Objective To compare the ability of single-phase,dual-phase,and triphasic models in forecasting postoperative pancreatic fistula(POPF)after pancreaticoduodenectomy(PD)using radiomics based on triphasic enhanced CT.Methods A total of 181 patients who underwent multi-phase enhanced CT prior to PD were retrospectively selected,and the collection phase included non-contrast,arterial phase(AP),and equilibrium phase(EP).3D Slicer software was utilized to segment the region of interest(ROI)for the postoperative pancreatic remnant on each phase.Radiomics feature extraction was performed using R software,followed by feature selection through least absolute shrinkage and selection operator(LASSO)regression with five-fold cross-validation to prevent model overfitting.The effective features selected were combined in a weighted linear manner to obtain a Radiomics score(Radscore).The patients were divided into training set and test set in a 7︰3 ratio.Logistic regression was employed to construct seven POPF prediction models(three single-phase,three dual-phase,and one triphasic models)based on different phase combinations.The diagnostic performance of the models was evaluated using the area under the curve(AUC)of receiver operating characteristic(ROC)curve,accuracy(ACC),sensitivity(SEN),and specificity(SPE).The DeLong test was applied to compare the differences in AUC among different models.Results After LASSO regression,24 effective features associated with POPF were selected from different phases.In the test set,the triphasic model exhibited the highest AUC and ACC(AUC=0.76,ACC=0.808).The calibration curve demonstrated the strongest agreement between the estimated probabilities and observed probabilities for the triphasic model.The decision curve analysis(DCA)curve indicated that the triphasic model had the largest threshold range with a higher net benefit.Conclusion Compared with single-phase and dual-phase models,the triphasic model based on enhanced CT provides better prediction of POPF after PD,aiding clinical decision-making and improve prognosis.

Objective To investigate the clinical effect of Nuan'gong decoction in the treatment of cold coagulation and blood stasis type menorrhagia.Methods A total of 120 patients with oligomenorrhea were selected and divided into two groups according to random number table method:estrogen and progesterone group and Nuan'gong decoction.The estrogen and progesterone group was treated with se-quential estrogen and progesterone therapy,while the Nuan'gong decoction group was treated with Nuan'gong decoction on the top of the estrogen and progesterone group.The therapeutic effects,menstrual status,and changes in uterine artery blood flow were compared be-tween the two groups.Results The total effective rate of the Nuan'gong decoction group was 91.67％,which was greatly higher than the 76.67％of the estrogen and progesterone group(P＜0.05).After treatment,the traditional Chinese medicine syndrome score and men-strual distress questionnaire(MDQ)Chinese version score of the Nuan'gong decoction group were lower than those of the estrogen and progesterone group(P＜0.05).After treatment,the duration of menstruation in the Nuan'gong decoction group was longer than that in the estrogen and progesterone group(P＜0.05),and the pictorial blood loss assessment chart(PBAC)score was higher than that in the estrogen and progesterone group(P＜0.05).After treatment,the levels of progesterone(P),estradiol(E2),luteinizing hormone(LH),and follicle stimulating hormone(FSH)in the Nuan'gong decoction group were higher than those in the estrogen and progesterone group(P＜0.05).After treatment,the uterine artery pulsatility index(PI),resistance index(BI)and systolic/diastolic peak flow ve-locity(S/D)in the Nuan'gong decoction group were lower than those in the estrogen and progesterone group.Conclusion For patients with cold coagulation and blood stasis type oligomenorrhea,Nuan'gong decoction for traditional Chinese medicine syndrome differentiation treatment can achieve great therapeutic effects,effectively prolong the duration of menstruation,restore menstrual flow and sex hormone levels,and improve the blood flow parameters of uterine artery.

