Objective:We aimed to develop a nomogram in corporating multidetector computed tomography(MDCT)imaging features and clinicopathological indicators for the preoperative prediction of axillary lymph node metastasis(ALNM)in patients with triple-negative breast cancer(TNBC).Methods:We retrospectively analyzed data from 265 female patients with pathologically confirmed TNBC treated at Harbin Medical University Cancer Hospital between November 2020 and October 2024.Patients were randomly assigned into a training cohort(n=161)and a validation cohort(n=104)in a 6:4 ratio.Feature selection was performed using least absolute shrinkage and selection operator(LASSO)regression with 10-fold cross-validation.Independent predictors of ALNM were identified by multivariate Logistic regression analysis,and a nomogram was constructed accordingly.Model performance was assessed using receiver operating characteristic(ROC)curves,calib-ration plots,and decision curve analysis(DCA).Results:Three independent predictors of ALNM were identified:clinical N-stage(odds ratio[OR]=6.789;95%confidence interval[CI]:2.203-22.20;P=0.001),short-axis diameter of lymph nodes on CT(OR=1.686;95%CI:1.349-2.257;P<0.001),and cortical thickness(OR=6.296;95%CI:2.170-19.310;P=0.001).The nomogram showed strong discrimination,with areas under the ROC curve(AUC)of 0.918(95%CI:0.860-0.977)in the training cohort and 0.885(95%CI:0.809-0.962)in the validation cohort.Calibration was confirmed by Hosmer-Lemeshow tests(P=0.609 and P=0.694 for training and validation cohorts,respectively).DCA demon-strated clinical utility across probability thresholds of 0.02-0.96 and 0.03-0.87 in the training and validation cohorts,respectively.Conclu-sions:This nomogram,integrating MDCT imaging features and clinical indicators,provides a practical tool for individualized preoperative risk assessment and may aid clinical decision-making in patients with TNBC.

Objective:To investigate the impact of body composition and inflammatory nutritional indicators on postoperative complications in patients with obstructive colorectal cancer,and to develop and validate a nomogram model.Methods:This is a retrospective case series study. The clinical data of 293 patients with obstructive colorectal cancer who were treated at the Department of Gastrointestinal Surgery,the Affiliated Hospital of Qingdao University,between January 2016 and January 2024,were retrospectively collected. The cohort included 182 males and 111 females,aged (65.0±12.1) years (range: 18 to 80 years). The dataset was randomly divided into a training group ( n=196) and a validation group ( n=97) with a 7∶3 ratio. Independent sample t test and multivariate logistic regression analysis were employed to identify independent risk factors associated with postoperative complications in patients with obstructive colorectal cancer. A preoperative nomogram model was subsequently developed for predicting postoperative complications,which was further validated using a validation cohort. Results:The training group comprised 119 males and 77 females,with 68 cases experiencing postoperative complications and 128 cases without complications. The validation group included 63 males and 34 females,with 30 cases experiencing postoperative complications and 67 cases without complications.Univariate analysis and multivariate analysis revealed that low skeletal muscle index ( OR=0.867,95% CI: 0.795 to 0.947),high visceral fat index ( OR=1.058,95% CI: 1.028 to 1.089),high systemic immune inflammation index ( OR=1.002, 95% CI: 1.000 to 1.003), low prognostic nutritional index ( OR=0.847,95% CI: 0.782 to 0.917),and preoperative anemia ( OR=2.714,95% CI: 1.161 to 6.344) were independent risk factors for postoperative complications (all P<0.05). A nomogram prediction model based on these five indicators was established. The area under the receiver operating characteristic (ROC) curve for the prediction model was 0.878 (95% CI: 0.829 to 0.928) in the training group and 0.849 (95% CI:0.767 to 0.930) in the validation group. Conclusions:The preoperative nomogram model,which incorporates inflammatory and nutritional indicators,demonstrates a good accuracy in predicting postoperative complications for patients with obstructive colorectal cancer. This model can effectively assist in guiding treatment decisions.

