Objective:To investigate the efficacy of a predictive model for differentiating benign and malignant renal tumors based on CT radiomic features and clinical features.Methods:A retrospective study was conducted on 1 395 patients with renal tumors admitted to the First Affiliated Hospital of Zhengzhou University from December 2011 to December 2021, including 842 males and 553 females. The median age was 55 (44, 59) years, and the median tumor diameter was 3.6 (2.7, 4.6) cm. All patients underwent contrast-enhanced CT scaning before surgery, and radiomic features were extracted from non-contrast, arterial, and venous phase images. Prediction models for distinguishing benign and malignant renal tumors were constructed using five machine learning algorithms (logistic regression, support vector machine, neural network, random forest, and extreme gradient boosting), and these models were then ensembled to construct a stacking classifier. All patients underwent partial nephrectomy, and they were divided into a training group (941 cases, December 2011 to June 2020) and a validation group (454 cases, July 2020 to December 2021) based on the date of surgery. A clinical-radiomic model was developed by combining the result of stacking classifier, clinical features and CT report results, and its predictive performance was evaluated in the validation group.Results:The radiomic signature based on the combined features and five machine learning algorithms(AUC 0.835-0.844) showed higher accuracy in predicting benign and malignant renal tumors compared to single phases (AUC 0.744-0.831). After integrating the five machine learning algorithms, the AUC of the three-phase combined radiomic model in the validation group improved to 0.847(95% CI 0.802-0.892). The clinical-radiomic model, incorporating radiomic features, clinical features, and CT report results, achieved a significantly higher AUC in the validation group compared to radiologists [0.919(95% CI 0.889-0.950)vs. 0.835(95% CI 0.786-0.883), P<0.01]. Conclusions:The predictive model integrating CT radiomics features, clinical characteristics, and CT report results demonstrates excellent discriminative ability in distinguishing benign and malignant renal tumors.

Objective:To investigate the efficacy of a 3D printed guide plate in the placement of a hinged external fixator for treatment of elbow terror triad.Methods:A retrospective study was conducted to analyze the data of 10 patients with elbow terror triad who had been treated at Department of Orthopedics, Northern Jiangsu People's Hospital Affiliated to Yangzhou University from July 2021 to July 2023 by the hinged external fixator placement assisted by a 3D printed guide plate. There were 6 males and 4 females, aged (48.2±19.7) years. The range of elbow motion and visual analogue scale (VAS) pain score in the patients were recorded and compared between preoperation and the last follow-up. Mayo elbow performance score (MEPS) and complications were also recorded at the last follow-up.Results:The central axis of the elbow rotation was successfully located at one time under the assistance of the 3D printed guide plate in the 10 patients. Intraoperative fluoroscopy and postoperative CT computer simulation verified that the rotation center of the hinged external fixator was consistent with that of the elbow joint. All patients were followed up for 12.0 (5.5, 13.5) months. The elbow flexion and extension at the last follow-up in the 10 patients were 126.2°±6.1° and 153.2°±5.9°, respectively, significantly better than those before operation (23.3°±6.7° and 121.2°±5.7°) ( P<0.05). Their VAS pain score was 1 (0, 1) point at the last follow-up, significantly lower than that before operation [3 (2, 3) points] ( P<0.05). Their MEPS score at the last follow-up was (88.0±6.8) points, giving 6 excellent and 4 good cases. No patient experienced such complications as pin tract infection, loosening or breakage of fixation needles, or radial nerve injury. Ectopic ossification occurred in 2 patients, and 1 patient underwent a secondary nerve release due to ulnar nerve symptoms. Conclusion:In the surgical treatment of elbow terror triad, application of a 3D printed guide plate to assist the placement of an external fixator can quickly and accurately locate the central axis of the elbow rotation, which promotes the early functional exercise of the patients to obtain a satisfactory functional prognosis.

