Objective:To analyze the impact of preoperative controlling nutritional status (CONUT) score on the prognosis of gallbladder cancer patients with curative resection.Methods:The clinical data of gallbladder cancer patients, treated at Department of Hepatobiliary and Pancreatic Surgery, Ningbo Medical Center Lihuili Hospital from January 2016 to December 2023 were retrospectively analyzed. A total of 184 patients were enrolled in this study, including 84 males and 100 females, aged (67.6±9.5) years. Based on preoperative CONUT score, 184 patients were divided into the low-score group (0-3 points, n=138) and the high-score group (4-12 points, n=46). The clinicopathological features including age, preoperative carbohydrate antigen 125 level, maximum tumor diameter, vascular invasion, postoperative T stage and postoperative hospital length of stay, were compared between two groups. Univariate and multivariate Cox regression analysis were performed to analyze the relationship between preoperative CONUT score and prognosis of gallbladder cancer patients with curative resection. Results:The age, preoperative carbohydrate antigen 125 level, maximum tumor diameter, vascular invasion ratio, postoperative T stage and postoperative hospital length of stay in the high-score group were higher than those in the low-score group, and the differences were statistically significant (all P<0.05). Multivariate Cox regression analysis revealed that high CONUT score (4-12 points) was associated with a higher risk of poor overall survival ( HR=1.932, 95% CI: 1.165-3.203, P=0.011) and poor recurrence-free survival ( HR=1.600, 95% CI: 1.002-2.554, P=0.049). Conclusion:CONUT score (4-12 points) is a risk factor for poor overall survival and recurrence-free survival. Assessment of the CONUT score is an important preoperative consideration.

OBJECTIVE To observe the changes of serum proteins in the mice with carbapenem-resistant hyperviru-lent Klebsiella pneumoniae(CR-hvKP)bloodstream infection by using liquid chromatogram-mass spectrometer(LC-MS),find out the differentially expressed proteins and carry out corresponding biological function analysis.METHODS The models of ICR mice with CR-hvKP and classical Klebsiella pneumoniae(cKP)bloodstream infec-tions were established,the serum specimens were collected from the mice at 12 hours of establishment of the in-fection models and were detected by using LC-MS.The result of LC-MS was identified by using Maxquant soft-ware.The corresponding bioinformatics analysis was performed for the differentially expressed proteins.RESULTS As compared with the normal control group,there were 24 upregulated proteins and 20 downregulated proteins in CR-hvKP group.As compared with cKP group,there were 107 upregulated proteins in the CR-hvKP group.The 134 differentially expressed proteins were retrieved one by one from Uniprot database,it was found that the pro-teins were involved in biological regulation,immune process,biological interaction,movement,metabolic process,response to stimulation,signal transduction,inflammatory response,oxidative stress and angiogenesis.The signal pathway analysis involved multiple metabolism-related pathways,including complement and coagula-tion cascades,cholesterol metabolism,bacterial infection,heme clearance,and assembly,remodeling and clear-ance of plasma lipoprotein.In terms of the proteins being attached great importance,the expression levels of kal-likrein B1(KLKB1)and serpin family A(Serpina)1b were downregulated as compared with the normal control group and were upregulated as compared with the cKP group;the expression levels of serum amyloid A protein(SAA)1,SAA2,Vanin-3(VNN3)and hemoglobinβpolypeptide chain b2(HBB-b2)were upregulated as com-pared with both the cKP group and the normal control group.CONCLUSIONS The CR-hvKP bloodstream infection involves the activation and action of multiple proteins.The rise of SAA1,SAA2,VNN3 and HBB-b2 or the de-cline of KLKB1 and Serpina1b may indicate the CR-hvKP bloodstream infection.

