Background and Amis:Gallbladder cancer(GBC)is the most common malignant tumor of the biliary tract,accounting for approximately 80%-95%of biliary tract cancers.This type of tumor has a poor prognosis,and currently,there are no effective tools for evaluating the prognosis of GBC.Therefore,this study was performed to investigate the factors influencing the prognosis of GBC patients to provide a reference for clinical practice.Methods:The clinical data and follow-up information from 160 GBC patients treated in the Hunan Provincial People's Hospital from January 2018 to January 2024 was retrospectively conducted.The clinicopathologic characteristics of GBC patients were analyzed.Kaplan-Meier and Log-rank tests were used to calculate and compare the differences in overall survival(OS)among GBC patients with different clinicopathologic characteristics and treatment methods.Multivariate analysis using Cox regression was performed to identify independent prognostic factors for GBC.Results:Among the 160 patients,113 were females and 47 were males.The median age of the patients was 62 years,with the main clinical manifestations being abdominal pain/distention(55.63%),jaundice(40.63%),appetite loss(30.62%),and weight loss(19.38%).Serum tumor markers,including CA19-9,CA125,CEA,and CA724,were elevated in 58.75%,30.63%,30.00%,and 20.63%of GBC patients,respectively.Clinical stage classification revealed that 139 patients(86.87%)had stage Ⅲ/Ⅳ disease,132 patients(82.5%)had T3/T4 stage,91 patients(56.87%)had N1/N2 stage,and 54 patients(33.75%)had M1 stage.The pathological type of GBC was predominantly adenocarcinoma(92.50%),with the majority classified as moderately differentiated(19.38%),moderately to poorly differentiated(34.37%),and poorly differentiated(24.37%).Neural or vascular invasion was present in 29.37%and 21.25%of patients,respectively.Univariate analysis showed that diabetes,jaundice,liver function(Child-Pugh classification),tumor marker levels(CA19-9,CA125,CEA,CA724,CYFRA 21-1),clinical TNM stage,degree of differentiation,vascular or neural invasion,surgical treatment,and other treatments(chemotherapy,immunotherapy,targeted therapy,traditional Chinese medicine,etc.)were significantly associated with the prognosis of GBC patients(all P<0.05).Multivariate Cox regression analysis revealed that diabetes,elevated CA125,and TNM stage were independent risk factors for poor prognosis in GBC,while chemotherapy-based drug treatment was an independent protective factor(all P<0.05).Conclusion:Diabetes,elevated CA125,TNM staging,and treatment methods are closely related to the prognosis of GBC patients.Targeted treatment strategies should be developed for patients with risk factors,and surgery or chemotherapy-based drug therapy should be prioritized to improve patient prognosis.

