The efficacy of preoperative neoadjuvant chemoradiotherapy(nCRT)in locally advanced rectal cancer(LARC)is predicted using radiomic features of the target areas in radiotherapy for rectal cancer and an interpretable machine learning model.The clinical data are collected from 290 LARC patients who are divided into effective and ineffective groups based on tumor regression grade.The extracted radiomic features and clinicopathological data are used to develop prediction models.The optimal model is determined based on AUC performance evaluation,and the explanatory analysis is conducted using nomogram and decision curve.A total of 223 patients are included in the study,with 48 in the effective group.There are 156 patients in the training set(34 in the effective group)and 67 patients in the validation set(14 in the effective group).The nomogram model shows the best performance,with AUC of 0.858 in the training set and 0.844 in internal test set,and decision curve analysis demonstrated its superior net clinical benefit across most threshold ranges than other models.Combining radiomics and clinical variables,the nomogram can effectively predict nCRT outcomes and support clinical decision-making.

Objective:To explore the safety and effectiveness of laparoscopic treatment for complicated appendicitis in children with and without abscess.Methods:A retrospective analysis was conducted on the clinical data of 363 patients with complicated appendicitis admitted to our department between May 2017 and Sep 2023. Patients were divided into two groups: the group without abscess and the group with abscess, comparing the surgical outcomes and incidence of postoperative complications between two groups.Results:As a result, all 277 cases in the non abscess group completed laparoscopic appendectomy, while all 86 cases in the periappendibular abscess group also completed laparoscopic appendectomy. The history of appendiceal abscess group was longer than that of the group without abscess [5(3-7) d vs. 2(1-3) d, Z=-11.59, P<0.05],the operation time was longer [86 (68-121) min vs. 63 (50-76) min, Z=-7.260, P<0.05], intraoperative bleeding was more [5(3-10) ml vs. 2(2-5) ml, Z=-7.010, P<0.001]. The incidence of postoperative complications was higher in the appendiceal abscess group, with a postoperative abdominal abscess rate of 11.1%,compared to 6.9% ( χ2=1.656, P=0.198), and the incision infection rate of 4.9%,compared to 4.0% ( χ2=0.008, P=0.930), the intestinal obstruction rate was 4.9%,compared to 3.2%, ( χ2=0.158, P=0.691), the intestinal injury rate was 1.3% ,compared to 0,( P=0.226). Conclusions:Laparoscopic appendectomy for periappendiceal abscess in children was safe and effective, especially for patients with a medical history of less than 7 d.

The efficacy of preoperative neoadjuvant chemoradiotherapy(nCRT)in locally advanced rectal cancer(LARC)is predicted using radiomic features of the target areas in radiotherapy for rectal cancer and an interpretable machine learning model.The clinical data are collected from 290 LARC patients who are divided into effective and ineffective groups based on tumor regression grade.The extracted radiomic features and clinicopathological data are used to develop prediction models.The optimal model is determined based on AUC performance evaluation,and the explanatory analysis is conducted using nomogram and decision curve.A total of 223 patients are included in the study,with 48 in the effective group.There are 156 patients in the training set(34 in the effective group)and 67 patients in the validation set(14 in the effective group).The nomogram model shows the best performance,with AUC of 0.858 in the training set and 0.844 in internal test set,and decision curve analysis demonstrated its superior net clinical benefit across most threshold ranges than other models.Combining radiomics and clinical variables,the nomogram can effectively predict nCRT outcomes and support clinical decision-making.

