Objective:To analyze the risk factors for lymph node metastasis（LNM）in rectal cancer and to construct a nomogram model for predicting the risk of LNM.Methods:The data of 106 patients with rectal cancer who were confirmed after radical surgery at the Inner Mongolia Autonomous Region People's Hospital from January 2023 to October 2024 was retrospectively analyzed. Based on postoperative pathological results，patients were divided into LNM-positive group（50 cases）and LNM-negative group（56 cases）. Clinical and ultrasound imaging data were compared between the two groups. Multivariate Logistic regression analysis was used to identify independent risk factors for LNM in rectal cancer patients. A nomogram prediction model was constructed based on statistically significant risk factors，and the model was verified by the ROC curve，calibration curve and DCA curve.Results:Multivariate Logistic regression analysis revealed that preoperative endorectal ultrasound（ERUS）- diagnosed T stage（uT），LNM status（uN），extramural vascular invasion status（ER-EMVI），and the tumor marker carcinoembryonic antigen（CEA）were independent risk factors for LNM in rectal cancer（all P<0.05）. The nomogram prediction model based on these indicators demonstrated excellent predictive performance，with an area under the curve of 0.835（95% CI=0.761 - 0.909）. Calibration curve analysis indicated a high consistency between the model's predictions and actual outcomes. Furthermore，the DCA confirmed that the nomogram model provided significant net benefits in clinical applications. Conclusions:The nomogram model constructed based on preoperative ERUS features（uT，uN，ER-EMVI）and tumor marker CEA can effectively assess the probability of LNM in rectal cancer patients，providing valuable support for clinical decision-making.

Objective To evaluate the clinical efficacy of modified Lishui Qiangxin Decoction(composed of Astragali Radix,Arecae Pericarpium,Descurainiae Semen Lepidii Semen,Poria,Polyporus,Cinnamomi Ramulus,Salviae Miltiorrhizae Radix et Rhizoma,Asini Corii Colla,Aucklandiae Radix,etc.)for elderly patients with chronic heart failure(CHF),and to investigate its effects on ventricular remodeling and serum levels of soluble tumor necrosis factor-like weak inducer of apoptosis(sTWEAK),high-sensitivity C-reactive protein(hs-CRP),and interleukin 6(IL-6).Methods A total of 150 elderly CHF patients with yang-qi deficiency and water retention-blood stasis syndrome treated at Tangshan Central Hospital from December 2021 to December 2024 were enrolled.The patients were divided into trial(n=76)group and control(n=74)group.The control group received standard western treatment(vasodilation,diuresis,and cardiotonic therapy),while the trial group received additional modified Lishui Qiangxin Decoction,both groups were treated for 8 weeks.The changes in traditional Chinese medicine(TCM)syndrome scores,Minnesota Living with Heart Failure Questionnaire(MLHFQ)scores,ventricular remodeling parameters[left ventricular mass(LVM),early to late diastolic mitral inflow velocity ratio(E/A),left ventricular ejection fraction(LVEF)],serum sTWEAK,hs-CRP,and IL-6 levels were observed,and clinical efficacy was evaluated.Results(1)After 8 weeks of treatment,the overall response rate in the trial group was 97.37％(74/76),while that in the control group was 86.49％(64/74).The intergroup comparison(by chi-square test)showed that the efficacy of the trial group was significantly superior to that of the control group(P＜0.05).(2)After treatment,the TCM syndrome scores for dyspnea,edema,cold intolerance and cold limbs,and palpitations and shortness of breath were significantly lower in both groups compared to before treatment(P＜0.05).Additionally,the reduction in scores was significantly greater in the trial group than in the control group(P＜0.01).(3)After treatment,the LVM of both groups decreased compared to before treatment(P＜0.05),and the E/A and LVEF increased compared to before treatment(P＜0.05).The reduction in LVM and the increase in E/A and LVEF in the trial group were significantly greater than those in the control group(P＜0.01).(4)After treatment,the serum levels of sTWEAK,hs-CRP,and IL-6 in both groups decreased compared to before treatment(P＜0.05),and the reduction in the trial group was significantly greater than that in the control group(P＜0.01).(5)After treatment,the MLHFQ scores of emotional,physical,symptom dimensions and total score of the MLHFQ scale in both groups decreased compared to before treatment(P＜0.05),and the reduction in the trial group was significantly greater than that in the control group(P＜0.01).Conclusion Modified Lishui Qiangxin Decoction effectively alleviates symptoms,improves left ventricular function,reduces inflammatory markers of sTWEAK,hs-CRP and IL-6,and enhances quality of life in elderly CHF patients with yang-qi deficiency and water retention-blood stasis syndrome.

