ObjectiveTo investigate the clinical features of tumor-induced acute pancreatitis （TIAP）， to construct and validate a predictive model for TIAP， and to provide help for early identification in clinical practice. MethodsA retrospective analysis was performed for the clinical data of 3 051 patients with acute pancreatitis （AP） who were admitted to The First Affiliated Hospital of Xinjiang Medical University from January 2020 to January 2026， among whom there were 72 patients with TIAP. To reduce class imbalance， 216 patients with non-tumor-related AP （2 979 patients） were randomly selected as conventional group using sex-stratified sampling， resulting in a cohort of 288 patients， and this cohort was randomly divided into a training set with 201 patients and a test set with 87 patients at a ratio of 7∶3. The two groups were compared in terms of general information and laboratory markers. The independent-samples t test was used for comparison of normally distributed continuous data between two groups， and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups； the chi-square test was used for comparison of categorical data between two groups. Recursive feature elimination and least absolute shrinkage and selection operator regression were used for screening of characteristic variables， and five machine learning models were constructed， i.e.， logistic regression model， random forest model， support vector machine model， extreme gradient boosting model， and light gradient boosting machine model. The receiver operating characteristic curve and the precision-recall curve were used to assess model performance； the calibration curve was used to assess goodness of fit； decision curve analysis was used to evaluate clinical applicability and practicality； Shapley additive explanations were used to assess model interpretability. ResultsIn the training set of 201 patients， there were 52 patients （25.9%） in the TIAP group， and in the test set of 87 patients， there were 20 patients （23.0%） in the TIAP group. Compared with the conventional group， the TIAP group had a significantly higher proportion of patients with pancreatic duct dilatation （χ²=79.474， P<0.05）， a significantly higher age （Z=-5.838， P<0.05）， and significantly lower levels of white blood cell count （Z=5.630， P<0.05）， amylase （Z=2.606， P<0.05）， hemoglobin （Z=5.038， P<0.05）， and neutrophil percentage （Z=5.269， P<0.05）， as well as a lower level of direct bilirubin （Z=0.936， P>0.05）. The five machine learning models constructed based on these seven variables had a certain predictive ability， among which the logistic regression model had the best performance in the test set， with an area under the curve of 0.893 （95% confidence interval： 0.821 — 0.953）， an average precision of 0.654 in the precision-recall curve， good calibration， and good clinical benefits based on the decision curve analysis. ConclusionThe predictive model for TIAP based on pancreatic duct dilatation， age， white blood cell count， amylase， hemoglobin， neutrophil percentage， and direct bilirubin shows good predictive performance and can provide important guidance for the early diagnosis of TIAP.

Guillain-Barré syndrome (GBS) is an autoimmune-mediated acute polyradiculoneuropathy. Its key feature is focal segmental demyelination along with inflammatory cell infiltration and axonal damage. In clinical practice, anti-ganglioside antibodies in the body fluid of GBS patients show heterogeneity, and conventional immunotherapy is ineffective in some GBS subtypes. Drawing on treatment options for other neuroimmune diseases, targeted regulation of antibody-complement system has now become an important direction in GBS treatment research. This paper examines the immune response mechanisms involving complement, antibodies and related inflammatory factors, explores new strategy in GBS immunotherapy, so as to provide theoretical basis and research entry points for GBS individualized treatment.

