Objective:To construct a nomogram model for predicting the incidence of hepatocellular carcinoma based on serum abnormal prothrombin and alpha-fetoprotein and evaluate the predictive effect.Methods:Retrospective analysis of data from 351 patients with liver disease who received treatment at the First Affiliated Hospital of Zhengzhou University from January 2021 to December 2023, including 285 males and 66 females, aged (52.9±11.9) years. Among the 351 patients, there were 229 cases (65.2%) of hepatocellular carcinoma, 87 cases (24.8%) of liver cirrhosis, and 35 cases (10.0%) of chronic hepatitis B. All patients were randomly divided into a training set ( n=245) and a testing set ( n=106) in a 7∶3 ratio without replacement sampling. The training set was used to construct the model, and the testing set was used to evaluate the model. At the same time, gender, age, disease type, and other indicators were compared between the two sets. The risk factors of hepatocellular carcinoma were analyzed by univariate and multivariate logistic regression based on the training set, and a nomogram was constructed to predict the incidence of hepatocellular carcinoma based on the multivariate results. Receiver operating characteristic (ROC) curve and calibration curve were used to evaluate the predictive performance of nomogram, and decision curve analysis was used to evaluate the clinical applicability of the model. Results:There was no statistically significant difference in age, gender, disease type, etc. between the training and testing sets of patients (all P>0.05). Univariate logistic regression analysis showed that age, abnormal prothrombin logarithm (LnPIVKA-Ⅱ), alpha-fetoprotein logarithm (LnAFP), and diabetes were associated with hepatocellular carcinoma (all P<0.05). Multivariate logistic regression analysis showed that older age ( OR=1.07, 95% CI: 1.03-1.12), higher LnPIVKA-Ⅱ ( OR=2.97, 95% CI: 1.97-4.46), higher LnAFP ( OR=1.43, 95% CI: 1.11-1.84) and diabetes ( OR=5.17, 95% CI: 1.02-26.17) were risk factors for hepatocellular carcinoma (all P<0.05). Based on the above variables, a nomogram model for predicting the incidence of hepatocellular carcinoma was constructed. The area under the ROC curve analysis of the nomogram for predicting the incidence of hepatocellular carcinoma was 0.920 (95% CI: 0.886-0.953) in the training set and 0.934 (95% CI: 0.891-0.977) in the testing set. The calibration curve fit well with the standard curve, and the prediction was basically consistent with the actual situation. The decision curve analysis showed that the net benefit of the model was greater than 0 under most thresholds (0.1-1.0). Conclusion:The nomogram constructed based on age, LnPIVKA-Ⅱ, LnAFP and diabetes can effectively predict the incidence of hepatocellular carcinoma and has clinical applicability.

Objective:To construct a nomogram model for predicting the incidence of hepatocellular carcinoma based on serum abnormal prothrombin and alpha-fetoprotein and evaluate the predictive effect.Methods:Retrospective analysis of data from 351 patients with liver disease who received treatment at the First Affiliated Hospital of Zhengzhou University from January 2021 to December 2023, including 285 males and 66 females, aged (52.9±11.9) years. Among the 351 patients, there were 229 cases (65.2%) of hepatocellular carcinoma, 87 cases (24.8%) of liver cirrhosis, and 35 cases (10.0%) of chronic hepatitis B. All patients were randomly divided into a training set ( n=245) and a testing set ( n=106) in a 7∶3 ratio without replacement sampling. The training set was used to construct the model, and the testing set was used to evaluate the model. At the same time, gender, age, disease type, and other indicators were compared between the two sets. The risk factors of hepatocellular carcinoma were analyzed by univariate and multivariate logistic regression based on the training set, and a nomogram was constructed to predict the incidence of hepatocellular carcinoma based on the multivariate results. Receiver operating characteristic (ROC) curve and calibration curve were used to evaluate the predictive performance of nomogram, and decision curve analysis was used to evaluate the clinical applicability of the model. Results:There was no statistically significant difference in age, gender, disease type, etc. between the training and testing sets of patients (all P>0.05). Univariate logistic regression analysis showed that age, abnormal prothrombin logarithm (LnPIVKA-Ⅱ), alpha-fetoprotein logarithm (LnAFP), and diabetes were associated with hepatocellular carcinoma (all P<0.05). Multivariate logistic regression analysis showed that older age ( OR=1.07, 95% CI: 1.03-1.12), higher LnPIVKA-Ⅱ ( OR=2.97, 95% CI: 1.97-4.46), higher LnAFP ( OR=1.43, 95% CI: 1.11-1.84) and diabetes ( OR=5.17, 95% CI: 1.02-26.17) were risk factors for hepatocellular carcinoma (all P<0.05). Based on the above variables, a nomogram model for predicting the incidence of hepatocellular carcinoma was constructed. The area under the ROC curve analysis of the nomogram for predicting the incidence of hepatocellular carcinoma was 0.920 (95% CI: 0.886-0.953) in the training set and 0.934 (95% CI: 0.891-0.977) in the testing set. The calibration curve fit well with the standard curve, and the prediction was basically consistent with the actual situation. The decision curve analysis showed that the net benefit of the model was greater than 0 under most thresholds (0.1-1.0). Conclusion:The nomogram constructed based on age, LnPIVKA-Ⅱ, LnAFP and diabetes can effectively predict the incidence of hepatocellular carcinoma and has clinical applicability.

