Objective:To explore the risk factors of short-term prognosis of severe Budd-Chiari syndrome (BCS) patients,established and verified the nomogram prediction model for these BCS patients and evaluated its clinical application value.Methods:This study is a retrospective cohort study. The clinical data of 171 patients with severe BCS diagnosed were retrospectively analyzed in the Department of Hepatopancreatobiliary Surgery First Affiliated Hospital of Zhengzhou University from January 2018 to December 2023. There were 105 males and 66 females, aged (52.1±12.8) years (range: 18 to 79 years). The patients were divided into two groups based on whether they died within 28 days: the death group ( n=38) and the survival group ( n=133). The risk factors for short-term death of patients were analyzed,and independent risk factors were screened by univariate and multivariate analysis. Furthermore,these factors were used to establish the nomogram prediction model. The area under the curve(AUC),the Bootstrap Resampling,the Hosmer-Lemeshow test and the Decision Curve Analysis(DCA) were used to verify the model′s differentiation,internal verification,calibration degree and clinical effectiveness,respectively. Results:Univariate and multivariate Logistics regression analysis showed that the history of hepatic encephalopathy,white blood cell,glomerular filtration rate and prothrombin time were independent risk factors ( P<0.05). The above factors were used to successfully establish the prediction model with 0.908 of AUC and 0.895 of the internal verification of AUC,indicating that the predictive model was valuable. The 0.663 P-values in the Hosmer-Lemeshow test indicated the high calibration degree of the model. The clinical effectiveness of the model was proved by the 18% clinical benefit population using the DCA curve with the 17% probability threshold. Conclusions:The independent risk factors are the history of hepatic encephalopathy,white blood cell,glomerular filtration rate and prothrombin time. An adequate basis was acquired by establishing a nomogram prediction model of the short-term prognosis of severe BCS,which was helpful for early clinical screening and identification of high-risk patients with severe BCS who could die in the short term and timely providing timely intervention measures for improving the prognosis.

Objective:To explore the risk factors of short-term prognosis of severe Budd-Chiari syndrome (BCS) patients,established and verified the nomogram prediction model for these BCS patients and evaluated its clinical application value.Methods:This study is a retrospective cohort study. The clinical data of 171 patients with severe BCS diagnosed were retrospectively analyzed in the Department of Hepatopancreatobiliary Surgery First Affiliated Hospital of Zhengzhou University from January 2018 to December 2023. There were 105 males and 66 females, aged (52.1±12.8) years (range: 18 to 79 years). The patients were divided into two groups based on whether they died within 28 days: the death group ( n=38) and the survival group ( n=133). The risk factors for short-term death of patients were analyzed,and independent risk factors were screened by univariate and multivariate analysis. Furthermore,these factors were used to establish the nomogram prediction model. The area under the curve(AUC),the Bootstrap Resampling,the Hosmer-Lemeshow test and the Decision Curve Analysis(DCA) were used to verify the model′s differentiation,internal verification,calibration degree and clinical effectiveness,respectively. Results:Univariate and multivariate Logistics regression analysis showed that the history of hepatic encephalopathy,white blood cell,glomerular filtration rate and prothrombin time were independent risk factors ( P<0.05). The above factors were used to successfully establish the prediction model with 0.908 of AUC and 0.895 of the internal verification of AUC,indicating that the predictive model was valuable. The 0.663 P-values in the Hosmer-Lemeshow test indicated the high calibration degree of the model. The clinical effectiveness of the model was proved by the 18% clinical benefit population using the DCA curve with the 17% probability threshold. Conclusions:The independent risk factors are the history of hepatic encephalopathy,white blood cell,glomerular filtration rate and prothrombin time. An adequate basis was acquired by establishing a nomogram prediction model of the short-term prognosis of severe BCS,which was helpful for early clinical screening and identification of high-risk patients with severe BCS who could die in the short term and timely providing timely intervention measures for improving the prognosis.

