Generation of a Predictive Clinical Model for Isolated Distal Deep Vein Thrombosis (ICMVT) Detection.

BACKGROUND Isolated distal deep vein thrombosis (ICMVT) increases the risk of pulmonary embolism. Although predictive models are available, their utility in predicting the risk is unknown. To develop a clinical prediction model for isolated distal calf muscle venous thrombosis, data from 462 patients were used to assess the independent risk variables for ICMVT. MATERIAL AND METHODS The area under curve (AUC) for Model A and Model B were calculated and other risk factors were based on age, pitting edema in the symptomatic leg, calf swelling with least 3 cm larger than the asymptomatic leg, recent bed rest for 3 days or more in the past 4 weeks, requiring general or major surgery with regional anesthesia, sex, and local tenderness distributed along the deep venous system as independent predictors of calf muscle venous thrombosis. Model A includes the risk variables for C-reactive protein and D-dimer. RESULTS The area under ROC curve for Model A training set was 0.924 (95% CI: 0.895-0.952), the area under ROC curve for Model B training set was 0.887 (95% CI: 0.852-0.922), and the AUC difference between the 2 models was statistically significant (P<0.001); the area under ROC curve for Model A obtained in the validation set was 0.902 (95% CI: 0.844-0.961), the area under ROC curve for Model B was 0.842 (95% CI: 0. 0.773-0.910), and the difference between the 2 models was statistically significant (P=0.012). CONCLUSIONS Predictive Model A better predicts isolated calf muscle venous thrombosis and is able to help clinicians rapidly and early diagnose ICMVT, displaying higher utility for missed diagnosis prevention and disease therapy.

Diagnostic Accuracy of CT-Guided Percutaneous Pulmonary Biopsy for Distinguishing Benign and Malignant Solitary Pulmonary Nodules.

Background: Isolated pulmonary nodules (SPNs) are small, circular lesions within lung tissue, often challenging to diagnose due to their size and lack of typical imaging features. Timely diagnosis is crucial for treatment decisions. However, the difficulty in qualitative diagnosis necessitates clinical biopsies. Objective: This study aimed to assess the diagnostic accuracy of CT-guided percutaneous lung biopsy for SPNs and identify potential risk factors for malignancy. Methods: We conducted a retrospective analysis of 112 patients with SPNs who underwent CT-guided core needle biopsy (CT-CNB) between June 2020 and June 2022. Histological and cytological results were obtained for all patients, and clinical data and imaging characteristics were compared between benign and malignant SPN groups. Binary logistic regression was used to analyze risk factors for malignancy, and complications were observed. Results: Cytological and histological specimens were successfully obtained for all patients. The cohort consisted of 43 patients with benign SPNs and 69 with malignant SPNs. Among the malignant SPN group, 67 cases were confirmed via CT-CNB and 2 through surgery, resulting in a sensitivity of 97.10% and specificity of 100.00%. The malignant nodules comprised 45 adenocarcinomas, 14 squamous cell carcinomas, 8 metastatic tumors, and 2 small cell carcinomas. Notably, 2 initially diagnosed as malignant cases were found to have chronic inflammation on preoperative biopsy but revealed adenocarcinoma and squamous cell carcinoma post-surgery. The benign nodules encompassed 20 granulomatous inflammation cases, 15 chronic inflammation, 3 fungal granulomas, 2 hamartomas, and 1 fibrous tissue. Cytological smears exhibited a sensitivity of 81.3% and a specificity of 100.0% for malignancy. Significantly, age ≥60, elevated tumor markers, and specific imaging signs (burr, foliation, pleural pull) were identified as risk factors for malignant SPNs using Binary Logistic regression (all P < .05). Conclusions: CT-guided percutaneous lung biopsy demonstrates excellent diagnostic efficacy and safety for distinguishing benign and malignant SPNs.

The Determination Method of Satisfactory Consistency of the Interval Number Pairwise Comparisons Matrix Based on Submatrix.

The decision-maker obtains the pairwise comparisons matrix by comparing two entities. In the process of comparing the two entities, the relationship between the two entities and other entities is not considered. In this way, the judgment may be illogical. This paper mainly studies the satisfactory consistency of the interval number pairwise comparisons matrix based on cyclic matrix. Firstly, the illogical judgment entity in the process of the decision-maker's judgment is expressed by the cyclic matrix. There are three entities and four entities to form the cyclic matrix. The relationship and various forms of the cyclic cycle formed by the four entities and the three entities are discussed; then, the satisfactory consistency of the interval number pairwise comparisons matrix is determined by judging whether there is a cyclic matrix in the submatrix of the interval number pairwise comparisons matrix. Finally, two examples are given to verify the rationality and effectiveness of the method.

