Objective To evaluate the predictive value of pathological tumor cell proportion size(PTS)and invasive lesion classification for recurrence of stage Ⅰ lung adenocarcinoma(LUAD).Methods A total of 160 patients who underwent stage Ⅰ LUAD resection in the hospital from February 2019 to February 2022 were retrospectively enrolled.According to PTS,the patients were divided into a high proliferation group(n=76)and a low proliferation group(n=84).According to the invasive lesion classification,the patients were divided into adenocarcinoma in situ(AIS)group(n=58),minimally invasive adenocarcinoma(MIA)group(n=52)and invasive adenocarcinoma(IAC)group(n=50).Cox proportional hazards regression was used to analyze the influencing factors of recurrence of stage Ⅰ LUAD.Kaplan-Meier was used to analyze the disease-free sur-vival(DFS)of each group,and the statistical power of variable factors was analyzed by receiver operating characteristic(ROC)curve.Results There were significant differences in mean tumor diameter,nodule type,margin condition,spread through air spaces(STAS),TNM stage,maximum tumor diameter,degree of differ-entiation,lymph node metastasis and proliferation cell nuclear antigen(Ki-67)proliferation index among pa-tients with different PTS(P＜0.05).STAS was a risk factor for DFS in patients with different PTS(P＜0.05),and the difference in DFS among patients with different PTS was statistically significant(P＜0.05).DFS in the low proliferation group was higher than DFS in the high proliferation group.PTS combined with STAS had a better efficacy in predicting stage Ⅰ LUAD recurrence[area under the curve(AUC)was 0.748].There were significant differences in mean tumor diameter,nodule type,margin condition,STAS,TNM stage,maximum tumor diameter,degree of differentiation,lymph node metastasis and Ki-67 proliferation index a-mong patients with different invasive lesions(P＜0.05).Margin condition and STAS were risk factors for DFS in patients with different invasive lesion types(P＜0.05).There was a significant difference in DFS be-tween patients with different invasive lesion types(P＜0.05),DFS in AIS group＞DFS in MIA group＞DFS in IAC group.The type of invasive lesions and margin condition combined with STAS had a good predictive value for stage Ⅰ LUAD recurrence(AUC was 0.784).Conclusion Different PTS combined with STAS can predict the recurrence of stage Ⅰ LUAD.Different invasive lesions combined with margin condition and STAS also have important predictive value for the recurrence of stage Ⅰ LUAD.

Objective To explore characteristics of patients with drug-induced liver injury(DILI),suspected drugs and outcomes,and to provide reference for clinical standard use of drugs and reduce adverse reactions of DILI.Methods Retrospective analysis of adverse drug reactions of 281 patients with DILI in Suzhou Hospital of Integrated Traditional Chinese and Western Medicine from 2016 to 2023.Age,sex,severity,clinical manifestations,clinical classification,Roussel Uclaf causality assessment method(RUCAM)score,injury degree,combination,disease type,suspected drugs and outcomes of patiengs were statistically analyzed.Results Among 281 patients with DILI,there were 83 general ADRs cases and 198 serious ADRs cases.In terms of clinical manifestations,main manifestations were yellow skin sclera,poor appetite,fatigue and so on.In terms of injury degree,156 cases suffered mild liver injury,121 cases suffered moderate liver injury,and 4 cases suffered severe liver injury.There were 164 cases of combined drug use and 117 cases of single drug use.The top diseases of patients were tumor,respiratory disease,tuberculosis infection and so on.Among the suspected drugs,the top three drugs were Chinese medicine,anti-tumor drugs and anti-tuberculosis drugs in order,and there were significant differences between different types of suspected drugs and whether they were used in combination(P＜0.05).There were significant differences in clinical classification and effectiveness(P＜0.05).Conclusion Chinese medicine,anti-tumor drugs and anti-tuberculosis drugs are relatively easy to cause DILI.The type of liver cell damage,combination of drugs,types of diseases,and underlying diseases all affect the occurrence of DILI.

