Objective To analyze the risk factors for hypothermia during modified radical mastectomy,and construct a nomogram model for predicting the occurrence of hypothermia during modified radical mastectomy based on the risk factors.Methods A total of 383 patients received modified radical mastectomy admitted to our hospital were selected and divided into the hypothermia group(n=58)and the normal group(n=325)according to whether hypothermia occurred.The clinical data of the patients were collected,and the univariate analysis and Logistic regression analysis were used to screen out the independent risk factors for intraoperative hypothermia,and a risk nomogram model for predicting intraoperative hypothermia was constructed by R software and verified.Results There were statistically significant differences in the hypothyroidism,preoperative basal body temperature,intraoperative room temperature,operation time,anesthesia time,intraoperative blood loss,and intraoperative infusion between the two groups(P<0.05).The hypothyroidism(OR=2.156,95%CI:1.158～4.016,P=0.015),abnormal preoperative basal body temperature(OR=2.451,95%CI:1.309～4.588,P=0.005),intraoperative room temperature<23℃(OR=2.027,95%CI:1.085～3.786,P=0.027),operation time>2 hours(OR=2.316,95%CI:1.239～4.327,P=0.008),anesthesia time>3 hours(OR=2.264,95%CI:1.206～4.252,P=0.011),intraoperative infusion volume>1 500 mL(OR=2.895,95%CI:1.543～5.432,P=0.001)were the independent risk factors for the occurrence of intraoperative hypothermia.The nomogram model showed that the score of intraoperative infusion volume>1 500 mL was 100 points,hypothyroidism was 93 points,anesthesia time>3 hours was 85 points,intraoperative room temperature<23℃was 84 points,operation time>2 hours was 79 points,and abnormal preoperative basal body temperature was 75 points.The nomogram model verification results demonstrated that the C-index was 0.834;the H-L goodness-of-fit test showed χ2=11.854 and P=0.078;the calibration curve was close to the ideal curve;the area under the receiver operating characteristic curve was 0.812;and the net benefit value was high at the threshold probability from 5%to 70%.Conclusion The nomogram model constructed in this study can more accurately and reliably predict the risk of hypothermia occurring during modified radical mastectomy,which meets the clinical need for an integrated model and helps to promote the steady development of individualized medicine.

The inflammatory effect of dietary is strongly related to the development of cancer,therefore,the diet-related inflammatory index was developed as a methodological tool to investigate the relationship between dietary,inflammation and tumors.In this paper,we summarized the results on diet-related inflammatory indices and common cancers of the digestive system based on relevant cancer epidemiological studies.The available epidemiological evidence suggests that pro-inflammatory diet is associated with an increased risk of gastrointestinal malignancies,with the strongest association with colorectal cancer,followed by esophageal and gastric cancers,and then pancreatic cancer,and the least evidence of studies with liver cancer.Among these studies,the level of evidence for esophageal cancer is lower than colorectal cancer,the study of gastric cancer has gender differences and problems in adjusting for confounders,and the study of pancreatic cancer has heterogeneous results.In view of the current research progress and deficiencies,prospective studies or population-based cohort studies,as well as strengthening nutritional epidemiological studies related to common tumors such as liver cancer could be considered in the future.This review is expecting to provide basic information and scientific basis for strengthening the related healthy eating behavior promotion in the prevention and control of digestive system tumors.

Objective To investigate the mechanism of Bushen Yixin Tablets in the treatment of diabetic nephropathy(DN).Methods The key targets of Bushen Yixin Tablets for the treatment of DN were predicted by network pharmacology.A high-glucose-processed MPC-5 cell model was constructed,enzyme-linked immunosorbent assay(ELISA),real-time quantitative polymerase chain reaction(RT-qPCR)and Western Blot were applied to verify the potential action targets and pathways of Bushen Yixin Tablets for the treatment of DN.Results Twenty-four active ingredients were obtained from Bushen Yixin Tablets.There were 131 targets involved in the treatment of DN by Bushen Yixin Tablets,and the results of pathway enrichment analysis showed that the key targets might mainly focus on inflammatory pathways,lipids and atherosclerosis.The further experimental validation showed that,compared with the high glucose group,the secretion level of matrix metalloproteinase 1(MMP-1)in the supernatant of MPC-5 cells in the medium-and high-dose groups of Bushen Yixin Tablets medicated serum were increased(P＜0.001),and the secretion levels of tissue inhibitor of metalloproteinase 1(TIMP-1)and transforming growth factor β1(TGF-β1)were decreased(P＜0.001).Compared with the high glucose group,the protein and mRNA expression levels of MMP1 and BCL-2 in the high-dose group of Bushen Yixin Tablets medicated serum were increased(P＜0.001),and the protein and mRNA expression levels of phosphatidylinositol 3-kinase(PI3K)and protein kinase B(AKT)were decreased(P＜0.001).Conclusion Bushen Yixin Tablets may play a protective role against DN by inhibiting the proliferation of glomerular mesangial cells and promoting the degradation of extracellular matrix through PI3K/AKT/BCL-2 pathway.

