Objective:To investigate the practical value of pancreatic duct bind with supporting tube combined with single-needle suture for pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy (LPD).Methods:The clinical data of 65 patients with pancreatic head or periampullary tumors who underwent LPD at the First Affiliated Hospital of Kunming Medical University between January 2021 and June 2024 were retrospectively analysed. Among them, 31 were male and 34 were female, aged (57.7±13.3) years. The patients were divided into two groups based on the method of pancreaticojejunostomy: 22 patients who underwent pancreatic duct bind with supporting tube single-needle suture pancreaticojejunos-tomy were included in the study group, 43 patients who underwent traditional pancreatic duct-to-mucosa pancreaticojejunostomy were included in the control group. The clinical data of the patients, including gender, age, operation time, pancreaticojejunostomy time, and postoperative complications, etc. were recorded.Results:Compared with the control group, the pancreaticojejunostomy time [(25.3±2.4) min vs. (47.0±3.9) min] and operation time [(425.2±52.1) min vs. (453.7±30.8) min] of the study group were both shortened, and the differences were statistically significant (both P<0.05). There was no statistically significant difference in the postoperative complication rate between the study group and the control group [18.2% (4/22) vs. 34.9% (15/43), P=0.161]. The incidence of clinically relevant pancreatic fistula in the study group was lower than that in the control group [4.5% (1/22) vs. 30.2% (13/43)], and the difference was statistically significant ( P=0.024). Conclusion:Pancreatic duct bind with supporting tube combined with single-needle suture pancreaticojejunostomy is safe and effective in LPD. Compared with traditional pancreatic duct-to-mucosa pancreaticojejunostomy, pancreatic duct bind with supporting tube combined with single-needle suture pancreaticojejunostomy has advantages in terms of clinically relevant pancreatic fistula rate, operation time, and pancreaticojejunostomy time.

Objective:To develop and validate a machine learning (ML) noninvasive model based on routine laboratory parameters to preoperatively predict the microvascular invasion (MVI) in patients with hepatocellular carcinoma (HCC).Methods:A total of 629 HCC patients who underwent hepatectomy at the First Affiliated Hospital of Fujian Medical University between January 2019 and December 2023 were retrospectively enrolled in this study and were divided chronologically into a training set ( n=464) and internal validation set ( n=165). A cohort with 190 HCC patients from Fujian Provincial Hospital were used as an external validation set. Preoperatively demographic features, tumor size and routine laboratory data were collected. All patients were divided into MVI-positive or MVI-negative group. The Boruta algorithm and LASSO regression algorithm were used to screen out related features in the training set. Eight different ML algorithms including multivariate logistic regression, decision tree (DT), random forest (RF), extreme gradient boosting (XGboost), k-nearest neighbor (KNN), support vector machine (SVM), light gradient boosting machine (LGBM) and Naive Bayes were used to construct the prediction models. The predictive performances of these models on training and internal validation sets were evaluated by the receiver operating characteristic (ROC) curve with the area under the curve (AUC). The ML model with the highest AUC values was defined as the optimal model and its performance was further validated in the external validation set. The calibration curve showed that the probability value curve was close to the actual occurrence probability curve, and the DCA showed that it could be applied within the threshold probability range of 0.3-0.8 to obtain net benefits. Results:After screening, eight parameters including α-fetoprotein (AFP), protein induced by vitamin K absence Ⅱ (PIVKA-Ⅱ), tumor size, eosinophil count, neutrophil count, creatinine, ApoA1 and total bilirubin were finally selected for the construction of the preoperative prediction model for MVI in HCC. Among all the tested eight ML algorithms, XGboost obtained the optimal performance with an AUC of 0.820 in training set, an AUC of 0.803 in internal testing set and an AUC of 0.758 in external testing set. Further stratified analysis showed that the AUC for preoperatively predicting MVI by XGboost was 0.817 for HCC patients with positive hepatitis B surface antigen, 0.779 for male patients and 0.790 for elder patients. The calibration curves showed good agreement between observed and predicted values and the decision curve analysis curve showed relatively higher net benefits.Conclusions:We successfully established and verified a novel XGboost model based on eight routine laboratory parameters with relatively high and reliable predictive accuracy to preoperatively predict MVI in HCC.

