Background and Aims:Pancreatic ductal adenocarcinoma(PDAC)is the most common pathological type of pancreatic cancer,with a poor long-term prognosis and a lack of individualized prognostic assessment tools.This study was conducted to construct a prognostic nomogram for PDAC patients based on large-sample real-world data from the SEER database using machine learning algorithms to provide precise and individualized prognostic evaluations to inform clinical decision-making. Methods:The clinical and prognostic data of PDAC patients pathologically diagnosed from 2000 to 2018 were extracted from the SEER database based on inclusion and exclusion criteria.The data were randomly divided into training(70％)and validation(30％)sets.In the training set,independent prognostic factors were identified using univariate and multivariate Cox proportional hazards models,LASSO regression,and random survival forests.A nomogram was developed to predict 6,12,and 36-month cancer-specific survival(CSS)and overall survival(OS).The model was then validated and assessed in both training and validation sets using the concordance index(C-index),receiver operating characteristic(ROC)curve,calibration curve,survival curves,and decision curve analysis. Results:A total of 4 237 patients were included,with 2 965 in the training set and 1 272 in the validation set,showing comparable baseline characteristics.The median follow-up time was 18(9-36)months for the training set and 18(9-37)months for the validation set.The multivariate Cox model indicated that age,T stage,N stage,M stage,differentiation,surgery,systemic therapy,and chemotherapy were independent factors for OS(all P＜0.05).For CSS,age,T stage,N stage,M stage,differentiation,surgery,and chemotherapy were independent factors(all P＜0.05).The LASSO regression model found that age,differentiation,T stage,N stage,M stage,chemotherapy,surgery,lymph node dissection,radiotherapy,and systemic therapy were associated with OS,while T stage,N stage,M stage,chemotherapy,surgery,lymph node dissection,radiotherapy,and systemic therapy were linked to CSS.The random survival forest model identified the top five variables affecting OS as systemic therapy,differentiation,N stage,chemotherapy,and T stage;and for CSS,they were systemic therapy,differentiation,N stage,chemotherapy,and AJCC stage.Based on the analyses from the multivariate Cox,LASSO,and random survival forest model,along with clinical significance,a prediction model was successfully constructed using seven clinical features:age,T stage,N stage,M stage,differentiation,surgery,and chemotherapy to predict OS and CSS at 6,12,and 36 months.The validation results showed C-indexes of 0.692(95％CI=0.681-0.704)and 0.680(95％CI=0.664-0.698)for OS in the training and validation sets,respectively,and 0.696(95％CI=0.684-0.707)and 0.680(95％CI=0.662-0.698)for CSS.ROC curves indicated good predictive value,and calibration curves closely matched the ideal 45° reference line. Conclusion:Age,TNM stage,differentiation,surgery,and chemotherapy are independent prognostic factors for PDAC patients.The prognostic model based on these variables has high discrimination and accuracy,assisting clinicians in developing precise and personalized treatment and follow-up plans for PDAC patients.

