Objective:To explore different types of psychological reactions of spouses of young and middle-aged breast cancer patients and their influencing factors based on potential profile analysis, so as to provide reference for targeted intervention in clinical practice.Methods:A cross-sectional investigation method was used to select the spouses of middle-aged and young patients with breast cancer who were hospitalized in the Second Affiliated Hospital of Guilin Medical University, Quanzhou County People's Hospital, and Bobai County People's Hospital from January 2023 to June 2024. General Data Questionnaire, Spousal Psychological Response Scale of Breast Cancer Patients, Perceived Partner Responsiveness Scale and Perceptive Social Support Scale were used to investigate. The potential profile analysis of spousal psychological reaction of young and middle-aged breast cancer patients was carried out, and the influencing factors of different categories were analyzed by ordered multiple Logistic regression.Results:A total of 232 questionnaires were distributed, and 211 valid questionnaires were collected, with an effective response rate of 91.0%.The spouses of 211 middle-aged and young patients with breast cancer were 30-59 (43.25 ± 2.58) years old. The total psychological response score was (69.96 ± 8.36). The low psychological response high coping group accounted for 24.6% (52/211), the moderate psychological response group accounted for 33.2% (70/211), and the high psychological response low coping group accounted for 42.2% (89/211). The results of ordered multiple Logistic regression analysis showed that cumulative care time, tumor stage of patients, perceived partner responsiveness, and perceived social support were the influencing factors of potential categories of psychological responses of spouses of young and middle-aged breast cancer patients ( OR values were 0.014-0.304, all P<0.05). Conclusions:There is heterogeneity in the psychological reactions of spouses of young and middle-aged breast cancer patients. According to the characteristics of the classification, the nursing staff should formulate targeted intervention strategies, focusing on improving the perceived partner responsiveness, establishing an effective social support system, and reducing the level of psychological response.

Objective To investigate an automated pretreatment technology for detecting levels of free silica in workplace dust. Methods An fully automated pretreatment workstation for detecting free silica levels in workplace dust was developed by integrating graphite-controlled digestion temperature, online-controlled dilution of digestion solutions, and filtration endpoint recognition based on monitoring technology, combined with multi-channel synchronous measurements. Results The fully automatic pretreatment workstation was used to digest and filter 14 standard samples of free silica produced by three institutions, and then detected by pyrophosphate method. The result range of high-, medium-, and low-level free silica standard samples detection was 66.5%-84.8%, 40.0%-44.5%, and 2.1%-24.8%, respectively. The mean relative standard deviations were 3.9%, 1.4% and 1.5%. Conclusion The fully automated pretreatment workstation produced results that met relevant requirements. It can effectively replace the manual digestion and filtration steps of the pyrophosphate method to measure free silica levels in workplace dust and enable rapid detection of free silica in dust samples.

Objective To explore the mechanism by which hyperandrogenic states induce preeclampsia in advanced maternal age through the LAMA3-PI3K/Akt pathway and assess its effects on the invasion and migration abilities of human trophoblast cells.Methods Human trophoblast cells were stimulated with dihydrotestosterone(DHT),followed by RNA sequencing(RNA-Seq)to identify differen-tially expressed genes,with gene ontology(GO)and Kyoto encyclopedia of genes and genomes(KEGG)analysis revealing LAM A3 as a key molecule.The mRNA and protein expression levels of LAMA3 were detected using real-time quantitative PCR(RT-qPCR)and Western blot.LAMA3-overexpressing human trophoblast cells were obtained by plasmid transfection.The invasion ability was assessed using the Matrigel-based Transwell assay,and the migration ability was evaluated by the scratch assay.Results DHT stimulation sig-nificantly inhibited the invasion and migration abilities of trophoblast cells.RNA-Seq analysis revealed that LAM A3 might be a key mole-cule involved,and further Western blot and RT-qPCR analyses showed that the protein and mRNA expression of LAM A3 in the placenta of advanced maternal age pregnancies were significantly higher than in normal pregnancies and consistent with findings in the placenta of preeclampsia patients.Overexpression of LAM A3 significantly suppressed trophoblast cell invasion and migration abilities,while also up-regulating the phosphorylation levels of PI3K and Akt.Treatment with a PI3K inhibitor restored both cell function and phosphorylation lev-els to normal.Conclusion Elevated androgen levels in trophoblast cells from advanced maternal age induce specific changes in LAMA3 expression,and LAMA3 regulates trophoblast migration and invasion through the PI3K/Akt signaling pathway.

