Objective To investigatethe relationship between gastroesophageal reflux disease (GERD) symptoms and clinicopathological characteristics, p53 expression, and survival of Chinese patients with esophageal adenocarcinoma. Methods A total of 3882 patients with esophageal adenocarcinoma, 970 matched patients with esophageal squamous cell carcinoma, and 970 matched patients with gastric cardia adenocarcinoma were included to compare the incidence of GERD symptoms. Patients with esophageal adenocarcinoma were divided into two groups according to the presence and absence of GERD symptoms. The differences in clinicopathological characteristics and p53 expression between the two groups were compared by chi-square test, and the differences in survival between the two groups were compared by landmark analysis. Results The incidence of GERD symptoms increased successively in esophageal squamous cell carcinoma, esophageal adenocarcinoma, and gastric cardia adenocarcinoma. In patients with esophageal adenocarcinoma, the proportions of male, less than 65 years old, lower thoracic tumors, tumors without squamous cell carcinoma, poorly differentiation, early tumors (stage 0-I), and p53-positive tumors in the group with GERD symptoms were higher than those in the group without GERD symptoms; moreover, the long-term survival (≥15 years) was better. Conclusion GERD symptom is an important clinical sign of esophageal adenocarcinoma. It is closely related to specific clinicopathological characteristics, p53 overexpression, and good long-term prognosis.

Objective To compare the differences in clinical prognosis and safety between thoracic endovascular aortic repair(TEVAR)combined with bare metal stent(BMS)implantation therapy and TEVAR alone in patients with type B aortic dissection(TBAD)after 6 months.Methods The clinical and imaging data of patients diagnosed with TBAD and treated with TEVAR or TEVAR combined with BMS implantation in Nanyang Central Hospital from March 2023 to March 2024 were retrospectively collected.The patients were divided into TEVAR group and TEVAR+BMS group according to different treatment methods.The aortic remodeling indicators and postoperative complications at discharge and 6 months after surgery were compared between the two groups.Results A total of 37 patients were included,including 20 patients in the TEVAR group and 17 patients in the TEVAR+BMS group.There were no statistically significant differences in baseline data between the two groups(all P＞0.05);at discharge and 6 months after surgery,the true lumen diameters and true lumen ratios of the abdominal aorta(proximal level of the celiac trunk and proximal level of the left renal artery)in the TEVAR+BMS group were better than those in the TEVAR group(all P＜0.05);the degree of thrombosis of the false lumen at 6 months after surgery was better in the TEVAR+BMS group than in the TEVAR group(P＜0.05);there was no statistically significant difference in postoperative complications between the two groups(P＞0.05).Conclusions TEVAR combined with BMS implantation therapy can significantly improve the aortic remodeling effect of patients with TBAD,without increasing the risk of postoperative complications and death caused by aortic-related factors.Bare stent implantation as an auxiliary treatment method for endovascular repair is a safe and effective optimized treatment plan.

Objective:To explore the effects of perceived stress on ego depletion of college students, as well as the mediating role of emotional eating and the moderating role of peer relationship.Methods:A cross-sectional survey of 1 088 college students was conducted using the perceived stress scale, the Dutch eating behavior questionnaire, the self-control resource depletion scale, and the peer relationship measurement from December 2023 to April 2024.PROCESS Macro program in SPSS 25.0 software was used to test the mediating effect of emotional eating and the moderating effect of peer relationship.Results:(1)The score of perceived stress, emotional eating, peer relationship and ego depletion were 39.26±8.35, 39.19±12.15, 2.00(1.00), and 18.19±7.15, respectively.(2)Perceived stress was positively correlated with emotional eating, ego depletion, and peer relationship( r=0.36, 0.61, 0.25, all P<0.01). Emotional eating was positively correlated with ego depletion and peer relationship( r=0.40, 0.19, both P<0.01). And ego depletion was positively correlated with peer relationship( r=0.23, P<0.01).(3)Emotional eating played a partial mediating role in the effect of perceived stress on ego depletion( β=0.077, 95% CI=0.053-0.104), and the mediating effect accounted for 12.38%(0.077/0.622) of the total effect.(4)Peer relationship played a moderating role between perceived stress and emotional eating. Under low peer relationship, perceived stress had a significant positive predictive effect on emotional eating( βsimple=0.46, P<0.01), and under high peer relationship, the predictive effect of perceived stress on emotional eating was significantly weaker( βsimple=0.26, P<0.01). Conclusions:Perceived stress not only directly affects ego depletion, but also indirectly affects ego depletion through emotional eating in college students.High levels of peer relationship can weaken the impact of perceived stress and high emotional eating on ego depletion.

