China Medical University Research Articles

Mapping of Scientific Production on Entrepreneurship Education: A Bibliometric Analysis of a Decade

Entrepreneurship education has received much attention due to the in-creasingly complex and globalised entrepreneurial environment, lead-ing to the rapid development of related academic research. This study aims to provide a bibliometric analysis of 1017 publications related to entrepreneurship education in the Scopus database from 2014 to 2023, drawing a knowledge map to identify key themes, influential contribu-tors, impactful articles, research trends and future research directions. The results of the biblioMagika analysis showed that entrepreneurship education literature is continuously growing, with Agus Wibowo as the most productive author and Wenzhou Medical University in China the most prolific institution that has attracted wide attention. VOSviewer analysis showed close author and country co-authorship and found that the key terms "Entrepreneurship Education", "Entrepreneurial In-tentions" and "Entrepreneurship" were at the forefront of research. Fur-thermore, the thematic and word maps analysed by Biblioshiny reflect-ed the primary themes of the study, guiding future research directions. However, this study was also limited by using fixed keywords to search the literature in the Scopus database, excluding non-English publica-tions. Overall, this study provides a comprehensive picture of entre-preneurship education research, which helps researchers understand the research status of this field and proposes future research avenues.

Trends of type 2 diabetes with pulmonary tuberculosis patients,2013–2022, and changes after the coronavirus disease 2019 (COVID-19) pandemic

BackgroundTo describe the trends of Type 2 Diabetes with Pulmonary Tuberculosis (T2DM-TB) patients from 2013 to 2022 and to investigate the impact of COVID-19 lockdown on glycemic control and associated factors in T2DM-TB. MethodsIn this population-based study of the First Affiliated Yijishan Hospital of Wannan Medical College in China, we described the 10-year trends of patients diagnosed with T2DM-TB. We included patients diagnosed with TB, T2DM-TB and T2DM-TB patients for comparative analysis, aged 15 years or older. Data were missing, and both multidrug-resistant (MDR) TB patients and non-T2DM patients were excluded from our study. ResultsWe pooled Type 2 Diabetes (T2DM) and Tuberculosis (TB) data from The First Affiliated Yijishan Hospital of Wannan Medical College in China, gathered between January 1, 2013, and December 31, 2022. The data included 14,227 T2DM patients, 6130 TB patients, and 982 T2DM-TB patients. During the past 10 years, the number of inpatients with TB decreased, while the number of patients with T2DM and T2DM-TB increased year by year. To rule out any influence factors, we analyzed the ratio of the three groups. The ratio of TB/T2DM decreased year by year (p < 0.05), while the ratio of TB-T2DM/TB increasing year by year (p = 0.008). During the COVID-19 epidemic period, there was no significant change in the ratio of TB-T2DM/T2DM (p = 0.156). There was no significant change in the proportion of male patients with TB and TB-T2DM (p = 0.325; p = 0.190), but the proportion of male patients with T2DM showed an increasing trend (p < 0.001). The average age of TB patients over the past 10 years was 54.5 ± 18.4 years and showed an increasing trend year by year (p < 0.001). However, there was no significant change in the age of T2DM or TB-T2DM patients (p = 0.064; p = 0.241). Patients data for the first (2013–2017) and the last (2018–2022) five years were compared. We found that the number of T2DM and TB-T2DM in the last five years was significantly higher than in the first five years, but the number of TB was significantly lower than in the first five years. There is a significant statistical difference in the proportion of TB/T2DM and TB-T2DM/TB, which is similar to the previous results. The average age (56.0 ± 17.6 years) of TB patients in the last five years is significantly higher than in the first five years (53.1 ± 18.9) (p < 0.001). The number of male patients with T2DM in the last five years is higher than that in the first five years, with significant difference (p < 0.001). ConclusionThe trends of T2DM-TB among hospitalized TB patients have increased significantly over the past 10 years, which may be related to the increase in the number of T2DM cases. The COVID-19 pandemic has been effective in controlling the transmission of TB, but it has been detrimental to the control of T2DM. Male patients with T2DM and elderly TB patients are the key populations for future prevention and control efforts.

Analysis of placental surface cysts using ultrasonography: Histological and clinical correlation

AbstractObjectiveThis study aimed to investigate the diagnostic utility of ultrasonography, along with the clinical and histopathologic characteristics, and prognosis specifically related to placental surface cysts.MethodWe conducted a retrospective analysis of patients diagnosed with placental surface cysts at the Shengjing Hospital of China Medical University, between July 2010 and November 2022. Data were collected from a computer database of ultrasound images, and electronic medical records were reviewed. Placental cysts not located on the placental surface and cases where delivery occurred at outside institutions were excluded from the analysis.ResultsWe gathered data from 22 pregnant women who presented with placental surface cystic masses. These women had a mean age of 28.14 ± 3.04 years and the cysts were identified by ultrasound at a mean gestational age of 29 ± 5 weeks. The cysts were found to have varying sizes (ranging from 8 to 88 mm, with an average size of 47 ± 24 mm). Thirteen patients (59.09%) had cysts located near the placental cord insertion site (PCIS). All neonates, except for one case of induced labor, had favorable prognoses. The majority of the cysts were identified as amniotic cysts. Pathological diagnosis revealed degenerative changes in the placenta, with the cysts attributed to subchorionic fibrin formation by the central cyst.ConclusionPlacental surface cysts typically do not present with specific clinical symptoms and are diagnosed through ultrasound. It is important to note that this study specifically focused on placental surface cysts, excluding those not located on the placental surface. Regular ultrasound follow‐up is recommended, and the prognosis for placental surface cysts is excellent.

