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Background: The effectiveness of metallic stents in treating ureteral strictures following surgery and radiotherapy for gynecological tumors is currently uncertain. We aimed to investigate the efficacy and safety of thermo-expandable metallic stent (Memokath) in the treatment of ureteral stricture after radiotherapy for gynecological tumors. Methods: In this descriptive cross-sectional study, 27 patients with ureteral stricture were treated with Memokath stent after gynecological tumor radiotherapy with or without chemotherapy that was admitted to our hospital from August 2021 to August 2023. Clinical data on efficacy, safety, and complications during stent insertion and indwelling were analyzed. Results: The successful insertion of thirty-three stents in twenty-seven patients studied. The stenosis length was 10.14 ± 6.76 cm, and the hospitalization was 4.43 ± 1.83 days. One patient has died from the primary disease carrying a patency stent. The Kaplan-Meier graph showed that the cumilative patency rate of patients with thermo-expandable metallic stent were 92.4% (SD = 5.2%) in eight months, 77.4% (9.1%) in 12 months and 67.7% (SD = 12%) in 29 months, while the cumilative survival rate was 87.5% (SD = 11.5%) in 29 months. The stent patency was 81.48% and later complications of stent indwelling were 5/27, including refractory urinary tract infection (UTI) in three cases, stent migration, and stent intolerance respectively. The creatinine levels, hydronephrosis degree, and glomerular filtration rate improved after the operation, and the first two indicators were statistically significant. Conclusion: Memokath stent is a safe and effective treatment for ureteral stricture after surgery and radiotherapy with or without chemotherapy for gynecological tumors. [ABSTRACT FROM AUTHOR]

Abstract Background The effectiveness of metallic stents in treating ureteral strictures following surgery and radiotherapy for gynecological tumors is currently uncertain. We aimed to investigate the efficacy and safety of thermo-expandable metallic stent (Memokath) in the treatment of ureteral stricture after radiotherapy for gynecological tumors. Methods In this descriptive cross-sectional study, 27 patients with ureteral stricture were treated with Memokath stent after gynecological tumor radiotherapy with or without chemotherapy that was admitted to our hospital from August 2021 to August 2023. Clinical data on efficacy, safety, and complications during stent insertion and indwelling were analyzed. Results The successful insertion of thirty-three stents in twenty-seven patients studied. The stenosis length was 10.14 ± 6.76 cm, and the hospitalization was 4.43 ± 1.83 days. One patient has died from the primary disease carrying a patency stent. The Kaplan-Meier graph showed that the cumilative patency rate of patients with thermo-expandable metallic stent were 92.4% (SD = 5.2%) in eight months, 77.4% (9.1%) in 12 months and 67.7% (SD = 12%) in 29 months, while the cumilative survival rate was 87.5% (SD = 11.5%) in 29 months. The stent patency was 81.48% and later complications of stent indwelling were 5/27, including refractory urinary tract infection (UTI) in three cases, stent migration, and stent intolerance respectively. The creatinine levels, hydronephrosis degree, and glomerular filtration rate improved after the operation, and the first two indicators were statistically significant. Conclusion Memokath stent is a safe and effective treatment for ureteral stricture after surgery and radiotherapy with or without chemotherapy for gynecological tumors.

Objective: To explore the Therapeutic effect of synchronous Integrated intensity modulated radiotherapy combined with chemotherapy in stage IIIc of Cervical Cancer Methods: A total of 58 patients with stage IIIC cervical cancer (KPS ≥ 80) were analyzed in this study. They were admitted to our hospital between August 2017 and August 2022. Synchronous integrated boost intensity-modulated radiotherapy (SIB-IMRT) and sequential boost intensity-modulated radiotherapy (LCB-IMRT) were used to treat pelvic and/or para-aortic metastatic lymph nodes, with 30 cases in the SIB group and 28 cases in the LCB group. Comparison of short-term and long-term efficacy. Comparison of recurrence and metastasis rates, radiation dose to organs at risk and incidence of adverse drug reactions. Result: 30 patients were treated with simultaneous integrated boost intensitymodulated radiotherapy (SIB-IMRT), and 28 patients were treated with sequential boost intensity-modulated radiotherapy (LCB-IMRT). At the completion of radiotherapy and 3 months after radiotherapy, there was no significant difference in clinical efficacy observed between the two treatment groups. The median overall survival (OS), progression-free survival (PFS), and disease-free survival (DMR) in the SIB-IMRT group were significantly higher compared to the LCB-IMRT group. The SIB-IMRT group demonstrated significantly lower rates compared to the LCB-IMRT group. Furthermore, within 3 years and 5 years, the rates of lymph node recurrence, cervical and vaginal local recurrence, and distant metastasis within the radiotherapy field were significantly lower in the SIB-IMRT group compared to the LCB-IMRT group. There were no significant differences observed between the two groups in terms of the maximum dose to the small intestine (Dmax), dose received by 2cc of the small intestine (D2cc), maximum dose to the rectum (Dmax), and dose received by 1cc of the bladder (D1cc). The incidence of bone marrow toxicity in the SIB-IMRT group was significantly lower compared to the LCB-IMRT group. Moreover, the occurrence of grade III and bone marrow toxicity was also significantly lower in the SIB-IMRT group compared to the LCB-IMRT group. Conclusion: The study has concluded that there is no significant differences in in terms of bladder associated adverse events and gastrointestinal toxicity in both Simultaneous Integrated Boost Intensity-Modulated Radiotherapy and Layered Conical Beam Intensity-Modulated Radiation Therapy. [ABSTRACT FROM AUTHOR]

Objective To analyze the effect of physical therapy on patients with urinary incontinence and its early influencing factors. Methods From June 2019 to December 2021, 200 patients with stress urinary incontinence (SUI) treated at the First Hospital of Hebei Medical University were included in the study and divided into an intervention group and a control group using a random number table. General clinical data, symptom severity, and quality of life were compared between the two groups. Based on treatment outcomes, patients in the intervention group were further divided into effective and ineffective groups. Multifactorial logistic regression models were used to analyze the factors affecting treatment outcomes. Risk line charts were drawn using R software to establish an efficacy prediction scoring model, which was then validated for its predictive value. Results There were no significant differences in age, body mass index (BMI), 1-hour urine leakage volume, I-QOL score, and rapid contraction of pelvic floor muscle electromyography between the two groups at baseline (all P>0.05). After treatment and at follow-up, both groups showed improvements in 1-hour urine leakage volume and I-QOL scores compared to baseline, with the intervention group showing significantly better improvements (all P<0.05). Patients in the effective group had significantly lower age, BMI, number of vaginal deliveries, and history of pelvic surgery compared to the ineffective group, while lying rest bladder neck height and standing rest bladder neck height were significantly higher (all P<0.05). Multifactorial logistic regression indicated that advanced age (OR=1.243, P=0.000), higher BMI (OR=1.792, P=0.000), and multiple vaginal deliveries (OR=6.537, P=0.003) were independent risk factors for ineffective physical therapy, while higher standing rest bladder neck height (OR=0.855, P=0.024) was an independent protective factor. The consistency index of the efficacy prediction scoring model for predicting SUI clinical outcomes was 0.986 (0.912-0.997), and the average absolute error between the predicted and actual rates was 0.013, indicating good consistency. Conclusion The efficacy prediction model based on age, BMI, and bladder neck height can effectively predict clinical outcomes in SUI patients, aiding in early intervention strategies. [ABSTRACT FROM AUTHOR]

Objective To investigate the clinical efficacy of vonoprazan and esomeprazole in the treatment of reflux esophagitis and analysis of risk factors for treatment failure. Methods One hundred patients with reflux esophagitis were selected for the study. Among them, 50 patients were treated with vonoprazan and the other 50 patients were treated with esomeprazole. After 4 and 8 weeks of treatment, gastroscopy was performed to evaluate the efficacy, and clinical symptom scores were used to assess the efficacy. Patients who failed to respond to treatment at week 8 underwent drug crossover treatment until week 12, and efficacy was evaluated by gastroscopy. Finally, patients were divided into treatment failure group and success group based on the gastroscopy evaluation at 8 weeks, and risk factors for treatment failure were analyzed using univariate and multivariate analyses. Results Significant differences were found in the efficacy of vonoprazan and esomeprazole groups at 4 weeks P < 0.05 and 8 weeks (P < 0.05) based on clinical symptom scores and gastroscopy evaluation. The total effective rate of patients who switched to vonoprazan after crossover treatment was 64.71%, while that of patients who switched to esomeprazole was 14.29%, and the difference between the groups was statistically significant (P < 0.05) . Treatment failure was not associated with gender, age, smoking history, or family his- tory (P > 0.05), but was associated with body mass index ≥= 24kg/m² 2), pre-bedtime eating, alcohol consumption, H. pylori infection, disease severity, and treatment drugs, with statistically significant differences between the groups (P< 0.05). Multivariate logistic regression analysis showed that body mass index ≥=24kg/m² 2), pre bedtime eating, disease severity, and treatment drugs were risk factors for treatment failure. Conclusion Vonoprazan is effective in the treatment of reflux esophagitis and is superior to esomeprazole. Risk factors for treatment failure include body mass index >= 24kg / (m ^ 2), alcohol consumption, severity of lesions, and pre- bedtime eating. [ABSTRACT FROM AUTHOR]

