Clinical data of PC patients who underwent TP from January 2016 to December 2021(TP group) and PD from January 2019 to December 2021(PD group) at Peking Union Medical College Hospital were retrospectively collected. Patients in the PD group were divided into the pancreatic fistula(PF) high-risk PD group and the recurrence high-risk PD group according to risk factors. After propensity score matching, the differences in postoperative short-term surgical efficacy indicators(postoperative complication rate, 30 d mortality rate, length of hospital stay, etc.), long-term surgical efficacy indicators(overall survival), and quality of life were compared between the TP group and the PF high-risk PD group or the recurrence high-risk PD group.

A total of 32 patients in the TP group and 114 patients in the PD group(99 patients in the PF high-risk PD group and 15 patients in the recurrence high-risk PD group) meeting the inclusion and exclusion criteria were enrolled.(1)TP group and PF high-risk PD group: after propensity score matching, 29 patients in the TP group and 56 patients in the PF high-risk PD group were finally included. There was no PF in the TP group, and the rate of PF in the PF high-risk PD group was 19.64%(P=0.027).There were no statistical differences in short-term surgical efficacy indicators such as other postoperative complication rates, Clavien-Dindo grading, length of stay, ICU stay, and 30 d mortality between the two groups(all P > 0.05). At the median follow-up time of 36 months, there was no significant difference in the quality of life questionnaire-core 30(QLQ-C30) scores between the two groups(P > 0.05).(2)TP group and recurrent high-risk PD group: Since there were no statistically significant differences between the baseline data of the two groups(P > 0.05), 32 patients in the TP group and 15 patients in the recurrent high-risk PD group were both included in the analysis. There was no PF in the TP group, and the rate of PF in the recurrent high-risk PD group was 20.00%(P=0.028).The other postoperative complication rates, Clavien- Dindo grading, length of hospital stay, ICU stay, 30 d mortality and other short-term surgical efficacy indicators were also not statistically different between the two groups(all P > 0.05). By the final follow-up, the median overall survival was longer in the TP group than the recurrent high-risk PD group(37.68 months vs. 15.24 months, HR=2.551, 95% CI: 1.144-5.689, P=0.018). Multifactorial Cox regression showed that recurrent high-risk PD and preoperative obstructive jaundice were independent risk factors in the poor long-term prognosis of patients with PC.

For PC patients at high risk of PF, TP can achieve short-term surgical outcomes and long-term quality of life comparable to PD with no burden of postoperative pancreatic fistula. For patients with high-risk recurrence, TP can significantly prolong the survival of PC patients while ensuring surgical safety.

Clinical data of patients hospitalized in the Department of Gastroenterology of Peking Union Medical College Hospital who underwent ERCP biliary stent drainage for pancreatic cancer combined with obstructive jaundice from January 1, 2023 to February 26, 2024 were retrospectively collected. They were categorized into the fusion technology group and the simple ERCP group according to whether EUS-FNA was performed in the same endoscopic unit. The differences in pathologic diagnosis rate, ERCP drainage success rate, postoperative complication rate and patients' single hospitalization time were compared between the two groups.

A total of 161 patients with pancreatic cancer combined with obstructive jaundice who underwent ERCP biliary stent drainage meeting the inclusion and exclusion criteria were enrolled, of which 80 were in the fusion technique group and 81 were in the simple ERCP group. The pathological diagnosis rate in the fusion technique group was higher than that in the simple ERCP group[92.50%(74/80) vs. 46.15%(12/26), P < 0.001], and the ERCP drainage success rate[82.50%(66/80) vs. 86.42%(70/81), P=0.360], the overall postoperative complication rate[5.00%(4/80) vs. 2.47%(2/81), P=0.443], and single hospitalization time[4 (4, 7)d vs. 5 (3, 9)d, P=0.397] were not statistically different from simple ERCP groups.

The fusion of EUS-FNA and ERCP enhances the efficiency of diagnosis and treatment for pancreatic carcinoma, warranting widespread adoption and further research.

