Objective:We aimed to develop a novel visualized model based on nomogram to predict postoperative overall survival.Methods:This was a multicenter, retrospective, observational cohort study, including participants with histologically confirmed gastric and colorectal cancer who underwent radical surgery from 11 medical centers in China from August 1, 2015 to June 30, 2018. Baseline characteristics, histopathological data and nutritional status, as assessed using Nutrition Risk Screening 2002 (NRS 2002) score and the scored Patient-Generated Subjective Global Assessment, were collected. The least absolute shrinkage and selection operator regression and Cox regression were used to identify variables to be included in the predictive model. Internal and external validations were performed.Results:There were 681 and 127 patients in the training and validation cohorts, respectively. A total of 188 deaths were observed over a median follow-up period of 59 (range: 58 to 60) months. Two independent predictors of NRS 2002 and Tumor-Node-Metastasis (TNM) stage were identified and incorporated into the prediction nomogram model together with the factor of age. The model's concordance index for 1-, 3- and 5-year overall survival was 0.696, 0.724, and 0.738 in the training cohort and 0.801, 0.812, and 0.793 in the validation cohort, respectively.Conclusions:In this study, a new nomogram prediction model based on NRS 2002 score was developed and validated for predicting the overall postoperative survival of patients with gastric colorectal cancer. This model has good differentiation, calibration and clinical practicability in predicting the long-term survival rate of patients with gastrointestinal cancer after radical surgery.

Objective:To investigate the changes in total radioactivity in patient body with differentiated thyroid carcinoma (DTC) after 131I treatment and the factors influencing its metabolism. Methods:The clinical data from 218 patients after DTC treatment in the Department of Nuclear Medicine, the Second Affiliated Hospital of Air Force Medical University from September 2021 to April 2022 were retrospectively analyzed. Based on administrated 131I dose, 171 patients were divided into low-dose group (≤ 3.7 GBq) and 47 into high-dose group (>3.7 GBq) . A whole body dynamic radiation monitoring system was used to measure the in vivo residual activity of 131I 24, 48 and 72 h after 131I administration and to explore their influencing factors. Results:24, 48 and 72 h after adimination of 131I, the residual activity of 131I in the low-dose group patients was significantly lower than in the high-dose group patients ( t= -7.46, -3.31, -2.01, P<0.05) . The discharge compliance rate at 24 and 48 h in the low-dose group was significantly higher than that in the high-dose group (21.0% vs. 4.3%, 98.2% vs. 89.4%, χ2 = 7.23, 5.91, P<0.05) , and all patients could meet the discharge criteria at 72 h. Univariate analysis showed that the residual 131I activity at 24 and 48 h was dependent on age, body mass index (BMI) , basal metabolism rate (BMR) and thyroid stimulating hormone (TSH) . As have been shown by multiple linear regression analysis, in the low-dose group, the older age, the higher BMR and the higher TSH level at 24 h tended to the higher 131I residual activity in the body. At 48 h, the higher BMI and the higher TSH level lead to the higher 131I residual activity in patient body. Meanwhile, in the high-dose group, the higher age and BMR at 24 h, tended to the higher in vivo131I residual activity. The influencing factors were analyzed in terms that 131I residual activity reaching 400 MBq in patient body at 24 and 36 h. The result showed that at 24 h the lower TSH level leaded to the lower 131I residual activity in patient body. At 36 h, the younger age, the lower TSH level, and the smaller 131I treatment dose tended to the lower in vivo131I residual activity. Conclusions:Age, BMI, BMR and TSH levels are the influencing factors for the change in total activity in patient body after 131I treatment of DTC. Radiation dose assessment based on the above indicators can provide a reference for adjusting the length of hospitalization time.

Objective To investigate the efficacy of preemptive analgesiawith ultrasound-guided modified dorsal penile nerve block combined ketorolac tromethamine for circumcision in pediatric patients.Methods Forty-five pediatric patients with ASA grade Ⅰ undergoing elective circumcision were randomly divided into 3 groups (n=15 each).The same intravenous compound anesthesia was used in the three groups.The pediatric patients underwent ultrasound-guided modified dorsal penile nerve block with a mixture of 0.1 ml/kg of 0.2% ropivacaine and 0.8% lidocaine before operation in group A and group B.The pediatric patients were given ketorolac tromethamine 1 mg/kg intramuscular injection before operation in group A and group C.The total consumption of propfol and sufentanil, occurrence of intraoperative body movement and respiratory depression, emergence time, time from waking up to going out of PACU and adverse reactions such as postoperative agitation, nausea, vomiting and pruritus were aslo recorded.The requirement for postoperative paracetamol suppositories was recorded.Results Compared with group C, the total consumption of propfol and sufentanil were significantly decreased, incidence of body movement andrespiratory depression were significantly decreased, the emergence time and time from waking up to going out of PACU was significantly shortened, requirement for paracetamol suppositories were significantly decreased in group A and group B(P<0.05).Compared with group B, incidence of requirement for paracetamol suppositories was significantly decreased in group A (P<0.05).No pediatric patients developed postoperative nausea, vomiting, pruritus and incidence of emergence agitation had no statistical difference in the three groups.Conclusion Preemptive analgesia with ultrasound-guided modified dorsal penile nerve block combined ketorolac tromethamine is safe and effective when used for circumcision in pediatric patients, and it has good efficacy of postoperative analgesia.