This article aims to present the efficacy analysis of electric vehicle (EV) charging/discharging process as a sink or a distributed energy source (DES) in the framework of LFC problem of multi-area multi-source deregulated power system (MAMS-DPS). The energy storage/extraction of EVs acts as a noteworthy role in mitigation of deviation frequency of DPS. A problem of AGC system for two-area DPS having two thermal power generators of non-reheat type and aggregated fleet of EVs in each area is considered to study here. The electric power contract between the distribution (DISCOs) and generation (GENCOs) companies in the restructured environment of DPS is specified through a contract participation matrix named as the DPM. In DPS area deviation frequency, generated and tie-line powers fluctuate in case of variation of load. To resolve these problems the efficacy of EV is accessed applying the optimal control scheme using TLBO algorithm and compared performances with the control schemes based on the optimization algorithms of GA as well as PSO, and PI, PID control schemes. The comparative performance of responses of system variables of the deviation frequency, generated power, and tie-line power are analysed applying the control schemes as PI control for without/with EV cases, and PID control, and the GA/PSO/TLBO-tuned PI/PID control schemes for with EV case. The TLBO-PID control scheme outperforms to mitigate the deviations observing the steady-state error, undershoot, overshoot, and settling time performance indices. [ABSTRACT FROM AUTHOR]

Background: Several treatment modalities are used for the treatment of periorbital rejuvenation with variable results. Recent studies showed that fractional radiofrequency may be an effective treatment modality for periorbital aging. This study aims to determine the efficacy and safety of negative pressure fractional microneedle radiofrequency (NPFMR) as a treatment for periorbital aging. Methods: Twenty‐five patients with periorbital aging were involved in this study. They were treated two times with an interval of 1 month. The patients were evaluated before treatment and 1, 3, and 6 months after the final treatment. Results: The research findings suggest that periorbital wrinkles of the patients were significantly improved by VISIA system (p < 0.05). Physiological indicators detected by MPA10 system showed that compared with before treatment, the hydration increased (p < 0.05) and trans epidermal water loss (TEWL) decreased (p < 0.05) at 3 and 6 months after treatment. The glossiness increased at 1 month after treatment compared to pre‐treatment (p < 0.05) and returned to the baseline level at 3 and 6 months after treatment. There was no significant change in melanin content (p > 0.05). Periorbital dermal thickness of the patients significantly increased at 1, 3, and 6 months after treatment according to skin ultrasound (p < 0.05). A periorbital skin biopsy revealed that the collagen fibers in the dermis were significantly thicker and more orderly after treatment, and the expression of type I collagen fibers and elastic fibers was increased compared with that before treatment. One patient developed post‐inflammatory hyperpigmentation (PIH) at 1 month after the first treatment, which improved after active treatment. No other adverse reactions were observed. Conclusions: NPMFR could be an effective and safe treatment modality for the treatment of periorbital aging. [ABSTRACT FROM AUTHOR]

This study aimed to assess the impact of dose rates due to natural decay of Iridium-192 sources and the risk factors of clinical outcomes for cervical cancer patients treated with high-dose-rate (HDR) brachytherapy. Four ninety-four patients were divided into relatively-high-radioactive (rHR), relatively-medium-radioactive (rMR), and relatively-low-radioactive (rLR) groups for retrospective treatment response comparison. The short-term outcomes were evaluated using the 1-month /3-month follow-up results based on RECIST 1.1. Local recurrence-free survival (LRFS) and metastatic recurrence-free survival (MRFS) were selected as long-term outcomes. A class of transformation models with adaptive lasso was applied to assess the risk factors of long-term outcomes. No significant difference was identified in short- or long-term outcomes of different radioactive groups. Subgroup analyses demonstrated similar findings. In multivariate factor analysis, advanced stage was significantly associated with higher risk of local recurrence and metastatic recurrence (HR = 1.66, 95%confidence interval [CI] = 1.14–2.43, p = 0.008; HR = 1.57, 95%CI = 1.23–2.00, p < 0.001). Significant associations were observed between local recurrence and pathology, and between metastatic recurrence and pre-treatment serum indices, respectively (HR = 8.62, 95%CI = 2.28–32.60, p = 0.002; HR = 1.98, 95%CI=1.20–2.26, p = 0.008). Overall, there was no significant difference in long- or short-term efficacy of the HDR brachytherapy among the groups with different levels of activity of radiation sources. Stage, pathology, and pretreatment serum indices were crucial factors that affected the long-term outcomes. [ABSTRACT FROM AUTHOR]

Objective: To compare the clinical efficacy of endoscopic retrograde cholangiopancreatography (ERCP) combined with laparoscopic cholecystectomy (LC) and laparoscopic common bile duct exploration and lithotomy (LCBDE) in the treatment of cholecystolithiasis combined with bile duct stones. Methods: From September 2018 to January 2022, 195 patients with cholecystolithiasis complicated with extrahepatic bile duct stones from Department of Department of General Surgery, Shanghai Jiading Central Hospital met the inclusion criteria, including 60 cases in the LC group and 86 cases in the LCBDE group. The general condition, operation success rate, complications and residual stone rate of the two groups were retrospectively analyzed. Results: In the simultaneous operation group, 58 patients successfully performed ERCP, and the indwelling rate of the abdominal drainage tube (41.7 % vs. 95.3 %) was significantly better than that in the LCBDE group. There was no significant difference in the conversion rate to open surgery, operation time, and intraoperative blood loss between the two groups. In the simultaneous surgery group, 4 patients (6.7 %) developed pancreatitis after ERCP, which was cured by conservative treatment. The pain score at 6 h after operation was significantly lower than that in the LCBDE group (3.9 ± 1.6 vs 6.5 ± 2.4). There were no significant differences in biliary leakage (1.7 % vs. 4.7 %), postoperative cholangitis (5.0 % vs. 5.8 %), incision infection (3.3 % vs. 3.5 %), and bile duct stone residue rate (5.0 % vs 3.5 %) between the two groups. There was no severe pancreatitis, second operation or death. The duration of hospital stay was shortened in the concurrent operation group (5.1 ± 2.3d vs 7.9 ± 3.7d), and the operation cost was significantly higher than that in the LCBDE group (48839.9 ± 8549.5 vs 34635.9 ± 5893.7 yuan). Conclusion: ERCP combined with LC and LCBDE are both safe and effective methods for the treatment of cholecystolithiasis combined with extrahepatic bile duct stones. The simultaneous operation group has certain advantages in patient comfort and rapid rehabilitation, which can be popularized in qualified units.

Abstract Introduction Pulsed dye laser (PDL) is currently considered to be the first-line treatment for port-wine stains (PWSs) on the extremities despite its less than satisfactory therapeutic efficacy. Hemoporfin-mediated photodynamic therapy (HMME-PDT) is a vascular-targeted therapy that has rarely been used to treat PWSs on the extremities. Here, we evaluate the clinical efficacy and safety of HMME-PDT for the treatment of PWSs on the extremities. Methods Clinical data and dermoscopic images of PWSs on the extremities were obtained from 65 patients who underwent HMME-PDT between February 2019 and December 2022. The clinical efficacy of HMME-PDT was analyzed by comparing the pre- and post-treatment images. The safety of HMME-PDT was evaluated through observation during the treatment period and post-treatment follow-up. Results The efficacy rate of a single HMME-PDT session was 63.0% and that of two and three to six sessions was 86.7% and 91.3%, respectively. A positive correlation was found between therapeutic efficacy and the number of HMME-PDT sessions. The therapeutic efficacy of HMME-PDT was better on the proximal extremities than on other parts of the extremities (P = 0.038), and the efficacy of treating PWSs in each site was relatively improved with an increase of treatment time. The clinical efficacy of HMME-PDT differed across four PWS vascular patterns identified by dermoscopy (P = 0.019). However, there was no statistical difference in the therapeutic efficacy based on age, sex, type of PWS, and treatment history (P > 0.05), which may be partly attributed to the relatively small sample size or poor cooperation of infant patients. No obvious adverse reactions were observed during the follow-up period. Conclusions HMME-PDT is a very safe and effective treatment for PWSs on the extremities. Multiple HMME-PDT treatments, lesions located in proximal limbs, and PWSs with type I and IV vascular patterns under dermoscopy were associated with higher efficacy of HMME-PDT. Dermoscopy may help predict the clinical efficacy of HMME-PDT. Trial Registration No. 2020KJT085.

