To construct a nomogram prediction model for early prediction of mortality risk in patients with non-mild acute pancreatitis (NMAP) and analyze its clinical application effect and advantages over other scoring systems.

Clinical data of 606 patients with NMAP from the large medical information mart for intensive careⅢ database (MIMIC-Ⅲ ) were selected. The patients were randomly divided into training and validation sets in a 7∶3 ratio. LASSO-Cox regression analysis was performed to construct a nomogram prediction model for mortality risk in NMAP patients. The model’s performance was assessed through receiver operating characteristic (ROC) curve, calibration curves, and decision curve analysis (DCA). Additionally, the predictive efficacy of the nomogram model was compared with BISAP, SOFA, qSOFA, APS Ⅲ, and OASIS scores.

LASSO-Cox regression analysis identified age, systolic blood pressure within 24 hours of admission, red blood cell distribution width (RDW), serum albumin, blood urea nitrogen (BUN), total bilirubin, and international normalized ratio (INR) as independent risk factors associated with mortality in NMAP patients (P<0.05). A nomogram prognostic model was developed based on these factors. The area under the curve (AUC) for the nomogram model was 0.76 (95% CI: 0.67-0.83), 0.79 (95% CI: 0.72-0.83), 0.83 (95% CI: 0.77-0.87), and 0.83 (95% CI: 0.78-0.88), respectively, for predicting mortality at 14, 30, 60, and 90 days in NMAP patients. The validation set demonstrated AUC values of 0.85 (95% CI: 0.76-0.94), 0.83 (95% CI: 0.76-0.91), 0.86 (95% CI: 0.79-0.93), and 0.87 (95% CI: 0.81-0.93), respectively. Calibration curves indicated excellent agreement between predicted and observed probabilities of mortality in both the training and validation sets. The DCA curve indicated that the nomogram had significantly positive net benefit when the threshold probability ranged from approximately 0.2 to 0.8. The ROC curve revealed superior prediction efficiency of the nomogram model compared to BISAP, SOFA, qSOFA, APSⅢ, and OASIS scores (P<0.05).

The nomogram model, incorporating age, systolic blood pressure within 24 hours of admission, RDW, serum albumin, BUN, total bilirubin, and INR offers a simple and convenient tool for accurate prediction of death risk in NMAP patients early.

To conduct a Meta-analysis of the safety and efficacy of robot-assisted laparoscopic radical resection of left colon cancer (RA) versus traditional laparoscopic-assisted radical resection of left colon cancer (LA).

Through CNKI, Wanfang Database, PubMed, NCBI and other databases, the control studies of RA and LA were retrieved from the database establishment to May 2021. Two researchers independently extracted relevant research data and collected relevant literature content, and Revman 5.3 software was used to analyze the collected data.

A total of 10 retrospective studies involving 4 770 cases of left colon cancer were included, including 2 309 cases of RA and 2 461 cases of LA. Compared to the LA group, the patients in RA group had shortert hospital stay (MD=-0.74, 95% CI: -1.33, -0.16; P=0.01), higher hospitalization cost (MD=1.02, 95% CI: 0.04, 2.00; P=0.04), less intraoperative bleeding (MD=-13.49, 95% CI: -20.91, -6.06; P<0.001), longer operation time (MD=42.64, 95% CI: 13.53, 71.74; P=0.004), earlier postoperative exhaust (MD=-0.29, 95% CI: -0.49, -0.09; P=0.004), earlier postoperative feeding time (MD=-0.30, 95% CI: -0.51, -0.09; P=0.005), and the conversion rate to open surgery was lower (OR=0.55, 95% CI: 0.45, 0.69; P<0.001). There were no significant differences in the number of dissected lymph nodes (MD=-0.20, 95% CI: -2.64, 2.24; P=0.87), the incidence of complications (OR=0.78, 95% CI: 0.60, 1.01; P=0.06).

RA is safe and feasible, and postoperative gastrointestinal function of patients can recover faster, but it has no significant advantage in terms of operation time, the number of dissected lymph nodes and incidence of complications.

