Objective To explore the impact of tumor-associated myeloid cell infiltration signatures on postoperative overall survival (OS) in patients with gastric cancer. Methods A retrospective analysis was performed on patients who underwent radical gastrectomy at Zhongshan Hospital, Fudan University from January 2005 to December 2019. Patients were randomly divided into a training set (n＝167) and an internal validation set (n＝168) at a 1:1 ratio. Meanwhile, 147 patients with gastric cancer treated at Zhongshan Hospital (Xiamen), Fudan University during the same period were enrolled as the external validation set (n＝147). Immunohistochemistry was used in all patients to evaluate the distribution characteristics of 18 immune markers in three regions of gastric cancer tissues, namely primary tumor (PT), invasive margin (IM), and normal tissue (NT). These markers include 11 myeloid cell markers (CD11b, CD33, CD11c, CD14, CD15, CD16, CD68, CD86, CD163, CD206, and CD66b) and 7 immune checkpoints (CD73, IDO, LAG3, PD-1, SIGLEC9, SIRPA, and TIM3). LASSO regression and Cox proportional hazards model were applied to screen immune markers associated with postoperative OS in gastric cancer patients, and a predictive model for 1-, 3-, and 5-year postoperative OS was established. Data from the internal and external validation set were used for internal and external verification of the predictive model. Receiver operating characteristic (ROC) curves were plotted and the area under the curve (AUC) was calculated to assess the discriminative ability of the model. Results In the training set, LASSO regression and Cox proportional hazards model identified 4 immune marker signatures (CD14_PT, CD15_PT, CD206_PT, and SIGLEC9_PT) to construct the predictive model. ROC curve analysis showed that the AUCs of the model for predicting 1-, 3-, and 5-year postoperative OS were 0.74, 0.75, and 0.84, respectively. When the model was applied to the internal and external validation sets, the AUCs for 1-, 3-, and 5-year postoperative OS were 0.74, 0.72, 0.72 (internal validation set) and 0.72, 0.71, 0.74 (external validation set), respectively. Cox multivariate regression analysis showed that the risk score was an independent risk factor for postoperative OS in patients with gastric cancer. Conclusion The model constructed based on LASSO-Cox regression exhibits good predictive performance and can effectively predict postoperative OS in gastric cancer patients, which may serve as a basis for intensive treatment of high-risk patients after surgery.

Objective: To investigate the health literacy level and its influencing factors among the elderly in Shunyi District, Beijing Municipality, so as to provide the evidence for developing health literacy intervention measures and improving the elderly's health literacy level. Methods: From September to November 2024, permanent residents aged ≥60 years in Shunyi District were selected by a multi-stage random sampling method combined with probability proportionate to size sampling method. The Chinese Elderly Health Literacy Questionnaire was used to conduct face-to-face surveys on basic information, health status, and health literacy. The health literacy level of the elderly was analyzed. Multivariable logistic regression model and decision tree model were used to analyze the influencing factors for health literacy level of the elderly. Results: There were 285 males (47.50%) and 315 females (52.50%). The mean age was (68.91±7.38) years. The health literacy level of the elderly was 14.33%. The literacy levels of basic concepts, basic knowledge, and basic skills were 43.33%, 5.33%, and 50.83%, respectively. The literacy levels of scientific aging concept, intrinsic capacity and geriatric syndromes, healthy lifestyle, information acquisition and self-care, health service utilization and chronic disease management, and safety and first aid were 52.33%, 7.17%, 51.83%, 58.83%, 72.00%, and 4.33%, respectively. Multivariable logistic regression analysis showed that educational level (high school/technical secondary school/technical school and above, OR=2.376, 95%CI: 1.020-5.532), monthly household income per capita (1 000-<3 500 yuan, OR=2.973, 95%CI: 1.349-6.555), residence (urban, OR=3.836, 95%CI: 2.071-7.105), and health attention (relatively concerned, OR=4.164, 95%CI: 1.779-9.742) were influencing factors for health literacy level of the elderly. Decision tree model results showed that educational level, monthly household income per capita, residence, and health attention were influencing factors for health literacy level of the elderly, with residence being the main influencing factor. Elderly people living in urban areas, relatively concerned about health, and with high school/technical secondary school/technical school and above educational level had higher health literacy level (40.00%). Conclusions The health literacy level of the elderly in Shunyi District is mainly affected by educational level, monthly household income per capita, residence, and health attention. It is recommended to focus on rural elderly with lower educational level, monthly household income per capita, and health attention.

Objective To identify the risk factors of corneal endothelial cell injury caused by phacoemulsification, so as to provide the evidence for formulating interventions for prevention of corneal endothelial cell injury among cataract patients. Methods A total 248 eyes from 212 cataract patients that underwent phacoemulsification were selected as study subjects. The associations of subjects’ age, gender, left/right eye, pupillary diameter, grades of lens nucleus hardness, duration of phacoemulsification, total ultrasound energy, total infusion fluid amount with endothelial cell loss were evaluated using univariate analysis, and the independent risk factors for corneal endothelial cell injury caused by phacoemulsification were identified using multiple linear regression analysis. Results The density of endothelial cells was (2282.4 ± 412.16) cells/mm² prior to phacoemulsification and (1921.77 ± 125.46) cells/mm² months after phacoemulsification in 239 affected eyes, and the proportion of endothelial hexagonal cells was (54.41 ± 7.22)% prior to phacoemulsification and (45.62 ± 3.58)% months after phacoemulsification (χ² = 5.43, P < 0.05). The incidence of corneal endothelial cell injury was 15.5% in 239 affected eyes. Univariate analysis showed that advanced age, small pupillary diameter, long duration of phacoemulsification, high grades of lens nucleus hardness and high total ultrasound energy were associated with endothelial cell loss, while gender and surgical eyes (left or right eye) were not associated with endothelial cell loss. Multiple linear regression analysis revealed that high grades of lens nucleus hardness, high total infusion fluid amount, long duration of phacoemulsification and high total ultrasound energy were independent risk factors for endothelial cell loss. Conclusions Lens nucleus hardness, high totalinfusion fluid amount, long duration of phacoemulsification and high total ultrasound energy are independent risk factors for endothelial cell loss caused by phacoemulsification.