Background and Amis:Gallbladder cancer(GBC)is the most common malignant tumor of the biliary tract,accounting for approximately 80%-95%of biliary tract cancers.This type of tumor has a poor prognosis,and currently,there are no effective tools for evaluating the prognosis of GBC.Therefore,this study was performed to investigate the factors influencing the prognosis of GBC patients to provide a reference for clinical practice.Methods:The clinical data and follow-up information from 160 GBC patients treated in the Hunan Provincial People's Hospital from January 2018 to January 2024 was retrospectively conducted.The clinicopathologic characteristics of GBC patients were analyzed.Kaplan-Meier and Log-rank tests were used to calculate and compare the differences in overall survival(OS)among GBC patients with different clinicopathologic characteristics and treatment methods.Multivariate analysis using Cox regression was performed to identify independent prognostic factors for GBC.Results:Among the 160 patients,113 were females and 47 were males.The median age of the patients was 62 years,with the main clinical manifestations being abdominal pain/distention(55.63%),jaundice(40.63%),appetite loss(30.62%),and weight loss(19.38%).Serum tumor markers,including CA19-9,CA125,CEA,and CA724,were elevated in 58.75%,30.63%,30.00%,and 20.63%of GBC patients,respectively.Clinical stage classification revealed that 139 patients(86.87%)had stage Ⅲ/Ⅳ disease,132 patients(82.5%)had T3/T4 stage,91 patients(56.87%)had N1/N2 stage,and 54 patients(33.75%)had M1 stage.The pathological type of GBC was predominantly adenocarcinoma(92.50%),with the majority classified as moderately differentiated(19.38%),moderately to poorly differentiated(34.37%),and poorly differentiated(24.37%).Neural or vascular invasion was present in 29.37%and 21.25%of patients,respectively.Univariate analysis showed that diabetes,jaundice,liver function(Child-Pugh classification),tumor marker levels(CA19-9,CA125,CEA,CA724,CYFRA 21-1),clinical TNM stage,degree of differentiation,vascular or neural invasion,surgical treatment,and other treatments(chemotherapy,immunotherapy,targeted therapy,traditional Chinese medicine,etc.)were significantly associated with the prognosis of GBC patients(all P<0.05).Multivariate Cox regression analysis revealed that diabetes,elevated CA125,and TNM stage were independent risk factors for poor prognosis in GBC,while chemotherapy-based drug treatment was an independent protective factor(all P<0.05).Conclusion:Diabetes,elevated CA125,TNM staging,and treatment methods are closely related to the prognosis of GBC patients.Targeted treatment strategies should be developed for patients with risk factors,and surgery or chemotherapy-based drug therapy should be prioritized to improve patient prognosis.

Objective To explore the effects of aripiprazole on clinical symptoms and neurotrophic factor levels in patients with schizophrenia. Methods Forty patients with schizophrenia and 40 normal controls were included in the study. The clinical symptoms of patients receiving aripiprazole only for 12 weeks were evaluated by using the Positive and Negative Syndrome Scale (PANSS). Stroop Color-Word Test (SCWT), Continuous Performance Test, Digit-Symbol Coding Test and Trail Making Test-A were used to evaluate the cognitive function both in patients and controls. Serum levels of Nerve Growth Factor (NGF), Brain Derived Neurotrophic Factor (BDNF) and Neurotrophin 3 (NT-3) were measured using enzyme linked immunosorbent assay. Results The clinical scores, cognitive function and levels of neurotrophic factors were different before and after treatment (P<0.01). And those were significantly lower in patients than in control group (P<0.05). Before treatment, BDNF was negatively correlated with PANSS negative symptom score (r=-0.362, P=0.022);NGF was related to the total score of PANSS (r=0.332, P=0.037) and positive symptoms (r=0.401, P=0.010); NT-3 was associated with negative symptom scores (r=-0.376, P=0.017) and SCWT-color words (r=0.332, P=0.037) in patient group. After treatment, the increase in BDNF was correlated with the reduction in PANSS total score (r=0.371, P=0.018), negative symptom score (r=0.345, P=0.029) and general pathology score (r=0.342, P=0.031). There was a correlation of the increase of NGF with the decrease of PANSS total scores (r=0.437, P=0.005) and with positive symptom scores (r=0.357, P=0.024). Conclusion Treatment with Aripiprazole can improve the clinical symptoms and cognitive functiona impairments in patients with schizophrenia, which may be related to the increase in serum levels of BDNF, NGF and NT-3.

