In recent 20 years, the incidence of thyroid cancer has shown an obvious upward trend, especially in female patients. As the second most common molecular marker of thyroid cancer, RAS mutation affects the occurrence and development of thyroid cancer mainly through RAS-RAF-MEK-ERK and PI3K-Akt signaling pathways. However, the effect of RAS mutation on the invasive characteristics, prognosis and survival rate of thyroid cancer is still controversial. This article reviews the research progress of RAS gene mutation in thyroid cancer.

Objective:To investigate the clinical manifestations, endoscopic characteristics, and prognostic factors of patients with colorectal extranodal NK/T cell lymphoma.Methods:The clinical data of 52 patients with colorectal extranodal NK/T cell lymphoma admitted to the First Affiliated Hospital of Zhengzhou University from January 2013 to January 2023 were retrospectively analyzed. Their clinical manifestations and endoscopic characteristics were summarized, and the prognostic factors were analyzed by Cox regression model.Results:Among the 52 patients with colorectal extranodal NK/T cell lymphoma, there were 35 males and 17 females, with a male-to-female ratio of 2.06∶1. Among the general symptoms, abdominal pain was the most common (39 cases), and B symptoms occurred in 47 patients, among which fever was the most common lymphoma B symptom (42 cases), and gastrointestinal perforation was the most common complication (18 cases). Forty-three patients underwent colonoscopy, and the main manifestations under endoscopy were the ulceration type (24 cases). The ulcers were irregular at the edges and often covered with moss at the bottom. The median survival time was 4.3 months. Multivariate Cox regression analysis showed that hemocytic syndrome ( HR=8.50,95% CI: 1.679-8.328, P=0.001), serum albumin ( HR=3.59,95% CI: 1.017-6.551, P=0.048), and with or without chemotherapy ( HR=0.31, 95% CI: 0.246-1.061, P=0.025) were independent factors influencing the overall survival of patients with colorectal extranodal NK/T cell lymphoma. Conclusions:Colorectal extranodal NK/T cell lymphoma is a rare disease with a very poor prognosis. When patients present with abdominal pain and lymphoma B symptoms, and when ulcers with irregular edges and moss covering the bottom are found under endoscopy, the disease should be considered, and endoscopic biopsy should be taken in time for pathological diagnosis. The prognosis of patients with hemophagocytic syndrome and hypoproteinemia is poor. This disease should be treated with chemotherapy and surgery, and on this basis, hemophagocytic syndrome and hypoproteinemia should be treated to improve the prognosis of patients.

Objective:To investigate the clinical manifestations, endoscopic characteristics, and prognostic factors of patients with colorectal extranodal NK/T cell lymphoma.Methods:The clinical data of 52 patients with colorectal extranodal NK/T cell lymphoma admitted to the First Affiliated Hospital of Zhengzhou University from January 2013 to January 2023 were retrospectively analyzed. Their clinical manifestations and endoscopic characteristics were summarized, and the prognostic factors were analyzed by Cox regression model.Results:Among the 52 patients with colorectal extranodal NK/T cell lymphoma, there were 35 males and 17 females, with a male-to-female ratio of 2.06∶1. Among the general symptoms, abdominal pain was the most common (39 cases), and B symptoms occurred in 47 patients, among which fever was the most common lymphoma B symptom (42 cases), and gastrointestinal perforation was the most common complication (18 cases). Forty-three patients underwent colonoscopy, and the main manifestations under endoscopy were the ulceration type (24 cases). The ulcers were irregular at the edges and often covered with moss at the bottom. The median survival time was 4.3 months. Multivariate Cox regression analysis showed that hemocytic syndrome ( HR=8.50,95% CI: 1.679-8.328, P=0.001), serum albumin ( HR=3.59,95% CI: 1.017-6.551, P=0.048), and with or without chemotherapy ( HR=0.31, 95% CI: 0.246-1.061, P=0.025) were independent factors influencing the overall survival of patients with colorectal extranodal NK/T cell lymphoma. Conclusions:Colorectal extranodal NK/T cell lymphoma is a rare disease with a very poor prognosis. When patients present with abdominal pain and lymphoma B symptoms, and when ulcers with irregular edges and moss covering the bottom are found under endoscopy, the disease should be considered, and endoscopic biopsy should be taken in time for pathological diagnosis. The prognosis of patients with hemophagocytic syndrome and hypoproteinemia is poor. This disease should be treated with chemotherapy and surgery, and on this basis, hemophagocytic syndrome and hypoproteinemia should be treated to improve the prognosis of patients.

