Objective: To investigate the significant factors influencing the need for perioperative blood transfusion in patients undergoing hepatectomy. Methods: Medical records of patients who underwent elective hepatectomy in our hospital from January 2020 to December 2021 were retrospectively collected. Variables associated with transfusion were analyzed using traditional logistic regression (LR) and machine learning algorithm, the Classification and Regression Tree (CRT). The predictive values of the two methods were compared by the area under the curve (AUC) of the ROC curve. Results: Among the 402 patients, 82(20.4%) received blood transfusions. Multivariable logistic regression analysis identified several risk factors for perioperative blood transfusion, including vascular invasion, preoperative hemoglobin level, intraoperative blood loss, duration of surgery, postoperative hemoglobin level, and postoperative complications (P<0.05). In the CRT model for predicting blood transfusion, intraoperative blood loss (cutoff: 450 mL) was the parent node, with preoperative Hb, postoperative complications, and hospital stay as child nodes. The LR model demonstrated superior predictive performance compared to the CRT model, with an AUC of 0.971 (95% CI: 0.956-0.985) vs 0.937 (95% CI: 0.909-0.965). The difference in AUC between the two methods was statistically significant (P<0.05). Conclusion: Although the CRT model did not outperform logistic regression in overall predictive accuracy, it still provides a valuable tool for assisting clinicians in making decisions about blood transfusion in the perioperative period of hepatectomy, thereby facilitating more individualized guidance for preoperative blood preparation in clinical practice.

Purpose/Significance To sort out the literature in the field of traditional Chinese medicine(TCM)in China in the past decade,and to expound the hot topics and development trends in this field.Method/Process Literature in the field of TCM in Wanfang Data from 2013 to 2022 is searched.The abstracts are taken as the research objects,the topics are extracted by BERTopic model,and CiteSpace is used for visualization and analysis.Result/Conclusion 12 683 papers in Chinese are included,and the 5 topics are found:clinical trials and efficacy,research on pathogenesis and pharmacology,the development of the field of TCM,treatment of chronic dis-ease,drug analysis and literature research.The paper makes an in-depth analysis of the topic of the development of traditional Chinese medicine,which continues to grow in popularity,and puts forward that the deep integration of artificial intelligence(AI)and TCM is the future trend.

Purpose/Significance The paper discusses the construction of the current elderly health policy system by using policy text min-ing and quantitative evaluation,and provides references for future policy adjustment and optimization.Method/Process Policies on elderly health issued by the relative departments from 2019 to 2023 are analyzed.The ROST text data mining tool is used to extract high-frequency words and build semantic networks.Gephi is utilized to visualize social network relationships for text analysis.Quantitative analysis of these policies is conducted using the PMC index model.Results/Conclusion The high-frequency words such as"national","society","knowl-edge","resources",and"guarantee"are identified as key areas in elderly health policies,which are interconnected within the social network.The overall trend of the elderly health policy formulation is positive.It is suggested to improve the accuracy and adaptability of the policy,clari-fy the time node and core elements of the policy,and enhance the strategic analysis of the function and content of the policy.

Objective To summarize the clinical characteristics of patients with occupational melanosis. Methods Diagnostic data of 69 patients with occupational melanosis was analyzed using retrospective analysis. Results The main occupational hazards for the 69 patients with occupational melanosis were coal tar, petroleum and its fractionated products, pigments and dyes and their intermediates, rubber additives and rubber products. The median length of occupational exposure and disease latency were 8.0 and 6.0 years, respectively, with a highly positive correlation between them (Spearman correlation coefficients=0.962, P<0.01). Skin lesions were mainly found on exposed areas such as the face-to-neck and limbs, prevalence of 94.2% and 75.4% respectively. And 78.3% of patients had skin lesion on more than two sites. The lesions were mostly in the form of irregular flakes (59.4%), with a gray-black color (44.9%). About 43.5% of patients experienced skin itching. Complete blood count, liver function, and kidney function were all within normal ranges. Skin biopsy results showed that epidermal hyperkeratosis, thinning of the spinous layer, liquefaction degeneration of basal cells, increased superficial dermal melanocytes, and infiltration of lymphocytes, histiocytes, and melanocytes around the blood vessels. Reflectance confocal microscopy (RCM) detection showed focal liquefaction degeneration of basal cells in the lesions, with a significant infiltration of melanocytes and inflammatory cells in the dermal papillae and superficial layers. Conclusion The primary target organ of occupational melanocytes is the skin, and no damage to other organs was identified thus far. Results from skin biopsies and RCM examinations can be used for differential diagnosis.

OBJECTIVETo detect potential mutation in a large Chinese pedigree affected with congenital corneal dystrophy.

