ObjectiveTo establish a nomogram predictive model based on magnetic resonance cholangiopancreatography-related parameters and liver-to-muscle ratio， and to investigate the application value of this model in preoperative assessment of liver reserve function in patients with hepatic space-occupying lesion. MethodsClinical data and Gd-EOB-DTPA MRI imaging data were collected from 112 patients with hepatic space-occupying lesion who were hospitalized and scheduled for surgery in Wuming Hospital of Guangxi Medical University from April 2022 to April 2024. According to the degree of liver injury， the patients were divided into Child-Pugh class A group （65 patients with compensated liver function） and Child-Pugh class B+C group （47 patients with decompensated liver function， including 42 patients with Child-Pugh class B liver function and 5 patients with Child-Pugh class C liver function）. The two groups of patients were measured in terms of liver-to-muscle ratio， relative signal intensity of the common bile duct， and bile duct score in different phases of contrast-enhanced CT scan， and univariate and multivariate Logistic regression analyses were used to identify independent predictive factors and establish a nomogram model. In addition， the receiver operating characteristic （ROC） curve， the calibration curve， and the decision curve were plotted to assess the discriminatory ability， accuracy， and clinical application value of the model. The independent-samples t test was used for comparison of normally distributed continuous data between two groups， and the Mann-Whitney U test was used for comparison of data with skewed distribution between two groups； the chi-square test was used for comparison of categorical data between two groups. ResultsThere were significant differences between the two groups in liver-to-muscle ratio at 5 minutes （Z=-3.99， P0.001）， 10 minutes （Z=-4.39， P0.001）， 15 minutes （Z=-4.23， P0.001）， and 20 minutes （Z=-5.40， P0.001） during the hepatobiliary phase， the relative enhancement degree of the common bile duct （Z=-4.85， P0.001）， and bile duct score （t=7.99， P0.001）. The multivariate Logistic regression analysis showed that liver-to-muscle ratio at 10 minutes during the hepatobiliary phase （odds ratio ［OR］=0.63， 95% confidence interval ［CI］： 0.44 — 0.90， P0.05）， liver-to-muscle ratio at 20 minutes during the hepatobiliary phase （OR=0.38， 95%CI： 0.17 — 0.82， P0.05）， and bile duct score （OR=0.17， 95%CI： 0.07 — 0.39， P0.05） were independent influencing factors for the preoperative diagnosis of liver function decompensation. The nomogram model established based on liver-to-muscle ratio at 10 minutes during the hepatobiliary phase， liver-to-muscle ratio at 20 minutes during the hepatobiliary phase， and bile duct score had an area under the ROC curve of 0.905 （95%CI： 0.849 — 0.960）， with a sensitivity of 78.7% with a specificity of 89.2%. ConclusionThe nomogram model established based on the liver-to-muscle ratio at 10 and 20 minutes during the hepatobiliary phase and bile duct score can effectively assess the status of liver reserve function in patients with hepatic space-occupying lesion before surgery.

Objective: To explore the associations of moderate to vigorous intensity physical activity (MVPA) and sedentary behavior (SB) among primary and secondary school students and their parents, so as to provide a scientific basis for formulating targeted physical activity promotion strategies for children and adolescents. Methods: From 2021 to 2022, basic information and 24 h movement behaviors of 2 484 pairs of students and their parents were collected from five primary and secondary schools in Haizhu District, Guangzhou City, with a convenient sampling combining with cluster sampling method. Component regression models were constructed to analyze the relationship between parental MVPA, SB and primary and secondary school students MVPA and SB, and a component isochronous substitution model was used to explore the effects of mutual substitution between parental MVPA, residual components (time use components other than SB during the 24 h period), and SB on the behavioral activities of MVPA and SB in primary and secondary school students. Results: Parental MVPA and SB of students in grade 1 to 3 were positively correlated with both students MVPA and SB ( β=0.06, 0.12, P <0.01). The component isochronous substitution model showed that substituting 10 and 20 minutes of MVPA for SB by parents in grade 1 to 3 was associated with an increase in MVPA of students, and substituting 10 and 20 minutes of residual ingredients for SB was associated with a decrease in SB of students, with mean changes of 0.8 (95% CI =0.4-1.2) and 1.4 (95% CI =0.7-2.2) and -1.4 (95% CI =-1.7 to -1.1) and -2.9 (95% CI =-3.4 to -2.3)( P <0.05). No statistically significant associations were observed between parents of students in grades 4 to 6 and 7 to 9 and students physical activity and sedentary behaviour ( P >0.05). Conclusions Parents of students in grades 1 to 3 increases MVPA and decrease SB are beneficial to increase MVPA and decrease SB of students. Parents could promote physical activity among primary and secondary school students, and the intervention gateway should be advanced, with the low grades as the optimal intervention period.

