ObjectiveTo investigate the risk factors for postpancreatectomy acute pancreatitis （PPAP） after minimally invasive pancreaticoduodenectomy （MIPD） and their association with major complications， to improve the understanding of PPAP and postoperative pancreatic fistula （POPF）， and to reduce the incidence rates of PPAP and POPF. MethodsA retrospective analysis was performed for the clinical data of 114 patients who underwent MIPD in Department of Hepatobiliary and Pancreatic Surgery， The First Affiliated Hospital of University of South China， from March 2015 to December 2023， and the definition of PPAP and its diagnostic criteria provided by the International Study Group of Pancreatic Surgery were used to determine the presence or absence of PPAP. The independent samples t-test or the Mann-Whitney U rank sum test was used for comparison of continuous data between groups， and the Kruskal-Wallis H test was used for comparison between multiple groups， and the Dunn-test was used for further comparison between two groups.； the chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups.， and the Bonferroni-test was used for further comparison between two groups. The multivariate logistic regression analysis was used to identify the risk factors for PPAP after MIPD. ResultsOf all 114 patients undergoing MIPD， 27 （23.7%） experienced PPAP. The multivariate analysis showed that main pancreatic duct diameter ≤3 mm （odds ratio ［OR］=5.083， 95% confidence interval ［CI］： 1.703 — 15.172， P=0.004）， soft pancreatic texture （OR=5.925， 95%CI： 1.986 — 17.677， P=0.001）， and C-reactive protein ≥180 mg/L on day 1 after surgery （OR=5.419， 95%CI： 1.586 — 18.513， P=0.007） were independent risk factors for the onset of PPAP after MIPD. Clinical analyses showed that the patients with PPAP tended to have significantly higher incidence rates of POPF， peritoneal infection， Clavien-Dindo grade 3/4 complications， discharge with tube， and 90-day postoperative death （χ²=5.676， 5.460， 9.863， 5.439， and 4.207， all P<0.05）. ConclusionMain pancreatic duct diameter， pancreatic texture， and C-reactive protein on day 1 after surgery are closely associated with the onset of PPAP after MIPD， and PPAP can lead to other postoperative complications and even death.

Objective: To explore the efficacy of vonoprazan fumarate in the treatment of laryngopharyngeal reflux disease（LPRD） evaluated by the Chinese version of the RSS-12 scale. Methods:A total of 100 LPRD patients treated in the otolaryngology-head and neck surgery outpatient clinic of our hospital were randomly divided into two groups（50 cases each）. The observation group was treated with vonoprazan fumarate（20 mg, once daily）, and the control group was treated with esomeprazole enteric-coated capsules（20 mg, twice daily） for 12 weeks. The selected observation indicators in this study included RSI, the Chinese version of RSS-12, and RFS scores before and after treatment. Results:Prior to treatment, there was no statistically significant difference in the Chinese version of RSS-12, RSI, and RFS between the two groups（P>0.05）. After 8 and 12 weeks of antacid treatment, both the Chinese version of RSS-12 and RSI significantly decreased in both group （P<0.05）. The changes in symptoms were particularly noticeable between 0-8 weeks of treatment according to the Chinese version of RSS-12 and RSI. After 12 weeks of treatment, the RFS scores significantly decreased compared to pretreatment levels （P<0.05）. After 12 weeks of antacid treatment, according to the Chinese version of RSS-12, 80% of patients in the observation group showed a good therapeutic response, compared to 64% in the control group; according to RSI, 90% of patients in the observation group showed a good therapeutic response, compared to 84% in the control group. There was no statistically significant difference in the treatment effect between the two groups after 12 weeks of treatment（P>0.05）. Conclusion:Vonoprazan fumarate can significantly improve the symptoms and signs of laryngopharyngeal reflux, and their treatment effect is not inferior to proton pump inhibitors. Compared with RSI, the Chinese version of RSS-12 can serve as a new screening tool for clinical diagnosis of LPRD in China.
Humans ; Sulfonamides/therapeutic use* ; Male ; Pyrroles/therapeutic use* ; Female ; Laryngopharyngeal Reflux/drug therapy* ; Treatment Outcome ; Middle Aged ; Esomeprazole/therapeutic use* ; Proton Pump Inhibitors/therapeutic use* ; Adult