Objective:To propose a detection method for the fault about abnormal maximum value of conductivity of hemodialysis machine on the basis of signal characteristics of jump transition,so as to solve the problem of lower accuracy in detecting fault about abnormal maximum value of conductivity of hemodialysis machine under the influence of interference source coupling.Method:Using a conductivity detector collected the conduction signal of dialysate,then,the processed and converted electrical signals were amplified,and the noise and interference signals from the electrical signal were further removed.The digital filter was constructed by using transfer functions and variable equations,and the digital filter was used to process and convert the original signal as electrical signal.The collected signals about flow volume of blood,flow volume of dialysate,and pressure of the hemodialysis machine were superposed and fitted.The mean values and standard deviations of signal changes were obtained by combining instantaneous frequency of the basic frequency of signal characteristics of jump transition.The chaos superposition was avoided when the signal mode was decomposed.The fault parameters of the signals of jump transition were extracted.The difference calculation was used to calculate the rate of signal change,and calibrate the signals of jump transition,and realize reconstruction for signals.The power spectrum was used to fit the power spectral density of the signals of jump transition.The conductivity value of the hemodialysis machine was calculated.Compare with the set threshold value,the detection for the faults about abnormal maximum value of conductivity of hemodialysis machine was realized.Results:The experimental results showed that the signal of jump transition was recognized at 1.5 and 4.5 s through applied the proposed method,and the corresponding conductivity values were respectively 15.0 and 14.7 mS/cm.The equipment occurred fault about abnormal maximum value of conductivity when it exceeded the preset threshold value 14.5 mS/cm.The false negative rate of the formulated method was less than 30%in detecting the fault about abnormal maximum value of conductivity of hemodialysis machine.Conclusion:This method improves the accuracy of detecting the faults about abnormal maximum value of conductivity of hemodialysis machine,which can effectively maintain stable operation of hemodialysis machine.

Objective:To investigate lymph node metastasis(LNM)in the prostatic anterior fat pad(PAFP)of PCa patients after robot-assisted radical prostatectomy(RARP),and analyze the clinicopathological features and prognosis of LNM in the PAFP.Methods:We retrospectively analyzed the clinicopathological data on 1 003 cases of PCa treated by RARP in the Department of Urolo-gy of PLA General Hospital from January 2017 to December 2022.All the patients underwent routine removal of the PAFP during RARP and pathological examination,with the results of all the specimens examined and reported by pathologists.Based on the pres-ence and locations of LNM,we grouped the patients for statistical analysis,compared the clinicopathological features between different groups using the Student's t,Mann-Whitney U and Chi-square tests,and conducted survival analyses using the Kaplan-Meier and Log-rank methods and survival curves generated by Rstudio.Results:Lymph nodes were detected in 77(7.7％)of the 1 003 PAFP samples,and LNM in 11(14.3％)of the 77 cases,with a positive rate of 1.1％(11/1 003).Of the 11 positive cases,9 were found in the upgraded pathological N stage,and the other 2 complicated by pelvic LNM.The patients with postoperative pathological stage≥T3 constituted a significantly higher proportion in the PAFP LNM than in the non-PAFP LNM group(81.8％[9/11]vs 36.2％[359/992],P=0.005),and so did the cases with Gleason score ≥8(87.5％[7/8]vs 35.5％[279/786],P=0.009).No statisti-cally significant differences were observed in the clinicopathological features and biochemical recurrence-free survival between the pa-tients with PAFP LNM only and those with pelvic LNM only.Conclusion:The PAFP is a potential route to LNM,and patients with LNM in the PAFP are characterized by poor pathological features.There is no statistically significant difference in biochemical recur-rence-free survival between the patients with PAFP LNM only and those with pelvic LNM only.Routine removal of the PAFP and inde-pendent pathological examination of the specimen during RARP is of great clinical significance.

