Objective To explore the risk factors of physical frailty in elderly patients with multiple digestive tract diseases, and to provide reference for clinical intervention. Methods The clinical data of 310 elderly patients with digestive tract diseases admitted to the Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University between May 2020 and May 2025 were retrospectively analyzed. The patients with physical frailty were included in the frailty group, and the remaining patients were assigned into the non-frailty group. The clinical data of the two groups were observed and compared. The influencing factors were explored by multivariate logistic regression analysis, and the prediction model was constructed. Results Among the 310 patients, 77 cases (24.84%) had physical frailty, and 233 cases (75.16%) did not experience frailty. The proportion of patients aged≥75 years, Charlson Comorbidity Index (CCI), Strength, Assistance in walking, Rise from a chair, Climb stairs, Falls (SARC-F) score, 4m walking time and the proportion of patients who failed to complete full-foot-length standing in the frailty group were higher than those in the non-frailty group, while the Mini Nutritional Assessment-Short Form (MNA-SF) score, grip strength, Tinetti balance and gait scale score were lower compared to the non-frailty group (P<0.05). Multivariate logistic regression analysis suggested that SARC-F score was an independent risk factor of physical frailty in elderly patients with digestive tract diseases, and Tinetti score was an independent protective factor (P<0.05). The prediction model was constructed based on multivariate results, and Hosmer-Lemeshow goodness-of-fit test revealed that the model had a good fitting degree (P>0.05). ROC curve analysis indicated that the area under the curve of the model was 0.96 (95%CI: 0.93-1.00). Conclusion The incidence rate of physical frailty is relatively high in elderly patients with digestive tract diseases, and SARC-F score and Tinetti score are associated with its occurrence.

OBJECTIVES: In recent years, the incidence and detection rate of pancreatic cystic lesions (PCLs) have increased significantly. Endoscopic ultrasound (EUS) plays an indispensable role in the diagnosis and differential diagnosis of PCLs. However, evidence comparing the diagnostic performance of EUS-guided fine-needle aspiration (EUS-FNA) and fine-needle biopsy (FNB) remains limited. This study aims to compare the diagnostic yield, adequacy of tissue acquisition, and safety between EUS-FNA and EUS-FNB in evaluating PCLs to inform clinical practice. METHODS: A retrospective review was conducted on patients with PCLs who underwent either EUS-FNA or EUS-FNB between January 2014 and August 2021. The diagnostic yield, tissue acquisition adequacy, and incidence of adverse events were compared between the 2 groups. RESULTS: A total of 90 patients with PCLs were included (52 in the FNA group and 38 in the FNB group). The diagnostic yield was similar between the FNA and FNB groups (94.2% vs 94.7%, P>0.05). The adequacy of tissue acquisition was 71.2% in the FNA group and 81.6% in the FNB group (P>0.05). No statistically significant difference was observed in the incidence of adverse events between the 2 groups (P>0.05). CONCLUSIONS Both EUS-FNA and EUS-FNB demonstrate equally high diagnostic yields and tissue adequacy in PCLs, with excellent safety profiles. Both methods are safe and effective diagnostic tools for evaluating PCLs.
Humans ; Endoscopic Ultrasound-Guided Fine Needle Aspiration/adverse effects* ; Retrospective Studies ; Female ; Male ; Pancreatic Cyst/diagnostic imaging* ; Middle Aged ; Biopsy, Fine-Needle/adverse effects* ; Aged ; Pancreatic Neoplasms/diagnosis* ; Adult ; Endosonography/methods* ; Pancreas/pathology* ; Diagnosis, Differential

