Objective To compare the ability of single-phase,dual-phase,and triphasic models in forecasting postoperative pancreatic fistula(POPF)after pancreaticoduodenectomy(PD)using radiomics based on triphasic enhanced CT.Methods A total of 181 patients who underwent multi-phase enhanced CT prior to PD were retrospectively selected,and the collection phase included non-contrast,arterial phase(AP),and equilibrium phase(EP).3D Slicer software was utilized to segment the region of interest(ROI)for the postoperative pancreatic remnant on each phase.Radiomics feature extraction was performed using R software,followed by feature selection through least absolute shrinkage and selection operator(LASSO)regression with five-fold cross-validation to prevent model overfitting.The effective features selected were combined in a weighted linear manner to obtain a Radiomics score(Radscore).The patients were divided into training set and test set in a 7︰3 ratio.Logistic regression was employed to construct seven POPF prediction models(three single-phase,three dual-phase,and one triphasic models)based on different phase combinations.The diagnostic performance of the models was evaluated using the area under the curve(AUC)of receiver operating characteristic(ROC)curve,accuracy(ACC),sensitivity(SEN),and specificity(SPE).The DeLong test was applied to compare the differences in AUC among different models.Results After LASSO regression,24 effective features associated with POPF were selected from different phases.In the test set,the triphasic model exhibited the highest AUC and ACC(AUC=0.76,ACC=0.808).The calibration curve demonstrated the strongest agreement between the estimated probabilities and observed probabilities for the triphasic model.The decision curve analysis(DCA)curve indicated that the triphasic model had the largest threshold range with a higher net benefit.Conclusion Compared with single-phase and dual-phase models,the triphasic model based on enhanced CT provides better prediction of POPF after PD,aiding clinical decision-making and improve prognosis.

Objective To compare the ability of single-phase,dual-phase,and triphasic models in forecasting postoperative pancreatic fistula(POPF)after pancreaticoduodenectomy(PD)using radiomics based on triphasic enhanced CT.Methods A total of 181 patients who underwent multi-phase enhanced CT prior to PD were retrospectively selected,and the collection phase included non-contrast,arterial phase(AP),and equilibrium phase(EP).3D Slicer software was utilized to segment the region of interest(ROI)for the postoperative pancreatic remnant on each phase.Radiomics feature extraction was performed using R software,followed by feature selection through least absolute shrinkage and selection operator(LASSO)regression with five-fold cross-validation to prevent model overfitting.The effective features selected were combined in a weighted linear manner to obtain a Radiomics score(Radscore).The patients were divided into training set and test set in a 7︰3 ratio.Logistic regression was employed to construct seven POPF prediction models(three single-phase,three dual-phase,and one triphasic models)based on different phase combinations.The diagnostic performance of the models was evaluated using the area under the curve(AUC)of receiver operating characteristic(ROC)curve,accuracy(ACC),sensitivity(SEN),and specificity(SPE).The DeLong test was applied to compare the differences in AUC among different models.Results After LASSO regression,24 effective features associated with POPF were selected from different phases.In the test set,the triphasic model exhibited the highest AUC and ACC(AUC=0.76,ACC=0.808).The calibration curve demonstrated the strongest agreement between the estimated probabilities and observed probabilities for the triphasic model.The decision curve analysis(DCA)curve indicated that the triphasic model had the largest threshold range with a higher net benefit.Conclusion Compared with single-phase and dual-phase models,the triphasic model based on enhanced CT provides better prediction of POPF after PD,aiding clinical decision-making and improve prognosis.

Objective To evaluate the clinical efficacy of kissing-stent implantation in the treatment of chronic iliac-vena cava occlusion.Methods The clinical data of 22 patients with chronic iliac-vena cava occlusion,who received kissing-stent implantation,were retrospectively analyzed.The surgical success rate and the procedure-related complications were recorded,the postoperative 3-,6-and 12-month stent patency rates were calculated,and the postoperative 6-month Villalta score was compared with its preoperative value.Results The technical success rate of kissing-stent implantation was 100％.No procedure-related surgical complications occurred.The postoperative 3-,6-and 12-month stent patency rates were 95.5％,90.9％and 86.1％respectively.The postoperative 6-month Villalta score was(12.14±2.80)points,which was remarkably lower than preoperative(20.91±3.16)points,the difference was statistically significant(P＜0.05).Conclusion The implantation of kissing-stent can successfully reconstruct iliac-vena cava with satisfactory short-term efficacy for chronic iliac-vena cava occlusion.