BACKGROUND: Tumor segment resection is one of the standard methods for the treatment of bone tumors. However, the reconstruction of bone defects after tumor resection faces many challenges. A growing number of researchers are focusing on 3D-printed prostheses for bone defect repair and reconstruction following bone tumor surgery. OBJECTIVE: To explore the feasibility of 3D-printed prostheses in the reconstruction of large bone defect following bone tumor surgery and to evaluate the postoperative outcomes. METHODS: Retrospective analysis of clinical data of 24 patients [19 males and 5 females, age 23.8 (6-61) years] who underwent bone tumor resection and 3D-printed prosthesis implantation in the Department of Bone Oncology, the First Affiliated Hospital of Xinjiang Medical University from December 2020 to September 2021 was conducted. There were 7 cases with distal femur tumor, 5 with pelvis tumor, 4 with proximal tibia tumor, 3 with middle femur tumor, 1 with distal tibia tumor, 1 with proximal humerus tumor, 1 with middle humerus tumor, 1 with scapula tumor, 1 with ulna tumor, and 22 cases with primary tumors (13 osteosarcoma, 4 Ewing sarcoma, 2 giant cell tumor of bone, 1 chondroblastoma, 1 chondrosarcoma, and 1 osteoblastoma), 2 metastatic carcinoma. Preoperative and postoperative imaging data were recorded and neoadjuvant chemotherapy was administered in 17 cases before surgery. The Musculoskeletal Tumour Society score was used to assess limb function before surgery and 6 months after surgery, and pain was assessed by the Visual Analog Scale, as well as the complications were recorded. RESULTS AND CONCLUSION: (1) All patients undergoing resection of the tumor segment and 3D-printed prosthesis implantation for the reconstruction of the bone defect were followed for 6-49 months, and the results showed that the length of osteotomy was (18.2 ± 7.3) cm and an average intraoperative bleeding volume was 740 (100-3 000) mL. (2) Two patients died of systemic metastasis, the remaining 22 had no pulmonary metastasis or recurrence during the followup period, and 1 patient developed aseptic loosening of the prosthesis at 25 months postoperatively. (3) The Musculoskeletal Tumour Society scores were significantly increased, while Visual Analog Scale scores were significantly decreased (P < 0.05) at 6 months postoperatively. (4) The Musculoskeletal Tumor Society score was rated excellent in all 22 patients at the final follow-up. (5) These results suggest that 3D-printed prosthesis is suitable for the reconstruction of large bone defects caused by bone tumor resection. Patients have good postoperative function and few complications. However, further investigations are needed to explore long-term follow-up results. [ABSTRACT FROM AUTHOR]

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Abstract Background Surgical approach and fixation material are crucial in the treatment of comminuted distal fibular fractures accompanied by tibial Pilon fractures. This study compared the efficacy of double-hooked locking plates and anatomic plates in minimally invasive percutaneous plate osteosynthesis (MIPPO) for the treatment of comminuted distal fibular fractures accompanied by tibial Pilon fractures. Methods Clinical data were collected from 96 patients diagnosed with comminuted distal fibular fractures accompanied by tibial Pilon fractures who had undergone MIPPO. Patients in the study group (n = 48) received double-hooked locking plate fixations and the control group (n = 48) received anatomical plate fixations. The operating time, intraoperative bleeding, length of hospital stays, full weight-bearing time, fracture healing time and complication rates in the two groups were compared. The quality of fracture reduction was evaluated using the Burwell–Chamley imaging scoring system; the ankle function was assessed based on the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Score. Results Patients in the study group had shorter operating time, less bleeding, significantly shorter hospital stays, and shorter time to full weight-bearing as well as fracture healing compared to the control group (P 0.05). Patients in the study group experienced better ankle recovery than those in the control group (93.75% vs. 75.00%) (P

Introduction: Pulsed dye laser (PDL) is currently considered to be the first-line treatment for port-wine stains (PWSs) on the extremities despite its less than satisfactory therapeutic efficacy. Hemoporfin-mediated photodynamic therapy (HMME-PDT) is a vascular-targeted therapy that has rarely been used to treat PWSs on the extremities. Here, we evaluate the clinical efficacy and safety of HMME-PDT for the treatment of PWSs on the extremities. Methods: Clinical data and dermoscopic images of PWSs on the extremities were obtained from 65 patients who underwent HMME-PDT between February 2019 and December 2022. The clinical efficacy of HMME-PDT was analyzed by comparing the pre- and post-treatment images. The safety of HMME-PDT was evaluated through observation during the treatment period and post-treatment follow-up. Results: The efficacy rate of a single HMME-PDT session was 63.0% and that of two and three to six sessions was 86.7% and 91.3%, respectively. A positive correlation was found between therapeutic efficacy and the number of HMME-PDT sessions. The therapeutic efficacy of HMME-PDT was better on the proximal extremities than on other parts of the extremities (P = 0.038), and the efficacy of treating PWSs in each site was relatively improved with an increase of treatment time. The clinical efficacy of HMME-PDT differed across four PWS vascular patterns identified by dermoscopy (P = 0.019). However, there was no statistical difference in the therapeutic efficacy based on age, sex, type of PWS, and treatment history (P > 0.05), which may be partly attributed to the relatively small sample size or poor cooperation of infant patients. No obvious adverse reactions were observed during the follow-up period. Conclusions: HMME-PDT is a very safe and effective treatment for PWSs on the extremities. Multiple HMME-PDT treatments, lesions located in proximal limbs, and PWSs with type I and IV vascular patterns under dermoscopy were associated with higher efficacy of HMME-PDT. Dermoscopy may help predict the clinical efficacy of HMME-PDT. Trial Registration No.: 2020KJT085. [ABSTRACT FROM AUTHOR]

Background and purpose: Lymph node metastasis (LNM) is the most common metastasis of differentiated thyroid cancer (DTC), and the efficacy of 131I on LNM is controversial. The aim of this study was to clarify the efficacy of 131I on LNM with good iodine uptake and the influencing factors. Methods: In this study, 161 iodine positive metastasis lymph nodes from 90 DTC patients treated by 131I from January 2015 to June 2019 in Xinhua Hospital Affiliated To Shanghai Jiao Tong University School of Medicine were included, and the clinical and imaging data of the patients were analyzed. SPSS 24.0 software was used to make statistical analysis. The measurement data were distributed according to the normal distribution, then the independent sample t-test was compared. The comparison of the counting data was conducted by χ2 test, and the multivariate analysis was carried out by logistic regression analysis. The receiver operating characteristic (ROC) curve between multiple quantitative indexes and the failure of 131I treatment were established, and the optimal diagnostic threshold was obtained. Results: Among 161 iodine positive metastasis lymph nodes, 71 (44.10%) were effective, and 90 (55.90%) were ineffective. Univariate analysis showed that there were significant differences in age, gender, pathological type, number of primary lesions, location of primary lesions, distant metastasis and serum thyroglobulin (Tg) level between the two groups (P

Background: Surgical approach and fixation material are crucial in the treatment of comminuted distal fibular fractures accompanied by tibial Pilon fractures. This study compared the efficacy of double-hooked locking plates and anatomic plates in minimally invasive percutaneous plate osteosynthesis (MIPPO) for the treatment of comminuted distal fibular fractures accompanied by tibial Pilon fractures. Methods: Clinical data were collected from 96 patients diagnosed with comminuted distal fibular fractures accompanied by tibial Pilon fractures who had undergone MIPPO. Patients in the study group (n = 48) received double-hooked locking plate fixations and the control group (n = 48) received anatomical plate fixations. The operating time, intraoperative bleeding, length of hospital stays, full weight-bearing time, fracture healing time and complication rates in the two groups were compared. The quality of fracture reduction was evaluated using the Burwell–Chamley imaging scoring system; the ankle function was assessed based on the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Score. Results: Patients in the study group had shorter operating time, less bleeding, significantly shorter hospital stays, and shorter time to full weight-bearing as well as fracture healing compared to the control group (P < 0.05). Additionally, the post-operative complication rates were significantly lower in the study group (6.16% vs. 22.92%) (P < 0.05), but there was no significant difference in the fracture reduction rate between the two groups (P > 0.05). Patients in the study group experienced better ankle recovery than those in the control group (93.75% vs. 75.00%) (P < 0.05). Conclusion: Double-hooked locking plates have advantages in the treatment of comminuted distal fibular fractures accompanied by tibial Pilon fractures during MIPPO due to their shorter operating time and less intraoperative bleeding, as well as shorter hospital stays, full weight-bearing time and fracture healing time, fewer complications and better ankle recovery. Therefore, double-hooked locking plates are worthy of clinical application. [ABSTRACT FROM AUTHOR]