This paper summarized professor WU Mianhua's experience in the treatment of tumors using Hehuanhua （Flos Albiziae）. He believes that the occurrence and development of tumors are closely related to emotions， and thereafter proposed the concept of "masses usually due to constraint， and should be treated by regulating the spirit".Hehuanhua is a light and aromatic flower that enters the heart， liver and spleen meridians， and is good at relieving constraint and regulating the spirit， harmonizing the center with aroma， which can be used to treat all kinds of tumor-related complications. Hehuanmi is flower buds， picked before the flowers fully blooms， have the effect of clearing and lightening upward， opening up the heart and mind， and unblocking liver qi. Commonly used formulas include self-made Ningxin Anmian Decoction （宁心安眠汤） to treat tumor-related insomnia， self-made Aitongxiao Formula （癌痛消方） to treat tumor-related pain， self-made Erhua Jieyu Formula （二花解郁方） to treat tumor-associated depression， and self-made Shugan Tiaohe Decoction （疏肝调和汤） to deal with peri-menopausal state after the treatment of tumors. Hehuanhua is an inflorescence， which captures the aromatic essence and has the function of removing the filth and turbidity， and can wake up the spleen and harmonize the stomach； therefore， it is often used in self-made Tiaomu Hezhong Decoction （调木和中汤） to treat chemotherapy-related digestive tract adverse reactions or combined with rose flowers to treat chemotherapy-induced oral ulcers.

Objective To investigate the effect and mechanism of miglitol on regulating the energy metabolism of brown adipocytes by activating UCP1 and preventing cold injury in mice after cold exposure. Methods Primary brown adipocytes were induced into mature adipocytes, the effect of miglitol on the viability of brown adipocytes was investigated by MTT method, the lipid droplet consumption level of cells after drug administration was investigated by Oil Red O staining technology, and the level of UCP1, a key protein of thermogenesis in brown adipocytes, was detected by Western blotting. The activity of anti-frostbite was investigated in cold exposure at 4 ℃ and −20 ℃. KM mice, which were randomly divided into control group, cold exposure group, miglitol group and all-trans retinoic acid group, and after 7 days of repeated administration, the body surface temperature of mice was detected by infrared thermal imaging system, the anal temperature change was detected by anal thermometer, and the expression levels of UCP1 and PGC1-α in adipose tissue were detected by immunoblotting. Results Compared with the control group, the lipid droplet consumption and UCP1 expression levels in brown adipocytes in the miglitol group were significantly increased. The levels of body surface temperature and rectal temperature increased significantly after cold exposure, and the levels of UCP1 and PGC1α in the brown adipose tissue of mice increased significantly, which indicated that the miglitol could activate the critical proteins UCP1 and PGC1α of the thermogenesis pathway, increase the thermogenesis of mice after cold exposure, and thus improve the effect of cold injury for toe swelling. Conclusion Miglitol could play a role in improving cold injury and body temperature in mice by increasing the level of UCP1 and PGC1α, which are key targets of the thermogenesis pathway to promote the thermogenesis of brown fat.

ObjectiveTo systematically review the association between non-alcoholic fatty liver disease （NAFLD） and depression， and to provide a basis for synergistic management in clinical practice. MethodsThis study was conducted according to the PRISMA guidelines， with the PROSPERO registration number of CRD42023482013. PubMed， Embase， the Cochrane Library， Web of Science， CNKI， Wanfang Data， VIP， and CBM were searched for articles on the association between NAFLD and depression published up to November 1， 2024. The articles were screened according to the inclusion and exclusion criteria， and related data were extracted. RevMan 5.3 was used to perform the Meta-analysis. ResultsA total of 18 studies were included， involving 396 793 participants. Among these studies， 12 discussed the influence of NAFLD on depression， involving 224 269 participants， among whom there were 75 574 patients with NAFLD. The Meta-analysis showed that NAFLD was significantly associated with the risk of depression （odds ratio ［OR］=1.21， 95% confidence interval ［CI］： 1.12 — 1.30， P0.001）. Six studies examined the influence of depression on NAFLD， involving 172 524 participants， among whom there were 29 368 patients with depression. The meta-analysis showed that depression caused a significant increase in the risk of NAFLD （OR=1.13， 95%CI： 1.05 — 1.22， P=0.001）. ConclusionThere is a significant bidirectional association between NAFLD and depression. It is recommended to perform the screening for depression and enhance mental health monitoring in patients with NAFLD， and metabolic function assessment and exercise intervention should be performed for patients with depression.