Operation duration has consistently been regarded as a important factor influencing the outcome of total knee arthroplasty(TKA).Prolonged operation time can give rise to an array of adverse events,ultimately leading to surgical failure,escalated healthcare expenses,and even jeopardizing patient survival.Numerous studies have demonstrated that prolonged operation time is linked with an augmented risk of postoperative complications.Recent investigations have revealed that extended operation duration can heighten the likelihood of postoperative pain,wound dehiscence,anemia and blood transfusion requirements,surgical site infection,sepsis,prolonged hospitalization and readmission rates;impact prosthetic longevity and patient survival rate.

The development of obesity is closely related to the disruption of central appetite regulation. Gastric growth hormone-releasing peptide is the only appetite-promoting peptide known to be present in the circulatory system. Ghrelin may act on the central homeostatic and hedonic feeding neural pathways to promote appetite and feeding behavior, and may be a new target for appetite regulation. In addition, Ghrelin is also involved in the regulation of energy homeostasis via promoting growth, regulating gastrointestinal function, and suppressing inflammatory response. Therefore, the research on the mechanism of ghrelin and its receptors will help understand the pathophysiological changes in the central appetite regulation process of obese patients, and to find potential targets for the treatment of obesity. In this paper, we focus on the molecular mechanism of appetite regulation by Ghrelin and its clinical application.

Objective:To investigate the clinical effects of a single lateral-rectus approach (LRA) in the Ti-Robot-assisted treatment of acetabular fractures involving the posterior column.Methods:A retrospective study was conducted to analyze the clinical data of 16 patients with acetabular fracture who had been admitted to Department of Trauma Orthopedics, Taihe Hospital from August 2021 to March 2023. There were 13 males and 3 females with a mean age of 51.5 (35.8, 56.8) years. By the Judet-Letournel classification, there were 4 anterior and posterior semi-transverse fractures, 2 T-shaped fractures, and 10 double-column fractures. The time from injury to operation was 6.0 (5.3, 7.8) d. All their acetabular fractures involving the posterior column were treated by a single LRA with the assistance of a Ti-Robot. Operation time, blood loss, complications, quality of fracture reduction, modified Merle d'Aubigné & Postel scores and acetabular recovery at the last follow-up were recorded.Results:In this cohort, the operation time was (4.1±0.6) h and the blood loss 400 (300, 575) mL. By the Matta evaluation, the fracture reduction was excellent in 10 cases, good in 5 cases, and poor in 1 case. The follow-up time was (11.3±3.9) months. Bone union was achieved in all fractures after 3.0 (2.3, 4.0) months. By the modified Merle d'Aubigné & Postel scores at the last follow-up, 9 cases were excellent, 6 cases were good and 1 case was fair. Injury to the lateral femoral cutaneous nerve occurred in 1 patient, and deep venous thrombosis in 6 patients. Follow-ups revealed no iatrogenic vascular injury, loosening or rupture of internal fixation, or incision infection.Conclusion:A single LRA approach can be used in the minimally invasive treatment assisted by a Ti-Robot for acetabular fractures involving the posterior column, demonstrating advantages of minimal invasion, high reduction quality and good functional recovery of the hip joint.

Objective: To understand social anxiety and relevant factors among graduate students under the normalization stage of COVID-19 epidemic prevention and control. Methods: Using convenience sampling method, an online questionnaire survey on graduate students from 5 universities in Jiangsu Province was conducted. Measurements used in the survey includes General Self Efficacy Scale (GSES), General Alienation Scale (GAS), Interaction Anxiousness Scale (IAS) and self made survey for basic information and household living conditions. Results: The overall score of graduate students self efficacy was (2.58±0.50). Average score was (30.68±6.22) for alienation, and (47.55±8.77) for interaction anxiety, with detection rate of social anxiety being 43.96%. Increased dependence on smartphones and electronic devices ( OR=1.86, 95%CI =1.32-2.61) and high alienation score (medium level: OR=2.06, 95%CI =1.45-2.92; high level: OR=5.19, 95%CI =1.00-27.00) were positively correlated with social anxiety. Increased communication with friends ( OR=0.65, 95%CI =0.47-0.90 and high self efficacy (medium level: OR= 0.37 , 95%CI =0.21-0.66; high level: OR=0.15, 95%CI =0.08-0.30) were negatively correlated with social anxiety. Conclusion At the normalization stage of COVID-19 epidemic prevention and control, social anxiety of graduate students is one of the mental health issues which need further attention. Participation in peer support helps prevent social anxiety through developing self efficacy, alleviating individual alienation, and reducing dependence on electronic devices among graduate students.