Objective To explore the mechanism by which hyperandrogenic states induce preeclampsia in advanced maternal age through the LAMA3-PI3K/Akt pathway and assess its effects on the invasion and migration abilities of human trophoblast cells.Methods Human trophoblast cells were stimulated with dihydrotestosterone(DHT),followed by RNA sequencing(RNA-Seq)to identify differen-tially expressed genes,with gene ontology(GO)and Kyoto encyclopedia of genes and genomes(KEGG)analysis revealing LAM A3 as a key molecule.The mRNA and protein expression levels of LAMA3 were detected using real-time quantitative PCR(RT-qPCR)and Western blot.LAMA3-overexpressing human trophoblast cells were obtained by plasmid transfection.The invasion ability was assessed using the Matrigel-based Transwell assay,and the migration ability was evaluated by the scratch assay.Results DHT stimulation sig-nificantly inhibited the invasion and migration abilities of trophoblast cells.RNA-Seq analysis revealed that LAM A3 might be a key mole-cule involved,and further Western blot and RT-qPCR analyses showed that the protein and mRNA expression of LAM A3 in the placenta of advanced maternal age pregnancies were significantly higher than in normal pregnancies and consistent with findings in the placenta of preeclampsia patients.Overexpression of LAM A3 significantly suppressed trophoblast cell invasion and migration abilities,while also up-regulating the phosphorylation levels of PI3K and Akt.Treatment with a PI3K inhibitor restored both cell function and phosphorylation lev-els to normal.Conclusion Elevated androgen levels in trophoblast cells from advanced maternal age induce specific changes in LAMA3 expression,and LAMA3 regulates trophoblast migration and invasion through the PI3K/Akt signaling pathway.

Objective:To explore different types of psychological reactions of spouses of young and middle-aged breast cancer patients and their influencing factors based on potential profile analysis, so as to provide reference for targeted intervention in clinical practice.Methods:A cross-sectional investigation method was used to select the spouses of middle-aged and young patients with breast cancer who were hospitalized in the Second Affiliated Hospital of Guilin Medical University, Quanzhou County People's Hospital, and Bobai County People's Hospital from January 2023 to June 2024. General Data Questionnaire, Spousal Psychological Response Scale of Breast Cancer Patients, Perceived Partner Responsiveness Scale and Perceptive Social Support Scale were used to investigate. The potential profile analysis of spousal psychological reaction of young and middle-aged breast cancer patients was carried out, and the influencing factors of different categories were analyzed by ordered multiple Logistic regression.Results:A total of 232 questionnaires were distributed, and 211 valid questionnaires were collected, with an effective response rate of 91.0%.The spouses of 211 middle-aged and young patients with breast cancer were 30-59 (43.25 ± 2.58) years old. The total psychological response score was (69.96 ± 8.36). The low psychological response high coping group accounted for 24.6% (52/211), the moderate psychological response group accounted for 33.2% (70/211), and the high psychological response low coping group accounted for 42.2% (89/211). The results of ordered multiple Logistic regression analysis showed that cumulative care time, tumor stage of patients, perceived partner responsiveness, and perceived social support were the influencing factors of potential categories of psychological responses of spouses of young and middle-aged breast cancer patients ( OR values were 0.014-0.304, all P<0.05). Conclusions:There is heterogeneity in the psychological reactions of spouses of young and middle-aged breast cancer patients. According to the characteristics of the classification, the nursing staff should formulate targeted intervention strategies, focusing on improving the perceived partner responsiveness, establishing an effective social support system, and reducing the level of psychological response.