Objective:To evaluate the effectiveness of transcutaneous lower eyelid blepharoplasty with a skin flap reserving the pretarsal fullness.Methods:From November 2017 to April 2022, a retrospective analysis was performed to assess the reserving of pretarsal fullness after the transcutaneous lower blepharoplasty with a skin flap in the Department of Burn and Plastic Surgery, General Hospital of Southern Theater Command, PLA. A subciliary incision was made below the ciliary margin and a skin flap was elevated at the surface of pretarsal orbicularis. The muscle was partially split at the position of pretarsal crease, leaving the pretarsal orbicularis oculi muscle and the pretarsal crease intact. Preseptal dissection was proceeded down to the level of arcus marginalis, exposing the orbital fat pads. For patient with tear trough deformity or volume deficiency in the medial cheek, retaining ligament laxity and fat repositioning were routinely performed. The muscle wound was closed edge to edge and the excess skin was excised conservatively. Postoperative complications were recorded. Face-Q scale was used for surgical decision and postoperative satisfaction evaluation. The scores range from 0 to 100, with higher scores indicating less regret the operation or greater satisfaction. The preoperative and postoperative digital photographs were used to evaluate the change of pretarsal fullness.Results:256 patients were included, of whom 233 cases were women and 23 cases were men. The age was (43.0±10.2) years. 24 cases had concomitant lateral canthoplasty due to hypotonia of lower eyelid, 22 had concomitant upper blepharoplasty, and 21 cases had brow lift surgery to correct upper eyelid relaxation. All patients had follow-up for (3.7±4.1) months, most patients were satisfied with the operation results. A total of 211 patients maintained a natural pretarsal fullness postoperatively, with the rate of 82.4%. The Face-Q satisfaction score was (75.8±18.6) and the surgical decision score was (80.3±15.4), indicating that most patients did not regret the operation. Postoperative complications included 8 cases of eyelid bags undercorrection, of whom 4 patients underwent secondary resection. 7 patients experienced infraorbital bulge for the uneven placement of the fat pad, 2 of them required revision surgery. Hematoma occurred in 4 cases and was resolved by hematoma clearance. Other complications included 3 cases of ectropion and 2 cases of minimal tear trough correction. Lower eyelid ectropion was corrected in one case.Conclusion:Reserving the pretarsal fullness in transcutaneous lower eyelid blepharoplasty with a skin flap provides excellent aesthetic results and high patient satisfaction. This technique is simple and effective.

Objective:To evaluate the effectiveness of transcutaneous lower eyelid blepharoplasty with a skin flap reserving the pretarsal fullness.Methods:From November 2017 to April 2022, a retrospective analysis was performed to assess the reserving of pretarsal fullness after the transcutaneous lower blepharoplasty with a skin flap in the Department of Burn and Plastic Surgery, General Hospital of Southern Theater Command, PLA. A subciliary incision was made below the ciliary margin and a skin flap was elevated at the surface of pretarsal orbicularis. The muscle was partially split at the position of pretarsal crease, leaving the pretarsal orbicularis oculi muscle and the pretarsal crease intact. Preseptal dissection was proceeded down to the level of arcus marginalis, exposing the orbital fat pads. For patient with tear trough deformity or volume deficiency in the medial cheek, retaining ligament laxity and fat repositioning were routinely performed. The muscle wound was closed edge to edge and the excess skin was excised conservatively. Postoperative complications were recorded. Face-Q scale was used for surgical decision and postoperative satisfaction evaluation. The scores range from 0 to 100, with higher scores indicating less regret the operation or greater satisfaction. The preoperative and postoperative digital photographs were used to evaluate the change of pretarsal fullness.Results:256 patients were included, of whom 233 cases were women and 23 cases were men. The age was (43.0±10.2) years. 24 cases had concomitant lateral canthoplasty due to hypotonia of lower eyelid, 22 had concomitant upper blepharoplasty, and 21 cases had brow lift surgery to correct upper eyelid relaxation. All patients had follow-up for (3.7±4.1) months, most patients were satisfied with the operation results. A total of 211 patients maintained a natural pretarsal fullness postoperatively, with the rate of 82.4%. The Face-Q satisfaction score was (75.8±18.6) and the surgical decision score was (80.3±15.4), indicating that most patients did not regret the operation. Postoperative complications included 8 cases of eyelid bags undercorrection, of whom 4 patients underwent secondary resection. 7 patients experienced infraorbital bulge for the uneven placement of the fat pad, 2 of them required revision surgery. Hematoma occurred in 4 cases and was resolved by hematoma clearance. Other complications included 3 cases of ectropion and 2 cases of minimal tear trough correction. Lower eyelid ectropion was corrected in one case.Conclusion:Reserving the pretarsal fullness in transcutaneous lower eyelid blepharoplasty with a skin flap provides excellent aesthetic results and high patient satisfaction. This technique is simple and effective.