Assessment and evaluation of online education and virtual simulation technology in dental education: a cross-sectional survey.

The global outbreak of coronavirus disease (COVID-19) has led medical universities in China to conduct online teaching. This study aimed to assess the effectiveness of a blended learning approach that combines online teaching and virtual reality technology in dental education and to evaluate the acceptance of the blended learning approach among dental teachers and students. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist was followed in this study. A total of 157 students' perspectives on online and virtual reality technology education and 54 teachers' opinions on online teaching were collected via questionnaires. Additionally, 101 students in the 2015-year group received the traditional teaching method (TT group), while 97 students in the 2017-year group received blended learning combining online teaching and virtual reality technology (BL group). The graduation examination results of students in the two groups were compared. The questionnaire results showed that most students were satisfied with the online course and the virtual simulation platform teaching, while teachers held conservative and neutral attitudes toward online teaching. Although the theoretical score of the BL group on the final exam was greater than that of the TT group, there was no significant difference between the two groups (P = 0.805). The skill operation score of the BL group on the final exam was significantly lower than that of the TT group (P = 0.004). The overall score of the BL group was lower than that of the TT group (P = 0.018), but the difference was not statistically significant (P = 0.112). The blended learning approach combining online teaching and virtual reality technology plays a positive role in students' learning and is useful and effective in dental education.

Association between triglyceride glucose index (TyG) and psychotic symptoms in patients with first-episode drug-naïve major depressive disorder.

Major depressive disorder (MDD) sufferers frequently have psychotic symptoms, yet the underlying triggers remain elusive. Prior research suggests a link between insulin resistance (IR) and increased occurrence of psychotic symptoms. Hence, this study sought to investigate the potential association between psychotic symptoms in Chinese patients experiencing their first-episode drug-naïve (FEDN) MDD and the triglyceride glucose (TyG) index, an alternative measure of insulin resistance (IR). Between September 2016 and December 2018, 1,718 FEDN MDD patients with an average age of 34.9 ± 12.4 years were recruited for this cross-sectional study at the First Hospital of Shanxi Medical University in China. The study collected clinical and demographic data and included assessments of anxiety, depression, and psychotic symptoms using the 14-item Hamilton Anxiety Rating Scale (HAMA), the 17-item Hamilton Depression Rating Scale (HAMD-17), and the positive subscales of the Positive and Negative Syndrome Scale (PANSS), respectively. Measurements of metabolic parameters, fasting blood glucose (FBG), and thyroid hormones were also gathered. To assess the correlation between the TyG index and the likelihood of psychotic symptoms, the study used multivariable binary logistic regression analysis. Additionally, two-segmented linear regression models were employed to investigate possible threshold effects in case non-linearity relationships were identified. Among the patients, 9.95% (171 out of 1,718) exhibited psychotic symptoms. Multivariable logistic regression analysis showed a positive correlation between the TyG index and the likelihood of psychotic symptoms (OR = 2.12, 95% CI: 1.21-3.74, P = 0.01) after adjusting for confounding variables. Moreover, smoothed plots revealed a nonlinear relationship with the TyG index, revealing an inflection point at 8.42. Interestingly, no significant link was observed to the left of the inflection point (OR = 0.50, 95% CI: 0.04-6.64, P = 0.60), whereas beyond this point, a positive correlation emerged between the TyG index and psychotic symptoms (OR = 2.42, 95% CI: 1.31-4.48, P = 0.01). Particularly, a considerable 142% rise in the probability of experiencing psychotic symptoms was found with each incremental elevation in the TyG index. Understanding the non-linear link between the TyG index and the risk of psychotic symptoms in Chinese patients with FEDN MDD highlights the potential for targeted therapeutic approaches. By acknowledging the threshold effect observed, there is an opportunity to mitigate risk factors associated with IR-related psychiatric comorbidities through tailored interventions. These preliminary results stress the need for further longitudinal research to solidify these insights and contribute to more effective therapeutic strategies.