Objective To investigate the impact of immobilization devices and treatment couches on the planned dose in stereotactic body radiation therapy(SBRT).Methods A retrospective study was conducted involving 23 SBRT patients,all of whom underwent CT simulation with foam padding or vacuum bag immobilization.For each patient,two sets of contours were outlined on CT images:one encompassing only the patient's skin(Body),and the other including the skin plus immobilization devices(BodyF).Initially,a reference plan(noFC)meeting clinical requirements was generated based on the Body contour.Without altering the plan(noFC)parameters and field setups,plan calculations were performed separately based on three different contours:BodyF(with immobi-lization devices only),Body+C(with treatment couch only),and BodyF+C(with both immobilization devices and treatment couch),yielding plan(F),plan(C),and plan(FC),respectively.By comparing the target and skin dose parameters across these four plans,the effects of immobilization devices and treatment couches on the planned dose were evaluated.Results Compared to plans based solely on the patient's skin contour,plans incorporating immobilization devices showed reduced high-dose,prescription dose coverage,and average dose in the target volume.Notably,the difference in the percentage of the planning target volume(PTV)receiving 105%of the prescribed dose(PTV/V105%p(%))between plan(FC)and plan(noFC)could reach 61.86%.Conversely,plans with immobilization devices increased both the maximum and average skin doses.Specifically,the dose to 10 cc of skin within 2 mm of the surface(body 2 mm/D 10 cc(Gy))showed a 21.36%difference between plan(FC)and plan(noFC).For all target and skin parameters,no statistically significant differences were observed between plan(C)and plan(noFC).Among plans with immobilization devices,the minimum distance from the target to the skin correlated inversely with skin dose,indicating greater impact on skin dose with closer proximity.Conclusions Immobilization devices in SBRT lead to beam attenuation and altered build-up effects,significantly reducing target dose parameters while increasing skin dose.The closer the target is to the skin,the greater the impact of immobiliza-tion devices on skin dose.It is recommended to incorporate immobilization devices into the contour design during radiotherapy planning.

Objective To explore the correlation between the pathogenesis of toxins damaging liver collateral and the incidence of type 2 diabetes mellitus(T2DM)based on the theory of five circuits and six qi.Methods A total of 986 patients with T2DM treated in the Department of Endocrinology and Metabolism at the Affiliated Hospital of Changchun University of Chinese Medicine from February 2019 to October 2023 were selected as the study subjects.The influences of circuit and qi indicators in the theory of five circuits and six qi on the constitutional characteristics of T2DM patients and the role of pathogenesis of toxins damaging liver collateral in the incidence of T2DM were investigated.Results(1)The five-circuit and six-qi analysis showed that the yearly circuit and sitian/zaiquan conditions had no significant effect on the constitutional characteristics of patients with T2DM(P＞0.05).However,dominant circuit,guest circuit,dominant qi and guest qi significantly influenced the constitutional characteristics of patients with T2DM(P＜0.05).For the distribution of circuit-qi indicators at birth among the 986 patients,dominant circuit was predominated by the terminal circuit of taiyang cold-water,guest circuit was characterized by deficient wood circuit or excessive water circuit,dominant qi was predominated by yangming dry-metal,and guest qi was characterized by taiyin damp-earth.(2)The correlation between the pathogenesis of toxins damaging liver collateral and the incidence of T2DM through comparative analysis revealed that the conveying and dispersing function of the liver plays a leading role in maintaining the body's yin-yang balance and ensuring free movement of qi,indicating that the critical role of toxins damaging liver collateral is the key to the incidence of diabetes.Conclusion Circuit-qi indicators have a certain influence on the constitutional characteristics of T2DM patients.The circuit-qi features at birth of the individuals prone to T2DM are as follows:dominant circuit predominated by the terminal circuit of taiyang cold-water,guest circuit characterized by deficient wood circuit or excessive water circuit,dominant qi being yangming dry-metal,and guest qi being taiyin damp-earth.Pathogenesis of toxins damaging liver collateral is closely related to the incidence of T2DM.Therefore,in treatment,the regulatory role of the liver should be emphasized,and liver-soothing herbs should be used based on syndrome differentiation,aiming for holistic treatment of the physique and the spirit and enhancing the therapeutic efficacy.The exploration will provide a new perspective and approach for the treatment of T2DM.