Objective:To explore the effect of group sandplay therapy on children with autism spectrum disorder(ASD).Methods:Ninety children with ASD of Zhuang nationality were randomly divided into individual sandplay group, parent-child sandplay group and peer sandplay group, with 30 cases in each group. All the children were taught by the method of applied behavior analysis (ABA). Individual sandplay group was added with individual sandplay therapy, parent-child sandplay group was added with parent-child group sandplay therapy, and peer sandplay group was added with peer group sandplay therapy. Autism Behavior Checklist(ABC), Childhood Autism Rating Scale (CARS), Psycho-educational Profile for Autistic and Developmentally Disabled Children Version 3(PEP-3), Social Responsiveness Scale (SRS) and Assessment of Changes in Behavioural Trends were used to evaluate the efficacy before and after treatment for 6 months. SPSS 24.0 software was used for F test, paired t test and nonparametric test for statistical analysis. Results:After intervention, the scores of social interaction(16.90±2.14, 16.56±1.87), sports(20.60±2.43, 20.10±2.25), self-care(16.90±2.14, 16.93±2.30), ABC (97.53±7.18, 96.57±6.61)and CARS(36.10±2.29, 36.10±2.45) in parent-child and peer sandplay group were significantly different from those((19.43±3.22), (22.77±2.24), (19.87±3.60), (108.23±7.59), (37.80±2.92)) in individual sandplay group ( P<0.05). There were significant differences in the efficacy of imitation (76.67%, 80.00%), social interaction (83.33%, 86.67%) and emotional expression (80.00%, 83.36%) between parent-child and peer sandplay group and individual sandplay group ( P<0.05). The scores of social cognition(16.07±3.20, 17.07±2.26), social communication(31.43±3.84, 33.20±3.64), autism behavior(23.90±3.60, 25.93±4.57)and SRS(101.97±9.81, 107.57±8.20)in parent-child and peer sandplay group were significantly different from those((18.17±3.05), (36.53±4.03), (27.90±5.22), (117.07±10.09))in individual sandplay group ( P<0.05). There were significant differences in the number of eye contact((2.26±0.78)times/unit, (2.33±0.80))times/unit) and physical contact((2.27±0.78))times/unit, (2.33±0.80))times/unit) between parent-child and peer sandplay group and the number((1.70±0.79))times/unit, (1.83±0.77))times/unit) of individual sandplay group( P<0.05). Conclusions:Group sandplay can significantly improve the social interaction of Zhuang children with autism spectrum disorder than individual sandplay.However, peer group sandplay has the same effect on language and social motivation, and parent-child group sandplay has the same effect on sensory ability and social perception as individual sandplay.

Objective To explore the association between the students’emotional quotient (EQ),personality trait and interpersonal trust, and to clarify the potential function of interpersonal trust of higher students. Methods Interpersonal Trust Scale, Emotional Quotient Table and Eysenck Personality Questionnaire (EPQ) were used to investigate 364 students from Guangxi University and Guangxi Teachers Education University.SPSS 18.0 software was used for one-way ANOVA variance analysis,Pearson product-moment correlation analysis and stepwise Multiple Linear regression analysis.Results The differences in interpersonal trust,EQ and personality trait of EPQ had statistical significance between males and females,and the males’scores were higher than those of females (P <0.05,P < 0.01);the differencs in Lie of EPQ between nations had statistical significance and the scores of Dong, Hui and Tujia ethnic minority were higher than those of other nationalities (P < 0.01 ); the difference in personality trait of EPQ between educational background had statistical significances, and the undergraduates’scores were higher than those of master students (P <0.05).EQ was positively correlated with EPQ-E and EPQ-L (r=0.274,P <0.01;r =0.145,P <0.01),and was negatively correlated with EPQ-N and EPQ-P (r=-0.422,P <0.01;r = -0.202,P <0.01);interpersonal trust was negatively correlated with EQ and EPQ-E (r=-0.273,P <0.01;r=-0.169,P <0.01);special trust was negatively correlated with EQ and EPQ-E (r=-0.252,P <0.01;r = - 0.151,P < 0.01);interpersonal trust and general trust were negatively correlated with EPQ-P (r =0.313,P <0.01;r =0.338,P <0.01),and they were positively correlated with EPQ-L (r=-0.201,P <0.01;r = -0.217,P <0.01).Conclusion The students’EQ,personality trait are related to interpersonal trust of the students in Guangxi universities,and they have important prediction effects. Improving students’ EQ and interpersonal trust plays a positive role, whereas, the possible negative effects accompanying should never be neglected.

Objective To explore the correlation between social support and subjective well-being of Zhuang elder people in rural area.Methods 320 Zhuang nationnality rural old man were randomly selected from the xiangxian town,the Guangxi Zhuang Autonomous Region.Left behind elderly among them (A group) was 160,non left behind elderly (B group) was 80,five elderly (C group) was 80.General access volume,Memorial University of Newfoundland scale of happiness (MUNSH) and social support rating scale (SSRS) were investigated.Results Memorial University of Newfoundland scale of happiness scores of A,B,C groups were (27.90± 10.61,35.11 ±9.92,31.67± 12.07),and the difference was statistically significant (F=11.45,P＜ 0.05).SSRS scores of A,B,C groups were (34.91±8.13,39.53±6.95,30.31±7.62),the difference was statistically significant (F=26.53,P＜0.05).A,B group's happiness score and objective support was positively correlated (r=0.20,0.25 ; P＜0.05),A,B,C group's happiness score is positively correlated with subjective support (r=0.17,0.36,0.31; P＜0.05),happiness score and utilization degree positive correlation in A,C groups (r=0.23,0.39; P＜0.05).Conclusion Zhuang rural elderly subjective well-being is associated with each dimension of social support,and strengthen social support helps to improve the old man's subjective sense of happiness.

