Objective To summarize the clinical efficacy of modified Morrow surgery in the treatment of hypertrophic obstructive cardiomyopathy. Methods A retrospective analysis was conducted on the clinical data of patients with hypertrophic obstructive cardiomyopathy treated with modified Morrow surgery at Zhongshan Hospital Affiliated to Fudan University from 2020 to 2023. Results A total of 318 patients were enrolled, including 156 males and 162 females, with an average age of (55.6±13.1) years. Preoperative echocardiography showed a mean interventricular septal thickness of (18.1±3.8) mm, peak left ventricular outflow tract pressure difference of (86.4±24.9) mm Hg. The surgery time was (162.3±51.0) min, extracorporeal circulation time was (80.9±31.0) min, and aortic occlusion time was (44.8±20.8) min. After the surgery, transesophageal echocardiography showed that the interventricular septal thickness was (11.0±1.8) mm and left ventricular outflow tract peak pressure difference was (9.4±5.1) mm Hg. The incidence rate of postoperative complete left bundle branch block was 45.3%, Ⅲ° atrioventricular block was 3.8%, and postoperative newly developed atrial fibrillation was 3.1%. The postoperative hospital stay was (6.6±4.9) days, and one perioperative death occurred, with a mortality rate of 0.3%. The follow-up time was (10.3±9.4) months, during which the transthoracic echocardiography revealed a ventricular septal thickness of (12.9±2.9) mm and a peak left ventricular outflow tract pressure difference of (13.9±10.0) mm Hg. Conclusion The modified Morrow procedure for the treatment of hypertrophic obstructive cardiomyopathy is safe and effective, with good results in the short and medium term.

Objective To compare the clinical efficacy of neuroendoscope-assisted evacuation and navigation-assisted puncture drainage in treating thalamic hemorrhage breaking into the ventricle. Methods A retrospective analysis was conducted on the clinical data of 93 patients with thalamic hemorrhage breaking into the ventricle at Taihe Hospital of Wannan Medical College between January 2022 and February 2024. The patients received neuroendoscope-assisted removal of thalamic hematoma combined with contralateral extraventricular drainage (n＝44, neuroendoscope group) and navigation-assisted thalamic hematoma puncture drainage combined with contralateral extraventricular drainage (n＝49, navigation group), respectively. The treatment efficacy, surgical situation, and prognosis between the two groups were compared. Results The neuroendoscope group had longer operation duration, more intraoperative blood loss, higher hospitalization costs than the navigation group (P＜0.05). The neuroendoscope group had higher hematoma clearance rate 3rd after surgery and shorter length of stay than the navigation group (P＜0.05). There was no significant difference in the incidence of intracranial infection after surgery between the two groups. The neuroendoscope group had higher Glasgow coma scale (GCS) score at 1 week after surgery and Glasgow outcome scale (GOS) score at 3 months after surgery (P＜0.01). Conclusions Compared with navigation-assisted puncture, neuroendoscope-assisted evacuation can improve the thalamic hemorrhage clearance rate, shorten the length of stay, and improve the prognosis of patients.

Objective To analyze the epidemiological characteristics of hepatitis E (HE) in Huai'an City from 2015 to 2024, and construct and validate the prediction effect of the Seasonal Autoregressive Integrated Moving Average (SARIMA) model, and to provide a scientific basis for HE prevention and control. Methods Data of reported HE cases in Huai'an City from January 2015 to December 2024 were extracted from the National Disease Control and Prevention Information System. Descriptive epidemiological methods were used to analyze the temporal, regional and population distribution characteristics of HE incidence. After data preprocessing, stationarity test and randomness test, the SARIMA model was constructed. The optimal model was selected by minimizing the Akaike Information Criterion (AIC). The model performance was evaluated by adjusted R-squared (Adj R²) and root mean square error (RMSE). The monthly incidence rate of HE in Huai'an City in 2025 was predicted and compared with the actual incidence data to validate the model. Results A total of 1 713 HE cases were reported in Huai'an City from 2015 to 2024, showing a fluctuating upward trend. Huaiyin District (339 cases) and Lianshui County (334 cases) were high-incidence areas. The cases were mainly concentrated in people aged 45 and above (83.3%), males (gender ratio 2.37:1) and farmers (70.8%). The optimal model was SARIMA (1,1,1)×(2,0,1)₁₂, with residual as white noise sequence. There was no statistical difference between the actual incidence and predicted value from January to August 2025 (P>0.05). Conclusion HE incidence in Huai'an has obvious aggregation and temporal fluctuation characteristics. The SARIMA model has a good prediction effect, which can provide reference for formulating targeted prevention and control strategies.

