Erythropoietic protoporphyria （EPP） is a rare inherited metabolic disease that often involves skin， blood， and nervous systems， and EPP with the main manifestations of severe liver damage and acute abdominal pain is extremely rare. By reviewing the clinical data and genetic testing results of a patient with EPP， this article discusses the clinical features and pathogenic genes of this disease， in order to improve the understanding of the disease among hepatologists and achieve early diagnosis and treatment.

Objective To investigate the changes and predictive value of Omentin-1 levels in patients with type 2 diabetes mellitus(T2DM)under different bone metabolic status.Methods A total of 120 T2DM pa-tients admitted to a hospital from June 2021 to December 2022 were selected and divided into group A(normal bone mass,T-value-1.0,36 cases),Group B(bone loss,-2.5＜T-value＜-1.0,49 cases)and group C(osteoporosis,T-value-2.5,35 cases)according to different bone mineral density.Another 50 healthy sub-jects who underwent physical examination in a hospital during the same period were selected as the healthy control group.Basic data,serum Omentin-1 and bone metabolism levels of the 4 groups were compared,and the correlation between serum Omentin-1 and bone metabolism and blood glucose levels was analyzed by Pear-son correlation analysis.Multiple stepwise regression analysis was conducted to analyze the factors affecting bone mineral density in T2DM patients.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of serum Omentin-1 level in T2DM with osteoporosis.Results The fasting blood glucose(FBG)level of groups A,B and C was higher than that of healthy control group,and the hemoglobin A1c(HbA1c)and homeostasis model assessment of insulin resistance(HOMA-IR)of healthy control group,group A and group B were lower than that of group C,with statistical significance(P＜0.05).Omentin-1,type Ⅰ procollagen N-terminal propeptide(P Ⅰ NP)and osteocalcin(BGP)in healthy control group,group A and group B were higher than those in group C,while the β-CTX sequence of type Ⅰ collagen in healthy con-trol group,group A and group B was lower than that in group C,and the difference was statistically signifi-cant(P＜0.05).Pearson correlation analysis showed that the serum Omentin-1 level in T2DM patients was negatively correlated with the levels of HbA1c,HOMA-IR and β-CTX(r=-0.770,-0.807,-0.759,P＜0.05),and positively correlated with the levels of P Ⅰ NP and BGP(r=0.868,0.879,P＜0.05),but no sig-nificant correlation with FBG level(r=-0.085,P=0.152).Omentin-1,P Ⅰ NP,β-CTX,BGP,HbA1c and HOMA-IR were independent influencing factors of BMD in T2DM patients(P＜0.05).ROC curve analysis showed that the area under the curve of serum Omentin-1 level predicting T2DM with osteoporosis was 0.835(95％CI:0.764-0.906),and when the cut-off value was 50.325 ng/mL,the sensitivity was 0.854,the speci-ficity was 0.801,and the Youden index was 0.655.Conclusion Serum Omentin-1 expression is low in T2DM patients,and its expression is closely related to bone mineral density,bone metabolism and insulin resistance in T2DM patients,and can effectively predict the occurrence of T2DM with osteoporosis.

Objective:The study retrospectively analyzed the etiology, clinical manifestations, emergency treatment and etiological treatment of a large sample of cases with hypercalcemic crisis.Methods:The clincial data of patients with hypercalcaemia cirisis who were administered in First Medical Center of Chinese PLA General Hospital from January 2009 to July 2022 were analyzed, inculding the general data, clinical manifestations, etiology, photographic examination, emergency treatment, etiological treatment, serological examination before and after treatment, pathological immunohistochemical findings and prognosis.Results:A total of 143 hypercalcaemia crisis patients(84 males and 59 females) with a mean age of 53.51±16.60 were enrolled. The most common disease was hyperparathyroidism(62/143), followed by solid malignancy(57/143) and multiple myeloma(12/143). Patients presented with digestive system symptoms at 76.91%, followed by neurological symptoms at 63.60%, urinary system symptoms at 58.76%, musculoskeletal symptoms at 55.23%, and cardiovascular system symptoms at 32.91%. After emergency calcium-lowering treatment, the remission rate of hypercalcemic crisis in 143 patients was 100%(143/143), and after etiological treatment, the remission rate of hypercalcemia was 85.31%(122/143).Conclusion:Early identification, emergency treatment and etiology treatment of hypercalcaemia crisis are essential. Effective treament with comprehensive calcium reduction can quickly relieve clinical symptoms and create opportunities for treatment for the cause. Targeted etiological interventions can lead to the correction or long-term remission of hypercalcemia.