To compare the safety, advantages and disadvantages of Hetao method and purse-string forceps method of insertion of anvil in laparoscopic high anterior rectal resection without auxiliary abdominal incision (CRC-NOSES Ⅳ type).

From January 2019 to September 2022, 103 patients with sigmoid colon cancer or high rectal cancer who underwent laparoscopic high anterior rectal resection (CRC-NOSES Ⅳ type) were selected as the study subjects. According to the different insertion methods of the anvil, 63 cases were divided into the Hetao group and 40 cases into the purse-string forceps group. The operation time, placement time, intraoperative blood loss, postoperative recovery and complications were compared between the two groups.

The placement time of anvil in the purse-string forceps group was (8.9±2.2) min, which was significantly shorter than (13.9±2.3) min in the Hetao group (t=10.908, P<0.001). There were no significant differences between the two groups in terms of operation time, intraoperative blood loss, bed-off time after operation, time of exhaust after operation, or time of hospitalization after operation. The incidence of anastomotic leakage, intestinal obstruction, anastomotic bleeding, abdominal bleeding, intra-abdominal infection and total complications in the two groups were not statistically significant.

Hetao method and purse-string forceps method have their own advantages and disadvantages, both of which are safe and reliable in laparoscopic high anterior rectal resection of CRC-NOSESⅣtype, with similar surgical complications and postoperative recovery. The two methods are worth trying and promoting.

To compare the diagnostic efficacy of ACR TI-RADS and C-TIRADS for malignant thyroid nodules, the value of recommending fine-needle aspiration biopsy (FNA), and the consistency in the application of the guidelines by physicians.

Using the ACR TI-RADS and C-TIRADS classification methods, ultrasography images of 3 018 thyroid nodules (size≥1 cm) from January 2009 to November 2018 in 5 hospitals were retrospectively analyzed. The receiver operating characteristics (ROC) curves were constructed using pathological findings as the gold standard to compare the diagnostic efficacy of the two guidelines. Area under the ROC curve (AUC), diagnostic sensitivity, specificity, Youden index and accuracy, and consistency of whether recommending FNA were analyzed to test the clinical applicability of the two guidelines.

The AUC of ACR TI-RADS and C-TIRADS were 0.892 and 0.884; the accuracy, sensitivity, and specificity of ACR TI-RADS were 0.812, 0.668, and 0.926, and of C-TIRADS were 0.811, 0.735, and 0.870. The unnecessary puncture rates for ACR TI-RADS and C-TIRADS were 40.2% and 31.9%; the concordance of FNA of the recommended nodes for ACR TI-RADS was good, while C-TIRADS was moderate (Fleiss’s Kappa=0.713 and 0.601).

ACR TI-RADS has better diagnostic efficacy than C-TIRADS. ACR TI-RADS has higher specificity and AUC, and C-TIRADS has higher sensitivity. C-TIRADS has lower unnecessary puncture rate and ACR TI-RADS has higher consistency in recommending FNA.

To explore the expression, prognosis, function, underlying mechanisms and significance of complement 3 (C3) in breast cancer, and to provide basis for further research on the mechanism of C3 in breast cancer.

TCGA, Breast Cancer Gene-Expression Miner, UALCAN, CPTAC, TIMER, Kaplan-Meier Plotter, GeneMANIA, DAVID were used for comprehensive analysis of the expression of C3 in the generic cancer, clinical features, prognostic value, and correlation immune. And then single genetic analysis was carried out by collecting clinical tissue samples for further validation.