BACKGROUND: Congenital heart disease (CHD) is a leading cause of birth defect-related mortality. However, more recent CHD mortality data for China are lacking. Additionally, limited studies have evaluated sex, rural-urban, and region-specific disparities of CHD mortality in China. METHODS: We designed a population-based study using data from the Dataset of National Mortality Surveillance in China between 2008 and 2021. We calculated age-adjusted CHD mortality using the sixth census data of China in 2010 as the standard population. We assessed the temporal trends in CHD mortality by age, sex, area, and region from 2008 to 2021 using the joinpoint regression model. RESULTS: From 2008 to 2021, 33,534 deaths were attributed to CHD. The period witnessed a two-fold decrease in the age-adjusted CHD mortality from 1.61 to 0.76 per 100,000 persons (average annual percent change [AAPC] = -5.90%). Females tended to have lower age-adjusted CHD mortality than males, but with a similar decline rate from 2008 to 2021 (females: AAPC = -6.15%; males: AAPC = -5.84%). Similar AAPC values were observed among people living in urban (AAPC = -6.64%) and rural (AAPC = -6.12%) areas. Eastern regions experienced a more pronounced decrease in the age-adjusted CHD mortality (AAPC = -7.86%) than central (AAPC = -5.83%) and western regions (AAPC = -3.71%) between 2008 and 2021. Approximately half of the deaths (46.19%) due to CHD occurred during infancy. The CHD mortality rates in 2021 were lower than those in 2008 for people aged 0-39 years, with the largest decrease observed among children aged 1-4 years (AAPC = -8.26%), followed by infants (AAPC = -7.01%). CONCLUSIONS CHD mortality in China has dramatically decreased from 2008 to 2021. The slower decrease in CHD mortality in the central and western regions than in the eastern regions suggested that public health policymakers should pay more attention to health resources and health education for central and western regions.
Humans ; Heart Defects, Congenital/mortality* ; Male ; Female ; China/epidemiology* ; Infant ; Child, Preschool ; Adult ; Child ; Adolescent ; Infant, Newborn ; Middle Aged ; Young Adult ; Aged ; Rural Population

The prevention and research of military training injuries(MTI)are crucial for reducing non-battle casualties,ensuring combat readiness,and enhancing the effectiveness of military training.In-depth analyses of the prevention and treatment strategies of MTI and related research can provide concrete guidance for scientific training practices.As a critical component of national defense,the Chinese Navy has experienced rapid development in recent years,and the prevention and research of MTI in naval forces have become a key focus.In recent years,rehabilitation medicine has been increasingly recognized for its importance in areas such as physical capability enhancement and injury prevention.The comprehensive adoption of rehabilitation concepts and the early implementation of rehabilitation measures have been widely accepted.It has important guiding significance for further strengthening the application of rehabilitation in preventing and treating injuries in naval training.This article discusses how to further strengthen the rehabilitation strategies for the prevention and research of MTI in the Navy,so as to provide insights and prospects for this field.

The primary aim of this study was to conduct a methodical examination and assessment of the prognostic efficacy exhibited by magnetic resonance imaging (MRI)-derived radiomic models concerning the preoperative prediction of lymph-vascular space infiltration (LVSI) in cervical cancer cases. A comprehensive and thorough exploration of pertinent academic literature was undertaken by two investigators, employing the resources of the Embase, PubMed, Web of Science, and Cochrane Library databases. The scope of this research was bounded by a publication cutoff date of May 15, 2023. The inclusion criteria encompassed studies that utilized radiomic models based on MRI to prognosticate the accuracy of preoperative LVSI estimation in instances of cervical cancer. The Diagnostic Accuracy Studies-2 framework and the Radiomic Quality Score metric were employed. This investigation included nine distinct research studies, enrolling a total of 1,406 patients. The diagnostic performance metrics of MRI-based radiomic models in the prediction of preoperative LVSI among cervical cancer patients were determined as follows: sensitivity of 83% (95% confidence interval [CI]=77%–87%), specificity of 74% (95% CI=69%–79%), and a corresponding AUC of summary receiver operating characteristic measuring 0.86 (95% CI=0.82–0.88). The results of the synthesized meta-analysis did not reveal substantial heterogeneity. This meta-analysis suggests the robust diagnostic proficiency of the MRI-based radiomic model in the prognostication of preoperative LVSI within the cohort of cervical cancer patients. In the future, radiomics holds the potential to emerge as a widely applicable noninvasive modality for the early detection of LVSI in the context of cervical cancer.