BACKGROUND: Spicy food consumption has been reported to be inversely associated with mortality from multiple diseases. However, the effect of spicy food intake on the incidence of vascular diseases in the Chinese population remains unclear. This study was conducted to explore this association. METHODS: This study was performed using the large-scale China Kadoorie Biobank (CKB) prospective cohort of 486,335 participants. The primary outcomes were vascular disease, ischemic heart disease (IHD), major coronary events (MCEs), cerebrovascular disease, stroke, and non-stroke cerebrovascular disease. A Cox proportional hazards regression model was used to assess the association between spicy food consumption and incident vascular diseases. Subgroup analysis was also performed to evaluate the heterogeneity of the association between spicy food consumption and the risk of vascular disease stratified by several basic characteristics. In addition, the joint effects of spicy food consumption and the healthy lifestyle score on the risk of vascular disease were also evaluated, and sensitivity analyses were performed to assess the reliability of the association results. RESULTS: During a median follow-up time of 12.1 years, a total of 136,125 patients with vascular disease, 46,689 patients with IHD, 10,097 patients with MCEs, 80,114 patients with cerebrovascular disease, 56,726 patients with stroke, and 40,098 patients with non-stroke cerebrovascular disease were identified. Participants who consumed spicy food 1-2 days/week (hazard ratio [HR] = 0.95, 95% confidence interval [95% CI] = [0.93, 0.97], P <0.001), 3-5 days/week (HR = 0.96, 95% CI = [0.94, 0.99], P = 0.003), and 6-7 days/week (HR = 0.97, 95% CI = [0.95, 0.99], P = 0.002) had a significantly lower risk of vascular disease than those who consumed spicy food less than once a week ( Ptrend <0.001), especially in those who were younger and living in rural areas. Notably, the disease-based subgroup analysis indicated that the inverse associations remained in IHD ( Ptrend = 0.011) and MCEs ( Ptrend = 0.002) risk. Intriguingly, there was an interaction effect between spicy food consumption and the healthy lifestyle score on the risk of IHD ( Pinteraction = 0.037). CONCLUSIONS Our findings support an inverse association between spicy food consumption and vascular disease in the Chinese population, which may provide additional dietary guidance for the prevention of vascular diseases.
Humans ; Male ; Female ; Prospective Studies ; Middle Aged ; Aged ; Vascular Diseases/etiology* ; Risk Factors ; China/epidemiology* ; Adult ; Proportional Hazards Models ; Cerebrovascular Disorders/epidemiology* ; East Asian People

Objective:To investigate the curative effects of the ulnar artery perforator flap carrying 2 and more perforators of same source artery on reconstruction of defects in hand.Methods:A retrospective observational study was conducted on 13 patients with hand injuries combined with bone or tendon exposure and met the inclusion criteria of the study were admitted to the Department of Hand Surgery, Wuxi NO.9 People’s Hospital Affiliated to Soochow University between April 2022 and September 2023. The patients were 8 males and 5 females with a mean age of 45.7 (25-67) years. Seven hand injuries were caused by mechanical crushing, 2 by hot crushing and 4 by machine strangulation. After debridement, the sizes of defect were found at 5.4 cm×5.1 cm to 8.2 cm×7.5 cm. Dopplor ultrasound was applied to locate the perforators before surgery. Perforator flaps carrying cutaneous branches of ulnar artery proximal to the wrist were designed for reconstruction of the defects in hand. The flaps were 6.0 cm×5.5 cm-8.5 cm×8.0 cm in size. Donor sites were covered by the ulnar artery perforator flaps sized 5.3 cm×2.7 cm-8.2 cm×4.0 cm and carryied 2 and more perforators of the same source artery. During harvest of the flaps, the number and calibre of perforators carried by flap, the calibre of the main trunk of the superior carpal branch of the ulnar artery and the length of its pedicle were recorded. A total of 35 perforators with 0.35-0.95 mm in calibre carried by 13 perforator flaps of ulnar artery were successfully retained. Five of the 13 flaps carried the perforators with a calibre smaller than 0.50 mm. Overall, there were 7 flaps with 2 perforators per flap, 4 with 3 perforators per flap, 1 with 4 perforators and 1 with 5 perforators. The cutaneous branch of ulnar artery in a caliber of 0.75-1.35 mm and proximal to the wrist was dissected as the vascular pedicle with 30.0-45.0 mm in length. All patients were included in the schedueled postoperative at outpatient clinic to observe the appearance and sensation of the flaps, and the occurrence of complication.Results:All flaps survived and the wounds healed at first intention without vascular compromises, wound dehiscence or obvious swelling. All patients received 8 - 20 months of follow-up, with 15 months in average. Flaps presented good appearance and colour, with soft texture and without bloating. TPD of the first flap was 8-18 mm, with an average of 10.5 mm±0.5 mm and that of the second or relay flap was 7-15 mm, with an average of 9.5 mm±0.5 mm. According to British Medical Research Council (BMRC) system, the sensory evaluation of the recipient sites achieved S 4 in 5 flaps, S 3 in 9 flaps and S 2 in 12 flaps. Conclusion:The ulnar artery perforator flap with 2 and more perforators of the same source artery has sufficient and reliable blood supply and is effective in reconstruction of hand defects.

