Objective:To explore the effect of personalized nutritional support based on nutritional risk screening on nutritional status and prognosis of patients with inflammatory bowel disease.Methods:A total of 100 patients with inflammatory bowel disease admitted to the Department of Gastroenterology, The First Affiliated Hospital of Wenzhou Medical University from January 2021 to September 2022 were selected as the study objects, and were divided into control group and observation group according to the random number method. NRS 2002 nutritional risk screening was performed on all patients. The control group was given routine nursing and nutritional support. On this basis, the observation group received patient-centered personalized nutrition support program shared by doctors and patients. The nutritional status, inflammatory indicators and prognosis of the two groups were compared and observed at admission, discharge, 1 month after discharge, and 3 months after discharge.Results:From admission to 3 months after discharge, albumin, prealbumin, nitrogen balance, triceps skinfold thickness in the two groups were significantly increased ( F = 8.43, 14.32, 10.27, 23.41, 7.66, 8.91, 6.84, 8.90, P < 0.05), while the malnutrition inflammation score was significantly decreased ( F = 4.84, 7.42, P < 0.05). Albumin, prealbumin, nitrogen balance, triceps skinfold thickness in the observation group were significantly higher than those in the control group at 3 months after discharge ( t = 7.95, 17.43, 6.55, 6.72, P < 0.001), and the malnutrition inflammation score was significantly lower than that of the control group ( t = 6.95, P < 0.001). As treatment progressed, the levels of C-reactive protein and fecal calprotectin gradually decreased and the erythrocyte sedimentation rate slowed down in both groups compared with the admission, with statistical significance ( F = 9.03, 11.28, 18.37, 19.20, 32.42, 28.88, P < 0.001). The levels of C-reactive protein and fecal calprotectin and erythrocyte sedimentation rate in the observation group were significantly lower than those in the control group 3 months after discharge ( t = 8.29, 7.99, 10.34, P < 0.001). Patients in the observation group had good compliance with the formulated diet plan, and no related rejection events occurred. The readmission rate of patients in the observation group was significantly lower than that of the control group ( χ2 = 10.18, P < 0.05). Conclusion:Individualized nutrition support programs based on nutritional risk screening can help improve the nutritional status and disease status of patients with inflammatory bowel disease.

Objective·To evaluate the relationship between anxiety level,alexithymia degree and quality of life in patients with anxiety disorders.Methods·Anxiety disorder patients admitted to the outpatient department of Shanghai Mental Health Center,Shanghai Jiao Tong University School of Medicine from October 1,2020 to March 31,2023 were selected as the research subjects,and 438 patients were ultimately included after exclusion.Among them,there were 271 patients with generalized anxiety disorder,101 patients with panic disorder,48 patients with social anxiety disorder,12 patients with agoraphobia,and 6 patients with specific phobia.Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale-17(HAMD-17),the twenty-item Toronto Alexithymia Scale(TAS-20)and World Health Organization Quality of Life Scale-Brief Form Questionnaire(WHOQOL-BREF)were used to assess the patients'anxiety level,depression level,alexithymia degree and quality of life,respectively,and the scale scores of patients with different subtypes of anxiety disorders were evaluated.Spearman correlation coefficient was used to analyze the correlation between anxiety level,depression level,alexithymia degree and quality of life in patients with anxiety disorders.Stepwise regression model was used to analyze the key variables affecting the quality of life in patients with anxiety disorders.Results·There were no significant differences in HAMA score,HAMD-17 score and TAS-20 score among patients with different subtypes of anxiety disorders,but the differences in WHOQOL-BRIEF score were statistically significant(H=10.076,P=0.039).The results of Spearman correlation analysis showed that the WHOQOL-BRIEF score of anxiety disorder patients was negatively correlated with HAMA score,HAMD-17 score and TAS-20 score(r=-0.256,P=0.000;r=-0.311,P=0.000;r=-0.342,P=0.000).The results of stepwise regression analysis showed that age,HAMA score,HAMD-17 score and TAS-20 score had significant impact on the quality of life of patients(all P<0.05).Conclusion·The quality of life in patients with different subtypes of anxiety disorders is different.The anxiety level,depression level and alexithymia degree are the key variables affecting their quality of life.

