OBJECTIVE To explore the influencing factors for successful detoxification in patients undergoing methadone maintenance therapy. METHODS A retrospective selection of 161 methadone maintenance therapy patients from the South Branch of Zhongshan Second People’s Hospital （including methadone maintenance treatment sites in Shiqi District， Xiqu District， Development Zone of Zhongshan City） from January 1， 2012， to January 1， 2025， was conducted as the study object. Data collected included patients’ sociodemographic information， drug abuse history， laboratory test results， medication records， etc. Patients were divided into the unsuccessful detoxification group and the successful detoxification group based on whether methadone detoxification was achieved. Univariate， univariate Cox regression， and multivariate Cox proportional hazards regression were used for influencing factor analysis， and the Kaplan-Meier method was employed for survival analysis. RESULTS Among the 161 methadone maintenance therapy patients， 96 were in the successful detoxification group and 65 in the unsuccessful detoxification group， yielding a successful detoxification rate of 59.63%. Multivariate Cox proportional hazards regression analysis revealed that age， registered residence status， age at first drug use， and duration of drug abuse were key influencing factors for successful detoxification in methadone maintenance therapy patients （P＜0.05）. Specifically， the successful detoxification rate for patients with Zhongshan local registered residence was 8.364 times higher than that for patients with non-local registered residence； for every 1-year increase in patient age， the successful detoxification rate decreased by 22.7%； for every 1-year increase in age at first drug use， the successful detoxification rate rose by 33.4%； and for every 1-year increase in duration of drug abuse， the successful detoxification rate increased by 33.5%. Survival analysis showed that the successful detoxification rate in the methadone low-dose group （≤30.8 mg） was significantly higher than that in the methadone high-dose group （＞30.8 mg） （P＝0.015）， and the successful detoxification rate in the population with Zhongshan local registered residence was significantly higher than that in those with non-local registered residence （P＜0.001）. CONCLUSIONS Age， registered residence status， age at first drug use， and duration of drug abuse are key influencing factors for successful detoxification in patients undergoing methadone maintenance therapy， and the last methadone dose may be associated with successful detoxification.

Background: s/Aims: Distal pancreatectomy with splenectomy (DPS) is a common surgical procedure for pancreatic body cancer.However, spleen-preserving distal pancreatectomy (SPDP) utilizing the Warshaw technique (WT) in malignancies is generally not favored due to concerns about inadequate resection. This study aims to assess the feasibility and oncologic outcomes of employing SPDP with WT in pancreatic body cancer. Methods: We conducted a retrospective analysis comparing 21 SPDP patients with 63 DPS patients matched by propensity score from January 2018 to November 2022. Clinical outcomes and follow-up data were analyzed using R. Results: Both groups exhibited similar demographic, intraoperative, and pathological characteristics, with the exception of a reduced number of total lymph nodes (p = 0.006) in the SPDP group. There were no significant differences in the rates of postoperative complications, recurrence, or metastasis. Local recurrence predominantly occurred in the central region as opposed to the spleen region.There were no cases of isolated recurrences in the splenic region. Median overall survival and recurrence-free survival times were 51.5 months for SPDP vs 30.5 months for DPS and 18.7 months vs 16.8 months, respectively (p > 0.05). The incidence of partial splenic infarction and left-side portal hypertension in the SPDP group was 28.6% (6/21) and 9.5% (2/21), respectively, without necessitating splenic abscess puncture, splenectomy, or causing bleeding from perigastric varices. Conclusions SPDP did not negatively impact local recurrence or survival rates in selected pancreatic body cancer patients. Further studies are necessary for validation.

