1.Predictive Modeling of Symptomatic Intracranial Hemorrhage Following Endovascular Thrombectomy: Insights From the Nationwide TREAT-AIS Registry
Jia-Hung CHEN ; I-Chang SU ; Yueh-Hsun LU ; Yi-Chen HSIEH ; Chih-Hao CHEN ; Chun-Jen LIN ; Yu-Wei CHEN ; Kuan-Hung LIN ; Pi-Shan SUNG ; Chih-Wei TANG ; Hai-Jui CHU ; Chuan-Hsiu FU ; Chao-Liang CHOU ; Cheng-Yu WEI ; Shang-Yih YAN ; Po-Lin CHEN ; Hsu-Ling YEH ; Sheng-Feng SUNG ; Hon-Man LIU ; Ching-Huang LIN ; Meng LEE ; Sung-Chun TANG ; I-Hui LEE ; Lung CHAN ; Li-Ming LIEN ; Hung-Yi CHIOU ; Jiunn-Tay LEE ; Jiann-Shing JENG ;
Journal of Stroke 2025;27(1):85-94
Background:
and Purpose Symptomatic intracranial hemorrhage (sICH) following endovascular thrombectomy (EVT) is a severe complication associated with adverse functional outcomes and increased mortality rates. Currently, a reliable predictive model for sICH risk after EVT is lacking.
Methods:
This study used data from patients aged ≥20 years who underwent EVT for anterior circulation stroke from the nationwide Taiwan Registry of Endovascular Thrombectomy for Acute Ischemic Stroke (TREAT-AIS). A predictive model including factors associated with an increased risk of sICH after EVT was developed to differentiate between patients with and without sICH. This model was compared existing predictive models using nationwide registry data to evaluate its relative performance.
Results:
Of the 2,507 identified patients, 158 developed sICH after EVT. Factors such as diastolic blood pressure, Alberta Stroke Program Early CT Score, platelet count, glucose level, collateral score, and successful reperfusion were associated with the risk of sICH after EVT. The TREAT-AIS score demonstrated acceptable predictive accuracy (area under the curve [AUC]=0.694), with higher scores being associated with an increased risk of sICH (odds ratio=2.01 per score increase, 95% confidence interval=1.64–2.45, P<0.001). The discriminatory capacity of the score was similar in patients with symptom onset beyond 6 hours (AUC=0.705). Compared to existing models, the TREAT-AIS score consistently exhibited superior predictive accuracy, although this difference was marginal.
Conclusions
The TREAT-AIS score outperformed existing models, and demonstrated an acceptable discriminatory capacity for distinguishing patients according to sICH risk levels. However, the differences between models were only marginal. Further research incorporating periprocedural and postprocedural factors is required to improve the predictive accuracy.
2.The influence of diabetes mellitus and high-sensitivity C-reactive protein on the risk of diges-tive system malignancy: a prospective cohort study
Kuan LIU ; Jiaxing LI ; Chao MA ; Wanchao WANG ; Yuan TIAN ; Zhigang DONG ; Wenqiang WEI ; Shuohua CHEN ; Shouling WU ; Siqing LIU
Chinese Journal of Digestive Surgery 2025;24(1):93-102
Objective:To investigate the influence of diabetes mellitus (DM) and high-sen-sitivity C-reactive protein (Hs-CRP) on the risk of digestive system malignancy.Methods:The pro-spective cohort study was conducted. The clinical data of 93 928 participants who participated health examination in 9 hospitals at Tangshan, including Kailuan General Hospital Affiliated to North China University of Science and Technology et al, in 2006 were selected. According to the presence or absence of DM and the level of Hs-CRP, all participants were divided into 4 groups, including the DM(-)CRP(-) group defined as absence of DM and Hs-CRP ≤3 mg/L, the DM(-)CRP(+) group defined as absence of DM and Hs-CRP>3 mg/L, the DM(+)CRP(-) group defined as