Objective To construct and validate a risk prediction model for malnutrition in non-di-alysis patients with stages 3 to 5 chronic kidney disease(CKD)based on Logistic regression(LR)and XGBoost algorithms,and to compare the predictive performance between the two models.Methods A total of 506 CKD patients were enrolled as study subjects.According to chronological order,they were divided into training set(n=404)and test set(n=102)at the ratio of 8 to 2.The training set was divided into case group and control group based on whether they were malnourished,with 202 cases in each group.The LR and XGBoost models were established,and the model efficacy was evaluated through the area under the receiver operating characteristic(ROC)curve(AUC),sensitivity,speci-ficity,GiViTI calibration curve band and clinical decision curve.Results The LR model identified age ≥60 years,disease of stage 5,reduced appetite,hypoalbuminemia,low prealbumin,low mid-arm muscle circumference and high perceived stress as independent risk factors for malnutrition among non-dialysis CKD patients,while physical activity was identified as a protective factor(P＜0.05).In the XGBoost model,the top five influential variables were serum albumin,appetite,physical activity,prealbumin and mid-arm muscle circumference.The AUC of the LR and XGBoost models in the train-ing set were 0.930 and 0.947 respectively,and those in the test set were 0.925 and 0.933.The pre-dictive ability of the latter was slightly higher(P＞0.05).The GiViTI calibration curve bands all showed good calibration capability.Conclusion The XGBoost model combined with shapley additive explanation performs better in identifying malnourished patients and guiding precise care.

Objective To investigate the clinical significance of monitoring the serum levels of Thyroglobulin (Tg) and Thyroglobulin Autoantibody (TgAb) in the 131I ablation therapy for patients with differentiated thyroidcarcinoma (DTC).Methods 102 patients with DTC treated by 131I ablation therapy in our hospital from May 2014 to July 2016 were selected.The serum levels of Tg and TgAb were detected by radioimmunoassay before 131I ablation therapy,6 months after I 13 1I ablation therapy and 12 months after 131I ablation therapy.The body imaging were performed at seventh days after 1311 ablation therapy.Results The serum levels of Tg and TgAb at 6 months and 12 months after surgery were significantly lower than those before operation,and the difference were statistically significant (t =9.260,17.507,2.534,4.797,P ＜ 0.05).The serum levels of Tg and TgAb in metastasis group were higher than that in non-metastasis group (t =10.257,7.353,P ＜0.05).The serum levels of Tg and TgAb in the effective group were lower than those in the ineffective group,and the difference were statistically significant (t =7.325,4.978,P ＜ 0.05).The positive rate of Tg combined with TgAb was similar with 131I-WBS screening methods and the difference was not statistically significant (P ＞ 0.05).The positive rate of Tg screening method and the positive rate of TgAb were higher than that of 131I-WBS screening method,but the difference was not statistically significant (P ＞ 0.05).Conclusions The level of serum Tg and TgAb is an important reference index for the efficacy,metastasis and recurrence of DTC after operation,and Tg combined with TgAb has a higher accuracy in the screening prognosis of DTC after operation.

Objective To explore the correlation between the levels of liver fibrosis and liver fibrosis biochemical parameters of advanced schistosomiasis patients. Methods A total of 48 advanced schistosomiasis patients were investigated and they were examined by the liver biopsy and B ultrasound imaging. At the same time,the liver fibrosis biochemical parameters,including glu-tamine transpeptidase(GGT),alkaline phosphatase(AKP),procollagenⅢ(PC-Ⅲ),collagen typeⅣ(Ⅳ-C),hyaluronic acid (HA)and laminin(LN),were detected. The liver fibrosis levels were classified by the liver biopsy and B ultrasound imaging,re-spectively,and the correlation between the levels of liver fibrosis and liver fibrosis biochemical parameters were analyzed statisti-cally. Results There was no correlation between the liver fibrosis levels classified by the liver biopsy and all the liver fibrosis bio-chemical parameters;there was a weak correlation between the liver fibrosis levels classified by the B ultrasound imaging and GGT,AKP,LN and PC-Ⅲ,respectively;there was a significant correlation between the liver fibrosis levels classified by the B ul-trasound imaging and HA andⅣ-C,respectively. Conclusions B ultrasound examination is a better,noninvasive fibrosis in-spection method. Liver fibrosis biochemical parameters combined with the B ultrasound examination may better reflect the overall condition of liver fibrosis.

Objective To explore the design of forehead flap pedicled with supratrochlear artery and shift way for aesthetic reconstruction of the nose without secondary operations for debulking.Methods Origin of blood supplies and the distributed situation of the vessel in the frontal region were studied through the internal carotid artery and the external carotid artery X-ray angiography.The frontal region existed polyphyletic blood supplies,the supratrochlear artery and the supraorbital artery set out many branches,respectively,in the level of frontal bone eyebrow plane.One constant,thicker horizontal branch from the superficial temporal artery obviously extended to the forehead median.The branches from three blood vessels mentioned above constituted the network of artery adequate in the muscle and the subcutaneous tissue level,assumed the three-dimensional distribution in the forchead region.The nasal reconstruction had been done for 9 patients with the oblique orientation designed forehead flap by using one side of supratrochlear artery as the pedicle and cutting skin paddle with the same or the opposite side of forehead flap.Results All flap survived completely with the restoration of nasal shape and functional satisfaction.Conclusion The forehead oblique orientation flap pedicled with one side supratrochlear artery is nourished by the rich blood supply.The flap can be split into two flaps:a myofascial flap and a skin flap in far part.Myofascial flap may be the good package of cartilage framework,and simultaneously split skin flap is favorable of the shape models.The flap may satisfy the demand of the nasal restoration.