Objective:To explore the regulation of eight weeks aerobic exercise on brain spontaneous activity in individuals with subthreshold depression.Methods:Through subject recruitment, a total of 44 subjects with subthreshold depression (subthreshold depression group, StD) who scored≥5 according to Patient Health Questionnare-9 (PHQ-9) but did not meet the diagnostic criteria for clinical depression, and 34 healthy subjects (health control group, HC) were included. Two groups of participants were given 8-week moderate-intensity aerobic exercise intervention, and resting state functional magnetic resonance imaging (rs-fMRI) data were collected before and after the intervention to analyze the fractional amplitude of low frequency fluctuations (fALFF) in the two groups. Horizontal two-sample t-tests with years of education as a covariate and longitudinal paired-samples t-tests were performed for fALFF in both groups at baseline and after 8-week moderate-intensity aerobic exercise intervention. The relationship between the fALFF values in significant difference brain regions and psycho-psychological scales were examined by Spearman correlation. Results:After 8 weeks of moderate intensity aerobic exercise, the scores of PHQ-9 and Self-Rating Anxiety Scale (SAS) in StD were significantly lower than baseline ( t=7.08,5.99, both P<0.001). There was no significant difference in fALFF value between StD and HC at baseline. After aerobic exercise intervention, compared with the HC, the fALFF value of the left parahippocampal gyrus in the StD was significantly decreased, and the fALFF value of the left superior frontal gyrus and left precentral gyrus was significantly increased. After aerobic exercise intervention, compared with the baseline, the StD had significantly higher fALFF values in the left inferior parietal lobe (supramarginal gyrus and angular gyrus), right supramarginal gyrus and left anterior cingulate gyrus. In addition, compared with the baseline, the fALFF value of the right precentral gyrus in the HC was significantly decreased. After aerobic exercise intervention, the fALFF value of the left inferior parietal lobe was negatively correlated with the SAS scores ( r= -0.31, P=0.038), the fALFF value of the left anterior cingulate gyrus and the PHQ-9 item 2 (low mood) scores was negatively correlated ( r= -0.41, P=0.006), and the fALFF values of the left inferior parietal lobe, right supramarginal gyrus and the PHQ-9 item 6 (low self-evaluation) scores were negative correlated ( r=-0.39, P=0.010; r=-0.30, P=0.048). Conclusion:Eight weeks of moderate-intensity aerobic exercise can regulate the spontaneous activity pattern of local brain regions in individuals with subthreshold depression, and fALFF analysis can provide objective evidence for the antidepressant effect of aerobic exercise.

Objective:To explore the regulation of eight weeks aerobic exercise on brain spontaneous activity in individuals with subthreshold depression.Methods:Through subject recruitment, a total of 44 subjects with subthreshold depression (subthreshold depression group, StD) who scored≥5 according to Patient Health Questionnare-9 (PHQ-9) but did not meet the diagnostic criteria for clinical depression, and 34 healthy subjects (health control group, HC) were included. Two groups of participants were given 8-week moderate-intensity aerobic exercise intervention, and resting state functional magnetic resonance imaging (rs-fMRI) data were collected before and after the intervention to analyze the fractional amplitude of low frequency fluctuations (fALFF) in the two groups. Horizontal two-sample t-tests with years of education as a covariate and longitudinal paired-samples t-tests were performed for fALFF in both groups at baseline and after 8-week moderate-intensity aerobic exercise intervention. The relationship between the fALFF values in significant difference brain regions and psycho-psychological scales were examined by Spearman correlation. Results:After 8 weeks of moderate intensity aerobic exercise, the scores of PHQ-9 and Self-Rating Anxiety Scale (SAS) in StD were significantly lower than baseline ( t=7.08,5.99, both P<0.001). There was no significant difference in fALFF value between StD and HC at baseline. After aerobic exercise intervention, compared with the HC, the fALFF value of the left parahippocampal gyrus in the StD was significantly decreased, and the fALFF value of the left superior frontal gyrus and left precentral gyrus was significantly increased. After aerobic exercise intervention, compared with the baseline, the StD had significantly higher fALFF values in the left inferior parietal lobe (supramarginal gyrus and angular gyrus), right supramarginal gyrus and left anterior cingulate gyrus. In addition, compared with the baseline, the fALFF value of the right precentral gyrus in the HC was significantly decreased. After aerobic exercise intervention, the fALFF value of the left inferior parietal lobe was negatively correlated with the SAS scores ( r= -0.31, P=0.038), the fALFF value of the left anterior cingulate gyrus and the PHQ-9 item 2 (low mood) scores was negatively correlated ( r= -0.41, P=0.006), and the fALFF values of the left inferior parietal lobe, right supramarginal gyrus and the PHQ-9 item 6 (low self-evaluation) scores were negative correlated ( r=-0.39, P=0.010; r=-0.30, P=0.048). Conclusion:Eight weeks of moderate-intensity aerobic exercise can regulate the spontaneous activity pattern of local brain regions in individuals with subthreshold depression, and fALFF analysis can provide objective evidence for the antidepressant effect of aerobic exercise.