Objective To discuss the method of constructing TCM word network and the subsequent optimization method;To solve the problems of natural language processing in the TCM-clinical decision support system using TCM terminology.Methods This study was based on several national standards and terminology dictionaries of TCM,such as Zhong Yi Lin Chuang Zhen Liao Shu Yu Ji Bing Part and Zhong Yi Yao Xue Zhu Ti Ci Biao,supplemented with related corpus on the Internet,and the framework of TCM word network was constructed with ontology as the guide.Word2Vec was used to load pre-trained models for similarity calculation,statistical and rule-based new word discovery,bibliometric analysis,and other methods to add or delete concept words and synonyms such as symptom terms and prescription terms.Results The TCM word network contained 55 semantic types and 13 semantic relationships,more than 110 000 concept words,and more than 300 000 synonyms.In addition to classifying concept words by semantic types,more detailed semantic classification was carried out in the upper and lower tree structures,in which more than 30 000 concept words had superordinate words,and nearly 2 600 concept words had subordinate words.At the same time,a process-based terminology supplementation mechanism,update review mechanism and cleaning mechanism were created.Conclusion TCM word network can not only be applied to the natural language processing process of TCM-clinical decision support system,but also can be applied to the normalization of data and the automatic construction of knowledge graph.

Objective To clarify the evidence of the frequency and risk factors for falls in knee osteoarthritis(KOA)of adults by meta-analysis.Methods Computerized searches of the CNKI,VIP,Wanfang data,CBM,PubMed,Cochrane Library,Embase,Web of Science were conducted for literature on risk factors for falls in adults with KOA from the inception of the databases to August 2024.After literature screening,data extraction,and quality evaluation,RevMan 5.4 software was used for Meta-analysis.Results A total of 26 articles were involved.Meta-analysis result showed that the rate of falls was 29.0％.Factors associated with increased risk of falls included being female(OR=1.35),decreased lower limb muscle strength(OR=1.72),decreased knee flexion muscle strength(OR=7.05),decreased static posture stability(OR=1.28),opioid use(OR=1.79),antidepressant use(OR=1.69),frequent stair climbing(OR=7.58),combined neurological disease(OR=1.77),history of falls(OR=3.29)and fear of falling(OR=2.54).Conclusion The rate of falls of patients with KOA is high.The adults with KOA who are women,have lower muscle strength of lower limbs and knee flexion muscle strength,poorer static posture stability,use opioids,antidepressant,frequent stair climbing,combined neurological disorders,previous falls in the past year and fear of falls are at higher risk of falls.Healthcare professionals should dynamically assess and detect the risk of falls in the patients with KOA and adopt targeted,individualized interventions to prevent falls.

Cancer cachexia is a complex syndrome caused by multiple factors,which seriously affects the quality of life and prognosis of patients.Its overall pathogenesis is related to the deficiency of spleen qi,insufficiency of kidney essence,internal generation of turbid toxins,and the obstruction of the production of qi,blood and essential qi,which cannot nourish the muscles and bones.Under the guidance of the dynamic diagnosis and treatment system of"spleen and kidney exhaustion as the root cause and internal accumulation of turbid toxins as the manifestation",the overall regulation is carried out from four dimensions:opening and closing the spleen and stomach,nourishing the kidney and promoting transportation,transforming turbid toxins and detoxification,and tonifying qi and nourishing yin.It has shown unique value in the intervention of cancer cachexia and can provide ideas and references for the clinical practice of TCM in treating cancer cachexia.