Objective To explore characteristics of patients with drug-induced liver injury(DILI),suspected drugs and outcomes,and to provide reference for clinical standard use of drugs and reduce adverse reactions of DILI.Methods Retrospective analysis of adverse drug reactions of 281 patients with DILI in Suzhou Hospital of Integrated Traditional Chinese and Western Medicine from 2016 to 2023.Age,sex,severity,clinical manifestations,clinical classification,Roussel Uclaf causality assessment method(RUCAM)score,injury degree,combination,disease type,suspected drugs and outcomes of patiengs were statistically analyzed.Results Among 281 patients with DILI,there were 83 general ADRs cases and 198 serious ADRs cases.In terms of clinical manifestations,main manifestations were yellow skin sclera,poor appetite,fatigue and so on.In terms of injury degree,156 cases suffered mild liver injury,121 cases suffered moderate liver injury,and 4 cases suffered severe liver injury.There were 164 cases of combined drug use and 117 cases of single drug use.The top diseases of patients were tumor,respiratory disease,tuberculosis infection and so on.Among the suspected drugs,the top three drugs were Chinese medicine,anti-tumor drugs and anti-tuberculosis drugs in order,and there were significant differences between different types of suspected drugs and whether they were used in combination(P＜0.05).There were significant differences in clinical classification and effectiveness(P＜0.05).Conclusion Chinese medicine,anti-tumor drugs and anti-tuberculosis drugs are relatively easy to cause DILI.The type of liver cell damage,combination of drugs,types of diseases,and underlying diseases all affect the occurrence of DILI.

Objective:To investigate the diagnostic value of magnetically controlled capsule gastroscope in elderly patients with suspected upper gastrointestinal bleeding.Methods:A total of 102 patients with suspected upper gastrointestinal bleeding who underwent magnetically controlled capsule gastroscopy (MCCG) in General Hospital of Ningxia Medical University from October 2020 to September 2022 were enrolled. Patients were divided into two groups according to age: 38 patients in group A (≤65 years old) and 64 patients in group B (> 65 years old). The case data, changes of vital signs, detection of lesions and adverse reactions of the two groups were compared.Results:There were significant differences in combined diseases between group A and group B. The stomach examination time in group A was significantly shorter than that of group B (15.49±2.04 min VS 16.61±2.02 min, t=-2.685, P=0.009). There was significant difference in small intestine examination time between the two groups (331.69±14.96 min VS 337.83±14.28 min, t=-1.229, P=0.227). The incidence of adverse reactions in group A was significantly lower than that in group B [0.00%(0/38) VS 6.25%(4/64), χ2=6.186, P=0.013]. The changes of vital signs before, during and after examination were not statistically different. The detection rates of upper gastrointestinal lesions were 92.1% (35/38) and 98.4% (63/64), respectively. The positive rates of upper gastrointestinal bleeding under MCCG were 60.0% (21/35) and 50.8% (32/63), respectively. Patients with unexplained upper gastrointestinal bleeding under MCCG received small intestine examination. The detection rates of small intestinal lesions by small intestine examination were 84.6% (11/13) and 91.7% (22/24), respectively. Conclusion:MCCG demonstrates excellent diagnostic accuracy in elderly patients with suspected upper gastrointestinal bleeding. Additionally, it is safe and suitable for use in elderly patients with multiple comorbidities, allowing for concurrent small intestine examination.