Background: This study compared the efficacy and safety of sequential immunosuppressive therapy in patients with non-end-stage IgA nephropathy (IgAN) with Lee's classification of IV ~ V and provided evidence for the use of immunotherapy in patients with severe IgAN. Methods: We retrospectively analyzed the clinical data of patients with Lee's IV ~ V non-end-stage IgA nephropathy. Results: 436 patients were diagnosed with IgAN, and 98 patients who met the inclusion criteria were included in this retrospective study. Of these, 17 were in the supportive care group, 20 in the P group (prednisone-only), 35 in P + CTX group (the prednisone combined with cyclophosphamide followed by mycophenolate mofetil), and 26 in the P + MMF group (prednisone combined with mycophenolate mofetil). The four groups showed differences in the segmental glomerulosclerosis score and the proportion of patients with Lee's grade IV (p < 0.05), but no differences in other indicators. Compared with the baseline values, urine protein-to-creatinine ratio (PCR) significantly decreased and serum albumin increased (p < 0.05), but there was no significant difference between the groups. The estimated Glomerular Filtration Rate (eGFR) of the P, P + MMF, and P + CTX groups were higher than that of the supportive care group at the 6th and 24th month after treatment (all p < 0.05). At the 24th month, the eGFR in the P + CTX group was higher than that in the P + MMF group (p < 0.05). The effective remission rate of the P + CTX group was higher than that of the supportive care group (p < 0.05). At 12 months, the effective remission rate of the P group was higher than that of the supportive care group (p < 0.05). At the 24th month, there was no significant difference in the effective remission rates among the three groups (P, P + MMF, and P + CTX). Nine patients with severe IgA nephropathy reached the endpoint. Conclusion: This study showed that immunosuppressive therapy insevere IgAN patient scan effectively reduce urinary protein, increase albumin, and protect renal function in the early stages of IgAN. P + CTX is the most commonly used, which has a high effective remission rate of urine protein and a low incidence of endpoint events. [ABSTRACT FROM AUTHOR]

An extensive investigation into the usefulness of probabilistic and fuzzy logic approaches to natural language semantics is presented here. Natural Language Processing (NLP) has witnessed rapid advancements in recent years, with semantics playing a crucial role in ensuring accurate comprehension and response. Traditional deterministic models often fall short of capturing the nuances of semantic meaning due to the ambiguity and variability inherent in human languages. The purpose of this research is to determine if probabilistic approaches and fuzzy logic can help us grasp the nuances of language more fully. We deployed a number of models that make use of Bayesian networks, Markov Chains, and probabilistic graphical models, in addition to fuzzy logic-based models that deal with nebulous and unreliable language variables. Each model was tested on a large corpus containing sentences written in a variety of languages and dialects, and then trained to decode and construct phrases that made sense semantically and contextually. Our findings demonstrate that probabilistic approaches have a better understanding of uncertain and changing semantic aspects than do conventional deterministic models. Because of its flexibility in representing ambiguity, fuzzy logic has shown impressive potential for handling nuanced language and meanings that change depending on context. There is promise for a unified strategy in semantic analysis, as demonstrated by the top performance of hybrid models that combine probabilistic and fuzzy logic elements. [ABSTRACT FROM AUTHOR]

BackgroundSchizophrenia is a common mental disease with high rates of recurrence and disability. The therapeutic effects of antipsychotic drugs monotherapy are insufficient on improving patients' ability to daily life and social functioning, with possible adverse reactions. Therefore, early, comprehensive and whole course management is necessary for the improvement of patients' symptoms, ability to daily life and social functioning, to help them back to society as soon as possible.ObjectiveTo assess the efficacy of whole course management in patients with schizophrenia.MethodsFrom January 2019 to Febuary 2020, one hundred and twenty-nine schizophrenia patients were recruited from Shihezi Oasis Hospital and divided into the study group (n=64) and control group (n=65) . Demographic data including gender, age, marital status and education level of all patients were recorded by researchers. Patients in the control group received the standard therapy. While, patients in the study group received the whole course management base on the standard therapy, and both of them were followed up for one year. Treatment efficacy in the two groups was assessed by Positive and Negative Syndrome Scale (PANSS, including positive, negative syndrome and the general psychopathological symptom score, used to assess the patient's psychiatric symptoms) , Social Functional Defect Screening Scale (SDSS, used to assess the degree of social functional defect) , and Activity of Daily Living Scale (ADL, used to assess the patient's ability of daily living) . And 8-item Morisky Medication Adherence Scale (MMAS-8, used to assess patient medication adherence) was used to assess medication compliance of discharged patients. And recurrence rates (used to evaluate clinical efficacy) were calculated in discharging patients only. All assessments were conducted before and 3, 6, 12 months after the study.ResultsThere were no significant differences between two groups in demographic factors including gender、age、marital status and education level and PANSS, ADL, SDSS, MMAS-8 scores (P>0.05) . Compared to the control group, there were lower scores of PANSS, SDSS and General Psychopathological Symptom Score at 6 and 12 month (P0.05) .ConclusionThe whole course management could effectively alleviate the severity of schizophrenic, and could improve the ability to daily life, social functioning, as well as medication adherence in patients with schizophrenia.

Background and purpose: Lymph node metastasis (LNM) is the most common metastasis of differentiated thyroid cancer (DTC), and the efficacy of 131I on LNM is controversial. The aim of this study was to clarify the efficacy of 131I on LNM with good iodine uptake and the influencing factors. Methods: In this study, 161 iodine positive metastasis lymph nodes from 90 DTC patients treated by 131I from January 2015 to June 2019 in Xinhua Hospital Affiliated To Shanghai Jiao Tong University School of Medicine were included, and the clinical and imaging data of the patients were analyzed. SPSS 24.0 software was used to make statistical analysis. The measurement data were distributed according to the normal distribution, then the independent sample t-test was compared. The comparison of the counting data was conducted by X² test, and the multivariate analysis was carried out by logistic regression analysis. The receiver operating characteristic (ROC) curve between multiple quantitative indexes and the failure of 131I treatment were established, and the optimal diagnostic threshold was obtained. Results: Among 161 iodine positive metastasis lymph nodes, 71 (44.10%) were effective, and 90 (55.90%) were ineffective. Univariate analysis showed that there were significant differences in age, gender, pathological type, number of primary lesions, location of primary lesions, distant metastasis and serum thyroglobulin (Tg) level between the two groups (P＜0.05). Multivariate logistic regression analysis showed that the pathological types (OR=11.827, 95% CI: 1.128-123.978, P=0.039), distant metastasis (OR=0.220, 95% CI: 0.093-0.522, P=0.001) and number of primary lesions (OR=0.421, 95% CI: 0.212-0.837, P=0.014) were closely related to the outcome of the treatment. Conclusion: Multiple primary foci, papillary thyroid carcinoma (PTC), distant metastasis, serum Tg higher than 43.51 ng/mL and the maximum diameter of metastatic lymph nodes greater than 16.8mm are the risk factors of ineffective 131I treatment. Increasing the treatment dose or choosing surgical resection as soon as possible is recommended for those patients. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate and compare the efficacy of seven conventional treatments and traditional Chinese medicine (TCM) combined therapies for oral lichen planus., Materials and Methods: This study employs PubMed, Web of Science, Cochrane Library, and Cnki to collect studies. After evaluating the quality and bias risk, RevMan 5.4.1 and R Gemtc package was utilised with a visual analogue scale and side effects as outcomes, to compare the efficacy of the seven treatments., Results: This study included 20 studies, with a sample size of 1669. Our results suggest that photodynamic therapy and TCM demonstrate the most significant decrease in visual analogue scale and the rank is as follows: photodynamic therapy > TCM > TCM combined with non-hormonal immunosuppressive drugs > TCM combined with glucocorticoids > chloroquine combined with glucocorticoids > non-hormonal immunosuppressive drugs > glucocorticoids. Among them, compared to glucocorticoids, photodynamic therapy (-1.55, 95% CI: (-3.09, -0.02)), TCM (-1.25, 95% CI: (-2.46, -0.06)) significantly outperform in statistics. Moreover, no side effects were reported by the photodynamic therapy treatment. In the comparison with non-hormonal immunosuppressive drugs, the result indicates TCM (-4.17, 95% CI (-8.24, -0.34)), glucocorticoids (-2.78, 95% CI (-5.69, -0.17)) and their combination (-2.83, 95% CI (-5.93, -0.05)) have a significantly lower probability of the appearance of side effects., Conclusion: This study indicates that TCM, from the perspectives of efficacy and the likelihood of side effects, outperforms all other common therapies, besides photodynamic therapy, in treating oral lichen planus.