Objective:To Explore the changes of annexin A2 and vascular endothelial cadherin (VE-Cad) in patients with cerebral infarction (CI) undergoing emergency thrombolysis, and analyze their relationship with progression within 10 d.Methods:Using a prospective research method, 78 patients with CI were selected from October 2019 to June 2022 in Xi'an International Medical Center Hospital, and all patients were treated with emergency thrombolysis. The serum levels of annexin A2 and VE-Cad before and after thrombolysis were measured by enzyme-linked immunosorbent assay, and the National Institute stroke scale (NIHSS) was used to assess patients' neurologic impairment. The baseline data, imaging findings at admission and routine laboratory examination indexes were recorded. The progression within 10 d after thrombolysis was recorded. Pearson correlation analysis was used to analyze the correlation between annexin A2, VE-Cad and NIHSS score. Multivariate Logistic regression was used to analyze the independent risk factors of progression within 10 d after thrombolysis in patients with CI. The value of annexin A2 and VE-Cad in predicting the progression within 10 d after thrombolysis in patients with CI was evaluated by the receiver operating characteristics (ROC) curve. A restricted cubic spline model was drawn to evaluate the dose-response relationship between annexin A2, VE-Cad and the progression within 10 d after thrombolysis in patients with CI.Results:Compared with before thrombolysis, the annexin A2 after thrombolysis was significantly higher: (24.50 ± 3.27) μg/L vs. (20.86 ± 3.84) μg/L, the VE-Cad and NIHSS score were significantly lower: (4.72 ± 1.05) mg/L vs. (6.81 ± 1.31) mg/L and (8.64 ± 2.35) scores vs. (13.01 ± 2.86) scores, and there were statistical differences ( P<0.01). Before and after thrombolysis, Pearson correlation analysis result showed there was a negative correlation between annexin A2 and NIHSS score ( r =-0.796 and - 0.568, P<0.01), and a positive correlation between VE-Cad and NIHSS score ( r = 0.820 and 0.502, P<0.01). Among 78 patients with CI treated with emergency thrombolysis, 7 cases (8.97%) experienced progression within 10 d. There were statistical differences in hypertension, diabetes, hyperlipidemia, onset to thrombolysis time, infarct site, systolic blood pressure, triacylglycerol, high-density lipoprotein cholesterol, and the NIHSS score, annexin A2, VE-Cad before and after thrombolysis between patients with progression within 10 d after thrombolysis and patients without progression within 10 d after thrombolysis ( P<0.05 or <0.01); there were no statistical differences in gender composition, age, body mass index, coronary heart disease, atrial fibrillation, smoking, alcohol consumption, family history of stroke, carotid plaques, blood glucose, diastolic blood pressure, white blood cell count, platelet count, total cholesterol low-density lipoprotein cholesterol between the two groups ( P>0.05). After adjusting for hypertension, diabetes and hyperlipidemia, multivariate Logistic regression analysis result showed that the infarction site, onset to thrombolysis time, VE-Cad after thrombolysis and annexin A2 after thrombolysis were still independent factors of progression within 10 d after thrombolysis in patients with CI ( OR = 2.570, 2.496, 3.147 and 0.352; 95% CI 1.285 to 5.139, 1.303 to 4.781, 1.629 to 6.080 and 0.158 to 0.782; P<0.05 or <0.01). ROC curve analysis results showed that the area under the curve of annexin A2 combined with VE-Cad after thrombolysis to predict the progression within 10 d after thrombolysis in patients with CI was significantly larger than that of annexin A2 and VE-Cad after thrombolysis alone (0.898 vs. 0.822 and 0.799, χ2 = 2.17 and 1.98, P = 0.039 and 0.048). The optimal cutoff values of annexin A2 and VE-Cad after thrombolysis were <23.27 μg/L and >4.92 mg/L, with a sensitivity of 88.24%, and a specificity of 77.05%. The restricted cubic spline analysis result showed that the continuous changes in annexin A2 after thrombolysis were roughly negatively correlated with the progression within 10 d after thrombolysis in patients with CI ( OR = 0.720, 95% CI 0.561 to 0.930, P = 0.010), the continuous changes in VE-Cad after thrombolysis were roughly positively correlated with the progression within 10 d after thrombolysis in patients with CI ( OR = 1.450, 95% CI 1.126 to 1.188, P = 0.004). When annexin A2<23.80 ng/L and VE-Cad>5.25 mg/L after thrombolysis, the risk of progression within 10 d after thrombolysis in patients with CI significantly increased. Conclusions:The expression of annexin A2 increases and VE-Cad decreases after emergency thrombolysis in patients with CI, and the expression levels of both are closely related to the degree of neurologic impairment, and the risk of progression within 10 d after thrombolysis could be determined clinically by detecting their changes.

