Objective:To investigate the current status and influencing factors of decision anxiety in guardians of children with acute appendicitis under Endoscopic retrograde appendicitis therapy (ERAT) background, and to provide reference for the development of targeted intervention programs for decision anxiety.Methods:Convenient sampling method was used to select 254 guardians of children with acute appendicitis treated in the Department of Pediatrics, Second Affiliated Hospital of PLA Air Force Medical University from February 2023 to April 2024. A cross-sectional survey was conducted using the General Data Questionnaire, the State-Trait Anxiety Inventory Form Y-State anxiety subscale and the Preparation for Decision Making Scale. Multiple linear regression was used to analyze the influencing factors in guardians of children with acute appendicitis.Results:Among the guardians of 254 children with acute appendicitis, 156 were males and 98 were females, aged (37.44 ± 3.63) years old. The decision anxiety score of guardians of children with acute appendicitis was (52.49 ± 6.54). The results of multiple linear regression showed that age of children, gender of guardian, education level of guardian, per capita monthly income of family, decision making tendency and decision preparation were the main influencing factors of decision anxiety in guardians of children with acute appendicitis ( t values were -7.07-3.58, all P<0.05), which could explain 64.4% of the total variation. Conclusions:The decision anxiety in guardians of children with acute appendicitis is at a high level. Medical staff should provide targeted decision guidance, improve decision assistance programs and provide more effective decision support for guardians of children with acute appendicitis.

Objective:To construct risk prediction models for enteral nutrition intolerance in patients with sepsis based on machine learning, and conduct internal validation to evaluate the predictive performance of the model.Methods:Convenience sampling was used to select 320 sepsis patients admitted to the Intensive Care Unit of the Affiliated Hospital of Hangzhou Normal University from June 2022 to June 2024 for the study. Patients were randomly divided into a training set ( n=240) and a validation set ( n=80) in a 3∶1 ratio. Univariate analysis of variance and Binary Logistic regression analysis were used to explore the factors influencing enteral nutrition intolerance in patients with sepsis. Four machine learning algorithms, namely, categorical boosting (CatBoost), extreme gradient boosting (XGBoost), support vector machine (SVM), and random forest (RF), were used to construct the risk prediction models. The performance of the prediction models was assessed through cross-validation, and the optimal risk prediction model was selected based on the area under the receiver operating characteristic curve, accuracy, sensitivity, specificity, recall, precision, and F1 value, and the model was validated in validation set. Results:Of the 320 patients with sepsis, enteral nutrition intolerance occurred in 131 patients, with an incidence of 40.94%. Age, body mass index, Acute Physiology and Chronic Health EvaluationⅡ scores, mode of enteral nutrition infusion, time of enteral nutrition initiation, albumin, and intra-abdominal pressure were influencing factors for enteral nutrition intolerance in patients with sepsis. Among the four risk prediction models, CatBoost, XGBoost, SVM, and RF, the RF model showed the best performance.Conclusions:In this study, we construct risk prediction models for enteral nutrition intolerance in sepsis patients based on four machine learning algorithms, among which the overall performance of the RF model is superior, which is helpful for healthcare professionals to accurately identify the risk of enteral nutrition intolerance in sepsis patients and formulate interventions at an early stage.