Objective:To analyze the influencing factors of platinum resistant recurrence in advanced epithelial ovarian cancer(AEOC),establish a nomogram model to predict platinum-resistant recurrence of AEOC,and inter-nally validate it.Methods:The clinicopathological data of 577 AEOC patients who achieved complete remission af-ter initial treatment in the Department of Gynecology,Yunnan Cancer Hospital from June 1,2013 to December 31,2021 were collected.According to whether the platinum free interval(PFI)was less than 6 months,the patients were divided into platinum-resistant recurrence group(130 cases)and non-platinum-resistant group(447 cases,including patients with platinum-sensitive recurrence and no recurrence after 6 months of follow-up).Multivariate Logistic regression analysis was used to screen for the independent risk factors affecting the recurrence of plati-num-resistant patients.Based on the independent risk factors,a nomogram prediction model was established,and Bootstrap method was used for internal verification.The area under the ROC curve(AUC),calibration curve and decision curve(DCA)were used to evaluate the performance of the model.Results:①There were statistically sig-nificant differences in age,bilateral ovarian invasion,FIGO staging,menopause,neoadjuvant chemotherapy(NACT),chemotherapy interval(TTC),platelet count(PLT),platelet count/lymphocyte count ratio(PLR),fibrino-gen/lymphocyte count ratio(FLR),prognostic nutritional index(PNI),albumin(ALB),CA125 level,ascites volume,residual lesions,perioperative chemotherapy frequency,and CA125 half-life between the two groups(P＜0.05).②Multivariate Logistic regression analysis showed that bilateral ovarian invasion,FIGO stage Ⅳ,TTC＞16 days,ini-tial ascites volume＞1000ml,perioperative chemotherapy frequency＞9 times,surgery with R2 resection,CA125 half-life＞52 days were independent risk factors for recurrence of platinum-resistant AEOC patients(OR＞1,P＜0.05).③The AUC of the nomogram model constructed based on the above 7 indicators was 0.791(95％Cl 0.747-0.835),and the calibration curve and ideal curve fitted well.DCA showed that the net benefit interval of the model was 0.037-0.800.Conclusions:The nomogram prediction model based on independent risk factors for the recurrence of platinum-resistance of AEOC patients has good discrimination,calibration and clinical appli-cability,which can better predict the recurrence risk of platinum-resistance in AEOC patients after the initial treat-ment.

Objective:To analyze the influencing factors of platinum resistant recurrence in advanced epithelial ovarian cancer(AEOC),establish a nomogram model to predict platinum-resistant recurrence of AEOC,and inter-nally validate it.Methods:The clinicopathological data of 577 AEOC patients who achieved complete remission af-ter initial treatment in the Department of Gynecology,Yunnan Cancer Hospital from June 1,2013 to December 31,2021 were collected.According to whether the platinum free interval(PFI)was less than 6 months,the patients were divided into platinum-resistant recurrence group(130 cases)and non-platinum-resistant group(447 cases,including patients with platinum-sensitive recurrence and no recurrence after 6 months of follow-up).Multivariate Logistic regression analysis was used to screen for the independent risk factors affecting the recurrence of plati-num-resistant patients.Based on the independent risk factors,a nomogram prediction model was established,and Bootstrap method was used for internal verification.The area under the ROC curve(AUC),calibration curve and decision curve(DCA)were used to evaluate the performance of the model.Results:①There were statistically sig-nificant differences in age,bilateral ovarian invasion,FIGO staging,menopause,neoadjuvant chemotherapy(NACT),chemotherapy interval(TTC),platelet count(PLT),platelet count/lymphocyte count ratio(PLR),fibrino-gen/lymphocyte count ratio(FLR),prognostic nutritional index(PNI),albumin(ALB),CA125 level,ascites volume,residual lesions,perioperative chemotherapy frequency,and CA125 half-life between the two groups(P＜0.05).②Multivariate Logistic regression analysis showed that bilateral ovarian invasion,FIGO stage Ⅳ,TTC＞16 days,ini-tial ascites volume＞1000ml,perioperative chemotherapy frequency＞9 times,surgery with R2 resection,CA125 half-life＞52 days were independent risk factors for recurrence of platinum-resistant AEOC patients(OR＞1,P＜0.05).③The AUC of the nomogram model constructed based on the above 7 indicators was 0.791(95％Cl 0.747-0.835),and the calibration curve and ideal curve fitted well.DCA showed that the net benefit interval of the model was 0.037-0.800.Conclusions:The nomogram prediction model based on independent risk factors for the recurrence of platinum-resistance of AEOC patients has good discrimination,calibration and clinical appli-cability,which can better predict the recurrence risk of platinum-resistance in AEOC patients after the initial treat-ment.

