Medical College Research Articles

Lenvatinib, sintilimab combined interventional treatment vs bevacizumab, sintilimab combined interventional treatment for intermediate-advanced unresectable hepatocellular carcinoma

BACKGROUND Bevacizumab and sintilimab combined interventional treatment (BeSiIT) and L envatinib and sintilimab combined interventional treatment (LeSiIT) are two commonly used therapeutic regimens for intermediate-advanced hepatocellular carcinoma (HCC) in clinical practice. AIM To compare the clinical efficacy and safety of BeSiIT and LeSiIT for the treatment of intermediate and advanced HCC. METHODS Patients diagnosed with intermediate-advanced HCC and initially treated with BeSiIT or LeSiIT in the Tianjin Medical University Cancer Institute and Hospital between February 2020 and July 2021 were included. The primary endpoint was progression-free survival (PFS), and the secondary endpoints were overall survival (OS), objective response rate (ORR), disease control rate (DCR), conversion rate, and treatment-related adverse events. RESULTS Total 127 patients met the inclusion criteria and were divided into BeSiIT and LeSiIT groups. Twenty-eight and fifty patients in the BeSiIT and LeSiIT groups, respectively, were assessed after 1:2 propensity score matching. PFS and OS rates were not significantly different between the two groups. No significant variations were noted in ORRs or DCRs according to the Response Evaluation Criteria in Solid Tumors (RECIST), and modified RECIST. BeSiIT group showed a better conversion rate than the LeSiIT group (P = 0.043). Both groups showed manageable toxicity profiles. Multivariate analysis showed that the independent factors associated with PFS were alpha-fetoprotein levels and carcinoembryonic antigen score. CONCLUSION In intermediate-to-advanced HCC, the BeSiIT and LeSiIT groups exhibited acceptable toxicities and comparable PFS, OS, and ORR.

Effect of Intensive Nursing Management on Quality of Life and Mental Health in Elderly Gastric Cancer Patients Undergoing Chemotherapy: A Retrospective Study

Aims/Background Implementing effective nursing management is particularly critical in the case of elderly gastric cancer (GC) patients receiving chemotherapy, who are more vulnerable to risk events. Therefore, this study explored the effect of intensive nursing management on quality of life (QoL) and mental health in elderly GC patients receiving chemotherapy. Methods A total of 155 elderly patients with GC undergoing chemotherapy in Central Hospital Affiliated to Shandong First Medical University from July 2021 to July 2023 were selected as the study subjects. The sample was divided into two groups according to different nursing methods: 74 patients who received intensive nursing management were classified in the observation group, while 81 patients treated with routine nursing management were classified under the reference group. The QoL, mental health and adverse reactions to chemotherapy were compared between the two groups. Results Before nursing management was implemented, there was no significant difference in the scores of the quality of life questionnaire-core 30 (QLQ-C30), patient health questionnaire-9 items (PHQ-9), and the Chinese version of the M.D. Anderson Symptom Inventory (MDASI-C) (p > 0.05). After management, in comparison with the reference group, the observation group showed significantly higher scores in each dimension of QLQ-C30, as well as significantly lower scores in PHQ-9 and MDASI-C (p < 0.001). The incidences of gastrointestinal reaction, myelosuppression, neurotoxicity, and hepatorenal damage were lower in the observation group than in the reference group (45.95% vs 70.37%, 40.54% vs 65.43%, 35.14% vs 53.09%, and 33.78% vs 51.25%, respectively; p < 0.05). Conclusion The application of intensive nursing management in treating elderly GC patients during chemotherapy effectively improves their physical and mental states, ameliorates clinical symptoms and enhances the QoL, showing certain clinical application value.