Objective:To investigate the relationship between serum insulin-like growth factor-1 (IGF-1) levels and intracranial or extracranial atherosclerosis in patients with cerebral small vessel disease (CSVD).Methods:A total of 407 patients with CSVD admitted to Xiangya Hospital of Central South University between July 2021 and September 2023 were enrolled in the study. Carotid duplex ultrasound was used to measure the internal diameter, intima-media thickness (IMT), vascular wall thickness, plaque property score, stenosis index, and stenosis ratio of the bilateral common carotid arteries, internal carotid arteries, external carotid arteries, and vertebral arteries. Magnetic resonance angiography was used to assess the degree of stenosis in intracranial arteries. Patients were divided into 4 groups based on the serum IGF-1 levels (low level group:≤5.21 ng/ml, medium level group:>5.21 ng/ml and ≤10.73 ng/ml, high level group:>10.73 ng/ml and ≤24.26 ng/ml, extremely high level group:>24.26 ng/ml). The IMT of the common carotid artery, carotid plaques, diameters of various cervical vascular lumens, carotid artery diameter stenosis, and intracranial artery stenosis in 4 groups of the patients were compared. The relationship between IGF-1 and intracranial and extracranial atherosclerosis was analyzed by univariate Logistic regression analysis and multivariate Logistic regression analysis.Results:There were inter group differences among the 4 groups in internal carotid artery diameter [low level group 5.45 (0.50) mm vs medium level group 5.32 (0.55) mm vs high level group 5.30 (0.55) mm vs extremely high level group 5.30 (0.50) mm; H=8.210, P=0.042]. The carotid IMT [low level group 0.80 (0.05) mm vs medium level group 0.80 (0.05) mm vs high level group 0.83 (0.03) mm vs extremely high level group 0.83 (0.09) mm; H=8.107, P=0.044], the proportion of carotid artery vascular wall thickening [low level group 52.9%(54/102) vs medium level group 48.0%(49/102) vs high level group 68.3%(69/101) vs extremely high level group 60.8%(62/102); χ2=9.889, P=0.020], the carotid artery plaque property score [low level group 1 (2) vs medium level group 2 (2) vs high level group 2 (2) vs extremely high level group 2 (2); H=8.913, P=0.030] and the proportion of anterior cerebral artery stenosis [low level group 2.9%(3/102) vs medium level group 2.0%(2/102) vs high level group 4.0%(4/101) vs extremely high level group 10.8%(11/102); χ2=10.473, P=0.014] had inter group differences among the 4 groups, and the differences were statistically significant. Univariate Logistic regression analysis indicated that carotid artery vascular wall thickening ( OR=1.197, 95% CI 1.003-1.429, P=0.046), anterior cerebral artery stenosis ( OR=1.814, 95% CI 1.148-2.867, P=0.011), and basilar artery stenosis ( OR=1.530, 95% CI 1.084-2.159, P=0.015) were correlated with IGF-1 levels. Multivariate Logistic regression analysis revealed that after adjusting for age, gender, low-density lipoprotein cholesterol (LDL-C), and C-reactive protein, IGF-1 was positively correlated with the carotid artery vascular wall thickening ( OR=1.311, 95% CI 1.014-1.696, P=0.039); after adjusting for age, IGF-1 was positively correlated with the anterior cerebral artery stenosis ( OR=2.130, 95% CI 1.201-3.776, P=0.010); after adjusting for gender, low-density lipoprotein cholesterol, and cholesterol levels, IGF-1 was positively correlated with basilar artery stenosis ( OR=1.688, 95% CI 1.063-2.681, P=0.027). Conclusions:There is an association between IGF-1 levels and intracranial and extracranial atherosclerosis in patients with CSVD. IGF-1 may play a role in the development and progression of atherosclerosis in CSVD.

