Objective To explore the application of cell block(CB)technology in the diagnosis of papillary thyroid carcinoma(PTC).Methods A total of 86 patients with thyroid nodules who were treated at Luoyang Central Hospital Affiliated to Zhengzhou University from February 2023 to December 2024 were retrospectively selected.Before the operation,all patients underwent ultrasound-guided fine needle aspiration biopsy.After the biopsy,the specimens were respectively subjected to cell smear(CS)and CB pathological examinations.Using postoperative pathology as the gold standard,the clinical application value of CS,CB,BRAFV600E gene detection,and combined detection in the preoperative diagnosis of PTC was evaluated.Results A total of 86 patients were included.Among them,42 cases were diagnosed as PTC by postoperative pathology,and 44 cases were benign lesions.The sensitivity(73.81％),specificity(97.73％),positive predictive value(96.88％),negative predictive value(79.63％),and accuracy(86.05％)of CB in the preoperative diagnosis of PTC were significantly higher than those of CS.The Kappa consistency test results showed that the consistency between CB pathological results and postoperative pathological results was better than that of CS.Receiver operating characteristic curve analysis indicated that the area under the curve(AUC)of CB was significantly higher than that of CS(0.858 vs.0.743,Z=2.391,P=0.017).Furthermore,the combination of CB and BRAFV600E gene detection further improved preoperative diagnostic performance,with a consistency with postoperative pathological results(Kappa=0.837)superior to other examination methods,and an AUC(0.918)significantly higher than other examination methods.Conclusion CB has significant clinical application value in the preoperative diagnosis of PTC,with diagnostic performance significantly superior to CS.Further combination with BRAFV600E gene detection can significantly improve preoperative diagnostic accuracy.

Objective To explore the application of cell block(CB)technology in the diagnosis of papillary thyroid carcinoma(PTC).Methods A total of 86 patients with thyroid nodules who were treated at Luoyang Central Hospital Affiliated to Zhengzhou University from February 2023 to December 2024 were retrospectively selected.Before the operation,all patients underwent ultrasound-guided fine needle aspiration biopsy.After the biopsy,the specimens were respectively subjected to cell smear(CS)and CB pathological examinations.Using postoperative pathology as the gold standard,the clinical application value of CS,CB,BRAFV600E gene detection,and combined detection in the preoperative diagnosis of PTC was evaluated.Results A total of 86 patients were included.Among them,42 cases were diagnosed as PTC by postoperative pathology,and 44 cases were benign lesions.The sensitivity(73.81％),specificity(97.73％),positive predictive value(96.88％),negative predictive value(79.63％),and accuracy(86.05％)of CB in the preoperative diagnosis of PTC were significantly higher than those of CS.The Kappa consistency test results showed that the consistency between CB pathological results and postoperative pathological results was better than that of CS.Receiver operating characteristic curve analysis indicated that the area under the curve(AUC)of CB was significantly higher than that of CS(0.858 vs.0.743,Z=2.391,P=0.017).Furthermore,the combination of CB and BRAFV600E gene detection further improved preoperative diagnostic performance,with a consistency with postoperative pathological results(Kappa=0.837)superior to other examination methods,and an AUC(0.918)significantly higher than other examination methods.Conclusion CB has significant clinical application value in the preoperative diagnosis of PTC,with diagnostic performance significantly superior to CS.Further combination with BRAFV600E gene detection can significantly improve preoperative diagnostic accuracy.

