Objective:To observe the effectiveness and safety of the application of Wei nasal jet tube(WNJT)in anesthesia induction for patients with extensive facial burns.Methods:A total of 60 patients who underwent multiple systemic scab removal and skin graft-ing surgery in our hospital from July 2021 to July 2023 were enrolled in this study.The patients were 18-60 years of age,with a body mass index of 18-29 kg/m2,ASA II or III,and Mallampati I-III.Using a random number table method,the patients were divided into WNJT ventilation group(W group)and mask ventilation group(M group),with 30 cases in each group.Before anesthesia induction,WNJT was inserted into one side of the nasal cavity for hand controlled normal frequency supraglottic jet ventilation in group W pa-tients,while oxygen ventilation was administered to group M patients through conventional two-hand clasped face masks.After 5 min,tracheal intubation was performed under a visual laryngoscope.The mean amplitude of diaphragm fluctuations,end expiratory carbon dioxide partial pressure(PETCO2),and blood oxygen saturation(SpO2)measured by ultrasound were recorded during spontaneous respi-ration at 5 min of oxygenation and nitrogen removal(T0),as well as at 1 min(T1),2 min(T2),3 min(T3),4 min(T4),and 5 min(T5,im-mediately before intubation)of anesthetic induction.Arterial blood gas(PaO2 and PaCO2)at T0 and T5 were measured.Heart rate(HR)and mean arterial pressure(MAP)were recorded at T0-T5 in both groups of patients.The occurrence of postoperative pharyngeal pain,facial or mandibular angle bleeding,gastrointestinal bloating,and nasal mucosal bleeding were recorded in both groups of pa-tients.Results:At T0,there were no statistically significant differences in mean amplitude of diaphragm fluctuations,HR,MAP,PaO2,PaCO2,PETCO2,and SpO2 between the two groups of patients.At T1-T5,the HR and MAP of patients in the W group were significantly lower than those in the M group(P<0.05).At T5,the PaO2 of patients in the W group was significantly higher than that in the M group,while the PaCO2 and PETCO2 were significantly lower than those in the M group(P<0.05).However,the difference in SpO2 was not sta-tistically significant.The W group had less facial or mandibular angle bleeding and postoperative gastrointestinal bloating than the M group,and the differences were statistically significant(P<0.05).There were no statistically significant differences between the two groups of patients in postoperative pharyngitis and nasal mucosal bleeding(P>0.05).Conclusion:During general anesthesia induction in patients with extensive facial burns,WNJT has the advantages of good ventilation effect,high safety,less complications such as gas-trointestinal bloating and facial or mandibular angle bleeding,and more stable hemodynamics.WNJT has good application prospects in clinical anesthesia.

Objective To investigate the correlation between WT1,BCR-ABL genes and interleukin-6(IL-6),vascular endothelial growth factor(VEGF),plasma protein C(PC),plasma protein S(PS)in patients with myeloproliferative neoplasms(MPN).Methods A total of 54 MPN patients treated in this hospital from January 2021 to January 2024 were selected as the MPN group,and 54 healthy subjects undergoing physical examination during the same period were selected as the control group.The gene relative expression levels of WT1,BCR-ABL and levels of IL-6,VEGF,PC,and PS were detected and compared between the two groups.The correlations between WT1,BCR-ABL gene relative expression levels and IL-6,VEGF,PC,PS levels were analyzed,and the diagnostic efficacy of WT1 and BCR-ABL genes for MPN was evaluated by receiver operat-ing characteristic(ROC)curve.Results Compared with the control group,the gene relative expression levels of WT1,BCR-ABL and the levels of IL-6 and VEGF in the MPN group were higher,while the levels of PC and PS were lower,with statistically significant differences(P<0.05).Pearson correlation analysis showed that WT1 and BCR-ABL gene relative expression levels were positively correlated with IL-6 and VEGF levels,and negatively correlated with PC and PS levels(P<0.05).The combined use of WT1 and BCR-ABL genes has higher diagnostic efficacy for MPN than single indicators,with an area under the curve(AUC)of 0.833 and a sensitivity of 88.69%.Conclusion The relative expression levels of WT1 and BCR-ABL genes are correlated with IL-6,VEGF,PC,and PS levels in MPN patients.The combination of WT1 and BCR-ABL genes can effec-tively diagnose MPN.