Objective:To analyze the impact of preoperative controlling nutritional status (CONUT) score on the prognosis of gallbladder cancer patients with curative resection.Methods:The clinical data of gallbladder cancer patients, treated at Department of Hepatobiliary and Pancreatic Surgery, Ningbo Medical Center Lihuili Hospital from January 2016 to December 2023 were retrospectively analyzed. A total of 184 patients were enrolled in this study, including 84 males and 100 females, aged (67.6±9.5) years. Based on preoperative CONUT score, 184 patients were divided into the low-score group (0-3 points, n=138) and the high-score group (4-12 points, n=46). The clinicopathological features including age, preoperative carbohydrate antigen 125 level, maximum tumor diameter, vascular invasion, postoperative T stage and postoperative hospital length of stay, were compared between two groups. Univariate and multivariate Cox regression analysis were performed to analyze the relationship between preoperative CONUT score and prognosis of gallbladder cancer patients with curative resection. Results:The age, preoperative carbohydrate antigen 125 level, maximum tumor diameter, vascular invasion ratio, postoperative T stage and postoperative hospital length of stay in the high-score group were higher than those in the low-score group, and the differences were statistically significant (all P<0.05). Multivariate Cox regression analysis revealed that high CONUT score (4-12 points) was associated with a higher risk of poor overall survival ( HR=1.932, 95% CI: 1.165-3.203, P=0.011) and poor recurrence-free survival ( HR=1.600, 95% CI: 1.002-2.554, P=0.049). Conclusion:CONUT score (4-12 points) is a risk factor for poor overall survival and recurrence-free survival. Assessment of the CONUT score is an important preoperative consideration.

OBJECTIVE To observe the changes of serum proteins in the mice with carbapenem-resistant hyperviru-lent Klebsiella pneumoniae(CR-hvKP)bloodstream infection by using liquid chromatogram-mass spectrometer(LC-MS),find out the differentially expressed proteins and carry out corresponding biological function analysis.METHODS The models of ICR mice with CR-hvKP and classical Klebsiella pneumoniae(cKP)bloodstream infec-tions were established,the serum specimens were collected from the mice at 12 hours of establishment of the in-fection models and were detected by using LC-MS.The result of LC-MS was identified by using Maxquant soft-ware.The corresponding bioinformatics analysis was performed for the differentially expressed proteins.RESULTS As compared with the normal control group,there were 24 upregulated proteins and 20 downregulated proteins in CR-hvKP group.As compared with cKP group,there were 107 upregulated proteins in the CR-hvKP group.The 134 differentially expressed proteins were retrieved one by one from Uniprot database,it was found that the pro-teins were involved in biological regulation,immune process,biological interaction,movement,metabolic process,response to stimulation,signal transduction,inflammatory response,oxidative stress and angiogenesis.The signal pathway analysis involved multiple metabolism-related pathways,including complement and coagula-tion cascades,cholesterol metabolism,bacterial infection,heme clearance,and assembly,remodeling and clear-ance of plasma lipoprotein.In terms of the proteins being attached great importance,the expression levels of kal-likrein B1(KLKB1)and serpin family A(Serpina)1b were downregulated as compared with the normal control group and were upregulated as compared with the cKP group;the expression levels of serum amyloid A protein(SAA)1,SAA2,Vanin-3(VNN3)and hemoglobinβpolypeptide chain b2(HBB-b2)were upregulated as com-pared with both the cKP group and the normal control group.CONCLUSIONS The CR-hvKP bloodstream infection involves the activation and action of multiple proteins.The rise of SAA1,SAA2,VNN3 and HBB-b2 or the de-cline of KLKB1 and Serpina1b may indicate the CR-hvKP bloodstream infection.

