Objective:To investigate the predictive value of computed tomography (CT) combined with dynamic enhanced magnetic resonance imaging (DCE-MRI) parameters in patients with colorectal cancer after radical surgery.Methods:A total of 180 patients with colorectal cancer admitted to the Second Hospital of Hebei Medical University from Dec. 2021 to Dec. 2023 were retrospectively selected as the study objects. All patients were treated with radical resection of colorectal cancer and followed up for 12 months. They were divided into good prognosis group ( n=129) and poor prognosis group ( n=51) according to whether tumor recurrence and metastasis occurred. All patients were examined by CT and DCE-MRI. Clinical data, CT and DCE-MRI parameters were compared between the two groups. Cox regression was used to analyze the influencing factors of short-term adverse prognosis in patients with colorectal cancer, and ROC curve was drawn to analyze the value of SUV max, K trans, K ep and Ve in single or combined prediction of short-term adverse prognosis in patients with colorectal cancer. Results:SUV max, K trans, K ep and Ve in the poor prognosis group were higher than those in the good prognosis group ( P<0.05) . Cox regression analysis showed that high levels of SUV max ( HR=2.818, 95% CI= 1.808-4.393) , K trans ( HR=516.829, 95% CI=6.745-30603.733) , K ep ( HR=117.756, 95% CI= 4.598-3015.614) and Ve ( HR=9453.000, 95% CI= 63.534-1406482.337) were independent risk factors for short-term adverse prognosis in patients with colorectal cancer ( P<0.05) . The AUC value of SUVmax, K trans, K ep and Ve combined predicted short term adverse prognosis in colorectal cancer patients was higher than that of single detection ( Z=3.126, 4.359, 4.368, 3.987, P<0.05) . Conclusion:CT combined with DCE-MRI parameters have high predictive value for short term poor prognosis of patients with colorectal cancer after radical surgery.

Objective:To investigate the predictive value of computed tomography (CT) combined with dynamic enhanced magnetic resonance imaging (DCE-MRI) parameters in patients with colorectal cancer after radical surgery.Methods:A total of 180 patients with colorectal cancer admitted to the Second Hospital of Hebei Medical University from Dec. 2021 to Dec. 2023 were retrospectively selected as the study objects. All patients were treated with radical resection of colorectal cancer and followed up for 12 months. They were divided into good prognosis group ( n=129) and poor prognosis group ( n=51) according to whether tumor recurrence and metastasis occurred. All patients were examined by CT and DCE-MRI. Clinical data, CT and DCE-MRI parameters were compared between the two groups. Cox regression was used to analyze the influencing factors of short-term adverse prognosis in patients with colorectal cancer, and ROC curve was drawn to analyze the value of SUV max, K trans, K ep and Ve in single or combined prediction of short-term adverse prognosis in patients with colorectal cancer. Results:SUV max, K trans, K ep and Ve in the poor prognosis group were higher than those in the good prognosis group ( P<0.05) . Cox regression analysis showed that high levels of SUV max ( HR=2.818, 95% CI= 1.808-4.393) , K trans ( HR=516.829, 95% CI=6.745-30603.733) , K ep ( HR=117.756, 95% CI= 4.598-3015.614) and Ve ( HR=9453.000, 95% CI= 63.534-1406482.337) were independent risk factors for short-term adverse prognosis in patients with colorectal cancer ( P<0.05) . The AUC value of SUVmax, K trans, K ep and Ve combined predicted short term adverse prognosis in colorectal cancer patients was higher than that of single detection ( Z=3.126, 4.359, 4.368, 3.987, P<0.05) . Conclusion:CT combined with DCE-MRI parameters have high predictive value for short term poor prognosis of patients with colorectal cancer after radical surgery.

A three-dimensional(3D)medical image segmentation network(CA-SegResNet)which incorporates a 3D coordinate attention mechanism is proposed to address the issue of segmenting identified vertebral bones from spinal computed tomography(CT)images.The network extracts image features through a deep residual convolutional neural network and fuses the feature maps from each encoder layer with the input of the corresponding decoder layer.Subsequently,a 3D coordinate attention module is introduced to capture inter-channel relationships as well as directional and positional information,establishing long-range dependencies across different spatial directions,thereby enabling precise segmentation of the identified vertebral bones.For the segmentation tasks involving the identified cervical vertebra(the 7th cervical vertebra)and the identified thoracic vertebra(the 12th thoracic vertebra)across 105 cases,CA-SegResNet achieves average Dice similarity coefficients(DSC)of 0.934 5 and 0.918 9 on the test set,with average Hausdorff distances(HD)of 7 and 8 mm.Compared with U-Net results,the average DSC is improved by 0.014 5 and 0.0463,while average HD is reduced by 176 and 388 mm.The results demonstrate that the network can realize the precise segmentation of identified vertebral bones from CT images.

