[Purpose]To analyze the trends of incidence and mortality of malignant tumors in Linzhou City of Henan Province from 2010 to 2019.[Methods]The incidence and mortality data of malignant tumors of Linzhou cancer registration areas from 2010 to 2019 were collected and evaluated for data quality.The crude incidence/mortality rates and age-standardized incidence/mortality rates by Chinese standard population(ASIRC/ASMRC)were calculated by sex,age and can-cer type.Joinpoint software was used to calculate the average annual percentage change(AAPC)to analyze the trends from 2010 to 2019.[Results]From 2010 to 2019,the crude incidence of malig-nant tumors in Linzhou City showed an upward trend,with an AAPC of 2.09％(95％CI:0.58％～3.63％),while the ASIRC tended to be stable.The incidence of malignant tumors showed a signifi-cant upward trend in the 15～29 and 60～69 age groups,and a significant downward trend in the 70～79 age group.From 2010 to 2019,the ASIRC of esophageal cancer and stomach cancer in both men and women showed a significant downward trend,while that of lung cancer and prostate cancer increased in men,and the incidences of thyroid cancer,uterus cancer,cervical cancer,lung cancer and breast cancer increased significantly in women.From 2010 to 2019,the crude mortality of malignant tumors in Linzhou showed a significant upward trend,with an AAPC of 1.18％(95％CI:0.88％～1.48％),while ASMRC showed a significant downward trend,with an AAPC of-1.63％(95％CI:-1.86％～-1.40％).The mortality increased in the group aged 80 and above,while the other age groups remained in a downward or stable state.From 2010 to 2019,the ASMRC of stomach cancer and esophageal cancer in both men and women showed a down-ward trend,while those of prostate cancer,and malignant tumors of the lip,oral cavity and pha-ryngeal in men increased,and that of ovarian cancer in women increased significantly.[Conclu-sion]The disease burden of malignant tumors in Linzhou City is still heavy.The incidence of common cancer types such as thyroid cancer,prostate cancer and lung cancer shows a significant-ly increasing trends from 2010 to 2019.

Objective To investigate the risk factors of adverse events in elderly patients with painless gastroenteroscopy,and construct a nomogram model for predicting the risk of adverse events.Methods 302 patients who underwent painless gastroenteroscopy from September 2023 to March 2024 were retrospectively enrolled and randomly divided into training set(211 cases)and validation set(91 cases)according to the 7∶3 ratio.The training set was divided into adverse event group(64 cases)and non-adverse event group(147 cases)according to whether adverse events occurred.Multivariate Logistic regression analysis was used to screen the risk factors for adverse events in elderly painless gastroenteroscopy patients,R 3.4.3 software was used to construct a nomogram model,and the validation set was used for external verification.The nomogram model discrimination was evaluated by drawing the receiver operator characteristic curve(ROC curve),and the calibration curve was drawn to evaluate the calibration degree of the nomogram model.Results Univariate analysis showed that,the comparison of overweight or obesity,smoking,hypertension,coronary heart disease,education level,pre examination sleep time,and exercise habits between the adverse event group and the non-adverse event group were statistically significant(P＜0.05);Multivariate Logistic regression analysis showed that overweight or obesity(OR=4.821,95％CI:1.052～11.651),smoking(OR=1.056,95％CI:1.313～3.109),hypertension(OR=1.356,95％CI:1.175～2.677),and coronary heart disease(OR=1.385,95％CI:1.168～2.765)were risk factors for adverse events during painless gastroenteroscopy in elderly patients(P＜0.05);The areas under the ROC curves for the training and validation sets were 0.921 and 0.795,respectively.The sensitivity was 90.62％(95％CI:0.846～0.965)and 82.14％(95％CI:0.689～0.856),and the specificity was 74.83％(95％CI:1.056～2.939)and 76.19％(95％CI:1.245～4.161),indicating that the nomogram model had good discriminability;The Hosmer-Lemeshow goodness of fit test results showed that the nomogram model had a good fit(P＞0.05),and the calibration curves of the training and validation sets both showed that the nomogram model had a good consistency between the actual and predicting incidence of adverse events(P＞0.05).Conclusion Overweight or obesity,hypertension,cornary heart disease and smoking are independently correlated with adverse events in painless gastroenteroscopy,and the nomogram model constructed based on the above factors to predict the risk of adverse events in painless gastroenteroscopy has good predictive efficacy.