Application of Intelligent Management Model Based on Electronic Patient-Reported Outcome During Immunotherapy in Patients with Gastric Cancer: A Single-Center Retrospective Study

Aims/Background Gastric cancer is the third leading cause of cancer-related death worldwide, which seriously affects the health of patients. Immunotherapy is a commonly used clinical treatment for gastric cancer, but the adverse events caused by it seriously affect the prognosis of patients. Therefore, it is necessary to control and manage the disease risk of patients during immunotherapy. To explore the effect of applying an intelligent management model based on electronic patient-reported outcome (ePRO) in patients with gastric cancer during immunotherapy. Methods The clinical data of 184 gastric cancer patients receiving immunotherapy in The Fourth Hospital of Hebei Medical University from September 2021 to September 2023 were retrospectively analyzed. Ninety patients receiving ePRO-based intelligent management were selected, and 85 patients were included in the observation group after excluding 5 patients. For the reference group, 94 patients receiving common case management were selected, with 90 patients being included after excluding 4 patients. After 6 months of follow-up, the nutritional status score, quality of life, treatment compliance and adverse events were compared between the two groups. Results No significant difference was detected in nutritional status and World Health Organization Quality of Life-BREF (WHOQOL-BREF) scores of the patients before discharge (p > 0.05). After 2 months of follow-up, compared with the reference group, the observation group had a higher proportion of patients in grade A and grade B, which was not statistically significant (p > 0.05), and significantly higher physiological and psychological scores (p < 0.001), but showed no meaningful differences in other fields (p > 0.05). After 4 months of follow-up, the nutritional status in the observation group was significantly improved (p < 0.05), and the subjects displayed higher WHOQOL-BREF scores (p < 0.05) than those in the reference group. No significant difference in the incidence of adverse events was detected (p > 0.05). After 6 months of follow-up, the treatment compliance of the observation group was 83.53%, which was significantly higher than that of the reference group (70.00%; p < 0.05). Conclusion The intelligent management model based on ePRO is conducive to improving the nutritional status of patients with gastric cancer during immunotherapy, as well as enhancing their quality of life and treatment compliance, making it worthy of clinical application.

Comparison of Effects between Nasal Bi-Level Positive Airway Pressure and Nasal Synchronized Intermittent Mandatory Ventilation in Neonatal Respiratory Distress Syndrome

Aims/Background Neonatal respiratory distress syndrome (NRDS) is characterized by progressive aggravation and rapid progression of respiratory distress, with a high incidence rate among premature infants. If left untreated, NRDS results in a poor prognosis. In recent years, various respiratory support modalities have received extensive attention in clinical practice. The therapeutic effect of different respiratory support modes on NRDS has gradually become the focus of clinical research. The aim of this study was to explore the therapeutic effects of nasal bi-level positive airway pressure (nBiPAP) and nasal synchronized intermittent mandatory ventilation (nSIMV) on NRDS. Methods This study retrospectively analyzed the clinical data of 157 newborns with NRDS in the Mudanjiang Medical University Affiliated Second Hospital from January 2021 to December 2023, finally including 153 cases after excluding 4 cases with missing clinical data. According to the non-invasive ventilation method, these newborns were categorized into a nBiPAP group (receiving nBiPAP treatment, n = 77) and an nSIMV group (receiving nSIMV treatment, n = 76). The blood gas indices, using time of ventilator, hospitalization time, therapeutic effects, and incidence of complications were compared between the two groups. Results The PaCO2, PaO2, and pH levels in the nBiPAP group were basically consistent with those in the nSIMV group before and after treatment (p > 0.05). The use time of ventilator, hospitalization time, and therapeutic effects in the nBiPAP group were similar to those in the nSIMV group (p > 0.05). Additionally, both groups demonstrated no significant difference in the incidence of complications such as intraventricular hemorrhage, apnea, necrotizing enterocolitis, and feeding intolerance (p > 0.05). The incidence rates of ventilator-associated lung injury and neonatal bronchopulmonary dysplasia in the nBiPAP group were lower than those in the nSIMV group, with a significant difference (p < 0.05). Conclusion Both nBiPAP and nSIMV have shown good effects in treating NRDS, with nBiPAP showing a significant advantage in reducing the incidence rates of complications such as ventilator-associated lung injury and neonatal bronchopulmonary dysplasia.