Objective:To observe the clinical efficacy of Tuina(Chinese therapeutic massage)plus Liu Zi Jue for adenoid hypertrophy(AH)due to Qi deficiency of lung and spleen and its effects on the adenoid-nasopharyngeal cavity ratio(A/N value)and traditional Chinese medicine(TCM)constitution scale score.Methods:A total of 64 children with AH due to Qi deficiency of the lung and spleen were randomized into a trial group and a control group,with 32 cases in each group.The trial group was treated with Tuina plus Liu Zi Jue,and the control group was treated with Tuina alone.The Tuina manipulations were the same in the two groups.Tuina treatment was performed 3 times a week,with an interval of at least 1 d.Liu Zi Jue was performed 2 sets each time and 5 times a week.After 8 weeks of treatment and at the 2-month follow-up,the clinical efficacy was compared between the two groups,and the changes in the main clinical symptom score,A/N value,and TCM constitution scale score were observed.Results:After treatment,the total effective rate of the trial group and the control group was 96.9%and 93.8%,respectively.The difference between the two groups was not statistically significant(P>0.05).At the follow-up,the total effective rate of the trial group was 93.8%,higher than 90.6%in the control group(P<0.05).After treatment and at the follow-up,the main clinical symptom score in both groups was lower than that before treatment(P<0.05);at the follow-up,the main clinical symptom score in the trial group was lower than that in the control group(P<0.05).After treatment,the A/N value in both groups was lower than that before treatment(P<0.05),and the value in the trial group was lower than that in the control group;however,the difference between the two groups was not statistically significant(P>0.05).After treatment and at the follow-up,the TCM constitution scale score in both groups was lower than that before treatment(P<0.05);the score after treatment in the trial group was lower than that in the control group(P<0.05).Conclusion:Tuina plus Liu Zi Jue can effectively improve the main clinical symptoms in children with AH due to Qi deficiency of lung and spleen,reduce the A/N value and TCM constitution scale score,with stable efficacy.

Objective:To observe the clinical efficacy of Tuina(Chinese therapeutic massage)plus Liu Zi Jue for adenoid hypertrophy(AH)due to Qi deficiency of lung and spleen and its effects on the adenoid-nasopharyngeal cavity ratio(A/N value)and traditional Chinese medicine(TCM)constitution scale score.Methods:A total of 64 children with AH due to Qi deficiency of the lung and spleen were randomized into a trial group and a control group,with 32 cases in each group.The trial group was treated with Tuina plus Liu Zi Jue,and the control group was treated with Tuina alone.The Tuina manipulations were the same in the two groups.Tuina treatment was performed 3 times a week,with an interval of at least 1 d.Liu Zi Jue was performed 2 sets each time and 5 times a week.After 8 weeks of treatment and at the 2-month follow-up,the clinical efficacy was compared between the two groups,and the changes in the main clinical symptom score,A/N value,and TCM constitution scale score were observed.Results:After treatment,the total effective rate of the trial group and the control group was 96.9%and 93.8%,respectively.The difference between the two groups was not statistically significant(P>0.05).At the follow-up,the total effective rate of the trial group was 93.8%,higher than 90.6%in the control group(P<0.05).After treatment and at the follow-up,the main clinical symptom score in both groups was lower than that before treatment(P<0.05);at the follow-up,the main clinical symptom score in the trial group was lower than that in the control group(P<0.05).After treatment,the A/N value in both groups was lower than that before treatment(P<0.05),and the value in the trial group was lower than that in the control group;however,the difference between the two groups was not statistically significant(P>0.05).After treatment and at the follow-up,the TCM constitution scale score in both groups was lower than that before treatment(P<0.05);the score after treatment in the trial group was lower than that in the control group(P<0.05).Conclusion:Tuina plus Liu Zi Jue can effectively improve the main clinical symptoms in children with AH due to Qi deficiency of lung and spleen,reduce the A/N value and TCM constitution scale score,with stable efficacy.