A 61-year-old female patient was treated with sintilimab (200 mg by intravenous infusion on the first day, 21 days as a cycle) for lung adenocarcinoma and multiple lymph node metastases in the left hilum and mediastinum (10 cycles in total). Headache and dizziness in the patient occurred about 1 month after the last medication. Cerebrospinal fluid examination showed white blood cell count 14×10 6/L, total protein 799.8 mg/L, Pandy′s test (+), immunoglobulin G 70.8 mg/L, and glucose and chloride within the reference value range. The antibodies against N-methyl-D-aspartate receptor in cerebrospinal fluid and serum were all positive. The patient was diagnosed as having sintilimab-induced autoimmune encephalitis. After receiving methylprednisolone sodium succinate by intravenous infusion for 7 days, the patient′s headache and dizziness were alleviated. After that, the methylprednisolone sodium succinate was switched to oral prednisone acetate tablets. At a 2-month follow-up, no symptoms of headache or dizziness recurred in the patient.

Objective To explore the feasibility,effectiveness,and safety of balloon catheter-assisted total hepatic vascular exclusion.Methods We designed and manufactured an endovascular catheter with three lumens and double balloons,which can be inserted into the retrahepatic inferior vena cava through the femoral vein.The superior and inferior vena cava of the liver can be blocked by filling balloon,and the total hepatic vascular exclusion was achieved by combining with pringle method.In animal experiments,total hepatic vascular exclusion was performed by balloon catheter-assist method(experimental group)or traditional methods(control group),and the complete time was compared between the two groups.Blood flow blocking effect was observed by angiography and incision of retrahepatic inferior vena cava under direct vision.The complications were recorded.Results Total hepatic vascular exclusion was successfully completed in both groups.The completion time in the experimental group was significantly shorter than that in the control group([12.5±1.2]min vs.[35.8±4.9]min,P<0.05).CT angiography,DSA,and direct vision of blood vessels all confirmed the effectiveness of balloon catheter-assisted hepatic blood flow exclusion.No catheter displacement,balloon rupture,or air embolism occurred.Conclusion The balloon catheter-assisted hepatic total vascular exclusion is simpler and more feasible than traditional method.

Objective To investigate the risk factors of adverse events in elderly patients with painless gastroenteroscopy,and construct a nomogram model for predicting the risk of adverse events.Methods 302 patients who underwent painless gastroenteroscopy from September 2023 to March 2024 were retrospectively enrolled and randomly divided into training set(211 cases)and validation set(91 cases)according to the 7∶3 ratio.The training set was divided into adverse event group(64 cases)and non-adverse event group(147 cases)according to whether adverse events occurred.Multivariate Logistic regression analysis was used to screen the risk factors for adverse events in elderly painless gastroenteroscopy patients,R 3.4.3 software was used to construct a nomogram model,and the validation set was used for external verification.The nomogram model discrimination was evaluated by drawing the receiver operator characteristic curve(ROC curve),and the calibration curve was drawn to evaluate the calibration degree of the nomogram model.Results Univariate analysis showed that,the comparison of overweight or obesity,smoking,hypertension,coronary heart disease,education level,pre examination sleep time,and exercise habits between the adverse event group and the non-adverse event group were statistically significant(P＜0.05);Multivariate Logistic regression analysis showed that overweight or obesity(OR=4.821,95％CI:1.052～11.651),smoking(OR=1.056,95％CI:1.313～3.109),hypertension(OR=1.356,95％CI:1.175～2.677),and coronary heart disease(OR=1.385,95％CI:1.168～2.765)were risk factors for adverse events during painless gastroenteroscopy in elderly patients(P＜0.05);The areas under the ROC curves for the training and validation sets were 0.921 and 0.795,respectively.The sensitivity was 90.62％(95％CI:0.846～0.965)and 82.14％(95％CI:0.689～0.856),and the specificity was 74.83％(95％CI:1.056～2.939)and 76.19％(95％CI:1.245～4.161),indicating that the nomogram model had good discriminability;The Hosmer-Lemeshow goodness of fit test results showed that the nomogram model had a good fit(P＞0.05),and the calibration curves of the training and validation sets both showed that the nomogram model had a good consistency between the actual and predicting incidence of adverse events(P＞0.05).Conclusion Overweight or obesity,hypertension,cornary heart disease and smoking are independently correlated with adverse events in painless gastroenteroscopy,and the nomogram model constructed based on the above factors to predict the risk of adverse events in painless gastroenteroscopy has good predictive efficacy.