Near infrared spectroscopy(NIRS)has emerged as an indispensable analytical technology for quality monitoring in industrial and agricultural production.It is widely used in quantitative analysis in areas such as food,agriculture and medicine.To meet the requirements of industrial and agricultural production,it is particularly important to develop a NIRS quantitative analysis model that can predict the multicomponent of different samples.In this study,the multicomponent quantitative analysis model of NIRS based on convolution neural network(MulCoSpecNet)was proposed.MulCoSpecNet was composed of an encoding and decoding module,an expert module,a gate module,a multicomponent quantitative prediction module,and a hyperparameter optimizer.The spectral noise and random errors were mitigated,and the signal-to-noise ratio was enhanced through up-sampling and down-sampling in the encoding and decoding module.Diverse weightings were employed by the expert module and gate module to construct distinct sub-spectra.The model prediction accuracy and generalization ability were enhanced by the multicomponent quantitative prediction module,which employed convolutional and pooling operations.The hyperparameters in the hyperparameter space were synchronously optimized by the hyperparameter optimizer.By taking public NIRS datasets of grain and corn as examples,the prediction results of MulCoSpecNet were compared with partial least squares(PLS),extreme learning machine(ELM),support vector regression(SVM)and back propagation neural network(BP).The results showed that compared to PLS,the prediction accuracy of MulCoSpecNet to grain and corn were increased by 25.5%?45.2%and 10.0%?35.7%,respectively.Compared to ELM,the prediction accuracy of MulCoSpecNet were increased by 17.8%?38.6%and 18.2%?37.2%,respectively.Compared to SVM,the prediction accuracy of MulCoSpecNet were increased by 33.6%?47.0%and 31.3%?50.7%,respectively.Compared to BP,the prediction accuracy of MulCoSpecNet were increased by 2.0%?58.5%and 29.6%?48.6%,respectively.The issues of low prediction accuracy and poor generalization ability were effectively solved by the MulCoSpecNet,which was a NIRS multicomponent prediction model based on convolutional neural network.It provided a theoretical foundation for establishing non-destructive and high-precision NIRS multicomponent quantitative analysis model.

Objective To analyze the risk factors of gastrointestinal bleeding in patients with type A aortic dissection(TAAD)after Sun's operation.Methods The clinical data of 87 patients who underwent TAAD Sun's operation in our hospital from March 2021 to June 2022 were retrospectively analyzed.They were divided into the bleeding group and the non-bleeding group according to whether there was gastrointestinal bleeding after operation.The clinical data of patients in the two groups was compared and analyzed.The binary Logistic regression analysis was used to analyze the risk factors of gastrointestinal bleeding.The clinical predictor of postoperative gastrointestinal bleeding was analyzed by receiver operating characteristic(ROC)curve.Results In this study,there were 40 cases of postoperative gastrointestinal bleeding(the bleeding group)and 47 cases of non-bleeding(the non-bleeding group).Compared with the non-bleeding group,the bleeding group had a shorter onset time,a higher proportion of patients with hypertension history,a higher preoperative creatinine abnormality rate,more intraoperative blood loss,longer postoperative mechanical ventilation time,higher postoperative infection rate,and higher poor prognosis rate,with statistically significant differences(P<0.05).There was no statistically significant difference in the gender,age,gastrointestinal diseases history,smoking history,preoperative platelets,preoperative international normalized ratio(INR),preoperative alanine aminotransferase(ALT),preoperative aspartate aminotransferase(AST),preoperative γ-glutamyl transpeptidase(GGT),preoperative dissection involving abdominal aorta,operation time,intraoperative cardiopulmonary bypass time,intraoperative circulatory arrest time,intraoperative aortic occlusion time or intraoperative blood transfusion rate.Logistic regression analysis showed that hypertension history(OR=2.468,95%CI:0.862 to 7.067,P=0.037),preoperative creatinine>105 μmol/L(OR=3.970,95%CI:1.352 to 11.659,P=0.011),long postoperative mechanical ventilation time(OR=1.015,95%CI:0.094 to 1.018,P=0.041)and postoperative infection(OR=3.435,95%CI:0.991 to 11.900,P=0.012)were the independent risk factors for postoperative gastrointestinal bleeding in TAAD patients.ROC curve showed that the postoperative mechanical ventilation time exceeding 64 hours were the clinical predictor of postoperative gastrointestinal bleeding in TAAD patients.Conclusion The prognosis of TAAD patients with postoperative gastrointestinal bleeding after Sun's operation is poor.Hypertension history,preoperative acute renal insufficiency,long postoperative mechanical ventilation time and postoperative infection are closely related to postoperative gastrointestinal bleeding in TAAD patients after operation,which should be paid more attention to,and corresponding evaluation,early identification and early intervention should be made to improve the prognosis of patients.