presence of DM and Hs-CRP ≤3 mg/L, and the DM(+)CRP(+) group defined as presence of DM and Hs-CRP >3 mg/L. The data of participants were collected by a fixed team of physicians. The first physical examination in 2006 was taken as the starting point for follow-up. The end event of follow-up was defined as the occurrence of digestive system malignancy or death, and the follow-up was up to December 31, 2021. Observation indicators: (1) comparison of clinical data among the 4 groups of participants; (2) the incidence and cumulative incidence rate of digestive system malignancy in participants; (3) influence of DM and Hs-CRP level on the risk of digestive system malignancy; (4) the combined influence of DM and Hs-CRP level on the risk of digestive system malignancy; (5) sensitivity analysis. Comparison of measurement data with normal distribution among multiple groups was conducted using the one-way analysis of variance. For pairwise comparison, least significant difference test was used for homogeneity of variance, and Dunnett′s T3 test was used for heterogeneity of variance. Comparison of measurement data with skewed distribution among multiple groups was conducted using the Kruskal-Wallis rank sum test, and Dunn-Bonferroni test was used for pairwise comparison. Comparison of count data among multiple groups was conducted using the chi-square test, and Bonferroni test was used among multiple comparisons. The Kaplan-Meier method was used to plot cumulative incidence curve, and Log-rank test was used for cumulative incidence rate analysis. The Cox proportional risk model was used for multivariate analysis. All models were adjusted for relevant confounders. Results:(1) Comparison of clinical data among the 4 groups of participants. Of the 93 928 participants, there were 70 743 cases in the DM(-)CRP(-) group, 14 644 cases in the DM(-)CRP(+) group, 6 425 cases in the DM(+)CRP(-) group, and 2 116 cases in the DM(+)CRP(+) group. There were significant differences in gender, age, fasting blood glucose, Hs-CRP, triglyceride, alanine aminotransferase, body mass index, marrital status, smoking, drinking, high school degree or above, physical exercise, high salt diet, high fat diet, positive hepatitis B virus surface antigen, fatty liver, liver cirrhosis, gallstone, taking hypoglycemic drugs, taking lipid-lowering drugs among the 4 groups of participants ( P<0.05). (2) The incidence and cumulative incidence rate of digestive system malignancy in participants. At the end-up of follow-up, 2 008 cases developed digestive system malignancy in the 93 928 participants, including 717 cases of colorectal cancer, 456 cases of liver cancer, 396 cases of gastric cancer, 195 cases of esophageal cancer, 144 cases of pancreatic cancer, 65 cases of gallbladder cancer or extrahepatic cholangiocarcinoma, 35 cases of small bowel cancer. The cumulative incidence rates of digestive system malignancy were 2.19%, 2.42%, 2.86%, 3.59% in participants of the DM(-)CRP(-) group, DM(-)CRP(+) group, DM(+)CRP(-) group, DM(+)CRP(+) group, respectively, showing a significant difference among the 4 groups ( χ2=31.72, P<0.05). (3) Influence of DM and Hs-CRP level on the risk of digestive system malignancy. After adjusting for the confounding factors of the participants, results of multivariate analysis showed that DM and Hs-CRP >3 mg/L were independent influencing factors for the incidence of digestive system malignancy ( hazard ratio=1.32, 1.19, 95% confidence interval as 1.13-1.56, 1.06-1.33, P<0.05). Futher analysis showed that there was a significant difference in interaction