Objective:To analyze the influencing factors of pancreatic fistula after pancreaticoduodenectomy (PD), and to construct and evaluate the prediction model of postoperative pancreatic fistula (POPF).Methods:Clinical data of 255 PD patients undergoing PD at the General Surgery Department of the Second Affiliated Hospital of Air Force Military Medical University from January 2016 to January 2023 were retrospectively analyzed as the training set, including 148 males and 107 females, aged 58.0 (52.0, 64.5) years. According to the occurrence of POPF, patiennts were divided into the pancreatic fistula group ( n=65, including grade B and C POPF) and the non-pancreatic fistula group ( n=190). The age, gender, body mass index (BMI), white blood cell (WBC) count and neutrophil/lymphocyte ratio (NLR) before surgery and on the postoperative day (POD) 3, albumin, diameter of pancreatic duct, texture of the pancreas, operation time, and amylase concentration in the drainage fluid on POD3 were compared between the groups. Multivariate logistic regression analyses were conducted to identify the influencing factors of POPF. The nomogram of the pancreatic fistula prediction model was constructed using the rms package. One thousand cases were selected as the test set through the Bootstrap resampling method. And in the test set the receiver operating characteristic (ROC) curve and calibration curve were drawn to evaluate the model. Results:Logistic univariate analysis showed that there were significant differences between the two groups in terms of age, BMI, WBC count and NLR (preoperative and on POD3), the concentration of amylase in drainage fluid on POD3, pancreatic duct diameter, and operation time (all P<0.05). The results of logistic multivariate regression analysis showed age ( OR=1.050, 95% CI: 1.011-1.091), BMI ( OR=1.127, 95% CI: 1.005-1.264) and the amylase concentration of the drainage fluid >367.5 U/L on POD3 ( OR=3.688, 95% CI: 1.849-7.354) were the influencing factors of POPF ( P<0.05). Based on the three influencing factors screened out by multivariate analysis, a histogram for the prediction of pancreatic fistula was constructed using the rms package. The area under the ROC curve of the nomogram for predicting the occurrence of pancreatic fistula after PD was 0.744 (95%CI: 0.679-0.809), with a sensitivity of 69.2% and a specificity of 70.5%. The calibration curve shows that the model's prediction is consistent with the actual situation in the overall trend, indicating a relatively high degree of calibration. Conclusion:Age, BMI and amylase concentration of drainage fluid >367.5 U/L on POD3 are the influencing factors for pancreatic fistula after PD. The nomogram model for predicting pancreatic fistula constructed based on this has good predictive and application value.

OBJECTIVE: This study aimed to explore the association between body mass index (BMI) and mortality based on the 10-year population-based multicenter prospective study. METHODS: A general population-based multicenter prospective study was conducted at four sites in rural China between 2013 and 2023. Multivariate Cox proportional hazards models and restricted cubic spline analyses were used to assess the association between BMI and mortality. Stratified analyses were performed based on the individual characteristics of the participants. RESULTS: Overall, 19,107 participants with a sum of 163,095 person-years were included and 1,910 participants died. The underweight (< 18.5 kg/m ²) presented an increase in all-cause mortality (adjusted hazards ratio [ aHR] = 2.00, 95% confidence interval [ CI]: 1.66-2.41), while overweight (≥ 24.0 to < 28.0 kg/m ²) and obesity (≥ 28.0 kg/m ²) presented a decrease with an aHR of 0.61 (95% CI: 0.52-0.73) and 0.51 (95% CI: 0.37-0.70), respectively. Overweight ( aHR = 0.76, 95% CI: 0.67-0.86) and mild obesity ( aHR = 0.72, 95% CI: 0.59-0.87) had a positive impact on mortality in people older than 60 years. All-cause mortality decreased rapidly until reaching a BMI of 25.7 kg/m ² ( aHR = 0.95, 95% CI: 0.92-0.98) and increased slightly above that value, indicating a U-shaped association. The beneficial impact of being overweight on mortality was robust in most subgroups and sensitivity analyses. CONCLUSION This study provides additional evidence that overweight and mild obesity may be inversely related to the risk of death in individuals older than 60 years. Therefore, it is essential to consider age differences when formulating health and weight management strategies.
Humans ; Body Mass Index ; China/epidemiology* ; Male ; Female ; Middle Aged ; Prospective Studies ; Rural Population/statistics & numerical data* ; Aged ; Follow-Up Studies ; Adult ; Mortality ; Cause of Death ; Obesity/mortality* ; Overweight/mortality*