Objective To compare therapeutic efficacy of anticoagulation alone and combining with intervention for treating severe cerebral venous thrombosis(CVT).Methods Data of 65 severe CVT patients were retrospectively analyzed.The patients were divided into anticoagulation group(n=32)or combined group(n=33)according to therapeutic methods.The modified Rankin scale(mRS)score at admission and discharge,the prognosis of patients,vascular recanalization rate as well as incidence of complications during follow-up period were compared between groups.Results No significant difference of mRS scores at admission was found between groups(P＞0.05),while mRS scores of combined group were lower than of anticoagulation group at discharge(P＜0.05).The rate of good prognosis at discharge(84.85%vs.59.38%),6 months after discharge(87.88%vs.65.63%)and 12 months after discharge(93.94%vs.75.00%)in combined group were all higher than those in anticoagulation group(all P＜0.05).The vascular recanalization rate in combined group was higher than that in anticoagulant group(100%vs.75.00%,P＜0.05).At the end of follow-up,no significant difference of complication incidence was found between groups(15.15%vs.18.75%,P＞0.05).Conclusion For patients with severe CVT,anticoagulation combined with interventional therapy could significantly alleviate clinical symptoms and improve prognosis compared with anticoagulation alone.

Objective To observe the value of stent implantation for treating idiopathic intracranial hypertension(IIH)complicated with venous sinus stenosis(VSS).Methods Data of 54 patients with IIH complicated with VSS who underwent stent implantation were retrospectively analyzed.The papillary edema grade,lumbar puncture-opening pressure(LP-OP)and trans-stenotic pressure gradient of venous sinus(ΔP)before and after stent implantation were compared,and the symptom improvement and treatment-related complications during the follow-up period were recorded.Results Totally 60 stents were successfully implanted in 54 patients.Before stent implantation,the papillary edema grade was 3(3,3),LP-OP was(391.39±92.62)mmH2O and the ΔP was 18.50(15.00,25.00)mmHg,which decreased to 1(0,1),(208.80±62.31)mmH2O and 1.25(0.88,2.55)mmHg after stent implantation,respectively,all with significant differences(all P＜0.001).Clinical symptoms improved after stent implantation in all 54 patients.At the end of follow-up,disappearance of headache,papillary edema,visual disorder,abducent nerve paralysis and tinnitus were noticed in 30(30/37,81.08%),38(38/45,84.44%),41(41/45,91.11%),8(8/10,80.00%)and 9 cases(9/10,90.00%),respectively.Treatment-related complications occurred in 4 cases(4/54,7.41%),all improved after intervention.Conclusion Stent implantation was effective and safe for treating IIH complicated with VSS.