between DM and Hs-CRP >3 mg/L ( P<0.05). (4) The combined influence of DM and Hs-CRP level on the risk of digestive system malign-ancy. After adjusting for confounding factors, results of multivariate analysis showed that using the DM(-)CRP(-) group as the control group, the risk of incidence of digestive system malignancy increased in the DM(-)CRP(+) group, DM(+)CRP(-) group, and DM(+)CRP(+) group, respectively ( hazard ratio=1.14, 1.23, 1.79, 95% confidence interval as 1.01-1.29, 1.02-1.48, 1.38-2.31, P<0.05). In the site-specific analysis of digestive system malignancy, using the DM(-)CRP(-) group as the control group, the risk of incidence of liver cancer increased in the DM(-)CRP(+) group ( hazard ratio=1.37, 95% confidence interval as 1.07-1.75, P<0.05), the risk of incidence of liver cancer and pancrea-tic cancer increased in the DM(+)CRP(-) group ( hazard ratio=1.60, 1.74, 95% confidence interval as 1.16-2.21, 1.00-3.02, P<0.05), the risk of incidence of small bowel cancer, pancreatic cancer and colorectal cancer increased in the DM(+)CRP(+) group ( hazard ratio=5.05, 2.31, 2.23, 95% confidence interval as 1.57-16.21, 1.00-5.31, 1.54-3.24, P<0.05). (5) Sensitivity analysis. After adjusting for confounding factors of excluding 3 types of participants (103 cases of digestive system malignancy within 1 year of follow-up, 2 370 cases of taking glucose-lowering drugs, and 915 cases of taking lipid-lowering drugs), results of multivariate analysis showed that using the DM(-)CRP(-) group as the control group, the risk of incidence of digestive system malignancy increased in the DM(+)CRP(-) group, and DM(+)CRP(+) group, respectively ( hazard ratioexcluding cases of digestive system malignancy within 1 year of follow-up=1.26, 1.66, 95% confidence interval as 1.04-1.52, 1.26-2.18, P<0.05; hazard ratioexcluding cases taking glucose-lowering drugs=1.23, 1.75, 95% confidence interval as 1.02-1.49, 1.31-2.33, P<0.05; hazard ratioexcluding cases taking lipid-lowering drugs=1.24, 1.80, 95% confidence interval as 1.03-1.49, 1.39-2.34, P<0.05). Conclusions:DM and Hs-CRP >3 mg/L are independent influencing factors for the incidence of digestive system malignancy. There is an interation and synergistic effect between DM and Hs-CRP to promote the incidence of digestive system malignancy.
3.Construction process of theoretical and technological systems of laparoscopic anatomic liver resection for hepatocellular carcinoma
Liang XIAO ; Ledu ZHOU ; Jipeng LI ; Qingfeng LI ; Jianing TANG ; Kuan HU ; Hanrui YANG
Chinese Journal of Digestive Surgery 2025;24(4):487-494
The development of surgery brings about the transformation of surgeons′ con-cepts, and in turn, each renewal of surgical concepts propels progress of surgical techniques. These two aspects complement each other. The treatment of hepatocellular carcinoma is a comprehensive therapy centered on surgery. With the deepening understanding of liver anatomy, the surgical methods have evolved from initial local resection to anatomical liver resection, and then to resection of the tumor-bearing portal vein territory. In recent years, with the emergence of hepatic membrane anatomy, portal plate theory, and three-dimensional visualization, the theoretical and technical systems of laparoscopic anatomical liver resection has become more and more mature. Based on own experience and literature reports, the authors systematically elaborate on the construction of theoretical and technological systems of laparoscopic anatomic liver resection for hepatocellular carcinoma, for reference by colleagues.