Objective To compare the differences in clinical prognosis and safety between thoracic endovascular aortic repair(TEVAR)combined with bare metal stent(BMS)implantation therapy and TEVAR alone in patients with type B aortic dissection(TBAD)after 6 months.Methods The clinical and imaging data of patients diagnosed with TBAD and treated with TEVAR or TEVAR combined with BMS implantation in Nanyang Central Hospital from March 2023 to March 2024 were retrospectively collected.The patients were divided into TEVAR group and TEVAR+BMS group according to different treatment methods.The aortic remodeling indicators and postoperative complications at discharge and 6 months after surgery were compared between the two groups.Results A total of 37 patients were included,including 20 patients in the TEVAR group and 17 patients in the TEVAR+BMS group.There were no statistically significant differences in baseline data between the two groups(all P＞0.05);at discharge and 6 months after surgery,the true lumen diameters and true lumen ratios of the abdominal aorta(proximal level of the celiac trunk and proximal level of the left renal artery)in the TEVAR+BMS group were better than those in the TEVAR group(all P＜0.05);the degree of thrombosis of the false lumen at 6 months after surgery was better in the TEVAR+BMS group than in the TEVAR group(P＜0.05);there was no statistically significant difference in postoperative complications between the two groups(P＞0.05).Conclusions TEVAR combined with BMS implantation therapy can significantly improve the aortic remodeling effect of patients with TBAD,without increasing the risk of postoperative complications and death caused by aortic-related factors.Bare stent implantation as an auxiliary treatment method for endovascular repair is a safe and effective optimized treatment plan.

Purpose To investigate the diagnostic value of quantitative 123I-Metaiodobenzylguanidine(MIBG)xSPECT/CT imaging in bone metastases of neuroblastoma in children.Materials and Methods We retrospectively assessed 123I-MIBG xSPECT/CT images of 61 children with neuroblastoma confirmed by pathology analyzed the influencing factors of bone metastatic lesions and normal bone quantitative parameters from March 2022 to March 2023 in Beijing Friendship Hospital,Capital Medical University,and compared the differences in standard uptake value(SUV).We used receiver operating characteristics curves to determine the optimum maximum standard uptake value(SUVmax),average standard uptake value(SUVavg),minimum standard uptake value(SUVmin)and peak standard uptake value(SUVpeak)cut-off value to diagnose bone metastatic lesions.Results There was no statistically significant difference in normal bone SUV values among different physical parameters(r=-0.204-0.071,all P>0.05).SUVmax,SUVavg,SUVmin and SUVpeak of bone metastatic lesions were significantly higher than those of normal bone(Z=-10.118--9.703,all P<0.000 1),and there was no significant statistical difference in SUV measurements of bone metastatic lesions among different Curie score intervals(H=0.226,0.107,0.149,0.342,all P>0.05).The area under the curve of SUVmax,SUVavg,SUVmin and SUVpeak were 0.929(95%CI 0.884-0.974),0.948(95%CI 0.906-0.989),0.935(95%CI 0.890-0.981),0.942(95%CI 0.899-0.985);sensitivity was 90.9%,90.2%,93.7%,92.3%,and specificity was 86.9%,93.4%,85.2%,88.5%,respectively,with statistically significant differences(P<0.000 1).The optimal diagnostic thresholds for SUVmax,SUVavg,SUVmin and SUVpeak were 0.39 g/ml,0.33 g/ml,0.20 g/ml and 0.33 g/ml,respectively.Conclusion We demonstrate that SUVavg above 0.33 g/ml in neuroblastoma patients have best diagnostic efficacy in the diagnosis of bone metastasis of neuroblastoma.Quantitative indexes of xSPECT/CT increase the specificity of diagnosing bone metastases of neuroblastoma,demonstrating the high diagnostic efficiency of 123I-MIBG xSPECT/CT imaging quantitative analysis and its potential usefulness as a diagnostic aid for visual evaluation.

Purpose To investigate the diagnostic value of quantitative 123I-Metaiodobenzylguanidine(MIBG)xSPECT/CT imaging in bone metastases of neuroblastoma in children.Materials and Methods We retrospectively assessed 123I-MIBG xSPECT/CT images of 61 children with neuroblastoma confirmed by pathology analyzed the influencing factors of bone metastatic lesions and normal bone quantitative parameters from March 2022 to March 2023 in Beijing Friendship Hospital,Capital Medical University,and compared the differences in standard uptake value(SUV).We used receiver operating characteristics curves to determine the optimum maximum standard uptake value(SUVmax),average standard uptake value(SUVavg),minimum standard uptake value(SUVmin)and peak standard uptake value(SUVpeak)cut-off value to diagnose bone metastatic lesions.Results There was no statistically significant difference in normal bone SUV values among different physical parameters(r=-0.204-0.071,all P>0.05).SUVmax,SUVavg,SUVmin and SUVpeak of bone metastatic lesions were significantly higher than those of normal bone(Z=-10.118--9.703,all P<0.000 1),and there was no significant statistical difference in SUV measurements of bone metastatic lesions among different Curie score intervals(H=0.226,0.107,0.149,0.342,all P>0.05).The area under the curve of SUVmax,SUVavg,SUVmin and SUVpeak were 0.929(95%CI 0.884-0.974),0.948(95%CI 0.906-0.989),0.935(95%CI 0.890-0.981),0.942(95%CI 0.899-0.985);sensitivity was 90.9%,90.2%,93.7%,92.3%,and specificity was 86.9%,93.4%,85.2%,88.5%,respectively,with statistically significant differences(P<0.000 1).The optimal diagnostic thresholds for SUVmax,SUVavg,SUVmin and SUVpeak were 0.39 g/ml,0.33 g/ml,0.20 g/ml and 0.33 g/ml,respectively.Conclusion We demonstrate that SUVavg above 0.33 g/ml in neuroblastoma patients have best diagnostic efficacy in the diagnosis of bone metastasis of neuroblastoma.Quantitative indexes of xSPECT/CT increase the specificity of diagnosing bone metastases of neuroblastoma,demonstrating the high diagnostic efficiency of 123I-MIBG xSPECT/CT imaging quantitative analysis and its potential usefulness as a diagnostic aid for visual evaluation.