Objective:To construct and validate a risk prediction model for major complications 30 days after surgery in the elderly patients with hip fracture.Methods:A retrospective study was conducted to analyze the clinical data of 276 elderly patients with hip fracture who had been admitted to Department of Trauma and Orthopaedics, The Hospital Affiliated to Chengde Medical University from June 2019 to December 2021. There were 96 males and 180 females with an age of (74.5±9.3) years, and 139 femoral neck fractures and 137 intertrochanteric fractures. The outcome of this study was whether major complications occurred within 30 days after surgery. Multiple logistic regression analysis identified the risk factors for major complications in the elderly patients with hip fracture within 30 days after surgery. The forward step-by-step method and likelihood ratio test were used to screen the best prediction model. A nomogram was constructed to display the model. The stability and effectiveness of the model were evaluated by the receiver operating characteristic curve (ROC), Hosmer-Lemeshow goodness-of-fit test, clinical decision curve and clinical impact curve analysis.Results:Logistic regression analysis showed that decreased preoperative hemoglobin ( P< 0.05), time from admission to surgery >72 hours ( OR=3.001, 95% CI: 1.564 to 5.758, P<0.001), control of nutritional status (CONUT) score >4 points ( OR=3.394, 95% CI: 1.724 to 6.680, P<0.001), and age-adjusted modified frailty index (aamFI) >2 points ( OR=2.875, 95% CI: 1.548 to 5.339, P= 0.001), increased operation time ( OR=1.016, 95% CI: 1.006 to 1.025, P=0.001), and surgical bleeding >60 mL ( OR=2.373, 95% CI: 1.016 to 5.540, P=0.046) were independent risk factors for major complications within 30 days after surgery in the elderly patients with hip fracture. The area under the ROC curve in the logistic risk prediction model was 0.846 (95% CI: 0.799 to 0.889), and the results of Hosmer-Lemeshow goodness-of-fit test showed ( χ2=8.080, P=0.426). The clinical decision curve and clinical impact curve showed that the prediction model was accurate and effective. Conclusion:Based on the patients' preoperative hemoglobin, time from admission to surgery, control of nutritional status score, age-adjusted modified frailty index, operation time and surgical blood loss, this study has constructed successfully a risk prediction model for complications 30 days after surgery in the elderly patients with hip fracture which enables medical staff to predict the occurrence of major postoperative complications.

ObjectiveTo investigate the clinical features of liver function and coagulation function in patients with Alongshan virus (ALSV) infection. MethodsClinical data were collected from 27 patients with ALSV infection who were admitted to Inner Mongolia General Forestry Hospital from May 2018 to September 2019, among whom there were 18 male patients and 9 female patients. Related data were extracted, and a database of relevant case reports was established. The descriptive epidemiological method was used to analyze the clinical features of liver function and coagulation markers, and the features of liver injury caused by ALSV infection were analyzed. ResultsFor the 27 patients, the abnormal rates of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma-glutamyl transpeptidase (GGT), cholinesterase, and total bile acid were 25.9%, 33.3%, 25.9%, 40.7%, 8%, and 8%, respectively; among the 27 patients, 4 (14.8%) had an ALT level of ＞2×upper limit of normal (ULN), 3 (11.1%) had an AST level of ＞2×ULN, 1 (3.7%) had an ALP level of ＞2×ULN, and 5 (18.5%) had a GGT level of ＞2×ULN. Among the 27 patients, 25 (17 male patients and 8 female patients) had the results of bilirubin test, among whom 1 had a reduction in total bilirubin (TBil) (3.30 μmol/L) and 3 had an increase in TBil (23.7 μmol/L, 26.2 μmol/L, and 32 μmol/L, respectively). The abnormal rates of the coagulation markers international normalized ratio, activated partial thromboplastin time, and fibrinogen were 3.7%, 11.1%, and 22.2%, respectively. ConclusionThere is a certain degree of liver injury in patients with ALSV infection, generally with mild symptoms.

Objective: To investigate the manufacturing procedures of personalized miniscrew-assisted rapid palatal expanders (pMARPE) using digital technologies and to evaluate the effect of the expanders when expanding the midpalatal suture of an adult. Methods: Digital technologies were used to make pMARPE, which was used to treat a 21-year-old woman with maxillary transverse deficiency (MTD). The relevant literature on MARPE was reviewed. Results: PMARPE could be manufactured using intraoral digital scanning, computer-aided design and computer-aided manufacturing(CAD/CAM ), and 3D printing technologies. After expansion, the width of the anterior midpalatal suture, posterior midpalatal suture and maxillary skeletal width increased by 3.9 mm, 3.2 mm and 4.7 mm, respectively. There was no significant change in the inclination of maxillary first molars, and the height of alveolar ridge decreased slightly. It could be seen that using digital technologies to manufacture personalized expanders was possible for MARPE , and the initial stability of miniscrews played an important role in the expansion success rate, the increase of molar inclination is composed of many parts, and the decrease of alveolar ridge height may be overestimated due to the measurement method, as shown by a literature review. Conclusion The midpalatal suture of an adult patient with MTD could be expanded by pMARPE. However, the effect of this expander on the inclination of the first molar and alveolar bone height needs to be further studied with a larger sample size.