Objective:To analyze the risk factors for lymph node metastasis（LNM）in rectal cancer and to construct a nomogram model for predicting the risk of LNM.Methods:The data of 106 patients with rectal cancer who were confirmed after radical surgery at the Inner Mongolia Autonomous Region People's Hospital from January 2023 to October 2024 was retrospectively analyzed. Based on postoperative pathological results，patients were divided into LNM-positive group（50 cases）and LNM-negative group（56 cases）. Clinical and ultrasound imaging data were compared between the two groups. Multivariate Logistic regression analysis was used to identify independent risk factors for LNM in rectal cancer patients. A nomogram prediction model was constructed based on statistically significant risk factors，and the model was verified by the ROC curve，calibration curve and DCA curve.Results:Multivariate Logistic regression analysis revealed that preoperative endorectal ultrasound（ERUS）- diagnosed T stage（uT），LNM status（uN），extramural vascular invasion status（ER-EMVI），and the tumor marker carcinoembryonic antigen（CEA）were independent risk factors for LNM in rectal cancer（all P<0.05）. The nomogram prediction model based on these indicators demonstrated excellent predictive performance，with an area under the curve of 0.835（95% CI=0.761 - 0.909）. Calibration curve analysis indicated a high consistency between the model's predictions and actual outcomes. Furthermore，the DCA confirmed that the nomogram model provided significant net benefits in clinical applications. Conclusions:The nomogram model constructed based on preoperative ERUS features（uT，uN，ER-EMVI）and tumor marker CEA can effectively assess the probability of LNM in rectal cancer patients，providing valuable support for clinical decision-making.

Rectal cancer is a common malignant tumor in China, with a high mortality rate ranking fifth. Neoadjuvant therapy for rectal cancer can improve patient prognosis and even achieve pathological complete remission (pCR) in some patients, thereby avoiding complications and functional damage caused by radical surgery. Therefore, how to accurately evaluate pCR before surgery is currently a research hotspot. In recent years, new imaging technologies such as endorectal ultrasound, magnetic resonance imaging (MRI), and positron emission computed tomography (PET-CT) have developed rapidly, and imaging evaluation of pCR after neoadjuvant therapy for rectal cancer has achieved good results. This article provides a review of this field, aiming to provide a basis for personalized treatment of rectal cancer patients.

Background::Understanding willingness to undergo pulmonary function tests (PFTs) and the factors associated with poor uptake of PFTs is crucial for improving early detection and treatment of chronic obstructive pulmonary disease (COPD). This study aimed to understand willingness to undergo PFTs among high-risk populations and identify any barriers that may contribute to low uptake of PFTs.Methods::We collected data from participants in the "Happy Breathing Program" in China. Participants who did not follow physicians’ recommendations to undergo PFTs were invited to complete a survey regarding their willingness to undergo PFTs and their reasons for not undergoing PFTs. We estimated the proportion of participants who were willing to undergo PFTs and examined the various reasons for participants to not undergo PFTs. We conducted univariable and multivariable logistic regressions to analyze the impact of individual-level factors on willingness to undergo PFTs.Results::A total of 8475 participants who had completed the survey on willingness to undergo PFTs were included in this study. Out of these participants, 7660 (90.4%) were willing to undergo PFTs. Among those who were willing to undergo PFTs but actually did not, the main reasons for not doing so were geographical inaccessibility ( n = 3304, 43.1%) and a lack of trust in primary healthcare institutions ( n = 2809, 36.7%). Among the 815 participants who were unwilling to undergo PFTs, over half ( n = 447, 54.8%) believed that they did not have health problems and would only consider PFTs when they felt unwell. In the multivariable regression, individuals who were ≤54 years old, residing in rural townships, with a secondary educational level, with medical reimbursement, still working, with occupational exposure to dust, and aware of the abbreviation "COPD" were more willing to undergo PFTs. Conclusions::Willingness to undergo PFTs was high among high-risk populations. Policymakers may consider implementing strategies such as providing financial incentives, promoting education, and establishing community-based programs to enhance the utilization of PFTs.