Objective To explore the risk factors of chemotherapy-induced adverse reactions(CIAEs)caused by capecitabine in colorectal cancer(CRC)patients and to construct a risk prediction model for CIAEs.Methods We retrospectively collected data from postoperative CRC patients treated with capecitabine tablets at our hospital between January 2021 and December 2023.Patients were divided into CIAEs and NCIAEs groups based on the presence or absence of CIAEs.Variable differences were screened using t-tests and chi-square tests.Stepwise multivariate logistic regression was employed to identify independent factors influencing CIAEs in CRC patients.Based on these independent risk factors,a risk prediction model for CIAEs in CRC patients was constructed using R software.The model's predictive ability,calibration,and clinical net benefits were evaluated using receiver operating characteristic(ROC)analysis,calibration curves,and decision curves.Results A total of 253 postoperative CRC patients treated with capecitabine were included in this study.Among them,201 patients developed CIAEs,with nausea and vomiting being the most common(69.96％).Multiple logistic regression results indicated that age[OR=3.018,95％CI(1.404,6.487),P=0.005],prognosis nutrition index[OR=0.129,95％CI(0.06,0.278),P＜0.001],and systematic inflammation index[OR=4.074,95％CI(1.316,12.615),P=0.015]were independent risk factors for CIAEs in CRC patients.The constructed risk prediction model demonstrated good predictive ability,calibration,and clinical net benefit.Conclusion The risk prediction model for CIAEs can be used for individualized prediction of CIAEs in CRC patients and serves as a simple and practical tool for CIAE prevention and nursing management.

The emergence of high virulent mutant strains of infectious bursal disease virus(IBDV)becomes a serious threat to the poultry industry.However,the live attenuated IBDV vaccine can potentially revert to a virulent strain.Therefore,it is a necessary to develop safe and effective IB-DV-associated vaccines.The construction of a recombinant Marek's disease(MD)vaccine strain,CVI988,expressing the IBDV VP2 protein,can protect against disease induced by both IBDV and Marek's disease virus(MDV).Here,the IBDV-VP2 gene was integrated into the UL55 locus of CVI988 by bacterial artificial chromosome(BAC)technique,resulting in the recombinant virus CVI988 BAC-VP2.The recombinant virus was characterized by PCR,IFA and subsequently the bi-ological properties of the recombinant virus were investigated.The results showed that the recom-binant virus CVI988 BAC-VP2 was successfully rescued.The VP2 protein stably expressed in chick-en embryo fibroblasts(CEF).The growth kinetics and plague size assays showed that there was comparable replication ability between recombinant virus and parental virus.This study provides the basis for the development of a low-cost vaccine against both IBDV and MDV infections.

Objective:To analyze the clinical characteristics, diagnosis and treatments of patients with POEMS syndrome initially diagnosed as pulmonary hypertension (PH).Methods:Clinical data of 7 patients who were initially diagnosed as PH and finally diagnosed as POEMS syndrome in Shanghai Pulmonary Hospital from May 2013 to November 2021 were retrospectively reviewed. Clinical manifestations, laboratory tests, echocardiography, hemodynamic findings, treatment and prognosis of patients were analyzed.Results:Seven patients, including 4 males and 3 female, aged (55±9) (44-62) years were presented with elevated pulmonary artery pressure by echocardiography at admission. Chest tightness and shortness of breath (7/7), fatigue (6/7) and lower limb edema (4/7) were the most common symptoms in the first-episode. Meanwhile, patients also presented symptoms associated with POEMS syndrome, including multiple peripheral neuropathy (7/7), multiserosal cavity effusion (6/7), organomegaly (5/7), skin changes (5/7), and endocrine lesions (4/7). Serum levels of vascular endothelial growth factor (VEGF) were significantly increased in all patients. The pulmonary arterial systolic blood pressure was (66±21)mmHg (1 mmHg=0.133 kPa) estimated by echocardiography. Six patients underwent right heart catheterization and significantly increased mean pulmonary artery pressure((35±9) mmHg) was confirmed; and their pulmonary vascular resistance was (4.00±2.10) Wood U. All patients received corresponding treatment for POEMS syndrome. The excise tolerance was improved in 5 patients after successful treatment with stable or reversed WHO functional class. One patient received hemodialysis treatment for uncontrolled POEMS. One patient died during follow-up. The echocardiography was followed up in 4 patients, and 2 of whom had a complete reversal of PH, 1 had a partial reversal, and 1 had not yet reversed.Conclusions:In patients with PH who have multisystem manifestations, such as multiple peripheral neuropathy, multiserosal cavity effusion, organomegaly and skin changes, POEMS syndrome should be considered, and proper and active treatment of POEMS may reverse PH and improve the prognosis of patients.

