OBJECTIVE To construct and evaluate nomogram prediction model for refractory chemotherapy-induced nausea and vomiting （CINV）. METHODS The data of malignant tumor patients who received chemotherapy at the Third People’s Hospital of Zhengzhou from January 2017 to December 2023 were collected. These patients were categorized into the occurrence group and the non-occurrence group according to the occurrence of refractory CINV. Multivariate Logistic regression analysis was employed to screen predictive factors for refractory CINV and constructing a nomogram prediction model. Model performance was assessed via receiver operating characteristic curve analysis. Model calibration was evaluated using Bootstrap resampling. Decision curve analysis （DCA） was used to determine the clinical net benefit of three strategies under different risk thresholds. Clinical impact curves were utilized to assess the clinical value of the model at different risk thresholds. Shapley additive explanations （SHAP） analysis was performed to evaluate individual factor contributions to the predictive model. RESULTS A total of 388 patients were included， with 219 experiencing refractory CINV. Multivariate Logistic regression identified 11 predictive factors for refractory CINV， including gastrointestinal disease history， anticipated nausea and vomiting， chemotherapy-induced emetic risk classification， and electrolyte levels， etc. The model’s area under the curve was 0.80 [95% confidence interval （0.76， 0.84）]， with a mean error of 0.036. DCA demonstrated the prediction model had higher clinical net benefit when the risk threshold was between 0.05 and 0.85. SHAP analysis revealed the top three predictive factors as gastrointestinal disease history （0.924）， chemotherapy- induced emetic risk classification （0.866）， and electrolyte levels （0.581）. CONCLUSIONS Eleven factors， including gastrointestinal disease history， anticipated nausea and vomiting， chemotherapy-induced emetic risk classification， and electrolyte levels， are identified as predictors of refractory CINV. The model based on these factors has good predictive ability， which can be used to predict the risk of refractory CINV.

OBJECTIVE To explore the influence of surgical history on chemotherapy -induced nausea and vomiting （CINV）. METHODS A retrospective case -control study was adopted ，with 824 patients undergoing chemotherapy as the object . A total of 27 items were collected ，including demographic data ，medical history data ，pre-chemotherapy data ，and chemotherapy treatment status. Logistic regression model was used to analyze the relationship between the history of surgery and the risk of CINV . The multiple models were constructed to correct potential confounding factors ，and subgroup analysis was performed on patients with surgical history . RESULTS The incidence of CINV was higher in patients with surgical history . The statistical result before adjustment was [OR＝1.72，95%CI（1.31，2.28），P＜0.001]；after adjusting potential confounding factors ，the statistical result was [OR＝1.78，95% CI（1.28，2.48），P＝0.001]. In the subgroup analysis ，the time between surgery and chemotherapy was different ， and the impact of surgical history on CINV was different ，and the results were statistically significant （P＝0.027）. The risk of CINV showed decreasing trend with the time ，and the results were statistically significant （P for trend ≤0.050）. Compared with patients who had not undergone surgery ，patients who had undergone surgery within one year had a higher risk of CINV [OR＝ 2.33，95%CI（1.52，3.59），P＜0.001]. CONCLUSIONS Patients with surgical history are more prone to CINV ，and the risk of CINV shows a downward trend in the length of time from surgery .