Objective:To visualize and analyze the literature related to the treatment of extremity lymphedema (EL) over the years 2012 to 2022 and to explore future research directions.Methods:Taking "lymphedema" and "treatment" as the themes, the study searched the Chinese and English literature related to EL treatment reported by Chinese scholars from 2012 to 2022 in Chinese National Knowledge Infrastructure (CNKI) and Web of Science (WOS) databases, and used CiteSpace software to visualize the literature, draw maps of authors, research institutes, keywords, etc., and carry out clustering and emergent word analysis on the keywords.Results:A total of 1 007 Chinese articles with 16 core authors and 236 English articles with 8 core Chinese authors were included. The author with the largest number of publications in Chinese was Liu Ningfei from the Ninth People’s Hospital of Shanghai Jiao Tong University School of Medicine (16 articles), and the author with the largest number of publications in WOS was Cheng Ming-Huei from Chang Gung Memorial Hospital Lin Kou Campus (Taiwan Province of China) (33 articles). The institution with the largest number of articles in Chinese was Sun Yat-sen University Cancer Center (16 articles), and the institution with the largest number of articles in English was Chang Gung University (Taiwan Province of China) (45 articles). "Breast cancer" "nursing care" and "quality of life" were the top 3 keywords in CNKI ; "breast cancer" "diagnosis" and "lower extremity" were the top 3 keywords in WOS. Cluster analysis of the keywords showed that 16 clusters in CNKI and 11 clusters in WOS covering evaluation indexes, treatment method and mechanism studies. The result of CNKI keyword emergence analysis showed that the top 10 emergent keywords were "postoperative breast cancer" "upper limb" "rehabilitation" "nursing care" "rehabilitation therapy" "intramuscular effect patch" "acupuncture therapy" "cervical cancer" "upper limb function" "lymphatic drainage". The result of WOS keyword emergence analysis showed that the top 10 emergent keywords were "prevalence" "extremity lymphedema" "therapy" "postmastectomy lymphedema" "transplantation" "cancer" "flap transfer" "mechanism" "surgical treatment" "reconstruction" .Conclusion:Surgical treatment, preventive nursing and lymphangiogenesis are the key research directions of EL treatment. Both traditional Chinese medicine and Western medicine have their own advantages in the treatment of EL, and the combination of traditional Chinese medicine and Western medicine can play a better role in the treatment. Multidisciplinary team can develop personalized solutions for patients.

Objective:To visualize and analyze the literature related to the treatment of extremity lymphedema (EL) over the years 2012 to 2022 and to explore future research directions.Methods:Taking "lymphedema" and "treatment" as the themes, the study searched the Chinese and English literature related to EL treatment reported by Chinese scholars from 2012 to 2022 in Chinese National Knowledge Infrastructure (CNKI) and Web of Science (WOS) databases, and used CiteSpace software to visualize the literature, draw maps of authors, research institutes, keywords, etc., and carry out clustering and emergent word analysis on the keywords.Results:A total of 1 007 Chinese articles with 16 core authors and 236 English articles with 8 core Chinese authors were included. The author with the largest number of publications in Chinese was Liu Ningfei from the Ninth People’s Hospital of Shanghai Jiao Tong University School of Medicine (16 articles), and the author with the largest number of publications in WOS was Cheng Ming-Huei from Chang Gung Memorial Hospital Lin Kou Campus (Taiwan Province of China) (33 articles). The institution with the largest number of articles in Chinese was Sun Yat-sen University Cancer Center (16 articles), and the institution with the largest number of articles in English was Chang Gung University (Taiwan Province of China) (45 articles). "Breast cancer" "nursing care" and "quality of life" were the top 3 keywords in CNKI ; "breast cancer" "diagnosis" and "lower extremity" were the top 3 keywords in WOS. Cluster analysis of the keywords showed that 16 clusters in CNKI and 11 clusters in WOS covering evaluation indexes, treatment method and mechanism studies. The result of CNKI keyword emergence analysis showed that the top 10 emergent keywords were "postoperative breast cancer" "upper limb" "rehabilitation" "nursing care" "rehabilitation therapy" "intramuscular effect patch" "acupuncture therapy" "cervical cancer" "upper limb function" "lymphatic drainage". The result of WOS keyword emergence analysis showed that the top 10 emergent keywords were "prevalence" "extremity lymphedema" "therapy" "postmastectomy lymphedema" "transplantation" "cancer" "flap transfer" "mechanism" "surgical treatment" "reconstruction" .Conclusion:Surgical treatment, preventive nursing and lymphangiogenesis are the key research directions of EL treatment. Both traditional Chinese medicine and Western medicine have their own advantages in the treatment of EL, and the combination of traditional Chinese medicine and Western medicine can play a better role in the treatment. Multidisciplinary team can develop personalized solutions for patients.

