Background/Aims: Non-pharmacological treatments are crucial for managing irritable bowel syndrome (IBS), yet patient engagement remains a challenge. Understanding patients' knowledge, attitudes, and practices regarding these treatments is essential for improving care. Methods: A cross-sectional study was conducted across 5 hospitals, from October 2023 to February 2024. A self-designed knowledge, attitudes, and practices questionnaire along with the IBS quality of life and IBS severity scoring system was administered, and 496 valid responses were analyzed. Statistical analyses included correlation tests, multivariate linear regression, and mediation effect analysis. Results: The median scores for knowledge, attitude, and practice were 28, 25.5, and 21, respectively. Significant positive correlations were found between knowledge-attitude (r = 0.195), knowledge-practice (r = 0.364), and attitude-practice (r = 0.151). The multivariate linear regression analysis further indicated that knowledge (β = 0.399, P < 0.001) and attitude (β = 0.219, P = 0.022) positively correlated with the practical performance. SEM revealed that knowledge had a significant direct effect on both attitude (β = 0.186, P = 0.013) and practice (β = 0.356, P = 0.006). However, the direct effect of attitude on practice was not significant, and attitude did not mediate the relationship between knowledge and practice. Conclusions IBS patients exhibit a significant gap between their positive attitudes and their actual practices concerning non-pharmacological treatments. Knowledge is a direct driver of practice, but positive attitudes alone are insufficient to translate into behavior. Healthcare providers must move beyond simply fostering positive attitudes and focus on targeted educational interventions that provide actionable knowledge and skills to improve patient outcomes.

Background::Clinical opportunistic screening is a cost-effective cancer screening modality. This study aimed to establish an easy-to-use diagnostic model serving as a risk stratification tool for identification of individuals with malignant gastric lesions for opportunistic screening.Methods::We developed a questionnaire-based diagnostic model using a joint dataset including two clinical cohorts from northern and southern China. The cohorts consisted of 17,360 outpatients who had undergone upper gastrointestinal endoscopic examination in endoscopic clinics. The final model was derived based on unconditional logistic regression, and predictors were selected according to the Akaike information criterion. External validation was carried out with 32,614 participants from a community-based randomized controlled trial.Results::This questionnaire-based diagnostic model for malignant gastric lesions had eight predictors, including advanced age, male gender, family history of gastric cancer, low body mass index, unexplained weight loss, consumption of leftover food, consumption of preserved food, and epigastric pain. This model showed high discriminative power in the development set with an area under the receiver operating characteristic curve (AUC) of 0.791 (95% confidence interval [CI]: 0.750–0.831). External validation of the model in the general population generated an AUC of 0.696 (95% CI: 0.570–0.822). This model showed an ideal ability for enriching prevalent malignant gastric lesions when applied to various scenarios.Conclusion::This easy-to-use questionnaire-based model for diagnosis of prevalent malignant gastric lesions may serve as an effective prescreening tool in clinical opportunistic screening for gastric cancer.

Objective:To screen out the differentially regulated metabolites by the analysis of serum metabolic fingerprints, and to provide potential biomarkers for diagnosis of lung cancer.Methods:A total of 228 subjects were enrolled in Changhai Hospital from January 27, 2021 to June 4, 2021, including 97 newly diagnosed lung cancer patients and 131 healthy individuals. Serum samples were collected from the enrolled cohort according to a standard procedure, and the enrolled cohort was divided into a training set and a completely independent validation set by stratified random sampling. The metabolic fingerprints of serum samples were collected by previously developed nano-assisted laser desorption/ionization mass spectrometry (nano-LDI MS). After age and gender matching of the training set, a diagnostic model based on serum metabolic fingerprints was established by machine learning algorithm, and the classification performance of the model was evaluated by receiver operating characteristic (ROC) curve.Results:Serum metabolic fingerprint for each sample was obtained in 1 minute using a novel nano-LDI MS, with consumption of only 1 μl original serum sample. For the training set, the area under ROC curve (AUC) of the constructed classifier for diagnosis of lung cancer was 0.92 (95% CI 0.87-0.97), with a sensitivity of 89% and specificity of 89%. For the independent validation set, the AUC reached 0.96 (95% CI 0.90-1.00) with a sensitivity of 91% and specificity of 94%, which showed no significant decrease compared to training set. We also identified a biomarker panel of 5 metabolites, demonstrating a unique metabolic fingerprint of lung cancer patients. Conclusion:Serum metabolic fingerprints and machine learning were combined to establish a diagnostic model, which can be used to distinguish between lung cancer patients and healthy controls. This work sheds lights on the rapid metabolic analysis for clinical application towards in vitro diagnosis.

