Objective:To investigate the risk factors for postoperative venous thromboembolism(VTE)in patients with non-small cell lung cancer(NSCLC),and establish a nomogram model for the accurate prediction of high-risk individuals.Methods:A total of 472 patients with NSCLC who underwent radical surgical resection in The First Affiliated Hospital of Anhui Medical University from June 2019 to December 2023 were included in the study.All patients were randomly assigned to the modeling group(n=332)or the internal validation group(n=140)at a ratio of 7∶3.In addition,200 patients with NSCLC admitted to Fuyang Hospital Affiliated with Anhui Medical University during the same period were randomly selected as the external validation group.To analyze the risk factors for post-operative VTE,patients in the modeling group were further assigned to the VTE group(n=58)or the non-VTE group(n=274),and the demographic data,clinicopathological features,and laboratory test results of the two groups were compared.Multivariate Logistic regression analysis was used to identify independent risk factors for VTE and to construct a nomogram model to predict VTE risk.The predictive ability of the model was evaluated using receiver op-erating characteristic(ROC)and calibration curves.Results:The incidence of post-operative VTE in patients with NSCLC was 16.9%.Patients in the VTE group were older(P=0.006),had a more advanced TNM stage(P<0.001),had more frequent vascular invasion(P=0.001),and had a longer duration of surgery(P=0.033)than patients in the non-VTE group.In addition,there were significant differences between patients in the VTE and non-VTE groups for pre-operative activated partial thromboplastin time(APTT)(P=0.003),D-dimer level(P<0.001),and serum carcinoembryonic antigen(CEA)level(P=0.029).Age,TNM stage,and pre-operative D-dimer level were independent risk factors for VTE in patients with NSCLC.Based on these four variables,a nomogram model was developed to predict the risk of post-operative VTE.The areas under the ROC curves for the modeling,internal validation,and external validation groups were 0.836,0.871,and 0.864,respectively.The calibration curve indicates a high degree of consistency between the predicted risks of the model and the actual risks that occur.Conclu-sions:The nomogram model based on age,TNM stage,operative time,and pre-operative D-dimer level can effectively identify individuals at risk of VTE,and it promises to be a valuable tool for risk assessment.

Craniocervical junction zone malformations often have an insidious onset, a variety of clinical phenotypes, and are often combined with multiple malformations, making their systematic classification and staging more difficult.At present, craniocervical junction area malformations are often classified into congenital and acquired, and can also be classified into skull base malformations, atlantoaxial malformations, and cardinal malformations according to their locations. For patients with obvious occipitocervical or atlantoaxial instability, combined with symptoms of high cervical spinal cord damage, internal fixation and fusion surgery should be performed aggressively to avoid irreversible nerve damage.There is a lack of detailed categorisation and summary of the treatment of diseases associated with craniocervical junction malformations in the literature, and the treatment strategies for some of these malformations are still controversial, with different perceptions and treatment concepts in the national and international literature.

Objective:To investigate the changes in the severity of mitral regurgitation in patients with large atrial septal defects after surgery.Methods:This study conducted a retrospective analysis using a self-controlled method on 145 patients with secundum atrial septal defects greater than 2 cm who underwent surgical treatment in the Department of Cardiology and Macrovascular Surgery at The First Affiliated Hospital of Anhui Medical University from January 2021 to October 2023. Among these patients, 74 underwent surgical closure, while 71 underwent surgical repair. Data including general information, defect size, number of surgeries of various types, preoperative transthoracic echocardiogram results, and follow-up results from the first and most recent transthoracic echocardiograms after discharge for all patients were collected. The Friedman test was used to compare the degree of mitral regurgitation before surgery and at the first and most recent follow-up after discharge. The differences in the severity of mitral regurgitation in patients before and after surgical treatment were analyzed.Results:Among the 145 patients, there were 25 males and 110 females, with an average age of (36 ± 14) years, height of (163.4 ± 8.2) cm, and body weight of (59.5 ± 10.5) kg. The diameter of the defect was (2.49 ± 0.35) cm. Before surgery, the severity of mitral regurgitation was classified as none, mild, and moderate (including mild to moderate) for 57 patients (39.3%), 83 patients (57.2%), and 5 patients (3.4%), respectively. The average follow-up duration was (324 ± 153) days. At the first follow-up after discharge, the severity of mitral regurgitation was none, mild, and moderate for 50 patients (34.5%), 87 patients (60.0%), and 8 patients (5.5%), respectively. At the most recent follow-up after discharge, the severity of mitral regurgitation was none, mild, and moderate for 30 patients (20.7%), 89 patients (61.4%), and 26 patients (17.9%), respectively. Compared with the preoperative severity of mitral regurgitation, the most recent follow-up showed worsening in 65 patients (44.8%) and improvement in 22 patients (15.2%). The mean rank sums for the three degrees of mitral regurgitation were 1.83, 1.91, and 2.26, with a statistically significant difference ( χ2 = 25.36, P = 0.001). Pairwise comparisons indicated that the most recent follow-up after discharge showed worsening compared with the preoperative severity of mitral regurgitation ( P < 0.05) and that it also worsened compared with the first follow-up after discharge ( P < 0.05). Conclusions:In patients with secundum atrial septal defects greater than 2 cm, undergoing surgery solely for atrial septal defects may result in the potential worsening of mitral regurgitation after the procedure.