Purpose To explore the feasibility of the deep learning-based segmentation of extra-pelvic region and metastases in advanced prostate cancer based on metastasis reporting and data system for prostate cancer(MET-RADS-P).Materials and Methods Four datasets(68,91,57 and 263 patients with head,neck,chest and abdomen metastases,respectively)from Jan 2017 to Jan 2022 in Peking University First Hospital were retrospectively collected for the development of the classification model of scanning range and segmentation model of different regions and metastases according to the scanning sites(head,neck,chest and abdomen).In addition,90 patients with prostate cancer confirmed by pathology and underwent whole-body MRI were collected for external validation of the developed model.The manual annotation of the regions and metastases were used as the"reference standard"for the model evaluation.The evaluation indexes included dice similarity coefficient(DSC)and volumetric similarity(VS).Results In the external validation set,the classification accuracy of head,neck,chest and abdomen were 100%(90/90),98.89%(89/90),96.67%(87/90)and 94.44%(85/90),respectively.The range of DSC,VS values of the segmentation model for organs in different regions were(0.86±0.10)-(0.99±0.01),(0.89±0.10)-(0.99±0.01),respectively.The range of DSC,VS values of the segmentation model for metastases in different regions were(0.65±0.07)-(0.72±0.13),(0.74±0.04)-(0.82±0.13),respectively.Conclusion The 3D U-Net model based on deep learning may achieve the segmentation of extra-pelvic region and metastasis in advanced prostate cancer.

Objective To explore the relationship between androgen level and adverse pregnancy outcome of pregnant women at advanced maternal age.Methods A total of 192 pregnant women who were admitted to Changzhou Maternal and Child Health Care Hospital for delivery from May to October 2022 were selected as the study objects.According to guidelines for diagnosis and treatment of hypertensive disorder complicating pregnancy and maternal age,the study objects were divided into simple pregnant women at advanced maternal age group,pregnant women at advanced maternal age complicated with hypertensive disorder complicating pregnancy,healthy control group and age-appropriate pregnant women complicated with hypertensive disorder complicating pregnancy group.Serum levels of five androgens[total testosterone(TT),sex hormone binding globulin(SHBG),free testosterone index(FTI),dehydroepiandrosterone sulfate(DHEAS)and androstendi-one(A2)]in each group were detected by chemiluminescence method.Results Compared with the healthy control group,TT,A2,FTI were significantly increased and SHBG was significantly decreased in the age-ap-propriate pregnant women complicated with hypertensive disorder complicating pregnancy group,the level of DHEAS was decreased in the simple pregnant women at advanced maternal age group,and the differences were statistically significant(P＜0.05).Pearson correlation analysis showed that TT was negatively correla-ted with age(P＜0.05),positively correlated with systolic blood pressure,diastolic blood pressure and body mass index(P＜0.05),and had no correlation with offspring sex and offspring weight(P＞0.05).Multivari-ate Logistic regression analysis showed that TT and body mass index were independent risk factors for hyper-tensive disorder complicating pregnancy in pregnant women(P＜0.05).Conclusion The level of androgen in pregnant women at advanced maternal age is related to the occurrence of hypertensive disorder complicating pregnancy.

Objective To investigate, analyze, and evaluate the risk data associated with the clinical use of absorbable sutures by retrieving and summarizing information from the databases of the US FDA and CNKI, as well as the adverse event reports related to absorbable sutures from January 2019 to October 2022 within Zhejiang province. The adverse event reports are obtained from both incident locations and monitoring organizations affiliated with the registrant. The aim is to identify the main risk factors associated with the clinical use of absorbable sutures. The key risk factors are potential product quality defects, product design and material selection, clinical selection and application, and postoperative recovery care including patient's self-care. Risk control strategies are further proposed to reduce or minimize the risk of adverse events caused by this product.
Humans ; Sutures/adverse effects* ; Risk Assessment ; Risk Factors