TCGA database analysis showed that there were significant differences in the expression of C3 in various malignant tumors, and it was correlated with clinical stage and prognosis. After the intersection of expression difference, prognostic correlation and clinical stage correlation, it was found that C3 had significant differences in kidney renal clear cell carcinoma, pan-kidney cohort (KICH+KIRC+KIRP), thyroid carcinoma, breast invasive carcinoma, and hepatocellular carcinoma, which were related to prognosis and clinical stage. C3 was lowly expressed in breast cancer. The mRNA level of C3 in cancer tissues was positively correlated with the prognosis of breast cancer. The expression of C3 in breast cancer tissues was lower than that in normal breast tissues in both unpaired and paired analyses, and the differences were statistically significant (both P<0.001). The results of Survfit function showed that there was significantly prognostic difference in overall survival (OS) between patients with low and high C3 expression (P=0.01), and low C3 expression level was associated with shorter OS in cancers. The level of C3 mRNA was analyzed by UALCAN platform and the ROC curve was drawn. The results showed that C3 level had specific diagnostic value for breast cancer. TIMER database analysis showed that C3 was positively correlated with immune cell infiltration in all types of breast cancer.

C3 is lowly expressed in breast cancer, which has prognostic value and specific diagnostic value. C3 plays a role in breast cancer and affects the prognosis, and the mechanism may be related to C3-related immune cell infiltration. Complement plays an important role in tumor immunity through tumor microenvironment.

To compare the milligant-morgant hemorrhoidectomy (MMH), procedure for prolapse and hemorrhoids (PPH), tissue selecting therapy (TST) and Doppler-guided hemorrhoidal artery ligation (DG-HAL) in the treatment of hemorrhoids, and to provide evidence-based reference in clinic.

The full-text database of CNKI, Wanfang Database, CBMdisc, Pubmed, Cochrane Library and Embase were retrieved from the date of their establishment to December 2020. Randomized controlled trials (RCTs) about MMH, PPH, TST and DG-HAL in the treatmnet of hemorrhoids were collected. Meta-analysis was conducted by using GeMTC 0.14.3 statistical software.

A total of 45 RCTs were included, involving 5 847 patients. Compared with MMH, DG-HAL (MD=-4.16, 95% CI: -6.49, -1.82; P<0.05) and PPH (MD=2.28, 95% CI: 0.64, 3.89; P<0.05) could significantly reduce the degree of postoperative pain, the incidence of urinary retention after TST was significantly lower (OR=2.08, 95% CI: 1.23, 4.09; P<0.05). Compared with MMH (OR=0.01, 95% CI: 0, 0.15; P<0.05) and PPH (OR=0.08, 95% CI: 0, 0.78; P<0.05), the incidence of anal stenosis after DG-HAL was lower. PPH (OR=6.56, 95% CI: 1.20, 57.74; P<0.05) and TST (OR=58.25, 95% CI: 4.37, 2 605.94; P<0.05) had lower anal stenosis rates than MMH, TST was better than PPH (OR=8.50, 95% CI: 1.23, 150.91; P<0.05), with statistical significance. The order of probability were as follows: DA-HAL>TST>PPH>MMH in pain scores 24 hours after operation, MMH>PPH>TST>DA-HAL in postoperative bleeding, MMH>PPH>DA-HAL>TST in urinary retention, MMH>PPH>TST>DA-HAL in anal stenosis, DA-HAL>PPH>MMH>TST in recurrence rate.

The four surgical methods show their own advantages in the treatment of hemorrhoids. DG-HAL and TST have low incidence of postoperative complications such as pain, bleeding, urinary retention, anal stenosis and obvious advantages in postoperative comfort and safety. However, in terms of recurrence rate, TST is the best and DG-HAL is the worst.

To evaluate the safety and efficacy of simultaneous resection compared with staged resection for synchronous colorectal liver metastases (CRLM) through the method of systematic evaluation.

A literature search was performed including PubMed, Cochrane Library, Embase, CNKI, Wanfang data and VIP databases from January 2011 to April 2021. The data were processed using RevMan 5.3 for Meta-analysis.

A total of 3 937 patients were included in 18 articles, including 1 767 patients undergoing simultaneous resection and 2 170 patients undergoing staged resection. The incidence of perioperative complications in the simultaneous resection group was higher than staged operation group (OR=1.23, 95% CI: 1.05, 1.46, P=0.01), the operative time was shorter (WMD= -162.11, 95% CI: -212.49, -111.73, P<0.001), and the postoperative hospital stay was less (WMD= -8.19, 95% CI: -10.56, -5.81, P<0.001). There were no significant differences in perioperative mortality, R0 resection rate, 5-year overall survival rate or intraoperative blood loss.