Objective:To analyze the incidence of surgical site infection (SSI) in patients undergoing colorectal cancer (CRC) surgery and to identify risk factors associated with SSI in an attempt to provide a reference for clinical prevention strategies.Methods:A retrospective cohort study was conducted. Clinical data were retrospectively collected from a total of 2,248 patients who underwent surgery for pathologically confirmed CRC between 2017 and 2022 at two centers: Huangshan Shoukang Hospital ( n=649) and Northern Jiangsu People's Hospital ( n=1 599). Inclusion criteria consisted of the following: (1) age >18 years; (2) pathologically confirmed CRC treated with curative resection, including extended resections (e.g. pelvic exenteration); (3) no surgical incisions other than abdominal or perineal; and (4) no use of prosthetic implants. The incidence of SSI was analyzed, and multivariate logistic regression was used to identify independent its risk factors. Results:A total of 121 patients (5.4%) developed SSI. Among them, 68 cases (56.2%) were organ/space infections, 35 cases (28.9%) were deep incisional infections, and 18 cases (14.9%) were superficial incisional infections. The median postoperative hospital stay was significantly longer in patients with SSI compared to those without (21.0 days vs. 13.0 days, U=65,754, P<0.001). The median hospitalization cost was also significantly higher in the SSI group (56,550 yuan vs. 43,645 yuan, U=72,008, P<0.001). Multivariate logistic regression analysis identified body mass index (BMI) ≤ 20 kg/m 2 (OR=4.25, 95%CI: 3.38-5.34, P<0.001), diabetes mellitus (OR=3.44, 95%CI: 1.89-6.24, P<0.001), open surgery (OR=4.23, 95%CI: 2.37-7.56, P<0.001), and colostomy or ileostomy (OR=1.67, 95% CI: 1.04-2.69, P=0.034) as independent risk factors for SSI. Conclusion:To prevent SSI following CRC surgery, attention should be given to optimizing body weight and glycemic control, promoting minimally invasive surgical approaches when feasible, and cautiously considering the necessity of colostomy or ileostomy.

OBJECTIVE: To analyze a patient with infertility due to complex chromosome rearrangement by optical genome mapping (OGM). METHODS: A female patient who was diagnosed with "primary infertility" at Shenzhen Longhua District Maternal and Child Health Care Hospital in April 2024 was selected as the study subject. Clinical data of the patient was collected. Chromosome G banding karyotyping analysis was carried out for the patient and her parents, in addition with OGM and copy number variation sequencing (CNV-seq). This study was approved by the Medical Ethics Committee of the Hospital (Ethics No.: 2023052504). RESULTS: The patient, a 33-year-old female, had infertility for the past 5 years. OGM revealed formation of two derivative chromosomes through rearrangement of chromosomes 5 and 18. A loss of heterozygosity on chromosome 5 was also detected by OGM and CNV-seq techniques. Both of her parents had a normal karyotype. CONCLUSION The OGM technique can refine the position of chromosomal breakpoints and determine the direction and position of insertional fragment. Combined with karyotype analysis, the OGM can accurately determine the chromosomal karyotype of the patient and facilitate genetic counseling.
Humans ; Female ; Adult ; Karyotyping ; DNA Copy Number Variations/genetics* ; Chromosome Mapping/methods* ; Chromosome Aberrations ; Infertility, Female/diagnosis*

