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.

Photoacoustic imaging (PAI), an emerging hybrid imaging modality, integrates the high spatial resolution of optical imaging with the deep-tissue imaging capability of ultrasound. Emerging evidence from recent studies in dental medicine has demonstrated the unique potential of PAI in screening, diagnosis, and therapeutic monitoring of oral pathologies, including periodontal diseases, oral cancers, and pulpal disorders. However, its clinical translation remains contingent upon addressing multiple technical barriers, particularly signal attenuation induced by optical scattering in biological tissues and limitations in real-time imaging efficiency. Therefore, investigating the advancements and challenges of PAI technology in the diagnosis of oral diseases will contribute to advancing further research and clinical applications, thereby providing practical support for improving the accuracy of early diagnosis and the efficacy of treatment for oral diseases.

Objective:To review the literature on surrogate decision making in stroke patients, and to clarify the application status of proxy decision making in stroke patients.Methods:Using the scope review guide as the methodological framework, studies on the application of surrogate decision in stroke patients, PubMed, Medline, CINAHL, Web of Science, Cochrane Library, CNKI, Wanfang, China Biology Medicine databases were searched from the database inception to January 12, 2024.Results:A total of 20 articles were included, including 12 cross-sectional studies, 6 qualitative studies, 1 cohort study, and 1 case report. At present, surrogate decision was mainly used in brain surgery, tube placement and comfort care. The agent had a complicated mood when making a decision and self-doubt after making a decision. Agency decision making was susceptible to demographic factors, disease-related factors, cultural factors, emotional and psychological factors and other factors. Although the outcomes of most proxy decisions were in line with patient preferences, there was a difference in the estimates of prognosis between agents and medical staff.Conclusions:Proxy decision making is widely used in the field of stroke, but the psychological burden of agents is heavy. Developing advance care planning for stroke patients and developing decision aids may help agents make the best decision.

Photoacoustic imaging (PAI), an emerging hybrid imaging modality, integrates the high spatial resolution of optical imaging with the deep-tissue imaging capability of ultrasound. Emerging evidence from recent studies in dental medicine has demonstrated the unique potential of PAI in screening, diagnosis, and therapeutic monitoring of oral pathologies, including periodontal diseases, oral cancers, and pulpal disorders. However, its clinical translation remains contingent upon addressing multiple technical barriers, particularly signal attenuation induced by optical scattering in biological tissues and limitations in real-time imaging efficiency. Therefore, investigating the advancements and challenges of PAI technology in the diagnosis of oral diseases will contribute to advancing further research and clinical applications, thereby providing practical support for improving the accuracy of early diagnosis and the efficacy of treatment for oral diseases.

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 review the literature on surrogate decision making in stroke patients, and to clarify the application status of proxy decision making in stroke patients.Methods:Using the scope review guide as the methodological framework, studies on the application of surrogate decision in stroke patients, PubMed, Medline, CINAHL, Web of Science, Cochrane Library, CNKI, Wanfang, China Biology Medicine databases were searched from the database inception to January 12, 2024.Results:A total of 20 articles were included, including 12 cross-sectional studies, 6 qualitative studies, 1 cohort study, and 1 case report. At present, surrogate decision was mainly used in brain surgery, tube placement and comfort care. The agent had a complicated mood when making a decision and self-doubt after making a decision. Agency decision making was susceptible to demographic factors, disease-related factors, cultural factors, emotional and psychological factors and other factors. Although the outcomes of most proxy decisions were in line with patient preferences, there was a difference in the estimates of prognosis between agents and medical staff.Conclusions:Proxy decision making is widely used in the field of stroke, but the psychological burden of agents is heavy. Developing advance care planning for stroke patients and developing decision aids may help agents make the best decision.

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*