Objective:To investigate the influencing factors for safe abdominal wall recons-truction in giant ventral hernia based on imaging and clinical features.Methods:The retrospective case-control study was conducted. The imaging and clinical data of 369 patients with giant ventral hernia who were admitted to Beijing Chaoyang Hospital of Capital Medical University from January 2017 to December 2023 were collected. There were 182 males and 187 females, aged (63±14)years. Among 369 patients, 311 cases underwent safe abdominal wall reconstruction and 58 underwent high-risk abdominal wall reconstruction. Observation indicators: (1) clinical and imaging characteris-tics; (2) analysis of influencing factors for safe abdominal wall reconstruction in giant ventral hernia. Comparison of measurement data with normal distribution between groups was conducted using the t test. Comparison of measurement data with skewed distribution between groups was conducted using the Mann-Whitney U test. Comparison of count data between groups was conducted using the chi-square test. Comparison of ordinal data between groups was conducted using the nonparametic rank sum test. Logistic regression, Lasso regression, and random forest analyses were used for influencing factors analysis. Results:(1) Clinical and imaging characteristics. There were significant differences between patients with safe and high-risk abdominal wall reconstruction in presence of a definite secondary abdominal cavity, maximum axial diameter of the defect, maximum transverse diameter of the defect, abdominal wall defect area, component separation index (CSI), abdominal wall opening angle, ratio of CSI, muscle grayscale at the defect, hernia sac volume, hernia sac-abdominal cavity volume ratio, and defect long-axis-to-abdominal cavity ratio ( P<0.05). (2) Analysis of influencing factors for safe abdominal wall reconstruction in giant ventral hernia. Results of Logistic regression analysis showed that presence of a definite secondary abdominal cavity, maximum axial diameter of the defect, maximum transverse diameter of the defect, abdominal wall defect area, CSI, abdominal wall opening angle, ratio of CSI, muscle grayscale at the defect (inner-superior or right), hernia sac volume, hernia sac-abdominal cavity volume ratio, and defect long-axis-to-abdominal cavity ratio were factors associated with safe abdominal wall reconstruction in giant ventral hernia [ odds ratio ( OR)=3.955, 1.189, 1.395, 1.127, 2.006, 1.042, 1.095, 0.881, 1.102, 1.109, 1.601, 95% confidence interval ( CI) as 2.179-7.178, 1.113-1.271, 1.267-1.537, 1.090-1.166, 1.651-2.437, 1.014-1.071, 1.066-1.125, 0.798-0.972, 1.057-1.148, 1.067-1.153, 1.343-1.909]. The top 3 factors for discriminative performance were abdominal wall CSI, ratio of CSI, maximum transverse diameter of the defect and the abdominal wall defect area, with area under the curve of 0.794, 0.777, 0.772, and 0.772, respectively. Results of Lasso regression analysis showed that body mass index, smoking, chronic obstructive pulmonary disease, American Society of Anesthesiologists classification, presence of a definite secondary abdominal cavity, abdominal wall defect area, abdominal wall opening angle, abdominal wall CSI, muscle grayscale at the defect (inner-superior or right), and hernia sac-to-abdominal cavity volume ratio were associated factors with safe abdominal wall reconstruction in giant ventral hernia (coefficients as -0.002, 0.003, 0.007, 0.014, 0.021, 0.077, 0.023, 0.059, -0.010, 0.037). Results of random forest analysis showed the abdominal wall CSI, maximum transverse diameter of the defect, abdominal wall defect area, ratio of defectr opening angle, maximum axial long diameter of the defect, hernia sac-to-abdominal cavity volume ratio, abdominal wall opening angle, defect long-axis-to-abdominal cavity ratio, muscle grayscale at the defect (inner-superior or right), and body mass index as associated factors with safe abdominal wall reconstruction in giant ventral hernia (importance score=0.092, 0.089, 0.079, 0.056, 0.051, 0.047, 0.045, 0.039, 0.038, 0.035). Conclusion:Abdominal wall CSI, abdominal wall defect area, abdominal wall opening angle, muscle grayscale at the defect (inner-superior or right), and hernia sac-to-abdominal cavity volume ratio are factors associated with safe abdominal wall reconstruction in giant ventral hernia.