In this retrospective study, we included patients who underwent contrast-enhanced ultrasound examination of pancreatic lesions at Peking Union Medical College Hospital from January 2017 to December 2022 and received a confirmed pathological diagnosis. Using pathological diagnosis as the gold standard, the study evaluated the accuracy of contrast-enhanced diagnostic ultrasound. It also analyzed the misdiagnosis of contrast-enhanced ultrasound in diagnosing various pathological types of pancreatic lesions.

Of the 859 patients who met inclusion and exclusion criteria, 489 were male(56.9%) and 370 were female(43.1%).Their age ranged from 16 to 85 years, with a median age of 60(53, 66) years. Except for 47 pancreatic space-occupying lesions that were difficult to categorize as either benign or malignant, a total of 812 cases were included in the diagnostic efficacy analysis of benign and malignant lesions. The results suggested that the diagnostic sensitivity and specificity of contrast-enhanced ultrasound for pancreatic malignant lesions were 98.3%(95% CI: 97.1%-99.1%) and 79.0%(95% CI: 70.1%-86.4%), AUC was 0.887(95% CI: 0.863-0.908), positive and negative predictive value were 96.9%(95% CI: 95.6%-97.9%) and 87.4%(95% CI: 79.6%-92.4%), positive and negative likelihood ratio were 4.69(95% CI: 3.24-6.80) and 0.02(95% CI: 0.01-0.04). The diagnostic accuracy rate of contrast-enhanced ultrasound for diagnosing benign and malignant pancreatic lesions was 95.8%. Of the 859 lesions examined, 48 cases were misdiagnosed by contrast-enhanced ultrasound, with a misdiagnosis rate of 5.6%(48/859), including 7 cases(0.8%) of undetermined diagnosis, while the diagnostic accuracy of pancreatic ductal adenocarcinoma was as high as 98.8%. No complications occurred in any of the patients.

Contrast-enhanced ultrasound is a safe and effective imaging method for evaluating microvascular perfusion in various pancreatic lesions. It has significant clinical value in diagnosing both benign and malignant pancreatic lesions, particularly in diagnosing pancreatic ductal adenocarcinoma.

Five C57BL/6J wild-type male mice aged 8-10 weeks were chosen and fed normally. Lamina propria lymphocytes (LPLs) and intestinal epithelial cells (IECs) were extracted, and totalcell RNA was extracted by Trizol reagent. The mRNA expression of SLAMF7 in cells was detected by reverse transcription polymerase chain reaction (RT-PCR) and real-time fluorescent quantitative polymerase chain reaction (RT-qPCR). Then 10 C57BL/6J wild-type male mice aged 8-10 weeks were randomly divided into control group (n=5) and model group (n=5). The control group was fed with normal drinking water, whereas the model group was fed with 2.5% dextran sodium sulfate (DSS) drinking water to establish a model of ulcerative colitis (UC). The mice in both groups were killed on the 5th day. Flow cytometry was used to detect the expression of SLAMF7 in immune cell subpopulations in the control group and the model group.

Compared with colonic IECs, the expression of SLAMF7 was higher in colonic LPLs(P=0.017). After DSS induced enteritis, the expression of SLAMF7 was up-regulated in neutrophils (P=0.001), but had no significant changes in CD4⁺T cells, CD8⁺T cells, CD19⁺B cells, macrophages and conventional dendritic cells(all P > 0.05).

SLAMF7 may play an important role in the occurrence and development of UC through neutrophil-related pathways.

Ovarian cancer patients who underwent cytoreductive surgery at Peking Union Medical College Hospital from January 2014 to December 2018 were retrospectively included. Clinical data such as the patients' general information, preoperative plasma albumin, American Society of Anesthesiologists(ASA) classification, intraoperative bleeding volume, operation time, perioperative (intraoperative and within 3 d postoperatively)allogeneic red blood cell transfusion were collected, and the correlation between preoperative hypoproteinemia (plasma albumin < 35 g/L) and the risk of allogeneic red blood cell infusion was analyzed by using multivariate Logistic regression.