Objective To investigate the optimal self care in lung cancer patients with peripherally inserted central catheter (PICC) in ladder-type nursing training,network education,continuing nursing care clinics,and other forms of nursing mode care.Methods Based on the baselien data of patients in the control group and observation group,PICC self management ability,PICC quantitative data,PICC-related infections,thrombosis,and other complications were compared,and the impact of continued nursing platform on lung cancer patients with indwelling PICC was analyzed.Results In the observation group self management ability and health behavior is higher than that of the control group (P＜0.001).PICC catheter -related complications no difference with the control group (P＞0.05),Patient satisfaction of the observation group than the control group,the difference was statistically significant (92.18％ vs.79.00％,P=0.015).Conclusion The self care based on the continued nursing mode established by PICC speciality nurses can improve the self-management level of patients with PICC,reduce PICC-related complications,and increase the patient's satisfaction.

To meet the requirements for the development of marine resources and military operations, divers usually dive deeper than the depth at which narcosis is present during air diving.Under this condition, heliox is required for this div-ing.Sofar, some countries have developed their own decompression tables for routine heliox diving.The best-known is tables from USA and France.In the preceding century, tables of Former Soviet Union and France used for routine heliox diving were introduced into China.On the basis of both types of tables,Chinese Navy developed their own tables for this purpose. In this paper, we summarized the characteristics of these tables from 5 countries and compared them in terms of structure, oxygen use, total decompression time, first stop and other features.This may provide a basis for future modification of ta-bles used in China and the development of new tables for routine heliox diving.

Objective To establish the animal model of chronic thromboembolic pulmonary hypertension(CTEPH) and to compare the accuracy of dual-energy CT (DECT) pulmonary angiography and histopathology for detecting CTEPH. Methods Eighteen canines were included in the study. All canines underwent paracentesis, embolization, CT scanning, pressure measurement and tranexamic acid feeding. The procedures were repeated every two weeks, until systolic/diastolic pressure in canines was≥30/15 mmHg or mean pulmonary artery pressure ≥ 20 mmHg.And then canines were sacrificed for histopathology examination. For CT pulmonary angiography (CTPA)in DE mode and DECT lung perfused blood volume (Lung PBV) images, the presence or absence of PE or perfusion defects were recorded on a per-canineand aper-lobe basis. With histopathological results as reference standard, the sensitivity, specificity of CTPA and lung PBV to detect PE were computed for two readers. The pairedχ2 test (McNemar test) was used to analyze the difference in diagnostic accuracy between CTPA and Lung PBV. Inter-reader agreement was also calculated with kappa test. Results CTEPH was demonstrated in 13 canines. On a per-canine basis, both readers found uneven and peripheral perfusion defects with DECT in 11 canines (84.6%, 11/13); while 5 canines (38.5%, 5/13) had cutoff or sudden stenosis of pulmonary arteries with CTPA;on a per-lobe basis,
both readers had sensitivities of 14.3%(5/35), 83.3%(30/36), specificities of 100.0%(30/30), 100.0%(29/29), accuracies of 53.8%(35/65), 90.8%(59/65)for CTPA and DECT, respectively. DECT had a higher sensitivity(χ2=-4.690,P<0.01)and accuracy(χ2=8.284,P<0.01) in detecting CTEPH. Excellent and moderate inter-reader agreements were observed with CTPA and DECT (Kappa=0.938, 0.572, both P<0.001). Conclusions It is feasible to make a CTEPH animal model with autologous thrombus. DECT shows a higher accuracy than CTPA to detect CTEPH in this canine model study.