Objective:To investigate the influencing factors for safe abdominal wall recons-truction in giant ventral hernia based on imaging and clinical features.Methods:The retrospective case-control study was conducted. The imaging and clinical data of 369 patients with giant ventral hernia who were admitted to Beijing Chaoyang Hospital of Capital Medical University from January 2017 to December 2023 were collected. There were 182 males and 187 females, aged (63±14)years. Among 369 patients, 311 cases underwent safe abdominal wall reconstruction and 58 underwent high-risk abdominal wall reconstruction. Observation indicators: (1) clinical and imaging characteris-tics; (2) analysis of influencing factors for safe abdominal wall reconstruction in giant ventral hernia. Comparison of measurement data with normal distribution between groups was conducted using the t test. Comparison of measurement data with skewed distribution between groups was conducted using the Mann-Whitney U test. Comparison of count data between groups was conducted using the chi-square test. Comparison of ordinal data between groups was conducted using the nonparametic rank sum test. Logistic regression, Lasso regression, and random forest analyses were used for influencing factors analysis. Results:(1) Clinical and imaging characteristics. There were significant differences between patients with safe and high-risk abdominal wall reconstruction in presence of a definite secondary abdominal cavity, maximum axial diameter of the defect, maximum transverse diameter of the defect, abdominal wall defect area, component separation index (CSI), abdominal wall opening angle, ratio of CSI, muscle grayscale at the defect, hernia sac volume, hernia sac-abdominal cavity volume ratio, and defect long-axis-to-abdominal cavity ratio ( P<0.05). (2) Analysis of influencing factors for safe abdominal wall reconstruction in giant ventral hernia. Results of Logistic regression analysis showed that presence of a definite secondary abdominal cavity, maximum axial diameter of the defect, maximum transverse diameter of the defect, abdominal wall defect area, CSI, abdominal wall opening angle, ratio of CSI, muscle grayscale at the defect (inner-superior or right), hernia sac volume, hernia sac-abdominal cavity volume ratio, and defect long-axis-to-abdominal cavity ratio were factors associated with safe abdominal wall reconstruction in giant ventral hernia [ odds ratio ( OR)=3.955, 1.189, 1.395, 1.127, 2.006, 1.042, 1.095, 0.881, 1.102, 1.109, 1.601, 95% confidence interval ( CI) as 2.179-7.178, 1.113-1.271, 1.267-1.537, 1.090-1.166, 1.651-2.437, 1.014-1.071, 1.066-1.125, 0.798-0.972, 1.057-1.148, 1.067-1.153, 1.343-1.909]. The top 3 factors for discriminative performance were abdominal wall CSI, ratio of CSI, maximum transverse diameter of the defect and the abdominal wall defect area, with area under the curve of 0.794, 0.777, 0.772, and 0.772, respectively. Results of Lasso regression analysis showed that body mass index, smoking, chronic obstructive pulmonary disease, American Society of Anesthesiologists classification, presence of a definite secondary abdominal cavity, abdominal wall defect area, abdominal wall opening angle, abdominal wall CSI, muscle grayscale at the defect (inner-superior or right), and hernia sac-to-abdominal cavity volume ratio were associated factors with safe abdominal wall reconstruction in giant ventral hernia (coefficients as -0.002, 0.003, 0.007, 0.014, 0.021, 0.077, 0.023, 0.059, -0.010, 0.037). Results of random forest analysis showed the abdominal wall CSI, maximum transverse diameter of the defect, abdominal wall defect area, ratio of defectr opening angle, maximum axial long diameter of the defect, hernia sac-to-abdominal cavity volume ratio, abdominal wall opening angle, defect long-axis-to-abdominal cavity ratio, muscle grayscale at the defect (inner-superior or right), and body mass index as associated factors with safe abdominal wall reconstruction in giant ventral hernia (importance score=0.092, 0.089, 0.079, 0.056, 0.051, 0.047, 0.045, 0.039, 0.038, 0.035). Conclusion:Abdominal wall CSI, abdominal wall defect area, abdominal wall opening angle, muscle grayscale at the defect (inner-superior or right), and hernia sac-to-abdominal cavity volume ratio are factors associated with safe abdominal wall reconstruction in giant ventral hernia.