OBJECTIVE：To stud y the effects of different processed products of Whitmania pigra on hemorheology and coagulation indexes in acute blood stasis model rats. METHODS ：SD rats were randomly divided into blank group ，model group ， aspirin group ，W. pigra hang-dried product low- ，medium- and high-dose groups ，W. pigra talcum powder-ironed product low- ， medium- and high-dose groups ，W. pigra wine bran-processed product low- ，medium- and high-dose groups ，with 6 rats in each group. Except for blank group ，other groups received subcutaneous injection of epinephrine hydrochloride and ice water bath for 15 d to induce acute blood stasis model. From the 8th day of modeling ，rats in aspirin group were given aspirin 0.2 g/kg intragastrically. Rats in each dose group of W. pigra processed products were given relevant medicine 0.35，1.4，3.5 g/kg intragastrically（calculated by crude drug ）. Rats in blank group and model group were given constant volume of normal saline intragastrically， once a day ， for consecutive 8 days. Hemorheology indexes as whole blood viscosity （high， medium and low shearrate ），plasma viscosity ，erythrocyte com deformation index ，erythrocyte aggregation index ，hematocrit， and blood coagulation indexes as prothrombin time （PT）， mail：wcl19960125@163.com activated partial prothrombin time （APTT），thrombin time （TT）were determined. RESU LTS：Compared with blank group ，whole blood viscosity under different shear rates ，plasma viscosity ， erythrocyte aggregation index and hematocrit of model group were increased significantly ，while erythrocyte deformation index was significantly decreased ，PT，TT and APTT were significantly shortened （P＜0.01）. Compared with model group ，whole blood viscosity under different shear rates ，plasma viscosity ，erythrocyte aggregation index and hematocrit of aspirin group and W. pigra hang-dried product ，talcum powder-ironed product ，wine bran-processed product high-dose groups were decreased significantly ， while erythrocyte deformation index were significantly increased ，and PT （only W. pigra talcum powder-ironed products high-dose group），APTT（except for W. pigra hang-dried products high-dose group ）and TT were prolonged significantly. The whole blood viscosity of W. pigra hang-dried product medium-dose group under low shear rate ，and those of W. pigra talcum powder-ironed product low-dose ，wine bran-processed product medium-dose groups under low and medium shear rates were decreased significantly. Erythrocyte deformation index of W. pigra talcum powder-ironed product medium-dose group was increased significantly ，while erythrocyte aggregation index was decreased significantly ，and PT ，TT were prolonged significantly. APTT of W. pigra hang-dried product medium-dose group was prolonged significantly. Hematocrit of W. pigra wine bran-processed product low-dose group was decreased significantly （P＜0.05 or P＜0.01）. CONCLUSIONS ： W. pigra hang-dried， talcum powder-ironed and wine bran-processed product can effectively improve hemorheology indexes and prolong blood coagulation time.

Melanogenesis is a biosynthetic pathway to produce melanin pigment in melanocyte, involving a series of intricate enzymatic and chemical catalyzed reactions. Melanogenesis involves five signaling pathways that converge on microphthalmia-associated transcription factor. In addition, many cytokines, involved in the regulation of melanogenesis, play an important role in the development, proliferation, differentiation and migration of melanocytes. Polyoxometalate can be used as a potential inhibitor of melanin production. Hence, this paper reviews the signaling pathways of melanogenesis and their regulatory mechanism, to apply polyoxometalates in the melanin production pathway, and briefly introduces the regulatory factors of related pathways.
Cell Differentiation ; Melanins ; Melanocytes ; Microphthalmia-Associated Transcription Factor ; Signal Transduction

Objective ToexploretheMRIperformanceofpapillarythyroidcarcinomawithhobnailfeatures(HPTC)andthedifferential diagnosisfromclassicpapillarythyroidcarcinoma(CPTC).Methods Dataof93patientswithconfirmedPTCandMRIexamination oneweekbeforesurgerywereretrospectivelycollected.Thedifferencesoftheage,sex,tumorsize,ADCvaluesand MRIfeaturesof HPTCandCPTCweredetermined.Results 10HPTCand78CPTCwereincludedinthisstudy.ThefrequencyofT2WIsignificantly highsignal,segmentationlinearlowsignal,lacesignandgyrus-likestructureofHPTCwassignificantlyhigherthanthatofCPTC (P=0.000).ComparedtoCPTC,HPTCshowedmoreirregularshape(P=0.005),largervolume(P=0.025),moremixedT2WI andDWIsignals(P=0.002,0.028,respectively),higherADCvalues(P=0.019),anddelayedmass-likeenhancement(P=0.041). Conclusion HPTClesionshavelargervolume,irregularshape,mixedT2WIsignals,mixedDWIsignalsandhigherADCvalues. Significantlyhighsignal,segmentationlinearlowsignal,lacesignandgyrus-likestructurearecommonlyobservedonT2WI.Delayed mass-likeenhancementpatternismorecommon.ThesecharacteristicscouldcontributetothediagnosisofHPTC.