Coverage for the vascular pedicle of a free fasciocutaneous flap using split thickness skin graft with auxiliary procedure to achieve a safe method with no impairment of vessels: a case series and literature review

BackgroundThe vascular pedicle of a free flap is the most critical structure that determines its viability. Most of the times it is covered with local skin flaps raised from the recipient site or with part of the free flap itself. However, there are conditions in which the vascular pedicle can be covered with skin graft. The purpose of the present study is to describe our experience in the use of split-thickness skin grafts (STSG) as an auxiliary procedure for pedicle coverage.MethodsAll patients who underwent microvascular fasciocutaneous free flap reconstruction at the Department of Plastic Surgery of China Medical University Hospital in Taichung from 1986 to 2021 were retrospectively evaluated. Patients who met all of the following criteria were eligible for the study: microvascular free flap reconstruction of any region of the body with a fasciocutaneous flap and cases where tension was detected during skin closure over the pedicle of the flap and STSG was applied as a cover.ResultsThere were 14 cases in this series treated from 1986 to 2021. Among them, 11 cases had no additional skin at the proximal end of the free flap, nor local flap at disposal in the recipient site to cover the vessels. In 3 other cases a vascular bridge flap was used for cross-leg flap transfer without possibility of tension free tubulization to protect the vessels. All reconstruction were successful.ConclusionsDuring microvascular transfer of free flaps, if no skin flap is available to cover the vascular pedicle, skin graft can be used to protect the vessels without compromising the circulation of the flap. Our results, in accordance with the literature, supports the safety of this technique when direct closure of the skin above and near the pedicle is not possible.Level of evidenceLevel IV, Therapeutic.

An investigation for the efficacy of teaching model of combining virtual simulation and real experiment for clinical microbiology examination.

As a convenient teaching tool, virtual simulation experiment technology had been widely utilized in the field of medical education. However, virtual learning could not fully replace the benefits of in-person instruction. Therefore, finding ways to integrate both methods was crucial for achieving optimal educational outcomes. The objective of this study was to compare the effectiveness of the self-built virtual simulation and design experiment combining teaching mode and the traditional experimental teaching mode in the clinical microbiology examination experiment teaching. This study was conducted at Shandong First Medical University in China. The experimental group consisted of 100 third-year students from the grade 2020 majoring in medical examination technology, who underwent an innovative teaching model combining virtual and real experiments. The control group comprised of 100 third-year students from the grade 2019 in the same major, who received traditional experimental teaching model. In this study, we referred to grade 2020 as cohort 2020 and grade 2019 cohort 2019. The performance of both groups was assessed via experimental and theoretical testing. Meanwhile, survey questionnaires were administered to evaluate the efficacy of the innovative experimental teaching model and students' level of satisfaction with it. Cohort 2020 conducted a survey for modules 1 to 4, while cohort 2019 only conducted a survey for module 4, as detailed in the Appendix. The majority of students in the experimental group expressed satisfaction with the teaching model that combined virtual and real experiments, as evidenced by their superior performance on both experimental operational skills (87.54 ± 8.93 vs. 82.39 ± 10.55) and theoretical knowledge tests (83.65 ± 9.02 vs. 80.18 ± 8.24) compared to those in the control group. The combination of virtual simulation experiment and design experiment in the microbiological examination of clinical specimens represented an effective pedagogical approach. The instructional approach had the potential to incite a passion for learning, enhance proficiency in standardized experimental techniques, foster the ability to integrate theory with practice, and cultivate clinical reasoning skills.

Efficacy and safety of first-line treatment with anti-CD38 monoclonal antibody-based regimen for primary plasma cell leukemia

Objective: To analyze the efficacy and safety of first-line treatment with an anti-CD38 monoclonal antibody regimen for primary plasma cell leukemia (pPCL). Methods: Patients diagnosed with pPCL from December 1st, 2018 to July 26th, 2023, receiving first-line treatment of anti-CD38 monoclonal antibody-based regimens across multiple centers including Peking University People's Hospital, Fuxing Hospital of Capital Medical University, Qingdao Municipal Hospital, Shengjing Hospital of China Medical University, Handan Central Hospital, the First Affiliated Hospital of Harbin Medical University, the Fourth Hospital of Hebei Medical University and General Hospital of Ningxia Medical University were consecutively included. A total of 24 pPCL patients were included with thirteen being male and eleven being female. The median age [M(Q1, Q3)] was 60 (57, 70) years. Patients were grouped according to peripheral blood plasma cell (PBPC) percentage [5%-19% (n=14) vs ≥20% (n=10)]. Last follow-up date was September 26th, 2023. The median follow-up period was 9.1 (4.2, 15.5) months. Patients' data related with clinical baseline characteristics, efficacy, survival and safety were retrospectively collected. Cox proportional hazards regression model was used to analyze risk factors associated with survival. Results: Among 24 pPCL patients, 16 (66.7%) patients had anemia at diagnosis, 13(54.2%) patients had thrombocytopenia, 8 (33.3%) patients had a baseline estimated glomerular filtration rate (eGFR)<40 ml·min-1·(1.73m2)-1, 13 (54.2%) patients had elevated lactate dehydrogenase (LDH) levels. The median PBPC percentage was 16% (8%, 26%) . Fluorescence in situ hybridization testing indicated that patients harboring 17p deletion, t(4;14) or t(14;16) were 6 (25.0%), 4 (16.7%) and 4 (16.7%), respectively. The overall response rate was 83.3% (20/24). The median progression-free survival (PFS) was 20.5 (95%CI: 15.8-25.2) months, and the median overall survival (OS) was not reached. Estimated 1-year and 2-year PFS and OS rates were 75.0% and 89.1%, 37.5% and 53.4%, respectively. The median PFS and OS for patients with PBPC percentages 5%-19% and≥20% were not reached and 20.5 (95%CI:15.7-25.3) months, 17.8 months and not reached, respectively. There was no significant statistical difference of PFS and OS between two groups (all P>0.05). Multivariate Cox regression analysis showed that 1p32 deletion was the risk factor associated with PFS (HR=7.7, 95%CI: 1.1-54.9, P=0.043). Seventeen patients (70.8%) developed grade 3-4 hematologic toxicities. Twelve patients (50.0%) developed grade 3-4 thrombocytopenia. Sixteen patients (66.7%) developed infection. All hematologic toxicities and infections were improved after supportive treatment. Conclusion: First-line treatment with anti-CD38 monoclonal antibody-based therapy for pPCL is effective and safe.