Objective:To explore the distribution of cardiovascular disease(CVD)and cardiovascular risk fac-tors(CVRF)in patients with epithelial ovarian cancer before treatment and their correlation with the histological type,stage and grade of ovarian cancer.Methods:A total of 401 newly diagnosed epithelial ovarian cancer pa-tients admitted to The First Affiliated Hospital of Dalian Medical University from January 1,2015 to December 31,2022 were enrolled.Analyze the distribution of CVD(including hypertension,coronary heart disease,stroke,etc.)and CVRF(including diabetes,dyslipidemia,high level of uric acid)in epithelial ovarian cancer patients.Univari-ate analysis and multivariate Logistic regression were performed on the association between CVD,CVRF and the histological type,grade and stage of epithelial ovarian cancer.Results:①Among 401 epithelial ovarian cancer pa-tients,43.6％had at least one CVD before therapy.The most common CVD was hypertension(41.1％),and the most common CVRF was dyslipidemia(57.9％).②Multivariate Logistic regression analysis showed that age ≥60 years was an independent risk factor for serous,high-grade,and advanced epithelial ovarian cancer(OR＞1,P＜0.05).Dyslipidemia was an independent risk factor for high-grade and advanced epithelial ovarian cancer(OR＞1,P＜0.05).High level of uric acid was an independent risk factor for advanced epithelial ovarian cancer(OR＞1,P＜0.05).③The proportion of high-density lipoprotein cholesterol(HDL-C)and lipoprotein A[Lp(A)]abnor-malities in patients with advanced epithelial ovarian cancer was significantly higher than in those with early stage epithelial ovarian cancer(P＜0.05),and the proportion of number of abnormal lipid components was higher in pa-tients with high grade and advanced epithelial ovarian cancer than in patients with low grade and early stage epi-thelial ovarian cancer,respectively(P＜0.05).Conclusions:Patients with epithelial ovarian cancer bear a signifi-cant burden of CVD and CVRF.Hypertension is the most common CVD,and dyslipidemia is the most common CVRF.Dyslipidemia was associated with epithelial ovarian cancer grade and stage.High level of uric acid was as-sociated with epithelial ovarian cancer stage.Active control of blood pressure and blood lipid levels is very impor-tant for epithelial ovarian cancer patients.

Objective:To investigate the effect of circular RNA(cireRNA)pumilio RNA binding family member 1(PUM1)on the proliferation,migration,invasion and apoptosis of endometrial cancer(EC)Ishikawa cells by regulating the miR-337-3p/nucleophosmin 1(NPM1)axis.Methods:Ishikawa cells were selected and plasmid sh-circPUM1 and its negative control(sh-NC),anti-miR-337-3p and its negative control(anti-NC)were transfected into Ishikawa cells by RNA interference.The experiment cells were divided into the control group(non-transfected cells),sh-NC group,sh-circPUM1 group,sh-circPUM1+anti-NC group and sh-circPUM1+anti-miR-337-3p group.The qPCR method was applied to detect the expressions of circPUM1,miR-337-3p,and NPM1 mRNA in Ishikawa cells in each group.CCK-8 method,EdU staining method,Transwell assay,and flow cytometry were applied respectively to detect the effects of knocking down circPUM1 on the proliferation,migration,invasion and apoptosis of Ishikawa cells.Western blot was applied to detect the changes in the expressions of PCNA,NPM1,MMP-9,SNAIL,E-cadherin,BAX and C-caspase-3 proteins in Ishikawa cells.Dual luciferase reporter gene experiment was applied to verify the targeting relationship between circPUM1 and miR-337-3p,and between miR-337-3p and NPM1.Results:Cell proliferation ability,EdU positive cell rate,migration and invasion numbers,circPUM1,NPM1 mRNA and protein,the expressions of PCNA,NPM1,MMP-9 and SNAIL protein in Ishikawa cells in the sh-circPUM1 group were significantly lower than those in the sh-NC group and Control group(all P<0.05);the apoptosis rate,the expressions of miR-337-3p,E-cadherin,BAX,and C-caspase-3 proteins were significantly higher than those in the sh-NC group and the Control group(all P<0.05).Compared with those in the sh-circPUM1 group and the sh-circPUM1+anti-NC group,the apoptosis rate,miR-337-3p,the expressions of E-cadherin,BAX,and C-caspase-3 proteins in the sh-circPUM1+anti-miR-337-3p group were significantly lower(all P<0.05);Cell proliferation ability,EdU positive cell rate,migration and invasion numbers,NPM1 mRNA and protein,the expressions of PCNA,NPM1,MMP-9,and SNAIL proteins were significantly higher(all P<0.05).CircPUM1 might target and negatively regulate miR-337-3p,and miR-337-3p might target and negatively regulate NPM1.Conclusion:Knocking down circPUM1 can inhibit the malignant biological behavior of Ishikawa cells,which might be achieved by targeting the miR-337-3p/NPM1 axis.