ObjectiveTo study the feasibility,efficacy and safety of u tilizing the laryngeal mask airway (LMA) ventilation compared with the endotracheal intubation ( ET ) in neonatal resuscitation for moderate and severe asphyxiated neonates.MethodsNeonates requiring positive pressure ventilation with heartrate ＜60 beats/min were collected and grouped quasi-randomizedly into LMA(36 cases) or ET(32 cases)ventilation.Differences of resuscitation effect,inserting time,successful once insertion rate and adverse reactions between the two groups were observed and compared.Results( 1 ) No significant difference was observed in Apgar scores at 1 min and 5 min between the two groups ( P＞0.05 ).(2) Success rate of once insertion was 94.4％ with average inserting time ( 7.58±1.16 ) s for LMP group,while it was 90.6％ and ( 7.89 ± 1.52) s for ET group.( 3 ) Successful resuscitation rate of LMA group ( 86.11％ ) was slightly lower than ET group (96.88％ ),but there was no statistical difference (P＞0.05).(4) Mean response time of LMA group [ (34.06 ± 10.56) s] was slightly lower than that of ET group [ (41.38 ±27.19) s],also ventilation time of LMA group [( 137.19 ±80.14) s] was slightly lower than that of ET group [ ( 171.09±84.28 ) s ],but neither showed statistical difference ( P＞0.05 ).(5) Adverse reactions were found in LMA group including nausea( 2 cases )and abdominal distention (1 cases),while there were laryngeal edema( 1 cases),pneumothorax(2 cases),respiratory tract bleeding( 1 cases) in ET group.ConclusionThe LMA ventilation is much easier to operate,with its effect no less than that of ET ventilation on resuscitation for moderate and severe asphyxiated cases,even it seems more safe.LMA ventilation can be a good substitute for ET ventilation,especially for those medical staffs who are unfamiliar with ET operation and primary hospital doctors in case of emergency.

ObjectiveTo investigate the outcome and repregnancy after different laparoscopicsurgical treatments for tubal pregnancy,and analyse the influential factors. MethodsIn 56 tubal pregnancypatients,28 cases performed laparoscopic salpingostomy (group A) and 28 cases peoformed laparoscopicsalpingectomy (group B). The perioperative condition, the rate of repregnancy and re-ectopic pregnancy was compared and analyzed. Logistic regression analysis was used to detect the effect on subsequent repregnancyof influential factors such as pelvic adhesion. ResultsMore bleeding and longer operative time were needed in group A than group B, there were significant differences between two groups (P ＜ 0.05 ). In follow-up of 6months to 6 yeats,the rate of repregnancy in group A and group B was 46.4％(13/28) and 32.1％(9/28)respectively,there was no significant difference between two groups (P ＞0.05). The rate of re-ectopic pregnancy in group A and group B was 10.7％ (3/28) and 28.6％ (8/28) respectively,there was significant difference between two groups (P ＜0.05). In the single factor analysis,the repregnancy in group A was significantly associated to pelvic adhesion and patency of the contralateral oviduct (P ＜ 0.05 ). Conclusions The rate of repregnancy of laparoscopic salpingostomy is higher than laparoscopic salpingectomy for tubal pregnancy. Each of pelvic adhesion and the patency of the contralateral oviduct is a factor that affects the postoperative fertility. The conservation operation is not recommended for those patients with extensive pelvic adhesion or seriously destroyed tube but normal contralateral oviduct.

Objective To compare the efficacy and toxicity of neoadjuvant chemotherapy with venous and arterial way in patients with locally advanced cervical cancer( LACC ). Methods A retrospective study was carried out on 70 patients suffering from tumor diameter≥4 cm and FIGO stage Ⅰ B- Ⅱ B disease of LACC. Among 70 patients, 36 were given venous chemotherapy ( venous group ) and 34 were given arterial interventional chemotherapy(arterial group). All patients received platinum-based neoadjuvant chemotherapy.The therapeutic toxic and adverse effects of the two groups were analyzed and compared. Results Clinical response to neoadjuvant chemotherapy occurred in 54 patients with a total effective rate of 77.1% (54/70),that of venous group was 72.2% (26/36) and that of arterial group was 82.4% (28/34),there was no significant difference between two groups (P ＞ 0.05 ). The number of the occurrence of gastrointestinal tract reaction and bone marrow depression in venous group (43,32 pieces) was more than that in arterial group (23,17 pieces)(P ＜ 0.01 ). Conclusion The results suggest that the therapeutic effects of venous and arterial interventional chemotherapy be similar,but the adverse effects of venous chemotherapy is more serious than that of arterial interventional chemotherapy.