Combining lecture-based and team-based learning to improve clinical immunology practice effects in the laboratory department of a teaching hospital in China

Objectives: In order to cope with the severe situation of the current COVID-19 epidemic and to provide better quality medical staffs for the Chinese medical system, as well as to promote the continuous development of clinical laboratory medicine towards standardization, normalization and technical automation. The application value of the lecture-based learning (LBL) and team-based learning (TBL) dual-track mode for internship in the clinical immunology subgroup of the laboratory department was evaluated in conjunction with the current undergraduate education mode of clinical laboratory technology in China, to provide a more efficient method for enhancing the comprehensive ability of interns in the laboratory department. Methods: A total of 61 laboratory interns from the grade 2017 of Southwest Medical University in China were collected and randomly divided into two groups: A and B. The group A adopted the traditional LBL teaching mode, and group B used the LBL-TBL dual-track teaching mode. The students' comprehensive abilities such as theoretical knowledge and experimental skills under the teaching models were compared. And finally the teaching effect was evaluated by theoretical assessment and questionnaire. Results: The satisfaction rate of group B was remarkably higher than that of group A in terms of analyzing skills, problems-solving ability and clinical operation (P &lt; 0.05). There was no significant difference between the two groups involving in theoretical achievement levels (P &gt; 0.05), but group B had a greater satisfaction rate than group A for enhancing theoretical knowledge acquisition. Conclusions: The LBL-TBL dual-track teaching mode plays a positive role for the internship in the laboratory department, which helps to improve the independent learning capability, analyzing skills and problems-solving ability. The LBL-TBL dual-track teaching method is worth further promotion in clinical immunology practice of the laboratory department.

A274 COVID-19 INFECTION RISK BETWEEN VACCINATED PATIENTS WITH ULCERATIVE COLITIS AND CROHN’S DISEASE : A RETROSPECTIVE COHORT STUDY IN TAIWAN

Abstract Background The effectiveness of coronavirus disease 2019 (COVID-19) vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in patients with inflammatory bowel disease (IBD) is well established, but it is not clear whether patients with ulcerative colitis (UC) and Crohn’s disease (CD) have different risks of COVID-19 infection after vaccination. Aims The aim of this study was to compare the risk of COVID-19 infection after vaccination in patients with UC and CD. Moreover, we also investigated risk factors related to COVID-19 infection and collected data on any adverse events and disease symptoms. Methods We conducted a retrospective cohort study in adult IBD patients who had received at least two doses of COVID-19 vaccination and compared the prevalence of infection between UC patients and CD patients using the medical records of China Medical University Hospital between 1 January 2020 and 31 March 2023. All data management and odds ratios calculations were performed using version 9.4 of SAS software (SAS Institute, Cary, NC, USA). Results Total 169 IBD patients (96 with UC, 73 with CD) were included in this study. UC patients were older than CD patients (44.92±13.72 vs. 37.27±15.27 years, p=0.0008)(Table 1). A high proportion were male (IBD 70.41%; UC 65.63%, and CD 76.71%). Most (57.4%) received three doses of COVID-19 vaccines. Azathioprine, steroid, and mesalazine medication histories were different between the groups (pampersand:003C0.05). COVID-19 infection prevalence was 49.11% (UC 56.25%, CD 39.73%; p=0.0333) (Figure 1). Logistic regression analysis suggested UC patients had an odds ratio of 1.95 (95% CI=1.05-3.62) and adjusted odds ratio of 2.78 (95% CI=1.20-6.44) for COVID-19 infection compared to CD patients, indicating a 1.95-fold to 2.78-fold higher risk (Figure 2). There was a trend towards a decreasing risk of COVID-19 infection with increasing number of vaccine doses. Medication was not identified as a risk factor. (Figure 3) Conclusions Our study identified a greater risk of COVID-19 infection in vaccinated patients with UC than those with CD. However, most patients who became infected with COVID-19 did not have severe symptoms and only one case was hospitalized. The mortality rate of COVID-19 in IBD patients is not specifically higher than the general population. Supporting the view that SARS-CoV-2 vaccination is effective in patients with IBD. Odds ratios (95% confidence interval) for logistic regression model predicting COVID-19 infection among vaccinated IBD patients Figure 1. The medications used before COVID-19 infection between vaccinated patients with ulcerative colitis (UC) and Crohn’s disease (CD). Figure2. The prevalence of COVID-19 infection between vaccinated patients with ulcerative colitis (UC) and Crohn's disease (CD). Figure 3. The symptoms after COVID-19 infection between vaccinated patients with ulcerative colitis (UC) and Crohn's disease (CD). Funding Agencies None

Factors related to university teaching that influence academic success of international medical students in China.

