Objective:To identify the risk factors for postoperative pain and construct a risk prediction model and validate it in the patients with mixed hemorrhoids.Methods:In this case-control study, 231 mixed haemorrhoid patients at Suzhou Hospital affiliated to Nanjing University Shool of Medicine from October 2022 to February 2024 were selected as the study subjects and divided into model group( n=161) and validation group( n=70)in a ratio of 7∶3, and the patients in model group were divided into pain group( n=40)and non-pain group( n=121)based on their pain scores at 24 h postoperatively. Univariate analysis and binary logistic regression analysis were used to identify the risk factors for postoperative pain in the patients with mixed haemorrhoids, and a column-line diagram prediction model was plotted, the differentiation and consistency of the column-line diagram model were validated using receiver operating characteristic (ROC) curves and calibration curves, and the clinical benefit of the model was evaluated using the decision curve analysis. Results:The results of logistic regression analysis showed that male, preoperative anxiety score≥50, self-efficacy score <80, and external peeling and internal ligation were independent risk factors for postoperative pain in patients with mixed haemorrhoids ( P<0.05). The area under the ROC curve in model group was 0.745, Hosmer-Lemeshow test χ2=1.912, P=0.752; in validation group, the area under the ROC curve was 0.729, Hosmer-Lemeshow test χ2=1.635, P=0.651, and the calibration curve was in good agreement with the actual curve, with good model consistency; the results of the decision curve analysis showed that, when interventions were conducted within the probability range of 0.1 to 0.9 for predicting postoperative pain in patients with mixed hemorrhoids, the clinical benefit was increased. Conclusions:Male, preoperative anxiety score≥50, self-efficacy score <80, and external peeling and internal ligation are independent risk factors for postoperative pain in patients with mixed haemorrhoids, and the column-line graph prediction model of postoperative pain constructed has good differentiation and consistency and high clinical benefit.

Objective:To identify the risk factors for postoperative pain and construct a risk prediction model and validate it in the patients with mixed hemorrhoids.Methods:In this case-control study, 231 mixed haemorrhoid patients at Suzhou Hospital affiliated to Nanjing University Shool of Medicine from October 2022 to February 2024 were selected as the study subjects and divided into model group( n=161) and validation group( n=70)in a ratio of 7∶3, and the patients in model group were divided into pain group( n=40)and non-pain group( n=121)based on their pain scores at 24 h postoperatively. Univariate analysis and binary logistic regression analysis were used to identify the risk factors for postoperative pain in the patients with mixed haemorrhoids, and a column-line diagram prediction model was plotted, the differentiation and consistency of the column-line diagram model were validated using receiver operating characteristic (ROC) curves and calibration curves, and the clinical benefit of the model was evaluated using the decision curve analysis. Results:The results of logistic regression analysis showed that male, preoperative anxiety score≥50, self-efficacy score <80, and external peeling and internal ligation were independent risk factors for postoperative pain in patients with mixed haemorrhoids ( P<0.05). The area under the ROC curve in model group was 0.745, Hosmer-Lemeshow test χ2=1.912, P=0.752; in validation group, the area under the ROC curve was 0.729, Hosmer-Lemeshow test χ2=1.635, P=0.651, and the calibration curve was in good agreement with the actual curve, with good model consistency; the results of the decision curve analysis showed that, when interventions were conducted within the probability range of 0.1 to 0.9 for predicting postoperative pain in patients with mixed hemorrhoids, the clinical benefit was increased. Conclusions:Male, preoperative anxiety score≥50, self-efficacy score <80, and external peeling and internal ligation are independent risk factors for postoperative pain in patients with mixed haemorrhoids, and the column-line graph prediction model of postoperative pain constructed has good differentiation and consistency and high clinical benefit.

BACKGROUNDIdiopathic pulmonary fibrosis (IPF) is a progressive diffuse parenchymal disease with a poor prognosis. A variety of cytokines and chemokines are involved in its pathophysiology. The aim of this study was to evaluate the clinical features in IPF patients with the expression of suppressor of cytokine signaling 1 (SOCS-1), which acts as a negative regulator of cytokine signaling.

METHODSIPF patients (n = 20) and healthy controls (n = 16) were included in this study. The expression of SOCS-1 was analyzed in peripheral blood mononuclear cells (PBMC) of subjects using RT-PCR. Interleukin 4 (IL-4), transforming growth factor β1 (TGF-β1) and type I collagen expression were also analyzed in each individual using enzyme-linked immunosorbent assay (ELISA). The clinical characteristics of IPF patients were delineated. These results were analyzed by SPSS13.0 statistics software.

RESULTSSOCS-1 mRNA expression was significantly decreased in the PBMC of IPF patients compared with healthy controls; serum levels of IL-4 and TGF-β1 were higher in IPF patients. The patients with lower expression of SOCS-1 developed lower percentage of forced vital capacity (FVC%) and DLCO/VA. A patients' SOCS-1 mRNA level was negatively correlated with serum levels of IL-4, and negatively correlated with their high-resolution computed tomography (HRCT) scores.

CONCLUSIONSSOCS-1 mRNA can be detected in PBMC, and it is down-regulated in IPF patients. The expression of SOCS-1 is associated with the severity of IPF patients' symptoms, so it might be the predictor of disease severity. SOCS-1 might play an important role in IPF by reducing the expression of the T helper type 2 (Th2) cell-related cytokine IL-4.

Adult ; Aged ; Aged, 80 and over ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Idiopathic Pulmonary Fibrosis ; metabolism ; Interleukin-4 ; metabolism ; Leukocytes, Mononuclear ; metabolism ; Male ; Middle Aged ; Suppressor of Cytokine Signaling 1 Protein ; Suppressor of Cytokine Signaling Proteins ; genetics ; metabolism ; Transforming Growth Factor beta1 ; metabolism