Objective To analyze the efficacy of self-formulated Bushen Qianyang Decoction combined with alendronate sodium and vitamin D3 in treating osteoporosis(OP)and to observe its effect on bone metabolism and trimethylamine oxide(TMAO)-nuclear factor κB(NF-κB)/activated T nuclear factor c1(NFATc1)pathway.Methods A total of 102 cases of patients with OP of spleen and kidney yang deficiency type who admitted to Taizhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2021 to January 2023 were randomly divided into an observation group and a western medicine group according to the random number table method,51 cases in each group.The western medicine group was treated with alendronate sodium and vitamin D,and the observation group was treated with self-formulated Bushen Qianyang Decoction on the basis of treatment for the western medicine group,and the course of treatment covered for 12 weeks.The changes of traditional Chinese medicine(TCM)syndrome score,Oswestry Disability Index(ODI)score,pain visual analogue scale(VAS)score,bone metabolism indicators,and levels of TMAO-NF-κB/NFATc1 pathway related factors before and after treatment in the two groups were observed.Moreover,the clinical efficacy and medication safety of the two groups were evaluated.Results(1)After 12 weeks of treatment,the total effective rate of the observation group was 96.08%(49/51),and that of the western medicine group was 78.43%(40/51).The intergroup comparison(tested by chi-square test)showed that the efficacy of the observation group was significantly superior to that of the western medicine group(P<0.01).(2)After treatment,the two groups presented the decreased scores of TCM symptoms such as cold pain in the lower back,soreness and fatigue,shortness of breath and reluctance to talk,vertigo and dizziness when compared with those before treatment(P<0.05),and the decrease of TCM syndrome scores in the observation group was significantly superior to that in the western medicine group(P<0.01).(3)After treatment,the ODI scores and pain VAS scores of patients in the two groups were decreased when compared with those before treatment(P<0.05),and the decrease in the observation group was significantly superior to that in the western medicine group(P<0.01).(4)After treatment,the serum osteocalcium(BGP)level in the two groups of patients was increased when compared with that before treatment(P<0.05),and the serum total procollagen type 1 intact N(amino)-terminal propeptide(PINP)and β-collagen degradation product(β-CTX)levels were decreased when compared with those before treatment(P<0.05),and the increase of the serum BGP level and the decrease of the serum PINP and β-CTX levels in the observation group were significantly superior to those in the western medicine group(P<0.01).(5)After treatment,the levels of serum TMAO,NF-κB,and NFATc1 in the two groups of patients were all decreased when compared with those before treatment(P<0.05),and the decrease of the above indicators in the observation group was significantly superior to that in the western medicine group(P<0.01).(6)The total incidence of adverse reactions in the observation group was 5.88%(3/51)and that in the western medicine group was 9.80%(5/51),and the intergroup comparison showed that the difference was not statistically significant between the two groups(P>0.05).Conclusion Self-formulated Bushen Qianyang Decoction combined with alendronate sodium and vitamin D3 exerts certain efficacy in treating OP patients with spleen and kidney yang deficiency type,which can effectively alleviate the symptoms such as cold pain in the lower back,alleviate the degree of dysfunction,improve bone metabolism,and inhibit the high-expressed TMAO,NF-κB,and NFATc1 in the serum.Moreover,the combined therapy does not cause serious adverse reactions,with high safety.

Objective To construct a nomogram prediction model for major adverse cardiovascular events(MACE)within 1 year after percutaneous coronary intervention(PCI)in elderly patients with acute coronary syndrome(ACS).Methods A retrospective analysis was conducted on 551 patients with diagnosed ACS and undergoing PCI in Department of Cardiovascular Medicine of Air Force Medical Center from 1 January 2020 to 1 April 2022.According to the occurrence of MACE during 1 year of follow-up,they were classified into MACE group(n=176)and non-MACE group(n=375).Risk factors for the occurrence of MACE in elderly ACS patients within 1 year after PCI were analysed using univariate and multivariate logistic regression,a nomogram prediction model was constructed,and the predictive power of the model was assessed using the area under the ROC curve(AUC).Results The MACE group had significantly higher Gensini score,systemic immune-inflammation index,and GRACE score,but obviously lower prognostic nutritional index than the non-MACE group(P＜0.01).Multivariate logistic regression analysis showed that recent smoking(OR=2.222,95％CI:1.361-3.628,P=0.010),hyperlipidaemia(OR=1.881,95％CI:1.145-3.089,P=0.013),prognostic nutritional index(OR=4.645,95％CI:2.788-7.739,P=0.001),LVEF(OR=5.177,95％CI:3.160-8.483,P=0.001),systemic immune-inflammation index(OR=5.396,95％CI:3.179-9.159,P=0.001),and preoperative di-agnosis of non-STEMI(OR=2.829,95％CI:1.356-5.901,P=0.006)or STEMI(OR=3.451,95％CI:1.596-7.463,P=0.002)were independent influencing factors for occurrence of MACE after PCI in elderly ACS patients.ROC curve analysis showed that the AUC value of the nomo-gram model for predicting MACE within 1 year after PCI in elderly ACS patients was 0.888.Con-clusion Our developed nomogram model is simple and practical,and can effectively predict the occurrence of MACE within 1 year after PCI in elderly ACS patients.And external validation should be carried out to ensure its generality.