Application of Narrative Nursing Combined With Focused Solution Model to Anxiety and Depression in Patients With Lung Tumor During Perioperative Period.

Background: In the face of the dual pressure of disease and operation, patients with lung tumors in the perioperative period often have adverse psychological states such as anxiety and depression. There are many risk factors affecting the psychological state of patients in the perioperative period, and there is still a lack of effective nursing countermeasures in clinical practice. Materials and Methods: We accessed our institutional database and retrospectively selected all patients with lung tumors who underwent surgical treatment between August 2018 and December 2018. Multivariate Logistic regression model was used to analyze the risk factors affecting the psychological state of patients during the perioperative period, and the HAD score, medication behavior, INR monitoring behavior and life behavior before and after narrative nursing combined with focused solution model nursing were compared with those of patients receiving conventional nursing plan. Results: According to the inclusion and exclusion criteria, 148 cases of lung tumor patients undergoing surgical treatment were studied in this study. There were 45 cases without anxiety and depression and 103 cases with anxiety and depression in 148 patients. Income, medical environment, worry about work, family members' psychological state, family care, sleep quality, mental history, worry about postoperative pain, patients' knowledge of the diagnosis of the condition and the nature of the tumor were the single factors that affected the psychological state of patients with pulmonary tumor during perioperative period (P < 0.05). Multivariate analysis showed that income status, sleep quality, psychological status of family members, fear of postoperative pain and nature of tumor were the independent risk factors for psychological status of patients with lung tumor during perioperative period (P < 0.05). There was no difference in HAD score, medication behavior, INR monitoring behavior and life behavior score between the two groups when entering the group (P > 0.05). At the time of discharge, the HAD scores of the two groups were decreased, and those in the study group were lower than those in the control group (P < 0.05). At the time of discharge, medication behavior, INR monitoring behavior and life behavior of the two groups were increased, and the study group was higher than the control group (P < 0.05). Conclusion: Income status, sleep quality, fear of postoperative pain, Patient's knowledge of their condition and nature of tumor are the independent risk factors affecting the psychological state of patients with lung tumor during perioperative period. Narrative nursing combined with focused solution model can effectively improve the anxiety and depression status of patients with lung tumor during perioperative period and enhance their compliance behavior, which is worthy of promotion.

Feasibility, safety and outcomes of ambulation within 2 h postoperatively in patients with lung cancer undergoing thoracoscopic surgery.

AIMS: The aims of this study were to evaluate the safety, feasibility and outcomes of ambulation within 2 h after thoracoscopic surgery in patients with lung cancer. BACKGROUND: There are no consensus guidelines on the ideal time for early ambulation following thoracic surgery, although enhanced recovery programmes have been proposed since years. METHODS: This non-randomized, concurrent-control study was conducted on patients who underwent thoracoscopic surgery between October 2020 and February 2021. Participants were assigned to either the observation group (ambulation within 2 h of extubation) or the control group (ambulation on the first postoperative day). RESULTS: Of the 325 patients who were eligible, 227 were included in the study. Eighty-three per cent of patients were able to walk any distance within 2 h of extubation, and no adverse events occurred in patients. The length of hospital stay and time to first postoperative flatus were significantly shorter in the observation group than in the control group. There were no differences in the occurrence of postoperative complications and orthostatic hypotension, readmission rate and 6-min walk distance at discharge. CONCLUSION: Ambulation within 2 h of extubation was safe and feasible and could lead to better recovery in patients with lung cancer undergoing thoracoscopic surgery.

Co-expression of the Arabidopsis SOS genes enhances salt tolerance in transgenic tall fescue (Festuca arundinacea Schreb.).

Crop productivity is greatly affected by soil salinity; therefore, improvement in salinity tolerance of crops is a major goal in salt-tolerant breeding. The Salt Overly Sensitive (SOS) signal-transduction pathway plays a key role in ion homeostasis and salt tolerance in plants. Here, we report that overexpression of Arabidopsis thaliana SOS1+SOS2+SOS3 genes enhanced salt tolerance in tall fescue. The transgenic plants displayed superior growth and accumulated less Na+ and more K+ in roots after 350 mM NaCl treatment. Moreover, Na+ enflux, K+ influx, and Ca2+ influx were higher in the transgenic plants than in the wild-type plants. The activities of the enzyme superoxide dismutase, peroxidase, catalase, and proline content in the transgenic plants were significantly increased; however, the malondialdehyde content decreased in transgenic plants compared to the controls. These results suggested that co-expression of A. thaliana SOS1+SOS2+SOS3 genes enhanced the salt tolerance in transgenic tall fescue.