Objective:We try to screen out predictive indicators with higher value by analyzing the differences in clinical and laboratory indicators between severe fever with thrombocytopenia syndrome (SFTS) patients in the intensive care unit (ICU) group and non-ICU group.Methods:The clinical and laboratory index data of 69 SFTS patients diagnosed in the laboratory in a hospital from June to December 2019 were retrospectively collected. According to the clinical outcome of the patients, they were divided into ICU and non-ICU groups. The differences in clinical manifestations and laboratory indicators between the two groups were analyzed. The receiver operating characteristic curve (ROC) was used to screen the more valuable predictive indicators.Results:Compared with the non-ICU group, ICU group SFTS patients had significantly higher procalcitonin (PCT), C-reactive protein (CRP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), glutamyl transpeptidase (GGT), leucine aminopeptidase (LAP), glutamate dehydrogenase (GDH), adenosine deaminase (ADA), cystatin C (Cys C), α-hydroxybutyrate dehydrogenase (α-HBDH), creatine kinase (CK), lactate dehydrogenase (LDH) levels ( W=530.0, P=0.003; W=496.5, P=0.015; W=496.0, P=0.015; W=535.5, P=0.002; W=545.5, P=0.001; W=498.5, P=0.013; W=537.0, P=0.002; W=523.0, P=0.004; W=512.0, P=0.007; W=502.0, P=0.012; W=486.0, P=0.023; W=509.0, P=0.008; W=541.0, P=0.002) and significantly lower platelet count (PLT), indirect bilirubin (IBIL), albumin/globulin ratio(A/G) and superoxide dismutase (SOD) levels ( W=199.0, P=0.024; W=175.5.5, P=0.009; t=-2.9, P=0.004; W=209.5, P=0.036; t=-3.0, P=0.004). ROC result showed that ALP [area under the curve (AUC)=0.804, 95% confidence interval ( CI) (0.679~0.929)] and LDH [AUC=0.805, 95% CI (0.680~ 0.930)] have a higher value for predicting the risk of severe illness. Conclusions:Abnormal liver function, heart function, and renal function indicators in SFTS patients indicate that patients are at risk of exacerbation. Among them, ALP and LDH levels have higher predictive value for risk of severe disease, suggesting that the monitoring of patients with the above symptoms should be strengthened in the clinical nursing process.

