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 effects of perioperative goal-directed fluid therapy (GDFT) on hemodynamics, postoperative recovery, and complications in elderly patientswith gastric cancer radical surgery complicated by hypertension. Methods A total of 88 elderly patients with gastric cancer radical surgery complicated by hypertension were enrolled and randomly divided into treatment group and control group, with 44 patients in each group. The treatment group received GDFT during the perioperative period, while the control group received conventional fluid therapy. The mean arterial pressure, heart rate, and central venous oxygen saturation (ScvO₂) at different time points, as well as postoperative exhaust time, postoperative hospital stay, and postoperative complication rates were compared between the two groups. Results The time effects (F=60.488, 49.789, 39.423), intergroup effects (F=17.317, 12.969, 10.101), and interaction effects (F=26.415, 22.546, 17.294) of mean arterial pressure, heart rate, and ScvO₂ in the two groups showed statistically significant difference(P < 0.05). After surgery, the mean arterial pressure, heart rate, and ScvO₂ in the treatment group were higher than those before anesthesia and the control group (P < 0.05). The postoperative exhaust time and hospital stay in the treatment group were (2.25±0.61) and (10.29±1.96) days, respectively, which were shorter than (2.82±0.71) and (12.36±2.29) days in the control group (P < 0.05). The total incidence of postoperative complications in the treatment group was lower than that in the control group (11.36% versus 29.54%, P < 0.05). Conclusion Applying GDFT during the perioperative period for elderly patients with gastric cancer radical surgery complicated by hypertension can provide a more stable hemodynamic environment, improve tissue perfusion, accelerate postoperative recovery, and reduce postoperative complications.

Objective To explore the value of prophylactic anticoagulation in the 28-day prognosis of patients with severe COVID-19.Methods The clinical data of COVID-19 patients admitted to Guangdong Provincial People's Hospital from December 2022 to January 2023 were collected,including age,gender,past medical history,routine blood test,liver and renal function,procalcitonin,coagulation function,Padua prediction score,antiviral therapy,hormonotherapy,immunotherapy and anticoagulation therapy.The patients were divided into an anticoagula-tion group and a non-anticoagulation group.The differences in various indicators were compared between the two groups.Cox regression was performed to assess the independent risk factors for 28-day mortality and the anticoagula-tion efficacy between the subgroups.Results Among 158 patients,128 received anticoagulation;There were significant differences between the two groups in case number of hypertension and critical condition,lymphocyte count,prothrombin time,D-dimer,and case number of immunotherapy.COX logistic regression showed that antico-agulation(HR = 2.25,95%CI:1.01～5.01,P = 0.048)was an independent risk factor for all-cause mortality of COVID-19 patients within 28 days.Subgroup analysis showed that anticoagulation therapy led to an increase in the 28-day mortality as level of procalcitonin of≥0.5 pg/mL(HR = 2.72,95%CI:1.05～7.04)or D-dimer of<2 000 ng/mL(HR = 9.16,95%CI:1.63～51.48).Conclusions Prophylactic anticoagulation did not reduce all-cause mortality of COVID-19 within 28 days.

Cyclooxygenases play a vital role in inflammation and are responsible for the production of prostaglandins. Two cyclooxygenases are described, the constitutive cyclooxygenase-1 and the inducible cyclooxygenase-2, for which the target inhibitors are the non-steroidal anti-inflammatory drugs (NSAIDs). Prostaglandins are a class of lipid compounds that mediate acute and chronic inflammation. NSAIDs are the most frequent choices for treatment of inflammation. Nevertheless, currently used anti-inflammatory drugs have become associated with a variety of adverse effects which lead to diminished output even market withdrawal. Recently, more studies have been carried out on searching novel selective COX-2 inhibitors with safety profiles. In this review, we highlight the various structural classes of organic and natural scaffolds with efficient COX-2 inhibitory activity reported during 2011-2021. It will be valuable for pharmaceutical scientists to read up on the current chemicals to pave the way for subsequent research.

Nonalcoholic fatty liver disease (NAFLD) has become one of the most prominent causes of chronic liver diseases and malignancies. However, few therapy has been approved. Radix Bupleuri (RB) is the most frequently used herbal medicine for the treatment of liver diseases. In the current study, we aim to systemically evaluate the therapeutic effects of saikosaponin A (SSa) and saikosaponin D (SSd), the major bioactive monomers in RB, against NAFLD and to investigate the underlying mechanisms. Our results demonstrated that both SSa and SSd improved diet-induced NAFLD. Integrative lipidomic and transcriptomic analysis revealed that SSa and SSd modulated glycerolipid metabolism by regulating related genes, like