4.Effectiveness of predicting ventilatory and lactate thresholds using a combination of muscle oxygenation and heart rate variability
Xiangxin LI ; Junchao YANG ; Zhihui LU ; Kuan TAO ; Junqiang QIU
Chinese Journal of Sports Medicine 2025;44(7):537-549
Objective To compare the effectiveness of the heart rate variability threshold(HRVT),muscle oxygenation threshold(MOT),and their combined threshold(COMT)in predicting the ventila-tory threshold(VT)and lactate threshold(LT).Methods Twenty male athletes at or above the nation-al level were recruited to perform an incremental exercise test to determine VT and LT,during which gas exchange,muscle oxygenation,and heart rate variability were collected.The HRVT,MOT,and COMT methods were then applied,and their predictive validity was evaluated by comparing the correla-tions and agreements between heart rate(HR)and power output(PO)at VT and LT.Results For HR,VT1 showed strong correlation and agreement with MOT1(r=0.958,ICC=0.944)and COMT1(r=0.957,ICC=0.951),with COMT1 having the smallest mean bias(1.4 bpm)and the narrowest limits of agreement(LOA)(-5.4 to 8.2 bpm).Moreover,VT2 demonstrated the highest correlation and agree-ment with COMT2(r=0.985,ICC=0.982),with a mean bias of-0.7 bpm and LOA of-5.0 to 3.7 bpm.Meanwhile,LT showed high correlation and good agreement with COMT2(r=0.884,ICC=0.754)and MOT2(r=0.886,ICC=0.738),with mean biases of-6.8 bpm and-7.3 bpm,and LOA of-17.5 to 3.8 bpm and-17.9 to 3.2 bpm,respectively.For PO,VT1 had the best correlation and agreement with MOT1(r=0.836,ICC=0.808),with a mean bias of-0.2 W and LOA of-11.7 to 11.3 W.VT2 performed best correlation and agreement with COMT2(r=0.910,ICC=0.900),with a mean bias of 2.3 W and LOA of-8.9 to 13.5 W.In LT prediction,MOT2(r=0.736,ICC=0.692)outperformed COMT2(r=0.635,ICC=0.618),with mean biases of-2.6 W and 0.2 W,and LOA of-26.0 to 20.7 W and-26.6 to 27.1 W,respectively.Conclusion All three indicators—HRVT,MOT,and COMT—demonstrates high validity in predicting VT and LT.MOT1 performs best for predicting PO at VT1,while COMT2 shows the highest consistency for predicting both HR and PO at VT2.Howev-er,for LT prediction,MOT2 is more advantageous for predicting PO,whereas COMT2 is more accu-rate for predicting HR.Therefore,method selection should be tailored to the specific threshold type and measurement target.
5.Effectiveness of predicting ventilatory and lactate thresholds using a combination of muscle oxygenation and heart rate variability
Xiangxin LI ; Junchao YANG ; Zhihui LU ; Kuan TAO ; Junqiang QIU
Chinese Journal of Sports Medicine 2025;44(7):537-549
Objective To compare the effectiveness of the heart rate variability threshold(HRVT),muscle oxygenation threshold(MOT),and their combined threshold(COMT)in predicting the ventila-tory threshold(VT)and lactate threshold(LT).Methods Twenty male athletes at or above the nation-al level were recruited to perform an incremental exercise test to determine VT and LT,during which gas exchange,muscle oxygenation,and heart rate variability were collected.The HRVT,MOT,and COMT methods were then applied,and their predictive validity was evaluated by comparing the correla-tions and agreements between heart rate(HR)and power output(PO)at VT and LT.Results For HR,VT1 showed strong correlation and agreement with MOT1(r=0.958,ICC=0.944)and COMT1(r=0.957,ICC=0.951),with COMT1 having the smallest mean bias(1.4 bpm)and the narrowest limits of agreement(LOA)(-5.4 to 8.2 bpm).Moreover,VT2 demonstrated the highest correlation and agree-ment with COMT2(r=0.985,ICC=0.982),with a mean bias of-0.7 bpm and LOA of-5.0 to 3.7 bpm.Meanwhile,LT showed high correlation and good agreement with COMT2(r=0.884,ICC=0.754)and MOT2(r=0.886,ICC=0.738),with mean biases of-6.8 bpm and-7.3 bpm,and LOA of-17.5 to 3.8 bpm and-17.9 to 3.2 bpm,respectively.For PO,VT1 had the best correlation and agreement with MOT1(r=0.836,ICC=0.808),with a mean bias of-0.2 W and LOA of-11.7 to 11.3 W.VT2 performed best correlation and agreement with COMT2(r=0.910,ICC=0.900),with a mean bias of 2.3 W and LOA of-8.9 to 13.5 W.In LT prediction,MOT2(r=0.736,ICC=0.692)outperformed COMT2(r=0.635,ICC=0.618),with mean biases of-2.6 W and 0.2 W,and LOA of-26.0 to 20.7 W and-26.6 to 27.1 W,respectively.Conclusion All three indicators—HRVT,MOT,and COMT—demonstrates high validity in predicting VT and LT.MOT1 performs best for predicting PO at VT1,while COMT2 shows the highest consistency for predicting both HR and PO at VT2.Howev-er,for LT prediction,MOT2 is more advantageous for predicting PO,whereas COMT2 is more accu-rate for predicting HR.Therefore,method selection should be tailored to the specific threshold type and measurement target.