Objective:To investigate the changes in the severity of mitral regurgitation in patients with large atrial septal defects after surgery.Methods:This study conducted a retrospective analysis using a self-controlled method on 145 patients with secundum atrial septal defects greater than 2 cm who underwent surgical treatment in the Department of Cardiology and Macrovascular Surgery at The First Affiliated Hospital of Anhui Medical University from January 2021 to October 2023. Among these patients, 74 underwent surgical closure, while 71 underwent surgical repair. Data including general information, defect size, number of surgeries of various types, preoperative transthoracic echocardiogram results, and follow-up results from the first and most recent transthoracic echocardiograms after discharge for all patients were collected. The Friedman test was used to compare the degree of mitral regurgitation before surgery and at the first and most recent follow-up after discharge. The differences in the severity of mitral regurgitation in patients before and after surgical treatment were analyzed.Results:Among the 145 patients, there were 25 males and 110 females, with an average age of (36 ± 14) years, height of (163.4 ± 8.2) cm, and body weight of (59.5 ± 10.5) kg. The diameter of the defect was (2.49 ± 0.35) cm. Before surgery, the severity of mitral regurgitation was classified as none, mild, and moderate (including mild to moderate) for 57 patients (39.3%), 83 patients (57.2%), and 5 patients (3.4%), respectively. The average follow-up duration was (324 ± 153) days. At the first follow-up after discharge, the severity of mitral regurgitation was none, mild, and moderate for 50 patients (34.5%), 87 patients (60.0%), and 8 patients (5.5%), respectively. At the most recent follow-up after discharge, the severity of mitral regurgitation was none, mild, and moderate for 30 patients (20.7%), 89 patients (61.4%), and 26 patients (17.9%), respectively. Compared with the preoperative severity of mitral regurgitation, the most recent follow-up showed worsening in 65 patients (44.8%) and improvement in 22 patients (15.2%). The mean rank sums for the three degrees of mitral regurgitation were 1.83, 1.91, and 2.26, with a statistically significant difference ( χ2 = 25.36, P = 0.001). Pairwise comparisons indicated that the most recent follow-up after discharge showed worsening compared with the preoperative severity of mitral regurgitation ( P < 0.05) and that it also worsened compared with the first follow-up after discharge ( P < 0.05). Conclusions:In patients with secundum atrial septal defects greater than 2 cm, undergoing surgery solely for atrial septal defects may result in the potential worsening of mitral regurgitation after the procedure.

