Objective To investigate the association of Chinese visceral adiposity index(CVAI)and high-sensitivity C-reactive protein(hs-CRP)with the risk of digestive malignancies in the Kailuan study population,and to provide a basis for the prevention and control of digestive malignancies in the population.Methods A prospective cohort study was conducted,and a total of 94 377 Kailuan workers who participated in the 2006 health examination,had no history of cancer,and had complete data on CVAI,CRP,and related covariates were selected as the observation cohort.According to the levels of CVAI and CRP,the subjects were divided into low CVAI+CRP≤3 mg/L group[CVAI(-)CRP(-)group],low CVAI+CRP>3 mg/L group[CVAI(-)CRP(+)group],high CVAI+CRP≤3 mg/L group[CVAI(+)CRP(-)group],and high CVAI+CRP>3 mg/L group[CVAI(+)CRP(+)group].An analysis of variance was used for comparison of normally distributed continuous data between groups,and the non-parametric Kruskal-Wallis H test was used for comparison of continuous data with skewed distribution between groups;the chi-square test was used for comparison of categorical data between groups.The Cox proportional-hazards regression model was used to assess the impact of CVAI and CRP alone or in combination on the risk of digestive malignancies.Results There were significant differences between the four groups in age,male/female ratio,total cholesterol,triglycerides,high-density lipoprotein cholesterol,systolic blood pressure,diastolic blood pressure,fasting blood glucose,high-sensitivity C-reactive protein,waist circumference,body mass index,marital status,alcohol consumption,smoking,reported income,and physical exercise(all P<0.05).During a mean follow-up time of 14.08±2.76 years,2 043 new-onset cases of digestive malignancies were identified by the end of follow-up on December 31,2021.The Cox proportional-hazards regression model showed that after adjustment for CRP and other factors,compared with the low CVAI group,the high CVAI group had a hazard ratio(HR)of 1.34(95%confidence interval[CI]:1.23-1.47)for the risk of digestive malignancies.After adjustment for CVAI and other factors,compared with the CRP≤3 mg/L group,the CRP>3 mg/L group had an HR of 1.14(95%CI:1.02-1.28)for the risk of digestive malignancies.Compared with the CVAI(-)CRP(-)group(n=40 978),the CVAI(-)CRP(+)group(n=6 210),the CVAI(+)CRP(-)group(n=36 502),and the CVAI(+)CRP(+)group(n=10 687)had an HR of 1.05(95%CI:1.01-1.09,P<0.05),1.32(95%CI:1.20-1.45,P<0.05),and 1.48(95%CI:1.28-1.70,P<0.05),respectively,for the risk of digestive malignancies.As for digestive malignancies at specific locations,the CVAI(+)CRP(+)group had an increased risk of liver cancer,gastric cancer,pancreatic cancer,colorectal cancer,and small intestinal cancer with an HR of 1.35(95%CI:1.05-1.81,P<0.05),1.48(95%CI:1.09-2.00,P<0.05),1.60(95%CI:1.07-2.41,P<0.05),1.76(1.40-2.21,P<0.05),and 3.85(95%CI:1.43-10.33,P<0.05),respectively.Conclusion A high level of CVAI,a high level of CRP,and high levels of CVAI and CRP in combination can all increase the risk of digestive malignancies,among which the high levels of CVAI and CRP in combination may lead to a higher risk.