6.Exercise fear condition in patients with coronary heart disease participating in phase Ⅱ cardiac rehabil-itation after PCI and its influencing factors
Hong-xin HUANG ; Yi-fan JIA ; Kuan-lie JIANG ; Xing-jue LI ; Hua-kang WANG ; Wei LU
Chinese Journal of cardiovascular Rehabilitation Medicine 2025;34(1):1-6
Objective:To investigate exercise fear condition and its influencing factors in patients with coronary heart dis-ease(CHD)involving in phase Ⅱ cardiac rehabilitation after percutaneous coronary intervention(PCI).Methods:Conven-ience sampling was performed among cardiac rehabilitation patients from a Shanxi grade-A tertiary hospital between Janu-ary 2023 and June 2023.General data questionnaire,Tampa Scale for Kinesiophobia-Short Version for Heart patients(TSK-SV H),the Multidimensional Scale of Perceived Social Support(MSPSS)and the Post Percutaneous Coronary In-tervention Health Literacy Scale(PPCIHLS)were used for assessment.Pearson and Spearman rank correlation analyses were applied to investigate the relationships between social support factors and health literacy factors with patients'fear of exercise;multivariate linear regression models and quantile regression models were used to analyze the influencing factors of fear of exercise.Results:Among the 118 patients,average TSK-SV H score was(33.78±3.79)points;10.2%patients showed significant fear.The correlation analysis showed that PPCIHLS score was negatively correlated with TSK-SV H score(r=-0.423,P<0.001).Results from multivariate regression analysis indicated that health literacy,cardiac func-tion class and drinking status affected the average score of exercise fear(P<0.05 all).The quantile regression model pro-vided additional insights,showing that the impact of factors such as living situation,drinking status,cardiac function class and health literacy on exercise fear varied across different quantiles.Notably,cardiac function class had a consistently posi-tive effect on TSK-SV H score at various quantiles.Conclusion:Improving health literacy and tailored rehabilitation plans are vital to reduce exercise fear and improve cardiac rehabilitation effect.
7.Expert Consensus on the Ethical Requirements for Generative AI-Assisted Academic Writing
You-Quan BU ; Yong-Fu CAO ; Zeng-Yi CHANG ; Hong-Yu CHEN ; Xiao-Wei CHEN ; Yuan-Yuan CHEN ; Zhu-Cheng CHEN ; Rui DENG ; Jie DING ; Zhong-Kai FAN ; Guo-Quan GAO ; Xu GAO ; Lan HU ; Xiao-Qing HU ; Hong-Ti JIA ; Ying KONG ; En-Min LI ; Ling LI ; Yu-Hua LI ; Jun-Rong LIU ; Zhi-Qiang LIU ; Ya-Ping LUO ; Xue-Mei LV ; Yan-Xi PEI ; Xiao-Zhong PENG ; Qi-Qun TANG ; You WAN ; Yong WANG ; Ming-Xu WANG ; Xian WANG ; Guang-Kuan XIE ; Jun XIE ; Xiao-Hua YAN ; Mei YIN ; Zhong-Shan YU ; Chun-Yan ZHOU ; Rui-Fang ZHU
Chinese Journal of Biochemistry and Molecular Biology 2025;41(6):826-832
With the rapid development of generative artificial intelligence(GAI)technologies,their widespread application in academic research and writing is continuously expanding the boundaries of sci-entific inquiry.However,this trend has also raised a series of ethical and regulatory challenges,inclu-ding issues related to authorship,content authenticity,citation accuracy,and accountability.In light of the growing involvement of AI in generating academic content,establishing an open,controllable,and trustworthy ethical governance framework has become a key task for safeguarding research integrity and maintaining trust within the academic community.This expert consensus outlines ethical requirements across key stages of AI-assisted academic writing-including topic selection,data management,citation practices,and authorship attribution.It aims to clarify the boundaries and ethical obligations surrounding AI use in academic writing,ensuring that technological tools enhance efficiency without compromising in-tegrity.The goal is to provide guidance and institutional support for building a responsible and sustainable research ecosystem.