Objective:To investigate the risk factors for postoperative venous thromboembolism(VTE)in patients with non-small cell lung cancer(NSCLC),and establish a nomogram model for the accurate prediction of high-risk individuals.Methods:A total of 472 patients with NSCLC who underwent radical surgical resection in The First Affiliated Hospital of Anhui Medical University from June 2019 to December 2023 were included in the study.All patients were randomly assigned to the modeling group(n=332)or the internal validation group(n=140)at a ratio of 7∶3.In addition,200 patients with NSCLC admitted to Fuyang Hospital Affiliated with Anhui Medical University during the same period were randomly selected as the external validation group.To analyze the risk factors for post-operative VTE,patients in the modeling group were further assigned to the VTE group(n=58)or the non-VTE group(n=274),and the demographic data,clinicopathological features,and laboratory test results of the two groups were compared.Multivariate Logistic regression analysis was used to identify independent risk factors for VTE and to construct a nomogram model to predict VTE risk.The predictive ability of the model was evaluated using receiver op-erating characteristic(ROC)and calibration curves.Results:The incidence of post-operative VTE in patients with NSCLC was 16.9%.Patients in the VTE group were older(P=0.006),had a more advanced TNM stage(P<0.001),had more frequent vascular invasion(P=0.001),and had a longer duration of surgery(P=0.033)than patients in the non-VTE group.In addition,there were significant differences between patients in the VTE and non-VTE groups for pre-operative activated partial thromboplastin time(APTT)(P=0.003),D-dimer level(P<0.001),and serum carcinoembryonic antigen(CEA)level(P=0.029).Age,TNM stage,and pre-operative D-dimer level were independent risk factors for VTE in patients with NSCLC.Based on these four variables,a nomogram model was developed to predict the risk of post-operative VTE.The areas under the ROC curves for the modeling,internal validation,and external validation groups were 0.836,0.871,and 0.864,respectively.The calibration curve indicates a high degree of consistency between the predicted risks of the model and the actual risks that occur.Conclu-sions:The nomogram model based on age,TNM stage,operative time,and pre-operative D-dimer level can effectively identify individuals at risk of VTE,and it promises to be a valuable tool for risk assessment.

Craniocervical junction zone malformations often have an insidious onset, a variety of clinical phenotypes, and are often combined with multiple malformations, making their systematic classification and staging more difficult.At present, craniocervical junction area malformations are often classified into congenital and acquired, and can also be classified into skull base malformations, atlantoaxial malformations, and cardinal malformations according to their locations. For patients with obvious occipitocervical or atlantoaxial instability, combined with symptoms of high cervical spinal cord damage, internal fixation and fusion surgery should be performed aggressively to avoid irreversible nerve damage.There is a lack of detailed categorisation and summary of the treatment of diseases associated with craniocervical junction malformations in the literature, and the treatment strategies for some of these malformations are still controversial, with different perceptions and treatment concepts in the national and international literature.

Objective To investigate the effect of cysteine-rich acidic secretory protein-like protein 1(SPARCL1)on atherosclerosis(AS)plaque formation.Methods A case-control study design was used,394 patients with con-firmed AS were selected as the case group,and 394 healthy medical examiners matched for age and gender were se-lected as the control group.The expression level of serum SPARCL1 was determined by enzyme-linked immunosor-bent assay;immunohistochemistry was used to assess the expression level and localization of SPARCL1 protein in the AS plaque region,and the expression of SPARCL1 protein was also detected in the neutrophils and monocytes of peripheral blood of AS patients and normal controls;SPARCL1 overexpressing and the recombinant adenoviral vec-tors were constructed to inhibit SPARCL1 overexpression and expression,and the effects of SPARCL1 on cell mi-gration were observed in the cell scratch assay using mouse macrophage cells(J774A.1)as target cells.Results Serum SPARCL1 levels in the AS patient group were lower than those in the healthy group(P<0.05);high SPARCL1 expression was detected in AS plaques and was mainly expressed in the cytoplasm of foamy cells;SPARCL1 expression levels in peripheral blood neutrophils and monocytes were lower than those in normal controls in AS patients(P<0.05);recombinant SPARCL1 overexpression and inhibition of expression of adenovirus was successfully constructed;the cell migration rate was decreased in J774A.1 cells that inhibited SPARCL1 expression and increased in J774A.1 cells that overexpressed SPARCL1(P<0.05).Conclusion SPARCL1 is highly ex-pressed in foam cells at the site of AS lesions,which may result from compensatory recruitment of peripheral blood monocytes and neutrophils,and SPARCL1 may be involved as a protective factors for blood vessels in inhibiting the development of AS plaques.