Objective To investigate the effects of mirabegron combined with electroacupuncture on urodynamic parameters in rats with overactive bladder(OAB)by regulating the insulin receptor substrate(IRS)/phosphatidylinositol 3-kinase(PI3 K)/protein kinase B(AKT)/endothelial nitric oxide synthase(eNOS)signaling pathway.Methods Sixty female SD rats were selected as the study subjects and randomly divided into control group,model group,mirabegron group,electroacupunc-ture group,and mirabegron+electroacupuncture group using a random number table method,with 12 rats in each group.Except for the control group,the other groups were used to establish OAB rat models by the bladder outlet obstruction method.The mirabegron group received intragastric administra-tion of 8 mg/kg mirabegron suspension.The electroacupuncture group received electroacupuncture stimu-lation for 5 min each time.The mirabegron+electroacupuncture group received intragastric administration of mirabegron suspension while undergoing electroacupuncture stimulation.The control group,the model group,and the electroacupuncture group received an equal volume of normal saline intragastrically once a day for 7 consecutive days.Urodynamic parameters(basal micturition pressure,peak mictu-rition pressure,micturition interval,and residual urine volume)were measured in each group.After measuring bladder blood flow using a laser speckle imaging instrument,the wet weight of the rat bladder tissue was weighed,and the bladder index was calculated.Enzyme-linked immunosorbent assay(ELISA)was used to detect the contents of urinary nerve growth factor(NGF),and interleu-kin-1[3(IL-1β),malondialdehyde(MDA),and superoxide dismutase(SOD)in bladder tissue.Western blot was used to detect the expression levels of phosphorylated(p)-IRS1,p-PI3K,p-AKT and p-eNOS in bladder tissue.Results Compared with the model group,the basal micturition pressure,peak micturition pressure,and bladder index were all decreased,the residual urine vol-ume was reduced,the micturition interval was prolonged,the bladder blood flow was increased,the SOD content in bladder tissue was increased,the NGF content in urine and the IL-1 β and MDA contents in bladder tissue were decreased,and the expression levels of p-IRS1,p-PI3K,p-AKT and p-eNOS were increased in the mirabegron group,the electroacupuncture group,and the mirabegron+electroacupuncture group,with statistically significant differences(P＜0.05 or P＜0.01).The results of the above indicators in the mirabegron+electroacupuncture group were all better than those in the mirabegron group and the electroacupuncture group,with statistically significant differ-ences(P＜0.05 or P＜0.01).Conclusion Mirabegron combined with electroacupuncture can improve urodynamic parameters in OAB rats than used alone,and its mechanism may be related to the activation of the IRS/PI3K/AKT/eNOS signaling pathway.

Objective The aim of this study is to retrospectively analyze the clinical and imaging characteristics,treatment and prognosis of 13 patients with granulomatous prostatitis(GP),and to provide reference for the diagnosis and treatment for GP.Methods The clinical information of 13 GP patients extracted from electronic medical records including demographic characteristic risk factors,clinical symptoms,laboratory findings,imaging findings(ultrasound,CT,MRI,FDG-PET-CT),treatment and outcomes were analyzed retrospectively from January 2018 to August 2023 at our center.Results The average age of 13 patients with GP was(65.69±6.46)years.And the average score of IPSS was(23.40±5.8).Five patients appeared positive results,of which 11 cases received digital rectal examination.The average level of pre-biopsy tPSA was(23.28±44.94)μg/L with fPSA/tPSA ratio of 0.11±0.05 and PSAD of(0.55±1.07)μg/l/mL.The pre-biopsy mean MRI PI-RADS 2.0 was(4.6±0.6)in this group of patients.Extraprostatic invasion was shown on imaging in 4 patients.The average number of biopsy needles was(19.6±3.9),and the pathological results showed tuber-culous granulomas in 2 cases(15.4％)and non-specific granulomatous inflammation in 11 cases(84.6％).Five patients received local treatment of the prostate after pathological confirmation(PVP in 4 cases,TURP in 1 case),2 patients re-ceived anti-tuberculosis therapy,and 3 cases were given antibiotics.Average follow-up was(20.6±11.2)months,and the average tPSA were(6.94±4.96)μg/L at 3-6 months after biopsy and/or surgery,with no obvious signs of malignancy during the follow-up period.Conclusion GP is the great mimicker of prostate cancer clinically and radiologically.Pros-tate biopsy is the method for confirming the diagnosis.For patients who are considering biopsy-free radical prostatectomy,it is important to consider the possibility of GP.