Objective:To investigate the feasibility of deep learning reconstruction (DLR) algorithm combined with a dual-low protocol (low radiation dose and low contrast medium dose) for thoracoabdominal aortic CT angiography (CTA).Methods:This cross-sectional study prospectively enrolled 56 patients suspected of aortic diseases who underwent aortic CTA at China-Japan Friendship Hospital from June 2023 to June 2024. All patients were randomly divided into two groups: Group A (28 cases) underwent CTA with a tube voltage of 100 kVp, automatic tube current modulation (noise index=10), and a contrast agent dose of 80 ml (flow rate 5 ml/s), with images reconstructed using the three-dimensional adaptive iterative dose reduction algorithm (AIDR). Group B (28 cases) underwent CTA with a tube voltage of 80 kVp, automatic tube current modulation (noise index=25), and a contrast agent dose of 40 ml (flow rate 3.5 ml/s), with images reconstructed using either the deep learning reconstruction algorithm-Advanced intelligent Clear-IQ Engine (AiCE subgroup) or the AIDR (AIDR subgroup). Two physicians evaluated the image quality of the three groups subjectively and objectively. Objective evaluation metrics included CT values, image noise (SD), signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) at the ascending aorta, carina-level descending aorta, celiac trunk-origin abdominal aorta, and common iliac bifurcation abdominal aorta carina. Subjective evaluation metrics included image quality and noise scores. Comparisons among the three datasets (Group A, AiCE subgroup, AIDR subgroup) were performed using one-way ANOVA or the Kruskal-Wallis test, with appropriate post-hoc tests for pairwise comparisons.Results:No significant differences were observed in CT values of the ascending aorta, descending aorta, and abdominal aorta between Group A and the AiCE subgroup or the AIDR subgroup ( P0.05). However, significant overall differences were found in SD, SNR, and CNR values for the ascending aorta, descending aorta, and abdominal aorta ( P0.05). Pairwise comparisons revealed that, except for no significant differences in SD, SNR, and CNR values of the ascending and descending aorta between Group A and the AiCE subgroup, and no significant difference in SNR values of the ascending and abdominal aorta between Group A and the AIDR subgroup ( P0.05), all other intergroup comparisons showed statistically significant differences ( P0.05). Significant overall differences were also observed in image quality and noise scores between Group A and the AiCE and AIDR subgroups ( P0.05). Except for no significant differences in image quality and noise scores between Group A and the AiCE subgroup ( P0.05), all other pairwise comparisons showed statistically significant differences ( P0.05). Conclusions:The application of deep learning reconstruction algorithm combined with a dual-low protocol in thoracoabdominal aortic CTA can reduce radiation dose and contrast agent dose while maintaining diagnostic image quality, demonstrating significant clinical value for widespread adoption.

Objective:To examine the funding landscape of the National Natural Science Foundation of China(NSFC)concerning research focused on the elderly as a specific demographic group.It seeks to analyze prevailing research hotspots and to offer insightful research ideas for scholars in this field.Methods:The study employed a retrospective research design.It involved retrieving data on approved projects related to the elderly from the NSFC's official database, covering the period from 2000 to 2020.The data set included variables such as funding year, project title, project category, supporting institution, and funding amount(application codes: H1901, H1902, H1903).Statistical analysis was conducted using Excel software, while visual analysis was performed using CiteSpace software.Results:Between 2000 and 2020, a total of 710 projects focused on geriatrics received funding, amounting to RMB 361, 032, 300, 000.This period exhibited a fluctuating upward trend in both the number of projects and the total funding amount.The primary funding categories were face-to-face projects and youth science fund projects, which together accounted for 44.4%(315/710), 34.4%(244/710)respectively.The distribution of project-relying units demonstrated significant regional imbalance, with Beijing, Zhejiang, Jiangsu, and Shanghai being the predominant areas.Notably, Nanjing Medical University, Peking University, and Shanghai Jiao Tong University ranked as the top three institutions, with funding percentages of 5.9%(42/710), 5.4%(38/710), and 4.5%(32/710), respectively.The research themes encompassed nucleoplasmic interactions, brain networks, and bioinformatics, among others.Conclusions:The NSFC has consistently provided funding for in-depth research in the critical field of geriatrics.The primary research directions focus on aspects such as the mechanisms of aging and the pathogenesis of neurological diseases associated with aging.With the application of innovative technologies and methodologies, significant breakthroughs and achievements are anticipated in geriatrics, contributing to the improvement of health outcomes and the enhancement of the quality of life for the elderly.