Objective:To explore the safety and effectiveness of laparoscopic treatment for complicated appendicitis in children with and without abscess.Methods:A retrospective analysis was conducted on the clinical data of 363 patients with complicated appendicitis admitted to our department between May 2017 and Sep 2023. Patients were divided into two groups: the group without abscess and the group with abscess, comparing the surgical outcomes and incidence of postoperative complications between two groups.Results:As a result, all 277 cases in the non abscess group completed laparoscopic appendectomy, while all 86 cases in the periappendibular abscess group also completed laparoscopic appendectomy. The history of appendiceal abscess group was longer than that of the group without abscess [5(3-7) d vs. 2(1-3) d, Z=-11.59, P<0.05],the operation time was longer [86 (68-121) min vs. 63 (50-76) min, Z=-7.260, P<0.05], intraoperative bleeding was more [5(3-10) ml vs. 2(2-5) ml, Z=-7.010, P<0.001]. The incidence of postoperative complications was higher in the appendiceal abscess group, with a postoperative abdominal abscess rate of 11.1%,compared to 6.9% ( χ2=1.656, P=0.198), and the incision infection rate of 4.9%,compared to 4.0% ( χ2=0.008, P=0.930), the intestinal obstruction rate was 4.9%,compared to 3.2%, ( χ2=0.158, P=0.691), the intestinal injury rate was 1.3% ,compared to 0,( P=0.226). Conclusions:Laparoscopic appendectomy for periappendiceal abscess in children was safe and effective, especially for patients with a medical history of less than 7 d.

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 investigate the effect of SUA level on adverse prognosis in elderly pa-tients with HF.Methods A retrospective analysis was conducted on 1583 patients admitted to Zigong Fourth People's Hospital between December 2016 and June 2019 due to a diagnosis of HF.The patients were divided into low SUA group(≤386.8 μmol/L,523 cases),medium SUA group(386.9-523.6 μmol/L,537 cases),and high SUA group(＞523.6 μmol/L,523 cases).Multivari-ate logistic regression model was employed to assess the relationship between SUA level and ad-verse outcomes in the elderly HF patients.Results The incidence of adverse events was signifi-cantly higher in the high SUA group than that in the low SUA group in 6 months of follow-up(P＜0.05).When compared with the low SUA group,the high SUA group had a significantly in-creased risk of readmission within 6 months(RR=1.531,95％CI:1.180-1.988,P=0.001),and elevated risk of compound events(RR=1.624,95％CI:1.255-2.102,P=0.000).NYHA grade Ⅳand diabetes were independent influencing factors for 6-month adverse prognosis in elderly pa-tients HF(P＜0.05,P＜0.01).An approximately linear trend was observed in the dose-response relationship of SUA level and adverse prognosis,indicating an increased risk of short-term death,readmission,and compound events as increment of SUA level.Conclusion Higher SUA level is significantly associated with adverse prognosis in elderly HF patients.

Objective To investigate the effect of SUA level on adverse prognosis in elderly pa-tients with HF.Methods A retrospective analysis was conducted on 1583 patients admitted to Zigong Fourth People's Hospital between December 2016 and June 2019 due to a diagnosis of HF.The patients were divided into low SUA group(≤386.8 μmol/L,523 cases),medium SUA group(386.9-523.6 μmol/L,537 cases),and high SUA group(＞523.6 μmol/L,523 cases).Multivari-ate logistic regression model was employed to assess the relationship between SUA level and ad-verse outcomes in the elderly HF patients.Results The incidence of adverse events was signifi-cantly higher in the high SUA group than that in the low SUA group in 6 months of follow-up(P＜0.05).When compared with the low SUA group,the high SUA group had a significantly in-creased risk of readmission within 6 months(RR=1.531,95％CI:1.180-1.988,P=0.001),and elevated risk of compound events(RR=1.624,95％CI:1.255-2.102,P=0.000).NYHA grade Ⅳand diabetes were independent influencing factors for 6-month adverse prognosis in elderly pa-tients HF(P＜0.05,P＜0.01).An approximately linear trend was observed in the dose-response relationship of SUA level and adverse prognosis,indicating an increased risk of short-term death,readmission,and compound events as increment of SUA level.Conclusion Higher SUA level is significantly associated with adverse prognosis in elderly HF patients.