OBJECTIVE: To investigate the association between long-term exposure to ambient fine particulate matter (PM _2.5) and its constituents and the risk of incident type 2 diabetes mellitus (T2DM), and to examine the modification roles of overweight status. METHODS: This prospective study included 27,507 adults living in rural China. The annual mean residential exposure to PM _2.5 and its constituents was estimated using a satellite-based statistical model. Cox models were used to estimate the risk of T2DM associated with PM _2.5 and its constituents. Stratified analysis quantified the role of overweight status in the association between PM _2.5 constituents and T2DM. RESULTS: Over a median follow-up of 9.4 years, 3,001 new T2DM cases were identified. The hazard ratio ( HR) for a 10 μg/m ³ increase in ambient PM _2.5 was 1.30 (95% confidence interval [ CI]: 1.17, 1.45). Among the constituents, the strongest association was observed with black carbon. Being overweight significantly modified the association between certain constituents and the risk of T2DM. Participants who were overweight and exposed to the highest quartile of PM _2.5 constituents had the highest risk of T2DM ( HR: 2.46, 95% CI: 2.04, 2.97). CONCLUSIONS Our findings indicate that PM _2.5 was associated with an increased risk of T2DM, with black carbon potentially being the primary contributor. Being overweight appeared to enhance the association between PM _2.5 and T2DM. This suggests that controlling both PM _2.5 exposure and overweight status may reduce the burden of T2DM.
Humans ; Diabetes Mellitus, Type 2/chemically induced* ; China/epidemiology* ; Particulate Matter/analysis* ; Overweight/epidemiology* ; Female ; Male ; Middle Aged ; Rural Population ; Air Pollutants/analysis* ; Adult ; Prospective Studies ; Environmental Exposure/adverse effects* ; Aged ; Risk Factors

Objective:To propose a detection method for the fault about abnormal maximum value of conductivity of hemodialysis machine on the basis of signal characteristics of jump transition,so as to solve the problem of lower accuracy in detecting fault about abnormal maximum value of conductivity of hemodialysis machine under the influence of interference source coupling.Method:Using a conductivity detector collected the conduction signal of dialysate,then,the processed and converted electrical signals were amplified,and the noise and interference signals from the electrical signal were further removed.The digital filter was constructed by using transfer functions and variable equations,and the digital filter was used to process and convert the original signal as electrical signal.The collected signals about flow volume of blood,flow volume of dialysate,and pressure of the hemodialysis machine were superposed and fitted.The mean values and standard deviations of signal changes were obtained by combining instantaneous frequency of the basic frequency of signal characteristics of jump transition.The chaos superposition was avoided when the signal mode was decomposed.The fault parameters of the signals of jump transition were extracted.The difference calculation was used to calculate the rate of signal change,and calibrate the signals of jump transition,and realize reconstruction for signals.The power spectrum was used to fit the power spectral density of the signals of jump transition.The conductivity value of the hemodialysis machine was calculated.Compare with the set threshold value,the detection for the faults about abnormal maximum value of conductivity of hemodialysis machine was realized.Results:The experimental results showed that the signal of jump transition was recognized at 1.5 and 4.5 s through applied the proposed method,and the corresponding conductivity values were respectively 15.0 and 14.7 mS/cm.The equipment occurred fault about abnormal maximum value of conductivity when it exceeded the preset threshold value 14.5 mS/cm.The false negative rate of the formulated method was less than 30%in detecting the fault about abnormal maximum value of conductivity of hemodialysis machine.Conclusion:This method improves the accuracy of detecting the faults about abnormal maximum value of conductivity of hemodialysis machine,which can effectively maintain stable operation of hemodialysis machine.