PURPOSE: To analyze risk factors for severe trauma and establish a nomogram for early risk prediction, to improve the early identification of severe trauma. METHODS: This study was conducted on the patients treated in 81 trauma treatment institutions in Gansu province from 2020 to 2022. Patients were grouped by year, with 5364 patients from 2020 to 2021 as the training set and 1094 newly admitted patients in 2020 as the external validation set. Based on the injury severity score (ISS), patients in the training set were classified into 2 subgroups of the severe trauma group (n = 478, ISS scores ≥25) and the non-severe trauma group (n = 4886, ISS scores <25). Univariate and binary logistic regression analyses were employed to identify independent risk factors for severe trauma. Subsequently, a predictive model was developed using the R software environment. Furthermore, the model was subjected to internal and external validation via the Hosmer-Lemeshow test and receiver operating characteristic curve analysis. RESULTS: In total, 6458 trauma patients were included in this study. Initially, this study identified several independent risk factors for severe trauma, including multiple traumatic injuries (polytrauma), external hemorrhage, elevated shock index, elevated respiratory rate, decreased peripheral oxygen saturation, and decreased Glasgow coma scale score (all p < 0.05). For internal validation, the area under the receiver operating characteristic curve was 0.914, with the sensitivity and specificity of 88.4% and 87.6%, respectively; while for external validation, the area under the receiver operating characteristic curve was 0.936, with the sensitivity and specificity of 84.6% and 93.7%, respectively. In addition, a good model fitting was observed through the Hosmer-Lemeshow test and calibration curve analysis (p > 0.05). CONCLUSION This study establishes a nomogram for early risk prediction of severe trauma, which is suitable for primary healthcare institutions in underdeveloped western China. It facilitates early triage and quantitative assessment of trauma severity by clinicians prior to clinical interventions.
Humans ; Nomograms ; Male ; Female ; Wounds and Injuries/diagnosis* ; Risk Factors ; Middle Aged ; Adult ; Injury Severity Score ; Risk Assessment ; ROC Curve ; Aged ; Logistic Models ; China ; Glasgow Coma Scale

Objective:To explore the value of the elasticity contrast index (ECI) in differential diagnosis of thyroid nodules, and contrast the effect of 4 different methods on measuring ECI.Methods:A total of 122 patients with 131 thyroid nodules in Binzhou Medical University Hospital from May 2018 to May 2019 were enrolled, and elastography was performed in 4 different ways such as in axial plane for internal (AI), axial plane for periintranodular (AP), longitudinal plane for internal (LI) and longitudinal plane for periintranodular (LP). The cut-off values for predicting malignant nodules in 4 different ways were determined separately using receiver operating characteristic (ROC) curve analysis.Results:There were 54 benign and 77 malignant ones in 131 nodules. The ECI in AI, AP, LI and LP in benign thyroid nodules was significantly lower than that in malignant ones: 2.10 (1.48, 2.34) vs. 3.07 (2.73, 3.87), 1.91 (1.64, 2.18) vs. 2.62 (2.24, 3.07), 2.19 (1.59, 2.39) vs. 3.00 (2.72, 3.63) and 1.89 (1.71, 2.16) vs. 2.66 (2.21, 3.10), and there was statistical difference ( P<0.05). Among the 4 different ways, the largest area under curve was achieved in AI with 0.925, and the corresponding optimal diagnostic threshold was 2.43 (with 90.9% sensitivity, 87.0% specificity, 88.5% accuracy, 89.7% positive predictive value and 86.8% negative predictive value). Conclusions:ECI is helpful for conventional ultrasound to diagnose thyroid nodules as malignant or benign. The best value is obtained in AI.