The nasal tip defect has a significant influence on one’s facial appearance, and reconstruction of this defect is challenging. In February 2021, a 44-year-old man with a soft tissue defect of the nasal tip after biting was diagnosed and treated in Xuzhou Renci Hospital. The nasal tip was reconstructed with a free preauricular flap based on the superficial temporal artery, which was anastomosed with the terminal branches of the facial artery by super microsurgical technique. After the operation, the skin flap survived with infection prevention, anticoagulation, and antispasmodic treatment. After three months of follow-up, the incision scar was un-noticeable, and the patient was satisfied with the appearance of the reconstructed nasal tip.

Objective:To investigate the risk factors of type 1 gastric neuroendocrine tumor (g-NET) in patients with autoimmune gastritis(AIG).Methods:From September 1, 2016 to February 28, 2022, 123 patients with AIG visited the First Affiliated Hospital of Zhengzhou University were retrospectively enrolled, including 37 cases with type 1 g-NET and 86 cases without type 1g-NET. The clinical data, serological indicators, and endoscopic manifestation of all the patients were analyzed, including the age at the time of AIG diagnosis (hereinafter referred to as the age at diagnosis), levels of gastrin 17 and pepsinogen Ⅰ (PGⅠ), presence or absence of gastric fundus and gastric body polyps, etc. The independent risk factors of type 1 g-NET in AIG patients were analyzed by univariate and multivariate logistic regression. The receiver operating characteristic curve (ROC) was plotted to analyze the optimal cut-off value, sensitivity and specificity of the independent risk factors in predicting type 1 g-NET in AIG patients. Independent sample t test, Mann-Whitney U test and chi-square test were used for statistical analysis. Results:Compared with those of the AIG patients without type 1 g-NET, the age at diagnosis of AIG patients with type 1 g-NET was younger ((57.49±11.16) years old vs. (48.49±10.96) years old), the level of gastrin 17 was higher (200.21 ng/L, 121.85 ng/L to 244.40 ng/L vs. 244.40 ng/L, 182.50 ng/L to 248.02 ng/L), and the proportion of patients with gastric fundus and gastric body polyps was higher(18.6%, 16/86 vs. 56.8%, 21/37), and the differences were statistically significant( t=-4.13, Z=-3.06, χ2=17.90; P<0.001, =0.002 and <0.001). The results of univariate logistic analysis showed that the age at diagnosis ( OR=0.931, 95% confidence interval (95% CI)0.895 to 0.967), gastrin 17( OR=1.012, 95% CI 1.005 to 1.019), PGⅠ( OR=0.974, 95% CI 0.950 to 0.998)and gastric fundus and gastric body polyps( OR=5.742, 95% CI 2.461 to 13.399)were the influencing factors of type 1 g-NET in AIG patients ( P<0.001, =0.001, =0.033 and <0.001). The results of multivariate logistic regression analysis indicated that the age at diagnosis( OR=0.921, 95% CI 0.881 to 0.964), gastrin 17( OR=1.011, 95% CI 1.001 to 1.020), gastric fundus and gastric body polyps( OR=7.696, 95% CI 2.710 to 21.857)were the independent risk factors of type 1 g-NET in AIG patients ( P<0.001, =0.024 and <0.001). The results of ROC analysis demonstrated that the optimal cut-off values for the age at diagnosis and gastrin 17 in predicting type 1 g-NET were 56.50 years old and 206.40 ng/L, respectively; with sensitivity of 83.8% and 70.3%, respectively, and specificity of 54.7% for both ( P<0.001 and=0.003). Conclusion:The age at diagnosis< 56.50 years old, gastrin 17>206.40 ng/L and the presence of gastric fundus and gastric body polyps are independent risk factors of type 1 g-NET in AIG patients.

The nasal tip defect has a significant influence on one’s facial appearance, and reconstruction of this defect is challenging. In February 2021, a 44-year-old man with a soft tissue defect of the nasal tip after biting was diagnosed and treated in Xuzhou Renci Hospital. The nasal tip was reconstructed with a free preauricular flap based on the superficial temporal artery, which was anastomosed with the terminal branches of the facial artery by super microsurgical technique. After the operation, the skin flap survived with infection prevention, anticoagulation, and antispasmodic treatment. After three months of follow-up, the incision scar was un-noticeable, and the patient was satisfied with the appearance of the reconstructed nasal tip.