Objective To evaluate the effect of a multidisciplinary collaborative quality control management (hereinafter referred to as "QC management") on improving the performance of biological safety cabinets in hospital. Methods A total of 63 ClassⅡbiological safety cabinets in active use at Peking University Third Hospital were selected as the study subjects using the before-after study mode. Conventional management was implemented on the biological safety cabinets from 2018 to 2021. QC management was used in 2022. The compliance of biological safety cabinets management norm and performance differences under the two models were compared. Results The median and the 25th and 75th percentiles [M(P₂₅, P₇₅)] of the service life among these 63 biological safety cabinets were 3 (1,6) years. The overall performance pass rate and inflow velocity pass rate of biological safety cabinets were higher in the QC management than that in the conventional management (90.5% vs 65.1%, 96.8% vs 84.1%, both P<0.05). However, there was no significant difference in downflow velocity, high-efficiency particulate air filter integrity, cleanliness, airflow smoke pattern, noise, and illumination pass rates of biosafety cabinets before and after the implementation of QC management (79.4% vs 88.9%, 90.5% vs 100.0%, 96.8% vs 100.0%, 85.7% vs 100.0%, 100.0% vs 100.0%, and 85.7% vs 96.8%, respectively; all P>0.05). Conclusion sQC management improves the standardization of biological safety cabinet management and key performance indicators in hospital.

To investigate the current status of sleep quality among nurses in tertiary hospitals in China, analyze the correlations of work stress and perceived organizational support with the risk of sleep problems, and further examine the mediating effect of perceived organizational support between work stress and sleep problems in nurses.

Objective:To discuss the diagnostic value of levels of growth stimulation expressed gene 2 protein(ST2),carbohydrate antigen 125(CA125),and human epididymis protein 4(HE4)in serum of the ovarian cancer patients,and to clarify their relationships with clinicopathological parameters of the ovarian cancer patients.Methods:A total of 136 patients with ovarian benign lesions or primary ovarian malignancies in our hospital confirmed by postoperative histopathology were randomly selected,including 53 cases in ovarian benign ovarian disease group and 83 cases in ovarian cancer group.Additionally,55 healthy female volunteers during the same period were enrolled as healthy control group.The fasting venous blood from all the subjects was collected on the first day of admission,and serum was retained;cyclic enhanced fluorescence immunoassay was used to detect ST2 levels of the subjects in various groups;chemiluminescence method was used to detect serum CA125 and HE4 levels of the subjects in various groups;receiver operating characteristic(ROC)curve was used to assess the diagnostic performance of each indicator;the Cut-off value and area under the ROC curve(AUC)were calculated,with AUC representing the diagnostic performance;Kendall's method was used to analyze the correlations between serum ST2 levels and TNM stage,maximum tumor diameter,distant metastasis,lymphnode metastasis,peritoneal metastasis,carcinoembryonic antigen(CEA),CA125,carbohydrate antigen 199(CA199),HE4,P53,and Kiel-67(Ki67)in the ovarian cancer patients.Results:Compared with healthy control group,the serum CA125 level of the patients in ovarian benign ovarian disease group was significantly increased(P<0.05).Compared with healthy control group and ovarian benign group,the serum levels of ST2,CA125,and HE4 of the patients in ovarian cancer group were significantly increased(P<0.05).The AUC values were 0.719(95%CI:0.616-0.822)for ST2,0.868(95%CI:0.794-0.942)for CA125,and 0.867(95%CI:0.793-0.942)for HE4.The combined detection of ST2+CA125+HE4 yielded an AUC of 0.894(95%CI:0.832-0.955).Significant differences were observed in serum ST2,CA125,and HE4 levels among ovarian cancer patients with different TNM stages,lymph node metastasis,distant metastasis,and peritoneal metastasis(P<0.05),while there were no significant differences in the patients with different ages or maximum tumor diameters(P>0.05).The ST2 level in serm of the ovarian cancer patients was positively correlated with TNM stage,distant metastasis,lymph node metastasis,peritoneal metastasis,CA125 level,HE4 level,and Ki67 level(P<0.05),but was not correlated with maximum tumor diameter,CEA,CA199 level,or P53 level(P>0.05).Conclusion:ST2,CA125,and HE4 are highly expressed in the serum of the ovarian cancer patients.Combined detection of serum ST2,CA125,and HE4 exhibits good sensitivity and specificity for ovarian cancer screening and improves diagnostic efficacy.ST2 is associated with advanced TNM stage and metastasis in ovarian cancer and may participate in the occurrence and progression of ovarian cancer.