Purpose To explore the value of CT-based radiomics in the preoperative prediction of lymphatic invasion of node-negative gastric cancer,and to construct a nomogram combined with clinical variables.Materials and Methods The clinical and CT imaging data of 173 gastric cancer patients with lymph node negative and pathologically confirmed gastric cancer in the Sir Run Run Shaw Hospital from January 2019 to June 2021 were retrospectively analyzed.A total of 60 cases with lymphovascular invasion(LVI)positive patients and 113 cases with LVI negative patients were included,and randomly divided into train cohort(n=121)and test cohort(n=52)at 7∶3.Based on the train cohort,the clinical model,the radiomics model,the fusion model were constructed and verified in the test cohort.Clinical data and conventional CT features included age,gender,tumor marker,tumor location,tumor morphology,enhancement range,etc.The clinical significant variables were selected through univariate and multivariate analysis to establish the clinical model.The tumor regions of interest were segmented and radiomics features were extracted by using the 3D-Slicer software.Key features were screened through least absolute shrinkage and selection operator regression analysis,and then the radiomics model was constructed with random forest algorithm,and converted to random forest score(RF score).The fusion model was constructed via combining clinical significant variables and RF score,and visualized as a nomogram.The receiver operator characteristic curve and area under curve(AUC)were used to evaluate the prediction performance of the models.Decision curve analysis was used to calculate the clinical practicability.Results The radiomics model was superior to the clinical model.The radiomics model AUC of the train cohort and the test cohort were 0.872(0.810 to 0.935)and 0.827(0.707 to 0.947),the clinical model AUC were 0.767(0.682 to 0.852)and 0.761(0.610 to 0.913).The nomogram further improved the predictive efficiency,the AUC in train cohort and test cohort reached 0.898(0.842 to 0.953)and 0.844(0.717 to 0.971),respectively.Decision curve analysis demonstrated clinical benefits of nomogram.Conclusion The radiomics model can be used to preoperatively predict LVI of node-negative gastric cancer.The nomogram can further improve the prediction efficiency.

Objective:Based on the principle of neuroplasticity, to explore the effect of square dancing on elderly patients with subjective cognitive decline (SCD).Methods:SCD patients in the main urban area of Nanjing were selected in this quasi experimental research from March to September 2022 and divided into experimental group and control group according to whether the subjects were willing to participate in square dance intervention, with 30 cases in each group. The experimental group received 6 months of square dancing intervention, and the control group received routine nursing. The differences of cognition, memory, language, executive ability, daily living ability and anxiety and depression were compared between the two groups.Results:Twenty-seven cases in the experimental group and 28 cases in the control group completed the intervention. After intervention, the scores of Montreal Cognitive Assessment Scale-15, the Geriatric Depression Scale, Hamilton Anxiety Scale and Trail Making Test B were 27.0(26.0, 28.0), 2.0(1.0, 4.0), (4.30 ± 2.04) points and (112.48 ± 25.42) seconds, respectively. Compared with the control group of 26.0 (24.0, 27.0), 4.0 (2.0, 5.8), (5.89 ± 1.45) points and (133.21 ± 32.39) seconds, the differences were statistically significant ( Z = -2.24, -2.72, t = - 2.05, -2.64, all P<0.05). Conclusions:Square dancing can improve the cognitive function of elderly patients with SCD, promote the improvement of memory, language, executive function and daily living ability, and effectively relieve anxiety and depression symptoms.

[Objective] To investigate the evolution of inflammation under conditions and the effects of ginsenosides on macrophages subjected to the simulated weightlessness, with the aim of mitigating the inflammation. [Methods] Initially, genes related to weightlessness, inflammation, and immunity were identified in the GeneCards database. Then, Search Tool for the Retrieval of Interaction Gene/Proteins (STRING) protein network analysis was conducted to determine the core targets involved in the weightlessness-induced inflammation. Subsequently, Label-Free Quantitative (LFQ) proteomics was carried out to discern the distinctive genes within ginsenoside-treated Tohoku Hospital Pediatrics-1 (THP-1) cells. Next, utilizing the outcomes of Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses, the biological processes and signaling pathways in which ginsenosides predominately engaged were scrutinized, and the primary targets of ginsenosides in combating weightlessness-induced inflammation were examined. Finally, enzyme-linked immunosorbent assay (ELISA) was performed to detect the secretion levels of interleukin (IL)-1β, IL-6, IL-8, and tumor necrosis factor (TNF)-α from lipopolysaccharide (LPS)-induced THP-1 cells under simulated weightlessness conditions, as well as during the weightlessness recovery period following treatment with ginsenosides. [Results] A total of 2 933 genes associated with inflammation, 425 genes linked to weightlessness, and 4 564 genes connected to immunity were retrieved from the GeneCards database. Protein-protein interaction (PPI) networks were generated to identify pivotal targets associated with weightlessness-induced inflammation such as IL-1β, IL-6, TNF, and albumin (ALB). It was found that ginsenosides primarily participated in the regulation of various inflammationrelated signaling pathways and pathways related to pathogenic microorganism infections. Moreover, it has a significant impact on the expression of proteins such as cluster of differentiation 40 (CD40), IL-1β, and poly ADP-ribose polymerase 1 (PARP1). As revealed in the simulated weightlessness cell test, ginsenosides exhibited a remarkable capacity to attenuate the secretion of inflammatory factors, specifically IL-6 and TNF-α (P < 0.000 1), in THP-1 macrophages following induction by LPS under simulated weightlessness conditions. In addition, it reduced the secretion of IL-1β, IL-6, IL-8, and TNF-α (P < 0.000 1) during the weightlessness recovery phase [Conclusion] Weightlessness can disrupt several inflammation-related signaling pathways, but ginsenosides were shown to mitigate the release of various inflammatory factors in macrophages subjected to simulated weightlessness, thereby exerting a protective role against inflammation. This study has laid a theoretical groundwork for further exploring the potential application of ginsenosides in safeguarding against LPS induced inflammation in a weightlessness environment.