Objective:To explore the current situation and influencing factors of quality of life of septic patients in intensive care unit (ICU) after discharge, and to provide theoretical basis for clinical early psychological intervention and continuity of care.Methods:A prospective observational study was conducted. The septic patients who were hospitalized in the department of critical care medicine of the Affiliated Hospital of Jining Medical University and discharged with improvement from January 1 to December 31, 2022 were selected as the research objects. The demographic information, basic diseases, infection site, vital signs at ICU admission, severity scores of the condition within 24 hours after ICU admission, various biochemical indexes, treatment process, and prognostic indexes of all the patients were recorded. All patients were assessed by questionnaire at 3 months of discharge using the 36-item short-form health survey scale (SF-36 scale), the activities of daily living scale (ADL scale), and the Montreal cognitive assessment scale (MoCA scale). Multiple linear regression was used to analyze the factors influencing the quality of life of septic patients after discharge from the hospital.Results:A total of 200 septic patients were discharged with improvement and followed up at 3 months of discharge, of which 150 completed the questionnaire. Of the 150 patients, 57 had sepsis and 93 had septic shock. The total SF-36 scale score of septic patients at 3 months of discharge was 81.4±23.0, and the scores of dimensions were, in descending order, role-emotional (83.4±23.0), mental health (82.9±23.6), bodily pain (82.8±23.3), vitality (81.6±23.2), physical function (81.4±23.5), general health (81.1±23.3), role-physical (79.5±27.0), and social function (78.8±25.2). There was no statistically significant difference in the total SF-36 scale score between the patients with sepsis and septic shock (82.6±22.0 vs. 80.7±23.6, P > 0.05). Incorporating the statistically significant indicators from linear univariate analysis into multiple linear regression analysis, and the results showed that the factors influencing the quality of life of septic patients at 3 months after discharge included ADL scale score at 3 months after discharge [ β= 0.741, 95% confidence interval (95% CI) was 0.606 to 0.791, P < 0.001], length of ICU stay ( β= -0.209, 95% CI was -0.733 to -0.208, P = 0.001), duration of mechanical ventilation ( β= 0.147, 95% CI was 0.122 to 0.978, P = 0.012), total dosage of norepinephrine ( β= -0.111, 95% CI was -0.044 to -0.002, P = 0.028), mean arterial pressure (MAP) at ICU admission ( β= -0.102, 95% CI was -0.203 to -0.007, P = 0.036) and body weight ( β= 0.097, 95% CI was 0.005 to 0.345, P = 0.044). Conclusions:The quality of life of patients with sepsis at 3 months after discharge is at a moderately high level. The influencing factors of the quality of life of patients with sepsis at 3 months after discharge include the ADL scale score at 3 months after discharge, the length of ICU stay, the duration of mechanical ventilation, the total dosage of norepinephrine, MAP at ICU admission and body weight, and healthcare professionals should enhance the treatment and care of the patients during their hospitalization based on the above influencing factors, and pay attention to early psychological intervention and continued care for such patients.