Academic success is extremely important for international medical students enrolled in Chinese universities, as it affects their performance in their licence exams and future work opportunities. However, insufficient research has been conducted on university academic staff's awareness of teaching-related factors that affect their students' academic success. A purposive sampling approach was taken in the study to recruit academics teaching in medical universities in China. The selection of informants was based on the subject they taught and their gender, experience of teaching international medical students, educational background and career stage. Semi-structured interviews were conducted with academics ( N = 36) between November 2020 and January 2021 at two medical universities in China. Each interview lasted between 30 and 70 minutes and was audiotaped, transcribed verbatim and thematically analysed. The teaching factors that academics perceived to have an important influence on the success of students were (i) pedagogy and content alignment; (ii) language barriers; (iii) resource management and the learning environment; and (iv) educator attributes and guidance. University faculties and departments involved in teaching international medical students should ensure that their academic staff are supported in their ongoing professional development and provided with resources to enhance their teaching quality. The four factors (and their sub-factors) listed above should be prioritised in such staff training.

Ultrasonic AccV: a potential indicator of peripheral arteriosclerosis in patients with chronic obstructive pulmonary disease

ObjectiveThis study aimed to investigate the risk factors for peripheral arteriosclerosis (PAS) and peripheral artery disease (PAD) in chronic obstructive pulmonary disease (COPD) patients and potential ultrasound indicators that could be used to improve detection.MethodOutpatients seeking care between January 1, 2017, and December 31, 2020, in The First Affiliated Hospital of China Medical University were prospectively recruited. Subjects were divided into COPD and non-COPD (control) groups, and the COPD group was further divided into PAD and non-PAD subgroup, at the same time, PAS and non-PAS subgroup. Indicators of PAD -ankle-brachial index (ABI), indicators of PAS- pulse wave velocity (PWV), and ultrasound indices -peak systolic blood flow velocity (PSV) and blood flow acceleration velocity (AccV) were compared.ResultSixty-nine (61.6%) of 112 enrolled subjects had COPD. COPD patients had higher age, and blood pressure (BP)lower than controls. Seventeen (24.6%) COPD patients had PAD, the prevalence of PAD increases with the decrease of lung function, and seven (16.3%) non-COPD patients had PAD, however, there was no significant statistical difference between COPD and non-COPD groups. Fifty (72.5%) COPD patients had PAS, and thirty-four (79.1%) non-COPD patients had PAS, however, there was also no significant difference. The PAS subgroup had higher age, body mass index(BMI), body fat percentage(BFP), lower FEV1 and FEV1/FVC, as well as higher levels of right brachial artery and left dorsalis pedis artery AccV. Factors that correlated with ABI were 6MWD, post-bronchodilator FEV1, FEV1/ FVC, and maximal middle expiratory flow between 75% and 25% of FVC. Age, BP, and 6MWD, but not pulmonary function, were associated with brachial-ankle PWV (baPWV). There was a positive correlation between baPWV and radial artery AccV bilaterally.ConclusionRadial artery AccV correlated well with baPWV, which suggests that ultrasound could be used to assess both morphological and functional changes in vessels, may serving as a better method to identify PAS in high-risk COPD patients.

A study on out-of-field leakage of an accelerator-based neutron beam for boron neutron capture therapy.

More and more accelerator-based boron neutron capture therapy (AB-BNCT) facilities are under the construction or commissioning stage, and the neutron beam characteristic measurements at each facility will start soon. In addition to the in-field neutron beam properties, the leakage of neutron beam is also important, which is related to the side effects of the patient. In the Virtual Technical Meeting on Advances in Boron Neutron Capture Therapy held by International Atomic Energy Agency (IAEA) in July 2020, the issue of the out-of-field leakage in BNCT was addressed. Heron Neutron Medical Corporation has been working on the beam design for China Medical University Hsinchu Hospital AB-BNCT research center. To evaluate the out-of-field leakage, both beam profile analysis and whole-body dose calculation are performed. An Oak Ridge National Laboratory (ORNL) Medical Internal Radiation Dose (MIRD) mathematical phantom is used to calculate the whole-body dose. For the estimated irradiation time which is set to be the time required for 80% of tumor dose to reach 20 Gy-w, the relative biological effectiveness weighted dose of abdomen region is less than 40 mGy-w and the whole-body dose is 104 mSv. The beam profile calculational result shows that the neutron ambient dose equivalent at 15 cm from the field edge is 11 mSv/Gy-w and drops to 5 mSv/Gy-w at 26 cm from the field edge. The gamma ray ambient dose equivalent is less than 1 mSv/Gy-w starting from 10 cm from the field edge. Although the neutron out-of-field leakage of the beam design is higher than that of the initially proposed guideline by IAEA in 2020, the whole-body dose, however, is reasonably low. Both the whole-body dose evaluation and the beam profile analysis are useful in the beam design consideration. The whole-body dose calculation together with the beam profile analysis can also be helpful in reaching an acceptable recommendation for the out-of-field leakage for BNCT neutron beam, a job wished to be accomplished in the near future as proposed in the 2023 IAEA's report on Advances in Boron Neutron Capture Therapy.