Objective:To construct risk prediction models for enteral nutrition intolerance in patients with sepsis based on machine learning, and conduct internal validation to evaluate the predictive performance of the model.Methods:Convenience sampling was used to select 320 sepsis patients admitted to the Intensive Care Unit of the Affiliated Hospital of Hangzhou Normal University from June 2022 to June 2024 for the study. Patients were randomly divided into a training set ( n=240) and a validation set ( n=80) in a 3∶1 ratio. Univariate analysis of variance and Binary Logistic regression analysis were used to explore the factors influencing enteral nutrition intolerance in patients with sepsis. Four machine learning algorithms, namely, categorical boosting (CatBoost), extreme gradient boosting (XGBoost), support vector machine (SVM), and random forest (RF), were used to construct the risk prediction models. The performance of the prediction models was assessed through cross-validation, and the optimal risk prediction model was selected based on the area under the receiver operating characteristic curve, accuracy, sensitivity, specificity, recall, precision, and F1 value, and the model was validated in validation set. Results:Of the 320 patients with sepsis, enteral nutrition intolerance occurred in 131 patients, with an incidence of 40.94%. Age, body mass index, Acute Physiology and Chronic Health EvaluationⅡ scores, mode of enteral nutrition infusion, time of enteral nutrition initiation, albumin, and intra-abdominal pressure were influencing factors for enteral nutrition intolerance in patients with sepsis. Among the four risk prediction models, CatBoost, XGBoost, SVM, and RF, the RF model showed the best performance.Conclusions:In this study, we construct risk prediction models for enteral nutrition intolerance in sepsis patients based on four machine learning algorithms, among which the overall performance of the RF model is superior, which is helpful for healthcare professionals to accurately identify the risk of enteral nutrition intolerance in sepsis patients and formulate interventions at an early stage.

OBJECTIVES: The application of photodynamic therapy in solid tumors has attracted increasing attention in recent years, and the efficiency of photosensitizers is a crucial determinant of therapeutic efficacy. This study aims to evaluate the cytotoxic effects of a novel photosensitizer, PEG-MTPABZ-PyC, in photodynamic therapy against gastric cancer cells. METHODS: Gastric cancer MKN45 cells were treated with PEG-MTPABZ-PyC. A high-content live-cell imaging system was used to assess the cellular uptake kinetics and subcellular localization of the photosensitizer. The cytotoxic effects of PEG-MTPABZ-PyC-mediated photodynamic therapy were examined using the cell counting kit-8 (CCK-8) assay and flow cytometry, while the intrinsic cytotoxicity of the photosensitizer alone was verified by the CCK-8 assay. Intracellular reactive oxygen species (ROS) generation after photodynamic therapy was detected using 2'-7'-dichlorodihydrofluorescein diacetate (DCFH-DA). RESULTS: PEG-MTPABZ-PyC alone exhibited no cytotoxicity toward MKN45 cells, indicating excellent cytocompatibility. The compound efficiently entered cells within 6 hours and localized predominantly in lysosomes. Upon light irradiation, PEG-MTPABZ-PyC-mediated photodynamic therapy induced significant cytotoxicity compared with the control group (P<0.05) and generated abundant intracellular ROS. CONCLUSIONS The novel photosensitizer PEG-MTPABZ-PyC demonstrates potent photodynamic cytotoxicity against gastric cancer cells, showing promising potential for further development in gastric cancer photodynamic therapy.
Humans ; Stomach Neoplasms/drug therapy* ; Photochemotherapy/methods* ; Photosensitizing Agents/pharmacology* ; Cell Line, Tumor ; Polyethylene Glycols/chemistry* ; Reactive Oxygen Species/metabolism* ; Mesoporphyrins/pharmacology*