Objective:To investigate the effect of nourishing yin and tonifying yang method on inflammatory response and bone metabolism in patients with T2DM complicated with osteoporosis (OP).Methods:A randomized controlled trial. From January 2022 to December 2023,80 patients with T2DM and OP in our hospital were selected as the observation objects, and they were divided into two groups by random number table method, with 40 cases in each group.On the basis of conventional treatment, the control group chewed vitamin D calcium chewable tablets, and the observation group added nourishing yin and tonifying yang Chinese medicine.Both groups were treated for 6 months. TCM syndrome scores were performed before and after treatment ;the levels of fasting blood glucose (FPG), 2 hPG and HbA1c were detected by intelligent blood glucose monitor;the levels of serum neutrophils and lymphocytes were detected by automatic blood analyzer, and the neutrophil/lymphocyte ratio (NLR) was calculated;the levels of serum IL-1β and TNF-α were detected by automatic chemiluminescence analyzer, the levels of type I procollagen amino terminal propeptide (PINP), type I collagen carboxy terminal peptide β special sequence (β-CTX) and 25-hydroxy vitamin D3 [25-(OH)D3] were detected by ELISA;Bone mineral density (BMD) was detected by bone mineral density detector. The adverse reactions during treatment were observed and recorded, and the clinical efficacy was evaluated.Results:The total effective rate was 92.5 %(37/40) in the observation group and 75.0 % (30/40) in the control group,the difference between the two groups was statistically significant ( χ2=4.50, P=0.034).After treatment, the scores of soreness and weakness of waist and knees, soreness and pain of waist and back, clear and long urine, pale tongue and white coating in the observation group were lower than those in the control group ( t=3.11, 3.75, 3.51, 3.74, P<0.01);the levels of serum FPG, 2 hPG and HbA1c in the observation group were lower than those in the control group ( t=3.11,3.20,3.39, P<0.01).The levels of serum NLR (2.63 ± 0.68 vs. 3.24 ± 0.79, t=3.70), IL-1β [(81.65 ± 8.30) ng/L vs. (89.03 ± 8.98) ng/L, t=3.82] and TNF-α [(35.14 ± 5.11) μg/L vs. (39.96 ± 5.38) μg/L, t=4.11] in the observation group were lower than those in the control group ( P<0.01). After treatment, the levels of PINP [(29.83 ± 3.92) ng/L vs. (34.02 ± 4.03) ng/L, t=4.71] and β-CTX [(21.30 ± 3.95 ) ng/L vs. (25.32 ± 4.18) ng/L, t=4.42] in the observation group were lower than those in the control group ( P<0.01), the levels of 25-(OH)D3 [(42.86 ± 5.12) μg/L vs. (38.08 ± 4.55) μg/L, t=4.41] and BMD [(0.90 ± 0.18) g/cm 3vs. (0.78 ± 0.16) g/cm 3, t=3.15] were higher than those in the control group ( P<0.01).During the treatment, the incidence of adverse reactions was 12.5% (5/40) in the observation group and 10.0 % (4/40) in the control group,there was no significant difference between the two groups ( χ2=0.13, P=0.723). Conclusion:The method of nourishing yin and tonifying yang can effectively improve the TCM syndromes of T2DM patients with OP, reduce the levels of blood glucose and inflammatory factors, improve bone metabolism, improve clinical efficacy and have good treatment safety.

Empathy is a cornerstone in cultivating medical ethics.This article delves into the profound significance of empathy and underscores the importance of promoting it among medical students and practitioners.It also details methods for strengthening empathy and capacity building concerned in students through oral medicine instruction,with the goal of nurturing oral healthcare professionals who provide compassionate care.

In light of the professional characteristics of oral medicine,oral medical students may be challenged with higher medical risks during the clinical internship stage.This article analyzes the potential risk factors in the process of oral medicine internships and proposes corresponding preventive strategies,aiming to ensure medical safety and promote the healthy development of medical students.

Objective To investigate the expression changes and clinical significance of serum pepsinogen(PG)and triggering receptor expressed on myeloid cells-1(TREM-1)in patients with reflux esophagitis(RE).Methods A total of 140 patients with RE who were treated from October 2021 to October 2023 were selected as the observation group,and 140 healthy adults who underwent physical examination during the same period were selected as the control group.Serum PG(PGⅠ and PGⅡ)and TREM-1 were detected by ELISA.Multivariate logistic regression was used to analyze the influencing factors of RE.Receiver operating characteristic(ROC)was used to analyze the diagnostic efficacy of serum PGⅠ,PGⅡ and TREM-1 levels for RE.Results The levels of interleukin(IL)-2,IL-6,Il-1β,PGⅡ,TREM-1 and tumor necrosis factor-α(TNF-α)in the observation group were significantly higher than those in the control group,while the level of PGⅠ was significantly lower than that in the control group(P<0.01).Serum IL-2,IL-6,IL-1β,TNF-α,PGⅡ and TREM-1 were risk factors for RE,while serum PGⅠ was a protective factor for RE(P<0.01).ROC curve analysis showed that the area under the ROC curve(AUC)of combined detection of PGⅠ,PGⅡ and TREM-1 in the diagnosis of RE was significantly higher than that of PGⅠ alone(Z=5.940,P<0.001)and PGⅡ alone(Z=6.764,P<0.001)and TREM-1 alone(Z=6.791,P<0.001).Conclusion The expression levels of serum PGⅡ and TREM-1 in patients with RE are increased,while the expression level of PGⅠ is decreased.The combined detection of the three can improve the diagnostic efficacy of RE.