A 30-year bibliometric analysis of the literature in the disciplines of orthopedics, surgery, or oncology on chondrosarcoma from 1993 to 2023.

A thorough bibliometric analysis of publications published in the field of chondrosarcoma research has not yet been performed using the Web of Science database, especially for publications published between 1993 and 2023. This study, with a focus on the fields of orthopedics, surgery, and oncology, aims to fill this knowledge gap by providing a thorough analysis of current knowledge in the field of chondrosarcoma. In this bibliometric study, a literature search was performed using the Web of Science database to find all publications on chondrosarcoma. A bibliometric software program was used for data visualization and analysis (opensource visualization application, Vosviewer). The Web of Science Core Collection data used for this retrospective bibliometric study, which covers the period from January 1993 to September 2023, revealed interesting trends in chondrosarcoma research. As the most popular fields of study, orthopedics, surgery, and oncology account for a sizable portion of publications. A noteworthy increase in research output from 2014 to 2023, accounting for 41.74% of the papers, reflects the thriving research environment. The leading countries for publication were China, Japan, and the United States, demonstrating cross-border cooperation in chondrosarcoma research. Their contributions were highlighted by their important affiliations with institutions such as Harvard University, Leiden University, and China Medical University Taiwan. A thorough keyword mapping analysis also highlighted research priorities and encouraged interdisciplinary cooperation. The field's scholarly importance and ongoing relevance are highlighted by the study's high citation count (30,076) and highly cited articles. Overall, this study offers crucial insights into the development and collaborative nature of the chondrosarcoma research landscape and its long-lasting influence on academic research and clinical practice.

Predicting the recurrence of usual-type cervical adenocarcinoma using a nomogram based on clinical and pathological factors: a retrospective observational study.

Usual-type cervical adenocarcinoma is the most frequent type of adenocarcinoma, and its prevalence is increasing worldwide. Tumor recurrence is the leading cause of mortality; therefore, recognizing the risk factors for cervical cancer recurrence and providing effective therapy for recurrent cervical cancer are critical steps in increasing patient survival rates. This study aimed to retrospectively analyze the clinicopathological data of patients with usual-type cervical adenocarcinoma by combining the diagnosis and treatment records after the initial treatment and recurrence. We retrospectively analyzed patients diagnosed with usual-type cervical adenocarcinoma who underwent radical hysterectomy and pelvic lymph node dissection at Shengjing Hospital of China Medical University between June 2013 and June 2022. We constructed a nomogram-based postoperative recurrence prediction model, internally evaluated its efficacy, and performed internal validation. This study included 395 participants, including 87 individuals with recurrence. At a 7:3 ratio, the 395 patients were divided into two groups: a training set (n = 276) and a validation set (n = 119). The training set was subjected to univariate analysis, and the risk variables for recurrence included smoking, ovarian metastasis, International Federation of Gynaecology and Obstetrics (FIGO) staging, lymphovascular space invasion, perineural invasion, depth of muscular invasion, tumor size, lymph node metastasis, and postoperative HPV infection months. The aforementioned components were analyzed using logistic regression analysis, and the results showed that the postoperative HPV infection month, tumor size, perineural invasion, and FIGO stage were independent risk factors for postoperative recurrence (p<0.05). The aforementioned model was represented as a nomogram. The training and validation set consistency indices, calculated using the bootstrap method of internal validation, were 0.88 and 0.86, respectively. The model constructed in this study predicted the postoperative recurrence of usual-type cervical cancer, as indicated by the receiver operating characteristic curve. The model demonstrated good performance, as evidenced by the area under the curve, sensitivity, and specificity values of 0.90, 0.859, and 0.844, respectively. Based on the FIGO staging, peripheral nerve invasion, tumor size, and months of postoperative HPV infection, the predictive model and nomogram for postoperative recurrence of usual-type cervical adenocarcinoma are precise and effective. More extensive stratified evaluations of the risk of cervical adenocarcinoma recurrence are still required, as is a thorough assessment of postoperative recurrence in the future.

Huaier granule improves liver inflammation and fibrosis and prevents recurrence in hepatitis B virus related hepatocellular carcinoma.