Objective:We aimed to develop a nomogram in corporating multidetector computed tomography(MDCT)imaging features and clinicopathological indicators for the preoperative prediction of axillary lymph node metastasis(ALNM)in patients with triple-negative breast cancer(TNBC).Methods:We retrospectively analyzed data from 265 female patients with pathologically confirmed TNBC treated at Harbin Medical University Cancer Hospital between November 2020 and October 2024.Patients were randomly assigned into a training cohort(n=161)and a validation cohort(n=104)in a 6:4 ratio.Feature selection was performed using least absolute shrinkage and selection operator(LASSO)regression with 10-fold cross-validation.Independent predictors of ALNM were identified by multivariate Logistic regression analysis,and a nomogram was constructed accordingly.Model performance was assessed using receiver operating characteristic(ROC)curves,calib-ration plots,and decision curve analysis(DCA).Results:Three independent predictors of ALNM were identified:clinical N-stage(odds ratio[OR]=6.789;95%confidence interval[CI]:2.203-22.20;P=0.001),short-axis diameter of lymph nodes on CT(OR=1.686;95%CI:1.349-2.257;P<0.001),and cortical thickness(OR=6.296;95%CI:2.170-19.310;P=0.001).The nomogram showed strong discrimination,with areas under the ROC curve(AUC)of 0.918(95%CI:0.860-0.977)in the training cohort and 0.885(95%CI:0.809-0.962)in the validation cohort.Calibration was confirmed by Hosmer-Lemeshow tests(P=0.609 and P=0.694 for training and validation cohorts,respectively).DCA demon-strated clinical utility across probability thresholds of 0.02-0.96 and 0.03-0.87 in the training and validation cohorts,respectively.Conclu-sions:This nomogram,integrating MDCT imaging features and clinical indicators,provides a practical tool for individualized preoperative risk assessment and may aid clinical decision-making in patients with TNBC.

Objective:To investigate the curative effects of the ulnar artery perforator flap carrying 2 and more perforators of same source artery on reconstruction of defects in hand.Methods:A retrospective observational study was conducted on 13 patients with hand injuries combined with bone or tendon exposure and met the inclusion criteria of the study were admitted to the Department of Hand Surgery, Wuxi NO.9 People’s Hospital Affiliated to Soochow University between April 2022 and September 2023. The patients were 8 males and 5 females with a mean age of 45.7 (25-67) years. Seven hand injuries were caused by mechanical crushing, 2 by hot crushing and 4 by machine strangulation. After debridement, the sizes of defect were found at 5.4 cm×5.1 cm to 8.2 cm×7.5 cm. Dopplor ultrasound was applied to locate the perforators before surgery. Perforator flaps carrying cutaneous branches of ulnar artery proximal to the wrist were designed for reconstruction of the defects in hand. The flaps were 6.0 cm×5.5 cm-8.5 cm×8.0 cm in size. Donor sites were covered by the ulnar artery perforator flaps sized 5.3 cm×2.7 cm-8.2 cm×4.0 cm and carryied 2 and more perforators of the same source artery. During harvest of the flaps, the number and calibre of perforators carried by flap, the calibre of the main trunk of the superior carpal branch of the ulnar artery and the length of its pedicle were recorded. A total of 35 perforators with 0.35-0.95 mm in calibre carried by 13 perforator flaps of ulnar artery were successfully retained. Five of the 13 flaps carried the perforators with a calibre smaller than 0.50 mm. Overall, there were 7 flaps with 2 perforators per flap, 4 with 3 perforators per flap, 1 with 4 perforators and 1 with 5 perforators. The cutaneous branch of ulnar artery in a caliber of 0.75-1.35 mm and proximal to the wrist was dissected as the vascular pedicle with 30.0-45.0 mm in length. All patients were included in the schedueled postoperative at outpatient clinic to observe the appearance and sensation of the flaps, and the occurrence of complication.Results:All flaps survived and the wounds healed at first intention without vascular compromises, wound dehiscence or obvious swelling. All patients received 8 - 20 months of follow-up, with 15 months in average. Flaps presented good appearance and colour, with soft texture and without bloating. TPD of the first flap was 8-18 mm, with an average of 10.5 mm±0.5 mm and that of the second or relay flap was 7-15 mm, with an average of 9.5 mm±0.5 mm. According to British Medical Research Council (BMRC) system, the sensory evaluation of the recipient sites achieved S 4 in 5 flaps, S 3 in 9 flaps and S 2 in 12 flaps. Conclusion:The ulnar artery perforator flap with 2 and more perforators of the same source artery has sufficient and reliable blood supply and is effective in reconstruction of hand defects.