Objective:To investigate the physicochemical and biological properties of different magnesium modified calcium phosphate bone cements.Methods:The different magnesium modified calcium phosphate bone cements were divided into magnesium citrate, magnesium lactate, magnesium malate, magnesium phosphate and magnesium glycinate groups, each of which was added with different magnesium agents in the proportion of 0%, 1%, 3% and 5% of the total weight of calcium phosphate bone cements. The initial and final setting time, injectability, anti-collapse performance and compressive strength of different magnesium modified calcium phosphate bone cements were tested. Furthermore, the screened bone cement extracts were used to culture with third generation osteoblasts. Bioactivity assays were performed using the Cell Proliferation and Toxicity Assay Kit (CCK-8). Alkaline phosphatase (ALP) staining and Alizarin Red S (ARS) staining were performed on osteoblasts to observe the osteogenic activity of magnesium malate modified calcium phosphate bone cements.Results:The addition of different proportions of different magnesium agents led to the shortening of the initial and final setting time of modified calcium phosphate bone cements. Moreover, the final setting time of 5% magnesium malate modified calcium phosphate bone cements was the shortest (<40 minutes), which was significantly shorter compared with other magnesium agents in the same proportion (all P<0.05). With the addition of different magnesium agents in different proportions, the injectability of bone cements was gradually increased, and the injectability of 5% magnesium malate calcium phosphate bone cements reached the highest for (87.3±1.9)%, which was significantly increased compared with other magnesium agents in the same proportion (all P<0.05). The anti-collapse performance of bone cements was decreased with the addition of different magnesium agents in different proportions. Magnesium citrate, magnesium phosphate and magnesium glycinate modified calcium phosphate bone cements could not resist the flushing of deionized water. In particular, magnesium malate modified calcium phosphate bone cements had the best anti-collapse performance, with the maximum weight loss rate for only (9.8±2.3)% after 30 minutes of deionized water flushing, which was better than the rest of the groups (all P<0.05). The compressive strength of magnesium lactate and magnesium phosphate modified calcium phosphate bone cements showed a decrease compared with original calcium phosphate bone cements, while the compressive strength of magnesium citrate and magnesium malate modified calcium phosphate bone cements was significantly increased compared with original calcium phosphate bone cements, of which 3% magnesium malate modified calcium phosphate bone cements had the greatest compressive strength of (6.2±0.2)MPa, significantly higher than the rest of the groups (all P<0.05). The sieve test yielded magnesium malate modified calcium phosphate bone cement, which had a weight loss of (27.0±0.9)% at 35 days in vitro. The release of magnesium ions was increased with increasing magnesium malate dose in the in vitro environment of magnesium malate modified calcium phosphate bone cements in different ratios. A stable magnesium ion release was achieved within 35 days.Also, the pro-proliferative and osteogenic effects of modified calcium phosphate bone cements on osteoblasts were more obvious with increase of magnesium malate dose. For 5% magnesium malate modified calcium phosphate bone cements, the cell number, ALP staining area ratio and calcium nodule area ratio were significantly increased compared with the groups in the proportion of 0% and 1% magnesium malate (all P<0.05). Conclusions:Among magnesium citrate, magnesium lactate, magnesium malate, magnesium phosphate and magnesium glycinate modified calcium phosphate bone cements, magnesium malate modified calcium phosphate bone cements have relatively suitable setting time, excellent anti-collapse performance and mechanical strength. Meanwhile, 5% magnesium malate modified calcium phosphate bone cements have better biological activity among different ratios of magnesium malate modified calcium phosphate bone cements, suggesting a potential value for clinical application.