Association between serum Klotho and the prevalence of osteoarthritis: A cross-sectional study from NHANES 2007–2016

Background Osteoarthritis (OA) is a degenerative joint disease prevalent in the elderly. Currently, the relationship between the senescence inhibitor Klotho and OA remains unclear. This study investigated the relationship between serum soluble Klotho (S-Klotho) and OA. Methods This cross-sectional study was based on the 2007–2016 National Health and Nutrition Examination Survey (NHANES). Three multifactorial logistic regression models were constructed to assess the association between serum Klotho and OA. Restricted cubic spline (RCS) curves were further used to assess whether there was a nonlinear relationship between serum Klotho and OA. Finally, stratified analyses and interaction tests were used to evaluate the association’s stability. To further investigate the relationship between serum Klotho and OA, we recruited 107 patients for analysis at the First Affiliated Hospital of Guangxi Medical University. Results The final 8,918 participants included in this study comprised 50.55% females and 49.45% males, with 18.10% of participants suffering from OA and a mean S-Klotho level of 846.41 (5.61) pg/ml. All three logistic regression models observed a negative association between continuous S-Klotho and OA risk. When S-Klotho was categorized into tertiles, the fully adjusted model showed that participants in the third tertile had a 17% lower risk of OA than those in the first tertile (OR = 0.83, 95% CI: 0.70, 0.99, P = 0.035). The RCS curves showed a linear negative association between S-Klotho and the incidence of OA (P for overall = 0.025; P for non-linearity = 0.667). Further subgroup analyses and interaction tests suggested that the negative association between S-Klotho and OA remained stable in different conditions. Research conducted in China has shown that the negative correlation between serum Klotho levels and the prevalence of OA remains evident among Chinese individuals (OR: 0.77, 95% CI: 0.66, 0.90, P<0.001). Conclusion Our study suggests that elevated levels of the senescence inhibitor S-Klotho may be a potential protective factor for OA, which may provide new insights into the diagnosis and treatment of OA.

Pediatric endocardial temporary pacemaker implantation: Clinical characteristics and outcomes from a Chinese National Regional Health Center

AbstractEndocardial temporary pacemakers (TP) are widely used in the treatment of cardiovascular diseases in adults, but their application and clinical experience in the treatment of pediatric cardiovascular cases are relatively limited. This study aims to share the experience of using endocardial TP at a pediatric medical center in China. The study included patients who received their first endocardial TP implantation in the Department of Cardiology at Children's Hospital of Chongqing Medical University, China, from 2016 to 2022. A retrospective analysis of their clinical data was conducted. Our study involved 45 children who underwent endocardial TP implantation. Among these, 25 children (55.56%) converted to sinus rhythm after pacemaker parameter adjustment and the pacemaker was successfully removed; 13 children (28.89%) did not recover sinus rhythm and ultimately required a permanent pacemaker; in 4 cases, the family refused permanent pacemaker implantation; in 1 case, the treatment was abandoned by the family; and 2 children died during hospitalization. Notably, among the 20 children with fulminant myocarditis (FM), 16 children (80.00%) converted to sinus rhythm after pacemaker parameter adjustment and the pacemaker was successfully removed; 3 children (15.00%) ultimately received a permanent pacemaker; and 1 child died during hospitalization. Endocardial TP have shown remarkable efficacy in the treatment of critical heart disease, especially FM.

Isolation and identification of bacterial pathogens associated with foodborne illnesses in stool samples: A prospective study

Introduction: Foodborne illnesses significantly impact public health, necessitating the isolation and identification of bacterial pathogens such as Salmonella, Escherichia coli, and Staphylococcus aureus. This study aims to isolate and identify bacteria from stool samples of individuals exhibiting food poisoning symptoms, enhancing understanding and prevention of these infections. Methods: This prospective study, conducted at GSL Medical College from August to September 2021, involved individuals over 18 years with food poisoning symptoms. Stool samples were collected, cultured on selective media, and analyzed for bacterial identification using Gram staining and biochemical tests, followed by statistical analysis of prevalence and symptoms. Results: The study included 100 participants, with 52% male and a majority (40%) aged 31–45 years. Abdominal pain (80%) and diarrhea (75%) were the most common symptoms. The predominant isolates were E. coli (30%) and Salmonella spp. (25%), with symptom correlations revealing distinct clinical presentations among the pathogens. Conclusion: This study underscores the significant role of pathogens in foodborne illnesses, particularly E. coli and Salmonella spp. The correlation between these pathogens and symptoms highlights diverse clinical presentations, emphasizing the need for effective food safety measures and public health interventions to mitigate the impact of foodborne infections on community health.