METHODSTwo patients from the pedigree were subjected to whole exome sequencing to determine the candidate gene. Suspected mutation was verified in 13 additional members by directional Sanger sequencing. Ccorrelation between genotype and phenotype was explored.

RESULTSA missense mutation, c.1877A>C (p.His626Pro), was detected in exon 14 of the TGFBI gene in 8 patients from the pedigree, but not in five unaffected members and 100 unrelated healthy controls. Respectively, the mutation was predicted as "affecting protein function", "probably damaging" and "disease causing" by SIFT, PolyPhen-2 and MutationTaster.

CONCLUSIONThe c.1877A>C mutation of the TGFBI gene probably underlies the disease in this pedigree.

The specific forms and contents of narrative nursing clinical practice were analyzed. On the basis of a brief review of the concept and origin of narrative nursing and the significance of it, this paper focuses on the field, methods, forms and evaluation methods of clinical practice of narrative nursing. The study found that through the literature review, the value of narrative medicine has been fully affirmed, but how to implement theory to a real clinical nursing practice environment has not yet been reported more. Therefore, exploring the narrative nursing in the clinical workplace, rich forms, contents and methods of clinical practice can provide new methods and new ideas for nursing humanistic care and clinical practice, and has certain social significance, academic significance, individual significance and application prospect.

This study aimed at preparing paeonol thermosensitive gel and preliminary exploring its properties in vitro.Tube inversion method was adopted to investigate the effects of concentrations of poloxamer 407 and poloxamer 188 on gelation temperature.Then,viscosity of the gel was detected by rotary viscometer,and in vitro erosion and drug release characteristics of the gel by no film stripping method.As a result,the gelation temperature of poloxamer 407 decreased with the increase of its concentration,while gelation temperature of poloxamer 407 increased with the accelerating concentration of poloxamer 188.The cumulative drug release of paeonol thermo sensitive gel was up to 70％ in 320 rin.Gel dissolution and drug release were simultaneously performed without burst release phenomenon.It was concluded that the preparation process of paeonol thermo sensitive gel was simple and easy to use with the overt effect of sustained-release.

Adult ; Female ; Foot Deformities, Congenital ; diagnosis ; genetics ; Hand Deformities, Congenital ; diagnosis ; genetics ; Humans ; Male ; Pedigree ; Young Adult

Objective To investigate the expressions of DKK1,SFRP4 and Wnt1 in cervical squamous cell carcino-ma(SCC), and the clinical significance thereof. Methods There were 76 samples of cervical squamous cell carcinoma were included in SCC group and 36 benign uterine resection specimens were control group (NC). The immunohistochemical meth-od was applied to detect the expressions of DKK1,SFRP4 and Wnt1 in two groups. Results The expression of DKK1 was significantly lower in SCC group than that in NC group (P＜0.05). The expression levels of SFRP4 and Wnt1 were significant-ly higher in SCC group than those of NC group (P＜0.05). There were significant differences in the expressions of DKK1, SFRP4 and Wnt1 between samples of different clinical staging, differentiation, sizes of tumor and lymph node metastasis (P＜0.05). The expression of DKK1 was negatively correlated with SFRP4 and Wnt1 in SCC group (P＜0.05). The expression of SFRP4 was positively correlated with Wnt1 in SCC group (P＜0.05). Conclusion The roles of SFRP4 and Wnt1 are syn-ergistic interactions in the development of SCC. DKK1 is an inhibiting factor of SCC.

Objective To elucidate gene mutation and promoter methylation changes of p16 gene in pheochromocytomas (PHEO) and paragangliomas (PGL) and to assess its relation with tumor clinical characters. Methods A total of 34 tumors (20 PHEO, 14 PG L, 15 benign, 19 malignant) were collected.Direct sequencing of p16 gene after PCR was performed to analyze genetic alterations. Hypermethylation of p16 gene promoter CpG island was analyzed by methylation specific PCR(MSP). In addition, mRNA expression was detected by RT-PCR. Results Homozygous deletion and gene mutation were not observed in 34 PHEO and PGL. Aberrant methylation of p16 gene promoter CpG island was found in 35.3% (12 of 34 tumors, 3 PHEO, 9 PGL). The p16 promoter hypermethylation in PGL was significantly higher than PHEO (P=0. 005). The higher p16 promoter hypermethylation was associated with malignant behavior, tumor number, and younger age at presentation, but no statistical significance, due to the limited number of cases. The p16 mRNA expression in malignant cases was lower than in benign tumors(0.83±0.65 vs 1.12±0.81 ,P=0.278). Conclusion p16 gene homozygous deletion and mutation were not frequent in PHEO and PGL. The promoter hypermethylation is mainly attributed to inactivation of the p16 gene.