Objective To understand the correlation of expression levels of serum stromal cell-derived factor 1α (SDF-1α), osteoprotegerin (OPG) and β2microglobulin (β2-MG) in patients with multiple myeloma (MM) with or without myeloma bone disease (MBD). Methods Eighty patients with MM who were admitted to the Affiliated Hospital of Inner Mongolia Medical University from January 2014 to June 2017 were selected; all of the patients met the international diagnostic criteria for MM. According to the symptoms such as bone pain, the patients were divided into group with MBD (45 cases) and group without MBD (35 cases). Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum levels of SDF-1α and OPG, and radioimmunoassay was used to detect the expression of MM major prognostic indicator β2-MG. The MBD score was evaluated in 45 patients selected by random number table after sacroiliac joint X-ray and three-dimensional bone reconstruction. The χ 2test was used to compare the categorical variables; the two independent sample t-test was used to compare the continuous variables that conformed to the normal distribution between two groups, and the Pearson method was used for the correlation analysis. Results The expression level of serum SDF-1α in the group with MBD was significantly higher than that in the group without MBD [0.31±0.17) pg/ml vs. (0.18±0.06) pg/ml], and the difference was statistically significant (t ＝-4.21, P < 0.001). The expression level of serum OPG in the group with MBD was significantly lower than that in the group without MBD [(0.73±0.50) pg/ml vs. (1.08±0.31) pg/ml], and the difference was statistically significant (t＝ 3.62, P< 0.001). Pearson analysis showed that β2-MG level in the group was positively correlated with SDF-1α level (r＝ 0.84, P< 0.001), and negatively correlated with OPG level (r＝ -0.48, P<0.001). The β2-MG level in the group without MBD did not show a correlation with the SDF-1α and OPG levels. Conclusions In the serum of patients with MBD, the expression levels of β2-MG and SDF-1α are increased, and the expression level of OPG is decreased. SDF-1α and OPG may be new clinical biochemical indicators for diagnosis, treatment and prognosis assessment in MBD.

Objective The investigation of diatom species composition and database of diatom scanning electron microscope in the Pearl River of Guangdong province. Methods Using the Lefort aqua regia digestion 19 different sampling sites (6 in the West River, 9 in the North River, and 4 in the East River) were sampled by us in June and September 2012.Water samples from each sampling site was digested and then observed by scanning electron microscopy. The diatom genera found in samples were recorded. Results 21 diatom genera, including Achnanthes, Cocconeis, Coscinodiscus, Cyclotella, Cymatopleura, Cymbella, Diatoma, Diploneis, Gomphonema, Gyrosigma, Hantzschia, Melosira, Navicula, Nitzschia, Pinnularia, Rhoicosphenia, Stauroneis, Stephanodisus, Surirella, Synedra, Tabellaria, were found in all the samples. Conclusion It is helpful to legal medical expert by using database of diatom scanning electron microscope in the Pearl River of Guangdong province. As hundreds of diatoms pictures were taken by SEM, it would be a valuable reference of diatoms identification for forensic experts as well as diagnosis of drowning place.

Objective:To study the effect and influence factor analysis of DLBCL patient with early stage who receive radiotherapy after chemotherapy.Methods: 374 cases of patients with DLBCL was selected from January 2010 to December 2015 in our hospital. By random number table method, the patients were divided into CHOP group (n=104), R-CHOP+RT group (n=93), R-CHOP group (n=80), CHOP+RT group (n=97). CHOP chemotherapy was given to all patients, 180 patients received radiotherapy after chemotherapy, and 169 patients received rituximab. Survival rates were compared between the 4 groups.Results: The survival rate of R-CHOP group in 12 months, 24 months, 50 months and 100 months were lower than R-CHOP+RT group, but the difference was not statistically significant in twelfth months(x2=2.02,P>0.05). The differences of 24 months, 50 months and 100 months were statistically significant (x2=4.08,x2=4.03,x2=8.79;P<0.05); The survival rate of CHOP group was 12 months and 24 months was higher than CHOP+RT group which the difference was not statistically significant (x2=1.05,x2=0.22;P>0.05); The survival rate of CHOP group in 50 months and 100th months was lower than CHOP+RT, but the difference was no significant difference (x2=1.62,x2=0.03;P>0.05). Smoking index, whether the use of rituximab, the age associated with the survival of patients, the difference was statistically significant.Conclusion: Early DLBCL patients with R-CHOP and radiotherapy combined treatment can be effective in patients with survival, while the use of rituximab chemotherapy, in addition to smoking on the prognosis of patients with serious adverse effects.

