Objective To analyze the independent factors affecting the prognosis of pancreatic cancer and construct a prediction model based on surveillance,epidemiology,and end results(SEER)database.Methods The clinical data of 7 801 American pancreatic cancer patients from 2010 to 2015 were obtained from SEER database.They were randomly divided into training group and validation group in a ratio of 7∶3.The nomogram was constructed after multivariate COX regression analysis of clinical variables in the training group.The accuracy of the model was verified by receiver operating characteristic(ROC)curve and calibration curve.Results Age,primary-site,grade,T-stage,N-stage,M-stage,surgery,radiotherapy and chemotherapy were related to the prognosis of the patients with pancreatic cancer.The area under curve(AUC)of overall survival(OS)ROC curve of 3-and 5-year were 0.90 and 0.91 respectively.The AUC of cancer specific survival(CSS)ROC curve were 0.91 and 0.91 respectively.The calibration curve showed a good consistency between the observed and predicted values.The selected clinical variables did have an impact on the prognosis of the patients with pancreatic cancer.Conclusions The model had good prediction accuracy and was helpful for clinical decision-making and personalized treatment of the patients with pancreatic cancer.

Objective To evaluate the diagnostic efficacy of artificial vision,radiomics(RAD)and deep learning(DL)in distinguishing atypical usual interstitial pneumonia(UIP)from nonspecific interstitial pneumonia(NSIP).Methods A retrospective analysis was conducted on 300 patients diagnosed with interstitial pneumonia(IP).A total of 56 cases of atypical UIP and 57 cases of NSIP were included.All patients underwent CT examination before biopsy,and were randomly divided into training and test groups.DL and RAD artificial intelligence models were developed and trained.The consistency of artificial vision assessment was performed via Kappa test and receiver operating characteristic(ROC)curve analysis was performed via logistic regression.Then,the differences in the area under the curve(AUC)of different models were compared via DeLong analysis.The diagnostic efficiency of the model was evaluated via AUC and accuracy(ACC)as the main indicators and compared with the artificial vision evaluation.Results Two radiologists showed significant consistency in the CT diagnosis and interpretation of atypical UIP and NSIP(Kappa=0.852,P＜0.01).On high-resolution computed tomography(HRCT),the atypical UIP patients mainly showed basal bronchiectasis,honeycombing,and reticular opacities,while,the NSIP patients showed basal reticular opacities,ground glass opacity(GGO)and subpleural avoidance sign.The probability of GGO exceeding the reticular opacities of the NSIP patients was significantly higher than that of the atypical UIP patients(P＜0.05).The DL model showed significantly higher diagnostic efficiency than RAD and artificial vision in the differential diagnosis of atypical UIP and NSIP(AUC:0.94 vs 0.85 vs 0.65,P＜0.01).Conclusion CT and RAD have a certain significant diagnostic value for atypical UIP and NSIP.Atypical UIP and NSIP can be more accurately differentiated and diagnosed based on the DL model,thereby,the management of IP is further strengthened in clinical practice.

Objective To explore the value of systemic immune-inflammation index(SⅡ)in differentiating acute and chronic cholecystitis.Methods A total of 297 patients with cholecystitis who underwent cholecystectomy in Jinshan Hospital,Fudan University from August 2020 to November 2023 were selected,and were divided into acute cholecystitis group(n=192)and chronic cholecystitis group(n=105).The patients in acute cholecystitis group were further divided into severe subgroup(n=114)and mild subgroup(n=78).The differential diagnosis values of SⅡ and neutrophil-to-lymphocyte ratio(NLR)in acute and chronic cholecystitis were evaluated by ROC curve.Results Compared with chronic cholecystitis group,males were more,older,the incidence of hypertension was higher,drainage volume increased,drainage time,hospital time,and surgical duration were all longer,blood cells,neutrophil count,monocyte count increased,total bilirubin,direct bilirubin,and creatinine were higher,SⅡ and NLR increased in the acute cholecystitis group(P＜0.05).Compared with the severe subgroup,the drainage volume decreased,drainage time,hospital stay,and surgical duration were shorter,white blood cell count,neutrophil count,monocyte count,and total bilirubin decreased,while lymphocyte count increased,SⅡ and NLR decreased in the mild subgroup(P＜0.05).The optimal cutoff values of SⅡ and NLR for distinguishing acute cholecystitis from chronic cholecystitis were 797.96 and 3.65,and the AUC were 0.847 and 0.869,with 73.2％and 74.2％of sensitivity,and 86.7％and 89.5％of specificity.The optimal cutoff values of SⅡ and NLR for distinguishing acute severe cholecystitis from mild cholecystitis were 1 056.59 and 4.65,the AUC were 0.768 and 0.779,with 77.0％and 82.3％of sensitivity,and 67.5％and 62.3％of specificity.There was no statistically significant difference between the values of SⅡ and NLR for distinguishing acute severe and acute cholecystitis.Conclusion SⅡ is a good hematological indicator for distinguishing acute cholecystitis from chronic cholecystitis with similar value to NLR.