Objectives:To evaluate the safety and efficacy of intravenous injection of tranexamic acid(TXA)in reducing the perioperative blood loss in patients with lung cancer spinal metastases undergoing posterior decompression surgery.Methods:A retrospective analysis was conducted on 68 patients with lung cancer spinal metastases who underwent decompression surgery between May 2011 and August 2022,with an average age of 63.1±1.3 years.Among them,there were 42 males and 26 females.According to whether received in-travenous injection of 1g TXA after the start of anesthesia to operation within 30mins,the patients were di-vided into observation group(26 cases)and control group(46 cases).The following data were collected includ-ing general information[age,gender,American Society of Aneshesiologists physical status classification system(ASA)grade,and the use of oral anticoagulant or antiplatelet drugs],tumor related information(pathological types and systemic treatments),laboratory related information(preoperative HGB,Hct,PLT,PT.APTT,and postoperative 1d Hct),and surgical related information(decompression site,exposed segment,surgical type,sur-gical time,blood transfusion volume on the day of surgery,postoperative drainage volume and drainage tube retention time,and postoperative hospitalization status),as well as the data related to lower limb venous thrombosis during postoperative hospitalization.The total blood loss was calculated using Gross's formula.t-test,Mann Whitney U test,and chi square test were used to evaluate the differences between the two groups.Results:There were no statistically significant differences between the two groups of patients in general information and tumor-related information such as age,gender,ASA grading,pathological type,and the use of oral anticoagulant or antiplatelet drugs(P＞0.05).The preoperative HGB levels in the observation group were significantly lower than those in the control group(P=0.035),while there were no statistically significant differences in other preoperative laboratory data such as Hct,PLT,PT,and APTT(P＞0.05).There were no statistically significant differences between the two groups of patients in terms of surgical decompression site,surgical type,exposed segment,and surgical time(P＞0.05).The blood loss in the observation group was significantly lower than that in the control group[961.3.4(741.5,1810.4)mL vs 1593.5(1170.2,1936.1)mL,P=0.013].The blood transfusion volume of the observation group was significantly lower than that of the control group[400(0,800)mL vs 800(400,800)mL,P=0.024].There were no significant differences between the two groups in terms of drainage volume,drainage tube retention time,postoperative hospitalization time,and newly developed lower limb venous thrombosis after surgery(P＞0.05).Conclusions:Intravenous injection of 1g TXA after the start of anesthesia to operation within 30mins can reduce the blood loss and transfusion volume in patients with lung cancer spinal metastases undergoing posterior decompression surgery.

Objectives:To evaluate the safety and efficacy of intravenous injection of tranexamic acid(TXA)in reducing the perioperative blood loss in patients with lung cancer spinal metastases undergoing posterior decompression surgery.Methods:A retrospective analysis was conducted on 68 patients with lung cancer spinal metastases who underwent decompression surgery between May 2011 and August 2022,with an average age of 63.1±1.3 years.Among them,there were 42 males and 26 females.According to whether received in-travenous injection of 1g TXA after the start of anesthesia to operation within 30mins,the patients were di-vided into observation group(26 cases)and control group(46 cases).The following data were collected includ-ing general information[age,gender,American Society of Aneshesiologists physical status classification system(ASA)grade,and the use of oral anticoagulant or antiplatelet drugs],tumor related information(pathological types and systemic treatments),laboratory related information(preoperative HGB,Hct,PLT,PT.APTT,and postoperative 1d Hct),and surgical related information(decompression site,exposed segment,surgical type,sur-gical time,blood transfusion volume on the day of surgery,postoperative drainage volume and drainage tube retention time,and postoperative hospitalization status),as well as the data related to lower limb venous thrombosis during postoperative hospitalization.The total blood loss was calculated using Gross's formula.t-test,Mann Whitney U test,and chi square test were used to evaluate the differences between the two groups.Results:There were no statistically significant differences between the two groups of patients in general information and tumor-related information such as age,gender,ASA grading,pathological type,and the use of oral anticoagulant or antiplatelet drugs(P＞0.05).The preoperative HGB levels in the observation group were significantly lower than those in the control group(P=0.035),while there were no statistically significant differences in other preoperative laboratory data such as Hct,PLT,PT,and APTT(P＞0.05).There were no statistically significant differences between the two groups of patients in terms of surgical decompression site,surgical type,exposed segment,and surgical time(P＞0.05).The blood loss in the observation group was significantly lower than that in the control group[961.3.4(741.5,1810.4)mL vs 1593.5(1170.2,1936.1)mL,P=0.013].The blood transfusion volume of the observation group was significantly lower than that of the control group[400(0,800)mL vs 800(400,800)mL,P=0.024].There were no significant differences between the two groups in terms of drainage volume,drainage tube retention time,postoperative hospitalization time,and newly developed lower limb venous thrombosis after surgery(P＞0.05).Conclusions:Intravenous injection of 1g TXA after the start of anesthesia to operation within 30mins can reduce the blood loss and transfusion volume in patients with lung cancer spinal metastases undergoing posterior decompression surgery.