Objective:To analyze the clinical characteristics of pulmonary hypertension (PH) induced by dasatinib.Methods:The relevant databases at home and abroad (as of December 31, 2020) were searched and the case reports on PH induced by dasatinib were collected. Clinical information including patient′s basic characteristics, dasatinib dose, occurrence time of PH, clinical manifestations, interventions, and outcomes were collected and analyzed by descriptive statistical method.Results:A total of 25 patients from 24 case reports were enrolled in the study, including 16 males and 9 females, aged from 23 to 73 years with an average age of 50 years. There were 22 patients with chronic myeloid leukemia (CML) and 3 with acute lymphoblastic leukemia (ALL); the dose of dasatinib was 140 mg daily in 14 patients, 100 mg daily in 7 patients, 70 mg daily in 2 patients, and unknown in 2 patients. Time from dasatinib application to PH occurrence was 10 days to 144 months, with a median time of 37 months. The clinical symptoms included varying degrees of dyspnea in 24 patients, edema in 8 patients, hepatomegaly in 5 patients, jugular vein dilatation in 5 patients, cough in 3 patients,and chest tightness in 3 patients, chest pain in 2 patients, and fatigue in 1 patient. Pleural effusion and/or pericardial effusion were found in 20 patients by chest CT, chest X-ray or echocardiography. Cardiac function was graded as Ⅳ in 8 patients, Ⅲ in 9 patients, and Ⅱ in 4 patients according to WHO classification method, and the grade was unknown in 4 patients. Right cardiac catheterization and/or echocardiography showed elevated mean pulmonary artery pressure and/or systolic pulmonary artery pressure in 25 patients. Twenty-four patients stopped dasatinib following the doctor′s advice after the diagnosis of PH, of which 22 patients were treated with phosphodiesterase 5 inhibitor, endothelin receptor antagonist, diuretic, and glucocorticoid, and the other 2 patients were not given special intervention; one patient took dasatinib intermittently by himself. Nineteen patients were switched to other tyrosine kinase inhibitors. After discontinuation of dasatinib and giving symptomatic treatments for 1 week to 36 months (mean 7 months), 17 patients were improved, 7 were partially improved, and 1 had unknown outcome.Conclusions:Dasatinib-related PH was more common in patients with CML, occurred more in male patients, and had a median occurrence time of 37 months after drug administration. The main clinical manifestation was dyspnea, often complicated with pleural effusion or pericardial effusion. After dasatinib withdrawal and specific treatments, most patients could be improved.

Objective:To analyze the clinical characteristics of pulmonary hypertension (PH) induced by dasatinib.Methods:The relevant databases at home and abroad (as of December 31, 2020) were searched and the case reports on PH induced by dasatinib were collected. Clinical information including patient′s basic characteristics, dasatinib dose, occurrence time of PH, clinical manifestations, interventions, and outcomes were collected and analyzed by descriptive statistical method.Results:A total of 25 patients from 24 case reports were enrolled in the study, including 16 males and 9 females, aged from 23 to 73 years with an average age of 50 years. There were 22 patients with chronic myeloid leukemia (CML) and 3 with acute lymphoblastic leukemia (ALL); the dose of dasatinib was 140 mg daily in 14 patients, 100 mg daily in 7 patients, 70 mg daily in 2 patients, and unknown in 2 patients. Time from dasatinib application to PH occurrence was 10 days to 144 months, with a median time of 37 months. The clinical symptoms included varying degrees of dyspnea in 24 patients, edema in 8 patients, hepatomegaly in 5 patients, jugular vein dilatation in 5 patients, cough in 3 patients,and chest tightness in 3 patients, chest pain in 2 patients, and fatigue in 1 patient. Pleural effusion and/or pericardial effusion were found in 20 patients by chest CT, chest X-ray or echocardiography. Cardiac function was graded as Ⅳ in 8 patients, Ⅲ in 9 patients, and Ⅱ in 4 patients according to WHO classification method, and the grade was unknown in 4 patients. Right cardiac catheterization and/or echocardiography showed elevated mean pulmonary artery pressure and/or systolic pulmonary artery pressure in 25 patients. Twenty-four patients stopped dasatinib following the doctor′s advice after the diagnosis of PH, of which 22 patients were treated with phosphodiesterase 5 inhibitor, endothelin receptor antagonist, diuretic, and glucocorticoid, and the other 2 patients were not given special intervention; one patient took dasatinib intermittently by himself. Nineteen patients were switched to other tyrosine kinase inhibitors. After discontinuation of dasatinib and giving symptomatic treatments for 1 week to 36 months (mean 7 months), 17 patients were improved, 7 were partially improved, and 1 had unknown outcome.Conclusions:Dasatinib-related PH was more common in patients with CML, occurred more in male patients, and had a median occurrence time of 37 months after drug administration. The main clinical manifestation was dyspnea, often complicated with pleural effusion or pericardial effusion. After dasatinib withdrawal and specific treatments, most patients could be improved.