Objective:To study the predictive role of tumor burden score (TBS) for tumor recurrence after radical resection in patients with hepatocellular carcinoma (HCC).Methods:Clinical data of 202 patients with HCC undergoing radical surgery at the 900th Hospital of Joint Logistics Support Force of the Chinese People's Liberation Army, between January 2015 and December 2017 were retrospectively analyzed, including 128 males and 74 females, aged (53.66±11.93) years old. The receiver operating characteristic (ROC) curve was used to assess the accuracy of TBS in predicting postoperative tumor recurrence. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors influencing postoperative tumor recurrence. A nomogram was established and validated using calibration curves and the C-index. Kaplan-Meier survival analysis was utilized to compare survival differences between the two patient groups.Results:The area under the ROC curve for TBS in predicting postoperative tumor recurrence in HCC patients was 0.779 (95% CI: 0.717-0.842), with an optimal cutoff value of 6.2. Univariate analysis revealed that factors such as hepatitis B virus DNA level >500 IU/ml, larger maximum tumor dia-meter, and TBS>6.2 were significant risk factors for postoperative tumor recurrence (all P<0.05). Multivariate analysis further indicated that TBS>6.2 ( OR=3.60, 95% CI: 1.081-12.012, P=0.037) and maximum tumor diameter ( OR=1.240, 95% CI: 1.034-1.487, P=0.020) were independent risk factors for postoperative recurrence. Based on these risk factors, a nomogram model was established, achieving a C-index of 0.788. Kaplan-Meier survival analysis showed a better postoperative overall survival and recurrence-free survival of the low TBS group compared to those of the high TBS group (all P<0.05). Conclusion:TBS can serve as a predictive indicator for the recurrence after radical resection in patients with HCC. Both TBS and tumor size are independent risk factors for postoperative recurrence. The nomogram model can be used for predicting recurrence following radical resection in HCC patients.

Brucella are a group of small gram-negative bacteria that infect the human body through various transmission routes. They can travel with the blood to various organs and tissues throughout the body, causing bacteremia, toxemia, sepsis, and local infections. Brucellosis is relatively rare in developed countries and more common in developing countries. Although the typical symptoms of brucellosis are easy to identify, some manifestations are not well-known, such as eye involvement in brucellosis patients. Eye inflammation is usually a late manifestation, and Brucella can cause different symptoms in the eyes, leading to misdiagnosis or missed diagnosis. Therefore, it should be considered in differential diagnosis. To further enhance the understanding of eye involvement in patients with brucellosis among healthcare workers, this article provides a review of its pathogenesis, clinical manifestations, auxiliary examinations, diagnosis, and treatment characteristics.

Objective:To investigate the risk factors and prognostic value of the textbook outcome (TO) in patients with advanced gastric cancer (AGC) who underwent neoadjuvant chemotherapy followed by surgical resection.Methods:This is a retrospective cohort study. A total of 253 patients with AGC who underwent neoadjuvant chemotherapy combined with gastrectomy and D2 lymphadenectomy in the Department of Gastric Surgery, Fujian Medical University Union Hospital from January 2010 to December 2019 were retrospectively included. There were 195 males and 58 females, aged (60.3±10.0) years (range: 27 to 75 years). The patients were then divided into the TO group ( n=168) and the non-TO group ( n=85). Multivariate Logistic regression was used to analyze the independent predictors of TO. Univariate and multivariate Cox analysis were used to analyze independent prognosis factors for overall survival (OS) and disease-free survival (DFS). Propensity score matching was performed to balance the TO and non-TO groups, and the Kaplan-Meier method was used to calculate survival rates and draw survival curves. Results:Among the 253 patients, 168 patients (66.4%) achieved TO. The Eastern Cooperative Oncology Group score ( OR=0.488, 95% CI: 0.278 to 0.856, P=0.012) and ypN stage ( OR=0.626, 95% CI:0.488 to 0.805, P<0.01) were independently predictive of TO. Multivariate analysis revealed that TO was an independent risk factor for both OS ( HR=0.662, 95% CI: 0.457 to 0.959, P=0.029) and DFS ( HR=0.687, 95% CI: 0.483 to 0.976, P=0.036). After matching, the 5-year OS rate (42.2% vs. 27.8%) and the 5-year DFS rate (37.5% vs. 27.8%) were significantly higher in the TO group than in the non-TO group (both P<0.05). Furthermore, patients in the non-TO group benefited significantly from postoperative chemotherapy (both P<0.05), but those in the TO group did not (both P>0.05). Conclusion:TO is an independent prognosis factor in patients undergoing neoadjuvant chemotherapy and surgery for AGC and is associated with postoperative chemotherapy benefits.