Objectives:To explore the relationship between carboxymethyl lysine (CML) and type 2 diabetes (T2DM) with myopenia, so as to provide some clinical reference for clinical prevention and early intervention of myopenia.Methods:A case-control study was conducted, selecting 142 T2DM patients admitted to the Endocrinology Department of the Affiliated Hospital of North China University of Science and Technology from November 2022 to November 2023. According to the diagnostic criteria of the 2019 consensus of experts on the diagnosis and treatment of sarcopenia, the patients were divided into a case group (T2DM with sarcopenia, 58 cases) and a control group (T2DM without sarcopenia, 84 cases). Collect and compare general information, serological data, and body composition data of two groups of patients. Two independent sample t-test is used for inter group comparison of metric data that conforms to normal distribution; Non parametric tests are used for inter group comparisons of non normally distributed quantitative data; The comparison of count data between groups is conducted using χ2 test. Multivariate logistic regression analysis was used to analyze the relationship between carboxymethyl lysine and type 2 diabetes with myopenia. Draw receiver operating characteristic (ROC) curves and analyze the efficacy of carboxymethyllysine in diagnosing T2DM with muscle atrophy. Results:Univariate analysis showed the BMI ((21.59±3.04) kg/m 2), FINS (4.49 (1.85,9.03) U/L), and FCP ((1.45±0.96) mg/L) levels of the patients in the case group were lower than those in the control group(27.32±3.74) kg/m 2, 6.91 (3.74, 11.99) U/L, (2.64±1.23) mg/L), while age, ((64.67±6.75) years old) of disease duration(12.16±6.69) years, and CML (5.70±2.14 μg/L) were higher than those in the control group ((62.23±7.33) years old, (8.70±8.01) years, (2.38±0.73) μg/L), and the differences were statistically significant (Statistical values were t=9.66, Z=2.86, t=6.46, t=2.02, t=2.70, t=13.17; P values were <0.001, 0.004, <0.001, 0.046, 0.008, <0.001). Multifactorial binary logistic regression analysis showed that CML ( OR(95%CI):3.242 (1.933-5.437)) and BMI ( OR(95%CI):0.636 (0.505-0.801)) were associated with T2DM combined with sarcopenia (all P<0.001). The results of the ROC curve showed that the area under the curve (AUC) of CML was 0.934, and the corresponding optimal cut-off value was 3.038 μg/L. The diagnostic efficacy of CML for the diagnosis of T2DM combined with myasthenia gravis was high, and the diagnostic results were in good agreement with the actual results. Conclusions:Carboxymethyl lysine is associated with T2DM combined with muscle atrophy. CML has a high diagnostic efficacy in diagnosing T2DM combined with muscle atrophy, and it has certain practical value in diagnosing T2DM combined with muscle atrophy.

Objective:To analyze the characteristics of basic research articles published in Chinese Journal of Trauma (hereinafter referred to as the "Journal") from 1985 to 2024. Methods:Data of basic research articles published in the Journal from 1985 to 2024 were retrieved from the Chinese Medical Journal Full-text Database. Excel was used to analyze publication volume, number of cited articles, citation rate, citation frequency, funding support, disciplinary distribution, key words, authors and institutional affiliations within 40 yearsResults:There were 10 687 publications in the Journal within 40 years, among which 617 (5.77%) were basic research articles, comprising 0 article in 1985-2000, 72 articles in 2001-2005, 200 articles in 2006-2010, 231 articles in 2011-2015, 84 articles in 2016-2020, and 30 articles in 2021-2024. Among them, 443 articles were cited, with a citation rate of 71.80% and total citations of 1 465. The average citation count per article was 2.37, with a maximum of 22 citations for a single article. Funded articles accounted for 76.67% (473/617) and showed a marginally higher citation rate (71.88%) compared to non-funded articles (71.53%). The top 4 disciplines by publication volume included orthopedics (203 articles, 32.90%), neurosurgery (119 articles, 19.29%), trauma orthopedics (75 articles, 12.16%), and emergency surgery (24 articles, 3.89%). High-frequency key words included "brain injury","spinal cord injury", "neurons", "stem cell", and "tissue engineering", etc. The first authors mainly came from Chongqing Municipality, Shanghai Municipality, Shandong Province, Jiangsu Province, Zhejiang Province and Tianjin Municipality; 7 authors published more than 2 articles, 3 of whom were from medical institutions in Chongqing Municipality.Conclusion:Over 40-year period, the basic research articles published in the Journal have demonstrated phased fluctuations, interdisciplinary convergence and shift in hotspots (e.g., from neural injury to regenerative medicine), as well as geographical and institutional disparities in contribution.