Objective:To analyze the influencing factors of platinum resistant recurrence in advanced epithelial ovarian cancer(AEOC),establish a nomogram model to predict platinum-resistant recurrence of AEOC,and inter-nally validate it.Methods:The clinicopathological data of 577 AEOC patients who achieved complete remission af-ter initial treatment in the Department of Gynecology,Yunnan Cancer Hospital from June 1,2013 to December 31,2021 were collected.According to whether the platinum free interval(PFI)was less than 6 months,the patients were divided into platinum-resistant recurrence group(130 cases)and non-platinum-resistant group(447 cases,including patients with platinum-sensitive recurrence and no recurrence after 6 months of follow-up).Multivariate Logistic regression analysis was used to screen for the independent risk factors affecting the recurrence of plati-num-resistant patients.Based on the independent risk factors,a nomogram prediction model was established,and Bootstrap method was used for internal verification.The area under the ROC curve(AUC),calibration curve and decision curve(DCA)were used to evaluate the performance of the model.Results:①There were statistically sig-nificant differences in age,bilateral ovarian invasion,FIGO staging,menopause,neoadjuvant chemotherapy(NACT),chemotherapy interval(TTC),platelet count(PLT),platelet count/lymphocyte count ratio(PLR),fibrino-gen/lymphocyte count ratio(FLR),prognostic nutritional index(PNI),albumin(ALB),CA125 level,ascites volume,residual lesions,perioperative chemotherapy frequency,and CA125 half-life between the two groups(P＜0.05).②Multivariate Logistic regression analysis showed that bilateral ovarian invasion,FIGO stage Ⅳ,TTC＞16 days,ini-tial ascites volume＞1000ml,perioperative chemotherapy frequency＞9 times,surgery with R2 resection,CA125 half-life＞52 days were independent risk factors for recurrence of platinum-resistant AEOC patients(OR＞1,P＜0.05).③The AUC of the nomogram model constructed based on the above 7 indicators was 0.791(95％Cl 0.747-0.835),and the calibration curve and ideal curve fitted well.DCA showed that the net benefit interval of the model was 0.037-0.800.Conclusions:The nomogram prediction model based on independent risk factors for the recurrence of platinum-resistance of AEOC patients has good discrimination,calibration and clinical appli-cability,which can better predict the recurrence risk of platinum-resistance in AEOC patients after the initial treat-ment.