Objective The aim of this study is to retrospectively analyze the clinical and imaging characteristics,treatment and prognosis of 13 patients with granulomatous prostatitis(GP),and to provide reference for the diagnosis and treatment for GP.Methods The clinical information of 13 GP patients extracted from electronic medical records including demographic characteristic risk factors,clinical symptoms,laboratory findings,imaging findings(ultrasound,CT,MRI,FDG-PET-CT),treatment and outcomes were analyzed retrospectively from January 2018 to August 2023 at our center.Results The average age of 13 patients with GP was(65.69±6.46)years.And the average score of IPSS was(23.40±5.8).Five patients appeared positive results,of which 11 cases received digital rectal examination.The average level of pre-biopsy tPSA was(23.28±44.94)μg/L with fPSA/tPSA ratio of 0.11±0.05 and PSAD of(0.55±1.07)μg/l/mL.The pre-biopsy mean MRI PI-RADS 2.0 was(4.6±0.6)in this group of patients.Extraprostatic invasion was shown on imaging in 4 patients.The average number of biopsy needles was(19.6±3.9),and the pathological results showed tuber-culous granulomas in 2 cases(15.4％)and non-specific granulomatous inflammation in 11 cases(84.6％).Five patients received local treatment of the prostate after pathological confirmation(PVP in 4 cases,TURP in 1 case),2 patients re-ceived anti-tuberculosis therapy,and 3 cases were given antibiotics.Average follow-up was(20.6±11.2)months,and the average tPSA were(6.94±4.96)μg/L at 3-6 months after biopsy and/or surgery,with no obvious signs of malignancy during the follow-up period.Conclusion GP is the great mimicker of prostate cancer clinically and radiologically.Pros-tate biopsy is the method for confirming the diagnosis.For patients who are considering biopsy-free radical prostatectomy,it is important to consider the possibility of GP.

Objective With the focus on emerging infectious diseases and diseases of unknown cause,the study aims to realize multi-point trigger monitoring of infectious diseases through key monitoring sites and key populations.Methods Using ar-tificial intelligence,deep learning,big data and other information technologies to build an intelligent information center for infec-tious diseases with patients'disease files as the core,construct a core capacity of infectious disease surveillance,early warning and situation prediction,and predict and evaluate the importance of infectious disease warning signals.Results The system cov-ered 1 425 primary-level medical institutions,18 hospitals,2 580+schools,4 134 pharmacies,4 laboratories and civil affairs departments,detected 55 kinds of infectious diseases and 6 kinds of syndrome monitoring signals.Since its launch,121 000 ac-tive notification cards have been issued,more than 54 000 new notification cards have been added,35.256 million times of multi-source monitoring and 14.4 million disease files have been recorded.Conclusion By expanding monitoring content and chan-nels,we realized early monitoring,auxiliary investigation and multi-mode visual early warning of infectious diseases,built a multi-point trigger mechanism,and moved forward the infectious disease surveillance.

Objective:To explore the application of triplet-primer PCR (TP-PCR) for the genetic testing and prenatal diagnosis in patients with Myotonic dystrophy type 1 (DM1).Methods:A total of 60 individuals from 48 pedigrees undergoing genetic testing at the Genetic and Prenatal Diagnosis Center of the First Affiliated Hospital of Zhengzhou University from May 2018 to October 2022 were selected as the study subjects. TP-PCR combined with capillary electrophoresis was applied to determine the number of CTG repeats of the DMPK gene, and prenatal testing was provided to four DM1 pedigrees. This study was approved by Medical Ethics Committee of the First Affiliated Hospital of Zhengzhou University (Ethics No. KS-2018-KY-36). Results:A total of 52 DM1 patients were detected, mostly with muscle weakness, muscular atrophy and myotonia as the initial symptoms, along with typical myotonic potentials. Some patients also had abnormalities of other systems. The number of abnormal CTG repeats of the DMPK gene was > 50, whilst the number of CTG repeats on the normal allele had ranged from 5 to 18. The number of the most common normal CAG repeats was 6 (30.77%, 16/52). Among the four DM1 pedigrees undergoing prenatal diagnosis, one fetus was healthy, whilst three fetuses were found to have abnormal CTG repeats (> 50 times) and diagnosed with DM1. Conclusion:TP-PCR can diagnose DM1 patients with speed and accuracy. However, this method cannot accurately determine the number of CTG repeats when it exceeds 50.