Objective To evaluate the safety and stability of 3D‐printed interbody fusion cages (3D‐printed cages) in anterior cervical discectomy and fusion (ACDF) by investigating the mid‐ and long‐term follow‐up outcomes. Methods In this prospective study, the clinical data of 30 patients with CSM admitted to the Second Hospital of Shanxi Medical University from May 2012 to May 2014 were analyzed. The cohort comprised 18 males and 12 females with an average age of 60.22 ± 3.2 years. All patients were examined by X‐ray, CT and MRI before the operation. A total of 30 cases of CSM were treated by ACDF with 3D printed cage implantation. Mid‐ and long‐term follow‐ups were performed after the surgery. Clinical efficacy was evaluated by comparing the JOA score, SF‐36 score, change in neurological function, cervical curvature index (CCI), vertebral intervertebral height (VIH) and fusion rate before the operation, 6 months after the operation, and at the last follow‐up. Results Two of the 30 patients were lost to follow‐up. The remaining patients were followed up for 48–76 (65.23 ± 3.54) months. The patients recovered satisfactorily with a significant clinical effect. The JOA score increased meanfully and the improvement rate was 89.4% at the final follow‐up. The SF‐36 score increased significantly from pre‐ to postoperatively. The height of the intervertebral space at the last follow‐up was not statistically significantly different from that at 6 months after surgery (P > 0.05), showing that the height of the intervertebral space did not change much and the severity of cage subsidence (CS) decreased. The CCI improved from pre‐ to postoperatively. The CCI did not change much from the 6‐month follow‐up to the last follow‐up. and the cage rate (CR) was 100% at the 6‐month and last follow‐ups. No severe complications, such as spinal cord injury, esophageal fistula, cerebrospinal fluid leakage, cervical hematoma or wound infection, occurred in any of the patients. Conclusion The clinical and radiological results show that the application of 3D‐printed cages in ACDF can significantly relieve symptoms. Moreover, 3D‐printed cages can restore the curvature of the cervical spine, effectively maintain the intervertebral height for a long time, and prevent complications related to postoperative subsidence.

Background: Port‐wine stain (PWS) is a congenital capillary malformation that often occurs on the face. Feasible and quantitative evaluation of facial port‐wine stain (FPWS) can significantly impact its clinical management and aid in future research. Aim: To develop and validate an easy‐to‐use scoring system for FPWS evaluation. Methods: A facial port‐wine stain area and severity index (FSASI) scoring system was proposed. To determine the FSASI score, the face was divided into four regions: forehead, right malar, left malar, and perioral. The severity of FPWS in each region was evaluated by three factors: percentage of the area affected, lesion color, and thickness. To evaluate the intra‐ and inter‐rater reliability of FSASI, two separate FSASI assessments on 111 clinical pictures were conducted by each rater in a one‐week interval, and the results from 6 independent raters at different time points were compared. Validity of the FSASI scores was assessed by comparing it with physician global assessment (PGA) and traditional classification data. Validity of the area and color elements of FSASI was also determined. The changes in FSASI scores after vascular‐targeted photodynamic therapy (V‐PDT) were analyzed to evaluate the treatment effect. Results: The FSASI scoring system showed good intra‐ and inter‐rater reliability (ICC >0.75, p < 0.001) and was found to be comparable to PGA scores (Spearman's r = 0.752–0.907, p < 0.001) and traditional classification data (Spearman's r = 0.426–0.662, p < 0.001). Efficacy analysis indicated that FSASI scores decreased after V‐PDT treatment. Conclusion: The results of this study demonstrated the reliability and validity of FSASI, which may be applied to assess the severity of FPWS and to evaluate treatment effects in clinical practice and research. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of paliperidone in the treatment of patients with depressive episodes with psychotic symptoms and its effect on neurological function and serum BDNF. Methods: Select 100 patients with depressive episodes with psychotic symptoms admitted in our hospital from January 2021 to October 2021 as the research objects, and randomly divide them into study group (n=50) and control group (n=50). The control group was treated with conventional drugs and depressive episode patients with psychotic symptoms, and the study group was treated with paliperidone and depressive episode patients with psychotic symptoms on the basis of the control group. Compared two groups of patients before and after treatment for 2 weeks, 6 weeks after treatment the Hamilton anxiety scale(HAMD) scores, Hamilton depression scale(HAMA) score, mental function defect degree, serum BDNE, mental derangement rating scale (BPRS) scores, social function defect SDSS score, daily life ability scale (ADL) and the incidence of adverse reactions. Results: There was no difference between the HAMA score and HAMD score of the two groups of patients before treatment (P>0.05). The HAMA score and HAMD score of the two groups of patients decreased at 2 weeks and 6 weeks after treatment, and the study group was lower than the control Group (P<0.05); the comparison of NIHSS score and serum BDNE level of the two groups of patients before treatment had no difference (P>0.05), the NIHSS scores of the two groups of patients were reduced 2 weeks after treatment and 6 weeks after treatment, and the study group Lower than the control group (P<0.05), the serum BDNE levels of the two groups increased, and the study group was higher than the control group(P<0.05); the BPRS of the two groups before treatment The scores of, SDSS and ADL were not different (P>0.05). The BPRS and SDSS of the two groups of patients were decreased 2 weeks after treatment and 6 weeks after treatment, and the study group was lower than that of the control group (P<0.05), and the ADL scores of the two groups of patients increased, and the study group was higher than that of the control group (P<0.05); There was no difference in the total incidence of adverse reactions between study group and control group (P>0.05). Conclusion: Applying paliperidone to patients with depressive episodes with psychotic symptoms can improve patients' anxiety, depression and neurological deficits, increase serum BDNE levels, and reduce patients' neurological and social deficits. The daily life ability of patients is worthy of clinical promotion and application. [ABSTRACT FROM AUTHOR]

To study the efficacy and safety of botulinum toxin (BTX) combined with broadband light (BBL) in the treatment of rosacea‐related erythema and flushing. A randomized, single‐blind, split‐face controlled study including 22 patients with erythemato telangiectatic rosacea were enrolled. Both cheeks were randomly divided into experimental group and control group. They were treated three times with an interval of 1 month. In the first treatment, the experimental group received BBL treatment and intradermal injection of BTX, and the control group received BBL treatment and intradermal injection of the same amount of normal saline; in the second and third treatments were both groups received the same BBL treatment. The patients were evaluated before the first treatment and 1, 2, 3, and 6 months after the treatment. Compared with the control group, the hydration in the experimental group increased and the global flushing symptom score (GFSS), VISIA red value, erythema index, transepidermal water loss, and sebum secretion decreased. The differences were statistically significant (p < 0.05). In the experimental group, at 3 months after the first treatment, compared with before treatment, the GFSS, VISIA red value, erythema index, transepidermal water loss and sebum secretion decreased the hydration increased. The sebum secretion returned to the pretreatment level in 6 months after treatment, and the other indexes maintained the level in 3 months after treatment. One patient had a slight lifting limitation of the corners of his mouth after 10 days of BTX injection, without special treatment, and recovered after 1 month. BTX intradermal injection combined with BBL has a definite therapeutic effect on the improvement of rosacea related erythema and flushing, which is better than simple BBL, and has high safety. It is worthy of clinical promotion. [ABSTRACT FROM AUTHOR]

Objective Follow‐up data of patients with spinal metastatic tumors were analyzed to investigate the effect of separation surgery combined with SBRT on clinical outcomes. Methods The clinical data of 52 patients with spinal metastatic tumors admitted to our hospital from January 2015 to December 2018 were retrospectively analyzed. There were 24 males and 28 females, aged 25–77 years, with an average of 56.7 ± 7.4 years. The separation surgery of all patients was successfully completed and followed up. Frankel neurological function grading, Karnofsky performance scores, VAS scores, Epidural spinal cord compression (ESCC) grading and muscle strength grading were used to assess the patients’ condition. Kaplan‐Meier analysis and the Log⁃rank test were used to calculate the hazard ratio (HR) and the 95% feasible interval for patients with different ages, genders, and treatments. The multivariate Cox regression model was used to calculate the risk value HR and the 95% feasible interval in patients undergoing only separation surgery or separation surgery combined with SBRT. Results After separation surgery, 46 patients had pain relief (88.5%), and the average VAS score decreased to 2.17 ± 0.52 points, which was significantly improved compared with preoperative score (P

BackgroundHemoporfin-mediated photodynamic therapy (HMME-PDT) is reported to be effective and safe for port-wine stains (PWS). However, its efficacy is influenced by several factors and there is no appropriate method to evaluate efficacy so far. Therefore, this study explored the clinical efficacy of HMME-PDT for PWS on the face and neck and the feasibility of evaluating treatment potency with optical coherence tomography (OCT).MethodsA total of 211 PWS patients subjected to HMME-PDT were recruited for study and correlations of therapeutic effect with treatment sessions, age, gender, lesion distribution and treatment history analyzed. OCT was utilized for quantitative analysis of PWS lesions of 36 selected patients before and after HMME-PDT.ResultsThe efficacy of two consecutive treatments was significantly higher than that of single treatment (P < 0.05). In multivariate analysis, after the first treatment, age, lesion distribution and treatment history were correlative factors affecting treatment efficacy (P < 0.05). The improvement effect on central facial lesions was lower than that on lateral facial lesions (P < 0.05). The efficacy of therapy on the group with no history of pulsed dye laser (PDL) treatment was greater than that on effective and ineffective treatment groups (P < 0.05). After the second session, age remained the only factor correlated with efficacy (P < 0.05). Dilated vessel diameter and depth before and after treatment were significantly different (P < 0.05). With increasing treatment times, age was the most significant factor influencing treatment efficacy.ConclusionsOur collective findings indicate that HMME-PDT therapy is effective and safe for PWS and support the utility of OCT in objective assessment of the efficacy of HMME-PDT.