Background: s/Aims: Distal pancreatectomy with splenectomy (DPS) is a common surgical procedure for pancreatic body cancer.However, spleen-preserving distal pancreatectomy (SPDP) utilizing the Warshaw technique (WT) in malignancies is generally not favored due to concerns about inadequate resection. This study aims to assess the feasibility and oncologic outcomes of employing SPDP with WT in pancreatic body cancer. Methods: We conducted a retrospective analysis comparing 21 SPDP patients with 63 DPS patients matched by propensity score from January 2018 to November 2022. Clinical outcomes and follow-up data were analyzed using R. Results: Both groups exhibited similar demographic, intraoperative, and pathological characteristics, with the exception of a reduced number of total lymph nodes (p = 0.006) in the SPDP group. There were no significant differences in the rates of postoperative complications, recurrence, or metastasis. Local recurrence predominantly occurred in the central region as opposed to the spleen region.There were no cases of isolated recurrences in the splenic region. Median overall survival and recurrence-free survival times were 51.5 months for SPDP vs 30.5 months for DPS and 18.7 months vs 16.8 months, respectively (p > 0.05). The incidence of partial splenic infarction and left-side portal hypertension in the SPDP group was 28.6% (6/21) and 9.5% (2/21), respectively, without necessitating splenic abscess puncture, splenectomy, or causing bleeding from perigastric varices. Conclusions SPDP did not negatively impact local recurrence or survival rates in selected pancreatic body cancer patients. Further studies are necessary for validation.

Background: s/Aims: Distal pancreatectomy with splenectomy (DPS) is a common surgical procedure for pancreatic body cancer.However, spleen-preserving distal pancreatectomy (SPDP) utilizing the Warshaw technique (WT) in malignancies is generally not favored due to concerns about inadequate resection. This study aims to assess the feasibility and oncologic outcomes of employing SPDP with WT in pancreatic body cancer. Methods: We conducted a retrospective analysis comparing 21 SPDP patients with 63 DPS patients matched by propensity score from January 2018 to November 2022. Clinical outcomes and follow-up data were analyzed using R. Results: Both groups exhibited similar demographic, intraoperative, and pathological characteristics, with the exception of a reduced number of total lymph nodes (p = 0.006) in the SPDP group. There were no significant differences in the rates of postoperative complications, recurrence, or metastasis. Local recurrence predominantly occurred in the central region as opposed to the spleen region.There were no cases of isolated recurrences in the splenic region. Median overall survival and recurrence-free survival times were 51.5 months for SPDP vs 30.5 months for DPS and 18.7 months vs 16.8 months, respectively (p > 0.05). The incidence of partial splenic infarction and left-side portal hypertension in the SPDP group was 28.6% (6/21) and 9.5% (2/21), respectively, without necessitating splenic abscess puncture, splenectomy, or causing bleeding from perigastric varices. Conclusions SPDP did not negatively impact local recurrence or survival rates in selected pancreatic body cancer patients. Further studies are necessary for validation.

Objective To explore the predictive value of two models based on machine learning algorithms in predicting the initial and subsequent doses of tacrolimus in kidney transplant recipients. Methods A retrospective analysis was conducted on the medical records of 1 013 Chinese kidney transplant recipients at the First Affiliated Hospital of Sun Yat-sen University from January 2015 to April 2019, focusing on the initial and subsequent doses in kidney transplant recipients. Thirty-three variables were collected for the initial dose, and twenty-six variables for the subsequent dose. A genetic algorithm combined with a random-restart hill-climbing algorithm was used to determine a small number of key clinical variables through majority voting, and variables with Lasso regression coefficients less than the optimal variable coefficient threshold were further eliminated. The selected clinical variables were input into a cascaded deep forest (CDF) and TabNet deep neural network for analysis and comparison based on structured tabular data, and the leave-one-subject-out method was used for validation. Results A total of 613 recipients were included in the training set, and 116 recipients were in the external validation set. In the initial dose algorithm of tacrolimus, the clinical variables ultimately included target concentration, time from surgery to target concentration, body weight, gender, type of surgery, time from surgery to first dose, WuZhi capsule, calcium channel blocker, creatinine, hemoglobin and CYP3A5. In the subsequent dose algorithm, the clinical variables ultimately included target concentration, time from surgery to target concentration, WuZhi capsule, creatinine, alanine aminotransferase, aspartate aminotransferase, previous dose, previous dose concentration and time from surgery to previous concentration. Based on the above variables, the TabNet model showed better predictive performance than the CDF model: in the initial dose prediction, the accuracy of the predicted dose within ±20% of the actual dose was 0.801, and the fitting index R² was 0.436; in the subsequent dose prediction, the corresponding accuracy and R² were 0.939 and 0.902, respectively. The results of feature contribution showed that CYP3A5 and target concentration contributed the most to the prediction of initial dose, while previous dose and its corresponding concentration had the greatest impact on subsequent dose prediction. In addition, the results of independent external validation were also satisfactory. Conclusions The optimized TabNet predictive model may provide important reference for drug dose prediction based on machine learning algorithms in clinical practice.