A total of 1001 ovarian cancer patients who met the inclusion and exclusion criteria were enrolled, of which 64 (6.4%) had preoperative hypoproteinemia and 481(48.1%) received perioperative allogeneic red blood cell transfusion. The rate of perioperative allogeneic red blood cell transfusion was higher in the patients with hypoproteinemia than in those without hypoproteinemia [84.4% (54/64) vs. 45.6% (427/937), P < 0.001]. Multivariate Logistic regression analysis corrected for confounders such as ASA classification, intraoperative bleeding volume, and operative time found that preoperative hypoproteinemia was significantly associated with the risk of perioperative allogeneic red blood cell transfusion (OR=5.68, 95% CI: 2.56-13.57, P < 0.001).

Preoperative hypoalbuminemia could be associated with the increased risk of perioperative transfusion in patients undergoing cytoreductive surgery for ovarian cancer.

Using a stratified cluster sampling method, we selected all social workers in the five streets of Chaoyang District, Beijing(Jiuxianqiao, Wangjing, Taiyanggong, Shibalidian, Sunhe) from November 2021 to March 2022 as the study population(social worker group), and the frontline medical staffs(medical professional group) of the same age range of the corresponding community hospitals of the same five streets, and the community residents(resident group) as the control population. The ratio of the social worker group, medical professional group, and resident group was 1∶1∶1. The Sojump platform was used to send electronic questionnaires to the wechat groups of social workers, healthcare workers, and community residents to carry out the survey. The screen positive rates for anxiety, depression, and sleep disorders were compared among the 3 groups. Multifactorial Logistic regression and decision tree were used to analyze the influencing factors of anxiety, depression, and sleep disorders among social workers.

A total of 954 questionnaires were collected, of which 62 were disqualified and excluded. Finally, 892 valid questionnaires(93.5%) were included for data analysis. Among them, there were 372 questionnaires(41.7%) from the social worker group, 262(29.4%) from the medical professional group, and 258(28.9%) from the resident group. The prevalences of anxiety, depression, and sleep disorders among social workers group were found to be 15.3%, 22.0%, and 48.1%, respectively, which were significantly higher than those in the medical professional group(7.6%, 10.3%, and 30.5%) and the resident group(7.0%, 8.5%, and 29.5%), all P < 0.001. Multiple Logistic regression showed that family burden(OR=1.80, 95% CI: 1.09-2.96) and Chinese perceived stress scale(CPSS) score(OR=1.34, 95% CI: 1.24-1.45) were independent influencing factors for anxiety among social workers; CPSS score(OR=1.29, 95% CI: 1.20-1.39) and social support rating scale(SSRS) score(OR=0.96, 95% CI: 0.92-1.00) were independent influencing factors for depression among social workers; family history of mental illness(OR=4.91, 95% CI: 1.27-18.94), CPSS score(OR=1.20, 95% CI: 1.14-1.27), and SSRS score(OR=0.95, 95% CI: 0.91-0.98) were independent influencing factors for sleep disorders among social workers. The results of decision tree analysis were consistent with those of multiple Logistic regression analysis. Family burden, CPSS score, and SSRS score were important variables affecting the mental health of social workers, among which CPSS score was strongly associated with anxiety, depression, and sleep disorders among social workers.

Social workers exhibited significant levels of anxiety, depression, and sleep disorders during the long-term pandemic prevention, with CPSS being the most significant influencing factor.

The clinical manifestations, auxiliary examination and prognosis of AOPP patients admitted in Fuyang People's Hospital from November 2020 to June 2022 were prospectively analyzed, and the patients were divided into non-CLS group and CLS group based on the presence or absence of capillary leak syndrome (CLS). Patients were admitted to hospital as the starting point, and death or discharge as the endpoint. Multiple Logistic regression analysis was used to explore the risk factors of AOPP complicated with CLS.

