Assessment of risk factors and establishment of a nomogram model to predict early high-output ileostomy.

OBJECTIVE: This study evaluated the prevalence and perioperative risk factors for early high-output ileostomy (EHOI) and developed a precise nomogram model to predict the occurrence of EHOI. METHODS: 140 patients who underwent ileostomy surgery at three hospitals in Wuhan, Hubei Province, between January 2022 and May 2022 were enrolled in this prospective cohort study. By using univariate and multifactorial logistic regression, independent risk variables for the development of EHOI were examined, and the nomogram model for predicting the risk of EHOI was created by using R software. The calibration curve and area under the receiver operating characteristic curve (ROC AUC) were used to evaluate the calibration and discrimination of the prediction model, Hosmer-Lemeshow to verify the fit of the model. Clinical impact curve (CIC) and decision curve analysis (DCA) were used to assess the model's clinical efficacy. RESULTS: A total of 132 patients participated in the study, and the incidence of EHOI was 25.8% (34/132). The nomogram model incorporated 3 risk factors hypertension, drinking habits, and high white blood cell (WBC) count after surgery. The AUC was 0.742, and the nomogram showed great calibration and clinical validity by comparing the calibration curve, DCA, and CIC. CONCLUSIONS: Hypertension, drinking, and high WBC was significantly correlated with EHOI. The nomogram model has great clinical value in predicting the EHOI.

Mapping global prevalence of depression among postpartum women.

Postpartum depression (PPD) is the most common psychological condition following childbirth, and may have a detrimental effect on the social and cognitive health of spouses, infants, and children. The aim of this study was to complete a comprehensive overview of the current literature on the global epidemiology of PPD. A total of 565 studies from 80 different countries or regions were included in the final analysis. Postpartum depression was found in 17.22% (95% CI 16.00-18.51) of the world's population. Meta-regression analysis showed that study size, country or region development, and country or region income were the causes of heterogeneity. Multivariable meta-regression analysis found that study size and country or area development were the most important predictors. Varied prevalence rates were noted in geographic regions with the highest rate found in Southern Africa (39.96%). Of interested was a significantly lower rate of PPD in developed countries or high-income countries or areas. Furthermore, the findings showed that there was a substantial difference in rates of PPD when marital status, educational level, social support, spouse care, violence, gestational age, breast feeding, child mortality, pregnancy plan, financial difficulties, partnership, life stress, smoking, alcohol intake, and living conditions were considered in the pooled estimates. Our results indicated that one out of every five women experiences PPD which is linked to income and geographic development. It is triggered by a variety of causes that necessitate the attention and committed intervention of primary care providers, clinicians, health authorities, and the general population.

[Study on the thermal field distribution of cholangiocarcinoma model by magnetic fluid hyperthermia].

Cholangiocarcinoma is a highly malignant tumor. It is not sensitive to radiotherapy and chemotherapy and has a poor prognosis. At present, there is no effective treatment. As a new method for treating cancer, magnetic fluid hyperthermia has been clinically applied to a variety of cancers in recent years. This article introduces it to the cholangiocarcinoma model and systematically studies the effect of magnetic fluid hyperthermia on cholangiocarcinoma. Starting from the theory of magnetic fluid heating, the electromagnetic and heat transfer models were constructed in the finite element simulation software COMSOL using the Pennes biological heat transfer equation. The Helmholtz coil was used as an alternating magnetic field generating device. The relationship between the magnetic fluid-related properties and the heating power was analyzed according to Rosensweig's theory. After the multiphysics coupling simulation was performed, the electromagnetic field and thermal field distribution in the hyperthermia region were obtained. The results showed that the magnetic field distribution in the treatment area was uniform, and the thermal field distribution met the requirements of hyperthermia. After the magnetic fluid injection, the cholangiocarcinoma tissue warmed up rapidly, and the temperature of tumor tissues could reach above 42 °C, but the surrounding healthy tissues did not heat up significantly. At the same time, it was verified that the large blood vessels around the bile duct, the overflow of the magnetic fluid, and the eddy current heat had little effect on thermotherapy. The results of this article can provide a reference for the clinical application of magnetic fluid hyperthermia for cholangiocarcinoma.

The Psychological Pressures of Breast Cancer Patients During the COVID-19 Outbreak in China-A Comparison With Frontline Female Nurses.

Objective: During the outbreak of the COVID-19 epidemic in China, breast cancer (BC) patients and healthcare workers faced several challenges, resulting in great psychological stress. We measured the psychological status of BC patients and female nurses and compared the severity within the two groups at the peak time-point of the COVID-19 outbreak. Methods: A total of 207 BC patients and 684 female nurses were recruited from Wuhan. They completed an anonymous questionnaire online using the most popular social media software in China, WeChat. The psychological status of BC patients and of female nurses was measured using the Chinese versions of the 9-item Patient Health Questionnaire (PHQ-9), the 7-item Generalized Anxiety Disorder scale (GAD-7), the 7-item Insomnia Severity Index (ISI), and the 22-item Impact of Event Scale-Revised (IES-R) for evaluation of post-traumatic stress disorder (PTSD). The differences between the two groups were analyzed. Results: The scores of BC patients and frontline female nurses for the four scales were significantly higher than those of non-frontline female nurses (P < 0.001). There were similar scores between BC patients and frontline female nurses for PHQ-9, GAD-7, and IES-R (P = 0.789, P = 0.101, P = 0.158, respectively). Notably, the scores of BC patients for ISI were significantly higher than those of the frontline female nurses (P = 0.016). A considerable proportion of BC patients reported symptoms of depression (106/207, 51.2%), anxiety (130/207, 62.8%), insomnia (106/207, 51.2%), and PTSD (73/207, 35.5%), which was more severe than that of female nurses. Conclusions: BC patients experienced great psychological pressure during the COVID-19 outbreak. The incidents of symptomatic anxiety, depression, sleep disorders, and PTSD were significantly comparable to that of frontline female nurses, and episodes of insomnia among BC participants were more serious than for frontline female nurses.