Objective:To develop a visualized nomogram with a predictive value to differentiate mass-forming chronic pancreatitis (MFCP) from pancreatic ductal adenocarcinoma (PDAC) patients with chronic pancreatitis (CP) history.Methods:The clinical and radiological data of 5 433 CP patients acoording to the Asia-Pacific Diagnostic Criteria between February 2011 and February 2021 in the First Affiliated Hospital of Naval Medical University were retrospectively analyzed, and 71 PDAC patients with CP history and 67 MFCP who underwent surgery or biopsy and pathologically confirmed were eventually enrolled. The training set included 44 patients with MFCP and 59 patients with PDAC who were diagnosed between February 2011 and April 2018. The validation set consisted of 23 patients with MFCP and 12 patients with PDAC who were diagnosed between May 2018 and February 2021. Univariate and multivariate logistic regression analyses were performed to develop a prediction model for PDAC and MFCP, and the model was visualized as a nomogram. ROC was used to evaluate the predictive efficacy of the nomogram, and the clinical usefulness was judged by decision curve analysis.Results:The univariate analysis showed that a significant association with pancreatic cancer were observed for the duct-to-parenchyma ratio ≥0.34, pancreatic duct cut-off, pancreatic portal hypertension, arterial CT attenuation, portal venous CT attenuation, delayed CT attenuation, and vascular invasion in both the training and validation cohorts, but the duct-penetrating sign in the training cohort only. The multivariable logistic regression analysis showed that statistically significant differences (all P value <0.05) existed in cystic degeneration, a duct-to-parenchyma ratio ≥0.34, the duct-penetrating sign, pancreatic portal hypertension and arterial CT attenuation between the two cohorts. The above parameters were selected for the logistic regression model. The predicted model=3.65-2.59×cystic degeneration+ 1.26×duct-to-parenchyma ratio≥0.34-1.40×duct-penetrating sign+ 1.36×pancreatic portal hypertension-0.05×arterial CT attenuation. Area under the curve, sensitivity, specificity and accuracy of the model-based nomogram were 0.87 (95 CI 0.80-0.94), 89.0%, 75.0% and 83.5% in the training cohort, and 0.94 (95 CI 0.82-0.99), 91.7%, 100% and 97.1% in the validation cohort, respectively. Decision curve analysis showed that when the nomogram differentiated MFCP from PDAC patients with CP history at a rate of 0.05-0.85, the application of the nomogram could benefit the patients. Conclusions:The nomogram based on CT radiological features accurately differentiated MFCP from PDAC patients with CP history and provide reference for guiding the treatment and judging the prognosis.

Objective To discuss the clinical application of mechanical thrombectomy with AngioJet system for acute lower limb arterial ischemia (ALI).Methods A total of 12 ALI patients,who underwent percutaneous mechanical thrombectomy with AngioJet systemn during the period from January 2015 to November 2016,were enrolled in this study.The clinical data were retrospectively analyzed.The blood flow classification score after thrombolysis in myocardial infarction (TIMI) was used to evaluate the blood perfusion condition,and Cooley standard of efficacy score was used to assess the clinical curative effect.Results The technical success rate of mechanical thrombectomy with AngioJet system was 91.7％ (11/12).The average restored perfusion time was (1.5±0.6) hours.The clinical success rate and limb salvage rate were 83.3％ (10/ 12) and 91.7％ (11/12),respectively.The TIMI flow scores were improved from preoperative grade 0 (n=8) and Ⅰ (n=4) to postoperative grade 0 (n=1),Ⅰ (n=3) and Ⅱ (n=8).In 11 patients (91.7％) the symptoms of lower limb arterial ischemia were strikingly improved after mechanical thrombectomy.In one patient,the postoperative TIMI flow score remained 0 as preoperative state and the symptoms of lower limb arterial ischemia were not improved although catheter directed thrombolysis therapy was employed for 24 hours,and above-knee surgical amputation had to be carried out.Cooley efficacy score showed that complete cure was seen in 4 patients (33.3％),good response in 6 patients (50.0％),general improvement in one patient (8.3％) and pool response in one patient (8.3％).No severe bleeding complications occurred.Conclusion Percutaneous mechanical thrombectomy with AngioJet can rapidly recover the blood perfusion in patients with ALI,thus,further deterioration of the disease can be prevented and the limb salvage rate can be improved.Therefore,this technique has good clinical application value.

Objective To assess the effects of hyperbaric oxygen(HBO) on indolent prostate cancer on a murine model. Methods Human prostate cancer cell line PC-3 ceils were injected into 40 severe combined-immunodeficient mice. They were randomized to undergo 20 sessions of either HBO or normobarie air in standardized conditions, and observed for 4 weeks before the histological assess-ment of any palpable tumors developed. The analysis parameters included tumour volume, microvessel density, apoptosis markers (p53, p27) and proliferative index (Ki-67). Results On the 28th day af-ter tumor vaccination, the tumor volume was (425.8±13.9)mm3 in HBO group and (433.6±12.8) mm3 in normobaric air group (P>0.05). Mierovessel density and Ki-67, p53, p27 protein expression were 69.7±9.5, (55. 2±6. 7)%, (31.9±5. 3)%, (80. 4±5. 7)% in HBO group;77. 1±8. 7, (50.6±7.3)%, (30.5±4. 7)%, (85.3±6.4)% in norrnobaric air group, respectively. There were no significant differences in both groups (P>0. 05). Conclusions HBO does not accelerate the growth of indolent prostate cancer in murine model. This result suggests that HBO does not increase the risk of residual prostate cancer reactivation when it is used to manage radiation-induced hemorrhag-ic cystitis in patients treated by pelvic radiotherapy for prostate cancer.