Objective:To investigate the effects of different feeding formulas on the feeding and growth and metabolism of premature infants in the early postnatal period.Methods:Eligible premature infants with the gestational age of ≤ 34 weeks hospitalized from March 2023 to March 2024 were selected as per inclusion criteria, excluding those with congenital metabolic diseases, severe congenital heart disease and developmental malformations of digestive tract. According to the feeding formulas within 2 weeks after birth, premature infants were divided into three groups, namely donor human milk (DHM) group, preterm formula (PF) group and extensively hydrolyzed formula (eHF) group. The characteristics of premature infants, perinatal condition, feeding formulas, milk intake on the 7th and 14th day, the time to the daily milk intake of 120ml/kg and 150ml/kg respectively, the time on parenteral nutrition, the length of hospitalization, feeding intolerance, cholestasis, extrauterine growth retardation and biochemical metabolic indexes at 7 days, 14 days and discharge were collected. The differences of feeding and biochemical metabolic parameters were compared across the three groups.Results:A total of 108 cases were enrolled ,of whom 39 were in DHM group, 37 in PF group and 32 in eHF group. There was no significant difference in gestational age, birth weight, head circumference and maternal complications across the three groups. The milk intake in the DHM group was (50.7±29.1) ml/(kg·d) on the 7th day, compared with (34.2±27.3) ml/(kg·d) in PF group ( P=0.031), and (103.1±36.7) ml/(kg·d) on the 14th day, compared with (73.9±39.2) ml/(kg·d) in the PF group. Compared with the PF group, the DHM group reached the daily milk intake of 120 ml/(kg·d) earlier [(18.5±10.4) days vs. (24.1±10.3) days, P=0.020], had shorter duration of parenteral nutrition [(17.9±10.9) days vs. (23.2±11.2) days, P=0.042], and lower incidence of feeding intolerance (28.2% vs. 48.6%). The length of hospitalization in DHM group was shorter than that in PF group [(33.8±15.5) days vs. (37.8±17.6) days], but there was no significant difference ( P>0.05). There was no significant difference between the DHM group and the eHF group in terms of the milk intake on the 7th and 14th day, the time to the daily milk intake of 120 ml/(kg·d), the time on parenteral nutrition, the length of hospitalization and feeding intolerance. At 1 and 2 weeks after birth, alkaline phosphatase in DHM group was higher than that in PF group and eHF group ( P<0.05), but there was no significant difference in biochemical nutritional metabolism parameters (hemoglobin, urea nitrogen, albumin, prealbumin, alkaline phosphatase and total bile acid) across the three groups at discharge( P>0.05). Conclusion:Early use of DHM in premature infants is better tolerated than PF and can help achieve complete enteral nutrition earlier and shorten the use of parenteral nutrition, while not affecting the growth and development of premature infants.

Objective:To analyze the mutation characteristics of rpoB gene in rifampicin-resistant Brucella strains. Methods:DNA of 4 rifampicin-resistant Brucella strains (JSY-26, G-9, WSY-13 and AW-3) isolated from Xinjiang Uygur Autonomous Region was selected, rifampicin rpoB gene was amplified by PCR and its nucleotide sequence was sequenced. The rpoB gene sequences of rifampicin-resistant Brucella standard strain (RB51) and sensitive strain (ALT-8) were used as reference, the mutation sites and types of the rpoB gene inside and outside the rifampicin resistance determination region (RRDR) of the 4 rifampicin-resistant Brucella strains were analyzed by Mega 7.0 software. Results:Through sequence alignment, both JSY-26 and WSY-13 strains underwent a single base point mutation at the RRDR 1 576 bp of the rpoB gene, with the base changing from guanine (G) to adenine (A). The G-9 strain underwent a single base point mutation at the RRDR 1 606 bp of the rpoB gene, with the base changing from cytosine (C) to A. The AW-3 strain showed 5 mutations of 3 types outside rpoB gene RRDR at 2 536, 2 537, 2 626, 2 636 and 2 654 bp, namely 3 insertion mutations [thymine (T) insertion once and C insertion twice], 1 deletion mutation (C deletion), and 1 single base point mutation (from G to C mutation).Conclusion:The RRDR mutations in the rpoB gene of the rifampicin-resistant Brucella strains are mainly characterized by single base point mutations, while multiple insertion and deletion mutations occur outside the RRDR.

The correlation between hearing loss (HL) and physical performance in patients receiving maintenance hemodialysis (MHD) remains poorly investigated. This study explored the association between HL and physical performance in patients on MHD. Methods: This multicenter cross-sectional study was conducted between July 2020 and April 2021 in seven hemodialysis centers in Shanghai and Suzhou, China. The hearing assessment was performed using pure-tone average (PTA). Physical performance was assessed using the Timed Up and Go Test (TUGT), handgrip strength, and gait speed. Results: Finally, 838 adult patients (male, 516 [61.6%]; 61.2 ± 2.6 years) were enrolled. Among them, 423 (50.5%) had mild to profound HL (male, 48.6% and female, 53.4%). Patients with HL had poorer physical performance than patients without HL (p < 0.001). TUGT was positively correlated with PTA (r = 0.265, p < 0.001), while handgrip strength and gait speed were negatively correlated with PTA (r = –0.356, p < 0.001 and r = –0.342, p < 0.001, respectively). Physical performance in patients aged <60 years showed significant dose-response relationships with HL. After adjusting for confounders, the odds ratios (95% confidence intervals) for HL across the TUGT quartiles (lowest to highest) were 1.00 (reference), 1.15 (0.73–1.81), 1.69 (1.07–2.70), and 2.87 (1.69–4.88) (p for trend = 0.005). Conclusion: Lower prevalence of HL was associated with a faster TUGT and a stronger handgrip strength in patients on MHD.