AIM To study the chemical constituents from Tetrastigma hemsleyanum Diels et Gilg and their antitumor activity in vitro.METHODS Silica gel,ODS,Sephadex LH-20 and semi-preparative HPLC were used for isolation and purification,then the structures of obtained compounds were identified by physicochemical properties and spectral data.The antitumor activity in vitro was determined by MTT mothod.RESULTS Twenty-eight compounds were isolated and identified as triphyllin A(1),eruberin B(2),(2S,4R)-5,7-dihydroxy-4,4'-dimethyl-6,8-dimethyl-flavan-5-O-β-D-6-acetylglucopyranoside-7-O-β-D-glucopyranoside(3),eruberin A(4),abacopterin Ⅰ(5),matteucinol(6),homoerodictyol(7),(2S)-5,3',4'-trihydroxy-7-methoxy-flavanone(8),(2S)-5,2',5'-trihydroxy-7-methoxyflavanone(9),galinsonside B(10),quercetin-3-O-β-D-glucopyranoside(11),kaempferol 3-O-robinobioside(12),rutin(13),geniposide(14),jasminoside A(15),β-sitostenone(16),sitosterol palmitate(17),β-sitosterol(18),ursolic acid(19),hyptadienic acid(20),3,4-dihydroxybenzoic acid(21),3,4-dimethoxybenzoic acid(22),gallic acid(23),dibutylphthalate(24),bis-(2-ethylhexyl)phthalate(25),9-nonadecenoic acid(26),triacylglycerol(27),crocin Ⅰ(28).The IC50 values of compound 1 for human gastric adenocarcinoma cells BGC-823 and human colon cancer cells HCT-116 were(22.07±0.38),(20.67±0.11)μmol/L,respectively.The IC50 value of compound 9 for BGC-823 cells was(21.58±0.05)μmol/L,and the IC50 value of compound 4 for HCT-116 cells was(16.67±0.36)μmol/L.CONCLUSION Compounds 1-10,14-15 and 28 are first isolated from Tetrastigma genus.Compounds 1,4,9 have weak antitumor activity in vitro.

AIM To study the chemical constituents from Periploca forrestii Schltr and their antitumor activity in vitro.METHODS Silica gel and Sephadex LH-20 were used for isolation and purification,then the structures of obtained compounds were identified by physicochemical properties and spectral data.The in vitro antitumor activity was evaluated by MTT mothod.RESULTS Twenty-four compounds were isolated and identified as lysidicichin(1),fraxidin(2),methoxylatifolone(3),corilagin(4),ligballinol(5),6-dehydroprogesterone(6),anomallenodiol(7),mustakone(8),eupatoricacid(9),honokiol(10),methyl 4-hydroxybenzoate(11),5,6,7,8-tetramethoxycoumarin(12),6,7-dimethoxycoumarin(13),5,6,7,4'-tetramethoxyflavone(14),2,3,2",3"-tetrahydrospirotaxone(15),sequoiavone(16),isocubebin(17),isoquercitrin(18),mellein(19),pistaciamide(20),suberoyltrigone(21)、daucosterol(22)、berchemol(23)、confluentin(24).The IC50 value of compound 18 for lung cancer cell NCI-H596 was(27.41±3.36)μmol/L.CONCLUSION Compounds 1-24 are isolated from P.forrestii for the first time.Compound 18 has good antitumor activity in vitro.