Objective To investigate the perioperative management of antithrombotic drugs in patients undergoing non-cardiac surgery.Methods Patients on long-term antithrombotic drugs who underwent non-cardiac surgery in our hospital were included.Through interviews with patients and physicians,perioperative antithrombotic medication regimens were reviewed and compared with the"Multidisciplinary Expert Consensus on Perioperative Management of Antithrombotic Therapy"to evaluate compliance with consensus and analyze influencing factors.Results A total of 372 patients were included in the analysis.Among them,355 patients were on long-term antiplatelet therapy alone,and 17 were on long-term oral anticoagulantion.364(97.8％)discontinued antithrombotic medications prior to surgery.109 patients(29.3％)received low molecular weight heparin(LMWH)bridging therapy.Among the 355 patients on antiplatelet therapy,108(30.4％)had discontinuation durations consistent with the consensus recommendations,while 186(52.4％)discontinued medications for longer periods.Postoperatively,the average hospital stay for antiplatelet therapy patients was 6.64 days,with only 37(10.4％)resuming therapy during hospitalization.The average hospital stay for patients on anticoagulants was 9.94 days,with only 2(11.8％)resuming therapy during hospitalization.Regarding perioperative risk assessment,only 40(10.8％)of patients underwent additional internal medical evaluation for thromboembolic risk after medication discontinuation,with the remainder assessed soly by surgeons.Coronary heart disease was an independent risk factor associated with internal medical evaluation(OR 2.851,95％CI 1.160-7.011,P=0.022).For bleeding risk assessment,surgeons evaluations aligned with the consensus in 68.0％of cases,but surgeons tended to underestimate risk compared to the consensus.Conclusions In this single-center study,perioperative antithrombotic management showed low compliance with expert consensus,characterized by prolonged preoperative medication discontinuation,high rates of LMWH bridging,and low postoperative in-hospital resumption of therapy.A robust multidisciplinary collaboration system should be established to enhance comprehensive patient assessment.

OBJECTIVE: To explore the application value of joint detection of serum neutrophil-to-lymphocyte ratio (NLR), prostate-specific antigen (PSA) and MMP26 in differentiating prostate cancer (PCa) from benign prostatic hyperplasia (BPH). METHODS: A total of 61 PCa patients (PCa group) and 63 BPH patients (BPH group) who were treated in The Affiliated Huaian Hospital of Xuzhou Medical University from May 2022 to May 2024 were retrospectively included. The relevant clinical data of all subjects were collected with the serum NLR, PSA and MMP26 levels being detected. Multivariate logistic regression analysis was used to analyze the influencing factors in differentiating PCa from BPH. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of serum NLR, PSA and MMP26 in differentiating PCa from BPH. RESULTS: The levels of TC and LDL-C in the PCa group were higher than those in the BPH group. And the level of HDL-C in the PCa group was lower than that in the BPH group (P<0.05). The serum levels of NLR, PSA and MMP26 in the PCa group were higher than those in the BPH group (P<0.05). The results of multivariate logistic regression analysis showed that NLR, PSA and MMP26 were risk factors for the diagnosis of PCa in patients (P<0.05). The ROC results showed that the area under the curve (AUC) of NLR, PSA MMP26 and joint diagnosis in the identification of PCa was 0.804, 0.800, 0.809 and 0.905, respectively. The comparison results of AUC showed that the joint diagnosis was superior to the single diagnosis (Z=2.262, 2.177, 2.002, P<0.05). CONCLUSION The joint detection of serum NLR, PSA and MMP26 has significant application value in the differentiation of PCa and BPH, which is expected to become an effective tool for early screening and diagnosis of PCa.
Humans ; Male ; Prostatic Hyperplasia/blood* ; Prostate-Specific Antigen/blood* ; Diagnosis, Differential ; Prostatic Neoplasms/blood* ; Retrospective Studies ; Neutrophils ; Lymphocytes ; ROC Curve ; Aged ; Middle Aged