Objective To analyze the risk factors for delayed tricuspid regurgitation after aortic valve replacement.Methods A total of 104 cases of aortic valve replacements due to aortic valve lesion in this hos-pital from January 2016 to December 2017 were retrospectively analyzed.The perioperative data were collected and the follow up was performed.The appearance of moderate or more regurgitation in the tricuspid valve was defined as having regurgitation,and mild and below mild regurgitation was defined as no regurgitation.The in-dependent influencing factors for delayed tricuspid regurgitation were analyzed by using univariate and multi-variate logistic regression.Results The average follow-up period was (6.0±0.7)years.There were 39 cases lost the follow-up,5 cases died (1 case died of brain hemorrhage and 4 cases died of heart failure).The inci-dence rate of delayed tricuspid regurgitation after aortic valve operation was 15.4％.The univariate analysis showed that atrial fibrillation (70.0％ vs. 9.1％,P<0.001) and pulmonary artery pressure (x2=9.785,P=0.016) were related with tricuspid regurgitation.The multivariate logistic regression analysis showed that at-rial fibrillation (OR=15.008,P=0.003) was the independent risk factor for the delayed tricuspid regurgita-tion after aortic valve surgery.Conclusion The patients with simple aortic valve surgery should pay attention to the atrial fibrillation situation to prevent the occurrence of delayed postoperative tricuspid regurgitation.

Objective:To establish a human buccal mucosa squamous cell carcinoma (BMSCC) cell line SCC117 in China, analyze and identify its basic biological characteristics.Methods:A 59-year-old Chinese male patient with BMSCC in the Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology in January 2011 was included in this study, his surgical specimens were primary cultured in vitro by improved tissue block culture method. The BMSCC cell line SCC117 was established after continuous passage and stable growth. The morphological characteristics of the cells were observed by light and electron microscope, and their basic biological characteristics were analyzed by growth curve, chromosome karyotype and xenotransplantation tumorigenicity in nude mice experiment. The expressions of cytokeratin (CK14), tumor-related proteins retinoblastoma tumor suppressor protein (RB), P53, E-cadherin, P21, phosphatase and tensin homolog deleted on chromosome ten (PTEN) were detected by immunohistochemical and human papilloma virus (HPV) were tested by PCR. SCC117 was identified by short tandem repeat (STR) analysis of genomic DNA. Results:SCC117, a human BMSCC cell line, had been continuously subcultured in vitro for more than 150 generations. The cells grew in polygonal mosaic and lost contact inhibition, the typical desmosomes and tensional fibrils were observed by electron microscope, and CK14 was positive by immunohistochemistry. The doubling time was 40.16 h, the chromosome mode of the cell line was concentrated between 67 and 69, hypo-triploid. All 4 nude mice inoculated with SCC117 cells developed tumors, indicating that the SCC117 cell line had the ability of xenogeneic tumorigenesis. The histopathological type of the transplanted tumor in nude mice was consistent with that of the primary tumor tissue, both of which were squamous cell carcinoma. The immunohistochemical results showed that in both human primary tumor and the transplanted tumor tissue in nude mice, RB, P53, and E-cadherin were all positive, P21 was weakly positive, while PTEN was negative. SCC117 was tested negative for the presence of HPV. STR sequence analysis showed that SCC117 cell line originated from primary tumor tissue and was not cross-contaminated by other cell lines. Conclusions:The human BMSCC cell line SCC117 was successfully established in China, which could provide a new experimental model for the study of oral SCC without HPV infection, especially BMSCC.

Objective    To assess the early outcome of transapical transcatheter aortic valve replacement (TAVR) for patients with aortic insufficiency. Methods    The patients with aortic valvular disease who underwent transapical TAVR from October 2020 to October 2022 in the Department of Cardiac and Vascular Surgery, the First Affiliated Hospital of Anhui Medical University were enrolled in the current retrospective study. The patients with aortic stenosis were assembled in a group A, and the patients with aortic insufficiency were assembled in a group B. The improvements of heart function and complications were assessed for the two groups. Results    A total of 56 patients were enrolled, including 32 males and 24 females with an average age of 73.34±5.10 years. There were 31 patients in the group A and 25 patients in the group B. There was no statistical difference between the two groups in the age, gender, height, weight, hypertension, coronary artery disease, peripheral vascular disease, chronic obstructive pulmonary disease, renal disorder or classification of heart function (P>0.05). Also, there was still no statistical difference in the rate of permanent peacemaker implants, emergent open surgery, valve re-implants, or perivalvular leakage (P>0.05). After TAVR, the left ventricular diastolic diameter, left ventricular ejection fraction, complicated moderated mitral and tricuspid regurgitation were significantly improved in both groups compared with preoperative findings (P<0.05); however, there was no statistical difference in these parameters between groups (P>0.05). Conclusion    Interventional valve (J-Valve) in the treatment of patients with aortic insufficiency through transapical TAVR significantly improves cardiac function and reduces functional valve regurgitation.