Objective:To explore the potential risk factors for cancer in patients with adenomatous polyps based on tumor markers and polyp lesion characteristics.Methods:A retrospective analysis was conducted to collect clinical data of 115 patients with adenomatous intestinal polyps who visited Nanjing Jiangbei Hospital from November 2022 to November 2024. They were divided into a cancerous group (17 cases) and a non cancerous group (98 cases) based on whether they were cancerous or not. Clinical data such as tissue type and polyp site and tumor marker levels such as carcinoembryonic antigen (CEA) and cancer antigen 72-4 (CA72-4) were collected at the first visit of all patients. The potential risk factors of adenomatous intestinal polyp canceration were investigated by Logistic regression analysis.Results:Univariate analysis revealed that the proportion of villous tubular adenomas, central depression of polyps, and lobulated polyps in the cancerous group were higher than those in the non cancerous group. Serum levels of CEA and CA72-4 were also higher in the cancerous group than in the non cancerous group : 13/17 vs.47.96% (47/98), 7/17 vs. 15.31% (15/98), 6/17 vs. 8.16% (8/98), (6.41 ± 1.81) μg/L vs. (4.23 ± 1.48) μg/L, (6.98 ± 1.83) kU/L vs. (5.66 ± 1.78) kU/L, respectively. The difference was statistically significant ( P<0.05). The results of Logistic regression analysis showed that the histological subtype of villous tubular adenoma, central depression of polyps, lobulated polyps, and high levels of CEA and CA72-4 were independent risk factors for cancer in patients with adenomatous intestinal polyps ( P<0.05). A nomogram risk model was constructed based on the influencing factors of canceration in patients with adenomatous intestinal polyps. The calibration curve was drawn, and the calibration curve was similar to the Y-X straight line, suggesting that the evaluation results of the nomogram risk model were highly consistent with the actual observation results. The receiver operating characteristic (ROC) curve was drawn. The results showed that the area under the curve (AUC) of the nomogram risk model for evaluating the canceration of patients with adenomatous intestinal polyps was 0.956, and the evaluation value was high. The decision curve was drawn, with the threshold of high risk as the horizontal coordinate and the net rate of return as the vertical coordinate. The results showed that when the threshold was in the range of 0 - 0.85, 0.96 - 0.99, the net benefit rate of predicting the cancer risk of patients with adenomatous intestinal polyps was greater than 0 and the maximum net benefit rate was 0.148. Conclusions:The histological classification of villous tubular adenoma, central depression of polyps, lobulated polyps, and high levels of CEA and CA72-4 are independent risk factors for cancer in patients with adenomatous intestinal polyps; The evaluation efficiency of the column chart risk model constructed based on the above factors is good.

Aim To explore the role of zinc transporter 6(SLC30A6)on the proliferation,migration and inva-sion capabilities of hepatocellular carcinoma(HCC)cell line Huh7,and to identify potential traditional Chi-nese medicine(TCM)small-molecule inhibitors targe-ting SLC30A6 from the China Natural Products Data-base(CNPD)using virtual screening techniques.Methods The expression levels,clinical characteris-ticsand prognostic value of SLC30A6 in HCC were pre-dicted based on TCGA and ICGC datasets.SLC30A6 was knocked down in Huh7 cells using lentiviral trans-fection.The effects on cell proliferation,migration,and invasion were assessed using CCK-8,EdU,wound heal-ing,and Transwell assays.The regulation of HCC cancer stem cell markers(CD44,CD133,CD90)by SLC30A6 was also examined.Based on the CNPD,a docking-based virtual screening strategy was employed,including high-throughput virtual screening,standard precision virtual screening,and high-precision virtual screening,to identify the potential drug candidates with high specificity and favorable drug-likeness.Results SLC30A6 expression was upregulated in HCC tissues.Higher SLC30A6 levels were associated with advanced pathological stages,histological grades,alpha-fetopro-tein(AFP)levels,vascular invasion,and poor progno-sis in HCC patients.SLC30A6 knockdown significantly inhibited the proliferation,migration,and invasion of Huh7 cells and reduced the levels of HCC cancer stem cell markers.Virtual screening identified six potential TCM small-molecule inhibitors.Conclusions SLC30A6 can regulate the proliferation,migrationand invasion of HCC cells.SLC30A6 may serve as a poten-tial prognostic biomarker and therapeutic target for HCC.