Objective To investigate the values of nucleoprotein transformation in sperm for predicting recurrent abortion.Methods A total of 521 infertile couples with complete test indicators on fertility were selected from the reproductive medical clinic of our hospital from 2019 to 2022,among which the ages of the male were from 23 to 56 years old.The following factors causing recurrent abortion were excluded,including the age of woman,body mass index,metabolic disease,antiphospholipid syndrome,uterine and accessory abnormalities,history of caesarean section and intrauterine myoma/cervical conectomy,peripheral blood chromosome abnormalities of both the couple,and adverse life history,such as smoking/alcohol abuse.According to the abortion situation,they were divided into the recurrent abortion group(≥two spontaneous abortions),one spontaneous abortion group and no abortion group.Tukey's multiple comparison was performed to compare the differences of nucleoprotein transformation of sperm in each group by using GraphPad6.0 sta-tistical software.The Pearson method was used to analyze the correlation between nucleoprotein transformation and recurrent abortion.The predictive values of nucleoprotein transformation in recurrent abortion were analyzed by the parameters of sensitivity,specificity,positive predictive value,negative predictive value,Youden index and odd ratio.Results The percentages of abnormal nucleoprotein transformation in recurrent abortion group[(33.31±13.83)％]were significantly higher than those in non-abortion group[(26.85± 15.38)％]and the one abortion group[(28.20±12.50)％,P＜0.05].Pearson correlation analysis showed that there was a significant positive correlation between abnormal nucleoprotein transformation and recurrent abortion.The sensitivity and specificity of nucleoprote-in transformation for predicting recurrent abortion were 45.24％and 73.64％,respectively.All of the data of positive predictive value(15.70％),negative predictive value(92.53％),Youden index(18.88％)and odd ratio(2.31)of nucleoprotein transformation in predicting recurrent abortion were higher than those of high DNA stainability(10.64％,90.31％,1.05％and 1.11).Conclusion In the spouses of patients with recurrent abortion,the immaturity of sperm nuclear protein is significantly increased and significantly posi-tively correlated with recurrent abortion.The abnormal nucleoprotein transformation of sperm may be the important factor of recurrent a-bortion in males,and it has high predictive value for recurrent spontaneous abortion in clinical practice.

Objective:To quantitatively evaluate the stiffness of pancreatic parenchyma and lesions by virtual touch tissue imaging and quantification (VTIQ) technique, and to investigate the potential usefulness of ultrasound shear wave elastography (SWE) in the prediction of clinically relevant post-operative pancreatic fistula (CR-POPF) after pancreatectomy.Methods:Patients who scheduled to receive pancreatectomy were prospectively enrolled in Zhongshan Hospital, Fudan University from March 2021 to December 2021. VTIQ assessment was applied to patients within one week before the scheduled surgery to make quantitative SWE evaluation of target tissue. The SWV values of body part pancreatic parenchyma and lesions were measured and recorded. The palpation stiffness of pancreas was qualitatively evaluated during the operation by the surgeon.CR-POPF was diagnosed according to 2016 International Study Group of Pancreatic Fistula (ISGPF) standard.Grade B/C pancreatic fistula was defined as CR-POPF positive. Recognized peri-operative risk factors of CR-POPF were analyzed. ROC curve analysis was used to evaluate the diagnostic efficacy of SWV value in predicting CR-POPF.Results:A total of 72 patients were finally enrolled in this study, including 47 (65.3%, 47/72) patients who received pancreaticoduodenectomy (PD) and 25 (34.7%, 25/72) patients who underwent distal pancreatectomy. CR-POPF occurred in 22 (30.6%, 22/72) patients after pancreatectomy. The SWV value of body part pancreatic parenchyma was significant lower in CR-POPF positive group than in CR-POPF negative group ( P<0.001). There was no significant difference in lesion SWV value between CR-POPF positive and negative groups ( P=0.664). Besides, the palpation stiffness was no difference between the two groups ( P=0.689). Taking SWV value of pancreatic parenchyma >1.16 m/s as a cut-off value for predicting CR-POPF, the area under the ROC curve (AUROC) was 0.816 with 0.760 of sensitivity, 0.634 of specificity, 67.5% of positive predictive value and 72.5% of negative predictive value, respectively. Conclusions:The VTIQ method may improve the objectivity and accuracy of CR-POPF prediction via pre-operative, non-invasive and quantitative evaluation of pancreatic stiffness, which has potential value in clinical applications.

