Objective:To analyze and identify the risk factors for preoperative hypokalemia in patients with gastrointestinal tumors and to construct a risk prediction model.Methods:A prospective research design was implemented. Patients with gastrointestinal tumors who underwent surgical treatment at the First Medical Center of the People ′s Liberation Army General Hospital between March 2023 and February 2024 were recruited as research participants through convenience sampling. These participants were randomly allocated into a modeling group or a validation group in a 7:3 ratio. Preoperative hypokalemia was defined as the outcome indicator. Multivariate Logistic regression analysis was employed to screen for risk factors, and a nomogram was subsequently constructed and validated. Results:Finally, a total of 600 patients were included in the study. In the modeling group ( n=420), 282 were male and 138 were female, 169 patients were under 60 years old, 233 patients were aged between 60 and 80 years, and 18 patients were over 80 years old. In the verification group ( n=180), there were 123 males and 57 females. Among these, 69 patients were under 60 years old, 102 patients were aged between 60 and 80 years, and 9 patients were over 80 years old. The multivariate Logistic regression analysis revealed that body mass index, occupation type, dietary habits, 6m walking speed test, grip strength relative to body mass index, and presence of digestive tract symptoms were independent risk factors for the development of preoperative hypokalemia ( χ2 values were 8.21~27.78, all P<0.05). The results of the model validation demonstrated that the areas under the receiver operating characteristic curves for the modeling and validation groups were 0.853 (95% CI 0.811-0.895) and 0.834 (95% CI 0.756-0.912), respectively, indicating a satisfactory level of predictive performance. Conclusions:The developed predictive model for preoperative hypokalemia in gastrointestinal tumors facilitates the accurate evaluation of the risk of preoperative hypokalemia and serves as a reference for effective clinical intervention.

Objective:To analyze the body composition of patients diagnosed with malignant gastrointestinal tumors and to assess the impact of obesity on surgical outcomes and postoperative recovery following laparoscopic radical surgery.Methods:Patients with malignant gastrointestinal tumors who underwent laparoscopic surgery in the Department of General Surgery at the First Medical Center of the Chinese PLA General Hospital from February to October 2023 were prospectively enrolled. The body composition was measured by bioelectrical impedance analysis. Accordingly, the obese patients were selected as the obese group, while non-obese patients entered the control group using propensity score matching. The clinical data, in particular the postoperative recovery, were compared between these two groups.Results:A total of 593 patients with malignant gastrointestinal tumors were included in the analysis, including 108 patients in the obese group and 107 in the control group. The two groups significantly differed in the six minute walking test ( P=0.003), postoperative anemia ( P=0.036), white blood cell count ( P<0.001), neutrophil percent ( P<0.001), and neutrophil-to-lymphocyte ratio (NLR) ( P=0.001). The obese group exhibited a significntly higher risk of developing complications after surgery ( P=0.039). Conclusions:Obese patients with malignant gastrointestinal tumors are more likely to experience complications such as muscle weakness, anemia, infection, and inflammation after a laparoscopic radical surgery. Close monitoring and proactive perioperative interventions should be taken to mitigate such risks.

Objective:To analyze and identify the risk factors for preoperative hypokalemia in patients with gastrointestinal tumors and to construct a risk prediction model.Methods:A prospective research design was implemented. Patients with gastrointestinal tumors who underwent surgical treatment at the First Medical Center of the People ′s Liberation Army General Hospital between March 2023 and February 2024 were recruited as research participants through convenience sampling. These participants were randomly allocated into a modeling group or a validation group in a 7:3 ratio. Preoperative hypokalemia was defined as the outcome indicator. Multivariate Logistic regression analysis was employed to screen for risk factors, and a nomogram was subsequently constructed and validated. Results:Finally, a total of 600 patients were included in the study. In the modeling group ( n=420), 282 were male and 138 were female, 169 patients were under 60 years old, 233 patients were aged between 60 and 80 years, and 18 patients were over 80 years old. In the verification group ( n=180), there were 123 males and 57 females. Among these, 69 patients were under 60 years old, 102 patients were aged between 60 and 80 years, and 9 patients were over 80 years old. The multivariate Logistic regression analysis revealed that body mass index, occupation type, dietary habits, 6m walking speed test, grip strength relative to body mass index, and presence of digestive tract symptoms were independent risk factors for the development of preoperative hypokalemia ( χ2 values were 8.21~27.78, all P<0.05). The results of the model validation demonstrated that the areas under the receiver operating characteristic curves for the modeling and validation groups were 0.853 (95% CI 0.811-0.895) and 0.834 (95% CI 0.756-0.912), respectively, indicating a satisfactory level of predictive performance. Conclusions:The developed predictive model for preoperative hypokalemia in gastrointestinal tumors facilitates the accurate evaluation of the risk of preoperative hypokalemia and serves as a reference for effective clinical intervention.

