ObjectiveTo investigate the incidence and trends of thyroid cancer in Wujiang District, Suzhou City, Jiangsu Province, from 2008 to 2022, and to provide a scientific evidence for the prevention and control of thyroid cancer. MethodsData on thyroid cancer incidence from 2008 to 2022 were collected from the Wujiang District Cancer Registry System. The data were stratified by year of diagnosis and age group, and indicators such as crude incidence rate, standardized incidence rate (SIR), age-specific incidence rate, and the average annual percentage change (AAPC) were calculated. ResultsBetween 2008 and 2022, a total of 2 244 new cases of thyroid cancer reported in Wujiang District. The overall crude incidence rate was 18.07/100 000, and the SIR was 16.02/100 000, with AAPCs of 28.30% and 30.59%, respectively. Among males, 543 new cases were reported, with a crude incidence rate of 8.88/100 000, a SIR of 7.98/100 000, and AAPCs of 24.99% and 28.19%, respectively. Among females, 1 701 new cases were reported, with a crude incidence rate of 27.00/100 000, a SIR of 23.80/100 000, and AAPCs of 30.06% and 31.97%, respectively. Both crude and standardized incidence rates increased significantly for the overall population as well as for males and females (P<0.05). The number and rates of age-specific incidences increased with age up to 55 years, peaking between 50 and <55 years. ConclusionThe incidence rate of thyroid cancer in Wujiang District is rapidly increasing. It is necessary to strengthen the prevention and control of thyroid cancer, especially among females, to mitigate the rapid increase in the incidence rate of thyroid cancer.

Although epilepsy is first known as a disease of seizures and convulsions, most patients with epilepsy also suffer from seizure-associated behavioral abnormalities in motor functions, psychiatric status, and cognition. These neurobehavioral comorbidities may have greater impacts on the quality of life of people with epilepsy than the seizures themselves and can profoundly interfere with the treatment compliance. While repeated seizures often lead to behavioral comorbidities, certain types of comorbid conditions may potentially increase the risk for epileptic seizures, indicative of some common mechanisms that might underlie these two conditions. As such, emerging evidence supports that inflammation within the brain might represent a key component of such a shared mechanism, given that neuroinflammation can be induced by seizures and various behavioral stressors, and in turn may exacerbate both conditions. Among inflammatory pathways that arise after prolonged seizures, PGE₂ signaling via the EP2 receptor promotes cytokine induction, blood-brain barrier disruption, reactive gliosis, neuronal death, and eventually, contributes to behavioral dysfunctions. Pharmacological inhibition of EP2 by small-molecule drug-like antagonists affords broad therapeutic benefits including anti-inflammatory and neuroprotective effects in several rodent seizure models, leading to long-lasting alleviation of neurobehavioral comorbidities, particularly cognitive impairments. Targeting this key inflammatory prostaglandin receptor might provide an adjunctive strategy, along with the current anti-seizure medications, to mitigate cognitive dysfunctions associated with seizure disorders.

Objective To analyze the epidemiological characteristics of population-based cohort of patients with the comorbidity of cardiovascular and cerebrovascular diseases and type 2 diabetes in Lingnan area,and to study the related influencing factors in the onset and progression of the disease. Methods A retrospective cohort study was used to collect data from people who underwent physical examination in the Eleventh People's Hospital of Guangzhou from May 2022 to December 2023. Data mainly included questionnaire surveys,physical examinations,and laboratory testing indicators. The 2022 was defined as the baseline to statistically analyze the occurrence and development of the comorbidity of cardiovascular and cerebrovascular diseases and type 2 diabetes in this population,and to analyze the related influencing factors of comorbidity and distribution of traditional Chinese medicine constitution in comorbidity population. Results Finally,a total of 26498 subjects were included,from which there were 359 patients with the comorbidity of cardiovascular and cerebrovascular diseases and type 2 diabetes (comorbidity group),accounting for 1.4％ of the total. Among them,290 were male,accounting for 80.8％,which is much higher than female. The mean age was(61.6±9.5)years old,which was significantly higher than that of the non-comorbidity group. The cases of comorbidity group were mainly concentrated in the age group of 45-75 years old,and no cases were found in people under 35 years old. There were 293 patients with the comorbidity of ischemic cardiovascular disease and type 2 diabetes,whose proportion (81.6％) is much higher than that of other types. Significant differences between comorbidity group and non-comorbidity group were found in terms of gender,age,age distribution,height,body mass,body mass index (BMI),smoking,alcohol consumption,marital status,exercise,and dampness syndrome (P<0.05). About 1.0％ of population at the baselined converted from non-comorbidities or single disease to comorbidities. The proportion of newly diagnosed patients with the comorbidity of ischemic cardiovascular disease and type 2 diabetes is the highest,up to 68.9％. BMI overweight or obesity,large waist circumference,smoking,dampness syndrome and exercise were the risk factors affecting the comorbidity of cardiovascular and cerebrovascular diseases and type 2 diabetes. A total of 264 cases of comorbidity group had finished evaluation of traditional Chinese medicine body constitutions. The proportion of balanced constitution was the highest (31.1％),followed by dampness-heat constitution (18.2％),yang-deficiency constitution (13.3％) and phlegm-dampness constitution (11.7％). Conclusion The incidence of the comorbidity of cardiovascular and cerebrovascular diseases and type 2 diabetes is high in Lingnan area,which may be related to dampness constitution,BMI overweight or obesity,large waist circumference,smoking,dampness syndrome and lack of exercise.