Objective To investigate the characteristics and differences of congenital endowment in senile dementia population based on the theory of five circuits and six qi.Methods Based on the cross-sectional data of China Health and Retirement Longitudinal Survey(CHARLS)in 2018,the dementia status of the population aged 60 and above in China was evaluated by using the Mini-Mental State Examination(MMSE),and the five-circuit and six-qi features at birth in the senile dementia population were analyzed by descriptive statistics and Chi-square goodness-of-fit test.Results A total of 854 patients with senile dementia were included.The five-circuit and six-qi features at birth in the senile dementia population were as follows:most of them were born at the heavenly stem of Bing while the least at the heavenly stem of Ji and Geng(P＜0.001),most of them were born at the earthly branch of Wei while the least at the earthly branch of Zi(P＜0.001),most of them were born at the yearly circuit of excessive water circuit while the least at the yearly circuit of excessive gold circuit and deficient earth circuit(P＜0.001),and most of the patients were born at sitan of taiyin damp-earth and zaiquan of taiyang cold-water while the least at sitan of jueyin wind-wood and zaiquan of shaoyang ministerial fire;no statistically significant differences were found in the dominant qi and guest qi(P＞0.05);most of the patients were born in the year of combination of circuit and qi being Shunhua while the least in the year of combination of circuit and qi being same celestial correspondence(P＜0.001),and the patients born in the year of Shunhua usually were frequently distributed in heavenly-stem and earthly-branch year of Jiawu(P＜0.001).Conclusion There is a certain relationship between the congenital endowment at birth and the incidence of senile dementia in the population of senile dementia.The circuit-qi features at birth for the prevalence of senile dementia are the yearly circuit of excessive water circuit,sitan of taiyin damp-earth and zaiquan of taiyang cold-water,and the year of the combination of circuit and qi being Shunhua.The population born at the time with the above circuit-qi features are prone to suffer the injury of the kidneys,the heart,and the spleen,and then result into illness.

Objective:To explore differences in the clinical and pathological features and postoperative survival after radical resection of biliary tract cancer in different locations such as intrahepatic cholangiocarcinoma,perihilar cholangiocarcinoma,distal cholangiocarcinoma,and gallbladder cancer.Methods:This is a retrospective case series study. The clinical and pathological data of 4 852 patients with biliary tract cancer admitted to the Department of Hepatobiliary Surgery,the First Affiliated Hospital of Xi ′an Jiaotong University from January 2013 to December 2022 were retrospectively analyzed. Among them, 2 110(43.49%%) patients were male and 2 742(56.51%) patients were female,aged from 26 to 88 years with age of (61.3±10.8) years. Observation indicators: (1) The distribution,diagnosis and treatment of patients with biliary tract cancer; (2) Comparison of clinical and pathological features of patients with biliary tract cancer after curative-intent resection; (3) Survival analysis of patients with biliary tract cancer after curative-intent resection; (4) Analysis of effect on adjuvant therapy for patients with biliary tract cancer after curative-intent resection. One-way analysis of variance,Kruskal-Wallis H test and χ 2 test were used for among-group comparisons,respectively. Survival univariate analysis was performed using the Kaplan-Meier method and Log-rank test. Results:Among the 4 852 patients with biliary tract cancer,there were 2 303 cases (47.46%) of gallbladder cancer,952 cases (19.62%) of intrahepatic cholangiocarcinoma,892 cases (18.38%) of perihilar cholangiocarcinoma,and 705 cases(14.53%) of distal cholangiocarcinoma. From the perspective of the year of diagnosis and treatment,the overall number of patients diagnosed and treated for biliary tract cancer has shown an upward trend. From the perspective of diagnosis and treatment,the curative-intent resection rate was 33.37%(1 619/4 852),and the curative-intent resection rate of distal cholangiocarcinoma was higher than that of other biliary tract cancer ( χ2=23.897, P<0.01). Univariate analysis showed that there were statistical differences in gender,age,bile duct stones,total bilirubin at admission,carcinoembryonic antigen,CA19-9,CA125,the degree of pathological differentiation,vascular invasion,microvascular invasion,perineural invasion,surgical margins,pT staging,and pN staging among patients for biliary tract cancer in different locations (all P<0.05). Survival comparison analysis showed that recurrence-free survival and overall survival of patients with gallbladder cancer after curative-intent resection were significantly better than those of intrahepatic cholangiocarcinoma,perihilar cholangiocarcinoma,and distal cholangiocarcinoma ( χ 2=87.780,83.717,both P<0.01). Comparing the postoperative prognosis of patients with biliary tract cancer between the two periods of 2013 to 2017 and 2018 to 2022, the results showed that recurrence-free survival and overall survival of patients with biliary tract cancer from 2018 to 2022 were significantly better than those from 2013 to 2017 ( χ 2=31.202,25.615, both P<0.01),and the proportion of early recurrence and short-term death after curative-intent resection was significantly reduced ( χ 2=21.588,9.623, both P<0.01),with gallbladder cancer being the most significant ( P<0.01). Postoperative adjuvant therapy for patients with biliary tract cancer can effectively prolong recurrence-free survival and overall survival ( χ 2=5.033,11.273,both P<0.05). Conclusions:Gallbladder cancer remains the most common biliary tract cancer with a relatively favorable prognosis after radical resection. There are significant differences in the clinical and pathological features of biliary tract cancer in different locations,and patients with adjuvant therapy effectively improving prognosis.