Objective: To evaluate the safety and stability of 3D‐printed interbody fusion cages (3D‐printed cages) in anterior cervical discectomy and fusion (ACDF) by investigating the mid‐ and long‐term follow‐up outcomes. Methods: In this prospective study, the clinical data of 30 patients with CSM admitted to the Second Hospital of Shanxi Medical University from May 2012 to May 2014 were analyzed. The cohort comprised 18 males and 12 females with an average age of 60.22 ± 3.2 years. All patients were examined by X‐ray, CT and MRI before the operation. A total of 30 cases of CSM were treated by ACDF with 3D printed cage implantation. Mid‐ and long‐term follow‐ups were performed after the surgery. Clinical efficacy was evaluated by comparing the JOA score, SF‐36 score, change in neurological function, cervical curvature index (CCI), vertebral intervertebral height (VIH) and fusion rate before the operation, 6 months after the operation, and at the last follow‐up. Results: Two of the 30 patients were lost to follow‐up. The remaining patients were followed up for 48–76 (65.23 ± 3.54) months. The patients recovered satisfactorily with a significant clinical effect. The JOA score increased meanfully and the improvement rate was 89.4% at the final follow‐up. The SF‐36 score increased significantly from pre‐ to postoperatively. The height of the intervertebral space at the last follow‐up was not statistically significantly different from that at 6 months after surgery (P > 0.05), showing that the height of the intervertebral space did not change much and the severity of cage subsidence (CS) decreased. The CCI improved from pre‐ to postoperatively. The CCI did not change much from the 6‐month follow‐up to the last follow‐up. and the cage rate (CR) was 100% at the 6‐month and last follow‐ups. No severe complications, such as spinal cord injury, esophageal fistula, cerebrospinal fluid leakage, cervical hematoma or wound infection, occurred in any of the patients. Conclusion: The clinical and radiological results show that the application of 3D‐printed cages in ACDF can significantly relieve symptoms. Moreover, 3D‐printed cages can restore the curvature of the cervical spine, effectively maintain the intervertebral height for a long time, and prevent complications related to postoperative subsidence. [ABSTRACT FROM AUTHOR]

Objective To analyze the predictive value of a modified cutoff score of Multi-disease Risk Assessment (MDRA) for invasive fungal infection in patients admitted in the intensive care unit (ICU) and explore the optimal time window for intervention. Methods We retrospectively collected the clinical data of patients at high risk of invasive fungal infection, who were admitted in the ICU in our department between July, 2016 and June, 2018. We compared the predictive value of the original and the modified MDRA cutoff scores for invasive fungal infection in these patients. Results We screened a total of 393 high-risk patients, among whom 276 had MDRA scores above 30; 101 of the patients had a subsequent diagnosis or a clinical diagnosis of invasive fungal infections. After statistical analysis, we used a MDRA score of 36 as the cut-off value, which showed a sensitivity of 85.61% and a specificity of 89.38% for predicting invasive fungal infection. Among the patients with a >MDRA score ≥36, the patients who received antifungal therapy within 24 h (37 cases, Group A0) had a significantly reduced mortality (P < 0.05) with also shortened duration of ventilator use and ICU stay (P < 0.05) as compared with the 76 patients (Group B0) who did not receive antifungal therapy in time. Conclusion In patients admitted in ICU, a MDRA score ≥36 has a high predictive value for invasive fungal infection and is indicative of immediate interventions with antifungal drugs.

Objective To explore the method and clinical value of 3 D printing technology in the operation of craniocervical junction deformity. Methods The clinical data of 26 patients with craniocervical junction malformation with 3D printing technology assisted operation were analyzed. The symptoms and imaging manifestations pre-and post operation were compared, and the therapeutic effect was evaluated by JOA score. Results All patients completed simulation surgery on the disease model of the skull base junction area before surgery. Intraoperative C-arm X-ray examination and postoperative CT 3D reconstruction showed that the angle and depth of the internal fixation screw were satisfactory. Among the patients in this group, 24 patients had complete or almost disappeared symptoms after the operation, with an excellent and good rate of 88 . 4% . There were no severe complications or deaths. The JOA score ( 13. 23 ± 0. 4) at 1 month after operation was significantly higher than that before operation ( 11. 35 ± 0. 39 ), and the difference was statistically significant(P <0. 01). Conclusion 3D printing technology can effectively assist in the formulation of surgical plans for complex skull base diseases, improve the surgical effect and safety, and have clinical promotion value. [ABSTRACT FROM AUTHOR]

Objective: To explore the Therapeutic effect of synchronous Integrated intensity modulated radiotherapy combined with chemotherapy in stage IIIc of Cervical Cancer., Methods: A total of 58 patients with stage IIIC cervical cancer (KPS ≥ 80) were analyzed in this study. They were admitted to our hospital between August 2017 and August 2022. Synchronous integrated boost intensity-modulated radiotherapy (SIB-IMRT) and sequential boost intensity-modulated radiotherapy (LCB-IMRT) were used to treat pelvic and/or para-aortic metastatic lymph nodes, with 30 cases in the SIB group and 28 cases in the LCB group. Comparison of short-term and long-term efficacy. Comparison of recurrence and metastasis rates, radiation dose to organs at risk and incidence of adverse drug reactions., Result: 30 patients were treated with simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT), and 28 patients were treated with sequential boost intensity-modulated radiotherapy (LCB-IMRT). At the completion of radiotherapy and 3 months after radiotherapy, there was no significant difference in clinical efficacy observed between the two treatment groups. The median overall survival (OS), progression-free survival (PFS), and disease-free survival (DMR) in the SIB-IMRT group were significantly higher compared to the LCB-IMRT group. The SIB-IMRT group demonstrated significantly lower rates compared to the LCB-IMRT group. Furthermore, within 3 years and 5 years, the rates of lymph node recurrence, cervical and vaginal local recurrence, and distant metastasis within the radiotherapy field were significantly lower in the SIB-IMRT group compared to the LCB-IMRT group. There were no significant differences observed between the two groups in terms of the maximum dose to the small intestine (Dmax), dose received by 2cc of the small intestine (D2cc), maximum dose to the rectum (Dmax), and dose received by 1cc of the bladder (D1cc). The incidence of bone marrow toxicity in the SIB-IMRT group was significantly lower compared to the LCB-IMRT group. Moreover, the occurrence of grade III and IV bone marrow toxicity was also significantly lower in the SIB-IMRT group compared to the LCB-IMRT group., Conclusion: The study has concluded that there is no significant differences in in terms of bladder associated adverse events and gastrointestinal toxicity in both Simultaneous Integrated Boost Intensity-Modulated Radiotherapy and Layered Conical Beam Intensity-Modulated Radiation Therapy., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Mu, Wang, Xu, Shi, Song, Wang, Gao and Yan.)

Objective: To compare the clinical efficacy of endoscopic retrograde cholangiopancreatography (ERCP) combined with laparoscopic cholecystectomy (LC) and laparoscopic common bile duct exploration and lithotomy (LCBDE) in the treatment of cholecystolithiasis combined with bile duct stones., Methods: From September 2018 to January 2022, 195 patients with cholecystolithiasis complicated with extrahepatic bile duct stones from Department of Department of General Surgery, Shanghai Jiading Central Hospital met the inclusion criteria, including 60 cases in the LC group and 86 cases in the LCBDE group. The general condition, operation success rate, complications and residual stone rate of the two groups were retrospectively analyzed., Results: In the simultaneous operation group, 58 patients successfully performed ERCP, and the indwelling rate of the abdominal drainage tube (41.7 % vs. 95.3 %) was significantly better than that in the LCBDE group. There was no significant difference in the conversion rate to open surgery, operation time, and intraoperative blood loss between the two groups. In the simultaneous surgery group, 4 patients (6.7 %) developed pancreatitis after ERCP, which was cured by conservative treatment. The pain score at 6 h after operation was significantly lower than that in the LCBDE group (3.9 ± 1.6 vs 6.5 ± 2.4). There were no significant differences in biliary leakage (1.7 % vs. 4.7 %), postoperative cholangitis (5.0 % vs. 5.8 %), incision infection (3.3 % vs. 3.5 %), and bile duct stone residue rate (5.0 % vs 3.5 %) between the two groups. There was no severe pancreatitis, second operation or death. The duration of hospital stay was shortened in the concurrent operation group (5.1 ± 2.3d vs 7.9 ± 3.7d), and the operation cost was significantly higher than that in the LCBDE group (48839.9 ± 8549.5 vs 34635.9 ± 5893.7 yuan)., Conclusion: ERCP combined with LC and LCBDE are both safe and effective methods for the treatment of cholecystolithiasis combined with extrahepatic bile duct stones. The simultaneous operation group has certain advantages in patient comfort and rapid rehabilitation, which can be popularized in qualified units., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 Published by Elsevier Ltd.)