[Purpose]To analyze the trends of incidence and mortality of malignant tumors in Linzhou City of Henan Province from 2010 to 2019.[Methods]The incidence and mortality data of malignant tumors of Linzhou cancer registration areas from 2010 to 2019 were collected and evaluated for data quality.The crude incidence/mortality rates and age-standardized incidence/mortality rates by Chinese standard population(ASIRC/ASMRC)were calculated by sex,age and can-cer type.Joinpoint software was used to calculate the average annual percentage change(AAPC)to analyze the trends from 2010 to 2019.[Results]From 2010 to 2019,the crude incidence of malig-nant tumors in Linzhou City showed an upward trend,with an AAPC of 2.09％(95％CI:0.58％～3.63％),while the ASIRC tended to be stable.The incidence of malignant tumors showed a signifi-cant upward trend in the 15～29 and 60～69 age groups,and a significant downward trend in the 70～79 age group.From 2010 to 2019,the ASIRC of esophageal cancer and stomach cancer in both men and women showed a significant downward trend,while that of lung cancer and prostate cancer increased in men,and the incidences of thyroid cancer,uterus cancer,cervical cancer,lung cancer and breast cancer increased significantly in women.From 2010 to 2019,the crude mortality of malignant tumors in Linzhou showed a significant upward trend,with an AAPC of 1.18％(95％CI:0.88％～1.48％),while ASMRC showed a significant downward trend,with an AAPC of-1.63％(95％CI:-1.86％～-1.40％).The mortality increased in the group aged 80 and above,while the other age groups remained in a downward or stable state.From 2010 to 2019,the ASMRC of stomach cancer and esophageal cancer in both men and women showed a down-ward trend,while those of prostate cancer,and malignant tumors of the lip,oral cavity and pha-ryngeal in men increased,and that of ovarian cancer in women increased significantly.[Conclu-sion]The disease burden of malignant tumors in Linzhou City is still heavy.The incidence of common cancer types such as thyroid cancer,prostate cancer and lung cancer shows a significant-ly increasing trends from 2010 to 2019.

A 61-year-old female patient was treated with sintilimab (200 mg by intravenous infusion on the first day, 21 days as a cycle) for lung adenocarcinoma and multiple lymph node metastases in the left hilum and mediastinum (10 cycles in total). Headache and dizziness in the patient occurred about 1 month after the last medication. Cerebrospinal fluid examination showed white blood cell count 14×10 6/L, total protein 799.8 mg/L, Pandy′s test (+), immunoglobulin G 70.8 mg/L, and glucose and chloride within the reference value range. The antibodies against N-methyl-D-aspartate receptor in cerebrospinal fluid and serum were all positive. The patient was diagnosed as having sintilimab-induced autoimmune encephalitis. After receiving methylprednisolone sodium succinate by intravenous infusion for 7 days, the patient′s headache and dizziness were alleviated. After that, the methylprednisolone sodium succinate was switched to oral prednisone acetate tablets. At a 2-month follow-up, no symptoms of headache or dizziness recurred in the patient.

Objective To explore the diagnostic value and clinical significance of multi-parametric magnetic resonance imaging(Mp-MRI)combined with the liver imaging reporting and data system(LI-RADS)grading criteria for diagnosing regenerative nodules and small hepatocellular carcinoma(SHCC)in patients with cirrhosis.Methods Eighty-six patients(132 nodules)admitted to our hospital from March 2019 to March 2023 with liver nodules of≤3 cm in diameter were selected.Based on the surgical pathology results,38 cases(54 nodules)of regenerative nodules in liver cirrhosis were classified into the benign group,and 48 cases(78 nodules)of SHCC were classi-fied into the malignant group.LI-RADS classification and Mp-MRI parameters[enhancement rate(ER),mean enhancement time(MET),maximum slope of increase(MSI),maximum slope of decrease(MSD),apparent diffusion coefficient(ADC),and fat fraction(FF)]were compared between the two groups,and their diagnostic values were analyzed.Results Based on the LI-RADS classification standard,76 positive and 56 negative nodules were detected among the 132 nodules,including ten false positives and 12 false negatives.The ER,MET,MSI,and ADC were lower in the malignant group than in the benign group,whereas the FF and MSD were higher in the malignant group than in the benign group(P<0.05).The area under the receiver operating characteristic(ROC)curve for the combined diagnosis of liver cirrhosis regenerative nodules and SHCC using Mp-MRI parameters and the LI-RADS classification standard was 0.946(95%CI:0.892-0.977),with a Youden index of 0.811,sensitivity of 88.46%,and specificity of 92.59%.These results were superior compared to the diagnosis using each Mp-MRI parameter and the LI-RADS classification standard alone.A significant difference in the LI-RADS clas-sification of nodules of different pathological grades was observed in the malignant group(P<0.05).The ER,MET,MSI,and ADC were highest in well-differentiated nodules,followed by moderately differentiated nodules,and were lowest in poorly differentiated nodules.FF and MSD were highest in poorly differentiated nodules,followed by moderately differentiated nodules,and were lowest in well-differen-tiated nodules(P<0.05).Spearman's correlation analysis showed that the LI-RADS classification and Mp-MRI parameters ER,MET,MSI,and ADC were positively correlated with the pathological grade of SHCC,whereas FF and MSD were negatively correlated with the pathological grade of SHCC(P<0.05).Conclusion The combination of Mp-MRI parameters and the LI-RADS classification criteria is reliable for diagnosing regenerative nodules in cirrhosis and SHCC and can provide important reference information for the clinical evalua-tion of SHCC pathological grading.