Objective:To investigate the risk factors and their diagnostic efficacy of perioperative lower limb deep vein thrombosis (DVT) in polytrauma patients with predominant severe limb trauma.Methods:A retrospective cohort study was conducted to analyze the clinical data of 155 polytrauma patients with predominant severe trauma who were admitted to Wuxi Ninth People′s Hospital from January 2021 to December 2024, including 64 males and 91 females, aged 13-95 years [(52.1±16.9)years]. Abbreviated injury scale (AIS) was 5-15 points [(7.4±2.1)points] and injury severity score (ISS) was 17-59 points [(21.3±6.5)points]. Based on the occurrence of DVT in the perioperative period, the patients were divided into preoperative DVT group with 17 patients (11.0%) and non-preoperative DVT group with 138 patients (89.0%) as well as postoperative DVT group with 24 patients (15.5%) and non-postoperative DVT group with 131 patients (84.5%). Basic clinical data were collected, including gender, age, body mass index (BMI), underlying diseases (hypertension, diabetes mellitus), hemoglobin level (Hb), platelet count (PLT), D-dimer, ISS, trauma site [cranial and brain trauma, thoracic and abdominal trauma, upper limb trauma, lower limb trauma (femoral fracture, patellar fracture, tibial or fibular fracture, foot fracture, vascular injury), and pelvic fracture], preoperative waiting time for surgery, surgical site (pelvis and lower limb, other areas), surgical protocols (pelvic and lower limb internal fixation, external fixation of lower limb, lower limb amputation), operation duration less or more than 2 hours, amount of intraoperative blood loss, intraoperative blood transfusion requirement, venous thromboembolism (VTE) prophylaxis (pharmacological and mechanical modalities) and length of hospital stay. Univariate analysis and multivariate binary Logistic regression analysis were conducted to investigate the correlation between the aforementioned indicators and incidence of perioperative lower limb DVT in polytrauma patients with predominant severe limb trauma and determine the independent risk factors. Receiver operating characteristic (ROC) curve and area under the curve (AUC) of the relevant risk factors were analyzed to evaluate and compare the diagnostic efficacy of the risk factors for perioperative lower limb DVT in polytrauma patients with predominant severe limb trauma.Results:Univariate analysis results showed that age, history of hypertension, D-dimer, thoracic and abdominal trauma, pelvic fracture, preoperative waiting time for surgery, and length of hospital stay were significantly correlated with preoperative of DVT of the lower limbs in the patients ( P<0.05). The results of multivariate binary Logistic regression analysis showed that age ( OR=1.05, 95% CI 1.00, 1.10, P<0.05), pelvic fracture ( OR=5.03, 95% CI 1.09, 23.20, P<0.05), preoperative waiting time for surgery ( OR=1.10, 95% CI 1.00, 1.22, P<0.05) and length of hospital stay ( OR=0.89,95% CI 0.81,0.98, P<0.05) were highly correlated with preoperative DVT of the lower limbs in the patients ( P<0.05). Univariate analysis results showed that age, D-dimer, ISS, foot fracture, and length of hospital stay were significantly correlated with postoperative DVT of the lower limbs in the patients ( P<0.05). The results of multivariate binary Logistic regression analysis showed that age ( OR=1.05, 95% CI 1.01, 1.08, P<0.01), D-dimer ( OR=1.05, 95% CI 1.00, 1.10, P<0.05), ISS ( OR=1.09, 95% CI 1.01, 1.17, P<0.05), and foot fracture ( OR=3.51 , 95% CI 1.25 , 9.87 , P<0.05) were significantly correlated with postoperative DVT of the lower limbs in the patients ( P<0.05). The results of the ROC curve analysis indicated that preoperative waiting time for surgery (AUC=0.83, 95% CI 0.75, 0.91) had the highest diagnostic efficacy for preoperative DVT of the lower limbs in the patients, with the diagnostic efficacies of pelvic fracture (AUC=0.75, 95% CI 0.65, 0.85) and age (AUC=0.70, 95% CI 0.59, 0.82) decreasing successively. For postoperative DVT of the lower limbs in the patients, D-dimer (AUC=0.71, 95% CI 0.61, 0.81) exhibited the highest diagnostic efficacy, followed by age (AUC=0.70, 95% CI 0.59, 0.81), ISS (AUC=0.64, 95% CI 0.51, 0.76) and foot fracture (AUC=0.62, 95% CI 0.49, 0.74), with diagnostic efficacy decreased successively. Conclusions:For polytrauma patients with predominant severe limb trauma, age, pelvic fracture and preoperative waiting time for surgery are independent risk factors for preoperative DVT, while age, D-dimer, ISS and foot fracture are independent risk factors for postoperative DVT. Additionally, preoperative waiting time for surgery has the best diagnostic efficacy for preoperative DVT, followed by pelvic fracture and age. D-dimer has the best diagnostic efficacy for postoperative DVT, followed by age, ISS and foot fracture.

