Objective: To investigate the factors affecting carotid plaques among perimenopausal women, so as to provide the basis for the prevention and early intervention of cardiovascular diseases in perimenopausal women. Methods: Perimenopausal women aged 40-60 who underwent health check-ups at Xingtai People's Hospital from January 2022 to January 2023 were selected as subjects by convenient sampling method. Demographic information, lifestyle, waist-to-hip ratio, and blood biochemical indicators were collected through questionnaire surveys, physical examinations, and laboratory tests. Carotid plaques were detected using a Doppler ultrasound diagnostic instrument. Factors affecting carotid plaques among perimenopausal women were identified using a multivariable logistic regression model. Results: Totally 2 146 perimenopausal women were surveyed, with an age of (50.04±5.82) years. Carotid plaques were detected in 525 cases, with a detection rate of 24.46%. Multivariable logistic regression analysis showed that older age (45-<50 years old, OR=1.474, 95%CI: 1.062-2.047; 55-60 years old, OR=1.779, 95%CI: 1.276-2.481), residing in urban areas (OR=1.601, 95%CI: 1.079-2.376), drinking (OR=1.805, 95%CI: 1.108-2.941), hypertension (OR=1.815, 95%CI: 1.290-2.553), abnormal waist-to-hip ratio (OR=2.479, 95%CI: 1.982-3.101), and abnormal atherogenic index of plasma (OR=1.325, 95%CI: 1.064-1.650) were associated with a higher risk of carotid plaques. College degree or above (college, OR=0.659, 95%CI: 0.502-0.865; bachelor's degree or above, OR=0.517, 95%CI: 0.397-0.673), physical exercise (OR=0.621, 95%CI: 0.494-0.781) were associated with a lower risk of carotid plaques. Conclusion The carotid plaques among perimenopausal women mainly affected by age, place of residence, educational level, alcohol consumption, physical exercise, hypertension, waist-to-hip ratio and atherogenic index of plasma.

Discipline construction is the main focus of the high-quality development of public hospitals. The authors elaborated on the practice of Zhongshan Hospital(Xiamen), Fudan University, based on the " double-center" homogenization management, implementing the 123456 strategy of " integrated management and homogeneous development" in discipline construction. The hospital has promoted discipline construction from six aspects: building discipline cluster, promoting talent cultivation, building science and technology innovation platform, precise personnel classification, medical and education collaborative education, and information sharing and support. It has achieved new development goals of filling weak discipline gaps, transforming talent transfusion into hematopoietic, and integrating medical, educational, research and management innovation. However, it also encountered difficulties such as homogenization barrier of discipline construction, shortage of excellent talents, and limited brand influence of superior disciplines. The authors put forward suggestions from three dimensions: deepening homogeneous management, building talent echelon, and increasing publicity, in order to provide experience for the high-quality development of other hospitals.

Objective:To analyze the image characteristics of gastrointestinal stromal tumor(GIST) and leiomyoma under white-light endoscopy and ultrasound endoscopy, so as to establish a nomogram model and to validate its performance.Methods:From August 1, 2019, to December 1, 2022, the clinical data of 224 patients with GIST or leiomyoma who underwent endoscopic ultrasound examination at the First Affiliated Hospital of Soochow University were retrospectively analyzed. The 224 patients were divided into the modeling group of 145 cases (78 cases of GIST and 67 cases of leiomyoma), and the validation group of 79 cases (41 cases of GIST and 38 cases of leiomyoma). The basic data of patients, parameters of white-light endoscopy and ultrasound endoscopy were screened to establish a binary logistic regression model and draw a nomogram. The receiver operating characteristic curve (ROC) was drawn, and the area under the curve (AUC) was used to evaluate the diagnostic efficiency of the model, and calibration curve was used to evaluate the consistency of predicted and observed probabilities. The model′s performance was compared with the diagnostic results of junior physicians (attending physicians) and senior physicians (associated chief physician). Decision curve analysis (DCA) was performed to evaluate the net benefit of the model. Independent sample t-test and chi-square test were used for statistical analysis. Results:Under white-light endoscopy, there were statistically significant differences in the lesion locations (esophagus: 0 vs. 56.7% (38/67); cardia: 11.5% (9/78) vs. 13.4% (9/67); gastric: 88.5% (69/78) vs. 29.9% (20/67)) and tumor morphyology (spherical or spheroid: 80.8% (63/78) vs. 28.4% (19/67); shuttle: 19.2% (15/78) vs. 71.6% (48/67)) between GIST and leiomyoma in the modeling group ( χ2=64.51 and 46.37, both P<0.001). Under ultrasound endoscopy, the proportion of patients with GIST whose lesions originated from the muscularis propria layer, with indistinct borders and with internal hyperechoic area were all higher than those of patients with leiomyoma (96.2% (75/78) vs. 62.7% (42/67); 53.8% (42/78) vs. 13.4% (9/67); 35.9% (28/78) vs. 10.4% (7/67)), and the differences were statistically significant ( χ2=25.91, 25.82 and 12.75, all P<0.001). Based on the logistic regression model, a nomogram model was established with age, tumor morphology, lesion origin, boundary clarity, and hyperechoic foci as predictive indicators. In the modeling group, the accuracy of nomogram model in the diagnosis of GIST and leiomyoma was 89.7% and 83.6%, respectively. In the validation group, the sensitivity, specificity, and accuracy in GIST and leiomyoma diagnosis of the nomogram model and senior physicians were all higher than those of junior physicians in differentiating GIST from leiomyoma (90.2%, 87.8% vs. 82.9%; 81.6%, 84.2% vs. 78.9%; 86.1%, 86.1% vs. 81.0%, respectively), and the sensitivity, specificity, and accuracy of the nomogram model were equal to those of senior physicians in differentiating GIST from leiomyoma. The AUCs of the nomogram model in the modeling group and validation group were 0.932 (95% confidence interval 0.891 to 0.974) and 0.916 (95% confidence interval 0.854 to 0.978), respectively. The calibration curves of the model indicated that the consistency between the predicted probabilities and observed probabilities was good, and DCA suggested good clinical net benefits of the model. Conclusion:The model exhibits good test efficiency, discrimination, prediction consistency and clinical net benefit when age, tumor morphology, lesion origin, boundary clarity, and hyperechoic foci are selected as indicators.

