Objective To explore the influencing factors of urinary dysfunction in patients with rectal cancer after laparoscopic surgery,and to construct and validate a column chart prediction model.Methods A retrospective analysis was conducted on the clinical data of 415 rectal cancer patients in our hospital from January 2021 to April 2024.According to the computer-generated allocation order,they were stochastically grouped into a modeling group of 311 cases and a validation group of 104 cases in a 3∶1 ratio.The modeling group was further separated into a urinary dysfunction group of 55 cases and a non urinary dysfunction group of 256 cases.The patient's sex,diabetes history,tumor diameter and other relevant data were collected;MultivariateLogisticregression analysis was used to screen for risk factors;R software was used to construct a column chart prediction model for predicting urinary dysfunction in patients with colorectal cancer after laparoscopic surgery;The Hosmer-Lemeshow test,ROC curve,calibration curve,and DCA curve were used to validate the predictive performance of the column chart model.Results Male[OR(95％CI)=3.512(1.637～7.533),P=0.001],diabetes[OR(95％CI)=3.684(1.639～8.280),P=0.002],tumor diameter ≥ 5 cm[OR(95％CI)=4.459(1.993～9.979),P=0.000],large intraoperative bleeding[OR(95％CI)=1.018(1.011～1.026),P=0.000],anterior resection of rectum combined with abdominal perineum resection[OR(95％CI)=3.885(1.901～7.940),P=0.000]were Independent risk factors for postoperative urination dysfunction in rectal cancer patients after laparoscopic surgery.In internal and external validations,the Hosmer-Lemeshau test for the column chart model showed x2=0.159,P=0.254＞0.05,and x2=5.991,P=0.648＞0.05.The areas under the receiver operating characteristic curve were 0.846 and 0.828,respectively.The calibration curve indicated that the simulated curve had a similar trend to the actual curve,indicating good discrimination and calibration of the column chart prediction model.Clinical decision curve analysis results showed that when the high-risk threshold probability was between 0.05 and 0.98,the column chart prediction model could produce better clinical benefits.Conclusion The column chart model constructed by integrating independent risk factors for urinary dysfunction in rectal cancer patients after laparoscopic surgery has high predictive value.

Objective To explore the influencing factors of urinary dysfunction in patients with rectal cancer after laparoscopic surgery,and to construct and validate a column chart prediction model.Methods A retrospective analysis was conducted on the clinical data of 415 rectal cancer patients in our hospital from January 2021 to April 2024.According to the computer-generated allocation order,they were stochastically grouped into a modeling group of 311 cases and a validation group of 104 cases in a 3∶1 ratio.The modeling group was further separated into a urinary dysfunction group of 55 cases and a non urinary dysfunction group of 256 cases.The patient's sex,diabetes history,tumor diameter and other relevant data were collected;MultivariateLogisticregression analysis was used to screen for risk factors;R software was used to construct a column chart prediction model for predicting urinary dysfunction in patients with colorectal cancer after laparoscopic surgery;The Hosmer-Lemeshow test,ROC curve,calibration curve,and DCA curve were used to validate the predictive performance of the column chart model.Results Male[OR(95％CI)=3.512(1.637～7.533),P=0.001],diabetes[OR(95％CI)=3.684(1.639～8.280),P=0.002],tumor diameter ≥ 5 cm[OR(95％CI)=4.459(1.993～9.979),P=0.000],large intraoperative bleeding[OR(95％CI)=1.018(1.011～1.026),P=0.000],anterior resection of rectum combined with abdominal perineum resection[OR(95％CI)=3.885(1.901～7.940),P=0.000]were Independent risk factors for postoperative urination dysfunction in rectal cancer patients after laparoscopic surgery.In internal and external validations,the Hosmer-Lemeshau test for the column chart model showed x2=0.159,P=0.254＞0.05,and x2=5.991,P=0.648＞0.05.The areas under the receiver operating characteristic curve were 0.846 and 0.828,respectively.The calibration curve indicated that the simulated curve had a similar trend to the actual curve,indicating good discrimination and calibration of the column chart prediction model.Clinical decision curve analysis results showed that when the high-risk threshold probability was between 0.05 and 0.98,the column chart prediction model could produce better clinical benefits.Conclusion The column chart model constructed by integrating independent risk factors for urinary dysfunction in rectal cancer patients after laparoscopic surgery has high predictive value.