Objective:To integrate implicit templates with deep learning techniques, a novel neural network, the tooth-deformable deep implicit network (T-DDIN), was constructed to achieve high-precision shape completion of tooth defects in a personalized manner.Methods:A total of 550 intraoral scan models were collected from patients treated at the Department of Orthodontics and Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University (500 for training and 50 for testing), between March 2022 and March 2024. T-DDIN reconstructed defective tooth morphology using an implicit template and a latent encoding prediction network. During model evaluation, Class Ⅱ cavity defects and occlusal wear defects were simulated in the test set. Morphological restoration was performed using both traditional computer aided design (CAD) methods and the T-DDIN deep learning approach. The two methods were compared based on three-dimensional deviation, occlusal adjustment volumes, cusp angle deviation, and restoration time.Results:The T-DDIN group demonstrated significantly lower three-dimensional deviation for Class Ⅱ cavity defects and occlusal wear restoration [(0.14±0.05) and (0.16±0.09) mm], occlusal adjustment volumes [(0.44±0.03) and (0.49±0.03) mm 3], and difference value of the tooth cusp angles (5.69°±1.90° and 6.04°±0.53°) compared to the traditional CAD group (both P<0.001). No significant differences were observed within the T-DDIN group between the two defect types in terms of three-dimensional deviation ( P=0.098) or occlusal adjustment volume ( P=0.154) or difference value of the tooth cusp angles ( P=0.196). However, in the traditional CAD group, three-dimensional deviation, occlusal adjustment volume and difference value of the tooth cusp angles was significantly higher in occlusal wear restorations than in Class Ⅱ cavity defects restorations ( P<0.001). The T-DDIN group, which involved Class Ⅱ cavity defects and occlusal wear, demonstrated significantly less recovery time of morphology (37.2±7.7) and (39.4±6.2) s compared to the traditional CAD group ( P<0.001). Conclusions:T-DDIN demonstrated superior stability and accuracy in morphological reconstruction for various types of dental defects while significantly reducing restoration time.

The Consolidated Standards of Reporting Trials (CONSORT) statement aims to enhance the quality of reporting for randomized controlled trial (RCT) by providing a minimum item checklist. It was first published in 1996, and updated in 2001 and 2010, respectively. The latest version was released in April 2025, continuously reflecting new evidence, methodological advancements, and user feedback. CONSORT 2025 includes 30 essential checklist items and a template for a participant flow diagram. The main changes to the checklist include the addition of 7 items, revision of 3 items, and deletion of 1 item, as well as the integration of multiple key extensions. This article provides a comprehensive interpretation of the statement, aiming to help clinical trial staff, journal editors, and reviewers fully understand the essence of CONSORT 2025, correctly apply it in writing RCT reports and evaluating RCT quality, and provide guidance for conducting high-level RCT research in China.

Objective: To investigate the epidemiological and spatio-temporal characteristics of influenza in Jiaxing City, Zhejiang Province, so as to provide insights into perfecting the prevention and control strategies of influenza. Methods: Data of influenza in Jiaxing City from 2019 to 2023 were collected from the Chinese Disease Prevention and Control Information System. Population data of the same period were collected from the Zhejiang Health Information Network Reporting System. The epidemiological characteristics of influenza were analyzed using descriptive analysis. Vector map information was collected from the Open Street Map, and the spatio-temporal clustering characteristics of influenza were analyzed using spatial autocorrelation and spatio-temporal scanning. Results: A total of 181 501 cases of influenza were reported in Jiaxing City from 2019 to 2023, with an average annual reported incidence of 653.93/105. The majority of cases were aged 5 to <15 years (59 785 cases, 32.94%). The majority of the occupations were students (78 239 cases, 43.11%) and pre-school children (33 715 cases, 18.58%). The county (city, district) with the highest reported incidence was Haining City (1 451.70/105), and the town (street) with the highest reported incidence was Chang'an Town (1 932.78/105). Spatial autocorrelation analysis showed that the incidence of influenza in Jiaxing City from 2019 to 2023 had positive spatial correlations (all Moran's I>0, all P<0.05), with a high-high clustering in the southern region. Spatio-temporal scanning analysis showed that there was a spatio-temporal clustering of influenza in Jiaxing City from 2019 to 2023, with the southern region being the primary-type clustering area and the period between November and January of the following year being the clustering time. Conclusion There was a significant spatio-temporal clustering of influenza in Jiaxing City from 2019 to 2023, with winter being the peak season and the southern region being the primary area.