Objective To compare the clinical efficacy and safety of carbon dioxide (CO2) versus high-frequency electroacupuncture based on the assistance of drilling and blunt dissection in the treatment of steatocystoma multiplex.Methods A randomized,self-controlled study was performed in 15 patients.The median line of the body served as the dividing line,and the lesions on the two sides of the median line of the body were randomly divided into 2 groups to be treated with CO2 laser or high-frequency electroacupuncture,which left micropathways into the cyst cavity.After the above treatment,contents in the cysts were squeezed out or drawn out with a mosquito clamp,and the cysts were bluntly dissected.The decrustation time,erythema subsiding time,adverse reactions and recurrence were compared among lesions at different sites or with different sizes.Results For the lesions at the same sites or with similar sizes after treatment,the decrustation time and erythema subsiding time were both significantly shorter in the CO2 laser group than in the high-frequency electroacupuncture group (both P ＜ 0.05).There were significant differences in the decrustation time and erythema subsiding time among lesions at different sites or with different sizes (all P ＜ 0.05).Mild pain occurred in the 2 groups,and no hematoma or secondary infection occurred.There were significant differences in the incidence of scar formation or pigmentation between the 2 groups (both P ＜ 0.05).During the follow-up of 6-18 months,relapse occurred in 1 patient in each group.Conclusion Compared with the high-frequency electroacupuncture,CO2 laser assisted by drilling and blunt dissection shows better efficacy in the treatment of steatocystoma multiplex,and it can remove lesions at various sites at one time.

Objective: To compare the efifcacy and safety of sirolimus-eluting stent (SES) and everolimus-eluting stent (EES) for treating the patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS). Methods: A total of 400 NSTE-ACS patients treated in Jining Medical College Hospital from 2013-09 to 2014-09 were studied. According to different stents, the patients were divided into 2 groups: SES group,n=220 and EES group,n=180. A prospective follow-up study was conducted for 1.5 years to compare the incidence rate of major adverse cardiovascular events (MACE). The patients were further stratiifed by GRACE scores as Low risk group (score<109), Medium risk group (score 109-140) and High risk group (score>140). MACE free survival was studied by Kaplan-Meier curve and analyzed by Long-rank test, predictive value of GRACE for 1.5 year MACE incidence rate was examined. Results: There were 355/400 (89%) patients completed (16.7 ± 5.7) months of follow-up study including 205 in SES group and 150 in EES group. MACE occurrence rates were similar between SES group and EES group (16.10% vs 18.0%), P>0.05. By GRACE score stratiifcation, MACE rates in High risk SES group were higher than High risk EES group (48.00%vs 16.00%),P<0.05; while they were similar between Medium risk groups (14.49% vs 28.00%) and Low risk groups (9.11% vs 12.86%), allP>0.05. ROC curve indicated that the predictive value of GRACE score for 1.5 year MACE incidence was for AUC=0.762, 95% CI (1.026-1.050),P<0.001. Conclusion: Implanting of EES would be more beneifcial for NSTE-ACS patients with high GRACE risk; GRACE score has the better predictive value for their long-term prognosis.

Objective To analyze the willingness and influencing factors for usage of pre-exposure prophylaxis(PrEP) among male students who have sex with men (MSM) in universities of Guangxi. Meth-ods 295 MSM students in universities were recruited by Snow-balling methods. Questionnaires were self-administered to collect social demographic information,AIDS related risky sexual behaviors and willingness for usage of PrEP. Logistic regression was employed for univariate and multivariate analysis. Results Of the 295 MSM,58(19.7%)had ever heard PrEP,265(89.8%) said that they would like to use PrEP. Multivari-ate logistic regression analysis showed that those who had found partners through friends ( OR=11.419,95%CI:1.363~95.641), those who would advise his friend to use PrEP ( OR=87.946,95%CI:13.660-566. 222),those who concerned the convenience to gain the medicine ( OR=119.652,95%CI:3.765-3802.184) and those who said that they could take medicine every day ( OR=88.245,95%CI:10.237-760.696) were more likely to accept PrEP. The subjects whose partners would be angry if they stick to use condoms( OR=0.106,95%CI:0.019-0.606),and those who suspected the effectiveness of drugs( OR=0.010,95%CI:0. 001-0.112) were less likely to accept PrEP. Conclusion The acceptability of PrEP is high in university students'MSM. The safety of drugs and the convenience to gain the medicine are the main influencing factors for usage of PrEP.Using of PrEP should be strengthened to the MSM.