Objective:To analyze the safety and efficacy of multi-vessel minimally invasive cardiac surgery-coronary artery bypass graft(MICS-CABG) through perioperative angiography results and complications.Methods:Clinical data of 1 073 patients who underwent multi-vessel MICS-CABG surgery at Peking University Third Hospital from December 2015 to June 2024 were collected using an ambispective cohort study. Among them, 745 were males(69.4%), with a median age of 65 years(58, 71), and a median ejection fraction of 0.66(0.56, 0.71). Double-vessel or triple-vessel lesions accounted for 932 cases(86.9%), while left main lesions were present in 449 cases(41.8%). The primary outcome was the evaluation of graft patency based on perioperative angiography or coronary artery computed tomography angiography results, while major cardiovascular adverse events during the perioperative period, surgical complications, and other surgical information were secondary outcomes. The clinical efficacy of multi-vessel MICS-CABG was evaluated.Results:In this study, the median number of grafts was 3, and complete revascularization was performed in 1 006 cases(93.8%); total arterial revascularization was performed in 308 cases(28.6%). Perioperative mortality was 11 cases(1.0%), and the main adverse cardiovascular and cerebrovascular events(MACCE) was 50 cases(4.8%). Three cases(0.3%) had poor wound healing, and 79 patients(7.4%) required transfusion. Postoperative coronary angiography was performed in 907 patients(84.5%) and coronary CTA was performed in 52 patients(4.8%), for an overall review rate of 89.4%(959/1073). The overall patency rate of the bridge vessel was 96.9%, and the patency rate of the left internal mammary artery was 98.2%.Conclusion:Multi-vessel MICS-CABG demonstrates excellent perioperative safety and is capable of achieving complete revascularization for the 3 regions of the heart. The quality of the anastomosis and the postoperative patency rate of the grafts is satisfactory.

Objective To investigate the association of Chinese visceral adiposity index(CVAI)and high-sensitivity C-reactive protein(hs-CRP)with the risk of digestive malignancies in the Kailuan study population,and to provide a basis for the prevention and control of digestive malignancies in the population.Methods A prospective cohort study was conducted,and a total of 94 377 Kailuan workers who participated in the 2006 health examination,had no history of cancer,and had complete data on CVAI,CRP,and related covariates were selected as the observation cohort.According to the levels of CVAI and CRP,the subjects were divided into low CVAI+CRP≤3 mg/L group[CVAI(-)CRP(-)group],low CVAI+CRP>3 mg/L group[CVAI(-)CRP(+)group],high CVAI+CRP≤3 mg/L group[CVAI(+)CRP(-)group],and high CVAI+CRP>3 mg/L group[CVAI(+)CRP(+)group].An analysis of variance was used for comparison of normally distributed continuous data between groups,and the non-parametric Kruskal-Wallis H test was used for comparison of continuous data with skewed distribution between groups;the chi-square test was used for comparison of categorical data between groups.The Cox proportional-hazards regression model was used to assess the impact of CVAI and CRP alone or in combination on the risk of digestive malignancies.Results There were significant differences between the four groups in age,male/female ratio,total cholesterol,triglycerides,high-density lipoprotein cholesterol,systolic blood pressure,diastolic blood pressure,fasting blood glucose,high-sensitivity C-reactive protein,waist circumference,body mass index,marital status,alcohol consumption,smoking,reported income,and physical exercise(all P<0.05).During a mean follow-up time of 14.08±2.76 years,2 043 new-onset cases of digestive malignancies were identified by the end of follow-up on December 31,2021.The Cox proportional-hazards regression model showed that after adjustment for CRP and other factors,compared with the low CVAI group,the high CVAI group had a hazard ratio(HR)of 1.34(95%confidence interval[CI]:1.23-1.47)for the risk of digestive malignancies.After adjustment for CVAI and other factors,compared with the CRP≤3 mg/L group,the CRP>3 mg/L group had an HR of 1.14(95%CI:1.02-1.28)for the risk of digestive malignancies.Compared with the CVAI(-)CRP(-)group(n=40 978),the CVAI(-)CRP(+)group(n=6 210),the CVAI(+)CRP(-)group(n=36 502),and the CVAI(+)CRP(+)group(n=10 687)had an HR of 1.05(95%CI:1.01-1.09,P<0.05),1.32(95%CI:1.20-1.45,P<0.05),and 1.48(95%CI:1.28-1.70,P<0.05),respectively,for the risk of digestive malignancies.As for digestive malignancies at specific locations,the CVAI(+)CRP(+)group had an increased risk of liver cancer,gastric cancer,pancreatic cancer,colorectal cancer,and small intestinal cancer with an HR of 1.35(95%CI:1.05-1.81,P<0.05),1.48(95%CI:1.09-2.00,P<0.05),1.60(95%CI:1.07-2.41,P<0.05),1.76(1.40-2.21,P<0.05),and 3.85(95%CI:1.43-10.33,P<0.05),respectively.Conclusion A high level of CVAI,a high level of CRP,and high levels of CVAI and CRP in combination can all increase the risk of digestive malignancies,among which the high levels of CVAI and CRP in combination may lead to a higher risk.

