Objective To analyze the influencing factors of hepatic encephalopathy(HE)after transjugular intrahepatic portosystemic shunt(TIPS)and construct a nomogram prediction model based on these factors.Methods A total of 290 patients with cirrhotic portal hypertensive variceal gastrointestinal bleeding in the Yuncheng Central Hospital Affiliated to Shanxi Medical University from January 2019 to December 2023 were selected and randomly divided into training set of 145 cases and validation set of 145 cases.All patients underwent TIPS treatment,and the incidence of HE within 3 months after TIPS was recorded.In the training set,patients were divided into HE group(n=42)and non-HE group(n=103)based on the occurrence of HE.Clinical materials were compared between the two groups,and Lasso-Logistic regression analysis was applied to explore the influencing factors of HE after TIPS.A nomogram prediction model was constructed based on the influencing factors and validated in both the training set and the validation set for its clinical value in predicting HE after TIPS.Results The overall incidence of HE was 29.31％,with incidence rates of 28.97％and 29.66％respectively in the training set and the validation set.In the training set,the HE group had significantly higher age,C grading of preoperative Child-Pugh ratio,diabetes mellitus ratio,total bilirubin(TBIL),prothrombin time(PT),serum sodium,serum creatinine,interleukin-6(IL-6),interleukin-18(IL-18),blood ammonia,monocyte chemotactic protein-1(MCP-1),postoperative portal venous pressure,and intestinal flora disturbance ratio when compared to the non-HE group,while the preoperative glial fibrillary acidic protein(GFAP)level was significantly lower in the HE group(P＜0.05).Lasso-Logistic regression analysis showed that preoperative C grading of Child-Pugh grading,diabetes mellitus,TBIL,PT,IL-6,IL-18,blood ammonia,GFAP,MCP-1 level,and postoperative intestinal flora disturbance were influencing factors for HE after TIPS(P＜0.05).A nomogram prediction model was constructed based on ten influencing factors selected by Lasso-Logistic regression analysis.The area under the curve(AUC)of this model for predicting HE after TIPS was 0.933(95％CI,0.889 to 0.976)in the training set and 0.944(95％CI,0.893 to 0.995)in the valida-tion set,with good consistency between the model's prediction and actual observation.Conclusion The nomogram prediction model for HE after TIPS,constructed based on the influencing factors selected by Lasso-Logistic regression analysis,has high predictive efficacy and accuracy.

Objective: To investigate knowledge and behaviors towards infectious diseases and factors associated with school absence for health reasons among primary and middle school students across 10 provinces in China, and to provide a reference for conducting a targeted health education of infectious disease and improving the controling and preventing levels of infectious disease in schools. Methods: Stratified multistage sampling was used in this self-administered, anonymous questionnaire survey was conducted among 17 042 primary and middle school students across 10 provinces during Mar. to Dec. 2013. Multivariate Logistic regression models were performed to identify factors associated with school absence for health reasons. Results: About 57.1% of all the participants reported infectious disease-related symptoms including fever, cough, headache, abdominal pain, diarrhea, as well as rash during the past two weeks; 42.4% reported absence from school for health reasons during the past year. The awareness rate of infectious diseases was between 42.5%-87.8%, and reported rates of behaviors towards infectious disease prevention were between 28.8%-97.7%. Living with parents(OR=0.91, 95%CI=0.84-0.99), higher father’s education level(OR=0.88, 95%CI=0.81-0.95), higher mother’s education level(OR=0.85, 95%CI=0.79-0.92), adequate knowledge and behavior towards infectious disease prevention (OR=0.97, 95%CI=0.96-0.98) and living in eastern areas (OR=0.90, 95%CI=0.83-0.98) were significantly associated with school absence for health reasons during the past year. Conclusion Knowledge and behaviors towards infectious diseases among primary and secondary school remains to be improved. Education on infectious disease prevention should be strengthened in schools to prevent the transmission and prevalence of infectious diseases.

Objective To study the expressions and significances of leptin,estrogen and estrogen receptor (ER) in pulmonary squamous carcinoma and adenocarcinoma.Methods The expressions of leptin and estrogen receptor were detected in 58 cases of lung adenocarcinoma and 63 cases of pulmonary squamous cell carcinoma and 50 cases of normal lung tissue samples by immunohistochemical menthod,the levels of estrogen were also detected in patients with venous blood at the same time.Comparison of differential expression of leptin,estrogen and estrogen receptor in lung adenocarcinoma and lung squamous cell carcinoma,normal tissues,and explore their relationships with lung adenocarcinoma.Results Leptin,estrogen and estrogen receptor positive rates in lung adenocarcinoma group were 65.5％,36.2％ and 58.6％ respectively,and 33.3％,15.9％,30.2％ in lung squamous cell carcinoma group.There were a statistical difference between the two groups (x2 =4.324,P＜0.050;x2 =5.372,P ＜0.050;x2 =5.718,P ＜0.050).In the normal control group the positive rates were 24.0％,4.0％ and 0 respectively,and there was a statistical difference compared with lung adenocarcinoma group (x2 =7.126,P ＜0.010;x2 =9.683,P＜0.005;x2 =22.308,P ＜0.005).In lung adenocarcinoma group,leptin,estrogen and estrogen receptor positive rate have no relationships with tumor stage (x2 =0.001,P=0.950;x2 =0.061,P =0.900;x2 =0.178,P=0.750) and primary tumor size (x2=0.023,P=0.900;x2 =0.001,P=0.950;x2 =0.001,P=0.950).Conclusion Leptin,estrogen and ER were expressed highly in adenocarcinoma of lung tumor.The expressions of leptin,estrogen and ER may associated with the carcinogenesis,development and clinical type of adenocarcinoma of lung.