Objective:To investigate the influencing factors of textbook outcomes in liver surgery (TOLS) after radical resection of gallbladder carcinoma.Methods:The retrospective case-control study was conducted. The clinicopathological data of 530 patients who underwent radical resection of gallbladder carcinoma in 15 medical centers, including the First Affiliated Hospital of Army Medical University et al, from January 2014 to January 2020 were collected. There were 209 males and 321 females, aged (61±10)years. Patients underwent radical resection of gallbladder carcinoma, including cholecystectomy, hepatectomy, invasive bile duct resection, and lymph node dissection. Observation indicators: (1) situations of TOLS; (2) influencing factors of TOLS. Measure-ment data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test. Comparison of ordinal data between groups was conducted using the Mann-Whitney U test. The univariate analysis was conducted using the corresponding statistical methods based on data type, and variables with P<0.10 were included in multivariate analysis. Multivariate analysis was conducted using the Logistic stepwise regression model. Results:(1) Situations of TOLS. All 530 patients underwent radical resection of gallbladder carcinoma, and there were 498 cases achieving R 0 resection, 508 cases without ≥grade 2 intra-operative adverse events, 456 cases without postoperative grade B and grade C biliary leakage, 513 cases without postoperative grade B and grade C liver failure, 395 cases without severe com-plications within postoperative 90 days, 501 cases did not being re-admission caused by severe com-plications within postoperative 90 days. Of the 530 patients, 54.53%(289/530) of patients achieved postoperative TOLS, while 45.47%(241/530) of patients did not achieve postoperative TOLS. (2) Influencing factors of TOLS. Results of multivariate analysis showed that American Society of Anesthesiologists classification >grade Ⅱ, preoperative jaundice, T staging as T3?T4 stage, N staging as N2 stage, liver resection as right hemi-hepatectomy, and neoadjuvant therapy were independent factors influencing TOLS in patients undergoing radical resection of gallbladder carcinoma ( odds ratio=2.65, 1.87, 5.67, 5.65, 2.55, 3.34, 95% confidence interval as 1.22?5.72, 1.18?2.95, 2.51?12.82, 2.83?11.27, 1.41?4.63, 1.88?5.92, P<0.05). Conclusion:American Society of Anesthesiologists classification >grade Ⅱ, preoperative jaundice, T staging as T3?T4 stage, N staging as N2 stage, liver resection as right hemi-hepatectomy, and neoadjuvant therapy are independent factors influencing TOLS in patients undergoing radical resection of gallbladder carcinoma.

Objective:To compare and analyze the predictive value of different inflammatory factors and tumor markers in intrahepatic cholangiocarcinoma and to develop a new and effective preoperative prognostic scoring system.Methods:102 and 72 cases with intrahepatic cholangiocarcinoma who underwent radical surgery in Tianjin Medical University Cancer Institute and Hospital and the Affiliated Hospital of Weifang Medical University were selected as the experimental group and the validation group, respectively. Clinicopathological and follow-up data were collected. Cox proportional-hazards model was used to analyze the predictive value of different prognostic markers. The relationship between prognostic markers and clinicopathological data was analyzed by rank sum test, χ2 or Fisher's exact test. Results:Among the direct inflammatory factors, tumor markers and combined inflammatory factors, prognostic inflammatory index (PII), carbohydrate antigen (CA) 19-9 and systemic inflammation score (SIS) were the most significant predictive factors for postoperative survival outcomes in patients with intrahepatic cholangiocarcinoma. The prognostic inflammatory and tumor score (PITS) was proposed as a new prognostic scoring system for intrahepatic cholangiocarcinoma. PII and CA19-9 were included into the scoring criteria for prognostic stratification of patients. PITS was an independent predictor of tumor-free survival and overall survival in patients with intrahepatic cholangiocarcinoma. Patients with high-grade PITS had later tumor grade and higher frequency of vascular invasion.Conclusion:PITS is highly effective prognostic scoring system for patients with intrahepatic cholangiocarcinoma. In addition, PITS is recommended for preoperative prognostic stratification in patients with intrahepatic cholangiocarcinoma.