This consensus will introduce the characteristics of fillers used in the surgical cavities of domestic nasal surgery patients based on relevant literature and expert opinions. It will also provide recommendations for the selection of cavity fillers for different nasal diseases, with chronic sinusitis as a representative example.
Humans ; Nasal Cavity/surgery* ; Nasal Surgical Procedures ; China ; Consensus ; Sinusitis/surgery* ; Dermal Fillers

Objective To investigate influenza awareness of community residents in Nanchang under routine epidemic management using the Knowledge-Attitude-Practice(KAP)framework.Methods A structured questionnaire,including four do-mains(disease overview,prevention,diagnosis,and treatment),was designed and administered via street and online surveys from December 2023 to February 2024.Statistical analyses,including chi-square tests and logistic regression,were performed to identify determinant factors.Results A total of 303 valid questionnaires were retrieved,with an effective rate of approximately 94.7％.Community residents in Nanchang demonstrated a certain degree of understanding of the overview,prevention,diagno-sis,and treatment of influenza,although some gaps were identified.Univariate analysis revealed statistically significant differ-ences in influenza cognition scores among urban and rural residents(P＜0.05),residents with different educational levels(P＜0.05)and exposure levels to influenza education(P＜0.05).Multivariate regression analysis identified these as influencing fac-tors for influenza awareness.Conclusion Collaborative efforts from the government,individuals,and various societal sectors are essential to enhance the public's overall ability to prevent and control influenza.

Objective:To investigate the association of serum levels of myoglobin(Myo)and reticulocyte(Ret)with cardiac function class in patients with chronic heart failure(CHF).Methods:A total of 106 CHF patients treated in First Rongjun Special Care Hospital of Hebei Province between February 2020 and February 2024 were retrospec-tively selected as the observation group.According to New York Heart Association(NYHA)cardiac function class,patients were divided into class Ⅱ group(n=61)and class Ⅲ～Ⅳ group(n=45),and 107 healthy people with nor-mal physical examination results were selected from our hospital simultaneously as control group.The Myo and Ret levels were compared between control group and observation group,class Ⅱ group and class Ⅲ～Ⅳ group.Spearman correlation analysis was used to analyze the association of Myo and Ret levels with NYHA class in CHF patients.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of Myo,Ret and their combined detection for NYHA class Ⅲ～Ⅳ in CHF patients.Results:Compared to participants in the control group,those in the observation group had significant higher Myo level[(50.42±9.98)μg/ml vs.(35.22±5.36)μg/ml]and significant lower Ret level[(2.24±0.68)％vs.(2.91±0.61)％](P＜0.001 all).Compared to those in class Ⅱ group,those in class Ⅲ～Ⅳ group had significant higher Myo level[(60.77±5.94)μg/ml vs.(42.79±2.97)μg/ml]and significant lower Ret level[(1.73±0.31)％vs.(2.62±0.62)％](P＜0.001 all).Spearman correlation analysis showed that Myo(r=0.654)was positively correlated with NYHA cardiac function class in CHF patients,while Ret(r=-0.589)was inversely correlated with it(P＜0.001 all).ROC analysis showed that a combination of Myo and Ret had significant higher predictive efficacy(AUC=0.926,95％CI 0.858～0.968)for NYH A class Ⅲ～Ⅳ in CHF patients than Myo(AUC=0.804,95％CI 0.716～0.875)and Ret(AUC=0.701,95％CI 0.604～0.786)alone(Z=2.745,4.183,P＜0.01 both).Conclusion:Our study showed that Myo and Ret levels were significantly correlated with NYHA class in CHF patients.Moreover,a combination of Myo and Ret levels showed better diagnostic value for NYHA class Ⅲ～Ⅳ in this population.