There is basic research suggesting that Huaier granule can inhibit liver cirrhosis and hepatocellular carcinoma (HCC), but this conclusion has not been clinically verified. We analyzed the distant cancer tissue of two groups of hepatitis B virus (HBV) related HCC with/without Huaier granule, to clarify the effect of Huaier granule on liver inflammation, liver fibrosis, and postoperative recurrence. We collected clinicopathological data of HCC patients who received two surgery procedures at Mengchao Hepatobiliary Hospital of Fujian Medical University in China from January 2014 to December 2020. Patients according to taking/not taking Huaier granule after the first hepatectomy were divided into two groups, 51 patients with Huaier granule for more than 6 months after operation (Group A); 56 patients without Huaier granule (Group B). The effects on liver inflammation, fibrosis grade, and postoperative recurrence were compared between two groups. The results showed that liver inflammation improved significantly in the Group A [19 (37.3%) cases improved, 31 (60.8%) cases remained unchanged, and 1 (2.0%) case deteriorated] was significantly more than that in the Group B [7 (12.5%) cases improved, 32 (57.1%) cases remained unchanged, and 17 (30.4%) cases deteriorated] (P<0.001). The liver fibrosis in the Group A [17 (33.3%) cases improved, 32 (62.7%) cases remained unchanged, and 2 (3.9%) cases deteriorated] was significantly improved in the Group B [5 (8.9%) cases improved, 45 (80.4%) cases remained unchanged, and 6 (10.7%) cases deteriorated] (P=0.005). The recurrence interval (27.0±21.2 months) in the Group A was significantly longer than that in the Group B (19.0±14.2 months) (P=0.026). Huaier granule can improve liver inflammation, fibrosis, and liver function and prolong the time to recurrence in HBV-related HCC. Given the high rate of postoperative recurrence and poor prognosis of HBV-related HCC, our findings may have useful clinical significance in the prevention of tumor recurrence in these patients.

WTAP-mediated abnormal m6A modification promotes cancer progression by remodeling the tumor microenvironment: bibliometric and database analyses.

Wilms' tumor 1 associated protein (WTAP) is an essential component of the m6A methyltransferase complex. The research on WTAP has been continuously developed and promoted in recent years. It is needed to make systematic specific bibliometric and database analyses on WTAP, to identify the cooperation and impact of authors, countries, institutions and journals, to evaluate the knowledge base and find the hotspot trends, and to detect the emerging topics regarding WTAP research. The related articles and reviews of WTAP in the Web of Science Core Collection from January 1999 to June 2022 were retrieved, and CiteSpace and VOSviewer were used to perform bibliometric and knowledge-map analyses. Multiple databases were used to explore the expression level of WTAP in pan-cancers and its correlation with prognosis and immune infiltration. In recent years, the number of publications on WTAP research has increased rapidly. Among the journals publishing WTAP research, Frontiers in Cell and Developmental Biology had the most papers, while Nature papers were most cited. The country with the highest number of publications on WTAP was China, and China Medical University was the institution with the most publications. The most prominent author was Haruo Sugiyama from Japan. Four main aspects of WTAP research included m6A modification, tumor association, cancer therapy, and regulatory mechanisms. The research frontiers and hotspots were m6A modification, methyltransferase, demethylation, tumor microenvironment (TME), and immunotherapy. Bioinformatics analysis showed that the expression of WTAP was up-regulated in a variety of tumors and closely related to TME and survival prognosis. From the bibliometric and database analyses on the researches on WTAP, it is suggested that up-regulated WTAP in cancers may promote cancer progression by mediating abnormal m6A modifications to reshape the TME, thereby affecting the survival prognosis of the patients. The information would provide helpful references for scholars focusing on WTAP and provide new insights for WTAP as a prognostic evaluation and immunotherapy for tumors in the future.

P264 The utility of ANCA in Ulcerative Colitis and Crohn’s Disease: A Retrospective Cohort Study in Taiwan

Abstract Background Inflammatory bowel disease (IBD) includes two chronic idiopathic inflammatory diseases: ulcerative colitis (UC) and Crohn disease (CD). The diagnosis of IBD depends on clinical, endoscopic, histological, radiological and biochemical criteria, which may be invasive, time consuming and usually not accepted by patients with IBD. Antineutrophil cytoplasmic antibodies (ANCAs) is believed to be related to IBD. The aim of this study was to investigate these serological markers and the evidence for their use in the diagnosis and management of IBD in Taiwan. Methods We conducted a retrospective cohort study in adult IBD patients who had received the serum examinations using the medical records of China Medical University Hospital between 1 January 1980 and 31 October. 2023. Results A total of 301 IBD patients (194 with UC, 107 with CD) were included in this current study. A high proportion were male (IBD 70.41%; UC 65.63%, and CD 76.71%). The mean diagnostic age of these enrolled patients was 42.9 years. In our patients, the prevalence of positive anti-HCV Ab is 0.0% in UC patients and 0.96% in CD patients. However, the prevalence of positive HBsAg was 14.5% in UC patients and 9.4% in CD patients. The prevalence of pANCA was 21.2% in UC patients and 1.4% in CD patients, respectively. The prevalence of cANCA was 3.1% in UC patients and 0.0% in CD patients. This pattern of low sensitivity and high specificity for pANCA is also seen in UC patients in various cohort studies. The serum positivity of p-ANCA was significantly higher in UC patients (Figure 1). UC patients with positive p-ANCA were older than CD patients with positive p-ANCA (44.9 vs. 37.3 years). Furthermore, we found that the incidence of positive p-ANCA in UC patients with E1, E2, and E3 at diagnosis was 3.5%, 39.2%, and 57.1%, respectively (Table 1). The serum levels of ANCA-IgG were indeed higher in patients in the severe group than those in the moderate and mild groups. Conclusion Serological biomarkers have been demonstrated to be a series of rapid, non-invasive approaches for assessments of early diagnosis, disease activity and prognosis for IBD. ANCA may be helpful in the early diagnosis of UC and in differentiating it from CD. UC patients with positive ANCA have a higher rate of intestinal mucosal vasculitis than UC patients with negative ANCA. Furthermore, ANCA may also contributes to the pathogenesis of HBV-related systemic vasculitis. Therefore, the management of HBV-related vasculitis includes control the immune complex formation and reaction as well as antiviral agents to reduce the antigenic load resulting in reduction of inflammation. Moreover, effective biomarkers with high sensitivity and specificity need to be investigated in the future.