Objective:To investigate the practical value of pancreatic duct bind with supporting tube combined with single-needle suture for pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy (LPD).Methods:The clinical data of 65 patients with pancreatic head or periampullary tumors who underwent LPD at the First Affiliated Hospital of Kunming Medical University between January 2021 and June 2024 were retrospectively analysed. Among them, 31 were male and 34 were female, aged (57.7±13.3) years. The patients were divided into two groups based on the method of pancreaticojejunostomy: 22 patients who underwent pancreatic duct bind with supporting tube single-needle suture pancreaticojejunos-tomy were included in the study group, 43 patients who underwent traditional pancreatic duct-to-mucosa pancreaticojejunostomy were included in the control group. The clinical data of the patients, including gender, age, operation time, pancreaticojejunostomy time, and postoperative complications, etc. were recorded.Results:Compared with the control group, the pancreaticojejunostomy time [(25.3±2.4) min vs. (47.0±3.9) min] and operation time [(425.2±52.1) min vs. (453.7±30.8) min] of the study group were both shortened, and the differences were statistically significant (both P<0.05). There was no statistically significant difference in the postoperative complication rate between the study group and the control group [18.2% (4/22) vs. 34.9% (15/43), P=0.161]. The incidence of clinically relevant pancreatic fistula in the study group was lower than that in the control group [4.5% (1/22) vs. 30.2% (13/43)], and the difference was statistically significant ( P=0.024). Conclusion:Pancreatic duct bind with supporting tube combined with single-needle suture pancreaticojejunostomy is safe and effective in LPD. Compared with traditional pancreatic duct-to-mucosa pancreaticojejunostomy, pancreatic duct bind with supporting tube combined with single-needle suture pancreaticojejunostomy has advantages in terms of clinically relevant pancreatic fistula rate, operation time, and pancreaticojejunostomy time.

Objective:To develop and validate a machine learning (ML) noninvasive model based on routine laboratory parameters to preoperatively predict the microvascular invasion (MVI) in patients with hepatocellular carcinoma (HCC).Methods:A total of 629 HCC patients who underwent hepatectomy at the First Affiliated Hospital of Fujian Medical University between January 2019 and December 2023 were retrospectively enrolled in this study and were divided chronologically into a training set ( n=464) and internal validation set ( n=165). A cohort with 190 HCC patients from Fujian Provincial Hospital were used as an external validation set. Preoperatively demographic features, tumor size and routine laboratory data were collected. All patients were divided into MVI-positive or MVI-negative group. The Boruta algorithm and LASSO regression algorithm were used to screen out related features in the training set. Eight different ML algorithms including multivariate logistic regression, decision tree (DT), random forest (RF), extreme gradient boosting (XGboost), k-nearest neighbor (KNN), support vector machine (SVM), light gradient boosting machine (LGBM) and Naive Bayes were used to construct the prediction models. The predictive performances of these models on training and internal validation sets were evaluated by the receiver operating characteristic (ROC) curve with the area under the curve (AUC). The ML model with the highest AUC values was defined as the optimal model and its performance was further validated in the external validation set. The calibration curve showed that the probability value curve was close to the actual occurrence probability curve, and the DCA showed that it could be applied within the threshold probability range of 0.3-0.8 to obtain net benefits. Results:After screening, eight parameters including α-fetoprotein (AFP), protein induced by vitamin K absence Ⅱ (PIVKA-Ⅱ), tumor size, eosinophil count, neutrophil count, creatinine, ApoA1 and total bilirubin were finally selected for the construction of the preoperative prediction model for MVI in HCC. Among all the tested eight ML algorithms, XGboost obtained the optimal performance with an AUC of 0.820 in training set, an AUC of 0.803 in internal testing set and an AUC of 0.758 in external testing set. Further stratified analysis showed that the AUC for preoperatively predicting MVI by XGboost was 0.817 for HCC patients with positive hepatitis B surface antigen, 0.779 for male patients and 0.790 for elder patients. The calibration curves showed good agreement between observed and predicted values and the decision curve analysis curve showed relatively higher net benefits.Conclusions:We successfully established and verified a novel XGboost model based on eight routine laboratory parameters with relatively high and reliable predictive accuracy to preoperatively predict MVI in HCC.

For Perihilar cholangiocarcinoma (pCCA), surgical resection is the only effective way to cure this disease. However, it has high postoperative mortality and high recurrence rate. Domestic and foreign scholars have constructed statistics-based evaluation methods to predict patients′ postoperative survival and complications, such as nomogram, scoring system and other prognostic models. Based on these methods, clinicians can better select patients who can benefit from surgery and choose the optimal? treatment for more severe patients. Through the adoption of other treatments or some ways to ameliorate some preoperative condition, to improve the patient′s mortality and survival. This article reviews the prognostic risk factors and prognostic models of pCCA in order to provide a reference for clinicians to predict the prognosis about the surgery.