Objective To investigate the protective effect of colchicine against myocardial ischemia-reperfusion injury(I/R)and explore the underlying mechanism.Methods H9C2 cells exposed to hypoxia/reoxygenation(H/R)were treated with 3 nmol/L colchicine,after which the changes in cell viability were assessed using MTT assay,and AMPK phosphorylation,the expressions of NOX4,NRF2,SOD2,BAX,Bcl-2,and cleaved caspase-3 were detected with Western blotting.Male C57BL/6 mice were randomized into sham operation,I/R,I/R+colchicine,and I/R+colchicine+dorsomorphin(DSMP)groups.After the treatments,myocardial expressions of p-AMPK/AMPK,8-OHdG,cleaved caspase-3,mitochondrial BAX(Mito-BAX),and cytoplasmic cytochrome C(Cyt-Cyto C)were examined and cardiac functions,infarct area,ATP content,and serum levels of lactic dehydrogenase(LDH)and cardiac troponin T(cTnT)levels were assessed.Results In H9C2 cells,H/R exposure significantly reduced AMPK phosphorylation and expressions of NRF2,SOD2,and Bcl-2,lowered cell viability,and up-regulated the expressions of NOX4,BAX,and cleaved caspase-3(P<0.05),and these changes were obviously alleviated by colchicine treatment(P<0.05).In the mouse models,myocardial I/R injury significantly reduced myocardial AMPK phosphorylation level,ATP content,and expressions of NRF2,SOD2 and Bcl-2,caused cardiac function impairment,enhanced NOX4,Mito-BAX,Cyt-Cyto C,BAX,8-OHdG,and cleaved caspase-3 expressions,and increased infarct area and serum LDH and cTnT levels(P<0.05).Colchicine treatment significantly reversed the damaging effects of I/R(P<0.05),but its protective effects was obviously antagonized by DSMP(P<0.05).Conclusion Colchicine alleviates myocardial I/R injury and protects cardiac function in mice by reducing myocardial oxidative stress and apoptosis via activating AMPK.

Objective To investigate the protective effect of colchicine against myocardial ischemia-reperfusion injury(I/R)and explore the underlying mechanism.Methods H9C2 cells exposed to hypoxia/reoxygenation(H/R)were treated with 3 nmol/L colchicine,after which the changes in cell viability were assessed using MTT assay,and AMPK phosphorylation,the expressions of NOX4,NRF2,SOD2,BAX,Bcl-2,and cleaved caspase-3 were detected with Western blotting.Male C57BL/6 mice were randomized into sham operation,I/R,I/R+colchicine,and I/R+colchicine+dorsomorphin(DSMP)groups.After the treatments,myocardial expressions of p-AMPK/AMPK,8-OHdG,cleaved caspase-3,mitochondrial BAX(Mito-BAX),and cytoplasmic cytochrome C(Cyt-Cyto C)were examined and cardiac functions,infarct area,ATP content,and serum levels of lactic dehydrogenase(LDH)and cardiac troponin T(cTnT)levels were assessed.Results In H9C2 cells,H/R exposure significantly reduced AMPK phosphorylation and expressions of NRF2,SOD2,and Bcl-2,lowered cell viability,and up-regulated the expressions of NOX4,BAX,and cleaved caspase-3(P<0.05),and these changes were obviously alleviated by colchicine treatment(P<0.05).In the mouse models,myocardial I/R injury significantly reduced myocardial AMPK phosphorylation level,ATP content,and expressions of NRF2,SOD2 and Bcl-2,caused cardiac function impairment,enhanced NOX4,Mito-BAX,Cyt-Cyto C,BAX,8-OHdG,and cleaved caspase-3 expressions,and increased infarct area and serum LDH and cTnT levels(P<0.05).Colchicine treatment significantly reversed the damaging effects of I/R(P<0.05),but its protective effects was obviously antagonized by DSMP(P<0.05).Conclusion Colchicine alleviates myocardial I/R injury and protects cardiac function in mice by reducing myocardial oxidative stress and apoptosis via activating AMPK.

To explore the value of portable oto-endoscopy system in clinical teaching of otolaryngology residents.