Objective:To evaluate the applicability of bone age (BA) assessment methods and to investigate the difference between BA and chronological age (CA) based on the data of children in rural areas of Beijing.Methods:A total of 412 healthy children (226 boys, 186 girls) with the age 8.6 (6.8, 10.3) years old were included in this study. The data of the prospective study were from a subgroup of the project "National Nutrition and Health Systematic Survey for 0-18 Years Old Children in China", which included children with age of 3-12 years old in Beijing rural areas. The non-dominant hand-wrist radiographs of all participants were obtained in April 2021. The Dr.Wise BA detection and analysis system was used to assess the BA according to the Tanner Whitehouse 3 (TW3) radius-ulna-short bone score (TW3-RUS), TW3 carpal bone score (TW3-Carpal), China-05 TW3-Chinese RUS (TW3-C RUS), China-05 TW3-Chinese carpal (TW3-C Carpal), and Greulich-Pyle (G-P) standards. The cases were stratified by the sex and different CA in the statistical analysis. The estimated BA obtained using different methods were compared with the CA using Wilcoxon signed ranks test.Results:The sex-stratified results showed that no significant difference was found between the estimated BA using G-P standards and CA in boys ( Z=-0.694, P=0.488), while all the other estimated BA results were statistically significantly higher than CA ( P<0.05). Stratified by both sex and CA, the estimated BA using G-P standards in 4-6 years old boy groups, as well as the estimated BA using TW3-Carpal and TW3-C Carpal standards in 11-12 years old girl groups were lower than CA, while in the other groups, the estimated BA were higher than CA. Conclusions:There were varying degrees of deviations in the BA estimations using TW3, China 05, and G-P methods for children in rural areas of Beijing. It is imperative to establish a new standard for the BA evaluation of the contemporary Chinese children.

Objective:To describe the effect of distraction lengthening to correct nail deformity in unilateral congenital brachydactyly type D (BDD).Methods:Patients with unilateral BDD who were treated by distraction lengthening between January 2020 and December 2021 in the Department of Plastic and Reconstructive Surgery of Shanghai 9th People’s Hospital were retrospectively reviewed. A transverse osteotomy was applied on the middle diaphysis of distal phalanx, and one pin was inserted percutaneously on both sides of the osteotomy site, then a mini external fixator was installed. Distraction lengthening was performed with a slow and sustained procedure. The aesthetic and functional results were compared preoperatively and postoperatively. Patient satisfaction questionnaires were recorded.Results:35 patients were enrolled, including 12 males and 23 females, with a mean age of 29.5 years. 17 thumbs were left and 18 thumbs were right. The time for distraction lengthening was 10-17 days, and the mean time was 12.3 days. The total time for external fixator maintenance was 55-70 days, with a mean time of 61.4 days. The mean follow-up was 18.6 months. The mean thumbnail length was increased from (9.2±0.6) mm to (14.2±0.4) mm [lengthening ratio, (54.4±7.5)%] after distraction lengthening ( P<0.05). The ratio of nail length to width changed from 0.63±0.05 to 1.05±0.04 [increase ratio, (68.2±10.5)%, P<0.05], which was equal to the normal value (1.07±0.03) ( P>0.05). Meanwhile, the distal thumb length increased from (22.6±0.7) mm to (29.6±1.0) mm ( P<0.05), with a mean increase of (6.9±1.0) mm, and the increase ratio was (30.8±4.8)%. The ratio of nail length to distal thumb length changed from 0.41±0.03 to 0.51±0.02 [increase ratio, (23.6±8.3) %, P<0.05]. The thumb function was not significantly influenced ( P>0.05). 33 patients (94.3%) were very satisfied with the results. Conclusion:Short nail deformity in BDD can be corrected by distraction lengthening with a good aesthetic appearance and without functional impairment.