Background/Aims: Chronic hepatitis C (CHC) patients who failed antiviral therapy are at increased risk for hepatocellular carcinoma (HCC). This study assessed the potential role of metformin and statins, medications for diabetes mellitus (DM) and hyperlipidemia (HLP), in reducing HCC risk among these patients. Methods: We included CHC patients from the T-COACH study who failed antiviral therapy. We tracked the onset of HCC 1.5 years post-therapy by linking to Taiwan’s cancer registry data from 2003 to 2019. We accounted for death and liver transplantation as competing risks and employed Gray’s cumulative incidence and Cox subdistribution hazards models to analyze HCC development. Results: Out of 2,779 patients, 480 (17.3%) developed HCC post-therapy. DM patients not using metformin had a 51% increased risk of HCC compared to non-DM patients, while HLP patients on statins had a 50% reduced risk compared to those without HLP. The 5-year HCC incidence was significantly higher for metformin non-users (16.5%) versus non-DM patients (11.3%; adjusted sub-distribution hazard ratio [aSHR]=1.51; P=0.007) and metformin users (3.1%; aSHR=1.59; P=0.022). Statin use in HLP patients correlated with a lower HCC risk (3.8%) compared to non-HLP patients (12.5%; aSHR=0.50; P<0.001). Notably, the increased HCC risk associated with non-use of metformin was primarily seen in non-cirrhotic patients, whereas statins decreased HCC risk in both cirrhotic and non-cirrhotic patients. Conclusions Metformin and statins may have a chemopreventive effect against HCC in CHC patients who failed antiviral therapy. These results support the need for personalized preventive strategies in managing HCC risk.

Objective To analyze the changes in the ratio of helper T cell 17 to regulatory T cells (Th17/Treg), serum ferritin (SF), microRNA-145 (miR-145), and microRNA-132 (miR-132) levels in breast cancer patients and their relationships with pathological parameters. Methods A total of 92 breast cancer patients from January 2022 to December 2023 were enrolled as study group, and 105 patients with benign breast diseases during the same period were selected as control group. Changes in SF, miR-132, Th17/Treg, and miR-145 were compared between the two groups, and the diagnostic value of these indicators for breast cancer was analyzed. Results Compared with the control group, the study group had higher peripheral blood Th17/Treg and serum SF levels, and lower serum miR-145 and miR-132 expression levels (P < 0.05). Patients with tumor diameters >2 cm, clinical stages of Ⅲ to Ⅳ, moderately or poorly differentiated tumors, and lymph node metastasis had lower serum miR-145 and miR-132 expression levels than those with tumor diameters ≤2 cm, clinical stages of Ⅰ to Ⅱ, highly differentiated tumor, and no lymph node metastasis (P < 0.05). Compared with patients with clinical stages of Ⅰ to Ⅱ, highly differentiated tumors, and no lymph node metastasis, those with clinical stages of Ⅲ to Ⅳ, moderately or poorly differentiated tumors, and lymph node metastasis had higher serum SF levels (P < 0.05). Patients with lymph node metastasis had higher Th17/Treg levels than those without (P < 0.05). The area under the curve (AUC) for combined detection of Th17/Treg, SF, miR-145, and miR-132 levels in breast cancer patients was higher than that for individual detection (P < 0.05), with higher sensitivity and specificity. Conclusion Th17/Treg, SF, miR-145, and miR-132 are abnormally expressed in the blood of breast cancer patients and are correlated with their pathological parameters. Combined detection of these four indicators has higher value in the clinical diagnosis of breast cancer.

OBJECTIVE: To investigate the effect of treatment of Müller A fracture of distal femur with small incision internal fixation assisted by homeopathic bidirectional-traction reduction device. METHODS: From January 2018 to December 2019, 22 patients (14 males and 8 females) with Müller type A distal femoral fractures were treated with homeopathic bidirectional-traction assisted reduction and minimally invasive small incision locking plate internal fixation;The age ranged from 29 to 58 years old with an average of (41.23±7.03) years. The time from injury to operation was 1 to 7 days with an average of (3.41±1.71) days. According to Müller classification, there were 4 cases of type A1, 10 cases of type A2, and 8 cases of type A3. The postoperative knee joint function was evaluated by Schatzker Lambert fracture criterion of distal femur. RESULTS: All the incisions healed in one stage without infection, osteomyelitis and other complications. All the fractures healed without malunion and nonunion. All of 22 patients were followed up for 12 to 18 months with an average of (14.50±2.02) months. The healing time was 3 to 6 months with an average of (4.64±1.14) months. According to Schatzker Lambert criteria for distal femoral fracture, 12 cases were excellent, 6 good, and 4 medium. CONCLUSION It is an ideal method to treat Müller type A fracture of distal femur with homeopathic bidirectional-traction assisted reduction device and minimally invasive small incision locking plate internal fixation.
Male ; Female ; Humans ; Adult ; Middle Aged ; Femoral Fractures/surgery* ; Femoral Fractures, Distal ; Traction ; Treatment Outcome ; Fracture Fixation, Internal/methods* ; Bone Plates