirrhosis （HR=1.09， 95%CI： 1.02‍ ‍—‍ ‍1.15， P=0.009） were independent risk factors for liver cancer in CHB patients. A nomogram prediction model was constructed based on the above four indicators， with an area under the ROC curve of 0.790， 0.845， and 0.829， respectively， in predicting the risk of liver cancer in CHB patients at 1， 3， and 5 years， and the bootstrap resampling method was used for internal validation and showed a C-index of 0. 778. The calibration curve showed that the prediction model had good stability， and the decision curve showed that it had certain clinical practicability. ConclusionThe increase in age， relatively high levels of TBil and GGT， and a long duration of liver cirrhosis are independent risk factors for liver cancer in CHB patients， and the nomogram model constructed based on these factors has a good predictive value and can be used in clinical practice to help develop strategies for the long-term monitoring of liver cancer.