Objective To investigate the expression changes and clinical significance of serum pepsinogen(PG)and triggering receptor expressed on myeloid cells-1(TREM-1)in patients with reflux esophagitis(RE).Methods A total of 140 patients with RE who were treated from October 2021 to October 2023 were selected as the observation group,and 140 healthy adults who underwent physical examination during the same period were selected as the control group.Serum PG(PGⅠ and PGⅡ)and TREM-1 were detected by ELISA.Multivariate logistic regression was used to analyze the influencing factors of RE.Receiver operating characteristic(ROC)was used to analyze the diagnostic efficacy of serum PGⅠ,PGⅡ and TREM-1 levels for RE.Results The levels of interleukin(IL)-2,IL-6,Il-1β,PGⅡ,TREM-1 and tumor necrosis factor-α(TNF-α)in the observation group were significantly higher than those in the control group,while the level of PGⅠ was significantly lower than that in the control group(P<0.01).Serum IL-2,IL-6,IL-1β,TNF-α,PGⅡ and TREM-1 were risk factors for RE,while serum PGⅠ was a protective factor for RE(P<0.01).ROC curve analysis showed that the area under the ROC curve(AUC)of combined detection of PGⅠ,PGⅡ and TREM-1 in the diagnosis of RE was significantly higher than that of PGⅠ alone(Z=5.940,P<0.001)and PGⅡ alone(Z=6.764,P<0.001)and TREM-1 alone(Z=6.791,P<0.001).Conclusion The expression levels of serum PGⅡ and TREM-1 in patients with RE are increased,while the expression level of PGⅠ is decreased.The combined detection of the three can improve the diagnostic efficacy of RE.

Objective:To investigate the efficacy of a predictive model for differentiating benign and malignant renal tumors based on CT radiomic features and clinical features.Methods:A retrospective study was conducted on 1 395 patients with renal tumors admitted to the First Affiliated Hospital of Zhengzhou University from December 2011 to December 2021, including 842 males and 553 females. The median age was 55 (44, 59) years, and the median tumor diameter was 3.6 (2.7, 4.6) cm. All patients underwent contrast-enhanced CT scaning before surgery, and radiomic features were extracted from non-contrast, arterial, and venous phase images. Prediction models for distinguishing benign and malignant renal tumors were constructed using five machine learning algorithms (logistic regression, support vector machine, neural network, random forest, and extreme gradient boosting), and these models were then ensembled to construct a stacking classifier. All patients underwent partial nephrectomy, and they were divided into a training group (941 cases, December 2011 to June 2020) and a validation group (454 cases, July 2020 to December 2021) based on the date of surgery. A clinical-radiomic model was developed by combining the result of stacking classifier, clinical features and CT report results, and its predictive performance was evaluated in the validation group.Results:The radiomic signature based on the combined features and five machine learning algorithms(AUC 0.835-0.844) showed higher accuracy in predicting benign and malignant renal tumors compared to single phases (AUC 0.744-0.831). After integrating the five machine learning algorithms, the AUC of the three-phase combined radiomic model in the validation group improved to 0.847(95% CI 0.802-0.892). The clinical-radiomic model, incorporating radiomic features, clinical features, and CT report results, achieved a significantly higher AUC in the validation group compared to radiologists [0.919(95% CI 0.889-0.950)vs. 0.835(95% CI 0.786-0.883), P<0.01]. Conclusions:The predictive model integrating CT radiomics features, clinical characteristics, and CT report results demonstrates excellent discriminative ability in distinguishing benign and malignant renal tumors.

Objective:To investigate the efficacy of a 3D printed guide plate in the placement of a hinged external fixator for treatment of elbow terror triad.Methods:A retrospective study was conducted to analyze the data of 10 patients with elbow terror triad who had been treated at Department of Orthopedics, Northern Jiangsu People's Hospital Affiliated to Yangzhou University from July 2021 to July 2023 by the hinged external fixator placement assisted by a 3D printed guide plate. There were 6 males and 4 females, aged (48.2±19.7) years. The range of elbow motion and visual analogue scale (VAS) pain score in the patients were recorded and compared between preoperation and the last follow-up. Mayo elbow performance score (MEPS) and complications were also recorded at the last follow-up.Results:The central axis of the elbow rotation was successfully located at one time under the assistance of the 3D printed guide plate in the 10 patients. Intraoperative fluoroscopy and postoperative CT computer simulation verified that the rotation center of the hinged external fixator was consistent with that of the elbow joint. All patients were followed up for 12.0 (5.5, 13.5) months. The elbow flexion and extension at the last follow-up in the 10 patients were 126.2°±6.1° and 153.2°±5.9°, respectively, significantly better than those before operation (23.3°±6.7° and 121.2°±5.7°) ( P<0.05). Their VAS pain score was 1 (0, 1) point at the last follow-up, significantly lower than that before operation [3 (2, 3) points] ( P<0.05). Their MEPS score at the last follow-up was (88.0±6.8) points, giving 6 excellent and 4 good cases. No patient experienced such complications as pin tract infection, loosening or breakage of fixation needles, or radial nerve injury. Ectopic ossification occurred in 2 patients, and 1 patient underwent a secondary nerve release due to ulnar nerve symptoms. Conclusion:In the surgical treatment of elbow terror triad, application of a 3D printed guide plate to assist the placement of an external fixator can quickly and accurately locate the central axis of the elbow rotation, which promotes the early functional exercise of the patients to obtain a satisfactory functional prognosis.