Objective To investigate the clinical effect of Nuan'gong decoction in the treatment of cold coagulation and blood stasis type menorrhagia.Methods A total of 120 patients with oligomenorrhea were selected and divided into two groups according to random number table method:estrogen and progesterone group and Nuan'gong decoction.The estrogen and progesterone group was treated with se-quential estrogen and progesterone therapy,while the Nuan'gong decoction group was treated with Nuan'gong decoction on the top of the estrogen and progesterone group.The therapeutic effects,menstrual status,and changes in uterine artery blood flow were compared be-tween the two groups.Results The total effective rate of the Nuan'gong decoction group was 91.67％,which was greatly higher than the 76.67％of the estrogen and progesterone group(P＜0.05).After treatment,the traditional Chinese medicine syndrome score and men-strual distress questionnaire(MDQ)Chinese version score of the Nuan'gong decoction group were lower than those of the estrogen and progesterone group(P＜0.05).After treatment,the duration of menstruation in the Nuan'gong decoction group was longer than that in the estrogen and progesterone group(P＜0.05),and the pictorial blood loss assessment chart(PBAC)score was higher than that in the estrogen and progesterone group(P＜0.05).After treatment,the levels of progesterone(P),estradiol(E2),luteinizing hormone(LH),and follicle stimulating hormone(FSH)in the Nuan'gong decoction group were higher than those in the estrogen and progesterone group(P＜0.05).After treatment,the uterine artery pulsatility index(PI),resistance index(BI)and systolic/diastolic peak flow ve-locity(S/D)in the Nuan'gong decoction group were lower than those in the estrogen and progesterone group.Conclusion For patients with cold coagulation and blood stasis type oligomenorrhea,Nuan'gong decoction for traditional Chinese medicine syndrome differentiation treatment can achieve great therapeutic effects,effectively prolong the duration of menstruation,restore menstrual flow and sex hormone levels,and improve the blood flow parameters of uterine artery.

ObjectiveTo investigate the feasibility and safety of endoscopic retrograde cholangiopancreatography （ERCP） combined with oral cholangiopancreatography in the treatment of major duodenal papilla gallbladder polyps. MethodsA retrospective analysis was performed for the clinical data of eight patients with choledocholithiasis and gallbladder polyps who underwent ERCP and combined with oral cholangiopancreatography for major duodenal papilla cholecystectomy in Center of Digestive Endoscopy， Jilin People’s Hospital， from May 2022 to June 2024， and related data were collected， including the success rate of surgery， the technical success rate of gallbladder polyp removal， the superselective method of cystic duct， the time of operation， the time of gallbladder polyp removal， and surgical complications. ResultsBoth the success rate of surgery and the technical success rate of gallbladder polyp removal reached 100%， and of all eight patients， three patients used guide wire to enter the gallbladder under direct view， while five patients received oral cholangiopancreatography to directly enter the gallbladder. The time of operation was 51.88±12.34 minutes， and the time of gallbladder polyp removal was 23.13±10.94 minutes. The diameter of gallbladder polyp was 2‍ ‍—‍ ‍8 mm， and pathological examination showed inflammatory polyps in three patients， adenomatous polyps in one patient， and cholesterol polyps in four patients. There were no complications during or after surgery. The patients were followed up for 2‍ ‍—‍ ‍27 months after surgery， and no recurrence of gallbladder polyp was observed. ConclusionOral cholangiopancreatography is technically safe and feasible in endoscopic major duodenal papilla cholecystectomy.

Objective:To assess the efficacy and safety profile of antaitasvir phosphate combined with yiqibuvir in the treatment of chronic hepatitis C (CHC) of various genotypes, without cirrhosis or with compensated cirrhosis.Methods:394 cases with CHC from 22 centers were collected from October 2021 to April 2023. They were randomly assigned to receive either the experimental drugs (antaitasvir phosphate 100 mg+yiqibuvir 600 mg) or placebo treatment in a 3∶1 ratio. The patients were administered drugs once a day for 12 consecutive weeks, and then followed up for 24 weeks after treatment cessation. All subjects were unblinded at the four-week follow-up following drug discontinuation, with the experimental drug group continuing to complete subsequent post-discontinuation follow-up. The placebo group was switched to receive the experimental drugs for a repeated 12-week treatment period and followed up for another 24 weeks after discontinuation of the drug (placebo delayed treatment phase).The sustained virologic response rate (SVR12) was observed for subjects in the double-blind phase and the placebo delayed-treatment phase at 12 weeks after treatment cessation.Virological resistance analysis was performed on subjects who failed treatment. The primary efficacy endpoint was SVR12. The number and percentage of subjects who achieved "HCV RNA

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.