Objective:To analyze the body composition of patients diagnosed with malignant gastrointestinal tumors and to assess the impact of obesity on surgical outcomes and postoperative recovery following laparoscopic radical surgery.Methods:Patients with malignant gastrointestinal tumors who underwent laparoscopic surgery in the Department of General Surgery at the First Medical Center of the Chinese PLA General Hospital from February to October 2023 were prospectively enrolled. The body composition was measured by bioelectrical impedance analysis. Accordingly, the obese patients were selected as the obese group, while non-obese patients entered the control group using propensity score matching. The clinical data, in particular the postoperative recovery, were compared between these two groups.Results:A total of 593 patients with malignant gastrointestinal tumors were included in the analysis, including 108 patients in the obese group and 107 in the control group. The two groups significantly differed in the six minute walking test ( P=0.003), postoperative anemia ( P=0.036), white blood cell count ( P<0.001), neutrophil percent ( P<0.001), and neutrophil-to-lymphocyte ratio (NLR) ( P=0.001). The obese group exhibited a significntly higher risk of developing complications after surgery ( P=0.039). Conclusions:Obese patients with malignant gastrointestinal tumors are more likely to experience complications such as muscle weakness, anemia, infection, and inflammation after a laparoscopic radical surgery. Close monitoring and proactive perioperative interventions should be taken to mitigate such risks.

OBJECTIVE To explore the course construction and teaching reform of solid preparation with the aim of cultivating high-quality technical and skilled talents. METHODS Teaching objectives were set according to the post requires of solid preparation. Examples from pharmaceutical companies were used and the teaching content was reorganized by integrating professional courses and certificates. School and enterprise cooperation was deepened, information-based and multi-scenario learning resources were built, and high-quality curriculum politics teaching resources were created. Professional education and ideological education, knowledge imparting and value guidance were fully integrated. Based on the project-driving method, the integration of "Theoretical-Virtual-Real" and online and offline blended teaching was carried out. The evaluation method was "three comprehensive evaluation". RESULTS AND CONCLUSION Through the practice of course construction and teaching reform, students’ grades significantly increased and their skills become proficient. Their recognition of their profession significantly improved, and their awareness of quality and responsibility was significantly enhanced. Good reform effects had been achieved.