Excessive ionizing radiation can disrupt the molecular structures of organisms,leading to health issues such as acute radiation syndrome and cancer,posing serious threats to human health.The development of radioprotective drugs holds significant importance for mitigating ionizing radiation damage and safeguarding public health,yet its research process faces multidimensional ethical challenges.This paper systematically explores the ethical issues involved in the full lifecycle of radioprotective drug development,focusing on the ethical particularities of animal experimentation,ethical dilemmas in human trials,data privacy and security risks,as well as challenges in managing conflicts of interest.Targeted solutions are proposed,including strengthening ethical review mechanisms,promoting interdisciplinary collaboration,constructing data security management systems,and establishing conflict-of-interest mediation mechanisms.These comprehensive measures aim to build a scientifically rigorous ethical framework for radioprotective drug research,fostering sustainable development in this field.

Objective:To investigate the risk factors and their diagnostic efficacy of perioperative lower limb deep vein thrombosis (DVT) in polytrauma patients with predominant severe limb trauma.Methods:A retrospective cohort study was conducted to analyze the clinical data of 155 polytrauma patients with predominant severe trauma who were admitted to Wuxi Ninth People′s Hospital from January 2021 to December 2024, including 64 males and 91 females, aged 13-95 years [(52.1±16.9)years]. Abbreviated injury scale (AIS) was 5-15 points [(7.4±2.1)points] and injury severity score (ISS) was 17-59 points [(21.3±6.5)points]. Based on the occurrence of DVT in the perioperative period, the patients were divided into preoperative DVT group with 17 patients (11.0%) and non-preoperative DVT group with 138 patients (89.0%) as well as postoperative DVT group with 24 patients (15.5%) and non-postoperative DVT group with 131 patients (84.5%). Basic clinical data were collected, including gender, age, body mass index (BMI), underlying diseases (hypertension, diabetes mellitus), hemoglobin level (Hb), platelet count (PLT), D-dimer, ISS, trauma site [cranial and brain trauma, thoracic and abdominal trauma, upper limb trauma, lower limb trauma (femoral fracture, patellar fracture, tibial or fibular fracture, foot fracture, vascular injury), and pelvic fracture], preoperative waiting time for surgery, surgical site (pelvis and lower limb, other areas), surgical protocols (pelvic and lower limb internal fixation, external fixation of lower limb, lower limb amputation), operation duration less or more than 2 hours, amount of intraoperative blood loss, intraoperative blood transfusion requirement, venous thromboembolism (VTE) prophylaxis (pharmacological and mechanical modalities) and length of hospital stay. Univariate analysis and multivariate binary Logistic regression analysis were conducted to investigate the correlation between the aforementioned indicators and incidence of perioperative lower limb DVT in polytrauma patients with predominant severe limb trauma and determine the independent risk factors. Receiver operating characteristic (ROC) curve and area under the curve (AUC) of the relevant risk factors were analyzed to evaluate and compare the diagnostic efficacy of the risk factors for perioperative lower limb DVT in polytrauma patients with predominant severe limb trauma.Results:Univariate analysis results showed that age, history of hypertension, D-dimer, thoracic and abdominal trauma, pelvic fracture, preoperative waiting time for surgery, and length of hospital stay were significantly correlated with preoperative of DVT of the lower limbs in the patients ( P<0.05). The results of multivariate binary Logistic regression analysis showed that age ( OR=1.05, 95% CI 1.00, 1.10, P<0.05), pelvic fracture ( OR=5.03, 95% CI 1.09, 23.20, P<0.05), preoperative waiting time for surgery ( OR=1.10, 95% CI 1.00, 1.22, P<0.05) and length of hospital stay ( OR=0.89,95% CI 0.81,0.98, P<0.05) were highly correlated with preoperative DVT of the lower limbs in the patients ( P<0.05). Univariate analysis results showed that age, D-dimer, ISS, foot fracture, and length of hospital stay were significantly correlated with postoperative DVT of the lower limbs in the patients ( P<0.05). The results of multivariate binary Logistic regression analysis showed that age ( OR=1.05, 95% CI 1.01, 1.08, P<0.01), D-dimer ( OR=1.05, 95% CI 1.00, 1.10, P<0.05), ISS ( OR=1.09, 95% CI 1.01, 1.17, P<0.05), and foot fracture ( OR=3.51 , 95% CI 1.25 , 9.87 , P<0.05) were significantly correlated with postoperative DVT of the lower limbs in the patients ( P<0.05). The results of the ROC curve analysis indicated that preoperative waiting time for surgery (AUC=0.83, 95% CI 0.75, 0.91) had the highest diagnostic efficacy for preoperative DVT of the lower limbs in the patients, with the diagnostic efficacies of pelvic fracture (AUC=0.75, 95% CI 0.65, 0.85) and age (AUC=0.70, 95% CI 0.59, 0.82) decreasing successively. For postoperative DVT of the lower limbs in the patients, D-dimer (AUC=0.71, 95% CI 0.61, 0.81) exhibited the highest diagnostic efficacy, followed by age (AUC=0.70, 95% CI 0.59, 0.81), ISS (AUC=0.64, 95% CI 0.51, 0.76) and foot fracture (AUC=0.62, 95% CI 0.49, 0.74), with diagnostic efficacy decreased successively. Conclusions:For polytrauma patients with predominant severe limb trauma, age, pelvic fracture and preoperative waiting time for surgery are independent risk factors for preoperative DVT, while age, D-dimer, ISS and foot fracture are independent risk factors for postoperative DVT. Additionally, preoperative waiting time for surgery has the best diagnostic efficacy for preoperative DVT, followed by pelvic fracture and age. D-dimer has the best diagnostic efficacy for postoperative DVT, followed by age, ISS and foot fracture.