Objective:To analyze the correlation between the modified Glasgow prognostic score (mGPS) and the prognosis of patients undergoing surgery for gallbladder cancer.Methods:Clinical data of 137 patients undergoing surgery for gallbladder cancer in the Department of Hepatobiliary and Pancreatic Surgery at Ningbo Medical Center Lihuili Hospital from January 2017 to December 2022 were retrospectively analyzed, including 58 males and 79 females, aged (67.7±10.1) years old. According to mGPS, patients were divided into the mGPS 0 group ( n=78), mGPS 1 group ( n=39) and mGPS 2 group ( n=20). Clinicopathological data, such as maximum tumor diameter, vascular invasion, perineural invasion, tumor differentiation and TNM stage, were compared between the groups. Survivals of patients were followed-up via outpatient follow-ups and telephone reviews, analyzed using the Kaplan-Meier method, and compared between the groups using the log-rank test. Univariate and multivariate Cox regression analysis were performed to identify prognostic factors for recurrence-free survival. Based on the results of multivariate analysis, a nomogram model of recurrence-free survival of gallbladder cancer patients was established and validated respectively. Results:The maximum tumor diameter, tumor differentiation, TNM stage, preoperative CA19-9 level and R 0 resection rate differed statistically among the mGPS 0, mGPS 1 and mGPS 2 groups (all P<0.05). Postoperative cumulative survival rate ( χ2=28.13) and recurrence-free survival rate ( χ2=25.39) of gallbladder cancer patients also differed among the mGPS groups (all P<0.001). Multivariate Cox regression analysis showed that the poor differentiation of tumor ( HR=2.433, 95% CI: 1.396-4.242, P=0.002), vascular invasion ( HR=2.809, 95% CI: 1.598-4.941, P<0.001), perineural invasion ( HR=1.980, 95% CI: 1.188-3.300, P=0.009), TNM stage Ⅲ-Ⅳ ( HR=2.689, 95% CI: 1.069-6.762, P=0.036) and mGPS 2 ( HR=2.496, 95% CI: 1.372-4.541, P=0.003) were independent risk factors for poor recurrence-free survival in gallbladder cancer. Based on the above risk factors, a nomogram of prediction model for recurrence-free survival in patients with gallbladder cancer was established, with a C-index value of 0.810 (95% CI: 0.769-0.851). The decision curve analysis findings demonstrated that the nomogram model had a significant positive net benefit, and the calibration curve demonstrated that the predicted results of the nomogram model correlates well with the actual results. Conclusions:The preoperative mGPS is associated with the overall prognosis of patients undergoing surgery for gallbladder cancer, and a high mGPS is a risk factor for poor prognosis. The mGPS-based nomogram of prediction model showed a good predictive value of the recurrence-free survival of patients undergoing surgery for gallbladder cancer.

BACKGROUND: In recent years, immunotherapy represented by programmed cell death 1 (PD-1)/programmed cell death ligand 1 (PD-L1) immunosuppressants has greatly changed the status of non-small cell lung cancer (NSCLC) treatment. PD-L1 has become an important biomarker for screening NSCLC immunotherapy beneficiaries, but how to easily and accurately detect whether PD-L1 is expressed in NSCLC patients is a difficult problem for clinicians. The aim of this study was to construct a Nomogram prediction model of PD-L1 expression in NSCLC patients based on 18F-fluorodeoxy glucose (18F-FDG) positron emission tomography/conputed tomography (PET/CT) metabolic parameters and to evaluate its predictive value. METHODS: Retrospective collection of 18F-FDG PET/CT metabolic parameters, clinicopathological information and PD-L1 test results of 155 NSCLC patients from Inner Mongolia People's Hospital between September 2016 and July 2021. The patients were divided into the training group (n=117) and the internal validation group (n=38), and another 51 cases of NSCLC patients in our hospital between August 2021 and July 2022 were collected as the external validation group according to the same criteria. Then all of them were categorized according to the results of PD-L1 assay into PD-L1+ group and PD-L1- group. The metabolic parameters and clinicopathological information of patients in the training group were analyzed by univariate and binary Logistic regression, and a Nomogram prediction model was constructed based on the screened independent influencing factors. The effect of the model was evaluated by receiver operating characteristic (ROC) curve, calibration curve and decision curve analysis (DCA) in both the training group and the internal and external validation groups. RESULTS: Binary Logistic regression analysis showed that metabolic tumor volume (MTV), gender and tumor diameter were independent influences on PD-L1 expression. Then a Nomogram prediction model was constructed based on the above independent influences. The ROC curve for the model in the training group shows an area under the curve (AUC) of 0.769 (95%CI: 0.683-0.856) with an optimal cutoff value of 0.538. The AUC was 0.775 (95%CI: 0.614-0.936) in the internal validation group and 0.752 (95%CI: 0.612-0.893) in the external validation group. The calibration curves were tested by the Hosmer-Lemeshow test and showed that the training group (χ2=0.040, P=0.979), the internal validation group (χ2=2.605, P=0.271), and the external validation group (χ2=0.396, P=0.820) were well calibrated. The DCA curves show that the model provides clinical benefit to patients over a wide range of thresholds (training group: 0.00-0.72, internal validation group: 0.00-0.87, external validation group: 0.00-0.66). CONCLUSIONS The Nomogram prediction model constructed on the basis of 18F-FDG PET/CT metabolic parameters has greater application value in predicting PD-L1 expression in NSCLC patients.
Humans ; Carcinoma, Non-Small-Cell Lung/drug therapy* ; Positron Emission Tomography Computed Tomography ; Lung Neoplasms/drug therapy* ; Fluorodeoxyglucose F18/therapeutic use* ; Nomograms ; Retrospective Studies ; B7-H1 Antigen/metabolism* ; Glucose/therapeutic use* ; Positron-Emission Tomography/methods*