Objective This study aims to analyze the relationship between reproductive tract microecological changes,metabolic differences,and pregnancy outcomes at different time points in the frozen-thawed embryo transfer cycle while patients are undergoing hormone replacement therapy,which will be a breakthrough point for improving outcomes.Methods A total of 20 women undergoing frozen-thawed single blastocyst transfer for the first time at the Reproductive Medicine Center of Fujian Maternal and Child Health Hospital between July 2022 and January 2023 were recruited for this study.Their vaginal and cervical secretions were collected for 16S rRNA sequencing and non-targeted metabolomics analysis on days 2-5 of menstruation,day 7 after estrogen replacement therapy started,the day when progesterone was added,and the day of transplantation.The subjects were divided into different groups according to their clinical pregnancy status and the sequencing results were analyzed using bioinformatics methods.Results 1)The alpha-diversity index of the vaginal and cervical microbiota was higher on days 2-5 of menstruation(P<0.01),but did not differ significantly on day 7 after oral estrogen replacement therapy started,the day of progesterone administration,and the day of transplantation(P≥0.1).2)Both the pregnant group and the non-pregnant group showed a variety of microorganisms and metabolites with significant differences in the lower reproductive tract at different time points.3)Microbial analysis at different time points showed that there were significant differences in vaginal flora,including Peptoniphilus,Enterocloster,Finegoldia,Klebsiella,Anaerobutyricum,Agathobaculum,Sporanaerobacter,Bilophila,Prevotella,and Anaerococcus in the pregnant group(P<0.05).4)Metabolite analysis at different time points showed that there were significant differences in 3-hydroxybenzoic acid,linatine,(R)-amphetamine,hydroxychloroquine,and L-altarate in the vaginal secretions of the pregnant group(P<0.05),and that there were significant differences in isocitric acid,quassin,citrinin,and 12(R)-HETE in the cervical secretions(P<0.05).5)Metabolite analysis at different time points showed that,in the non-pregnant group,there were significant differences in linatine,decanoyl-L-carnitine,aspartame,sphingosine,and hydroxychloroquine in the vaginal secretions(P<0.05),and the isocitric acid,quassin,ctrinin,and 12(R)-HETE in the cervical secretions(P<0.05).6)Combined microbiome and metabolomics analysis showed that certain metabolites were significantly associated with microbial communities,especially Klebsiella.Conclusions Significant differences in the microbiota genera and metabolites at different time points were found during the frozen-embryo transfer cycle of hormone replacement therapy,which may be used as potential biomarkers to predict pregnancy outcomes of embryo transfer.

Objective:To evaluate the efficacy and safety of hypomethylating agents (HMA) in patients with myelodysplastic syndromes (MDS) .Methods:A total of 409 MDS patients from 45 hospitals in Zhejiang province who received at least four consecutive cycles of HMA monotherapy as initial therapy were enrolled to evaluate the efficacy and safety of HMA. Mann-Whitney U or Chi-square tests were used to compare the differences in the clinical data. Logistic regression and Cox regression were used to analyze the factors affecting efficacy and survival. Kaplan-Meier was used for survival analysis. Results:Patients received HMA treatment for a median of 6 cycles (range, 4-25 cycles) . The complete remission (CR) rate was 33.98% and the overall response rate (ORR) was 77.02%. Multivariate analysis revealed that complex karyotype ( P=0.02, OR=0.39, 95% CI 0.18-0.84) was an independent favorable factor for CR rate. TP53 mutation ( P=0.02, OR=0.22, 95% CI 0.06-0.77) was a predictive factor for a higher ORR. The median OS for the HMA-treated patients was 25.67 (95% CI 21.14-30.19) months. HMA response ( P=0.036, HR=0.47, 95% CI 0.23-0.95) was an independent favorable prognostic factor, whereas complex karyotype ( P=0.024, HR=2.14, 95% CI 1.10-4.15) , leukemia transformation ( P<0.001, HR=2.839, 95% CI 1.64-4.92) , and TP53 mutation ( P=0.012, HR=2.19, 95% CI 1.19-4.07) were independent adverse prognostic factors. There was no significant difference in efficacy and survival between the reduced and standard doses of HMA. The CR rate and ORR of MDS patients treated with decitabine and azacitidine were not significantly different. The median OS of patients treated with decitabine was longer compared with that of patients treated with azacitidine (29.53 months vs 20.17 months, P=0.007) . The incidence of bone marrow suppression and pneumonia in the decitabine group was higher compared with that in the azacitidine group. Conclusion:Continuous and regular use of appropriate doses of hypomethylating agents may benefit MDS patients to the greatest extent if it is tolerated.