8.The influence of diabetes mellitus and high-sensitivity C-reactive protein on the risk of diges-tive system malignancy: a prospective cohort study
Kuan LIU ; Jiaxing LI ; Chao MA ; Wanchao WANG ; Yuan TIAN ; Zhigang DONG ; Wenqiang WEI ; Shuohua CHEN ; Shouling WU ; Siqing LIU
Chinese Journal of Digestive Surgery 2025;24(1):93-102
Objective:To investigate the influence of diabetes mellitus (DM) and high-sen-sitivity C-reactive protein (Hs-CRP) on the risk of digestive system malignancy.Methods:The pro-spective cohort study was conducted. The clinical data of 93 928 participants who participated health examination in 9 hospitals at Tangshan, including Kailuan General Hospital Affiliated to North China University of Science and Technology et al, in 2006 were selected. According to the presence or absence of DM and the level of Hs-CRP, all participants were divided into 4 groups, including the DM(-)CRP(-) group defined as absence of DM and Hs-CRP ≤3 mg/L, the DM(-)CRP(+) group defined as absence of DM and Hs-CRP>3 mg/L, the DM(+)CRP(-) group defined as presence of DM and Hs-CRP ≤3 mg/L, and the DM(+)CRP(+) group defined as presence of DM and Hs-CRP >3 mg/L. The data of participants were collected by a fixed team of physicians. The first physical examination in 2006 was taken as the starting point for follow-up. The end event of follow-up was defined as the occurrence of digestive system malignancy or death, and the follow-up was up to December 31, 2021. Observation indicators: (1) comparison of clinical data among the 4 groups of participants; (2) the incidence and cumulative incidence rate of digestive system malignancy in participants; (3) influence of DM and Hs-CRP level on the risk of digestive system malignancy; (4) the combined influence of DM and Hs-CRP level on the risk of digestive system malignancy; (5) sensitivity analysis. Comparison of measurement data with normal distribution among multiple groups was conducted using the one-way analysis of variance. For pairwise comparison, least significant difference test was used for homogeneity of variance, and Dunnett′s T3 test was used for heterogeneity of variance. Comparison of measurement data with skewed distribution among multiple groups was conducted using the Kruskal-Wallis rank sum test, and Dunn-Bonferroni test was used for pairwise comparison. Comparison of count data among multiple groups was conducted using the chi-square test, and Bonferroni test was used among multiple comparisons. The Kaplan-Meier method was used to plot cumulative incidence curve, and Log-rank test was used for cumulative incidence rate analysis. The Cox proportional risk model was used for multivariate analysis. All models were adjusted for relevant confounders. Results:(1) Comparison of clinical data among the 4 groups of participants. Of the 93 928 participants, there were 70 743 cases in the DM(-)CRP(-) group, 14 644 cases in the DM(-)CRP(+) group, 6 425 cases in the DM(+)CRP(-) group, and 2 116 cases in the DM(+)CRP(+) group. There were significant differences in gender, age, fasting blood glucose, Hs-CRP, triglyceride, alanine aminotransferase, body mass index, marrital status, smoking, drinking, high school degree or above, physical exercise, high salt diet, high fat diet, positive hepatitis B virus surface antigen, fatty liver, liver cirrhosis, gallstone, taking hypoglycemic drugs, taking lipid-lowering drugs among the 4 groups of participants ( P<0.05). (2) The incidence and cumulative