Objective To establish the three-dimensional (3D) finite element (FE) model of thoracolumbosacral T1-S spine based on the computed tomography (CT) images of patients with scoliosis and study its dynamic characteristics. Methods The established scoliotic model was validated by axial compression and shear loading, and the predicted responses were in good agreement with the experimental data. The modal and harmonic analyses were performed using the ABAQUS software, and during the harmonic analysis, the dynamic response of the model was collected at frequencies 5 Hz and 10 Hz. Results From the modal analysis, the first fourth-order modal was extracted. The first- and second-order resonant frequencies of the model were 1.097 Hz and 1.384 Hz, respectively, and the vibration mode was longitudinal bending and lateral bending, respectively. The distribution of the second- and third-order modal resonant frequencies were 5.688 Hz and 28.090 Hz, and the vibration mode was vertical vibration and twisting around the long axis, respectively. The peak amplitude in the harmonic analysis appeared near the modal frequencies, and the average amplitude of vertebral body of the lateral convex segment was larger than that of other segments of the scoliotic spine. Under the vibration frequencies of 5 Hz and 10 Hz, the stress inhomogeneously concentrated on the concave and convex sides of the segments of the vertebral deformity as well as on the intervertebral disc. Conclusions The segments of the spinal deformity in patients with scoliosis were the weak links of their spines and more vulnerable to damage in a vibrating environment. Patients with scoliosis should avoid a vibrating environment, particularly in a sensitive frequency range. The research outcomes provide methodological assistance and mechanical analysis references for the protection, rehabilitation treatment, and clinical pathological studies of patients with scoliosis.

BACKGROUND: Inherent modal analysis and harmonic response analysis on the human normal lumbosacral vertebraehave been reported, but there is a lack of comparative research on their modal analysis results before and after pediclescrew fixation.OBJECTIVE: To explore the dynamic characteristics of human lumbosacral vertebrae using three-dimensional finiteelement method.METHODS: Finite element model of lumbosacral vertebrae (L1-S1) before and after pedicle screw fixation was developedand validated based on CT images, and the modal analysis and harmonic response analysis were then conducted.RESULTS AND CONCLUSION: (1) Representative nodes were selected at the spinous process segments of L1, L3 andL5, and numbered as A, B, and C, respectively. (2) The maximum displacement of each node in Y and Z directions oflumbosacral vertebral model after internal fixation was significantly decreased compared with those of the normallumbosacral vertebral model, suggesting that screw fixation system plays a protective role in lumbosacral vertebrae, andreduces its amplitude under external load, thus diminishing its sensitivity to external load. (3) The lumbosacral vertebralmodal analysis can provide basis for further study on dynamic analysis, and the parameters such as natural frequency,modal shape and vibration amplitude of the lumbar spine have been determined.

Objective:To analyze clinical application of intra?aortic balloon pump in the treatment of septic shock.Methods:A total of 62 patients with septic shock in our hospital were assigned into the control group and the observation group according to digital table method, with 31 cases in each group. Patients in the control group were treated with conventional antishock method and patients in the observation group were given intra?aortic balloon pump therapy based on the treatment.Blood pressure, heart rate, urine volume and adverse event in the two groups were compared after treatment.Results:After treatment,blood pressure, heart rate and urine volume of the observation group were improved significantly compared with that in the control group (P<0.05).The overall incidence of adverse events in the observation group (16.13%) was significantly lower than that in the control group (45.16%) after treatment (P<0.05). Conclusion:Intra-aortic balloon pump therapy exerts obvious effect in the treatment of septic shock, significantly improves the patient??s blood pressure and heart rate, increases urine volume, causes less adverse events,and is safe and effective.

Objective To investigate the prognostic value of CD 4+CD25+/high CD127 low/-and CD14+HLA-DRlow/-for evaluating the severity of acute pancreatitis .Methods The percentages of CD4+CD25+/highCD127low/-and CD14+HLA-DRlow/-and the CD64 index were measured by flow cytometry in pa-tients with acute pancreatitis ( including 43 cases of mild acute pancreatitis and 24 cases of severe acute pan-creatitis).Moreover, the levels of C-reactive protein (CRP), acute physiology and chronic health evaluationⅡ( APACHEⅡ) score and CT severity index ( CTSI ) were detected for a correlation analysis .Results The percentages of CD4+CD25+/highCD127low/-and CD14+HLA-DRlow/-and the CD64 index in patients with severe and mild acute pancreatitis were significantly higher than those in healthy subjects .Patients with se-vere acute pancreatitis showed higher percentages of CD 14+HLA-DRlow/-than patients with mild acute pan-creatitis.With the disease progression, the CD64 index and the levels of CD4+CD25+/highCD127low/-, CD14+HLA-DRlow/-and CRP were significantly dropped after an initial increase in patients with mild acute pancrea -titis, while these indexes were continuously elevated in patients with severe acute pancreatitis .The percent-age of CD14+HLA-DRlow/-was positively correlated with CD64 index, CRP level, APACHEⅡ score and CTSI.Conclusion CD14+HLA-DRlow/-level was closely related to the severity of acute pancreatitis , which could be used as immune parameter for the estimation of the clinical severity of acute pancreatitis .

Objective To investigate the application of 3.0 MR for Gamma knife radios surgery(GKS) for treatment trigeminal neuralgia(TN) and the effect of 3.0 MR on therapy.Methods Sixty-two patients with TN underwent GKS,between May 2005 to June 2011 at Wanjie Hospital were included as our subjects.3.0MR 3-D FIESTA sequence scan were performed before treatment,during treatment 3.0MR orientation guided to select the trigeminal neuralgia (TN) brain cistern segment target spot.The 4 mm collimator was used and the maximum dose was to 70-90 Gy.Results The followed up periods was 6-36 months,total effective rate was 92 ％,the total alleviate cases was 51 part for 8 cases,none for 3,ipsilateral facial numbness,tinnitus,masticatory muscle weakness was found.Conclusion 3.0MR can clearly display trigeminal neuralgia and duty blood vessel,nicety orientation TN root,and then enhance GKS treatment TN rate,as well as avoid complication.