Escherichia coli diarrhoea among the adults – prospective research

Introduction: Eschrichia coli is common diarrhea causing agent. This study aimed to identify the bacterial pathogens responsible for diarrhea and abdominal pain in adults. Foodborne illnesses remain a significant public health concern, with Escherichia coli. Methods: The study, conducted from January to May 2021 at GSL Medical College, included adults with diarrhea and abdominal pain. Stool samples were collected, processed, and cultured on selective media to identify bacterial pathogens. Statistical analysis was performed to assess pathogen prevalence and its association with symptoms, using descriptive statistics for findings interpretation. Results: Among 100 adults with diarrhea and abdominal pain, 52% were male, and the majority (40%) were aged 31–45 years. Abdominal pain (80%) and diarrhea (75%) were the most common symptoms. Escherichia coli was the leading isolate (30%), followed by Salmonella spp. (25%) and Staphylococcus aureus (20%). Conclusion: In conclusion, this study highlights Escherichia coli as the primary bacterial cause of diarrhea among adults, followed by Salmonella spp. and Staphylococcus aureus. These findings underscore the importance of targeted food safety measures and public health interventions to address foodborne pathogens and prevent related illnesses in communities. Key words: Escherichia coli, Diarrhea, Foodborne pathogens, Abdominal pain, Bacterial isolation

Surgical treatment of locally advanced kidney cancer in the T3a–с stage

BACKGROUND: Kidney cancer is a common pathologic condition, which ranks the 3rd place among urologic cancers. In 4–10% of patients, while growing it metastasizes upward the venous vessels up to the thoracic vena cava and right atrium. Selection of the optimal tactics for surgical treatment of such patients still remains a complex and unsolved task. AIM: To assess the surgical treatment findings for the patients suffered from kidney cancer with tumor invasion in the renal and inferior vena cava. MATERIALS AND METHODS: 115 patients with renal cell carcinoma complicated by tumor invasion into renal and inferior vena cava have been operated in North-Western State Medical University named after I.I. Mechnikov from 2003 to 2023. They were 76 (66.1%) men and 39 (33.9%) women, their mean age was 67.0 ± 4.1. Stage T3a covered 53 (46.1%), T3b — 33 (28.7%) and T3c 29 (25.2%) patients. Metastatic lesion of one lymph node was observed in 21 (18.3%) and of multiple nodes in 6 (5.2%) patients. Distant metastases were found in 26 (22.6%) patients: in the lungs in 9.6% and in the adrenal glands in 5.2%. All patients were treated with radical nephrectomy, removing blood trombi from the inferior vena cava system. Eight (7.0%) of them, received the treatment by the method developed in the clinic, which consists in preliminary endovascular extraction of the cranial trombus part. Another 3 (2.6%) patients were treated using cardiopulmonary bypass machine. RESULTS: Early postoperative complications developed in 36 (31.4%) patients. The most common and severe of them were pulmonary embolism (4.4%) and acute cardiovascular insufficiency (10.4%). These complications appeared the causes of death of 4 patients. The mortality rate was 3.5%. The three year survival rate in the T3a group was 70.6%, T3b group — 66.0% and T3c group — 50.6% (p 0.05). CONCLUSIONS: Nephrectomy with vena cava thrombectomy is a radical surgical treatment. Its complexity increases as the tumor thrombus spreads further through the venous system and in some cases requires an interdisciplinary approach.