For patients with synchronous CRLM, simultaneous resection may has a higher incidence of complications, and staged resection is still a good choice for patients with poor tolerance, late stage of the primary tumor, large range of liver resection and other conditions that may increase the difficulty of surgery.

To investigate the regulation of hypoxia-inducible factor-1α (HIF-1α)on monocarboxylate transporter-1 (MCT-1) expression in intestinal epithelial cells under hypoxia, and the protective effects of short-chain fatty acids (SCFAs) on intestinal barrier under hypoxia.

Normal ileum and ischemic ileum were resected and stained by immunohistochemistry targeting MCT-1. Normal C57 mice, intestinal epithelial-specific HIF-1α^ΔIEC mice and HIF-1α^flox/flox controlled mice were randomly divided into Sham group, ischemia reperfusion (I/R) group, I/R plus butyrate group. The distal ileum tissues were collected for immunohistochemical staining and the intestinal fluid in the intestinal lumen was detected for SCFAs. Intestinal epithelial cell line Caco-2 was cultured and hypoxia model was established. The cells were divided into control group, hypoxia group, hypoxia+siHIF-1α group, hypoxia+butyrate group and siMCT-1+hypoxia+butyrate group. Expression of MCT-1, HIF-1α and tight junction protein were detected by Western blotting. Changes in intestinal epithelial barrier function were assessed by transepithelial electrical resistance (TER).

Compared with Sham group, intestinal SCFAs in I/R group did not change significantly. Both ischemia and hypoxia could induce high expression of MCT-1 in intestinal epithelial cells. HIF-1α^ΔIEC mice had lower intestinal MCT-1 expression than the control group and were more sensitive to I/R injury. Butyrate mediated intestinal barrier protection and up-regulated tight junction proteins Claudin1 and Occludin when HIF-1α and MCT-1 were normally expressed.

HIF-1α mediates the expression of MCT-1 in intestinal epithelial cells during hypoxia and participates in the protection of intestinal barrier by SCFAs.

To study the expression of aquaporin 3 (AQP3) in obstructive small intestinal tissues and analyze its significance in clinical practice.

Pathological sections, hematoxylin eosin staining (HE), and AQP3 immunohistochemical staining were performed in 25 normal small intestine, 25 hyperemic edema and 25 necrotic small intestine, to observe the structural changes and AQP3 expression status.

The expression of AQP3 was strongly positive in normal small intestine. With the progression of small intestinal obstruction, intestinal congestion and edema, fibrous tissue hyperplasia, and vascular dilatation occurred. In parallel, the expression of AQP3 was significantly decreased in hyperemic edema small intestine compared to normal small intestine (P<0.001). AQP3 showed no expression in necrotic small intestine due to the destruction of small intestine, when progressing to the necrotic stage. The small intestinal obstruction patients with decreased AQP3 expression tended to have higher systemic inflammation than those with high AQP3 expression (P<0.05).

As the degree of necrosis worsens, the expression of AQP3 decreases in a gradient manner, suggesting that AQP3 may be a reliable marker for predicting necrosis of the obstructed small intestine.

To compare the short-term efficacy of robotic distal gastrectomy (RDG) and traditional laparoscopic distal gastrectomy (LDG) by Meta-analysis.

A literature search was performed including EMBASE, Pubmed, Cochrane Library, CNKI, CBM, VIP and Wanfang databases. The retrieval time was from the establishment of the database to October 2020. NOS scoring system was used to evaluate literature quality. Statistical analysis was performed using Review Manager 5.3 software.