Objective:To explore the clinical efficacy of apatinib combined with tirelizumab in the treatment of advanced gastric cancer patients who failed first-line chemotherapy, as well as its impact on peripheral blood tumor angiogenesis regulatory factor levels and long-term survival.Methods:A prospective study was conducted on 144 advanced gastric cancer patients who failed first-line chemotherapy and were admitted to the Handan Central Hospital from January 2020 to December 2021. They were divided into two groups using a random number table method, with 72 patients in each group. The control group was treated with tirezizumab alone, while the observation group was treated with apatinib combined with tirezizumab. After four consecutive courses of treatment, the short-term efficacy of both groups was observed. We compared the levels of serum tumor markers [carcinoembryonic antigen (CEA), carbohydrate antigen (CA)199, CA724, CA125], tumor angiogenesis regulatory factors [vascular endothelial growth factor (VEGF), stromal cell-derived factor-1α (SDF-1 α), insulin-like growth factor-1 (IGF-1), matrix metalloproteinase-9 (MMP-9)], and quality of life scores between two groups before and after treatment. Long term follow-up was conducted on all patients, and the long-term survival status of two groups was statistically analyzed. Two groups of adverse reactions were compared.Results:The objective remission rate and disease control rate (51.39%, 80.56%) of the observation group were significantly higher than those of the control group (31.94%, 61.11%, all P<0.05). After treatment, the serum levels of CEA, CA199, CA724, CA125, VEGF, SDF-1α, IGF-1, and MMP-9 in both groups were significantly reduced compared with those before treatment (all P<0.05), and the observed group showed a more significant decrease in the above indicators (all P<0.05). After treatment, the scores of physical function, emotional function, social function, role function, and overall health status in the European Organization for Research and Treatment of Cancer Core Scale C30 were significantly higher than before treatment (all P<0.05), and the increase was more significant in the observation group (all P<0.05). The median progression free survival and median overall survival in the observation group were 5.9 months and 13.1 months, respectively, significantly longer than those in the control group (4.5 months and 9.6 months) (all P<0.05). During the treatment period, both groups experienced varying degrees of adverse reactions such as hypertension, leukopenia, thrombocytopenia, and liver and kidney damage, but both were mainly grade Ⅰ-Ⅱ. The overall adverse reactions were clinically controllable and tolerable by patients. The incidence of hypertension, thrombocytopenia, hand foot syndrome, and oral ulcers in the observation group was significantly higher than that in the control group (all P<0.05). Conclusions:The combination of apatinib and tirezizumab can effectively regulate the levels of peripheral blood tumor markers and angiogenic regulatory factors in advanced gastric cancer patients who have failed first-line chemotherapy, improve short-term anti-tumor efficacy, and bring more survival benefits to patients.

Objective:To explore the effects of dietary phosphate restriction education on serum phosphorus level, dietary phosphate intake and the knowledge of hyperphosphatemia in maintenance hemodialysis (MHD) patients.Methods:This study was a retrospective cohort study. A total of 116 hemodialysis patients in Huashan Hospital, Huadong Hospital and Tongji Hospital from October 2019 to December 2020 were enrolled in this study. They were divided into short-term group (84 cases) and long-term group (32 cases). The short-term group did not receive education or received education≤60 minutes. Meanwhile, the long-term group received education>60 minutes. Serum phosphorus level, dietary phosphate intake and knowledge of hyperphosphatemia were compared between the two groups after 4 weeks.Results:At baseline, age [64(56, 69) years old vs 65(60, 73) years old, Z=-1.493, P=0.136], the proportion of males [58.3%(49/84) vs 56.3%(18/32), χ2=0.041, P=0.839], dialysis age [55(26, 130) months vs 53(20, 132) months, Z=-0.062, P=0.951], body mass index, diabetes history, single-pool Kt/V, proportion of calctriol used, blood calcium, blood phosphorus, intact parathyroid hormone and dietary protein, dietary phosphorus and dietary phosphorus protein ratio had no statistical significance between short-term group and long-term group (all P>0.05). Adequate dietary phosphate restriction education reduced dietary phosphate intake [777.98(653.81, 943.16) mg/d vs 896.56(801.51, 1 015.51) mg/d, Z=-2.903, P=0.004], phosphate/protein ratio [13.16(11.52, 14.21) mg/g vs 15.27(13.31, 17.48) mg/g, Z=-3.929, P<0.001] and serum phosphorus level [(1.42±0.37) mmol/L vs (1.85±0.44) mmol/L, t=4.984, P<0.001]. Meanwhile, such education significantly improved achievement rate of serum phosphorus (62.5% vs 41.7%, χ2=4.034, P=0.045). In addition, patients in long-term group answered more questions correctly (completely correct plus partially correct) about the causes (93.8% vs 72.6%, χ2=6.120, P=0.013), poor prognosis (78.1% vs 52.4%, χ2=6.372, P=0.012) of hyperphosphatemia as well as the types of food with high phosphate (65.6% vs 52.4%, χ2=1.650, P=0.199). Conclusion:Adequate dietary phosphate restriction education reduces serum phosphorus level and dietary phosphate intake, and improves the knowledge of hyperphosphatemia in MHD patients.