Objective:To develop the discrimination experience questionnaire for HIV/acquired immunodeficiency syndrome(AIDS) patients and test the reliability and validity of the questionnaire.Methods:Based on the literature review and semi-structured interviews to clarify the operational definition of discrimination for HIV/AIDS and develop the item pool. The questionnaire was developed though 2 rounds Delphi consultation and a pilot test. A total of 410 HIV/AIDS patients in Shanghai Public Health Clinical Center of Fudan University from June to December 2020 were selected to investigate the questionnaire, item analysis was used to screen items. SPSS 22.0 software was used for reliability test and exploratory factor analysis, the AMOS 21.0 software was used for confirmatory factor analysis to test the reliability and validity of the questionnaire.Results:The questionnaire consisted 2 dimensions(external discrimination and internal discrimination) and 10 items. Exploratory factor analysis showed that two common factors were extracted from the frequency of discrimination and the degree of negative psychological impact of discrimination experience on patients, and the cumulative variance contribution rates were 48.367% and 55.403%, respectively. The confirmatory factor analysis on the frequency of discrimination showed that Chi square degree of freedom ratio ( χ2/ df) was 2.831, P<0.05, root mean square of approximation error (RMSEA) was 0.093, goodness of fit index (GFI) was 0.928, comparative fit index (CFI) was 0.925, incremental fit index (IFI) was 0.926; the confirmatory factor analysis on the negative psychological impact of discrimination experience on patients showed that χ2/ df was 1.740, P<0.05; RMSEA was 0.076, GFI was 0.925, CFI was 0.936, IFI was 0.938. The content validity of the questionnaire was 0.9. The Cronbach α coefficientof questionnaire was 0.811, and the test-retest coefficient was 0.862 ( P<0.01). Conclusions:The discrimination experience questionnaire for HIV/AIDS patients has good reliability and validity, and it can be used to measure the discrimination for HIV/AIDS patients.

Objective To determine the content of Sinapine thiocyanate in the Baixi Kechuan Cream by HPLC and to lay foundation for establishing the quality control standard of the preparation. Methods The HPLC system consisted of the column of DIKMA inertsil (pH=3,5 ?m,250 mm?4.6 mm). The acetonitrile and 3% acetic acid were used as the mobile phase A and B,respectively,and gradient elution was used. The detective wavelength was 326 nm and the flow rate was 1.0 mL/min. The column temperature was room temperature. Results The method was linear within the range of 0.8～4.0 ?g (r=0.999 6,n=5). The average recovery was 100.83%,and RSD=1.95% (n=5). Conclusion The method is quick,simple,highly reproductive and steady,and it can be used for quality control of the preparation.