Background:Non-alcoholic liver disease is of increased concern and contributing to economic burdens not only in developing countries but in developed countries as well.Identifying the biomarker of early diagnosis and early intervention approaches for non-alcoholic liver disease is unmet and required further investigation.Although the alpha-ketoglutarate(α-KG)is recently proposed to be a potential biomarker in differentiating patients with obesity from those with non-alcoholic liver disease,how α-ketoglutatate is involved in the fatty liver progression is not clear. Methods:A high-fat diet(HFD)feeding animal model,liver functional assays,and molecular approaches were adopted to clarify the impact of α-KG in fatty liver progression. Results:In the current study,it was found that dietary α-KG would inhibit weight gain in male and female mice fed with a normal chew or HFD.HFD feeding caused fatty liver in male mice,but α-KG treatment could substantially inhibit hepatic steatosis progression.Biochemical studies revealed the possible linkage of α-KG protective functions to lipid metabolism.Further analysis identified the important role of peroxisome proliferator-activated receptors in beneficial α-KG-mediated effects on fatty liver progression. Conclusions:The current study demonstrates the therapeutic potential of α-KG and how it may be used,via dietary supplementation,as a preventive intervention for non-alcoholic liver disease in obese patients.

Objective:To explore the role of the standardized uptake value(SUV) of Fluorine‐18 flurodeoxyglucose(18 F‐FDG) PET/CT in differentiating the types of non‐Hodgkin lymphoma(NHL) .Methods:The 18 F‐FDG PET/CT data of 246 patients with initial onset NHL were retrospectively analyzed .The SUVs between aggressive and indolent NHL ,as well as that between B and T/NK cell NHL ,were compared .Results:The SUV in 194 cases of aggressive NHL was 18 .5 ± 9 .6 ,while that in 35 cases of indolent NHL was 8 .7 ± 6 .2 ,and there was significant difference between them(P<0 .01) .The SUV in 214 cases of B cell NHL was 20 .0 ± 9 .7 ,while that in 32 cases of T/NK cell NHL was 11 .6 ± 5 .2 ,and there was significant difference between them(P<0 .01) .Conclusions:During the 18 F‐FDG PET/CT examination ,SUV has some reference value for differentiating pathological types of NHL .

Objective To investigate the application of theoretical K value and the calibration K value on Hitachi 7600 Automatic Biochemical Analyzer .Methods Rate method was employed to detect alanine aminotransferase (ALT ) ,aspartate aminotransferase (AST) ,gamma-glutamyl transpeptidase(γ-GT) ,creatine kinase(CK) and lactate dehydrogenase(LDH) .The theoretical K value and K values calibrated by two kinds of calibration serum were recorded as K ,K1 ,K2 and the three kinds of calibration results of enzymes mentioned above were compared .Results The theoretical K values of ALT ,AST ,γ-GT ,CK and LDH were all less than their two kinds of actual K values .The results of the calibration K value were significantly superior to that of the theoretical K value .The calibration results R2 value of five kinds of enzymes were all greater than 0 .95 .Conclusion The theoretical K value is not suitable for clinical laboratories ,and the two kinds of calibration serum can meet the needs of quality control and clinical work .