Objective:To evaluate the efficacy of eculizumab in treating hematopoietic stem cell transplantation-associated thrombotic microangiopathy (TA-TMA) .Methods:This retrospective study included 11 patients who developed TA-TMA after allogeneic hematopoietic stem cell transplantation and subsequently received eculizumab treatment at Peking University People′s Hospital between June 2018 and May 2024. The incidence of TA-TMA, treatment details, and clinical outcomes were analyzed.Results:Among the 11 included patients [4 males, 7 females; median age: 29 years (range: 9-56) ], underlying diseases were severe aplastic anemia (SAA) in 5 patients, acute lymphoblastic leukemia (ALL) in 3 patients, and acute myeloid leukemia (AML) in 3 patients. The median time to TA-TMA diagnosis was 48 days post-transplantation (range: 4-213 days), and all patients met the diagnostic criteria for high-risk TA-TMA. The median interval from TA-TMA diagnosis to the initiation of eculizumab treatment was 12 days (range: 1-56 days). Patients received a median of 3 doses of eculizumab (range: 1-14). Ten of the 11 patients were assessed as having no response (NR) to eculizumab at the end of treatment or at death. One patient achieved a partial response (PR) but subsequently died after TA-TMA relapsed due to infection. At the last follow-up, all patients were either lost to follow-up or had died. The median follow-up duration was 88 days (range: 33-326 days), and the median time from TA-TMA diagnosis to the last follow-up was 31 days (range: 21-113 days) .Conclusion:Eculizumab demonstrated poor efficacy in this TA-TMA cohort. This might be attributable to the critical and complex condition of the patients, delayed initiation of eculizumab treatment, and insufficient dosage.

Objective:To evaluate the safety and efficacy of donor-purified CD34 + stem cell boosts in patients with poor hematopoietic reconstruction (PHR) after haploid hematopoietic stem cell transplantation (haplo-HSCT) for aplastic anemia (AA) . Method:A retrospective analysis was conducted on 11 patients with AA and PHR who underwent haplo-HSCT and received donor-purified CD34 + stem cell boosts at Peking University People’s Hospital. Recovery of blood cell counts, incidence of graft-versus-host disease (GVHD), and overall survival (OS) were assessed. Results:Of the 11 patients with PHR, two were diagnosed with prolonged isolated thrombocytopenia (PT), one was primary poor graft function (PGF), and eight were diagnosed with secondary PGF. The median time to PHR diagnosis was 110 days (range: 60-330 days), and the median interval from transplantation to purified CD34 + hematopoietic stem cell infusion was 194 days (range: 125-456 days). The two patients with PT achieved complete platelet recovery at 22 and 13 days after CD34 + stem cell infusion, respectively. Among the remaining nine patients with PGF, six achieved complete hematopoietic recovery, with a median absolute neutrophil count recovery time of 19 days (8-158 days), HGB recovery time of 32.5 days (range: 13-158 days), and platelet recovery time of 31.5 days (range: 7-171 days). The incidence of chronic GVHD after infusion was 18.2%, with no cases of acute GVHD observed. The OS rate was 90.9% (10/11) in the 11 patients, with a median follow-up of 614 days (range: 153-1 765 days) . Conclusion:Donor-purified CD34 + stem cell boost may be an effective therapeutic strategy for PHR in patients with AA after haplo-HSCT.

The orientation of the acetabular cup in hip joint anteroposterior radiograph is a key factor in evaluating the postoperative outcomes of total hip arthroplasty (THA). Currently, measurement of the acetabular cup anteversion angle primarily relies on manual drawing of auxiliary lines by orthopedic surgeons and calculations using scientific calculators. This study proposes an automated computer-aided measurement method for the acetabular cup anteversion angle based on hip joint anteroposterior radiograph. The proposed method segments hip prosthesis images using an improved Otsu algorithm, identifies feature points at the acetabular cup opening by combining circle-fitting theory and the cup's geometric characteristics, and fits an ellipse to the cup opening to calculate the anteversion angle. A total of 104 hip joint anteroposterior radiographs, including 71 right-sided and 81 left-sided prostheses, were analyzed. Two orthopedic surgeons independently measured the postoperative anteversion angles, and the results were compared with computer-generated measurements for correlation analysis. Spearman and Pearson correlation analyses demonstrated significant correlations between the proposed method and manual measurements for both the right group ( r = 0.795, P < 0.01) and the left group ( r = 0.859, P < 0.01). This method provides a reliable reference for orthopedic surgeons to assess postoperative prognosis.
Humans ; Acetabulum/anatomy & histology* ; Arthroplasty, Replacement, Hip/methods* ; Algorithms ; Hip Prosthesis ; Hip Joint/diagnostic imaging* ; Radiography ; Image Processing, Computer-Assisted/methods*