Objective To explore the status quo of depression and medical-social support in human immunodeficiency virus(HIV)/acquired immunodeficiency syndrome(AIDS)hemodialysis patients,as well as the effect of medical-social support on depression.Methods A total of 80 HIV/AIDS hemodialysis patients from Xixi Hospital in Hangzhou from March 2022 to March 2024 were collected.Center for epidemiological survey-depression scale(CES-D)and medical social support scale(MOS-SSS)were used to assess patients for depression and medical social support.Structural equation model was used to analyze relationship between medical social support and depression.Results 42 of the 80 subjects(52.5%)had depressive symptoms(CES-D score≥16 points).The results of univariate analysis showed that health status,antiviral treatment status,medical social support had an impact on HIV depression(P<0.05).Simple linear regression showed that health status(95%CI:-9.901--2.635)and antiviral treatment status(95%CI:-12.969--3.394)were the influencing factors for depression(P<0.05).The total score of medical social support,tangible support dimension,information and emotional support dimension,positive social interaction dimension,emotional support dimension were associated with depression(P<0.001).Multiple linear regression analysis showed that medical social support was negatively associated with depression.The higher medical social support was the lower incidence of depression.Conclusion The prevalence of depression in AIDS hemodialysis patients is high,and medical social support has a positive effect on alleviating their condition.

Objective To explore the status quo of depression and medical-social support in human immunodeficiency virus(HIV)/acquired immunodeficiency syndrome(AIDS)hemodialysis patients,as well as the effect of medical-social support on depression.Methods A total of 80 HIV/AIDS hemodialysis patients from Xixi Hospital in Hangzhou from March 2022 to March 2024 were collected.Center for epidemiological survey-depression scale(CES-D)and medical social support scale(MOS-SSS)were used to assess patients for depression and medical social support.Structural equation model was used to analyze relationship between medical social support and depression.Results 42 of the 80 subjects(52.5%)had depressive symptoms(CES-D score≥16 points).The results of univariate analysis showed that health status,antiviral treatment status,medical social support had an impact on HIV depression(P<0.05).Simple linear regression showed that health status(95%CI:-9.901--2.635)and antiviral treatment status(95%CI:-12.969--3.394)were the influencing factors for depression(P<0.05).The total score of medical social support,tangible support dimension,information and emotional support dimension,positive social interaction dimension,emotional support dimension were associated with depression(P<0.001).Multiple linear regression analysis showed that medical social support was negatively associated with depression.The higher medical social support was the lower incidence of depression.Conclusion The prevalence of depression in AIDS hemodialysis patients is high,and medical social support has a positive effect on alleviating their condition.

Purpose: This study aimed to investigate reproductive concerns among breast cancer patients of reproductive age, analyze the influencing factors, explore the relationship between coping styles, fear of progression (FOP), and reproductive concerns, and identify the multiple effects of coping styles on the relationship between FOP and reproductive concerns among Chinese breast cancer patients. Methods: A cross-sectional, descriptive study was conducted among breast cancer patients in four tertiary grade A hospitals in Fujian, China, from January 2022 to September 2022. A total of 210 patients were recruited to complete paper-based questionnaires, which included the general data questionnaires, the Reproductive Concerns After Cancer Scale (RCACS), the Fear of Progression Questionnaire-Short Form (FOP-Q-SF), and the Medical Coping Modes Questionnaire (MCMQ). Structural equation models were utilized to evaluate the multiple effects of coping styles on FOP and reproductive concerns. Results: Reproductive concerns in breast cancer patients had a mean score of 53.02 (SD, 10.69), out of a total score of 90, and coping styles for cancer (confrontation, avoidance) were closely associated with FOP and reproductive concerns. FOP showed a significant positive correlation with reproductive concerns (r = .52, p < .01). At the same time, confrontation was significantly negatively correlated with both FOP (r = −.28, p < .01) and reproductive concerns (r = −.39, p < .01). Avoidance was positively correlated to both FOP (r = .25, p < .01) and reproductive concerns (r = .34, p < .01). The impact of FOP on reproductive concerns is partially mediated by confrontation and avoidance, with effect sizes of .07 and .04, respectively. These mediating factors account for 22.0% of the total effect. Conclusions The FOP directly impacted reproductive concerns, while coping styles could partially mediate the association between FOP and reproductive concerns. This study illustrates the role of confrontation and avoidance in alleviating reproductive concerns, suggesting that it is necessary to focus on the changes in reproductive concerns among reproductive-age breast cancer patients. Healthcare professionals can improve disease awareness and reduce patients' FOP, thereby promoting positive psychological and coping behaviors and ultimately alleviating reproductive concerns.