Objective:To describe the effect of distraction lengthening to correct nail deformity in unilateral congenital brachydactyly type D (BDD).Methods:Patients with unilateral BDD who were treated by distraction lengthening between January 2020 and December 2021 in the Department of Plastic and Reconstructive Surgery of Shanghai 9th People’s Hospital were retrospectively reviewed. A transverse osteotomy was applied on the middle diaphysis of distal phalanx, and one pin was inserted percutaneously on both sides of the osteotomy site, then a mini external fixator was installed. Distraction lengthening was performed with a slow and sustained procedure. The aesthetic and functional results were compared preoperatively and postoperatively. Patient satisfaction questionnaires were recorded.Results:35 patients were enrolled, including 12 males and 23 females, with a mean age of 29.5 years. 17 thumbs were left and 18 thumbs were right. The time for distraction lengthening was 10-17 days, and the mean time was 12.3 days. The total time for external fixator maintenance was 55-70 days, with a mean time of 61.4 days. The mean follow-up was 18.6 months. The mean thumbnail length was increased from (9.2±0.6) mm to (14.2±0.4) mm [lengthening ratio, (54.4±7.5)%] after distraction lengthening ( P<0.05). The ratio of nail length to width changed from 0.63±0.05 to 1.05±0.04 [increase ratio, (68.2±10.5)%, P<0.05], which was equal to the normal value (1.07±0.03) ( P>0.05). Meanwhile, the distal thumb length increased from (22.6±0.7) mm to (29.6±1.0) mm ( P<0.05), with a mean increase of (6.9±1.0) mm, and the increase ratio was (30.8±4.8)%. The ratio of nail length to distal thumb length changed from 0.41±0.03 to 0.51±0.02 [increase ratio, (23.6±8.3) %, P<0.05]. The thumb function was not significantly influenced ( P>0.05). 33 patients (94.3%) were very satisfied with the results. Conclusion:Short nail deformity in BDD can be corrected by distraction lengthening with a good aesthetic appearance and without functional impairment.

Cell Line, Tumor ; Cell Proliferation ; Humans ; Melanins ; Melanoma ; Particulate Matter

The pathogenesis of diabetes is complicated by several factors including autoimmunity, environment, heredi?ty, and etc. Autophagy is a kind of intracellular biodegradation processes, which plays an important role in intracellular ho?meostasis of islet cells. In diabetes, autophagy is involved in the endoplasmic reticulum stress, mitochondrial dysfunction and inflammatory, and it affects the development of the disease. In this paper, we reviewed the interactions of autophagy with endoplasmic reticulum stress and mitochondrial dysfunction with inflammation in diabetes in order to investigate the patho?genesis of diabetes, to find new strategies for prevention or treatment of diabetes.

Objective To investigate the application value of DWI and SWI in the diagnosis of diffuse axonal injury (DAI). Methods MR imaging was performed in 23 patients with clinically diagnosed DAI including the routine se-quences, DWI and SWI sequences.The detected number of lesions was compared among the different sequences.The characteristics of sig|lal and distribution of lesions were analyzed. Results DAI lesions located in the white matter,juncfional zone of cortex and medulla,basal ganglia, corpus eaihsum brain stem arm cerebelhm. The detected number of non-hemorrhagic lesion on DWl was the highest and significantly higher than that on other sequences.The deteced number of hemorrhagic lesion on SWI was the highest and significantly higher than that on other sequences. Conclu-sion Combination of DWl and SWI can improve detection ratio of DAI lesions, provide more image evidence for early clinical diagnosis,so DWI and SWI should be the first and naltilm sequence in the MRI exaafination of DAI detection.

Objective To investigate the effect of carbon dioxide (CO2) pneumoperitoneum with different duration periods on renal function.Methods Eighty-nine patients undergoing laparoscopic operations from October 2009 to December 2011 were divided into 3 groups according to operative time.The patients whose operative time was less than 1 hour belonged to group T1,between 1 hour and 2 hours belonged to group T2,and more than 2 hours belonged to group T3.The levels of serum creatinine,urinary creatinine,urinary microalbumin were detected at preoperation as well as 10 minutes,1 hour,24 hours after operation.Results There was no significant difference regarding of the endogenous creatinine clearance rate(Ccr) postoperatively between group T1 and T2 (P ＞ 0.05).The Ccr levels at 10 minutes after operation in group T3 was significant lower than at preoperation(P ＜0.05),and increased gradually at 1 h and 24 h after operation.The ratio of urinary microalbumin to urinary creatinine (A/C) increased at post-operation compared with at pre-operation in all 3 groups (P ＜ 0.05),but there was no significant difference between the 3 groups after operation (P ＞ 0.05).The renal function post-operation of patients over 60 years old was as same as that of patients less 60 years old in group T1 (P ＞ 0.05).However,the Ccr level in patients over 60 years old at post-operation was lower than that of patients less 60 years old in group T2 and T3 (P ＜ 0.05).Conclusion Long CO2 pneumoperitoneum could lead to the acute and obvious injury on renal function,especially in the patients over 60 years old.Fortunately,the renal function recovered to be normal gradually in a short time.