Biochemical liver function tests are important methods to determine liver function in clinical practice， but abnormal liver biochemical parameters are not completely equivalent to liver damage. Some genetic and immune factors can also cause abnormal liver biochemical parameters， but with good prognosis in most cases. This article summarizes the causes of some benign abnormal liver biochemical parameters， so as to help clinicians to broaden their thinking of diagnosis and treatment， take into account genetic and immune factors， and avoid misdiagnosis and mistreatment.

Morita therapy has been bom for more than 100 years.Inpatient Morita therapy is highly oper-able and easy to master.It can improve many refractory neuroses through four-stage treatment.But more neuroses are treated in outpatient clinics,and Morita therapy cannot be used in hospitalized patients.Therefore,the formula-tion of expert opinions on outpatient operations is particularly important.This paper is based on domestic and for-eign references,and after many discussions by domestic Morita therapy experts,and then drew up the first version of the expert opinions on operation of outpatient Morita therapy.Meanwhile the operation rule of Morita therapy in three stages of outpatient treatment was formulated:in the etiological analysis stage,under the theoretical guidance of Morita therapy,analyze the pathogenic factors,to improve treatment compliance and reduce resistance;during the operating stage,guide patients to engage in constructive and meaningful actions,realizing the achievement of letting nature take its course principle;in the cultivating character and enriching life stage,pay attention to positive infor-mation,expanding the scope and content of actions,improving the ability to adapt to complex life,and preventing recurrence caused by insufficient abilities.It will lay a foundation for the promotion of Morita therapy in domestic outpatient clinics,so that more patients with neurosis and other psychological diseases could receive characteristic Morita therapy treatment in outpatient clinics.

Objective:To explore the current status of physical frailty in elderly patients with chronic obstructive pulmonary disease (COPD) and analyze its influencing factors.Methods:A total of 278 COPD patients who were admitted to Geriatric Medicine Center of Xinjiang Uygur Autonomous Region People's Hospital from February 2018 to February 2020 were selected as the research objects by the convenient sampling method. FRAIL Scale was used to assess frailty status of the patients. General information questionnaire and clinical questionnaires were used to investigate. Ordinal Logistic regression model was used to analyze the influencing factors of frailty in elderly COPD patients.Results:A total of 278 questionnaires were issued and 260 valid questionnaires were returned, including 120 cases without frailty, 97 cases in early frailty and 43 cases in frailty. The results of ordinal logistic regression analysis showed that age [ OR=1.324, 95% CI: (1.011-1.632) ], whether exercise regularly [ OR=0.265, 95% CI: (0.004-0.765) ], whether lack of nutrition [ OR=1.335, 95% CI: (0.258-1.985) ], with or without comorbidities [ OR=1.654, 95% CI: (0.521-1.865) ], lung function classification [ OR=2.356, 95% CI: (1.520-3.690) ], whether inflammation [ OR=1.258, 95% CI: (0.024-1.821) ] and prolonged length of stay in hospital due to exacerbation of COPD in the past 1 year [ OR=0.854, 95% CI: (0.214-1.662) ]were influencing factors of frailty in elderly COPD patients (all P<0.05) . Conclusions:The frailty of elderly patients with COPD is affected by factors such as age, exercise, nutritional status, length of stay in hospital, lung function, inflammation and complications. Nursing staff should prevent frailty and delay the progression of frailty in COPD patients through effective intervention.

BACKGROUND:Borosilicate cannot only be mineralized to form hydroxy carbonate apatite layer, but also have strong chemical reactivity to promote bone cel regeneration. OBJECTIVE:To investigate the effect of the borosilicate bioglass on the growth behavior of rabbit osteoblasts through in vitro culture experiment. METHODS:The initial and secondary extracts of borosilicate bioglass were prepared according to the requirement of ISO10993-12: 2007. The bone marrow mesenchymal stem cels of rabbits were isolated and cultured. The second generation bone marrow mesenchymal stem cels were induced to differentiate into osteoblasts. The osteoblasts of the 5th-15th RESULTS AND CONCLUSION:The osteoblasts proliferation in the initial extract and secondary extract groups was better than that in the α-MEM medium group (P < 0.05). The osteoblasts proliferation in the initial extract group was better than that in the secondary extract group (P < 0.05). The total protein content of osteoblasts in the initial extract group was higher than that in the secondary extract and α-MEM medium group (P < 0.05). There were no significant differences in the alkaline phosphatase activity, apoptosis rate, horizontal migration distance of osteoblast and transmembrane cel number in Transwel between these three groups. These results demonstrate that borosilicate bioglass has good biocompatibility and has a certain benign regulatory role in generations were obtained and cultured with the initial and secondary extracts of borosilicate bioglass and α-MEM medium, respectively. The effects of borosilicate bioglass on the osteoblasts proliferation, protein synthesis, alkaline phosphatase activity, cel apoptosis, and cel migration in horizontal and vertical direction were observed.RESULTS AND CONCLUSION: The osteoblasts proliferation in the initial extract and secondary extract groups was better than that in the α-MEM medium group (P < 0.05). The osteoblasts proliferation in the initial extract group was better than that in the secondary extract group (P < 0.05). The total protein content of osteoblasts in the initial extract group was higher than that in the secondary extract and α-MEM medium group (P < 0.05). There were no significant differences in the alkaline phosphatase activity, apoptosis rate, horizontal migration distance of osteoblast and transmembrane cell number in Transwell between these three groups. These results demonstrate that borosilicate bioglass has good biocompatibility and has a certain benign regulatory role in osteoblast proliferation.