Objective: To explore the clinical effect of the method of Liangxuesanyu stasis on the patients with severe pneumonia and its mechanism. Methods: From March 2018 to October 2019, 60 patients who met the diagnosis criteria of severe pneumonia were selected from the Department of critical medicine, Affiliated Hospital of Nanjing University of traditional Chinese medicine. They were divided into 30 Chinese medicine groups and 30 control groups according to the random number table method. Patients in both groups were given conventional Western medicine treatment such as anti-infection, phlegm elimination, nutritional support, and respiratory support. Patients in the Chinese medicine group were added Liangxuesanyu Granules (shuiniujiao 20g, zhidahuang 10g, taoren 10g, shengdi 20g, mudanpi 10g, chishao 15g, danshen 20g), Wash with warm water to 200ml, and take 100ml orally or nasally each morning and evening. The course of treatment is 14 days. The differences in respiratory function, inflammatory response, and mortality at 28 days were compared between the two groups of patients before and on the 7th and 14th days after treatment. Results: The oxygenation index (PO2/FiO2) of the Chinese medicine group was significantly higher than that of the control group at the 7th day after treatment (P<0.01). The tracheal intubation rate, Murray score, WBC, TNF-α, and PCT were all lower than those of the control group. (P<0.05); On the 14th day after treatment, the oxygenation index (PO2/FiO2) of the Chinese medicine group was higher than the control group (P <0.05), the TNF-α was lower than the control group (P<0.05), and the Murray score was significantly lower than the control group (P<0.01); The mechanical ventilation time of the Chinese medicine group was lower than that of the control group (P<0.05), and the length of hospital stay and 28-day mortality were not significantly different from those of the control group (P>0.05). Conclusion: The intervention of Liangxuesanyu method in the treatment of severe pneumonia can effectively reduce the inflammatory response of patients, improve the oxygenation level and reduce the time of mechanical ventilation. [ABSTRACT FROM AUTHOR]

In a pivotal phase 3 study (Study 305), eribulin mesylate improved overall survival (OS) in patients with previously treated metastatic breast cancer (MBC) compared with treatment of physician's choice (TPC). This post hoc, pooled subgroup analysis of two phase 3 studies (Study 305 and Study 301) reports the influence of the number of prior chemotherapy regimens (0‐6) on OS in patients with locally advanced/MBC randomized to eribulin versus TPC/capecitabine. Patients with ≤ 3 prior chemotherapies for locally advanced/MBC had longer median OS with eribulin (15.3 months) versus control (13.2 months; hazard ratio, 0.858; P =.01). [ABSTRACT FROM AUTHOR]

To improve the energy-saving effect of the ground source heat pump air-conditioning system, an example is investigated, and the annual loads of the building are simulated and analyzed. The thermal energy management operation modelling is conducted. The hydraulic analysis is performed for different modes in each section. Given the same flow and tube type, a larger pipe diameter indicates a smaller hydraulic loss. Compared with the parallel 5-well loop and the parallel 10-well loop, the hydraulic loss of the series 2-well loop is the highest. When the sub-catch is connected to 5 loops, as the number of series wells increases, the tube length gets longer, the flow rate allocated by the loop gets less, and the load increases. Besides, the energy efficiency ratio of the ground source side decreases as the heat rejection load increases. Therefore, by adjusting the pipe diameter, the pipe type, and the depth of the well, the hydraulic loss can be reduced. The energy-saving effect of the loop in the parallel mode is better. Given the limited number of the managed wells, the parallel circuit can be adjusted to the same program. The connection allows the collector to distribute the flow evenly. The energy efficiency ratio of the ground source can be improved by changing the diameter of the horizontal trunk pipe. It is hoped that the hydraulic optimization design of the ground source heat pump air-conditioning system can provide a theoretical basis for the application and promotion of the ground source heat pumps. [ABSTRACT FROM AUTHOR]

Objective: This study aims to investigate the clinical efficacy of minimally invasive microsurgical resection of intraspinal tumors with the aid of Caspar retractors.Materials and Methods: A total of 125 intraspinal tumor patients with lesions smaller than 6 cm, who were treated at the Neurosurgery Department of our hospital from March 2010 to March 2016, were retrospectively analyzed. Among these, 73 patients underwent microsurgical resection of intraspinal tumors with the aid of Caspar retractors, while 52 patients underwent conventional laminectomy for resection of intraspinal tumors. Relevant indicators between both groups of patients were compared, including length of surgical incision, duration of surgery, postoperative drainage volume, time to first out-of-bed activity after surgery, postoperative hospitalization period, visual analog score (VAS) score, and Japanese Orthopedic Association (JOA) score, at 1 month after surgery.Results: Compared with the conventional laminectomy group, patients who underwent microsurgical resection with the aid of Caspar retractors had better outcomes in terms of length of surgical incision, postoperative drainage volume, time to first out-of-bed activity after surgery, postoperative hospitalization period, and VAS scores (p < 0.05). However, JOA scores at 1 month after surgery did not have any significant differences (p > 0.05).Conclusions: The microsurgical resection of intraspinal tumors with the aid of Caspar retractors has advantages of small trauma, less bleeding, and faster recovery. It is a safe and efficacious method for treating small intraspinal tumors. [ABSTRACT FROM AUTHOR]

Objective: Follow‐up data of patients with spinal metastatic tumors were analyzed to investigate the effect of separation surgery combined with SBRT on clinical outcomes. Methods: The clinical data of 52 patients with spinal metastatic tumors admitted to our hospital from January 2015 to December 2018 were retrospectively analyzed. There were 24 males and 28 females, aged 25–77 years, with an average of 56.7 ± 7.4 years. The separation surgery of all patients was successfully completed and followed up. Frankel neurological function grading, Karnofsky performance scores, VAS scores, Epidural spinal cord compression (ESCC) grading and muscle strength grading were used to assess the patients' condition. Kaplan‐Meier analysis and the Log⁃rank test were used to calculate the hazard ratio (HR) and the 95% feasible interval for patients with different ages, genders, and treatments. The multivariate Cox regression model was used to calculate the risk value HR and the 95% feasible interval in patients undergoing only separation surgery or separation surgery combined with SBRT. Results: After separation surgery, 46 patients had pain relief (88.5%), and the average VAS score decreased to 2.17 ± 0.52 points, which was significantly improved compared with preoperative score (P < 0.01). Muscle strength grading decreased in seven cases, showed no change in two cases, and recovered in 19 cases. Postoperative Frankel neurological function grading and Karnofsky performance scores were also significantly improved compared with preoperative scores (P < 0.01). The patients who accepted separation surgery were followed up for 9–47 months (26.3 ± 18.1 months), and 15 patients died due to the deterioration of the primary tumor. Thirteen patients received SBRT after surgery, including 12 cases of pain relief. The average VAS score of these 13 patients decreased to 1.64±0.41 points, which was significantly improved compared with preoperative and postoperative (P < 0.01), and muscle strength recovered in eight cases. Frankel neurological function grading and Karnofsky performance scores of these patients were also significantly improved compared with preoperative and postoperative Frankel neurological function grading and Karnofsky performance scores (P < 0.01). The patients who accepted separation surgery combined with SBRT were followed up for 11–38 months (mean 22.5 ± 10.2 months), and five cases died of primary tumor. Univariate and multivariate analysis showed that separation surgery combined with SBRT was an independent predictor of overall survival rate (OS). Conclusions: Separation surgery combined with SBRT is an effective way to treat spinal metastatic tumors as it not only has smaller surgical trauma, but can also significantly relieve pain, improve nerve function, and relieve spinal cord compression. [ABSTRACT FROM AUTHOR]