Objective: To clarify the predictive value for long-term prognosis of GRACE score and SYNTAX score in patients with non-ST elevation acute coronary syndrome (NSTE-ACS).
Methods: A total of 784 NSTE-ACS patients treated in our hospital from 2009-01 to 2014-01 were retrospectively studied. According to the treatment, the patients were divided into 3 groups: Medication group,n=410, Stent group,n=325 and CABG group,n=49. Based on 2 scoring systems, the patients were divided into another 3 groups: Low risk group, Medium risk group and High-risk group. The relationship between GRACE score and SYNTAX score was studied by Pearson correlation analysis, survival analysis was conducted by Kaplan-Meier method, univariate and multivariate analysis were performed by Cox proportional hazard model, and the area under curve (AUC) of ROC analysis was used to compare two methods.
Results: All 784 patients completed the follow-up study at the median of 47.7 months. Pearson correlation analysis showed that there was a weak positive correlation between GRACE score and SYNTAX score (r=0.40,P<0.01). Survival analysis presented that by GRACE score system, the MACE occurrence rates in Low risk group, Medium risk group and High-risk group were elevated accordingly as 13.81%, 23.64% and 36.55% respectively. And by SYNTAX system, MACE occurrence rates in Medium risk group and High-risk group were 39.29% and 37.93%, which were both higher than that in Low risk group (23.99%), while the scores between Medium and High risk groups were similar,P>0.05. Cox proportional hazard model and ROC analysis indicated that GRACE and SYNTAX scores had the important predictive value for lone term prognosis of NSTE-ACS. ROC analysis of GRACE score, SYNTAX score, the combination of GRACE and SYNTAX scores showed that 3 of them all had good predictive value for MACE occurrence, three of 95% CI had signiifcant overlapping without statistic differences.
Conclusion: GRACE score and SYNTAX score are related, both of them have important while similar predictive value for long term prognosis in NSTE-ACS patients, the combination of 2 scores cannot increase the predictive value. GRACE score is appropriate for the risk stratiifcation in NSTE-ACS patients.

To develop a determination method forβ,β'-dimethylacrylalkannin and salvianolic acid B in Shangyangyu ointment by solid phase extraction coupled with HPLC. Methods:Solid phase extraction coupled with HPLC was used with a C18 (250 mm × 4. 6 mm, 5 μm) column, the mobile phase was acetonitrile-water-methanol-formic acid (700∶300∶30∶15) with the flow rate of 1. 0 ml·min-1. For β, β'-dimethylacrylalkannin, the detection wavelength was 275nm, and for salvianolic acid B, the detection wavelength was 286nm. Under the above conditions, the contents of main componentsβ,β'-dimethylacrylalkannin and salvianolic acid B in Shangyangyu ointment were determined. Results:The linear relationship was promising when the concentration ofβ,β'-dimethyl-acrylshikonin was within the range of 23. 780-118. 900μg·ml-1(r=0. 999 5) with the recovery of 99. 5% (RSD=1. 07%) and that of salvianolic acid B was within the range of 19.840-99.200 μg·ml-1(r=0.999 3) with the recovery of 98.2% (RSD=2.1%). Conclusion:The method is simple, accurate and fast with good separation, which can be used in the quality control of Shangyangyu ointment.

OBJECTIVETo assess the methodological quality and reporting quality on Meta-analysis being published in the Chinese Journal of Gastrointestinal Surgery.

METHODSComputerized literature searching was carried out in Wanfang Medical Online to collect articles that Meta-analysis was used in the Chinese Journal of Gastrointestinal Surgery since it was founded till July, 2014. Manual retrieval was also conducted. Two researchers independently screened for literature and extracted data. Qualities on methodologies or on the processes of reporting and reviewing were evaluated by both AMSTAR and PRISMA scales.

RESULTSForty-two papers on meta-analyses were included in this study. Results on the quality of methodology evaluation showed that the lowest and highest scores were 6 and 9 respectively, the median score was 7. Two articles (4.8%) were rated as high, 40 articles (95.2%) as moderate and 0 articles (0%) as low. Although the quality of methodology was above the average, however, there were still some problems seen in some papers as the conflict of interest was not stated, the list of studies (included and excluded) was not provided, a comprehensive literature search was not performed, the likelihood of publication bias was not assessed, etc. Results on the quality of reporting evaluation showed that the lowest and highest scores were 14 and 22 respectively, the average score was 18.43 ± 2.03, 3 articles (7.1%) scored less than 15 points, 35 articles (83.3%) scored 15.5-21 points, and 4 articles (9.6%) scored 21.5-27 points. The included reviews had high quality on the titles of the report, inclusion criteria, rationale of introduction, synthesis of results, results of individual. However, the abstract, objectives of introduction, scheme and registered, inclusion criteria, research screening, additional analysis, conclusion limitations, funding support etc. were lack of comprehensive reports.