Objective To study the effects of intramedullary pressure on the fluid flow behavior in bones.Methods Multi-scale models of macro bone tissue and macro-meso osteon groups were established using the COMSOL Multiphysics software.Considering the interrelationship of different pore scales,such as the bone marrow cavity,Haversia canal,and bone lacunar-canaliculus,the pore pressure and flow rate of hollow bone tissues and bone tissues with intramedullary pressure were compared,and the effects of the amplitude and frequency of intramedullary pressure on the pressure and flow velocity of the liquid in the bone were analyzed.Results When intramedullary pressure was considered,the pore pressure in bone tissues with intramedullary pressure was 6.4 kPa higher than that in hollow bone tissues.The flow pressure increased significantly with an increase in the intramedullary pressure amplitude,but the flow velocity remained unchanged.The frequency of intramedullary pressure had little effect on pore pressure and flow velocity.Conclusions The multi-scale pore model established in this study can accurately analyze bone fluid flow behavior.These results are of great significance for an in-depth understanding of force conduction in the bone.

Objective : To establish myeloid ( including macrophage and granulocyte) specific knockout mice of mammalian sterile line 20-like kinase 1 (MST1) gene for furtherinvestigating the role and the mechanism of MST1 in macrophages in related clinical diseases． Methods : Mst1flox/flox LysM-Cre ( referred to as Mst1ΔM/ΔM hereafter) mice were generated by crossing Mst1flox/floxwith lysozyme (Lysm-Cre) mice．The loxP site and Cre gene were amplified by PCR for genotyping．The knockdown efficiency of MST1 in macrophages was verified by quantitative PCR and immunofluorescence．The main immune cell populations in the livers were detected by flow cytometry. Results: Mst1flox/flox LysM-Cre (Mst1ΔM/ΔM ) was the genotype of macrophage specific knockout MST1 mice．The results of qPCR and immunofluorescence showed that the knock-out efficiency of MST1 was more than 70% in bone marrow- derived macrophages and peritoneal macrophages．Flow cytometry showed that macrophage knockout of MST1 had no significant effect on the main immune cell populations in the liver of mice． Conclusion Macrophage-specific knockout of MST1 mouse model is successfully established，which lays a foundation for further investigation on the role and mechanism of macrophage MST1 in clinical related disease.

ObjectiveTo investigate effect of conducting training of autism spectrum disorder （ASD） early screening skill on improving the ability to early identify ASD of medical staffs in primary care hospitals. MethodsIn September 2021， the training of ASD early screening skills was carried out for medical staffs from 20 primary care hospitals in Chengdu. After training， the training effect was evaluated. The numbers of referrals from primary care hospitals to superior hospitals， confirmed ASD as well as their average diagnostic age of children with ASD before and after training were used as evaluation indicators. ResultsAfter training， the number of children with suspected ASD referred by primary care hospitals was more than that before training ［（16.65±11.60） vs. （3.40±2.23）， t=5.431， P<0.01］， the number of children diagnosed with ASD was more than that before training［（6.85±4.93） vs. （2.45±1.67）， t=4.171， P<0.01］， and the differences were statistically significant. As for the diagnosed age of ASD children， after training， the average age was lower than that before training ［（34.95±11.67） vs. （42.2±14.64）， t=-2.553， P=0.019］. ConclusionTraining of ASD early screening skills for medical staffs in primary care hospitals may help to improve their ability to early screening ASD children.

BACKGROUND: Perioperative treatment has become an increasingly important aspect of the management of patients with non-small cell lung cancer (NSCLC). Small-scale clinical studies performed in recent years have shown improvements in the major pathological remission rate after neoadjuvant therapy, suggesting that it will soon become an important part of NSCLC treatment. Nevertheless, neoadjuvant immunotherapy may be accompanied by serious adverse reactions that lead to delay or cancelation of surgery, additional illness, and even death, and have therefore attracted much attention. The purpose of the clinical recommendations is to form a diagnosis and treatment plan suitable for the current domestic medical situation for the immune-related adverse event (irAE). METHODS: This recommendation is composed of experts in thoracic surgery, oncologists, thoracic medicine and irAE related departments (gastroenterology, respirology, cardiology, infectious medicine, hematology, endocrinology, rheumatology, neurology, dermatology, emergency section) to jointly complete the formulation. Experts make full reference to the irAE guidelines, large-scale clinical research data published by thoracic surgery, and the clinical experience of domestic doctors and publicly published cases, and repeated discussions in multiple disciplines to form this recommendation for perioperative irAE. RESULTS: This clinical recommendation covers the whole process of prevention, evaluation, examination, treatment and monitoring related to irAE, so as to guide the clinical work comprehensively and effectively. CONCLUSIONS Perioperative irAE management is an important part of immune perioperative treatment of lung cancer. With the continuous development of immune perioperative treatment, more research is needed in the future to optimize the diagnosis and treatment of perioperative irAE.