Analysis of safety and effectiveness of stent angioplasty for failure of thrombectomy in patients with acute intracranial atherosclerotic occlusion. Retrospective continuous analysis of the clinical data of 458 patients with acute stroke undergoing endovascular artery thrombectomy in Changhai Hospital of Second Military Medical University from May 2013 to February 2018. Patients with acute intracranial atherosclerotic occlusion treating with stent implantation were included and the safety and effectiveness of stent angioplasty was evaluated. There was successful stent release in 55 patients. There were 36 cases (65.5%) with occlusion located in the anterior circulation and 19 cases (34.5%) in the posterior circulation. Twenty patients underwent intravenous thrombolysis before surgery, and the time of admission to intravenous thrombolysis was (39.9 ± 13.2) minutes. Fifty-four patients (98.2%) achieved modified thrombolysis in cerebral infarction 2b-3 recanalization. The National Institutes of Health Stroke Scale score 2.0 (0.0,6.0) 7 days after surgery was significantly improved compared with the preoperative National Institutes of Health Stroke Scale score 12.5 (6.0–20.0) (Z = –4.073, P < 0.05). Intracranial hemorrhage occurred in 7 patients (12.7%) after surgery, among them, symptomatic intracranial hemorrhage occurred in 2 cases (3.6%). CTP examination of the skull 3–5 days after operation showed: Among 39 cases (70.9%): 33 cases (84.6%) were patency, 4 cases (10.3%) were occlusion, 2 cases (5.1%) were moderate stenosis, and 16 cases (29.1%) were not examined by computed tomography perfusion. Ninety-day follow-up showed that a total of 43 cases were followed up, and 12 cases were lost to follow-up. Thirty-four patients (79.1%) had a good prognosis 90 days after surgery (modified Rankin scale score 0–2) and 9 patients died (20.9%). When thrombectomy in patients with acute intracranial atherosclerotic occlusion fails, stent angioplasty is safe and effective; however, short-term stent reocclusion after surgery cannot be ignored. Because of the small sample size, larger multicenter clinical studies are needed to confirm this result. [ABSTRACT FROM AUTHOR]

Therapeutic efficacy of the use of oral atorvastatin in the treatment of patients with aspiration pneumonia complicated with cerebral infarction was investigated. Three hundred and fourteen cerebral infarction patients complicated with aspiration pneumonia who were admitted to the emergency department of Beijing Chaoyang Hospital Jingxi Branch from May 2015 to July 2017 were retrospectively analyzed. Among them, 160 patients who took atorvastatin were treated as observation group, and the remaining 154 patients were the control group. Patients were given basic treatment after diagnosis, and atorvastatin was also used for patients in the observation group. Venous blood was extracted to detect blood lipids and inflammatory cytokines. Patients were followed up for a period of six months, and the mortality was recorded. After treatment, blood lipid function and inflammatory factors in both groups were significantly improved (P<0.05). Hospital stay in the observation group (86.88%) was significantly shorter than that in the control group (76.33%) (P<0.01). After treatment, levels of TC, LDL, TG and CRP in the observation group (86.25%) were significantly lower than those in the control group (76.32%) (P=0.01). However, after treatment, level of HDL-C in the observation group (11.88%) was significantly higher than that in the control group (23.38%) (P=0.01). After treatment, levels of IL-6, IL-8 and TNF-α in the observation group were significantly lower than those in the control group (P<0.01). Total effective rate in the observation group was significantly higher than that of the control group (P=0.01). Total death rate in the observation group was significantly lower than that in the control group (P=0.02). In conclusion, atorvastatin is effective in the treatment of cerebral infarction patients complicated with aspiration pneumonia. [ABSTRACT FROM AUTHOR]

Most cancer biologists still rely on conventional two-dimensional (2D) monolayer culture techniques to test in vitro anti-tumor drugs prior to in vivo testing. However, the vast majority of promising preclinical drugs have no or weak efficacy in real patients with tumors, thereby delaying the discovery of successful therapeutics. This is because 2D culture lacks cell–cell contacts and natural tumor microenvironment, important in tumor signaling and drug response, thereby resulting in a reduced malignant phenotype compared to the real tumor. In this sense, three-dimensional (3D) cultures of cancer cells that better recapitulate in vivo cell environments emerged as scientifically accurate and low cost cancer models for preclinical screening and testing of new drug candidates before moving to expensive and time-consuming animal models. Here, we provide a comprehensive overview of 3D tumor systems and highlight the strategies for spheroid construction and evaluation tools of targeted therapies, focusing on their applicability in cancer research. Examples of the applicability of 3D culture for the evaluation of the therapeutic efficacy of nanomedicines are discussed.

Background: Cough variant asthma (CVA) is one of the most common respiratory diseases in children, which has a serious impact on the quality of life and daily activities of children. For severe CVA, immunomodulatory drugs are needed., Aim: To evaluate the efficacy of salmeterol combined with budesonide in the treatment of pediatric CVA., Methods: 130 children with CVA from January 2020 to December 2022 were prospectively selected and randomly divided into an observation group (salmeterol combined with budesonide) and a control group (budesonide combined with a placebo). Compare the clinical efficacy of two groups before and after intervention. The evaluation parameters include cough frequency score, nocturnal cough arousal, and lung function indicators. Serum inflammatory markers, immune function markers and airway anatomical indicators were also measured., Results: After the intervention, the total effective rate of the observation group was significantly higher than that of the control group, and the cough frequency score and the night cough wake rate of the observation group were lower than that of the control group, with a statistically significant difference. In addition, the changes of lung function indicators, serum markers and immune function markers in the observation group were better than those in the control group., Conclusion: The clinical efficacy of salmeterol combined with Budesonide in the treatment of CVA is better than that of Budesonide alone., Competing Interests: Conflict-of-interest statement: There are no conflicts of interest to report., (©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.)

The aims of this study were to investigate the clinical effects of I 125 implantation combined with radiofrequency ablation in treating bone metastases (BM) and analyze its clinical application so as to provide better treatment protocols for the treatment of BM. A total of 63 BM patients were randomly divided into the I 125 implantation group (CON, treated with I 125 seeds alone, 33 patients) and the combination group (I 125 -MA, 30 patients) to compare the clinical efficacy and adverse effects. After treatment, the clinical efficacy of Group I 125 -MA was significantly better than Group CON, and the quality of life was improved significantly (P< 0.05). I 125 -MA has relatively better clinical efficacy in treating BM, which can not only significantly improve patients’ life quality but also cause no serious adverse reaction. The therapy of I 125 implantation combined with radiofrequency ablation provides a new idea for treating bone metastases. Compare Group I 125 -MA and Group CON, remission rates of bone pain were 76.7% vs 42.4% (P< 0.05); movement ability: 73.3% vs 39.4% (P< 0.05); quality of life: improvement rates: 70% vs 42.4% (P< 0.05), the median initial time of relieve pain: 3.5 days vs 7.6 days (P< 0.05). [ABSTRACT FROM AUTHOR]

Aims: This work was designed to identify the subgroup of advanced hepatocellular carcinoma (HCC) patients for whom treatments containing immune checkpoint blockers (ICBs) were most effective. Materials & methods: A meta-analysis was performed to explore the subgroup population with the greatest benefit of treatments containing ICBs. Results: A total of 2228 patients from four randomized control trials were included. Treatments containing ICBs had better overall survival, progression-free survival and higher objective response rate over treatment without ICBs. Subgroup analysis revealed that treatments containing ICBs were highly effective in improving the overall survival of males, patients with macrovascular invasion and/or extrahepatic spread and viral-related HCC patients. Conclusion: Treatments containing ICBs are more effective for males, patients with macrovascular invasion and/or extrahepatic spread and viral-related HCC patients.

The regional electronic health records data are initially collected from several different hospitals and then undergo several rounds of data collection,transformation and integration,so there may exist a variety of quality problems.A new evaluation process for data usability was presented.The evaluation metrics were obtained by firstly gathering research requirements of clinicians,and then designing of requirement templates in the process.An example of obtaining evaluation metrics based on the requirement analysis with heart failure was also given.By using the process,ten metrics related to the data completeness and consistency were obtained and then the data of the provincial regional platform were evaluated for the usability.Finally,that the completeness and the consistency of data related to clinical research needs to be improved was shown.

Objective: To investigate the effect of posterior nasal neurectomy（PNN） with pharyngeal neurectomy （PN） on chronic sinusitis with nasal polyps （CRSwNP）complicated with perennial allergic rhinitis （PAR）. Methods: 83 patients with perennial allergic rhinitis combined with chronic group-wide sinusitis with nasal polyps who attended our hospital from July 2020 to July 2021 were selected. All patients underwent conventional functional endoscopic sinusitis surgery（FESS）+ nasal polypectomy. Patients were divided according to whether they underwent PNN+PN. 38 cases in the experimental group underwent FESS combined with PNN+PN; 44 cases in the control group underwent conventional FESS alone. All patients underwent the VAS, RQLQ, and MLK before treatment, and at 6 months and 1 year after surgery. Meanwhile, other relevant data were collected and the preoperative and postoperative follow-up data were collected and analyzed to assess the differences between the two groups. Results: The total postoperative follow-up period was 1 year. The recurrence rate of nasal polyps at 1 year postoperatively and the nasal congestion VAS score at 6 months postoperatively were not statistically significant in the two groups（ P >0.05）. However, the patients in the experimental group had statistically significantly lower effusion and sneezing VAS scores, MLK endoscopy scores and RQLQ scores at 6 months and 1 year postoperatively, and nasal congestion VAS scores at 1 year postoperatively compared to the control group（ P <0.05）. Conclusion: For patients with perennial AR complicated with CRSwNP, the combination of the PNN+PN in FESS can significantly improve the short-term curative effect, and PNN+PN is a safe and effective surgical treatment., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)