Objective:To investigate the value of intratumoral and peritumoral radiomics models based on 18F-FDG PET-CT in predicting epidermal growth factor receptor (EGFR) mutation status in lung adenocarcinoma and interpret peritumoral radiomics features. Methods:This study was a cross-sectional study. Patients with lung adenocarcinoma who underwent 18F-FDG PET-CT at the Third Affiliated Hospital of Soochow University between January 2018 and April 2022 were retrospectively collected and samplied into a training set (309 cases) and a test set (206 cases) in a 6∶4 ratio randomly. Radiomics features were extracted from the intratumoral and peritumoral regions of interest based on PET and CT images, respectively, and the optimal feature sets were selected. Radiomics models were established using the XGBoost algorithm, and radiomics scores (intratumoral CT label, peritumoral CT label, intratumoral PET label, peritumoral PET label) were calculated. Logistic regression analysis was used to construct a clinical model and a combined model (incorporating PET-CT intratumoral and peritumoral radiomics, clinical features, and CT semantic features). The predictive performance of the models was evaluated using receiver operating characteristic curves and the area under the curve (AUC). Unsupervised clustering, Spearman correlation analysis, and visualization methods were used for the interpretability of peritumoral radiomics features. Results:In both the training and test sets, the AUC value of CT peritumoral labels was greater than that of CT intratumoral labels for predicting EGFR mutation status in lung adenocarcinoma (training set: Z=3.84, P<0.001; test set: Z=1.99, P=0.046). In the test set, the AUC value of PET intratumoral labels (0.684) was slightly higher than that of PET peritumoral labels (0.672) for predicting EGFR mutation status, but the difference was not statistically significant ( P>0.05). The combined model had the highest AUC value for predicting EGFR mutation status of lung adenocarcinoma in both the training and test sets and was significantly better than the clinical model (training set: Z=6.52, P<0.001; test set: Z=2.31, P=0.021). Interpretability analysis revealed that CT peritumoral radiomics features were correlated with CT shape features, and there were significant differences in CT peritumoral features between different EGFR mutation statuses. Conclusions:The value of CT peritumoral labels is superior to that of CT intratumoral labels in predicting EGFR mutation status in lung adenocarcinoma. The predictive performance of the model can be improved by combining PET-CT intratumoral and peritumoral radiomics, clinical features, and CT semantic features.