Objective:To investigate the clinical characteristics and prognosis of follicular lymphoma (FL) patients with different primary sites using the Surveillance, Epidemiology, and End Results (SEER) database.Methods:Clinical data of 7167 patients with early-stage FL (stage I-II) from the SEER database between 2000 and 2015 were respectively analyzed. Primary sites were divided into intranodal and extranodal types. Intranodal primary sites included supradiaphragmatic lymph nodes (LN), subphrenic lymph nodes and Waldeyer's ring. Extranodal primary sites consisted of skin, gastrointestinal tract, duodenum, head and neck, other sites. Prognostic factors and overall survival (OS) in patients with different primary sites were analyzed. OS rate was evaluated using Kaplan-Meier method and survival difference between primary sites was compared with log-rank test. Inverse probability treatment weighting (IPTW) and multi-variable analysis were applied to adjust for confounding factors. Multivariate Cox regression analysis of influencing factors of OS was performed.Results:The median age was 63 years old, with the median follow-up time of 63 months. There was no difference in prognosis among the intranodal groups or between the intranodal and extranodal groups. The 10-year OS rates of the supradiaphragmatic lymph LN ( n=2146), subdiaphragmatic LN ( n=2811), and the Waldeyer's ring ( n=151) groups were 70.7%, 69.9% and 73.4%, respectively ( P=0.422 for infradiaphragmatic LN vs. supradiaphragmatic LN, P=1.000 for Waldeyer's ring vs. supradiaphragmatic LN), and 70.3% and 68.9% for intranodal ( n=5108) and extranodal ( n=2059), respectively. There was no significant difference in OS between the groups ( P=0.581) after IPTW adjustment. The most common primary sites in extranodal disease were skin, gastrointestinal tract, head and neck, and duodenum. The 10-year OS for skin, gastrointestinal tract, and cutaneous was 74.2%, 74.7%, and 87.3%, respectively, significantly higher than 55.6% for other sites (duodenum vs. others sites, gastrointestinal vs. others sites, skin vs. others sites: all P<0.001). Multivariate Cox regression analysis revealed that difference in OS was not significant among the intranodal groups or between the intranodal and extranodal groups. However, different extranodal primary site was an independent prognostic factor for OS. Conclusions:Early FL patients with supradiaphragmatic LN, subdiaphragmatic LN and Waldeyer's ring, and between the intranodal and extranodal primary sites obtain similar prognosis. However, early-stage FL patients with different extranodal primary sites have prognostic differences. The prognosis of primary skin, gastrointestinal tract and duodenum is significantly better than that of other extranodal primary sites.

The cultivation of innovation ability is not only the essential requirement of graduate education,but also the strate-gic demand of the development of the communist party and our country,and is of great significance to the realization of the Chinese dream of the great rejuvenation of the Chinese nation.Curriculum ideology and politics should run through the whole process of post-graduate innovation ability training.However,the curriculum ideology and politics and postgraduate innovation ability training lack deep integration.It's important for postgraduates'growth and scientific research innovation that the curriculum ideology and politics covers the whole process of scientific research activities.Therefore,this paper focuses on the design and specific implementation schemes of the curriculum ideology and politics on the postgraduate innovative ability training at the respiratory disease research team in the department of medical immunology.It makes a basis for optimizing postgraduate curriculum ideology and politics teaching in the future,which also provides ideas for cultivating innovative talents with both morality and ability in medical specialty.