Malignant tumors in children are one of the most important diseases that threaten the health and quality of life of children and are the second most common cause of death in children.With the continuous improvement and progress of treatment technology, the long-term survival rate of children with tumor has been significantly improved, but both the disease itself and the treatment can impair the immune function of children, which makes them vulnerable to various infectious diseases and secondary serious complications, and even become a source of infection, endangering the health of others. Vaccination is the most cost-effective measure to prevent infectious diseases. For children with normal immune functions, the benefits of vaccination usually outweigh the disadvantages. However, there is a lack of detailed data on the vaccination situation, efficacy and safety of vaccine use for such immunocompromised tumor survivors, and there are no authoritative and uniform vaccination recommendations. This article reviewed and summarized the literature and consensus of some domestic and foreign scholars on current status of post-treatment vaccination status, efficacy and safety of vaccination for children with tumors after treatment, with the aim of providing a reference for the practice in this field in China.

Objective:To explore the effect of applying standardized patient teaching based on Calgary-Cambridge communication model in nurse patient communication training for junior college interns, and to enrich the teaching methods of nurse patient communication training in domestic medical institutions.Methods:This study was a quasi-experimental study. In July 2022, 78 students were selected from 335 junior college interns in the First Affiliated Hospital of Shandong First Medical University by random coding method, and were randomly divided into the experimental group (39 students) and the control group (39 students) by lot. The control group received routine training. The experimental group received standardized patient teaching based on Calgary Cambridge communication model: teaching the key points of communication, guiding demonstration based on Calgary Cambridge communication model, and guiding reflection and exploration. The nurse patient communication ability, nurse patient communication practice skills, communication self-efficacy, and teaching satisfaction of the two groups of interns were compared between the two groups after 8 weeks of training.Results:After training, the total score of nurse patient communication ability evaluation in the experimental group was (91.41 ± 5.35) points, higher than that in the control group (88.08 ± 7.40) points, there was significant difference ( t=2.24, P<0.05); after training, the communication self-efficacy score of the experimental group was (30.21 ± 4.28) points, higher than that of the control group (27.94 ± 5.09) points, there was significant difference ( t=2.09, P<0.05); the total score of communication practice skills in the experimental group was (173.59 ± 18.48) points, higher than that in the control group (158.44 ± 15.57) points, there was significant difference ( t=3.82, P<0.05); the total score of communication teaching and training satisfaction in the experimental group was (16.77 ± 2.94) points, higher than that in the control group (15.22 ± 1.90) points, and there was significant difference ( t=2.68, P<0.05). Conclusions:The standardized patient teaching based on Calgary Cambridge communication model can effectively improve the practical skills of nurse patient communication of junior college interns, and promote the improvement of their nurse patient communication self-efficacy, which is conducive to the improvement of nurse patient communication ability junior college intern.

OBJECTIVE: To carry out genetic testing and prenatal diagnosis for a woman featuring moderate intellectual disability (ID). METHODS: The patient had presented at the First Affiliated Hospital of Zhengzhou University on April 28, 2021. With informed consent, peripheral blood and amniotic fluid samples were collected for the extraction of genomic DNA. Pathogenic copy number variations (CNVs) were detected with CNV-seq, and single gene variants were detected by whole exome sequencing (WES) and Sanger sequencing. Candidate variant was verified by Sanger sequencing, and CNV-seq and multiplex ligation-dependent probe amplification (MLPA) were used to detect fetal CNVs. RESULTS: The 23-year-old woman had moderate ID, sideway walking, and unstable holding. Ultrasonography at 18⁺³ weeks' gestation had revealed no fetal abnormality. No pathogenic CNV was detected in the woman by CNV-Seq, while WES revealed that she has harbored a heterozygous c.1675C>T (p.Arg559*) variant of the DLG4 gene, which was verified by Sanger sequencing. Based on guidelines from the American College of Medical Genetics and Genomics, the variant was predicted to be likely pathogenic (PVS1+PM2_supporting). Sanger sequencing has confirmed that the fetus has inherited this variant, and CNV-Seq also revealed that that fetus has harbored a 0.1 Mb heterozygous deletion at Xp21.1, which has encompassed the DMD gene, and the result was verified by MLPA. CONCLUSION The heterozygous c.1675C>T variant of the DLG4 gene probably underlay the mental retardation in this woman, and her fetus was found to harbor the same variant in addition with deletion of the DMD gene, which may predispose to ID type 62.
Female ; Humans ; Pregnancy ; Young Adult ; Disks Large Homolog 4 Protein ; DNA Copy Number Variations ; Fetus ; Genetic Testing ; Intellectual Disability/genetics* ; Pregnant Women