Workplace violence against medical students during clinical practice and its relevant factors: a mixed methods study

ABSTRACT Our study aims to describe the status of workplace violence against medical students during clinical practice, which consists of its prevalence, types, perpetrators, students’ responses and influences on them, reasons for workplace violence and to determine some relevant factors of this issue through both quantitative questionnaire and qualitative interview. A descriptive cross-sectional study with mixed methods was conducted on 320 students from the second-year to the sixth-year classes at Hanoi Medical University from August 2022 to February 2023. The questionnaire was based on the WHO questionnaire survey ‘Workplace violence in the health sector – country case studies research instruments – Geneva 2003’. 10 students from quantitative research who completed the questionnaire, experienced at least one type of workplace violence and consented to continue taking part in the research were chosen for in-depth interviews. The prevalence of students witnessing and/or experiencing workplace violence was 35.6% and 19.4% of the sample population had experienced at least one kind of workplace violence. Medical staff were the most common perpetrators. 86.8% of students who were exposed to workplace violence did not report the incidents for a variety of reasons. The major reasons leading to workplace violence related to patients, patients’ relatives and students, among which the first-ranked ones were the patients’ education level and their unsatisfied expectations. Some relevant factors to workplace violence against medical students were determined by quantitative analysis such as students’ grade (OR = 3.09) and region (OR = 3.31) and were explored additionally by qualitative interview such as the student management of the instructors, students’ personality, attitude and appearance as well as hospital environment. Based on the research findings, establishing prevention methods, which require action from both individuals (students, medical staff) and organizations (universities, hospitals) is recommended.

Risk factors of the low anterior resection syndrome (LARS) after ileostomy reversal in rectal cancer patient.

This study is aimed at identifying risk factors of Low Anterior Resection Syndrome following ileostomy reversal in rectal cancer patients who had undergone preventive ileostomy. This retrospective analysis was conducted on a cohort of 605 patients treated at the Fourth Hospital of Hebei Medical University between January 2018 and December 2021. These patients were grouped based on LARS score, and Clinical and follow-up data were collected to conduct univariate analyses of potential factors influencing LARS occurrence based on variable type. Variables with statistical significance were included in a logistic regression model to analyze potential influences on the occurrence of LARS. Univariate and Multivariate logistic regression analysis showed that N2 stage (OR = 2.290 95%CI: 1.076-4.873, P = 0.031), chemoradiotherapy (OR = 2.271, 95%CI: 1.246-4.138, P = 0.007), and anastomosis height (OR = 0.836, 95%CI: 0.717-0.975, P = 0.022) were independent influences on the occurrence of LARS. In model 3 (adjusting for all covariates), the relationship between anastomotic height and patient LARS status showed a negative correlation. In subgroup analyses, there were significant differences in the effect of anastomotic height on LARS in subgroups with different hemoglobin concentrations. A high occurrence rate of LARS is observed in rectal cancer patients with preventive ileostomy reversal. N2 stage, history of chemoradiotherapy, and anastomotic height are independent influence factors for the occurrence of major LARS after ileostomy reversal.

Clinical and pathologic characteristics of inflamed juvenile conjunctival nevus and its treatment with immunosuppressant eye drops.

To clarify the clinical and pathologic findings of 7 patients with inflamed juvenile conjunctival nevus (IJCN) treated with tacrolimus. Retrospective study. The medical records of 7 male patients diagnosed with IJCN between February 2007 and October 2022 at the Kansai Medical University Hospital and Ideta Eye Hospital were retrospectively reviewed. The patients' mean age was 11.3 (8-20) years, and the average follow-up period was 18 months. The patients underwent anterior segment optical coherence tomography (AS-OCT) and anterior segment optical coherence tomography angiography (AS-OCTA). All the patients were treated with steroids or immunosuppressant eye drops, or both. Histopathologic examinations were performed on specimens resected from 2 patients. The clinical characteristics of IJCN were as follows: (1) presence of cysts within a pigmented conjunctival mass, (2) tumor accompanied by feeder vessels, and (3) predominantly found in boys with allergic diseases. AS-OCT and AS-OCTA revealed the presence of a cystic structure with poor vascular signals within it and numerous vessels distributed on the sclera underlying the lesion. Immunosuppressant eye drops relieved the congestion, diminished the inflow vessels, and induced shrinkage of the cysts in all the patients. Histopathologic examinations revealed infiltration of inflammatory cells such as lymphocytes and macrophages and low proliferative activity of melanocytes with no division pattern. This study clarified the clinical and histologic characteristics of IJCN. Noninvasive AS-OCT and AS-OCTA might be useful for diagnosing IJCN. The histopathologic findings of this study indicate that immunosuppressive and antiallergic agents can effectively bring about disease remission.