Objective To discuss the cause and treatment strategy for open laryngotracheal trauma.Methods The clinical data of 38 cases with open laryngotracheal trauma admitted from 1998 to 2012 were collected and analyzed.Of them,one patient died in emergency department despite energetic resuscitation,37 were hospitalized and given advanced treatment after life support measures in emergency department.They were treated with tracheotomy before or during operation.Of them,32 patients were regularly followed up for imaging studies.Result Except 1 patient died of exsanguination from carotid artery rupture,the other 37 survived after successful treatment.Twenty patients were treated with debridement and suture of the wounds and laryngoplasty (20/37,54.1％),8 patients were operated with laryngoplasty plus intraluminal stents implanted (8/37,21.6％) ; the rest 9 patients (9/37,24.3％) were separately given placement of nickel-titanium shape memory alloy stent (n =2),laryngofissure with rubber gloves throat models implanted and laryngoplasty (n =3),linear silicone tube implanted and laryngoplasty with trans-cervical approach (n =1) and tracheoesophageal fistula neoplasty with laryngoplasty and laryngofissure (n =3).The operated patients were followed-up for 0.5 to 3 years after discharge.Of them,35 patients (35/37,94.6％) had successful decannulation,breathing smoothly and swallowing normally,23 patients (23/37,62.2％) had almost normal pronunciation,12 patients (12/37,32.4％) had different degrees in hoarseness of voice,and 2 patients (2/37,5.4％) were referred to other hospital because of failure in extubation with severe stenosis of laryngotrachea.Conclusions When the patients with open laryngotracheal trauma were treated,the essential strategy was to prevent shock,hemorrhage,and asphyxia.In the case of patent respiratory tract and stable vital signs,laryngotracheal reconstruction should be carried out as soon as possible to prevent complications,thereby obtaining good therapeutic effect.

Objective To observe the effect of one-lung ventilation (OLV) on cerebral oxygen balance and energy metabolism during total intravenous anesthesia for thoracoscopic surgery.Methods Thirty patients scheduled for thoracoscopic surgery were selected.After inducing and intubating,patients were assigned to maintenance of anesthesia with propofol by target controlled infusion in order to maintain a bispectral index(BIS) between 40 and 60,and end-tidal partial pressure of carbon dioxide (PETCO2) between 30mmHg and 35mmHg.Mean arterial pressure (MAP),heart rate (HR),SpO2,PetCO2,cerebral blood flow velocity (CBFv),BIS value and nasopharyngeal temperature(NPT) were measured,always with the patients in the lateral position,in four phases:10min after beginning twolung ventilation (TLV),15 min after beginning OLV (OLV + 15),30min after beginning OLV (OLV + 30) and 60 min after beginning OLV(OLV + 60).Blood samples were drawn simultaneously and analyzed within 5min.The Da-jvO2,CERO2,CMRO2,Da-jvLac and Da-jvGlu at each phase were calculated.Results In all patients,a decrease in PaO2 [(172±85) vs (428±42);(162±54) vs (428±42);(185±61) vs (428±42)] and MAP [(70±10) vs (81 ±11) ; (71 ± 12) vs (81 ± 11)] occurred during OLV (t =15.02,13.14,23.25,20.16,18.02,all P ＜ 0.05).SjvO2 at the phase:OLV + 15 and OLV + 30 were significantly lower than those at TLV [(54.0 ± 1.2) ％ vs (65.0 ± 0.8) ％ ;(55.0±1.5)％ vs (65.0 ±0.8)％] (t =3.12,2.14,all P＜0.05).Ca-jvO2[(50 ± 12)％ vs(40 ± 12)％ ;(54±11)％ vs (40 ± 12)％],CMRO2 [(186 ±40) vs (162 ± 35);(191 ±24) vs (162 ±35)]and CERO2 [(36 ± 12) vs (30 ± 1 1) ; (35 ± 10) vs (30 ± 11)] atthephase:OLV + 15 andOLV + 30weresignificantlyhigher than those at TLV (t =5.23,4.28,1.86,2.01,8.21,10.11,all P ＜ 0.05).After OLV,Da-jvGlu [(0.45 ± 0.10) vs (0.22 ± 0.30) ; (0.52 ± 0.20) vs (0.22 ± 0.30) ; (0.40 ± 0.20) vs (0.22 ± 0.30)] significantly increased (t =6.45,12.03,15.10,all P ＜ 0.05).The differences of Da-jvLac and CBFv at every phase were not significant (P ＞0.05).Conclusion During total intravenous anesthesia,OLV resulted in an increase of consumption of cerebral oxygen and energy.It may be not good for cerebral oxygen balance and energy metabolism.The efficient prevention is necessary clinically.