Objective:To explore the distribution of cardiovascular disease(CVD)and cardiovascular risk fac-tors(CVRF)in patients with epithelial ovarian cancer before treatment and their correlation with the histological type,stage and grade of ovarian cancer.Methods:A total of 401 newly diagnosed epithelial ovarian cancer pa-tients admitted to The First Affiliated Hospital of Dalian Medical University from January 1,2015 to December 31,2022 were enrolled.Analyze the distribution of CVD(including hypertension,coronary heart disease,stroke,etc.)and CVRF(including diabetes,dyslipidemia,high level of uric acid)in epithelial ovarian cancer patients.Univari-ate analysis and multivariate Logistic regression were performed on the association between CVD,CVRF and the histological type,grade and stage of epithelial ovarian cancer.Results:①Among 401 epithelial ovarian cancer pa-tients,43.6％had at least one CVD before therapy.The most common CVD was hypertension(41.1％),and the most common CVRF was dyslipidemia(57.9％).②Multivariate Logistic regression analysis showed that age ≥60 years was an independent risk factor for serous,high-grade,and advanced epithelial ovarian cancer(OR＞1,P＜0.05).Dyslipidemia was an independent risk factor for high-grade and advanced epithelial ovarian cancer(OR＞1,P＜0.05).High level of uric acid was an independent risk factor for advanced epithelial ovarian cancer(OR＞1,P＜0.05).③The proportion of high-density lipoprotein cholesterol(HDL-C)and lipoprotein A[Lp(A)]abnor-malities in patients with advanced epithelial ovarian cancer was significantly higher than in those with early stage epithelial ovarian cancer(P＜0.05),and the proportion of number of abnormal lipid components was higher in pa-tients with high grade and advanced epithelial ovarian cancer than in patients with low grade and early stage epi-thelial ovarian cancer,respectively(P＜0.05).Conclusions:Patients with epithelial ovarian cancer bear a signifi-cant burden of CVD and CVRF.Hypertension is the most common CVD,and dyslipidemia is the most common CVRF.Dyslipidemia was associated with epithelial ovarian cancer grade and stage.High level of uric acid was as-sociated with epithelial ovarian cancer stage.Active control of blood pressure and blood lipid levels is very impor-tant for epithelial ovarian cancer patients.

Objective:To investigate the current status and influencing factors of decision anxiety in guardians of children with acute appendicitis under Endoscopic retrograde appendicitis therapy (ERAT) background, and to provide reference for the development of targeted intervention programs for decision anxiety.Methods:Convenient sampling method was used to select 254 guardians of children with acute appendicitis treated in the Department of Pediatrics, Second Affiliated Hospital of PLA Air Force Medical University from February 2023 to April 2024. A cross-sectional survey was conducted using the General Data Questionnaire, the State-Trait Anxiety Inventory Form Y-State anxiety subscale and the Preparation for Decision Making Scale. Multiple linear regression was used to analyze the influencing factors in guardians of children with acute appendicitis.Results:Among the guardians of 254 children with acute appendicitis, 156 were males and 98 were females, aged (37.44 ± 3.63) years old. The decision anxiety score of guardians of children with acute appendicitis was (52.49 ± 6.54). The results of multiple linear regression showed that age of children, gender of guardian, education level of guardian, per capita monthly income of family, decision making tendency and decision preparation were the main influencing factors of decision anxiety in guardians of children with acute appendicitis ( t values were -7.07-3.58, all P<0.05), which could explain 64.4% of the total variation. Conclusions:The decision anxiety in guardians of children with acute appendicitis is at a high level. Medical staff should provide targeted decision guidance, improve decision assistance programs and provide more effective decision support for guardians of children with acute appendicitis.