Prediction of Ki-67 expression and malignant potential in gastrointestinal stromal tumors: novel models based on CE-CT and serological indicators.

To identify more reliable imaging and serological indicators for predicting Ki-67 expression and malignant potential in gastrointestinal stromal tumors, as well as to develop a preoperative prediction model with clinical utility. This study retrospectively analyzed patients with gastrointestinal stromal tumors (GIST) diagnosed at the First Affiliated Hospital of Jinzhou Medical University between May 2018 and May 2024. Univariate logistic analyses, two-way stepwise regression, P-value stepwise regression, and LASSO regression were employed to screen for Ki-67 high expression and high malignant potential risk factors associated with GIST. Models were established using various regression methods; Nomograms, calibration curves, and clinical decision curves were generated for the two best prediction models. Two-way stepwise regression analysis revealed that diameter (P=0.037; OR=1.22; 95% CI: 1.01 - 1.46), growth pattern (extraluminal type: P=0.028; OR=3.54; 95% CI: 1.14 - 10.94), enhancement model (P=0.099; OR=0.39; 95% CI: 0.12 - 1.20), EVFDM (P=0.069; OR=0.43; 95% CI: 0.17 - 1.07), PLR (P=0.099; OR=3.06; 95% CI: 0.81 - 11.59), and OPNI (P=0.058; OR=2.38; 95% CI: 0.97 - 5.84) are identified as independent risk factors for Ki-67 expression. Utilizing the two-way stepwise regression model to predict Ki-67 expression, the area under the curve (AUC) for the training group was 0.865 (95% CI: 0.807-0.922), while for the validation group it was 0.784 (95% CI: 0.631-0.937). The Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) for the training group were 153.360 and 174.619, respectively. Two-way stepwise regression analysis revealed that volume (P < .001, OR = 1.06; 95% CI: 1.03 - 1.09), contour (P = 0.066; OR = 0.17; 95% CI: 0.05 - 0.62), ulcer (P = 0.094; OR = 0.16; 95% CI: 0.03 - 0.98), IBSC (P = 0.008; OR = 5.27; 95% CI: 1.57 - 17.69), and OPNI (P = 0.045; OR = 0.22; 95% CI: 0.05 - 0.96) are independent risk factors for malignant potential. Utilizing the two-way stepwise regression model to predict malignant potential, the AUC for the training group was 0.950 (95% CI: 0.920 - 0.980), while for the validation group it was 0.936 (95% CI: 0.867 - 1.000). The AIC and BIC values for the training group were 96.330 and 114.552, respectively. Diameter, growth pattern, enhancement pattern, EVFDM, PLR, and OPNI are independent risk factors for GIST with high Ki-67 expression. Additionally, volume, contour, ulceration, IBSC, and OPNI serve as independent risk factors for GIST with high malignant potential. The preoperative models developed using CT images can predict the malignant potential and Ki-67 expression status of GIST to a certain extent. When combined with serological indicators, these models' predictive performance can be further enhanced.

Effect of stress on study skills self-efficacy in Nursing students: the chain mediating role of general self-efficacy and self-directed learning.

The purpose of the study is to explore the current level of nursing students' study skills self-efficacy, and whether general self-efficacy and self-directed learning ability mediate the relationship between perceived stress (including positive stress and negative stress) and study skills self-efficacy. The survey was conducted among 1,289 nursing students including 795 students from Jinzhou Medical University and 494 students from Dalian University. Participants completed a self-designed questionnaire, which included the Study Skills Self-Efficacy Scale, Perceived Stress Scale, General Self-Efficacy Scale, Self-Directed Learning Instrument, gender, age, academic year, and other demographic characteristics. Descriptive analysis, independent-samples t-test, one-way analysis of variance, Pearson correlation analyses, and the bootstrap method were used for data analysis. Positive stress significantly positively predicted students' study skills self-efficacy, with an effect size of 0.686. Moreover, general self-efficacy and self-directed learning mediate the relationship between positive stress and study skills self-efficacy in nursing students, with effect sizes of 0.235 and 0.245, respectively. The direct effect of negative pressure on students' study skills self-efficacy is not statistically significant, but it has a significant negative predictive effect on study skills self-efficacy under the mediation of general self-efficacy and self-directed learning, with effect sizes of -0.337 and -0.238, respectively. This study explains how stress affects students' study skills self-efficacy, and the results have certain enlightenment significance for improving the stress management ability and study skills self-efficacy of college students in the future.