A total of 2 456 patients with 14 relevant literatures met the standards, including 852 patients (34.69%) in RDG group and 1 604 patients (65.31%) in LDG group. Compared with LDG group, RDG group had longer operation time (WMD=-22.59, 95% CI: -25.55, -19.62; P<0.001), less intraoperative blood loss (WMD=34.29, 95% CI: 20.71, 47.87; P<0.001), earlier postoperative first feeding time (WMD=0.33, 95% CI: 0.13, 0.54; P=0.002), and shorter hospital stay (WMD=0.88, 95% CI: 0.05, 1.71; P=0.04). There were no statistical differences in the postoperative first exhaust time, the number of lymph node dissection and the incidence of total complications, as well as in the following common postoperative complications, such as poor healing of abdominal incision, infection, intra-abdominal hemorrhage, intestinal obstruction and intestinal leakage between the two groups.

RDG for distal gastric cancer can reduce intraoperative blood loss, shorten the first postoperative feeding time and the hospital stay. However, it has no obvious advantages in terms of shortening the operation time, the postoperative first exhaust time, the number of lymph node dissection and the incidence of total complications.

To explore the correlation between disheveled-associated activator of morphogenesis 1 (Daam1) and Fascin expression in breast cancer tissues and their relationship with clinicopathological parameters and prognosis.

A total of 92 breast cancer patients admitted to Shijiazhuang Sixth Hospital from January 2019 to December 2021 were selected as the research objects. The expression of Daam1 and Fascin proteins and mRNA in breast cancer tissues and corresponding adjacent tissues was detected by immunohistochemistry and quantitative real-time PCR, respectively. The relationship between Daam1 and Fascin protein expression and clinicopathological parameters of breast cancer was analyzed. Kaplan-Meier method was used to analyze the relationship between Daam1 and Fascin expression and breast cancer prognosis. The correlation between Daam1 and Fascin expression was analyzed using Spearman rank correlation or Pearson correlation.

The positive rates of Daam1 and Fascin protein and mRNA expression levels in breast cancer tissues were significantly higher than those in adjacent normal tissues, and the differences were statistically significant (P<0.01). Positive expression of Daam1 was significantly associated with distant metastasis in breast cancer (P<0.05). Fascin-positive expression was significantly associated with hypodifferentiation, PR positivity, ER positivity, lymph node metastasis and distant metastasis in breast cancer tissues (P<0.05). The cumulative disease-free survival rates in the Daam1 and Fascin-positive expression groups were significantly lower than those in the Daam1 and Fascin-negative expression groups, and the differences were statistically significant (Log-rank χ²=3.883, 5.159; P=0.049, 0.023). The expression of Daam1 and Fascin protein and mRNA in breast cancer tissues were significantly positively correlated (r=0.742, 0.689, both P<0.05).

Daam1 and Fascin are positively correlated and highly expressed in breast cancer tissues, closely related to the clinicopathological features and prognosis of patients, and may be involved in the occurrence, development and metastasis of breast cancer.

To investigate the relationship between miR-145-5p expression level and the clinicopathological characteristics and prognosis of hepatocellular carcinoma (HCC).

The relative expression of miR-145-5p in fresh frozen HCC and paraneoplastic tissues, HCC cell lines and formalin-fixed paraffin-embedded HCC tissues was detected by quantitative real-time PCR (qPCR), and HCC microarray data in GEO were also analyzed. The relationship between expression of miR-145-5p and clinicopathological characteristics of HCC was analyzed, and Kaplan-Meier curve and Cox proportional risk regression model were used for prognostic analysis.

miR-145-5p expression was lower in HCC cell lines and HCC tissues than in normal hepatocytes and paraneoplastic tissues (P<0.001). miR-145-5p low expression group was associated with metastasis and poor differentiation related parameters: tumor number (P=0.040), vascular invasion (P=0.010), Edmondson-Steiner grading (P=0.003). Cox proportional risk regression model identified tumor number, vascular invasion, Edmondson-Steiner grading, BCLC stage, and miR-145-5p expression as independent risk factors for overall survival in patients with HCC (HR=2.864, 2.114, 3.157, 4.106, 3.594; all P<0.05), and they were also independent risk factors for disease-free survival in patients with HCC (HR=1.764, 1.880, 3.726, 3.443, 1.909; all P<0.05).

Low expression of miR-145-5p is associated with aggressive metastasis of HCC and is expected to be an effective therapeutic target to improve the prognosis of advanced HCC.