Objective To compare the serum protein profiles between people with successful aged 80 years and over in Bama versus Nanning,to identify the possible causes of the long life expectancy in Bama.Methods We evaluated the serum protein profiles using surface-enhanced laser desorption ionization time-of-flight mass spectrometry (SELDI-TOF-MS) with 4 different chromatographic surfaces,including the weak cation exchange (CM10),immobilized metal affinity capture (IMAC) 30-Cu,strong anion exchange (Q10) and hydrophobic surface (H50) protein chip arrays in people with successful aged 80 years and over living in Bama versus in Nanning city.SELDI-TOF-MS had a molecular mass detection range of 2000-50,000 D,with a first signal-to noise (S/N) ratio of 5,frequency of peak cluster of over 15 ％,and second S/N ratio of 2 and peak fluctuation of 0.3％ (m/z).Results The total numbers of serum protein (peptide) peaks for people with successful aging in Bama and Nanning were 71 on CM10,46 on IMAC30-Cu,81 on Q10,and 52 on H50.Among subjects from Bama as compared with Nanning (P＜0.05; mean ＞SD for each protein peak),there were 8 differently expressed protein peaks on CM10,of which 2 were upregulated and 6 downregulated; 7 on IMAC-Cu,of which 2 were upregulated and 6 downregulated; 5 on Q10,all of which were upregulated; and 6 on H50,of which 3 were upregulated and 3 downregulated.Conclusions There are marked differences in the serum protein profiles between people with successful aging living in Bama versus in Nanning.Most of the proteins are downregulated among people aged over 80 years in Bama.

ObjectiveTo investigate the psychological loneliness status of the Zhuang empty nester in rural area,and analyze the influencing factors.Methods 320 cases were randomly extracted in certain groups in xiangxian town,Shanglin County of Guangxi Zhuang Autonomous Region,including 160 empty nester( Group A),80 living with families elderly people (Group B ),80 state-fending elderly people (Group C ).The questionnaire and University of California Los Angeles Loneliness Scale(UCLA) were applied for this investigation.ResultsThe top three single-positive rates of the UCLA of the Group A was their hobby different from others (69.54％),lack of sense of intimacy(65.56％ ) and lack of trust(61.59％ ).The UCLA score was significantly different in the Group A(52.44 ±7.29),the Group B(32.16 ±9.01),the Group C(39.65 ± 8.11 ) (F=178.97,P ＜ 0.05).Multiple regression analysis showed a negative correlation between the UCLA score and the number of great-grandson living with the elderly,a positive correlation between the UCLA score and the interval of the children to visit the elderly.ConclusionThe Zhuang empty nester in rural area was very lonely.It is helpful to alleviate the loneliness of the Zhuang empty nester in rural area through establishing a comprehensive pension system,the duties of children to their parents and the family harmony.

OBJECTIVETo study effective method of showing the microvascular architecture of human and rabbit skin flaps.

METHODSAccording to endogenous alkaline phosphatase activity, Gomori-Takamatsu method and NBT/BCIP method were used to observe the microvascular architecture.

RESULTSBoth methods had capability to demonstrate the microvascular architecture of the human skin flap, whereas the examining results of rabbits were negative.

CONCLUSIONSGreat difference of endogeneous alkaline phosphatase activity exists in different animals. Gomori-Takamatsu method and NBT/BCIP method are useful in study of microvascular architecture of human skin flaps.

Alkaline Phosphatase ; metabolism ; Animals ; Humans ; Male ; Microcirculation ; anatomy & histology ; Rabbits ; Surgical Flaps ; blood supply