Single-incision laparoscopic cholecystectomy (SILC) represents a significant evolution in minimally invasive surgery, designed to accomplish cholecystectomy via a single umbilical incision. This approach seeks to reduce abdominal wall trauma while optimizing cosmetic outcomes. SILC is a safe and feasible minimally invasive technique for cholecystectomy under defined conditions; however, its broader adoption will require further evidence-based research and the establishment of standardized protocols to support its widespread implementation. When performed by skilled surgeons in carefully selected patients, SILC demonstrates clinical outcomes comparable to those of conventional multiport laparoscopic cholecystectomy, with notable improvements in incision aesthetics. Nonetheless, the technique is limited by a constrained operative field and a protracted learning curve. In response, continuous advancements in instrumentation and procedural modifications have propelled the further development and clinical integration of SILC. Drawing on current literature and clinical experience, this review delineates the technical characteristics, current clinical applications, primary benefits, and prevailing challenges associated with SILC.

Objective This study aimed to provide an effective scientific basis for prevention and control of cockroaches on aircrafts by identifying cockroach-carried pathogens,and assess the insecticidal efficacy of gel bait mediated cockroach control on aircrafts,to provide technical guidance for aircraft disinsection.Methods Cassette-trapping was used to trap cockroaches,and the carried pathogens were detected using bacterial cultivation techniques.The gel bait mediated killing rate was calculated after 1,7,and 30 d by field application of gel bait.Results A total of 411 cockroaches were captured,and all were identified as Blattella germanica.26 strains of pathogenic bacteria were isolated from the trapped cockroaches.The killing rates of cockroaches were 58.8％-96.3％with 1-30 day application of gel bait.Statistically significant differences were observed in cockroach killing rates on different days(χ2=58.95,P<0.01).Conclusions B.germanica carry a large variety of pathogenic bacteria and opportunistic pathogens and are thus important infectious disease carriers.Gel bait agents have proven to be very effective against cockroaches on aircrafts.

Aim To investigate the effect of high-fat diet on the tight junction function injury of Sertoli cells through the NF-κB/NLRP3 signaling pathway in mice and to explore the underlying mechanism.Methods Male C57BL/6J mice were fed with high-fat or normal diet for five months.The body and gonadal organ weight of mice were measured,and their indices were calculated.The sperm concentration,the sperm viabili-ty,the testicular histomorphology and the expression levels of tight junction proteins ZO-1,Occludin and Claudin-11 were measured.TM4 cells were treated with palmitic acid(PA)for 24 h.Cell viability was detected by CCK-8 method.Then,TM4 cells were di-vided into different groups treated with PA(0,50,100,200 and 300 μmnol·L-1),and the expression lev-els of tight junction proteins ZO-1,Occludin and Clau-din-11 were detected by Western blot.The tight junc-tion permeability of TM4 cells were detected by transepithelial electrical resistance(TEER)and FITC-dextran.The expression levels of mRNA and proteins for the NF-κB/NLRP3 pathway-related factors were de-tected by RT-qPCR and Western blot.Results The results from animal experiments showed that high-fat diet increased body weight and seminal vesicle weight of mice,and decreased testicular index,epididymal in-dex,sperm concentration and sperm motility of mice.High-fat diet also caused testicular tissue structure damage and down-regulated the expression levels of tight junction proteins ZO-1 and Occludin,without af-fecting the expression of Claudin-11.In vitro,PA sig-nificantly down-regulated the expression levels of ZO-1,Occludin and Claudin-11 in TM4 cells,increased the cell permeability,as well as up-regulated the mRNA and protein expression levels of NLRP3/NF-κB signa-ling pathway-related factors in TM4 cells.Conclusions High-fat diet can impair the function of tight junction of testicualr Sertoli cells,and the machanism may be related to the activation of the NF-κB/NLRP3 signaling pathway,resulting in Sertoli cell inflammation in mice.