Objective To investigate the effect of recombinant human lactoferrin(rhLF)on fracture healing in rat models with femur fracture and the proliferation of rat primary osteoblasts.Methods Male rats were randomly di-vided into 3 groups:simple fracture group(SF group),collagen film-treated group(CF group)and rhLF-com-pound collagen lamination film-treated group(CLF group).The fracture healing was observed by X-ray image and histological microscopy with HE and Masson staining.The newborn SD rats with osteoblasts were treated with differ-ent concentrations of rhLF,and osteoblast proliferation was detected by MTT method.Results The bone scabs in the CLF group were significantly larger than those in the SF and CF groups at 1,2,and 3 weeks postoperatively(P＜0.05).There was no difference in the comparison between the groups at 4th week.The proliferation of cartilag-inous and sclerotic bone scabs in the CLF group was more pronounced and showed the appearance of mature trabec-ulae and lamellar bone with a high degree of maturation of the bone scabs.The groups with 100 mg/L and 500 mg/L rhLF showed a significant decrease in A value for rat primary osteoblasts cultured in vitro as compared with the control group(P＜0.05).The A value increased significantly at the first day(P＜0.05).The concentration of rhLF increased at the fifth and tenth days.Conclusions rhLF has an accelerating effect on fracture healing which is manifested by fast scab formation,large volume and high maturity.The rhLF can promote the proliferation of os-teoblasts cultured in vitro,and the effect is mainly manifested in the rapid proliferation stage of osteoblasts.

BACKGROUND:Pauwels Ⅲ femoral neck fracture is a typical unstable fracture characterized by high vertical shear force and high incidence of postoperative complications.At present,there are many fixation methods for Pauwels Ⅲ fracture,and there is no clear conclusion as to which internal fixation is the best fixation method for Pauwels Ⅲ femoral neck fracture in young adults. OBJECTIVE:To compare the clinical effect of three inverted triangle cannulated screws assisted transverse lag screws and femoral neck system in fixing Pauwels Ⅲ femoral neck fractures of young adults. METHODS:From May 2021 to December 2022,21 young and middle-aged patients with Pauwels Ⅲ femoral neck fracture were treated with three inverted triangle cannulated screws assisted by transverse lag screws and femoral neck system in Affiliated Hospital of Southwest Medical University.Of them,9 patients were treated with three inverted triangle cannulated screws and one transverse lag screws perpendicular to the fracture line as the 3+1 cannulated screw group and 12 patients were treated with femoral neck system as the femoral neck system group.The two fixation methods were compared in terms of operation time,intraoperative blood loss,total incision length,intraoperative fluoroscopy times,fracture healing time,and limb function. RESULTS AND CONCLUSION:(1)All patients were followed up.Patients in the 3+1 cannulated screw group were followed up for 10-25 months,with a mean of(17.44±4.30)months.The patients in the femoral neck system group were followed up for 8-24 months,with a mean of(15.58±4.68)months.(2)The intraoperative fluoroscopy times and Harris score at 3 months postoperatively in the femoral neck system group were better than those in the 3+1 cannulated screw group,and the difference was statistically significant(P<0.05).The intraoperative blood loss,total incision length,and femoral neck shortening distance in the 3+1 cannulated screw group were better than those in the femoral neck system group,and the differences were statistically significant(P<0.05).There was no significant difference in operation time,fracture healing time,and Harris score at the last follow-up between the two groups(P>0.05).(3)It is indicated that three inverted triangle cannulated screws assisted transverse lag screw and femoral neck system can achieve good clinical effects in the treatment of young and middle-aged Pauwels Ⅲ femoral neck fracture.The femoral neck system has fewer intraoperative fluoroscopy times and better early overall stability,while the 3+1 cannulated screw is more minimally invasive,easier to operate.Both fixation methods are worthy of clinical application and promotion,and can be selected according to the actual clinical situation.