Objective To explore the targets and mechanism of Buyang Huanwu Decoction in preventing and treating atherosclerosis through network pharmacology,molecular docking and animal experiment.Methods The main active components and related targets of Buyang Huanwu Decoction were obtained and screened through databases such as TCMSP,HERB,UniProt,PubChem,SwissADME and SwissTargetPrediction.Six disease databases such as DrugBank,GeneCards,DisGeNET,OMIM,PharmGKB and TTD were used to obtain AS related targets.R language was used to obtain common targets for the drug and disease.STRING 11.5 database was used for protein interaction network analysis,and Cytoscape 3.9.1 software was used to conduct network topology parameters and obtain core targets.GO and KEGG enrichment analysis were performed on the common targets using DAVID platform.Molecular docking of core genes with the main active components of Buyang Huanwu Decoction was conducted using AutoDock Vina 1.5.6 software.An AS mouse model was established and intervened with Buyang Huanwu Decoction.The lipid content of the mouse aortic sinus was observed using Oil Red O staining.Western blot was used to detect the expression of PI3K/AKT/p38 signaling pathway,and ELISA was used to detect the contents of TNF-α and IL-17 in mouse serum.Results A total of 104 main active components and 283 action targets of Buyang Huanwu Decoction were obtained,as well as 5 347 AS related targets and 218 common targets for drugs and disease.Buyang Huanwu Decoction may use key active components such as quercetin,kaempferol and baicalin as core targets for TP53,MAPK1,AKT1,and exert its therapeutic effect on AS through PI3K-Akt signaling pathway,TNF signaling pathway and IL-17 signaling pathway,etc.Molecular docking indicated that quercetin,luteolin,kaempferol and baicalin had good affinity with TP53,HSP90AA1,MAPK1,AKT1 and RELA targets.MAPK1 had strong binding activity with baicalin and luteolin.The experimental results showed that Buyang Huanwu Decoction could reduce the lipid content in aortic sinus of AS mice,reduce the contents of TNF-α and IL-17 in serum(P<0.01)and significantly down-regulate the expression levels of PI3K,p-AKT and p-p38 proteins(P<0.05,P<0.01).Conclusion The mechanism of Buyang Huanwu Decoction for preventing and treating AS may be related to regulating the expression of the PI3K/AKT/p38 signaling pathway,thereby reducing inflammatory response.

Objective To understand the clinical applicability and implementation of expert consensus on the implementation and removal of protective restraints in psychiatry,and to provide references for promoting the standardized practice of psychiatric protective restraints and updating the consensus.Methods By the convenience sampling method,a questionnaire survey was conducted among nurses from 480 hospitals in 30 provinces from June 15 to July 15,2024.The survey was conducted using the instrument for evaluating clinical applicability of guide-lines(version 2.0)and a self-compiled questionnaire on the clinical implementation of the restraint consensus.Results A total of 7,844 valid questionnaires were collected,with a valid questionnaire recovery rate of 93.78％.The results of clinical applicability scoring showed that the consensus had the lowest availability score(64.72％)and the highest acceptability score(76.74％).The results showed that nurses' receiving training and the level of their hospitals were the main influencing factors for scores in various dimensions(P＜0.05).4,774 participants(87.42％)believed that the application of consensus could enhance the standardization of nurses' restraint operations.The safety rate of the restraint consensus was 79.51％,and the economic ratio was 76.87％.Among the evaluators,1,739(22.17％)believed that there were implementation obstacles in the consensus.Conclusion The clinical applicability of the consensus is relatively good,and the application of the consensus helps to improve the standardization of clinical operations.In the future,efforts should be made to strengthen the promotion and training of the consensus,develop hierarchical promotion strategies according to the characteristics of medical institutions,and improve the quality of evidence for the consensus,so as to further enhance the clinical application effect of the consensus.

Objective:To analyze a patient with infertility due to complex chromosome rearrangement by optical genome mapping (OGM).Methods:A female patient who was diagnosed with " primary infertility" at Shenzhen Longhua District Maternal and Child Health Care Hospital in April 2024 was selected as the study subject. Clinical data of the patient was collected. Chromosomal G banding karyotyping analysis was carried out for the patients and her parents, in addition with OGM and copy number variation sequencing (CNV-seq). This study was approved by the Medical Ethics Committee of the Hospital (Ethics No.: 2023052504).Results:The patient, a 33-year-old female, had infertility for the past 5 years. OGM revealed formation of two derivative chromosomes through rearrangement of chromosomal 5 and 18. A loss of heterozygosity on chromosome 5 was also detected by OGM and CNV-seq techniques. Both of her parents had a normal karyotype.Conclusion:The OGM technique can refine the position of chromosome breakpoints and determine the direction and position of insertional fragment. Combined with karyotype analysis, the OGM can accurately determine the chromosomal karyotype of the patient and facilitate genetic counseling.

Retinal vein occlusion (RVO) is a serious retinal vascular disease, often accompanied by systemic cardiovascular and cerebrovascular diseases, the eye changes include macular edema, retinal ischemia, and even neovascularization, etc. As a common chronic disease of the fundus, it seriously affects patients' vision and quality of life. With the development of optical coherence tomography, the role of choroid in the occurrence and development of RVO has become a research hotspot. The research on the changes of the choroid layer of the eye with RVO has expanded from a simple two-dimensional thickness analysis to a more comprehensive multidimensional observation index such as three-dimensional volume, blood flow density and velocity. In addition, some cutting-edge research combines artificial intelligence algorithm techniques to improve the accuracy and depth of analysis. In the future, it is still necessary to further improve the data of the choroid layer of the eye with RVO, enhance the overall understanding of RVO, and provide new ideas for clinical prevention and treatment of RVO.