Objective:To investigate the risk factors and prognostic value of the textbook outcome (TO) in patients with advanced gastric cancer (AGC) who underwent neoadjuvant chemotherapy followed by surgical resection.Methods:This is a retrospective cohort study. A total of 253 patients with AGC who underwent neoadjuvant chemotherapy combined with gastrectomy and D2 lymphadenectomy in the Department of Gastric Surgery, Fujian Medical University Union Hospital from January 2010 to December 2019 were retrospectively included. There were 195 males and 58 females, aged (60.3±10.0) years (range: 27 to 75 years). The patients were then divided into the TO group ( n=168) and the non-TO group ( n=85). Multivariate Logistic regression was used to analyze the independent predictors of TO. Univariate and multivariate Cox analysis were used to analyze independent prognosis factors for overall survival (OS) and disease-free survival (DFS). Propensity score matching was performed to balance the TO and non-TO groups, and the Kaplan-Meier method was used to calculate survival rates and draw survival curves. Results:Among the 253 patients, 168 patients (66.4%) achieved TO. The Eastern Cooperative Oncology Group score ( OR=0.488, 95% CI: 0.278 to 0.856, P=0.012) and ypN stage ( OR=0.626, 95% CI:0.488 to 0.805, P<0.01) were independently predictive of TO. Multivariate analysis revealed that TO was an independent risk factor for both OS ( HR=0.662, 95% CI: 0.457 to 0.959, P=0.029) and DFS ( HR=0.687, 95% CI: 0.483 to 0.976, P=0.036). After matching, the 5-year OS rate (42.2% vs. 27.8%) and the 5-year DFS rate (37.5% vs. 27.8%) were significantly higher in the TO group than in the non-TO group (both P<0.05). Furthermore, patients in the non-TO group benefited significantly from postoperative chemotherapy (both P<0.05), but those in the TO group did not (both P>0.05). Conclusion:TO is an independent prognosis factor in patients undergoing neoadjuvant chemotherapy and surgery for AGC and is associated with postoperative chemotherapy benefits.

Objective To explore the application value of test bolus combined with a high-flow rate injection scheme in improving the quality of thyroid CT enhancement images.Methods A total of 126 patients who underwent thyroid plain scan and enhanced CT were selected.Among them,63 underwent conventional examination methods(control group),while the remaining 63 patients received test bolus and high-flow rate injection scheme(experimental group).Objective evaluation included the signal-to-noise ratio(SNR),contrast-to-noise ratio(CNR),thyroid enhancement rate,thyroid parenchyma-cancer difference,artifact index(AI)of the two groups of arterial phase images,thyroid enhancement rate of the two groups of venous phase images,and contrast agent dose of the two groups were all compared.Statistical analysis was performed via independent sample t-test or Mann-Whitney U test.Subjective evaluation included the evaluation of thyroid display in two groups of arterial phase images was conducted via the 4-point method,followed by the implementation of the Mann-Whitney U test.Results The SNR,CNR,thyroid enhancement rate,thyroid parenchyma-cancer difference,and AI in the arterial phase images of the experimental group were all significantly superior to those of the control group(P＜0.05).There was no statistically significant difference in the thyroid enhancement rate in the venous phase between control group and experimental group(P＞0.05);The contrast agent dose of the experimental group was significantly lower than that of the control group(P＜0.01).The thyroid display score observed in the arterial phase images of the experimental group was significantly higher than that of the control group(P＜0.01).Conclusion Using a test bolus combined with a high-flow rate injection scheme can significantly improve the image quality of thyroid CT enhancement.

Clinical cases of necrotizing fasciitis and complete urethral defects in the scrotal region are rare. The diagnosis and treatment are very challenging. This article reports one case. The patient was admitted to the hospital after 1 week of poor urination and 2 days of scrotal swelling, and then underwent bladder diversion, surgical debridement, vacuum-sealing drainage, and wound closure. After four weeks, the wound healed and the patient was discharged. Six months later after surgery, scrotal urethral reconstruction was performed using a circular phimosis pedicled skin flap graft to repair the 12 cm urethral defect. The urethral catheter was removed after three weeks. The bladder fistula tube was removed after 5 weeks. During the follow-up of one year, there was no occurrence of urinary fistula and urinary obstruction.