Objective:To investigate the risk factor of renal anemia in maintenance hemodialysis patients (MHD) and the association of N-terminal pro-brain natriuretic (NT-proBNP) level with renal anemia.Methods:Patients who received MHD for more than 3 months at Huashan Hospital affiliated to Fudan University from August 2018 to November 2018 were selected as the subjects. The patients were divided into anemia group and non-anemia group according to the hemoglobin level. The patients' general data, the laboratory examination and dialysis related data during the observation period were collected. Pearson correlation analysis was used to analyze the correlation between anemia indicators, dialysis-related indicators and blood NT-proBNP levels. Stepwise multiple linear regression analysis was used to analyze the risk factors for anemia in MHD patients.Results:A total of 160 patients with MHD were included in this study, aged (63.11±11.35) years. There were 79 males (49.4%) and 81 females (50.6%). The dialysis age was (118.01±82.32) months, hemoglobin was (110.09±13.48) g/L, and the median NT-proBNP was 3 985 ng/L. There were 73 cases (45.6%) in anemia group and 87 cases (54.4%) in non-anemic group, and NT-proBNP levels were significantly higher in anemia group than that in the non-anemia group ( t=-3.714, P<0.001). Hemoglobin levels were positively correlated with weekly dialysis time ( r=0.228) and albumin ( r=0.349), and negatively correlated with NT-proBNP levels ( r=-0.318). Hematocrit was positively correlated with weekly dialysis time ( r=0.283), serum calcium ( r=0.317), phosphorus ( r=0.264) and albumin ( r=0.513) with significance (all P<0.05). Univariate regression analysis showed that the level of ln (NT-proBNP) was negatively correlated with hemoglobin ( P<0.001). Stepwise multiple linear regression results showed that low albumin level and high NT-proBNP level were independent risk factors for renal anemia in MHD patients. Conclusions:The increase level of NT-proBNP in MHD patients is independently associated with the decrease level of hemoglobin. Low albumin level and high NT-proBNP level are risk factors for renal anemia, suggesting that the treatment of renal anemia needs to consider improving the factors such as malnutrition and high volume.

OBJECTIVE: To screen the key genes related to the prognosis of lung adenocarcinoma through big data analysis and explore their clinical value and potential mechanism. METHODS: We analyzed GSE18842, GSE27262, and GSE33532 gene expression profile data obtained from the Gene Expression Omnibus (GEO). Bioinformatics methods were used to screen the differentially expressed genes in lung adenocarcinoma tissues and KEGG and GO enrichment analysis was performed, followed by PPI interaction network analysis, module analysis, differential expression analysis, and prognosis analysis. The expressions of MAD2L1 and TTK by immunohistochemistry were verified in 35 non-small cell lung cancer specimens and paired adjacent tissues. RESULTS: We identified a total of 256 genes that showed significant differential expressions in lung adenocarcinoma, including 66 up-regulated and 190 down-regulated genes. Thirty-two up-regulated core genes were screened by functional analysis, and among them 29 were shown to significantly correlate with a poor prognosis of patients with lung adenocarcinoma. All the 29 genes were highly expressed in lung adenocarcinoma tissues compared with normal lung tissues and were mainly enriched in cell cycle pathways. Seven of these key genes were closely related to the spindle assembly checkpoint (SAC) complex and responsible for regulating cell behavior in G2/M phase. We selected SAC-related proteins TTK and MAD2L1 to test their expressions in clinical tumor samples, and detected their overexpression in lung adenocarcinoma tissues as compared with the adjacent tissues. CONCLUSIONS Seven SAC complex-related genes, including TTK and MAD2L1, are overexpressed in lung adenocarcinoma tissues with close correlation with the prognosis of the patients.
Adenocarcinoma of Lung/genetics* ; Big Data ; Cell Cycle Proteins/genetics* ; Computational Biology ; Gene Expression Profiling ; Gene Expression Regulation, Neoplastic ; Humans ; Lung Neoplasms/genetics* ; M Phase Cell Cycle Checkpoints ; Mad2 Proteins/genetics* ; Protein-Serine-Threonine Kinases/genetics* ; Protein-Tyrosine Kinases/genetics*