Objective:To investigate the feasibility of deep learning reconstruction (DLR) algorithm combined with a dual-low protocol (low radiation dose and low contrast medium dose) for thoracoabdominal aortic CT angiography (CTA).Methods:This cross-sectional study prospectively enrolled 56 patients suspected of aortic diseases who underwent aortic CTA at China-Japan Friendship Hospital from June 2023 to June 2024. All patients were randomly divided into two groups: Group A (28 cases) underwent CTA with a tube voltage of 100 kVp, automatic tube current modulation (noise index=10), and a contrast agent dose of 80 ml (flow rate 5 ml/s), with images reconstructed using the three-dimensional adaptive iterative dose reduction algorithm (AIDR). Group B (28 cases) underwent CTA with a tube voltage of 80 kVp, automatic tube current modulation (noise index=25), and a contrast agent dose of 40 ml (flow rate 3.5 ml/s), with images reconstructed using either the deep learning reconstruction algorithm-Advanced intelligent Clear-IQ Engine (AiCE subgroup) or the AIDR (AIDR subgroup). Two physicians evaluated the image quality of the three groups subjectively and objectively. Objective evaluation metrics included CT values, image noise (SD), signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) at the ascending aorta, carina-level descending aorta, celiac trunk-origin abdominal aorta, and common iliac bifurcation abdominal aorta carina. Subjective evaluation metrics included image quality and noise scores. Comparisons among the three datasets (Group A, AiCE subgroup, AIDR subgroup) were performed using one-way ANOVA or the Kruskal-Wallis test, with appropriate post-hoc tests for pairwise comparisons.Results:No significant differences were observed in CT values of the ascending aorta, descending aorta, and abdominal aorta between Group A and the AiCE subgroup or the AIDR subgroup ( P0.05). However, significant overall differences were found in SD, SNR, and CNR values for the ascending aorta, descending aorta, and abdominal aorta ( P0.05). Pairwise comparisons revealed that, except for no significant differences in SD, SNR, and CNR values of the ascending and descending aorta between Group A and the AiCE subgroup, and no significant difference in SNR values of the ascending and abdominal aorta between Group A and the AIDR subgroup ( P0.05), all other intergroup comparisons showed statistically significant differences ( P0.05). Significant overall differences were also observed in image quality and noise scores between Group A and the AiCE and AIDR subgroups ( P0.05). Except for no significant differences in image quality and noise scores between Group A and the AiCE subgroup ( P0.05), all other pairwise comparisons showed statistically significant differences ( P0.05). Conclusions:The application of deep learning reconstruction algorithm combined with a dual-low protocol in thoracoabdominal aortic CTA can reduce radiation dose and contrast agent dose while maintaining diagnostic image quality, demonstrating significant clinical value for widespread adoption.