Objective:To summarize survival outcomes and prognostic factors in esophageal cancer (EC) patients treated with intensity-modulated radiotherapy (IMRT).Methods:A retrospective analysis was performed on the clinical and follow-up data of 1 637 patients with EC who were admitted to our hospital from January 2005 to December 2017 and met the inclusion criteria.The 5-year overall survival (OS), progression-free survival (PFS) and pattern of recurrence were analyzed. The Kaplan-Meier method was used to calculate survival rates, Log-rank test for univariate analysis and Cox method for multivariate analysis were used to detect survival difference.Results:1-year, 3-year and 5-year OS and PFS of the entire group were 65.9% and 45.8%, 34.2% and 25.0%, 27.0% and 18.5%, respectively. Median OS and PFS were 19.4 months (95% CI=18.0-20.7 months) and 10.4 months (95% CI=9.3-11.3 months), respectively. Univariate analysis showed that the sex, KPS, tumor location, T stage, N stage, M stage, TNM stage, radiation dose and treatment modality were prognostic factors for 5-year OS and PFS of EC patients ( P<0.05). Multivariate analysis indicated that the sex, KPS, TNM stage, radiation dose and treatment modality were independent prognostic factors for 5-year OS and PFS ( P<0.05). Conclusions:EC patients treated with IMRT can obtain a promising survival. The sex, KPS, TNM stage, radiation dose and treatment modality are independent prognostic factors for prognosis.

Objective:To summarize survival outcomes and prognostic factors in esophageal cancer (EC) patients treated with intensity-modulated radiotherapy (IMRT).Methods:A retrospective analysis was performed on the clinical and follow-up data of 1 637 patients with EC who were admitted to our hospital from January 2005 to December 2017 and met the inclusion criteria.The 5-year overall survival (OS), progression-free survival (PFS) and pattern of recurrence were analyzed. The Kaplan-Meier method was used to calculate survival rates, Log-rank test for univariate analysis and Cox method for multivariate analysis were used to detect survival difference.Results:1-year, 3-year and 5-year OS and PFS of the entire group were 65.9% and 45.8%, 34.2% and 25.0%, 27.0% and 18.5%, respectively. Median OS and PFS were 19.4 months (95% CI=18.0-20.7 months) and 10.4 months (95% CI=9.3-11.3 months), respectively. Univariate analysis showed that the sex, KPS, tumor location, T stage, N stage, M stage, TNM stage, radiation dose and treatment modality were prognostic factors for 5-year OS and PFS of EC patients ( P<0.05). Multivariate analysis indicated that the sex, KPS, TNM stage, radiation dose and treatment modality were independent prognostic factors for 5-year OS and PFS ( P<0.05). Conclusions:EC patients treated with IMRT can obtain a promising survival. The sex, KPS, TNM stage, radiation dose and treatment modality are independent prognostic factors for prognosis.

Objective:To identify the risk factors of non-sentinel lymph node (nSLN) metastasis in breast cancer patients with 1~2 positive axillary sentinel lymph node (SLN) and construct an accurate prediction model.Methods:Retrospective chart review was performed in 917 breast cancer patients who underwent surgery treatment between 2002 and 2017 and pathologically confirmed 1-2 positive SLNs. According to the date of surgery, patients were divided into training group (497 cases) and validation group (420 cases). A nomogram was built to predict nSLN metastasis and the accuracy of the model was validated.Results:Among the 917 patients, 251 (27.4%) had nSLN metastasis. Univariate analysis showed tumor grade, lymphovascular invasion (LVI), extra-capsular extension (ECE), the number of positive and negative SLN and macro-metastasis of SLN were associated with nSLN metastasis (all P<0.05). Multivariate Logistic regression analysis showed the numbers of positive SLN, negative SLN and macro-metastasis of SLN were independent predictors of nSLN metastasis (all P<0.05). A nomogram was constructed based on the 6 factors. The area under the receiver operating characteristic curve was 0.718 for the training group and 0.742 for the validation group. Conclusion:We have developed a nomogram that uses 6 risk factors commonly available to accurately estimate the likelihood of nSLN metastasis for individual patient, which might be helpful for radiation oncologists to make a decision on regional nodal irradiation.

Glioblastoma (GBM) is one of the most common tumors of the central nervous system, which is the most lethal brain cancer. GBM treatment is based primarily on surgical resection, combined with radiotherapy and chemotherapy. Despite the positive treatment, progression free survival and overall survival were not significantly prolonged because GBM almost always recurs. We are always looking forward to some new and effective treatments. In recent years, a novel treatment method called tumor treating fields (TTFields) for cancer treatment has been proposed. TTFields devices were approved by the Food and Drug Administration (FDA) for adjuvant treatment of recurrent and newly diagnosed GBMs in 2011 and 2015, respectively. This became the first breakthrough treatment for GBM in the past 10 years after the FDA approved bevacizumab for patients with relapsed GBM in 2009. This paper summarized the research results of TTFields in recent years and elaborated the mechanism of action of TTFields on GBM, including cell and animal experimental research, clinical application and social benefits.