Aim To investigate the effect of high-fat diet on the tight junction function injury of Sertoli cells through the NF-κB/NLRP3 signaling pathway in mice and to explore the underlying mechanism.Methods Male C57BL/6J mice were fed with high-fat or normal diet for five months.The body and gonadal organ weight of mice were measured,and their indices were calculated.The sperm concentration,the sperm viabili-ty,the testicular histomorphology and the expression levels of tight junction proteins ZO-1,Occludin and Claudin-11 were measured.TM4 cells were treated with palmitic acid(PA)for 24 h.Cell viability was detected by CCK-8 method.Then,TM4 cells were di-vided into different groups treated with PA(0,50,100,200 and 300 μmnol·L-1),and the expression lev-els of tight junction proteins ZO-1,Occludin and Clau-din-11 were detected by Western blot.The tight junc-tion permeability of TM4 cells were detected by transepithelial electrical resistance(TEER)and FITC-dextran.The expression levels of mRNA and proteins for the NF-κB/NLRP3 pathway-related factors were de-tected by RT-qPCR and Western blot.Results The results from animal experiments showed that high-fat diet increased body weight and seminal vesicle weight of mice,and decreased testicular index,epididymal in-dex,sperm concentration and sperm motility of mice.High-fat diet also caused testicular tissue structure damage and down-regulated the expression levels of tight junction proteins ZO-1 and Occludin,without af-fecting the expression of Claudin-11.In vitro,PA sig-nificantly down-regulated the expression levels of ZO-1,Occludin and Claudin-11 in TM4 cells,increased the cell permeability,as well as up-regulated the mRNA and protein expression levels of NLRP3/NF-κB signa-ling pathway-related factors in TM4 cells.Conclusions High-fat diet can impair the function of tight junction of testicualr Sertoli cells,and the machanism may be related to the activation of the NF-κB/NLRP3 signaling pathway,resulting in Sertoli cell inflammation in mice.

Objective:To analyze the influencing factors of pancreatic fistula after pancreaticoduodenectomy (PD), and to construct and evaluate the prediction model of postoperative pancreatic fistula (POPF).Methods:Clinical data of 255 PD patients undergoing PD at the General Surgery Department of the Second Affiliated Hospital of Air Force Military Medical University from January 2016 to January 2023 were retrospectively analyzed as the training set, including 148 males and 107 females, aged 58.0 (52.0, 64.5) years. According to the occurrence of POPF, patiennts were divided into the pancreatic fistula group ( n=65, including grade B and C POPF) and the non-pancreatic fistula group ( n=190). The age, gender, body mass index (BMI), white blood cell (WBC) count and neutrophil/lymphocyte ratio (NLR) before surgery and on the postoperative day (POD) 3, albumin, diameter of pancreatic duct, texture of the pancreas, operation time, and amylase concentration in the drainage fluid on POD3 were compared between the groups. Multivariate logistic regression analyses were conducted to identify the influencing factors of POPF. The nomogram of the pancreatic fistula prediction model was constructed using the rms package. One thousand cases were selected as the test set through the Bootstrap resampling method. And in the test set the receiver operating characteristic (ROC) curve and calibration curve were drawn to evaluate the model. Results:Logistic univariate analysis showed that there were significant differences between the two groups in terms of age, BMI, WBC count and NLR (preoperative and on POD3), the concentration of amylase in drainage fluid on POD3, pancreatic duct diameter, and operation time (all P<0.05). The results of logistic multivariate regression analysis showed age ( OR=1.050, 95% CI: 1.011-1.091), BMI ( OR=1.127, 95% CI: 1.005-1.264) and the amylase concentration of the drainage fluid >367.5 U/L on POD3 ( OR=3.688, 95% CI: 1.849-7.354) were the influencing factors of POPF ( P<0.05). Based on the three influencing factors screened out by multivariate analysis, a histogram for the prediction of pancreatic fistula was constructed using the rms package. The area under the ROC curve of the nomogram for predicting the occurrence of pancreatic fistula after PD was 0.744 (95%CI: 0.679-0.809), with a sensitivity of 69.2% and a specificity of 70.5%. The calibration curve shows that the model's prediction is consistent with the actual situation in the overall trend, indicating a relatively high degree of calibration. Conclusion:Age, BMI and amylase concentration of drainage fluid >367.5 U/L on POD3 are the influencing factors for pancreatic fistula after PD. The nomogram model for predicting pancreatic fistula constructed based on this has good predictive and application value.

Objective:To investigate the characteristics of attention bias to aggressive information under self-threat priming in college students with different types of high self-esteem.Methods:A total of 650 college students were selected,and high self-esteem participants were selected through the Self Esteem Scale(SES).Then,43 partic-ipants were selected from different types of high self-esteem(fragile and safe)groups through the Implicit Associa-tion Test(IAT).Each group participated in Raven's Standard Progressive Matrices(SPM)with different difficulty levels to complete self-threat priming,and then completed the spatial cue experiment.When the cue was invalid,the attention bias was obtained according to the variation of the reaction time difference(RTI)between the subjects're-sponses to aggressive words and neutral words.Results:The RTI values of the fragile high self-esteem group were higher under high self-threat priming than that of the secure high self-esteem group(P＜0.01).Under low self-threat priming,there was no significant difference in RTI values among different types of high self-esteem groups(P＞0.05).Conclusion:Fragile high self-esteem group are more likely to develop attention bias towards aggressive words under high self-threat priming than that of secure high self-esteem group.