Using the follicular unit extraction technique in treatment of male androgenetic alopecia.

The incidence of androgenetic alopecia in males is on the rise annually, with hair transplantation using follicular unit extraction (FUE) gaining increasing acceptance as an appropriate treatment for these individuals. A retrospective study was undertaken, involving 158 male patients diagnosed with androgenetic alopecia, who underwent treatment between January 2016 and December 2020 at the Medical Cosmetology Department of the First Affiliated Hospital of Xi'an Medical University. Demographic data and treatment characteristics were documented and analyzed. Clinical efficacy, operation-related complications, patient satisfaction rates, and quality of life scores were assessed and analyzed. Following FUE hair transplantation, over 90% of the hair follicles survived in 158 patients, with more than 85% of patients achieving a hair follicle survival rate exceeding 95% at 12 months post-operation. Patient satisfaction rates exceeded 98%, while the complication rate was below 6%. Our findings demonstrate that FUE is a minimally invasive hair transplant technique associated with a high hair follicle survival rate and optimal hair density. This approach proves effective in treating male androgenetic alopecia and merits further clinical application.

Morphometric Study of Nutrient Foramen of Human Adult Humerus and Its Clinical &amp; Medico-legal Implications

BACKGROUND: Nutrient arteries, along with other arteries supplying the humerus, are crucial not only for the healing of serious injuries such as humeral shaft fractures but also for microsurgical vascularized bone transplantation. Therefore, understanding the precise location and morphometry of nutrient foramen in bones like the humerus is essential to prevent common complications, such as non-union of fractures. This study aims to examine the location and topography of nutrient foramen in the humerus and to establish their clinical &amp; medico-legal significance.MATERIAL METHODS: The study was conducted on 400 dried adult humerus bones of both sexes from Western Uttar Pradesh, sourced from the Department of Anatomy &amp; Department of Forensic Medicine &amp; Toxicology at Mahatma Vidur Autonomous State Medical College, Bijnor. Measurements and observations were carried out using an osteometric board.RESULT: Nutrient foramen was absent in 30 humerus (7.50%), single in 76.50%, and double in 16% of cases. Most humerus had medium-sized foramina (1-2 mm) on both the left and right sides, accounting for 78.80%. The majority of foramina were found on the anteromedial surface (85.02%), with fewer on the posterior surface. Additionally, most foramina were located in the middle third of the humeral diaphysis.CONCLUSION: Surgeons and orthopedists must possess precise knowledge of the number, size, shape, direction, and location of the nutrient foramen to accurately assess the humerus's vascular supply and avoid injury during surgical procedures. Morphometric data is also essential in identifying unknown remains, evaluating the severity and timing of trauma, and determining potential surgical complications in cases of medical malpractice.

ASSESSMENT OF RISK FACTORS AND FOLLOW-UP OUTCOMES FOR HEARING LOSS IN HIGH-RISK NEONATES

Objective: Hearing loss in neonates, particularly those in high-risk categories such as NICU graduates, can significantly impede speech, cognitive, and psychosocial development. Early detection and management are pivotal to mitigating these risks. Methods: A prospective observational study was conducted on 425 neonates at SDM Medical College and Hospital, utilizing Otoacoustic Emissions (OAE) for initial auditory screening. This study assessed the incidence of hearing loss in relation to neonatal risk factors, including birth weight, ABO incompatibility, and maternal health conditions. Results: A majority of the neonates (58.82%) were screened within 3-7 d post-birth. Notable risk factors impacting hearing outcomes included low birth weight, with 11.53% of neonates weighing between 1.0 and 1.50 kg. The initial failure rates in OAE screenings were low, with 2.59% failing in the right ear, 1.18% in the left, and 0.94% in both ears. Conclusion: The study underscores the efficacy of early hearing screenings in identifying potential hearing loss in neonates, especially those exposed to multiple risk factors. Continuous and comprehensive monitoring is crucial for these high-risk groups to facilitate timely and effective interventions.