Postoperative radiotherapy increase the overall survival rate offor breast cancer improves overall survivalpatients, but. Nevertheless, the heart is at risk of radioactive heart damageradiation-induced cardiac injury due to its anatomical location, which is inevitably exposed to radiation during radiotherapy. The heart is considered a "high-risk organ" sensitive to radiation, and its radiation dose should be as low as possible. Previous studies have evaluated the effect of overall heart radiation dose on long-term cardiovascular events, but the. However, new study has found that the average heart dose does not accurately reflect the degree of heart radiation exposure. In recent years, more and morewidespread attention has been paid to subclinical cardiac injury after radiotherapy, aiming at early identification of latent cardiac injury. In addition, the relationship between specific cardiac substructural doses and arrhythmias is unclear. This paper focuses onIn this article, the limitations of average cardiac dose in predicting radioactive heart injuryradiation- induced cardiac injury, the indicators of early identification of the indicators for cardiac injury and the influencing factors of radiation-induced cardiac injury in breast cancer radioactive heart injurywere illustrated, and focuses on the relationship between radiation damage of different cardiac substructures and arrhythmia was evaluated, so asaiming to achieve fine cardiac risk management in breast cancer patients and reduce the non-cancer mortality in breast cancer patients.

OBJECTIVE： To optimize the integrated processing technology for “precise decoction pieces” of Helianthus annuus. METHODS： The contents of total flavonoids and total protein in H. annuus were determined by UV spectrophotometry with rutin and bovine serum albumin as control. Refering to Chinese Pharmacopoeia， the contents of water soluble extract， dilute ethanol extracts and ethyl acetate extract were determined. Based on the different needs such as maintaining quality consistency with the original medicinal materials， preference for anti-gout treatment， preference for liver calming and pain relief， using the contents of total flavonoids， total protein and 3 kinds of polar extract as indexes， gray correlation method was used to optimize the integrated processing technology of 3 kinds of “precise decoction pieces” of H. annuus. RESULTS： Gray correlation analysis showed that the ideal sample sequence of decoction pieces in massive shape dried at 60 ℃ with the original medicinal materials and decoction pieces with preference use of liver calming and pain relief was the most relevant； the ideal sample sequence of ideal sample sequence of decoction pieces in massive shape dried in the shade with decoction pieces with clinical application preference of anti-gout therapy was the most relevant. CONCLUSIONS： Different integrated processing technology for “precise decoction pieces” of H. annuus can be adopted for different needs. If it is necessary to keep the quality consistent with the original medicinal materials or to prepare H. annuus decoction pieces for liver calming and pain relieving， medicinal material can be cut into massive shape and dried at 60 ℃； if it is necessary to prepare H. annuus decoction pieces for anti-gout treatment， cutting into massive shape and drying in the shade can be adopted.

Objective To investigate the value of contrast‐enhanced ultrasound ( CEUS ) in the differential diagnosis of pancreatic neoplasia ( SPN ) before operation . Methods Forty‐six cases of SPN confirmed by operation and histopathological results from January 2012 to June 2018 were enrolled in the study . According to the European Ultrasound Association ( EFSUMB) guidelines for CEUS in 2018 ,the enhancement pattern of pancreatic lesion with normal surrounding pancreatic parenchyma was used for reference . T he enhancement pattern of SPN were observed during the arterial phase ,venous phase and delayed phase . CEUS pattern of 16 cases with pancreatic ductal adenocarcinoma ( PDAC ) with cystic changes proved by histopathology were observed and compared with SPN . Results T he mean size of 46 cases of SPN was ( 32 .72 ± 25 .51) mm . Fifteen SPN lesions located in the head of pancreas ,31 cases located in the body and tail of the pancreas . Most of SPN were solidcystic lesions with thin separation on conventional B mode ultrasoud ,without communication with the main pancreatic duct . Color flow signals could be detected in 78 .3% ( 36/46) SPN lesions . After the injection of 2 .4 ml ultrasound contrast agent , the substantial part of all SPN showed hyperenhancement ( n＝ 44 ,99 .7% ) or isoenhancement ( n ＝ 2 , 4 .3% ) during the arterial phase ,venous phase and late phase . However ,93 .8% ( 15/16 ) of the PDAC lesion with cystic changes showed consistent hypo enhancement throughout the arterial ,venous and late phase ( P ＜0 .05) . T he accuracy of preoperative diagnosis of CEUS was 95 .6% . Conclusions Depending on its unique advantages such as real‐time observation ,high‐resolution imaging ,and no radiation ,CEUS is helpful for early detection ,accurate localization and preoperative diagnosis of SPN . CEUS has potential role for clinical decision‐making before treatment .