incidence rate of digestive system malignancy in participants. At the end-up of follow-up, 2 008 cases developed digestive system malignancy in the 93 928 participants, including 717 cases of colorectal cancer, 456 cases of liver cancer, 396 cases of gastric cancer, 195 cases of esophageal cancer, 144 cases of pancreatic cancer, 65 cases of gallbladder cancer or extrahepatic cholangiocarcinoma, 35 cases of small bowel cancer. The cumulative incidence rates of digestive system malignancy were 2.19%, 2.42%, 2.86%, 3.59% in participants of the DM(-)CRP(-) group, DM(-)CRP(+) group, DM(+)CRP(-) group, DM(+)CRP(+) group, respectively, showing a significant difference among the 4 groups ( χ2=31.72, P<0.05). (3) Influence of DM and Hs-CRP level on the risk of digestive system malignancy. After adjusting for the confounding factors of the participants, results of multivariate analysis showed that DM and Hs-CRP >3 mg/L were independent influencing factors for the incidence of digestive system malignancy ( hazard ratio=1.32, 1.19, 95% confidence interval as 1.13-1.56, 1.06-1.33, P<0.05). Futher analysis showed that there was a significant difference in interaction between DM and Hs-CRP >3 mg/L ( P<0.05). (4) The combined influence of DM and Hs-CRP level on the risk of digestive system malign-ancy. After adjusting for confounding factors, results of multivariate analysis showed that using the DM(-)CRP(-) group as the control group, the risk of incidence of digestive system malignancy increased in the DM(-)CRP(+) group, DM(+)CRP(-) group, and DM(+)CRP(+) group, respectively ( hazard ratio=1.14, 1.23, 1.79, 95% confidence interval as 1.01-1.29, 1.02-1.48, 1.38-2.31, P<0.05). In the site-specific analysis of digestive system malignancy, using the DM(-)CRP(-) group as the control group, the risk of incidence of liver cancer increased in the DM(-)CRP(+) group ( hazard ratio=1.37, 95% confidence interval as 1.07-1.75, P<0.05), the risk of incidence of liver cancer and pancrea-tic cancer increased in the DM(+)CRP(-) group ( hazard ratio=1.60, 1.74, 95% confidence interval as 1.16-2.21, 1.00-3.02, P<0.05), the risk of incidence of small bowel cancer, pancreatic cancer and colorectal cancer increased in the DM(+)CRP(+) group ( hazard ratio=5.05, 2.31, 2.23, 95% confidence interval as 1.57-16.21, 1.00-5.31, 1.54-3.24, P<0.05). (5) Sensitivity analysis. After adjusting for confounding factors of excluding 3 types of participants (103 cases of digestive system malignancy within 1 year of follow-up, 2 370 cases of taking glucose-lowering drugs, and 915 cases of taking lipid-lowering drugs), results of multivariate analysis showed that using the DM(-)CRP(-) group as the control group, the risk of incidence of digestive system malignancy increased in the DM(+)CRP(-) group, and DM(+)CRP(+) group, respectively ( hazard ratioexcluding cases of digestive system malignancy within 1 year of follow-up=1.26, 1.66, 95% confidence interval as 1.04-1.52, 1.26-2.18, P<0.05; hazard ratioexcluding cases taking glucose-lowering drugs=1.23, 1.75, 95% confidence interval as 1.02-1.49, 1.31-2.33, P<0.05; hazard ratioexcluding cases taking lipid-lowering drugs=1.24, 1.80, 95% confidence interval as 1.03-1.49, 1.39-2.34, P<0.05). Conclusions:DM and Hs-CRP >3 mg/L are independent influencing factors for the incidence of digestive system malignancy. There is an interation and synergistic effect between DM and Hs-CRP to promote the incidence of digestive system malignancy.