Objective:To establish a rapid and quantitative method for the determination of immunoglobulin G4 (IgG4) by fluorescence immunochromatography and to analyze its clinical application value.Methods:Fluorescence immunoassay for quantitative detection of IgG4 was obtained by means of preparation of kits in a competitive reaction mode and combining immunoassay with fluorescence quantitative assay. The linearity, precision, accuracy, anti-interference ability and stability of the method were evaluated, and compared with immune-scattering turbidimetry, receiver operating characteristic curve (ROC) was plotted, area under the curve (AUC) was calculated, and the critical value for the diagnosis of pancreatitis related diseases was determined, and sensitivity and specificity were calculated.Results:The linear range of fluorescence immunoassay for IgG4 was 0.2-10.0 g/L. The accuracy coefficient of variation was less than 15%, and the accuracy deviation was within ±15%. Bilirubin (2.5 g/L), triglyceride (10 g/L) and hemoglobin (10 g/L) had no significant effect on the quantitative determination. Within 14 months, 1.20 g/L and 2.65 g/L reference samples were detected with concentration deviations within ±15%. The kit validity period was >12 months. Serum samples of 200 healthy people were detected by fluorescence immunochromatography, and the normal reference value of IgG4 was <2.03 g/L. fluorescence immunochromatography and Immunoturbidimetry were used to detect IgG4 concentrations in 383 clinical serum samples. The results showed that the two methods were consistent ( P>0.05). Using 2.01g/L IgG4 as the critical value, the sensitivity and specificity of fluorescence immunochromatography were 96.3% and 95.5% by ROC curve analysis, respectively. Conclusions:Fluorescence immunochromatography was a simple, rapid and accurate method for the quantitative detection of IgG4, and had high sensitivity and specificity for the diagnosis of pancreatitis related diseases. It was suitable for quantitative detection of bulk samples in outpatient and emergency departments.

BACKGROUND:The major aim of repair of lumbar spondylolisthesis is to restore and reconstruct the stability of spine sequence, and to relieve compression of herniated disc on nerve root. Pedicle screw system and bone graft fusion become the preferred way to treat spondylolisthesis of most scholars. Most scholars are prone to posterior interbody fusion or posterolateral interbody fusion.
OBJECTIVE:To compare the clinical curative effects of posterior autologous iliac bone graft fusion and posterior Cage intervertebral bone graft fusion in patients with degenerative lumbar spondylolisthesis by observing fusion rate and height of intervertebral loss.
METHODS:A total of 61 patients with degenerative lumbar spondylolisthesis in Xuancheng Central Hospital from July 2008 to December 2013 were enrol ed in this study. According to the different types of interbody fusion, 37 cases in autologous ilium group received posterior autologous iliac bone graft fusion. 24 cases in the Cage interbody fusion cage group underwent posterior Cage interbody fusion cage fusion. Operation time, blood loss, spondylolisthesis reduction, graft fusion and Japanese Orthopaedic Association score were compared between 
the two groups. The significance of different fusion manners on prognosis was explored in patients with degenerative lumbar spondylolisthesis.
RESULTS AND CONCLUSION:No significant difference in blood loss was detected between the two groups (P>0.05). However, the operation time was significantly longer in the autologous ilium group than in the Cage interbody fusion cage group (P<0.05). The reduction rate, bone graft fusion rate and improvement rate of clinical curative effects were good in both groups, and no significant difference was detectable in above indexes between the two groups (P>0.05). Significant difference in the height of intervertebral loss was detectable between the two groups in final fol ow-up (P<0.05). The height of intervertebral loss was better in the Cage interbody fusion cage group than in the autologous ilium group. These findings indicate that two kinds of bone graft fusion manners for lumbar spondylolisthesis obtained good reduction and clinical curative effects, but the height of intervertebral loss was smal in the Cage interbody fusion cage fusion during long-period fol ow-up, and the clinical effect was good.