Objective:To analyze the influencing factors of platinum resistant recurrence in advanced epithelial ovarian cancer(AEOC),establish a nomogram model to predict platinum-resistant recurrence of AEOC,and inter-nally validate it.Methods:The clinicopathological data of 577 AEOC patients who achieved complete remission af-ter initial treatment in the Department of Gynecology,Yunnan Cancer Hospital from June 1,2013 to December 31,2021 were collected.According to whether the platinum free interval(PFI)was less than 6 months,the patients were divided into platinum-resistant recurrence group(130 cases)and non-platinum-resistant group(447 cases,including patients with platinum-sensitive recurrence and no recurrence after 6 months of follow-up).Multivariate Logistic regression analysis was used to screen for the independent risk factors affecting the recurrence of plati-num-resistant patients.Based on the independent risk factors,a nomogram prediction model was established,and Bootstrap method was used for internal verification.The area under the ROC curve(AUC),calibration curve and decision curve(DCA)were used to evaluate the performance of the model.Results:①There were statistically sig-nificant differences in age,bilateral ovarian invasion,FIGO staging,menopause,neoadjuvant chemotherapy(NACT),chemotherapy interval(TTC),platelet count(PLT),platelet count/lymphocyte count ratio(PLR),fibrino-gen/lymphocyte count ratio(FLR),prognostic nutritional index(PNI),albumin(ALB),CA125 level,ascites volume,residual lesions,perioperative chemotherapy frequency,and CA125 half-life between the two groups(P＜0.05).②Multivariate Logistic regression analysis showed that bilateral ovarian invasion,FIGO stage Ⅳ,TTC＞16 days,ini-tial ascites volume＞1000ml,perioperative chemotherapy frequency＞9 times,surgery with R2 resection,CA125 half-life＞52 days were independent risk factors for recurrence of platinum-resistant AEOC patients(OR＞1,P＜0.05).③The AUC of the nomogram model constructed based on the above 7 indicators was 0.791(95％Cl 0.747-0.835),and the calibration curve and ideal curve fitted well.DCA showed that the net benefit interval of the model was 0.037-0.800.Conclusions:The nomogram prediction model based on independent risk factors for the recurrence of platinum-resistance of AEOC patients has good discrimination,calibration and clinical appli-cability,which can better predict the recurrence risk of platinum-resistance in AEOC patients after the initial treat-ment.

Objective:To analyze the influencing factors of platinum resistant recurrence in advanced epithelial ovarian cancer(AEOC),establish a nomogram model to predict platinum-resistant recurrence of AEOC,and inter-nally validate it.Methods:The clinicopathological data of 577 AEOC patients who achieved complete remission af-ter initial treatment in the Department of Gynecology,Yunnan Cancer Hospital from June 1,2013 to December 31,2021 were collected.According to whether the platinum free interval(PFI)was less than 6 months,the patients were divided into platinum-resistant recurrence group(130 cases)and non-platinum-resistant group(447 cases,including patients with platinum-sensitive recurrence and no recurrence after 6 months of follow-up).Multivariate Logistic regression analysis was used to screen for the independent risk factors affecting the recurrence of plati-num-resistant patients.Based on the independent risk factors,a nomogram prediction model was established,and Bootstrap method was used for internal verification.The area under the ROC curve(AUC),calibration curve and decision curve(DCA)were used to evaluate the performance of the model.Results:①There were statistically sig-nificant differences in age,bilateral ovarian invasion,FIGO staging,menopause,neoadjuvant chemotherapy(NACT),chemotherapy interval(TTC),platelet count(PLT),platelet count/lymphocyte count ratio(PLR),fibrino-gen/lymphocyte count ratio(FLR),prognostic nutritional index(PNI),albumin(ALB),CA125 level,ascites volume,residual lesions,perioperative chemotherapy frequency,and CA125 half-life between the two groups(P＜0.05).②Multivariate Logistic regression analysis showed that bilateral ovarian invasion,FIGO stage Ⅳ,TTC＞16 days,ini-tial ascites volume＞1000ml,perioperative chemotherapy frequency＞9 times,surgery with R2 resection,CA125 half-life＞52 days were independent risk factors for recurrence of platinum-resistant AEOC patients(OR＞1,P＜0.05).③The AUC of the nomogram model constructed based on the above 7 indicators was 0.791(95％Cl 0.747-0.835),and the calibration curve and ideal curve fitted well.DCA showed that the net benefit interval of the model was 0.037-0.800.Conclusions:The nomogram prediction model based on independent risk factors for the recurrence of platinum-resistance of AEOC patients has good discrimination,calibration and clinical appli-cability,which can better predict the recurrence risk of platinum-resistance in AEOC patients after the initial treat-ment.

