Objective To compare the efficacy of multivariate logistic regression and XGBoost models in predicting major adverse cardiovascular events(MACE)after percutaneous coronary in-tervention(PCI)in elderly patients with coronary artery calcification(CAC).Methods A total of 120 elderly patients with CAC lesions undergoing PCI in our hospital from June 2020 to June 2023 were retrospectively enrolled in this study.The incidence of MACE was observed during 1 year of follow-up.Nine patients were lost during the period,and the left patients were divided into MACE group(28 patients)and non-MACE group(83 patients).Multivariate logistic regression analysis and XGBoost model were used to screen the influencing factors of MACE in elderly CAC patients after PCI.ROC curve and calibration curve were drawn to compare the predictive efficiency of the two models.Results The MACE group had significantly advanced age,larger proportions of smoking and diabetes,higher LDL-C and Gensini score,and increased ratios of diseased vessels ≥3,severe calcification,combined rotary grinding and number of stent implantation when compared with the non-MACE group(P＜0.05,P＜0.01).Multivariate logistic regression model showed that smoking,diabetes,LDL-C,Gensini score,and number of stents implanted were independent risk factors for MACE in CAC patients after PCI(P＜0.05,P＜0.01).XGBoost model indicated that the top five important feature scores were Gensini score of 35,number of stent implantation score of 25,combined diabetes score of 22,smoking score of 18,and LDL-C score of 15.ROC curve analysis revealed that the AUC value of multivariate logistic regression model in predicting MACE in elderly CAC patients after PCI was 0.925(95％CI:0.859-0.966),with a sensitivity of 82.14％and a specificity of 97.59％,and the value of the XGBoost model was 0.918(95％CI:0.850-0.961),with a sensitivity of 89.29％and a specificity of 78.31％.There was no significant difference in predictive efficacy between the two models(Z=0.148,P=0.8823).Conclusion Multiple logistic regression model and XGBoost model show equally efficacy in predicting MACE in elderly CAC patients after PCI.Smoking,diabetes,LDL-C,Gensini score and number of stents implanted are independent risk factors for MACE in the patients.

Objective To compare the efficacy of multivariate logistic regression and XGBoost models in predicting major adverse cardiovascular events(MACE)after percutaneous coronary in-tervention(PCI)in elderly patients with coronary artery calcification(CAC).Methods A total of 120 elderly patients with CAC lesions undergoing PCI in our hospital from June 2020 to June 2023 were retrospectively enrolled in this study.The incidence of MACE was observed during 1 year of follow-up.Nine patients were lost during the period,and the left patients were divided into MACE group(28 patients)and non-MACE group(83 patients).Multivariate logistic regression analysis and XGBoost model were used to screen the influencing factors of MACE in elderly CAC patients after PCI.ROC curve and calibration curve were drawn to compare the predictive efficiency of the two models.Results The MACE group had significantly advanced age,larger proportions of smoking and diabetes,higher LDL-C and Gensini score,and increased ratios of diseased vessels ≥3,severe calcification,combined rotary grinding and number of stent implantation when compared with the non-MACE group(P＜0.05,P＜0.01).Multivariate logistic regression model showed that smoking,diabetes,LDL-C,Gensini score,and number of stents implanted were independent risk factors for MACE in CAC patients after PCI(P＜0.05,P＜0.01).XGBoost model indicated that the top five important feature scores were Gensini score of 35,number of stent implantation score of 25,combined diabetes score of 22,smoking score of 18,and LDL-C score of 15.ROC curve analysis revealed that the AUC value of multivariate logistic regression model in predicting MACE in elderly CAC patients after PCI was 0.925(95％CI:0.859-0.966),with a sensitivity of 82.14％and a specificity of 97.59％,and the value of the XGBoost model was 0.918(95％CI:0.850-0.961),with a sensitivity of 89.29％and a specificity of 78.31％.There was no significant difference in predictive efficacy between the two models(Z=0.148,P=0.8823).Conclusion Multiple logistic regression model and XGBoost model show equally efficacy in predicting MACE in elderly CAC patients after PCI.Smoking,diabetes,LDL-C,Gensini score and number of stents implanted are independent risk factors for MACE in the patients.