Objective:To investigate the clinical efficacy of humidified high flow nasal cannula oxygen inhalation (HFNC) versus conventional nasal cannula oxygen inhalation on hypoxemia after complex ventral hernia surgery in elderly patients.Methods:The retrospective cohort study was conducted. The clinical data of 80 elderly patients with hypoxemia after complex ventral hernia surgery who were admitted to Huadong Hospital Affiliated to Fudan University from January 2021 to June 2022 were collected. There were 44 males and 36 females, aged (74±7)years. Of the 80 patients, 40 cases undergoing HFNC were allocated into HFNC group, and 40 cases undergoing conventional nasal cannula oxygen inhalation were allocated into conventional group, respectively. Observation indicators: (1) postoperative blood gas analysis; (2) postoperative complications. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the rank sum test. Count data were represented as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Repeated measurement data were analyzed using the repeated ANOVA. Results:(1) Postoperative blood gas analysis. Before surgery and at 12 hours, 24 hours, 3 days after surgery, the partial pressure of blood oxygen was (13.5±2.3)kPa, (13.4±3.2)kPa, (13.8±2.3)kPa, (13.7±2.0)kPa for the HFNC group, and (12.7±2.1)kPa, (12.9±2.4)kPa, (12.3±2.5)kPa, (13.9±2.1) kPa for the conventional group. The partial pressure of carbon dioxide was (5.6±0.7)kPa, (5.0±0.6)kPa, (4.7±0.6)kPa, (4.9±0.6)kPa for the HFNC group, and (5.6±0.6)kPa, (4.4±0.8)kPa, (5.0±4.8)kPa, (5.1±1.1)kPa for the conventional group. The saturation of blood oxygen was 97.8%±2.2%, 98.1%±2.1%, 98.9%±1.8%, 99.2%±2.0% for the HFNC group, and 97.8%±3.1%, 97.8%±2.1%, 99.0%±1.5%, 98.8%±2.0% for the conventional group. The oxygenation index was 259±28, 300±45, 352±46, 353±57 for the HFNC group, and 262±29, 297±54, 304±63, 345±53 for the conventional group, respectively. There was a significant difference in the interven-tion effect of partial pressure of blood oxygen between the two groups ( Fgroup=4.09, P<0.05) and no significant difference in the time effect or interaction effect ( Ftime=2.37, Finteraction=1.71, P>0.05). There were significant differences in the time effect and interaction effect of partial pressure of carbon dioxide between the two groups ( Ftime=7.23, Finteraction=13.21, P<0.05) and no significant difference in the intervention effect ( Fgroup=1.02, P>0.05). There was a significant difference in the time effect of saturation of blood oxygen between the two groups ( Ftime=5.54, P<0.05) and no significant difference in the intervention effect or interaction effect ( Fgroup=1.78, Finteraction=0.46, P>0.05). There were signifi-cant differences in the intervention effect, time effect, interaction effect of oxygenation index between the two groups ( Fgroup=8.21, Ftime=42.07, Finteraction=3.49, P<0.05). (2) Postoperative complications. The time in intensive care unit and cases with pulmonary infection were 3(3,3)days and 3 for the HFNC group, versus 6(5,7)days and 10 for the conventional group, showing significant differences between the two groups ( Z=27.50, χ2=4.50, P<0.05). Cases with atelectasis and endotrachead intubation were 0 and 1 for the HFNC group, versus 4 and 7 for the conventional group, showing no significant difference between the two groups ( P>0.05). There was no death in either group. Conclusion:Humidified high flow oxygen inhalation has certain advantages over conventional nasal cannula oxygen inhalation in improving partial pressure of blood oxygen and oxygenation index after complex ventral hernia surgery in elderly patients.

Objective To establish a prognosis prediction scale for aspirin combined with clopidogrel in treatment of acute cerebral infarction (ACI) and evaluate its prediction effectiveness. MethodsA retrospective analysis of clinical features of 202 ACI patients, admitted to and accepted aspirin combined with clopidogrel in our hospital from October 2017 to April 2019, was performed. According to the differences of National Institutes of Health Stroke Scale (NIHSS) scores before and after treatment, the patients were divided into good prognosis group and poor prognosis group; univariate and multivariate Logistic regression analyses were used to screen the independent risk factors for prognoses of acute cerebral infarction; assignment of these factors was performed, respectively, to establish prediction scale; and finally the prediction scale was applied to the patients for verification.ResultsOf the 202 patients, 167 had a good prognosis and 35 had a poor prognosis. Multivariate Logistic regression analysis revealed that age≥50 years, hypertension, homocysteine, and carotid stenosis≥50％ were independent risk factors for prognoses 14 d after onset in patients with ACI (P< 0.05); the assigned values of age≥50 years, hypertension grading I, hypertension grading II, hypertension grading III, homocysteine, and 中华神经医学杂志2019年11月第18卷第11期Chin J Neuromed, November 2019, Vol.18, No.11 carotid stenosis≥50％ were 1, 1, 2, 3, 1, and 1, respectively; the total pridiction scale scores were 0-6. Validation results showed that the poor prognosis rate of patients with predictive scale scores≥3 was 91.3％ (157/172) and that of patients with predictive scale scores<3 was 33.3％ (10/30).Conclusion The predictive scale established in this study can be used to quickly and accurately identify patients with acute cerebral infarction who are suitable for aspirin combined with clopidogrel.