Objective To investigate the effects of arthroscopic modified suture-bridge surgery on shoulder stability,pain and imaging anatomical parameters of elderly patients with full-thickness rotator cuff injury.Methods A total of 104 elderly patients with full-thickness rotator cuff injury admitted to Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine from September 2021 to June 2023 were selected and divided into the suture-bridge group and the modified group according to random number table method,with 52 cases in each group.Patients in the suture-bridge group underwent arthroscopic suture-bridge surgery,and patients in the modified group underwent arthroscopic modified suture-bridge surgery.Perioperative indexes,the range of motion of shoulder joint,American Shoulder and Elbow Surgeons(ASES)score,visual analogue scale(VAS)score,Constant shoulder function score,University of California Los Angeles(UCLA)shoulder score,recovery of shoulder joint,Sugaya classification of imaging before and after surgery,and the rate of complications were compared between the two groups.Results There was no significant difference in the length of incision,operation time,joint perfusion volume,intraoperative blood loss,or hospitalization time of patients between the two groups(P>0.05).The external rotation,forward flexion,and abduction ranges of motion 6 months after surgery of patients in the modified group were greater than those in the suture-bridge group(P<0.05);The ASES,Constant,and UCLA scores 6 months after surgery of patients in the modified group were higher than those in the suture-bridge group,while the VAS score was lower than that in the suture-bridge group,with statistically significant differences(P<0.05);The proportions of patients who experienced complete painlessness in shoulder joint,had the same range of motion as the healthy side,and recovered to work ability before surgery 6 months after surgery in the modified group were higher than those in the suture-bridge group,and the Sugaya classification of imaging in the modified group was better than that in the suture-bridge group,with statistically significant differences(P<0.05);There was no significant difference in the incidence of shoulder joint swelling,limb numbness,bleeding,or retear of patients between the two groups(P>0.05).Conclusion Arthroscopic modified suture-bridge surgery for elderly patients with full-thickness rotator cuff injury can relieve postoperative pain,improve shoulder joint function,expand range of motion of shoulder joint,and improve imaging anatomical parameters without increasing the rate of complications.

Objective To compare the performance of 3 risk prediction models based on machine learning in predicting the risk of compassion fatigue among obstetrics and gynaecology nurses.Methods Using the convenience sampling method,1 323 obstetrics and gynaecology nurses from 11 tertiary hospitals in 9 cities were selected from December 2022 to March 2023,and were randomly divided into a training set and a test set according to 7∶3 ratio.Compassion Fatigue Scale,Five Facet Mindfulness Questionnaire and Emotional Intelligence Scale were used for the survey.A total of 3 types of risk prediction models were constructed for the factors affecting the compassion fatigue of obstetrics and gynaecology nurses,namely,Logistic Regression,Decision Tree,and Random Forest.The accuracy,precision,specificity,sensitivity,Fl score and AUC were used to compare the predictive performance of the 3 models.Results Finally 1 276 maternity nurses completed the survey.All 3 models showed that nature of employment,years of experience,mindfulness and emotional intelligence were independent risk factors for compassion fatigue in obstetrics and gynaecology nurses(P＜0.05).The results of model comparison showed that the accuracy of Logistic regression,decision tree and random forest were 0.804,0.806,0.796;the precision was 0.821,0.827,0.823;the sensitivity was 0.956,0.949,0.939;the Fl score was 0.883,0.884,0.877;the AUC was 0.704(95％CI:0.701～0.713),0.760(95％CI:0.751～0.771),0.742(95％CI:0.723～0.762)respectively.Conclusion The risk prediction model of factors affecting compassion fatigue among obstetrics and gynaecology nurses constructed by decision tree performed the best,and the predictive performance was better than that of the random forest and logistic regression models.The multi-model effectively predicts the risk of compassion fatigue in obstetrics and gynecology nurses,explores the interaction of influencing factors in multiple dimensions,and it can inform the early identification and prevention of compassion fatigue and the development of related interventions.