Objective To systematically evaluate the research progress of risk prediction models for periprosthetic joint infection(PJI)after total joint arthroplasty(TJA),analyze the limitations of current researches,and propose optimized suggestions.Methods Chinese and English databases such as PubMed,Embase,Web of Science,Co-chrane Library,SinoMed,Wanfang Database,VIP Database,and CNKI were retrieved systematically.The re-trieved period was from the establishment of each database to August 31,2024.Two researchers independently screened literatures and extracted data according to the CHARMS checklist,and the risk of bias in the included studies was evaluated by the PROBAST tool.Results A total of 14 studies were included in this study,involving 17 prediction models.The most common predictors included history of diabetes mellitus,obesity(body mass index[BMI]≥30 kg/m2),advanced age(≥65 years old),history of traumatic fracture,and prolonged operation time(≥2 hours).All of the included studies had high risks of bias,mainly study subject selection bias(such as single-center sample)and statistical analysis bias(such as unadjusted confounding factors).Conclusion Most of the cur-rently published risk prediction models for PJA after TJA have good predictive performance,however,there are sig-nificant limitations in the research design,especially in the insufficient control of bias risk.Future research needs to focus on improving methodological design,including adoption of prospective multi-center studies,definition of standardized predictive variables,and sufficient adjustment of confounding factors.

BACKGROUND: Immune checkpoint inhibitors (ICIs) have been included in various neoadjuvant therapy (NAT) regimens for non-small cell lung cancer (NSCLC). However, due to the relatively short period for the use of ICIs in NAT, patients' clinical outcomes with different regimens are uncertain. Our study aims to examine the efficacy of neoadjuvant immunotherapy (NAIT) for NSCLC patients and compare the overall survival (OS) and event-free survival (EFS) of patients receiving different NAT regimens. METHODS: This study retrospectively included 308 NSCLC patients treated with different NAT regimens and subsequent surgery in National Cancer Center between August 1, 2016 and July 31, 2022. Kaplan-Meier survival analysis and Cox proportional hazards regression analysis were conducted to evaluate the prognosis of patients. RESULTS: With a median follow-up of 27.5 months, the 1-year OS rates were 98.8% and 96.2%, and the 2-year OS rates were 96.6% and 85.8% in patients of the NAIT and neoadjuvant chemotherapy (NACT) group, respectively (hazard ratio [HR], 0.339; 95% confidence interval [CI], 0.160-0.720; P = 0.003). The 1-year EFS rates were 96.0% and 88.0%, and the 2-year EFS rates were 92.0% and 77.7% for patients in the NAIT and NACT groups, respectively (HR, 0.438; 95% CI, 0.276-0.846; P = 0.010). For patients who did not achieve pathological complete response (pCR), significantly longer OS ( P = 0.012) and EFS ( P = 0.019) were observed in patients receiving NAIT than those receiving NACT. Different NAT regimens had little effect on surgery and the postoperative length of stay (6 [4, 7] days vs . 6 [4, 7] days, Z = -0.227, P = 0.820). CONCLUSIONS NAIT exhibited superior efficacy to NACT for NSCLC, resulting in longer OS and EFS. The OS and EFS benefits were also observed among patients in the NAIT group who did not achieve pCR.
Humans ; Carcinoma, Non-Small-Cell Lung/mortality* ; Male ; Female ; Lung Neoplasms/mortality* ; Middle Aged ; Immune Checkpoint Inhibitors/therapeutic use* ; Neoadjuvant Therapy/methods* ; Retrospective Studies ; Aged ; Adult ; Kaplan-Meier Estimate ; Treatment Outcome ; Immunotherapy/methods*