Objective To investigate the value of multi-phase contrast enhanced MR in the diagnosis and differential diagnosis of thyroid nodules. Methods From September 2015 to January 2018,176 patients with 257 thyroid nodules(109 malignant and 148 benign)preoperatively evaluated by multi-phase contrast enhanced MR were included in the present study.The final diagnoses for all cases were proved by the final pathological reports in our hospital.The diagnostic value of multi-phase contrast enhanced MR in thyroid nodules was analyzed retrospectively. Results The outflow ring sign can be regarded as a specific sign of papillary thyroid carcinoma (χ2＝125.03,P＝0.000)and the diagnostic sensitivity,specificity,positive predictive value and negative predictive value were 66.06%,98.65%,97.30%and 79.78%,respectively.The obvious enhancement was more common in benign thyroid nodules (χ2＝33.45,P＝0.000)and it can be regarded as a specific sign of adenoma and adenomatoid nodule(χ2＝74.7 5 ,P＝0.000 ).Conclusion The multi-phase contrast enhanced MR has important clinical application value in the diagnosis and differential diagnosis of thyroid nodules.The outflow ring sign can be regarded as a specific sign of papillary thyroid carcinoma,and the obvious enhancement was an important feature of benign nodules,especially of adenoma and adenomatoid nodules.

OBJECTIVETo observe the effect of electroacupuncture (EA) on the expressions of CD36 gene and protein in peritoneal macrophages of atherosclerotic rabbits, and to explore the mechanism of acupuncture regulation of atherosclerosis.

METHODSA total of 26 male New Zealand rabbits were randomly divided into a blank group (7 rabbits) and a model group (19 rabbits). The rabbits in the blank group were fed with common feedstuff, and those in the model group were applied with high fat diet and arteria carotis communis bullon injury. One rabbit was sacrificed after 8 weeks to observe the morphological changes of carotid atherosclerotic plaques by HE staining to verify model establishment separately in the blank group and model group. The model rabbits were randomized into a control group, an EA group and a western medication group, 6 rabbits in each one. Common feedstuff was used in the blank group and high fat feed in the other groups. No intervention except grabbing and fixation as the EA group was in the blank group and control group. Rabbits in the EA group were treated with acupuncture at bilateral "Neiguan" (PC 6), "Zusanli" (ST 36), "Guanyuan" (CV 4), and EA with sparse-dense wave was connected at bilateral "Neiguan" (PC 6) and "Zusanli" (ST 36) for 20 min, 4 Hz/20 Hz and 1 mA. 20 mL suspension of 1mg/kg/d atorvastatin calcium tablets were prescribed by intragastric administration in the western medication group for 4 courses, 6 d as one course with 1 d between two courses, once a day. The expression of CD36 protein in peritoneal macrophages was detected by Western blot. Reverse transcription (RT) of RNA and polymerase chain reaction (PCR) of cDNA were used to detect the expression of CD36 mRNA in peritoneal macrophages.

RESULTSIn the blank group, the vascular wall thickness was uniform and the endothelium was intact. There was no accumulation of foam cells and atherosclerotic plaques. In the model group, the intima of the artery obviously thickened; the intima was damaged; the atherosclerotic plaque and inflammatory cell infiltration were found in the intima, and the foam cells were seen. After treatment, the expressions of CD36 protein and CD36 mRNA in the control group, EA group and western medication group were higher than those in the blank group (all<0.01). Those in the EA group and western medication group were lower than the expressions in the control group (all<0.01). There was no statistical significance for the expressions of CD36 protein and CD36 mRNA between the EA group and the western medication group (both>0.05). .

CONCLUSIONEA can reduce the expressions of CD36 protein and CD36 mRNA in peritoneal macrophages of atherosclerotic rabbits, which may be one of the mechanisms of EA treatment of atherosclerosis.