Aim To investigate the protective effect of Vaccarin(Va)on epithelial-mesenchymal transition(EMT)in renal fibrosis model mice through regulating STAT3,and the underlying mechanism.Methods Left ureter ligation was used to establish a mouse model of unilateral ureteral obstruction(UUO);human kid-ney tubular epithelial(HK2)cells were induced to differentiate by transforming growth factor-β(TGF-β)in vitro.HE and Masson staining were used to observe the morphological changes of renal tissue;kits were used to detect the levels of BUN,Cr,IL-1β and IL-7 in mouse serum;CCK-8 was used to detect the effect of Va on the viability of HK2 cells;RT-PCR was used to detect the levels of inflammatory factors in HK2 cells;Western blot was used to detect the expression of STAT3,p-STAT3,E-cadherin,and α-SMA proteins in renal tissue and HK2 cells;to further investigate the regulation of Va on STAT3,JAK/STAT3 pathway acti-vator RO8191 was used to treat TGF-β-induced HK2 cells,and functional loss was detected.Results Va improved the pathological damage in UUO mice,inhibi-ted the levels of BUN,Cr and inflammatory factors;Va inhibited the phosphorylation of STAT3,upregulated E-cadherin,and downregulated α-SMA protein expres-sion;RO8191 counteracted the inhibitory effect of Va on the phosphorylation of STAT3.Conclusions Va inhibits the phosphorylation of STAT3 and the release of inflammatory factors,improves EMT,thus exerting an anti-renal fibrosis effect.

OBJECTIVE To understand the current status of prevention and control of traditional Chinese medicine(TCM)diagnosis and treatment technique-related infections in various grades of hospitals in Jiangsu Province so as to provide bases for management departments to put forward the norms.METHODS The questionnaire was de-signed by the methods such as Delphic correspondence,the current status of prevalence,prevention and control of TCM diagnosis and treatment technique-related infections among the health care workers in the hospitals of Jiang-su Province was investigated by using convenience sampling method.RESULTS A total of 508 questionnaires were collected from 13 cities of Jiangsu Province.The results showed that the TCM treatment room(63.64％)was the most common operation site for minimally invasive TCM diagnosis and treatment techniques,the bedside(62.50％)of the patients was the major operation site for Chinese medicine enema,and the central sterile supply department(55.31％)was the preferred choice of cleaning and disinfection site for daily recycled TCM apparatu-ses.'One person used for once,airing and preparing for later use after cleaning and disinfection for once'was the major approach taken for the cleaning and disinfection of Gua Sha boards(82.45％)and TCM pots(87.50％).67.87％of the health care workers said that they wound cleaned and disinfected the medical apparatuses of dress-ing,ironing and fumigation every time after the use.The natural ventilation and ultraviolet light(50.39％)was the major method that was taken for the ventilation and disinfection of the treatment rooms for TCM operations.Quick-drying hand disinfectant and non-touch hand-washing equipment(39.37％)were the most commonly e-quipped hand hygiene facilities.CONCLUSIONS The prevention and control of TCM diagnosis and treatment tech-nique-related infections and the health care workers' capabilities for prevention and control of the infection have made remarkable progress in the various grades of hospitals in Jiangsu Province.However,there is still room for further improvement,and the standardized management and construction should be completed so as to safeguard the TCM diagnosis and treatment techniques.

Excessive ionizing radiation can disrupt the molecular structures of organisms,leading to health issues such as acute radiation syndrome and cancer,posing serious threats to human health.The development of radioprotective drugs holds significant importance for mitigating ionizing radiation damage and safeguarding public health,yet its research process faces multidimensional ethical challenges.This paper systematically explores the ethical issues involved in the full lifecycle of radioprotective drug development,focusing on the ethical particularities of animal experimentation,ethical dilemmas in human trials,data privacy and security risks,as well as challenges in managing conflicts of interest.Targeted solutions are proposed,including strengthening ethical review mechanisms,promoting interdisciplinary collaboration,constructing data security management systems,and establishing conflict-of-interest mediation mechanisms.These comprehensive measures aim to build a scientifically rigorous ethical framework for radioprotective drug research,fostering sustainable development in this field.