CONCLUSIONSArticles on Meta-analysis published in the Chinese Journal of Gastrointestinal Surgery are of high quality. The Chinese Journal of Gastrointestinal Surgery can provide better evidence for clinical decision to gastrointestinal surgeons. However, both of qualities on methodology and reports sill call for continuous improvement.

Objective To assess the methodological quality and reporting quality on Meta-analysis being published in the Chinese Journal of Gastrointestinal Surgery. Methods Computerized literature searching was carried out in Wanfang Medical Online to collect articles that Meta-analysis was used in the Chinese Journal of Gastrointestinal Surgery since it was founded till July , 2014. Manual retrieval was also conducted. Two researchers independently screened for literature and extracted data. Qualities on methodologies or on the processes of reporting and reviewing were evaluated by both AMSTAR and PRISMA scales. Results Forty-two papers on meta-analyses were included in this study. Results on the quality of methodology evaluation showed that the lowest and highest scores were 6 and 9 respectively, the median score was 7. Two articles (4.8%) were rated as high, 40 articles (95.2%) as moderate and 0 articles (0%) as low. Although the quality of methodology was above the average , however, there were still some problems seen in some papers as the conflict of interest was not stated , the list of studies (included and excluded) was not provided, a comprehensive literature search was not performed, the likelihood of publication bias was not assessed, etc. Results on the quality of reporting evaluation showed that the lowest and highest scores were 14 and 22 respectively , the average score was 18.43±2.03, 3 articles (7.1%) scored less than 15 points, 35 articles (83.3%) scored 15.5-21 points, and 4 articles (9.6%) scored 21.5-27 points. The included reviews had high quality on the titles of the report, inclusion criteria, rationale of introduction, synthesis of results, results of individual. However, the abstract, objectives of introduction, scheme and registered, inclusion criteria, research screening, additional analysis, conclusion limitations, funding support etc. were lack of comprehensive reports. Conclusions Articles on Meta-analysis published in the Chinese Journal of Gastrointestinal Surgery are of high quality. The Chinese Journal of Gastrointestinal Surgery can provide better evidence for clinical decision to gastrointestinal surgeons. However, both of qualities on methodology and reports sill call for continuous improvement.

Objective To assess the methodological quality and reporting quality on Meta-analysis being published in the Chinese Journal of Gastrointestinal Surgery. Methods Computerized literature searching was carried out in Wanfang Medical Online to collect articles that Meta-analysis was used in the Chinese Journal of Gastrointestinal Surgery since it was founded till July , 2014. Manual retrieval was also conducted. Two researchers independently screened for literature and extracted data. Qualities on methodologies or on the processes of reporting and reviewing were evaluated by both AMSTAR and PRISMA scales. Results Forty-two papers on meta-analyses were included in this study. Results on the quality of methodology evaluation showed that the lowest and highest scores were 6 and 9 respectively, the median score was 7. Two articles (4.8%) were rated as high, 40 articles (95.2%) as moderate and 0 articles (0%) as low. Although the quality of methodology was above the average , however, there were still some problems seen in some papers as the conflict of interest was not stated , the list of studies (included and excluded) was not provided, a comprehensive literature search was not performed, the likelihood of publication bias was not assessed, etc. Results on the quality of reporting evaluation showed that the lowest and highest scores were 14 and 22 respectively , the average score was 18.43±2.03, 3 articles (7.1%) scored less than 15 points, 35 articles (83.3%) scored 15.5-21 points, and 4 articles (9.6%) scored 21.5-27 points. The included reviews had high quality on the titles of the report, inclusion criteria, rationale of introduction, synthesis of results, results of individual. However, the abstract, objectives of introduction, scheme and registered, inclusion criteria, research screening, additional analysis, conclusion limitations, funding support etc. were lack of comprehensive reports. Conclusions Articles on Meta-analysis published in the Chinese Journal of Gastrointestinal Surgery are of high quality. The Chinese Journal of Gastrointestinal Surgery can provide better evidence for clinical decision to gastrointestinal surgeons. However, both of qualities on methodology and reports sill call for continuous improvement.