Objective To explore the influencing factors of coal workers''''cognitive function. Meth-ods There was a physical examination on 3205 workers in the coal mine enterprise.The physical examina-tion included height,weight,blood pressure,blood routine examination and routine urine test,and Mini Men-tal State Examination (MMSE) was used to evaluate the cognitive function.The coal workers were divided in-to cognitive dysfunction group (84 cases) and cognitive function normal group (3121 cases) according to MMSE scores.Logistic regression analysis was used to explore the influencing factors of cognitive function. Results The prevalence of cognitive dysfunction was 2. 62％ in coal workers. The age of the cognitive dys-function group(47.27±8.24) was significantly higher than that in the cognitive function normal group (41.39 ±8.65)(P<0.05),and the degree of culture in cognitive dysfunction group was significantly lower than those in the cognitive function normal group (χ2= 46. 610, P<0. 01 ) . The low density lipoprotein cholesterol ((2.72±0.65)mmol/L),urine pH(5.54±1.51) in the cognitive dysfunction group were significantly lower than those in the cognitive function normal group((2.89±0.73)mmol/L,(5.92±1.28))(P<0.05). The lo-gistic regression analysis showed that age, culture level, BMI, low density lipoprotein cholesterol, urine pH were the impacting factors of cognitive dysfunction. Conclusion Cognitive dysfunction is influenced by age, culture level,BMI and low density lipoprotein cholesterol. The higher of the age and the lower of the culture level,BMI,low density lipoprotein cholesterol,urine pH,the more vulnerable to cognitive dysfunction.

Objective To explore the gray and white matter microstructures in the brain of patients with different degrees of chronic mountain sickness(CMS).Methods 30 cases of CMS (10 cases in each group divided into mild,moderate and severe groups according to the severity)were collected as experimental group,and 10 normal adults in high altitude area were collected as the normal control group.All cases underwent MRI conventional head sequences,diffusion weighted imaging (DWI)and diffusion kurtosis imaging (DKI)sequences.The values of mean kurtosis(MK),radial kurtosis(RK),kurtosis anisotropy(KA)and apparent diffusion coefficient(ADC) graphs were reconstructed by post-processing software respectively.Selected the region of interest(ROI)symmetrically and fixedly, then measured and analyzed the parameter values of ROI in the same area.Results Compared the CMS groups with normal control group,the diffusion parameters and ADC values in certain parts of deep gray matter nucleus and white matter fibers were statistically significant,and the difference was significant with the progression of the disease.Conclusion DKI combined with DWI has certain value in evaluating the gray and white matter microstructure of human brain,there are some difference in the brain microstructure between CMS patients and high altitude normal subjects,additionally,the difference in different degrees of CMS is diverse.

Objective To carry out a control study on the mental health,perceived stress,and coping styles of executives and underground workers in coal enterprise.Methods Totally 238 executives of state-owned coal enterprise and 240 underground workers were tested by symptom self-assessment scale (SCL-90), perceived stress scale and simple coping style scale. Then the test results were analyzed.Results according to the SCL-90 results,the total score of coal enterprise executives was (123.670±27.850) and it was lower than that of national norm (t=-3.151,P<0.01). The total score of underground workers was (138.610±49.720) and it was higher than that of national norm (t=2.882,P<0.01). The difference between them was significant (t=-4.05,P<0.01);the score of perceived stress of enterprise executives (15.70±7.37) was lower than that of underground workers (t=-9.553,P<0.01);the scores of positive coping of executives were (2.04±0.43),and they were significantly higher than those of the underground workers (t= 2.886,P<0.01);the scores of negative coping of executives were (1.06±0.49),and they were significantly lower than those of the underground workers (t=-9.225,P<0.01).Conclusions Executives of coal enterprise get a better psychological health level than underground workers;the executives are not sensitive to perceived stress;and they use more positive coping styles to deal with difficulties and setbacks. The underground workers are sensitive to perceived stress,and they use more negative coping styles to deal with difficulties and setbacks.