The correlation between hearing loss (HL) and physical performance in patients receiving maintenance hemodialysis (MHD) remains poorly investigated. This study explored the association between HL and physical performance in patients on MHD. Methods: This multicenter cross-sectional study was conducted between July 2020 and April 2021 in seven hemodialysis centers in Shanghai and Suzhou, China. The hearing assessment was performed using pure-tone average (PTA). Physical performance was assessed using the Timed Up and Go Test (TUGT), handgrip strength, and gait speed. Results: Finally, 838 adult patients (male, 516 [61.6%]; 61.2 ± 2.6 years) were enrolled. Among them, 423 (50.5%) had mild to profound HL (male, 48.6% and female, 53.4%). Patients with HL had poorer physical performance than patients without HL (p < 0.001). TUGT was positively correlated with PTA (r = 0.265, p < 0.001), while handgrip strength and gait speed were negatively correlated with PTA (r = –0.356, p < 0.001 and r = –0.342, p < 0.001, respectively). Physical performance in patients aged <60 years showed significant dose-response relationships with HL. After adjusting for confounders, the odds ratios (95% confidence intervals) for HL across the TUGT quartiles (lowest to highest) were 1.00 (reference), 1.15 (0.73–1.81), 1.69 (1.07–2.70), and 2.87 (1.69–4.88) (p for trend = 0.005). Conclusion: Lower prevalence of HL was associated with a faster TUGT and a stronger handgrip strength in patients on MHD.

Melanoma is the most malignant skin tumor, which is characterized by early metastasis and poor prognosis. In recent years, adoptive immunotherapy, as a new immunotherapy, has made great breakthrough in treatment of solid tumors. Represented by tumor-infiltrating lymphocyte, adoptive immunotherapy exhibits remarkable effects in melanoma. Its combination with immunotherapy or targeted therapy will be a certain trend for future development, while the large-scale clinical study on adoptive immunotherapy remains to be carried out. This article reviews the research progress of adoptive immunotherapy on melanoma.

Melanoma is a common and highly malignant tumor with rapid development, poor prognosis and high mortality in the field of plastic surgery. The incidence rate around the world is increasing year by year and the mortality rate ranks first among skin and soft tissue tumors. The rapid development of targeted and immunotherapeutic drugs has greatly improved the prognosis of patients with advanced melanoma. Currently, the improvement of curative effect brought by monotherapy with mainstream targeted drugs is still limited, and the overall remission rate is about 20%. A large number of clinical trials of non first-line and potential targeted drugs have been carried out, showing the value of these drugs and potential targets to clinicians. This article mainly reviews the potential targets and clinical trials of melanoma, in order to help clinicians better understand the prospect of targeted treatments of the disease and find more effective therapeutic drugs.

Melanoma is the skin malignancy with high potential of metastasis, and its morbidity rate is increasing every year. Melanoma patients exhibit a significantly elevated tumor mutational burden, with a higher prevalence of neoantigenic epitopes, leading to widespread activation of immune cells. Consequently, melanoma demonstrates a favorable response rate to immunotherapy. In this study, the infiltration landscape of common immune cells and their function in the melanoma microenvironment were depicted and analyzed. This study contributes to a better understanding among clinical practitioners of the role of the immune system in the development and progression of melanoma, and provides valuable guidance for the development of novel immunotherapeutic agents.

Melanoma is the most malignant skin tumor, which is characterized by early metastasis and poor prognosis. In recent years, adoptive immunotherapy, as a new immunotherapy, has made great breakthrough in treatment of solid tumors. Represented by tumor-infiltrating lymphocyte, adoptive immunotherapy exhibits remarkable effects in melanoma. Its combination with immunotherapy or targeted therapy will be a certain trend for future development, while the large-scale clinical study on adoptive immunotherapy remains to be carried out. This article reviews the research progress of adoptive immunotherapy on melanoma.

Melanoma is a common and highly malignant tumor with rapid development, poor prognosis and high mortality in the field of plastic surgery. The incidence rate around the world is increasing year by year and the mortality rate ranks first among skin and soft tissue tumors. The rapid development of targeted and immunotherapeutic drugs has greatly improved the prognosis of patients with advanced melanoma. Currently, the improvement of curative effect brought by monotherapy with mainstream targeted drugs is still limited, and the overall remission rate is about 20%. A large number of clinical trials of non first-line and potential targeted drugs have been carried out, showing the value of these drugs and potential targets to clinicians. This article mainly reviews the potential targets and clinical trials of melanoma, in order to help clinicians better understand the prospect of targeted treatments of the disease and find more effective therapeutic drugs.

Melanoma is the skin malignancy with high potential of metastasis, and its morbidity rate is increasing every year. Melanoma patients exhibit a significantly elevated tumor mutational burden, with a higher prevalence of neoantigenic epitopes, leading to widespread activation of immune cells. Consequently, melanoma demonstrates a favorable response rate to immunotherapy. In this study, the infiltration landscape of common immune cells and their function in the melanoma microenvironment were depicted and analyzed. This study contributes to a better understanding among clinical practitioners of the role of the immune system in the development and progression of melanoma, and provides valuable guidance for the development of novel immunotherapeutic agents.