[Neuroprotective effects of learning on glutamate-induced neuronal damage in rat hippocampus].

AIM: To investigate the neuroprotective effect of learning on glutamate-induced neuronal damage. METHODS: SD rats were intraperitoneally injected with monosodium glutamate (MSG) during the period of 3-9 days after born, and were trained to find their food by light-dark discrimination at 1 month old or 2 months old. At 3 months old, all rats were killed and their brains were taken out and cut into sections and ultrathin sections. The survival neurons in hippocampus were counted under light microscope, and under electric microscope, the ultrastructure, the numbers of synapses and the length of synaptic active zone in fields CA1 of hippocampus were observed. RESULTS: The survival neurons in field CA3 and CA4, the number of synapses and the length of synaptic active zone in field CA1 of hippocampus increased in learning group than non-learning group. CONCLUSION: These finding indicate that discriminative learning can alleviate neuronal injury of hippocampus induced by MSG.

[Effects of fluvastatin on the levels of C-reactive protein and lipids in patients with hyperlipidemia].

OBJECTIVE: To observe the changes of C-reactive protein (CRP) level and its relationship with blood lipids, and the effects of fluvastatin on CRP and the lipids in patients with hyperlipidemia. METHODS: Serum levels of cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), very-low-density lipoprotein cholesterol (VLDL-C) and lipoprotein(a)[Lp(a)] were measured by enzyme assay, and plasma CRP level by immunonephelometry before and after fluvastatin treatment (20 mg/d for 4 weeks) in patients with hyperlipidemia. RESULTS: CRP levels were above normal in 90.3% hyperlipidemia cases in spite of the various accompanying diseases. Fluvastatin treatment significantly reduced TC (-7.49%), TG (-14.32%), LDL (-13.88%), VLDL (-18.48%) and TC/HDL(-13.50%) levels (P<0.01), and also brought down Lp(a) concentration (-13.81%). CRP levels was very effectively reduced after the treatment (-15.92%, P<0.001). No association between basal CRP levels and basal lipids and Lp(a) concentrations was observed. Positive correlation of CRP, however, was observed after fluvastatin treatment with TC/HDL (r=0.62, P=0.041) and Lp(a) (r=0.320, P=0.011), while inverse relations were noted between CRP and HDL (r=-0.288, P=0.023). CONCLUSION: CRP levels increases markedly in patients with hyperlipidemia, a fact that is independent of the accompanying diseases. In addition to modulating blood lipid levels, fluvastatin also reduces CRP level, the latter possibly serving as an independent predictive factor for atherosclerotic cardiovascular diseases and also as an indicator for estimating the effectiveness of the treatment.

[Coagulative and fibrinolytic changes in patients with essential hypertension and the effect of sustained-release nifedipine].

OBJECTIVE: To investigate the changes of coagulation and fibrinolysis status in patients with essential hypertension (EH) and observe the therapeutic effect of sustained-release nifedipine. METHODS: Ninety-nine EH patients were divided according to their diastolic blood pressure (DBP) into mild group (48 cases), moderate group (29 cases) and severe group (22 cases), and 25 patients among the groups were chosen at random to receive sustained-release nifedipine for 2 weeks. Twenty healthy subjects served as control group. Plasma D-dimer (DD), fibrin monomer (FM) and tissue-type plasminogen activator (tPA) levels were determined in all the subjects by enzyme-linked immunosorbent assay (ELISA). RESULTS: The plasma DD and FM levels were much higher, while tPA level was much lower in hypertensives than those of normal controls, exacerbating with the severity of the disease. DBP was positively correlated with plasma FM level (r=0.374,P<0.001). In patients with left ventricular hypertrophy, left ventricular enlargement and left atrial enlargement, higher levels of DD, FM and tPA were detected. Nifedipine treatment produced significant reduction in plasma DD and FM levels along with the increase in tPA level [DD: (40.7+/-23.5) mg/dl vs (23.8+/-16.5) mg/dl; FM: (7.0+/-1.6) ng/microliter vs (4.8+/-1.5) ng/microliter tPA: (0.31+/-0.14) ng/ml vs(0.41+/-0.05) ng/ml, P<0.001]. CONCLUSION: Enhanced coagulative activity and lowered fibrinolytic activity characterize EH patients and nifedipine may correct this disorder.