OBJECTIVETo compare the efficacy of three methods for forensic diatom test, namely strong acid digestion-centrifuge enrichment-light microscopy (SD-CE-LM), microwave digestion-membrane filtration-automated scanning electron microscopy (MD-ME-SEM), and microwave digestion-membrane filtration-light microscopy (MD-MF-LM).

METHODSSixty samples were randomly divided into 3 groups for diatom test using three methods, and the sample preparation time, degree of digestion and recovery rate of diatoms were compared.

RESULTSThe sample preparation time was the shortest with MD-MF-LM and the longest with SD-CE-LM (P<0.05). MD-ME-SEM and MD-MF-LM allowed more thorough tissue digestion than SD-CE-LM. MD-ME-SEM resulted in the highest total recovery rate of diatom, followed by MD-MF-LM and then by SD-CE-LM (P<0.05); the recover rate of different diatom species was the highest with MD-ME-SEM, followed by MD-MF-LM and SD-CE-LM (P<0.05).

CONCLUSIONSD-CE-LM has a low recovery rate of diatoms especially for those with lengths shorter than 40 µm or densities less than 1/5. With a high recovery rate and accuracy in diatom test, MD-ME-SEM is suitable for diagnosis of suspected drowning cases. MD-MF-LM is highly efficient, sensitive and convenient for forensic diatom test.

Centrifugation ; Diatoms ; isolation & purification ; Drowning ; Forensic Sciences ; methods ; Humans ; Microscopy ; Microscopy, Electron, Scanning ; Microwaves ; Specimen Handling

Objective To compare the efficacy of three methods for forensic diatom test, namely strong acid digestion-centrifuge enrichment-light microscopy (SD-CE-LM), microwave digestion-membrane filtration-automated scanning electron microscopy (MD-ME-SEM), and microwave digestion-membrane filtration-light microscopy (MD-MF-LM). Methods Sixty samples were randomly divided into 3 groups for diatom test using three methods, and the sample preparation time, degree of digestion and recovery rate of diatoms were compared. Results The sample preparation time was the shortest with MD-MF-LM and the longest with SD-CE-LM (P<0.05). MD-ME-SEM and MD-MF-LM allowed more thorough tissue digestion than SD-CE-LM. MD-ME-SEM resulted in the highest total recovery rate of diatom, followed by MD-MF-LM and then by SD-CE-LM (P<0.05);the recover rate of different diatom species was the highest with MD-ME-SEM, followed by MD-MF-LM and SD-CE-LM (P<0.05). Conclusion SD-CE-LM has a low recovery rate of diatoms especially for those with lengths shorter than 40μm or densities less than 1/5. With a high recovery rate and accuracy in diatom test, MD-ME-SEM is suitable for diagnosis of suspected drowning cases. MD-MF-LM is highly efficient, sensitive and convenient for forensic diatom test.

Objective To compare the efficacy of three methods for forensic diatom test, namely strong acid digestion-centrifuge enrichment-light microscopy (SD-CE-LM), microwave digestion-membrane filtration-automated scanning electron microscopy (MD-ME-SEM), and microwave digestion-membrane filtration-light microscopy (MD-MF-LM). Methods Sixty samples were randomly divided into 3 groups for diatom test using three methods, and the sample preparation time, degree of digestion and recovery rate of diatoms were compared. Results The sample preparation time was the shortest with MD-MF-LM and the longest with SD-CE-LM (P<0.05). MD-ME-SEM and MD-MF-LM allowed more thorough tissue digestion than SD-CE-LM. MD-ME-SEM resulted in the highest total recovery rate of diatom, followed by MD-MF-LM and then by SD-CE-LM (P<0.05);the recover rate of different diatom species was the highest with MD-ME-SEM, followed by MD-MF-LM and SD-CE-LM (P<0.05). Conclusion SD-CE-LM has a low recovery rate of diatoms especially for those with lengths shorter than 40μm or densities less than 1/5. With a high recovery rate and accuracy in diatom test, MD-ME-SEM is suitable for diagnosis of suspected drowning cases. MD-MF-LM is highly efficient, sensitive and convenient for forensic diatom test.