Objective:To assess the predictive value of the percentage of Gleason pattern 4 (G4%) in prostate biopsy for adverse pathology and biochemical recurrence.Methods:We retrospectively analyzed consecutive patients who underwent radical prostatectomy in our institution between January 2019 and December 2023, and included those who were diagnosed with ISUP 2-3 cancer at biopsy. A total of 109 patients were included in this study. The average age of patients was (67.40±6.11) years, and the average BMI of patients was (25.36±2.97) kg/m 2. 49 Cases (45.0%) had a PI-RADS score of 5, and the median prostate volume was 32.60 (24.57, 45.63) ml. The median of most recent tPSA before biopsy was 9.76 (6.89, 12.95) ng/ml, the median PSAD was 0.28 (0.17, 0.44) ng/ml 2, and the median f/tPSA was 0.11 (0.08, 0.16). Clinical T 2b or higher stage was found in 84 cases (77.1%). The total biopsy core length was (22.91±5.18) cm, with a median of 24 (20, 24) biopsy cores and a median of 6 (4, 9) positive cores. Gleason score 3+ 4 was found in 52 cases (47.7%), and Gleason score 4+ 3 in 57 cases (52.3%). Cribriform was present in 30 cases (27.5%). G4% was calculated based on the proportion of Gleason grade 4 tumor relative to total tumor, tumor proportion relative to total tissue, and tissue length. Patients were divided into high-G4% (≥2.45%) and low-G4% (<2.45%) groups based on the median G4% value, with 55 and 54 cases, respectively. No significant differences were observed in baseline characteristics between the two groups ( P>0.05). The main risk factor of adverse pathology was analyzed by logistic regression, and receiver operating characteristic (ROC) curve and area under curve (AUC) were performed. Patients were further stratified by the G4% cutoff value from ROC, and Kaplan-Meier survival curves were plotted to compare biochemical recurrence free survival (BCRFS) between groups. The main risk factor affecting BCRFS was analyzed by Cox regression. Adverse pathology was defined as postoperative Gleason score ≥4+ 3 or pathological stage ≥T 3a. Results:Adverse pathology occurred in 44 (80.0%) high-G4% and 16 (29.6%) low-G4% patients ( P<0.01). Multivariate analysis identified G4% as an independent risk factor for adverse pathology ( OR=1.23, 95% CI 1.02-1.50, P=0.033). The highest ROC AUC value was seen for G4% (0.799), significantly outperforming Gleason score (0.799 vs. 0.641, P=0.003), tPSA (0.799 vs. 0.615, P=0.003), PSAD (0.799 vs. 0.679, P=0.038), positive cores (0.799 vs. 0.677, P=0.009), clinical T stage (0.799 vs. 0.607, P=0.001) and cribriform (0.799 vs. 0.639, P=0.001). The G4% cutoff value for predicting biochemical recurrence was 10.97%. The median BCRFS was significantly higher in the low G4% (<10.97%) group than that in the high G4% (≥10.97%) group (55 vs. 28 months, P=0.002). Cumulative recurrence free survival rates at 1 and 3 years were 94.6% vs. 74.1% and 78.0% vs. 47.6%, respectively. Multivariate Cox regression analysis indicates that G4% was an independent risk factor affecting BCRFS ( HR=1.11, 95% CI 1.00-1.23, P=0.041). Conclusions:For patients with ISUP 2-3 nmPCa, a higher G4% in biopsy specimens demonstrates strong predictive ability for adverse pathology and biochemical recurrence, outperforming traditional clinical indicators such as Gleason score and PSA.

Objectives:This study aimed to explore the association between perceived mental stress (MS), lymphocyte subset variations, and coronary lesion severity in patients with coronary artery disease (CAD).Methods:Patients with CAD were enrolled in this study from September 2023 to May 2024. Perceived Stress Scale-14 (PSS-14) was used to evaluate MS during the last 1 month. Lymphocyte subsets were analyzed, including the percentage and absolute counts of CD3 +, CD3 +CD4 +, CD3 +CD8 +, CD3 -CD19 +, CD3 -CD56 +16 +, and the Th/Ts ratio. Statistical analysis was conducted using SPSS 24.0. Results:This study recruited patients with 323 CAD, with an average age of 61 (56, 68) years, including 203 males and 120 females. According to the PSS-14, a score of 14-42 and 43-70 were categorized as normal and increased MS, respectively. Patients with CAD with increased MS had significantly higher Gensini scores than those with normal MS [37(19,64) vs. 28(12,50), Z=-2.19, P=0.029]. Male CAD patients with increased MS exhibited significantly higher Gensini scores [39(20, 58) vs. 26(12, 45), Z=-2.37, P=0.018], levels of CD3 +CD8 +%[28.3%(23.6%,36.6%) vs. 25.9%(21.0%,32.4%), Z=-2.05, P=0.041], and CD3 +CD8 +absolute value [485 (346, 675) vs. 396 (309, 510) cells/μl, Z=-2.55, P=0.011] than those with normal MS. In male patients with CAD, a positive correlation was observed between Gensini scores (correlation coefficient: 0.181, P=0.011), PSS-14 scores, and CD3 +CD8 +absolute value (correlation coefficient: 0.162, P=0.038). Conclusion:This study reveals a positive correlation between MS and coronary stenosis severity, with notable sex differences. In male patients with CAD, higher levels of MS are associated with more severe coronary stenosis. The potential underlying mechanism may involve the regulation of lymphocyte subsets .