9.Construction process of theoretical and technological systems of laparoscopic anatomic liver resection for hepatocellular carcinoma
Liang XIAO ; Ledu ZHOU ; Jipeng LI ; Qingfeng LI ; Jianing TANG ; Kuan HU ; Hanrui YANG
Chinese Journal of Digestive Surgery 2025;24(4):487-494
The development of surgery brings about the transformation of surgeons′ con-cepts, and in turn, each renewal of surgical concepts propels progress of surgical techniques. These two aspects complement each other. The treatment of hepatocellular carcinoma is a comprehensive therapy centered on surgery. With the deepening understanding of liver anatomy, the surgical methods have evolved from initial local resection to anatomical liver resection, and then to resection of the tumor-bearing portal vein territory. In recent years, with the emergence of hepatic membrane anatomy, portal plate theory, and three-dimensional visualization, the theoretical and technical systems of laparoscopic anatomical liver resection has become more and more mature. Based on own experience and literature reports, the authors systematically elaborate on the construction of theoretical and technological systems of laparoscopic anatomic liver resection for hepatocellular carcinoma, for reference by colleagues.
10.Clinical comprehensive evaluation of Binghuang Fule Ointment in treatment of eczema.
Ming CHEN ; Fu-Mei LIU ; Chang-Kuan FU ; Yu-Er HU ; Yan-Ming XIE ; Yuan-Yuan LI
China Journal of Chinese Materia Medica 2025;50(9):2582-2588
Through a systematic review of the literature on the treatment of eczema with Binghuang Fule Ointment, the "6+1" assessment model was used to comprehensively evaluate its clinical value, providing a basis for decisions on the allocation of medical resources, rational clinical medication use, and hospital procurement and supply of Chinese patent medicines in China. Based on the relevant standards in the Guidelines for the Management of Clinical Evidence and Value Evaluation of Drugs, diversified research methods were adopted, including evidence-based medical evidence, questionnaire surveys, and pharmacoeconomic evaluations. These methods were combined with both qualitative and quantitative research approaches, and the multi-criteria decision analysis(MCDA) model was applied to perform a comprehensive evaluation of Binghuang Fule Ointment in treating eczema. Safety was evaluated based on evidence adequacy assessments and known risk evaluations, and thus the safety was rated as grade A, indicating that its risk is controllable, its safety is good, and there is sufficient evidence to confirm its safety. The evidence of effectiveness came from the results of Meta-analysis, which showed that Binghuang Fule Ointment + conventional treatment/Binghuang Fule Ointment vs conventional treatment had better clinical effective effect, and the effectiveness was rated as grade A. The economic evaluation, integrating evidence value and evidence quality results, thus the economy was rated as grade B. Innovation was evaluated based on three primary indexes and 18 secondary indexes, with Binghuang Fule Ointment's innovation rated as grade B, indicating a good level of innovation. Suitability was assessed through a questionnaire survey and Chinese patent medicine information service data, and Binghuang Fule Ointment's suitability was rated as grade B, indicating good suitability. Accessibility was assessed based on the proportion of Binghuang Fule Ointment's daily cost relative to the median disposable income of urban and rural residents. The proportion was only 0.05% in urban residents' median disposable income, and 0.14% in rural residents' median disposable income. Accessibility was rated as grade B, reflecting good accessibility. Binghuang Fule Ointment was prescribed by a senior Tibetan doctor with many years of clinical experience at the People's Hospital of Tibet Autonomous Region. Its traditional Chinese medicine characteristics were rated as grade B. Based on the results from the "6+1" evaluation dimensions, the comprehensive value score of Binghuang Fule Ointment was calculated using CSC v2.0 software, yielding a score of 0.79, which corresponds to a class A, indicating good clinical value.
Humans
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Ointments
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Drugs, Chinese Herbal/therapeutic use*
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Eczema/economics*

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