Objective To determine the impact of hypertension on the outcomes of patients with COVID-19. Methods This matched cohort study was conducted among a total 442 patients with COVID-19 admitted in Honghu People's Hospital and First Affiliated Hospital of Nanchang University between January 1 to March 18, 2020, including 61 patients with hypertension and 381 normotensive patients. To minimize the effects of the confounding factors including age, gender and other comorbidities, we excluded patients with comorbidities other than hypertension, and matched the patients with and without hypertension for age and gender at a 1:1 ratio. We analyzed the clinical characteristics, laboratory findings and clinical outcomes of in 32 matched pairs of patients with and without hypertension. Results Compared with the normotensive patients, COVID-19 patients with hypertension were more likely to develop bacterial infections (P=0.002) and had higher neutrophil counts (P=0.007), neutrophil/lymphocyte ratio (P=0.045), and lactate dehydrogenase levels (P=0.035). A greater proportion of patients had bilateral patchy opacities on chest CT (P=0.012) in the hypertension group than in the normotensive group. COVID-19 patients with hypertension group were more likely to receive antibiotics (P=0.035) and corticosteroid therapies (P=0.035). Conclusion Hypertension increases the risk of bacterial infection in patients with COVID-19. Hypertensive patients with COVID-19 have higher neutrophil counts and neutrophil/lymphocyte ratios and are more likely to require treatment with antibiotics. Hypertensive patients with COVID-19 should therefore take cautions to avoid bacterial infections.

Objective To determine the impact of hypertension on the outcomes of patients with COVID-19. Methods This matched cohort study was conducted among a total 442 patients with COVID-19 admitted in Honghu People's Hospital and First Affiliated Hospital of Nanchang University between January 1 to March 18, 2020, including 61 patients with hypertension and 381 normotensive patients. To minimize the effects of the confounding factors including age, gender and other comorbidities, we excluded patients with comorbidities other than hypertension, and matched the patients with and without hypertension for age and gender at a 1:1 ratio. We analyzed the clinical characteristics, laboratory findings and clinical outcomes of in 32 matched pairs of patients with and without hypertension. Results Compared with the normotensive patients, COVID-19 patients with hypertension were more likely to develop bacterial infections (P=0.002) and had higher neutrophil counts (P=0.007), neutrophil/lymphocyte ratio (P=0.045), and lactate dehydrogenase levels (P=0.035). A greater proportion of patients had bilateral patchy opacities on chest CT (P=0.012) in the hypertension group than in the normotensive group. COVID-19 patients with hypertension group were more likely to receive antibiotics (P=0.035) and corticosteroid therapies (P=0.035). Conclusion Hypertension increases the risk of bacterial infection in patients with COVID-19. Hypertensive patients with COVID-19 have higher neutrophil counts and neutrophil/lymphocyte ratios and are more likely to require treatment with antibiotics. Hypertensive patients with COVID-19 should therefore take cautions to avoid bacterial infections.

Objective To compare the effect of silver-coated dressing and general aseptic dressing on the wound healing of abdominal operation. Methods A total of 94 patients from the general surgery department of Second Affiliated Hospital of Xi'an Jiaotong University who underwent abdominal operation were divided into two groups by double blind method, 49 cases in silver-coated dressing group, and 45 cases in general aseptic dressing group. The wound healing of the two groups were observed after wound dressing change, and the wound dressing change times, the healing time, the degree of pain, the positive rate of bacterial culture and the incidence rate of scar healing were observed in the two groups. Results The patients in silver-coated dressing and general aseptic dressing group had no significant differences in gender, age, length of incision, type of incision and poor wound healing type (all P>0.05);after two wound dressings change treatment, the wound dressing change times and incision healing timeof the silver-coated dressing group was (6.52 ± 1.52) times and (16.34 ± 5.96) days, which were less than those of the general aseptic dressing group, which were (8.74 ± 2.35) times and (23.32 ± 8.32) days; and the pain severity (NRS) scored 4.13 ± 1.01, which was lower than that of general aseptic dressing group (6.54 ± 0.95), with significant difference between two groups (t=5.482, 4.704, 11.890, P < 0.05). The bacterial culture positive rates of the silver-coated dressing group was 60.00% (21/35), which was higher than that of the general aseptic dressing group, 23.33%(7/30), the difference was statistically significant (P<0.01);at the same time, the scar healing cases was 4 in the silver-coated dressing group, which was less than 11 cases in the general aseptic dressing group. The difference was statistically significant (P < 0.05). Conclusions The silver-coated wound dressing method is better than the general aseptic wound dressing, and has obvious advantages in the treatment of abdominal poor healing incision. The silver-coated wound dressing can promote the healing of incision, reduce scar healing, shorten the hospitalization time, reduce the suffering of patients.