[Objective]To investigate the causes and treatment methods of postoperative complications of femoral fractures treated with interlocking intramedullary nails.[Method]A total of 243 cases of femoral fractures from Jan 1999 to Dec 2004 were treated with interlocking intramedullary nails.There were 14 cases having complications,delayed union in 1,nonunion in 3,nailing failure in 6(locking scerw loosen in 4,locking scerw folding in 1,locking scerw breakage in 2),nail breakage in 1,re-fracture in 1 and knee ankylosis in 1.Two cases with delayed union to convert the fixation from statictody namicin time;3 cases with nonunion were treated with bone grafting.Breakage nail and re-fractuer cases were treated with enlarging intramedullary tunels,exchanging nails and bone grafting.One of locking scerw loosen were treated with exchanging nails and bone grafting.Knee ankylosis were treated with quadriceps plasty.[Result]Through treatment,the delayed union and the nonunion were all healed and got recovery of knee function.[Conclusion]Though it has certain complications,the interlocking intramedullary nails used for femoral fractures have more advantages than other internal fixations.It needs to take valid measures to reach a satisfying result when complication appears.

OBJECTIVETo investigate the levels and changes of sexual hormone in serum and seminal plasma, and the epidermal growth factor (EGF), alpha-glucosidase, and fructose in the seminal plasma of non-obstructive azoospermic patients, and to assess the significance of the analysis of their chromosomes.

METHODSThirty-six non-obstructive azoospermic males and 26 normal males were chosen. The results in reproductive endocrine and genetics obtained by radioimmunoassay, colorimetry, and chromosomes G and C banding assay were compared and analyzed to explore into the causes of infertility.

RESULTSThe levels of FSH, LH, PRL and E2 in the serum of the non-obstructive azoospermic patients were higher than those of the control group, but the T level had no significant difference between the two groups. There were no obvious differences in the sexual hormones except in FSH of the seminal plasma. There were 2 cases of abnormal sex chromosomes, 2 cases of big Y chromosomes and 7 cases of small Y chromosomes in the non-obstructive azoospermic patients. No correlation was found between EGF and fructose in the seminal plasma.

CONCLUSIONThe level of sexual hormone in serum, alpha-glucosidase in seminal plasma and abnormal chromosomes might be closely related to non-obstructive azoospermia.

Adult ; Azoospermia ; etiology ; genetics ; metabolism ; Case-Control Studies ; Chromosome Banding ; Chromosomes, Human, Y ; Epidermal Growth Factor ; metabolism ; Gonadal Steroid Hormones ; metabolism ; Humans ; Male ; Semen ; chemistry ; alpha-Glucosidases ; metabolism

Objective To study surgical treatment of complex fractures of the tibial plateau. Methods Forty eight cases of complex fractures of the tibial plateau were treated with internal fixation from January 1997 to December 2001. According to Schatzker classification, 12 cases were type Ⅲ, 9 cases type Ⅳ, 14 cases type Ⅴand 13 cases type Ⅵ. They were treated with open reduction and internal fixation with buttress plates and allograft implantation for defective fractures. Results Forty six cases of the forty eight were followed up for 1 to 4 years. The excellent and good rate was 77%. Conclusion The complex fractures of the tibia plateau should be treated surgically, and the operation procedures should be varied according to the fracture types.

Objective To describe postmedial approach to the knee and discuss the main technique using it to repair and reconstruct posterior cruciate ligament (PCL). Methods 24 patients with PCL injury were operated on with the postmedial approach. 13 cases were repaired directly using the technique of pulling out steel wire and 11 cases were reconstructed by semitendinosus. Prone position was adopted in 16 cases and supine position in 8 cases (21 cases had been followed up over six months). Applied anatomy, main techniques and clinical results were evaluated. Results The postmedial approach saved 30～60 minutes compared with the posteior approach, and was not restricted by body posture. Neurovascular structure did not need to be dissected, PCL repair and reconstruction could be finished in one incision.By a six month follow up evaluation, no symptoms of instability occured and they were completely stable on physical examination. Conclusion The postmedial approach is simple, safe, and yields excellent exposure. It's an ideal approach for repair and reconstruction of the PCL.The technique of pulling and steel wire and semitendinosas drawn out "U" shaped pins fixation are essential methods to repair and reconstruct the PCL.