Assessing AI chatbots efficacy in ophthalmic triage and referrals: A comparative study

To evaluate the efficacy of AI chatbots (OpenAI ChatGPT GPT-3.5, Google Bard, and WebMD) compared to human ophthalmology trainees in triage and referrals for common ophthalmic conditions. A single-center study was conducted at MKCG Medical College, Berhampur, Odisha, involving six ophthalmology trainees. The performance of AI chatbots was assessed based on diagnostic accuracy and triage categorization. Key performance indicators included the accuracy of the top three suggested diagnoses and concordance in recommendations for investigations and referrals. Physician respondents identified the correct diagnosis among the top three suggestions in 95% of cases. Google Bard achieved 90% accuracy, ChatGPT 85%, and WebMD 20%. High concordance was observed between physician and AI recommendations for investigations and referrals. AI chatbots demonstrate promising potential in supporting triage and referral decisions for ophthalmic conditions. While human expertise remains crucial, AI tools can augment diagnostic accuracy, improve efficiency, and enhance patient care. Future research should focus on refining AI algorithms, integrating clinical data, and exploring real-world implementation strategies.

Cervical Lymph Nodes Metastasis From Non-head and Neck Primary Carcinomas: A Retrospective Analysis of 1448 Patients.

To investigate the clinicopathological features of individuals who have cervical lymph node metastasis (CLNM) from non-head and neck primary carcinomas. The data of 1448 patients diagnosed with CLNM from non-head and neck primary carcinomas at the Yunnan Cancer Hospital, Third Affiliated Hospital of Kunming Medical University, China, from January 2013 to December 2023 were collected. The patients' general information, imaging data, and pathological information were retrospectively analyzed. There were 780 men and 668 women among the 1448 patients, for a male-to-female ratio of 1.17:1. The median age was 56 years (range 21-81 years). The most prevalent primary sites in males were the lung (n = 508, 65.1%) and, in females, the breast (n = 276, 41.3%). The most prevalent pathological kind (n = 949), or 65.5% of cases, was adenocarcinoma. There was a significant difference in the proportion of adenocarcinoma between males (n = 385, 49.4%) and females (n = 564, 84.4%). The common sites of CLNM from non-head and neck primary carcinomas were level V (1,236 cases, 85.4%). In a subgroup of 1133 patients with primary cancer located in symmetrical or unilateral organs, 60.3% exhibited ipsilateral lymph node metastasis, 27.6% had bilateral lymph node metastasis, and 12.1% showed contralateral lymph node metastasis exclusively. For patients with CLNM, especially those with metastasis to cervical areas IV-V and those with adenocarcinoma pathology, it is particularly important to screen for primary foci in the lungs, breast, urogenital system, and digestive system after excluding head and neck primary cancers.

Development and validation of a risk prediction model for cognitive impairment in breast cancer patients.

Breast cancer patients often experience cognitive impairment as a complication during treatment, which seriously affects their quality of life. This study aimed to assess the risk factors associated with cognitive impairment in breast cancer patients and to construct and validate a nomogram model to predict cognitive impairment in this population. In this study, we used a convenience sampling method to select 423 breast cancer patients who attended the Department of Breast Surgery at the First Hospital of Jinzhou Medical University from September 2023 to March 2024. We analyzed these patients' cognitive impairment risk factors through LASSO regression and logistic regression analysis to develop a predictive model. The model was evaluated using the area under the curve (AUC) from the receiver operating characteristic (ROC) curve and the calibration curve and decision curve analysis. This study found a prevalence of cognitive impairment of 19.62% among breast cancer patients. A nomogram model was developed based on six influencing factors: age, educational level, pathological type, treatment program, emotional state, and fatigue. The area under the curve (AUC) for the model's training and validation groups was 0.944 and 0.931, respectively. The model calibration curves showed a high degree of consistency, and the decision curve analysis (DCA) indicated good clinical applicability of the model. This nomogram demonstrates good discrimination, calibration, and clinical applicability, making it a more intuitive predictor of the risk of cognitive impairment in breast cancer patients.