Objective To discuss the effect of von willebrand factor (vWF) antibody on idiopathic thrombotic thrombocytopenic purpura(TTP) .Methods 28 cases of idiopathic thrombotic thrombocytopenic purpura were selected in our hospital from January 2011 to June 2013 ,and 30 healthy persons as control group ,ADAMTS13 and vWF of two groups were detected .Results 3 cases of patients were detected with positive vWF antibody ,vWF antibody negative in the remaining patients .3 patients with positive vWF antibody ADAMTS13 antibodies were negative ,ADAMTS13 levels were lower than the normal value .The levels of ADAMTS13 in vWF antibody positive patients was significantly lower than that of vWF antibody negative patients and the control group ,(P<0 .01) .vWF antibody positive patients plasma vWF antibody A was higher than vWF antibody negative and the control group (P<0 .01) .In idiopathic TTP after PE ADAMTS13 antigen increased significantly ,vWF antibody and A levels decreased significantly (P<0 .05) .Conclusion vWF antibodies in idiopathic thrombotic thrombocytopenic plays an important role in the pathogenesis of purpura ,vWF antibody may affect patients ADAMTS13 ,promote vWF complex formation ,effect of disease .

Objective To evaluate risk factors of restenosis of vertebral artery origin after stenting.Methods A total of 144 continuous cases were collected for this retrospective analysis.More than 50％ of stenosis in the original sites after treatment was defined as restenosis.Patients were divided into restenosis group (39 patients) and none-restenosis group (105 patients).The risk factors associated with restenosis were compared between the two groups by Chi-square test,including sex,age,presence of hypertension,diabetes,coronary heart disease,hyperlipidemia,smoking and drinking,the difference of preoperative neurological symptoms,combination with other vessels,stenosis,as well as stent type and stent size.Logistic regression was used to test the risk factors for restenosis.Results The incidence of restenosis of vertebral artery origin after stenting was 26.4％,and all of them occurred in 5 months.Between the two groups,there was no significant difference of distribution of sex (male 89,female 34,x2 =0.804,P =0.370),age(60 vs 21 patients of more than 60 years old,x2 =2.358,P =0.125),hypertension (67 vs 28 patients,x2 =0.253,P =0.615),diabetes (27 vs 9 patients,x2 =0.914,P =0.91),hyperlipidemia (6 vs 5 patients,x2 =0.478,P =0.489),coronary heart disease(32 vs 6 patients,x2 =2.489,P =0.115),smoking (50 vs 24 patients,x2 =0.129,P =0.719),drinking(20 vs 13 patients,x2 =0.001,P =0.978),diameter of stents (53 vs 18 patients of more than 4 mm,x2 =0.213,P =0.645),length of stents (45 vs 19 patients of more than 15 mm,x2 =0.927,P =0.336),preoperative neurological symptoms (93 vs 29 patients,x2 =0.250,P =0.617).There was significant difference of factors including combination with the bilateral stenosis (43 vs 24 patients,x2 =4.844,P =0.028),combination with the internal carotid artery stenosis(49 vs 26 patients,x2 =4.558,P =0.033) and stent types(59 vs 11 patients of drug eluting stent,x2 =8.916,P =0.003) between the two groups.Bare stents and combination with internal carotid artery stenosis were independent risk factors for restenosis by logistic regression.Conclusions The incidence of restenosis with vertebral artery origin occurs in 5 months after surgery.Bare stents and combination with internal carotid artery stenosis increased the incidence of restenosis,and preoperative neurological symptoms of vertebrobasilar system and presence of the bilateral stenosis may induce restenosis.