Objective:To explore the non-bacterial pathogen distribution, epidemiological characteristics, and clinical features of acute respiratory infections in children in Sichuan Province.Methods:Using a retrospective cohort study method, this study selected hospitalized children diagnosed with acute respiratory infections at West China Second Hospital of Sichuan University from February 2019 to January 2021, and tested 13 pathogens using polymerase chain reaction (PCR)-fragment analysis. The children were divided into infant group (<1 year old), toddler group (1 year old ≤ age <3 years old), preschool group (3 years old ≤ age <6 years old) and school-age group (6 years old ≤ age <18 years old). The distribution of pathogen positive rates, seasonal epidemic characteristics, clinical characteristics, and some laboratory test indicators were analyzed in children. Statistical analysis was performed on the results using SPSS 22.0 software, with count data expressed as percentages and inter group comparisons using SPSS 22.0 software χ2 Inspection. Results:A total of 2 922 pediatric patients were included in this study, with 1 748 (59.8%) positive for pathogens detected. Among them, 1 391 (79.6%) were detected as a single pathogen, and 357 (20.4%) were detected as a mixture of two or more pathogens. The most commonly detected pathogens were rhinovirus (HRV) (39.7%), syncytial virus (RSV) (22.8%), and parainfluenza virus (PIV) (12.5%). Pathogen positivity is more common in children under 6 years old ( χ2=146.59, P<0.001), with a slightly higher positivity rate in male children (61.3%, 1 047/1 707) than in female children (57.7%, 701/1 215) ( χ2=3.91, P=0.048), and compared with pathogen negative children, positive children are more prone to symptoms such as cough, wheezing, and shortness of breath ( χ2=259.15, 366.06, 12.48, P<0.001). The distribution of different pathogens varies among children of different age groups, and HRV is more common in children aged 1-3 and 3-6 years old ( χ2=9.74, P<0.001), while RSV is more common in children under 1 year old ( χ2=178.63, P<0.001), while mycoplasma pneumoniae (MP) and influenza virus (InfA/B) are less common in children under 1 year old ( χ2=92.54, 12.90,22.21, P<0.01). The prevalence of multiple pathogens showed seasonal changes. HRV showed a high prevalence trend in spring and autumn, while the prevalence of RSV infection was mainly seen in autumn and winter festivals. The positive rate of different pathogens after the outbreak of novel coronavirus pneumonia was significantly lower than that before the outbreak ( χ2=252.68, P<0.001). Conclusion:The detection rate of non-bacterial respiratory pathogens in children in Sichuan Province from 2019 to 2021 is high, which is prone to symptoms such as cough, wheezing, and shortness of breath, with HRV and RSV being the main types. The positive rate of respiratory pathogens varies among different age groups, genders, and seasons.

Objective To explore the efficacy and safety of recombinant human anti-severe acute respiratory syn-drome coronavirus 2(anti-SARS-CoV-2)monoclonal antibody injection(F61 injection)in the treatment of patients with coronavirus disease 2019(COVID-19)combined with renal damage.Methods Patients with COVID-19 and renal damage who visited the PLA General Hospital from January to February 2023 were selected.Subjects were randomly divided into two groups.Control group was treated with conventional anti-COVID-19 therapy,while trial group was treated with conventional anti-COVID-19 therapy combined with F61 injection.A 15-day follow-up was conducted after drug administration.Clinical symptoms,laboratory tests,electrocardiogram,and chest CT of pa-tients were performed to analyze the efficacy and safety of F61 injection.Results Twelve subjects(7 in trial group and 5 in control group)were included in study.Neither group had any clinical progression or death cases.The ave-rage time for negative conversion of nucleic acid of SARS-CoV-2 in control group and trial group were 3.2 days and 1.57 days(P=0.046),respectively.The scores of COVID-19 related target symptom in the trial group on the 3rd and 5th day after medication were both lower than those of the control group(both P＜0.05).According to the clinical staging and World Health Organization 10-point graded disease progression scale,both groups of subjects improved but didn't show statistical differences(P＞0.05).For safety,trial group didn't present any infusion-re-lated adverse event.Subjects in both groups demonstrated varying degrees of elevated blood glucose,elevated urine glucose,elevated urobilinogen,positive urine casts,and cardiac arrhythmia,but the differences were not statistica-lly significant(all P＞0.05).Conclusion F61 injection has initially demonstrated safety and clinical benefit in trea-ting patients with COVID-19 combined with renal damage.As the domestically produced drug,it has good clinical accessibility and may provide more options for clinical practice.