Objective To observe the effect of aspirin intervention on thrombosis in lung cancer patients with peripherally inserted central catheter (PICC).Methods From December 2007 to June 2012,a total of 997 cases of lung cancer received PICC insertion in Shanghai Chest Hospital.The patients admitted from December 2007 to October 2011 were in the control group (n =562),while those admitted from November 2011to June 2012 were in the intervention group (n =435).The control group received conventional catheterization and saline tube sealing; the study group was treated with the modified Seldinger technique,oral administration of aspirin enteric tablets,and diluted heparin sodium tube sealing.Results The incidence of thrombosis was4.09％ (23/562) in the control group and 2.99％ (13/435) in the intervention group.In the control group,17 cases of thrombosis occurred within 1 week after catheter insertion,3 between 1 week to 1 month,and 3 after 1 month ; in the intervention group,4 cases of thrombosis occurred within 1 week after catheter insertion,5between 1 week to 1 month,and 4 after 1 month,presenting a significant difference compared with the control group (Z =-2.221,P =0.026).A significant intergroup difference was also observed in terms of thrombus location (Z =-2.066,P =0.039):in the control group,17 cases had thrombus in peripheral superficial vein,and 6 in supraclavicular vein or internal jugular vein; while in the intervention group,5 cases had thrombus in peripheral superficial vein,and 8 in supraclavicular vein or internal jugular vein.Conclusion The prophylactic oral administration of aspirin could effectively reduce the thrombosis in lung cancer patients treated with chemotherapy via PICC.

Objective To evaluate the value of dual energy CT with Lung Vessels application in diagnosing pulmonary embolism (PE) of children.Methods Forty-seven patients with nephrotic syndrome and aged ≤ 18 years old (32 male,15 female,mean age 15 years) underwent dual-energy CT pulmonary angiography (CTPA).Two radiologists recorded the presence or absence of emboli and counted the clots on a per-patient and per-lobe basis with Lung Vessels,respectively.With conventional CTPA as reference standard,sensitivity,specificity,positive predictive value (PPV),negative predictive value (NPV) of Lung Vessels application to detect PE were computed for two readers.Inter-reader agreement was also calculated.Results Conventional CTPA detected 51 clots in 35 lung lobes in 13 patients,giving PE incidence was 27.6％ (13/47) for this cohort.On a per-patient basis,readers 1 and 2 detected 25 and 21 patients with PE with Lung Vessels,corresponding to sensitivities,specificities,PPVs,and NPVs of 100.0％ (13/13),58.6％ (17/29),43.3％ (13/30),100.0％ (17/17) and 100.0％ (13/13),76.5％ (21/29),50.0％ (13/26),100.0％ (21/21),respectively.On a per-lung lobe basis,readers 1 and 2 detected 74 and 63 clots with Lung Vessels,respectively,corresponding to sensitivities,specificities,PPVs,and NPVs of 94.3％ (33/35),79.5％ (159/200),44.6％ (33/74),98.7％ (159/161) and 97.1％ (34/36),85.5％ (171/200),54.0％ (34/63),98.8％ (171/173),respectively.On a per-clot basis,134 and 105 clots were detected with Lung Vessels application,corresponding to sensitivities,specificities,PPVs,and NPVs for DECT of 96.1％ (49/51),64.9％ (159/245),36.3％ (49/135),98.7％ (159/161) and94.1％ (48/51),75.0％ (171/228),45.7％ (48/105),98.3％ (171/174)for readers 1 and 2,respectively.Excellent or good inter-reader agreement was observed on a per-patient,per-lobe and per-clot basis (Kappa =0.828,0.859,0.695 ; all P ＜ 0.01).Conclusions Dual-energyCT with Lung Vessels application has a high sensitivity and negative predictive value for PE detection in children.More clots are detected with Lung Vessels application than conventional CTPA,which deserve further investigation.

Background and purpose: Regional lymph node metastasis was significantly associated with the prognosis of patients with non-small cell lung cancer (NSCLC). This study was designed to compare paclitaxel liposome plus cisplatin (LP) with gemcitabine and cisplatin (GP) in patients with regional lymph node metastasis of advanced NSCLC as a ifrst-line treatment. Methods:A total of 55 patients were randomly assigned to receive either liposomal paclitaxel (175 mg/m2) and cisplatin (75 mg/m2) or gemcitabine (1 000 mg/m2) and cisplatin (75 mg/m2) every 3 weeks. Results:Objective response rate (ORR) of lung primary foci was 37.9%in the LP arm and 30.8%in the GP arm (P>0.05) and the disease control rate (DCR) was 91.3%and 80.8%respectively (P>0.05);ORR of regional metastasis lymph node was higher in the LP arm (44.8%vs 15.4%, P<0.05).There was no signiifcant difference in DCR (93.1%vs 73.1%, P=0.101), although slight trends favoring paclitaxel liposome were seen;There was signiifcant difference in median overall survival (17.0 vs 12.0 months, P<0.05). LP was associated with significantly less thrombocytopenia and gastrointestinal side effects (P<0.05), but no signiifcant difference was observed in hyphemia, leucopenia, hepatotoxicity, renal toxicity and allergic reactions (P>0.05). Conclusion: Liposomal paclitaxel plus cisplatin is superior to gemcitabine plus cisplatin with less toxicity and better tolerated, it deserves further research and clinic application for patients with regional lymph node metastasis of advanced NSCLC.