A total of 38 AOPP patients were included, of which 17 (44.7%) were complicated with CLS. There were statistical differences in age (P=0.015), blood concentration of dichlorvos (P=0.001), blood concentration of dipterex(P < 0.001), creatinine (P < 0.001) and APACHEⅡ score (P < 0.001) between non-CLS group and CLS group. Multivariate Logistic regression analysis showed that blood concentration of dipterex ≥0.44 μg/mL and APACHEⅡ score≥10.5 were independent risk factors for AOPP complicated with CLS. The mortality rate of CLS group was higher than that of CLS group (P < 0.001).

Patients with AOPP are more likely to be complicated by CLS, and the mortality rate is higher. High-risk patients can be identified early by dipterex blood concentration and APACHE Ⅱ score, and early intervention can be carried out to improve the prognosis of patients.

This study was a retrospective cohort study. Pregnant women diagnosed with placenta previa were selected from Beijing Obstetrics and Gynecology Hospital, Capital Medical University, from January 2017 to December 2021. The general information, past history, antenatal information[including pulsatility index(PI) of uterine artery, ultrasonic signs, etc.] and operation information of the pregnant women were obtained through the hospital electronic medical record system. According to the results of operation, the patients were divided into accreta group and non-accreta group. The diagnostic value of uterine artery PI associated with multiple parameters in the placenta accreta spectrum disorders was analysed.

A total of 80 pregnant women were divided into accreta group(34 cases) and non-accreta group(46 cases) according to the inclusion and exclusion criteria. Compared with the non-accreta group, the age of pregnant women in the accreta group(P=0.017) and history of cesarean section(P < 0.001) significantly increased, and the mean PI of uterine artery significantly decreased(P=0.006). There were significant differences in ultrasonic signs such as local interruption or disappearance of the posterior placental lower vocal cords(P < 0.001), abundant blood flow after placenta(P < 0.001), and interruption or disappearance or irregularity of the boundary of the uterus and bladder(P=0.003). The area under the ROC curve of uterine artery PI, cesarean section history and ultrasonic signs in the diagnosis of placenta accreta spectrum disorders was 0.96(95% CI: 0.93-0.99), the sensitivity was 97.06%(95% CI: 91%-100%), and the specificity was 65.22%(95% CI: 51%-79%).

Uterine artery blood flow PI associated with multiple parameters has high sensitivity in the prediction of placenta accreta spectrum disorders, which is helpful in the early detection of this disease.

We conducted a search in the Web of Science Core Collection database, specifically looking for articles or reviews in English on multimorbidity in older adults published between January 1, 2000 and October 24, 2023. VOSviewer 1.6.18 software was used to extract the contents in the literature and draw the cooperative network diagram of high-producing countries(≥30 articles) and institutions(≥43 articles) as well as the timeline diagram of high-frequency keywords(≥74 occurrences) co-occurrence relationship. CiteSpace 6.1.R6 software was used to co-occur and cluster analyze the information of authors, research institutions and countries. The "bibliometrix" package in R was used to analyze the evolution of keywords in the literature.

A total of 2590 documents consisting of 2230 Articles and 360 Reviews were obtained. The worldwide publication count significantly increased since 2000. Among the countries, the United States had the highest number of publications (35.02%, 907/2590) and total citations(31 343 times) in this field. The University of Toronto in Canada had the largest number of articles(2.59%, 67/2590). Jenny Ploeg of McMaster University was recognized as the most prolific author(1.24%, 32/2590). When it came to journals, BMC Geriatrics had the highest amount of literature related to multimorbidity(3.82%, 99/2590). The key areas of research in this field included multimorbidity, older adults, frailty, aging, and polypharmacy. Notably, there was growing interest in studying the relationship between multimorbidity and aging in older adults, as well as the impact of frailty and polypharmacy on multimorbidities.

In recent years, research on multimorbidities in the elderly has primarily centered around examining the correlation between comorbidities and aging, as well as exploring the impact of frailty and polypharmacy on individuals with multimorbidities. Future research could delve into primary health care, comprehensive geriatric assessment for older adults with multimorbidities, and maintenance of their overall quality of life.