Objective To find out the display rules of the key part of the proximal femur and fracture line and obtain the best viewing position and angle by placing the femoral neck at different positions and different angles through X-ray.Methods Six dry specimens of cadaveric femur were from Department of Anatomy,Tianjin Medical University.Three models of complete femoral neck model,tin line fracture model and steel saw fracture model were made respectively.The tin line fracture model was based on the Pauwells angle,using the tin wire(1mm) wrapped around the femoral necks to make three kinds of fracture models (Pauwells angle 30°,50° and 70°);steel saw fracture model was made by hacksaw,then reposition in situ,to make three kinds of fracture models same as the tin line fracture model.The projection manner included different positions and different angles,different projection positions include:parallel with the femoral shaft,perpendicular to the femoral shaft,parallel to the femoral neck and perpendicular to the femoral neck;different projection angles included:from 40°,30°,20°,15°,10° and 5° in the head side to 5°,10°,15 °,20 °,30 °and 40° in the foot side and vertical angle 0°.For the complete femoral neck model,we observed the imaging characteristics of the key parts of the femoral head and neck (tension trabecular bone and pressure trabecular bone;lesser trochanter;intertrochanteric line;length of neck of femur and femoral head shape),looking for the display rules,and obtained the best viewing position.For tin line fracture model and steel saw fracture model,we tried to find the best display angle and position by the different projection position and angle.Results The results of complete femoral neck model:Lesser trochanter:in perpendicular to the femoral shaft position showed the best,gradually increased with the foot side deflection;tension trabecular bone and pressure trabecular bone:in parallel with the femoral shaft position 10°on the head side;intertrochanteric line:no difference between parallel with the femoral shaft with perpendicular to the femoral shaft;Femoral neck shape:deflect to both sides,head of femur was out of shape.The results of tin line fracture model:the Pauwells angle 30° model showed the best position in parallel with the femoral shaft position 20° on the head side;the Pauwells angle 50° model showed the best position in parallel with the femoral shaft position 5° on the head side;the Pauwells angle 70° model showed the best position in parallel with the femoral shaft position 10° on the head side.The results of steel saw fracture model were the same with the tin line fracture model.Conclusion There was the best viewing angles and positions for the key anatomy of the proximal femur and different Pauwells angle classification of femoral neck fracture.The image doctor could make more accurate projection,according to the different types of femoral neck fracture.

Objective To study the feasibility,safety,indications and possible advantages of minimally invasive surgery over traditional open surgery in treating pancreatic body or tail lesions.Methods From December 2009 to December 2014,the clinical data of 71 patients with lesions in pancreatic body or tail who underwent minimally invasive distal pancreatectomy (MIDP) or open distal pancreatectomy (ODP) at the General Surgery of Huadong Hospital were retrospectively analyzed.There were 22 patients in the MIDP group and 49 patients in the ODP group.The operations in 15 patients in the MIDP group were performed by the Da Vinci robot-assisted surgical system and 7 patients by laparoscopic distal pancreatectomy.Results The MIDP group had a shorter time to pass first flatus [(MIDP (2.5 ± 1.0) d vs ODP (3.5 ±1.0)d,P ＜ 0.05],and shorter postoperative hospital stay [(MIDP (15.2 ± 7.9) d vs ODP (23.4 ±21.2) d,P ＜ 0.05] than the ODP group.There were no significant differences on total pancreatic fistula rate [MIDP 45.5％ (10/22) vs ODP 55.1％ (27/49),P ＞ 0.05] and symptomatic postoperative pancreatic fistula rate [MIDP 18.2％ (4/22) vs ODP 18.4％ (9/49),P ＞ 0.05] between the two groups.The MIDP group had a significant longer operative time [MIDP (246.3 ±75.3)min vs ODP (168.1 ±33.7)min,P＜0.05] than the ODP group.Conclusions Minimally invasive surgery is safe and feasible in treatment of lesions in pancreatic body or tail with less trauma and faster recovery.The application of robotic surgery has expanded the treatment options for lesions in pancreatic body or tail.

Objective To investigate the efficacy of platelet-rich plasma and hyaluronic acid intra-articular injection in patients with knee osteoarthritis. Method The following databases, including PubMed, Embase, the Cochrane Library and WANFANG, were used for collecting the randomized controlled trials, prospective control trials and experimental research about the therapy efficacies of platelet-rich plasma and hyaluronic acid on knee osteoarthritis. The meta-analysis was performed using RevMan 5.3 for Windows. Results Eleven publications, including six RCTs, one PCT and four ER, met the inclusion criteria. There were significant differences in WOMAC scores and IKDC scores between the PRP group and the HA group. but no significant differences were observed in Lequesne index between the PRP group and the HA groups at six month post treatment. Conclusion PRP intra-articular injection was better and more durable than HA in the treatment of knee osteoarthritis.