Survival nomograms for vulvar squamous cell carcinoma based on the SEER database and a Chinese external validation cohort.

The aim of study was to construct a nomogram to effectively predict the overall survival (OS) and cancer-specific survival (CSS) for patients with vulvar squamous cell carcinoma (VSCC). The training cohort consisted of 5405 patients with VSCC, extracted from the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2015. Eighty-four patients with VSCC were selected from the disease database of the Shengjing Hospital of China Medical University from 2014 to 2020, and enrolled as the external validation cohort. Significant independent prognostic factors were identified using Cox regression analysis and used to develop nomograms to predict 1-, 3-, and 5-year OS and CSS in patients with VSCC. The nomogram predicting OS was developed based on tumor size, histological grade, International Federation of Gynecology and Obstetrics (FIGO) stage, regional lymph node involvement, distant metastases, surgery, chemotherapy, age, and race. The nomogram for CSS was constructed using the similar factors, excluding race but including marital status. The nomogram for 1-, 3-, and 5-year OS demonstrated robust performance with receiver operating characteristic curves (AUCs) exceeding 80% (0.86, 0.84, and 0.82), outperforming the FIGO staging alone (0.77, 0.75, and 0.72). Similarly, for CSS, our nomograms achieved larger AUCs of 0.89, 0.88, and 0.86 compared with FIGO staging alone (0.81, 0.79, and 0.78). The nomograms more accurately predict prognosis than simple FIGO staging. Moreover, the nomograms developed in this study provide a convenient, operable, and reliable tool for individual assessment and clinical decision-making for patients with VSCC.

Success of susceptibility-guided eradication of Helicobacter pylori in a region with high secondary clarithromycin and levofloxacin resistance rates.

Resistance to clarithromycin (CLA) and levofloxacin (LFX) of Helicobacter pylori (H. pylori) is increasing in severity, and successful eradication is essential. Presently, the eradication success rate has greatly declined, leaving a large number of patients with previous treatment histories. To investigate secondary resistance rates, explore risk factors for antibiotic resistance, and assess the efficacy of susceptibility-guided therapy. We recruited 154 subjects positive for Urea Breath Test who attended The First Affiliated Hospital of China Medical University between July 2022 and April 2023. Participants underwent a string test after an overnight fast. The gastric juice was obtained and transferred to vials containing storage solution. Subsequently, DNA extraction and the specific DNA amplification were performed using quantitative polymerase chain reaction (qPCR). Demographic information was also analyzed as part of the study. Based on these results, the participants were administered susceptibility-guided treatment. Efficacy was compared with that of the empiric treatment group. A total of 132 individuals tested positive for the H. pylori ureA gene by qPCR technique. CLA resistance rate reached a high level of 82.6% (n = 109), LFX resistance rate was 69.7% (n = 92) and dual resistance was 62.1% (n = 82). Gastric symptoms [odds ratio (OR) = 2.782; 95% confidence interval (95%CI): 1.076-7.194; P = 0.035] and rural residence (OR = 5.152; 95%CI: 1.407-18.861; P = 0.013) were independent risk factors for secondary resistance to CLA and LFX, respectively. A total of 102 and 100 individuals received susceptibility-guided therapies and empiric treatment, respectively. The antibiotic susceptibility-guided treatment and empiric treatment groups achieved successful eradication rates of 75.5% (77/102) and 59.0% (59/411) by the intention-to-treat (ITT) analysis and 90.6% (77/85) and 70.2% (59/84) by the per-protocol (PP) analysis, respectively. The eradication rates of these two treatment strategies were significantly different in both ITT (P = 0.001) and PP (P = 0.012) analyses. H. pylori presented high secondary resistance rates to CLA and LFX. For patients with previous treatment failures, treatments should be guided by antibiotic susceptibility tests or regional antibiotic resistance profile.