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors, with rapid progression and a poor prognosis. More and more studies have shown that there are small open reading frames (sORFs) on the molecular sequences of a large number of non-coding RNAs (ncRNAs), which can encode conserved peptides that play an important role in controlling the occurrence and development of HCC. This article introduces the discovery, prediction, and validation methods of ncRNA-encoding polypeptides and reviews its research progress, with the aim of providing new targets and ideas for early-stage diagnosis, targeted therapy, and prognosis assessment of HCC.

Hepatocellular carcinoma (HCC) is the most common liver malignant tumor with complex pathogenesis and a poor prognosis. Metabolic reprogramming has been recognized as one of the important cancer markers, and the liver, as an important organ for lipid metabolism in the human body, plays an important role in the process of the occurrence and development of HCC. More and more evidence shows that long-chain non-coding RNA (lncRNA) can influence the lipid metabolism process by regulating key enzymes and transcription factors, as well as being involved in the occurrence and development of HCC. Therefore, explicating the mechanism of lncRNA in lipid metabolism reprogramming is conducive to providing new targets and strategies for the diagnosis and treatment and improving the prognosis of HCC patients. This article summarizes the latest research progress on the involvement of lncRNA in the reprogramming process of HCC lipid metabolism.

Abstract: Objective　To understand the situation of pulmonary tuberculosis (TB) screening in schools of various levels and types in Guizhou Province, and to provide a scientific basis for strengthening the proactive detection and effective prevention and control measures for TB in key age groups in schools. Methods　In 2021, proactive screening and entrance physical examination were conducted for new students and faculty members in Guizhou Province. "Tuberculosis Screening Questionnaire for Schools in Guizhou Province" was filled out, and the physical examination information was uploaded through the "Healthy Guizhou Smart Disease Control Cloud Platform". According to the Prevention and Control Guidelines of China's Learning Schedule (2020 edition), different screening methods were adopted for different physical examination subjects. The main screening methods included three types, namely tuberculin skin test, chest X-ray examination (X-ray chest X-ray), and investigation of suspicious symptoms of pulmonary tuberculosis. Results　A total of 1 789 108 students from 18 192 schools were screened, including 1 739 680 new students who underwent physical examinations, 16 922 students who underwent middle and high school entrance examinations, and 32 506 teachers and staff who underwent physical examinations. In 2021, the reported TB incidence rate in Guizhou Province was 85.40 per 100 000, with the highest rates reported in Bijie City, Qiannan Prefecture, and Zunyi City. Symptom screening was conducted for 58 380 individuals across nine cities and prefectures, of which 3 440 individuals (5.89%) presented with suspicious symptoms; PPD tests were conducted for 1 180 442 individuals, with 22 175 cases (1.88%) testing strongly positive; chest X-ray screening involved 366 170 individuals, with 2 837 individuals (0.77%) showing abnormal chest radiographs. The proportion of individuals with suspicious symptoms in public schools (8.11%) was higher than in private schools (1.63%); non-boarding schools had a higher proportion of individuals with suspicious symptoms (6.06%) compared to boarding schools (5.46%). Among the different school types, vocational schools had the highest proportion of individuals with suspicious symptoms (9.09%), while vocational high schools had the lowest (0.32%); these differences were statistically significant (χ2=994.19, 7.69, and 1 257.5, all P<0.01). The proportion of strong positive students in boarding schools (2.15%) was higher than that in non-boarding schools (1.32%), with a statistically significant difference (χ2=981.40, P<0.01); among school types, universities had the highest rate of strong positivity (6.61%), while kindergartens had the lowest (0.59%), with statistically significant differences (χ2=10 707.60, P<0.01). Among different school types, nine-year schools (elementary and junior high) had the highest proportion of abnormal chest radiographs (4.09%), while ordinary secondary vocational schools had the lowest (0.08%), with statistically significant differences (χ2=1 418.191, P<0.01). Conclusions　Carrying out physical examination and screening for admission is one of the important measures to reduce the tuberculosis epidemic in schools. The proactive screening work in Guizhou Province needs to be further implemented to achieve full coverage. It is necessary to strengthen the proactive detection of schools in high epidemic areas, especially the screening efforts and health education for key populations such as universities and high schools, to curb the occurrence of TB epidemic in schools.