Objective:To analyze the incidence of surgical site infection (SSI) in patients undergoing colorectal cancer (CRC) surgery and to identify risk factors associated with SSI in an attempt to provide a reference for clinical prevention strategies.Methods:A retrospective cohort study was conducted. Clinical data were retrospectively collected from a total of 2,248 patients who underwent surgery for pathologically confirmed CRC between 2017 and 2022 at two centers: Huangshan Shoukang Hospital ( n=649) and Northern Jiangsu People's Hospital ( n=1 599). Inclusion criteria consisted of the following: (1) age >18 years; (2) pathologically confirmed CRC treated with curative resection, including extended resections (e.g. pelvic exenteration); (3) no surgical incisions other than abdominal or perineal; and (4) no use of prosthetic implants. The incidence of SSI was analyzed, and multivariate logistic regression was used to identify independent its risk factors. Results:A total of 121 patients (5.4%) developed SSI. Among them, 68 cases (56.2%) were organ/space infections, 35 cases (28.9%) were deep incisional infections, and 18 cases (14.9%) were superficial incisional infections. The median postoperative hospital stay was significantly longer in patients with SSI compared to those without (21.0 days vs. 13.0 days, U=65,754, P<0.001). The median hospitalization cost was also significantly higher in the SSI group (56,550 yuan vs. 43,645 yuan, U=72,008, P<0.001). Multivariate logistic regression analysis identified body mass index (BMI) ≤ 20 kg/m 2 (OR=4.25, 95%CI: 3.38-5.34, P<0.001), diabetes mellitus (OR=3.44, 95%CI: 1.89-6.24, P<0.001), open surgery (OR=4.23, 95%CI: 2.37-7.56, P<0.001), and colostomy or ileostomy (OR=1.67, 95% CI: 1.04-2.69, P=0.034) as independent risk factors for SSI. Conclusion:To prevent SSI following CRC surgery, attention should be given to optimizing body weight and glycemic control, promoting minimally invasive surgical approaches when feasible, and cautiously considering the necessity of colostomy or ileostomy.

Objective To explore the targets and mechanism of Buyang Huanwu Decoction in preventing and treating atherosclerosis through network pharmacology,molecular docking and animal experiment.Methods The main active components and related targets of Buyang Huanwu Decoction were obtained and screened through databases such as TCMSP,HERB,UniProt,PubChem,SwissADME and SwissTargetPrediction.Six disease databases such as DrugBank,GeneCards,DisGeNET,OMIM,PharmGKB and TTD were used to obtain AS related targets.R language was used to obtain common targets for the drug and disease.STRING 11.5 database was used for protein interaction network analysis,and Cytoscape 3.9.1 software was used to conduct network topology parameters and obtain core targets.GO and KEGG enrichment analysis were performed on the common targets using DAVID platform.Molecular docking of core genes with the main active components of Buyang Huanwu Decoction was conducted using AutoDock Vina 1.5.6 software.An AS mouse model was established and intervened with Buyang Huanwu Decoction.The lipid content of the mouse aortic sinus was observed using Oil Red O staining.Western blot was used to detect the expression of PI3K/AKT/p38 signaling pathway,and ELISA was used to detect the contents of TNF-α and IL-17 in mouse serum.Results A total of 104 main active components and 283 action targets of Buyang Huanwu Decoction were obtained,as well as 5 347 AS related targets and 218 common targets for drugs and disease.Buyang Huanwu Decoction may use key active components such as quercetin,kaempferol and baicalin as core targets for TP53,MAPK1,AKT1,and exert its therapeutic effect on AS through PI3K-Akt signaling pathway,TNF signaling pathway and IL-17 signaling pathway,etc.Molecular docking indicated that quercetin,luteolin,kaempferol and baicalin had good affinity with TP53,HSP90AA1,MAPK1,AKT1 and RELA targets.MAPK1 had strong binding activity with baicalin and luteolin.The experimental results showed that Buyang Huanwu Decoction could reduce the lipid content in aortic sinus of AS mice,reduce the contents of TNF-α and IL-17 in serum(P<0.01)and significantly down-regulate the expression levels of PI3K,p-AKT and p-p38 proteins(P<0.05,P<0.01).Conclusion The mechanism of Buyang Huanwu Decoction for preventing and treating AS may be related to regulating the expression of the PI3K/AKT/p38 signaling pathway,thereby reducing inflammatory response.