Objectives:This study aims to evaluate the safety and efficacy of minimally invasive small inci-sion decompression surgery for patients with thoracolumbar metastatic cancer.Methods:A retrospective analy-sis was conducted on 71 cases of spinal metastases who underwent posterior decompression surgery in our de-partment from June 2017 to March 2024.There were 55 males and 16 females with an average age of 63.9±1.2 years.Among them,24 patients underwent posterior minimally invasive small incision decompression surgery,and 47 patients underwent routine posterior decompression surgery.Independent sample t-test and chi square test were used to evaluate the differences between the two groups of patients in baseline data such as age,gender,primaiy tumor pathological type and blood supply,surgical site,and preoperative embolism,as well as the differences in total blood loss,surgical time,surgical complications,postoperative allogeneic blood transfusion volume,postoperative drainage volume and drainage tube retention time,and postoperative hospital-ization time.Results:There was no significant difference in baseline data between the two groups of patients(P＜0.001).The postoperative blood loss in the minimally invasive small incision group was significantly lower than that in the conventional surgery group(P=0.003).The postoperative blood transfusion(P=0.011),total drainage volume(P=0.000),drainage tube retention time(P=0.000),and postoperative hospital stay(P=0.000)were significantly reduced in the minimally invasive small incision group compared to the conventional surgery group.The decrease in ALB on the first day after surgery in the minimally invasive group was significantly improved compared to the conventional surgery group(P=0.040).There was no significant difference in the in-cidence of dural injury,postoperative pain,and functional improvement between the two groups of patients.Conclusions:Minimally invasive small incision decompression surgery can effectively reduce surgical blood loss and allogeneic blood transfusion in patients,shorten postoperative hospital stay,and improve surgical complications and postoperative function similar to conventional surgery.

The cultivation of innovation ability is not only the essential requirement of graduate education,but also the strate-gic demand of the development of the communist party and our country,and is of great significance to the realization of the Chinese dream of the great rejuvenation of the Chinese nation.Curriculum ideology and politics should run through the whole process of post-graduate innovation ability training.However,the curriculum ideology and politics and postgraduate innovation ability training lack deep integration.It's important for postgraduates'growth and scientific research innovation that the curriculum ideology and politics covers the whole process of scientific research activities.Therefore,this paper focuses on the design and specific implementation schemes of the curriculum ideology and politics on the postgraduate innovative ability training at the respiratory disease research team in the department of medical immunology.It makes a basis for optimizing postgraduate curriculum ideology and politics teaching in the future,which also provides ideas for cultivating innovative talents with both morality and ability in medical specialty.

Objectives:This study aims to evaluate the safety and efficacy of minimally invasive small inci-sion decompression surgery for patients with thoracolumbar metastatic cancer.Methods:A retrospective analy-sis was conducted on 71 cases of spinal metastases who underwent posterior decompression surgery in our de-partment from June 2017 to March 2024.There were 55 males and 16 females with an average age of 63.9±1.2 years.Among them,24 patients underwent posterior minimally invasive small incision decompression surgery,and 47 patients underwent routine posterior decompression surgery.Independent sample t-test and chi square test were used to evaluate the differences between the two groups of patients in baseline data such as age,gender,primaiy tumor pathological type and blood supply,surgical site,and preoperative embolism,as well as the differences in total blood loss,surgical time,surgical complications,postoperative allogeneic blood transfusion volume,postoperative drainage volume and drainage tube retention time,and postoperative hospital-ization time.Results:There was no significant difference in baseline data between the two groups of patients(P＜0.001).The postoperative blood loss in the minimally invasive small incision group was significantly lower than that in the conventional surgery group(P=0.003).The postoperative blood transfusion(P=0.011),total drainage volume(P=0.000),drainage tube retention time(P=0.000),and postoperative hospital stay(P=0.000)were significantly reduced in the minimally invasive small incision group compared to the conventional surgery group.The decrease in ALB on the first day after surgery in the minimally invasive group was significantly improved compared to the conventional surgery group(P=0.040).There was no significant difference in the in-cidence of dural injury,postoperative pain,and functional improvement between the two groups of patients.Conclusions:Minimally invasive small incision decompression surgery can effectively reduce surgical blood loss and allogeneic blood transfusion in patients,shorten postoperative hospital stay,and improve surgical complications and postoperative function similar to conventional surgery.