Objective:To analyze the influencing factors of platinum resistant recurrence in advanced epithelial ovarian cancer(AEOC),establish a nomogram model to predict platinum-resistant recurrence of AEOC,and inter-nally validate it.Methods:The clinicopathological data of 577 AEOC patients who achieved complete remission af-ter initial treatment in the Department of Gynecology,Yunnan Cancer Hospital from June 1,2013 to December 31,2021 were collected.According to whether the platinum free interval(PFI)was less than 6 months,the patients were divided into platinum-resistant recurrence group(130 cases)and non-platinum-resistant group(447 cases,including patients with platinum-sensitive recurrence and no recurrence after 6 months of follow-up).Multivariate Logistic regression analysis was used to screen for the independent risk factors affecting the recurrence of plati-num-resistant patients.Based on the independent risk factors,a nomogram prediction model was established,and Bootstrap method was used for internal verification.The area under the ROC curve(AUC),calibration curve and decision curve(DCA)were used to evaluate the performance of the model.Results:①There were statistically sig-nificant differences in age,bilateral ovarian invasion,FIGO staging,menopause,neoadjuvant chemotherapy(NACT),chemotherapy interval(TTC),platelet count(PLT),platelet count/lymphocyte count ratio(PLR),fibrino-gen/lymphocyte count ratio(FLR),prognostic nutritional index(PNI),albumin(ALB),CA125 level,ascites volume,residual lesions,perioperative chemotherapy frequency,and CA125 half-life between the two groups(P＜0.05).②Multivariate Logistic regression analysis showed that bilateral ovarian invasion,FIGO stage Ⅳ,TTC＞16 days,ini-tial ascites volume＞1000ml,perioperative chemotherapy frequency＞9 times,surgery with R2 resection,CA125 half-life＞52 days were independent risk factors for recurrence of platinum-resistant AEOC patients(OR＞1,P＜0.05).③The AUC of the nomogram model constructed based on the above 7 indicators was 0.791(95％Cl 0.747-0.835),and the calibration curve and ideal curve fitted well.DCA showed that the net benefit interval of the model was 0.037-0.800.Conclusions:The nomogram prediction model based on independent risk factors for the recurrence of platinum-resistance of AEOC patients has good discrimination,calibration and clinical appli-cability,which can better predict the recurrence risk of platinum-resistance in AEOC patients after the initial treat-ment.

Objective:To analyze the influencing factors of platinum resistant recurrence in advanced epithelial ovarian cancer(AEOC),establish a nomogram model to predict platinum-resistant recurrence of AEOC,and inter-nally validate it.Methods:The clinicopathological data of 577 AEOC patients who achieved complete remission af-ter initial treatment in the Department of Gynecology,Yunnan Cancer Hospital from June 1,2013 to December 31,2021 were collected.According to whether the platinum free interval(PFI)was less than 6 months,the patients were divided into platinum-resistant recurrence group(130 cases)and non-platinum-resistant group(447 cases,including patients with platinum-sensitive recurrence and no recurrence after 6 months of follow-up).Multivariate Logistic regression analysis was used to screen for the independent risk factors affecting the recurrence of plati-num-resistant patients.Based on the independent risk factors,a nomogram prediction model was established,and Bootstrap method was used for internal verification.The area under the ROC curve(AUC),calibration curve and decision curve(DCA)were used to evaluate the performance of the model.Results:①There were statistically sig-nificant differences in age,bilateral ovarian invasion,FIGO staging,menopause,neoadjuvant chemotherapy(NACT),chemotherapy interval(TTC),platelet count(PLT),platelet count/lymphocyte count ratio(PLR),fibrino-gen/lymphocyte count ratio(FLR),prognostic nutritional index(PNI),albumin(ALB),CA125 level,ascites volume,residual lesions,perioperative chemotherapy frequency,and CA125 half-life between the two groups(P＜0.05).②Multivariate Logistic regression analysis showed that bilateral ovarian invasion,FIGO stage Ⅳ,TTC＞16 days,ini-tial ascites volume＞1000ml,perioperative chemotherapy frequency＞9 times,surgery with R2 resection,CA125 half-life＞52 days were independent risk factors for recurrence of platinum-resistant AEOC patients(OR＞1,P＜0.05).③The AUC of the nomogram model constructed based on the above 7 indicators was 0.791(95％Cl 0.747-0.835),and the calibration curve and ideal curve fitted well.DCA showed that the net benefit interval of the model was 0.037-0.800.Conclusions:The nomogram prediction model based on independent risk factors for the recurrence of platinum-resistance of AEOC patients has good discrimination,calibration and clinical appli-cability,which can better predict the recurrence risk of platinum-resistance in AEOC patients after the initial treat-ment.