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Objective:To construct and validate a predictive model for the risk of excessive blood loss in pa-tients with ruptured tubal pregnancy,and to provide a basis and tool for the assessment of changes in the condi-tion of patients with ruptured tubal pregnancy.Methods:Clinical data of inpatients with ruptured tubal pregnancy from January 2014 to July 2021 were retrospectively analyzed,who underwent surgical treatment in the Depart-ment of Gynecology,Dongguan Maternal and Child Health Hospital.The pelvic blood volume was categorized into excessive blood loss and non-excessive blood loss groups based on whether the amount of pelvic blood was found to be≥750 ml intraoperatively.Factors influencing the occurrence of excessive blood loss were screened and modeled by univariate analysis,Lasso regression,and multi-factor Logistic stepwise regression.The area un-der the subject working characteristic curve(AUC)was used to evaluate the discrimination of the predictive mod-el,the model's consistency was evaluated by calibration curve and goodness-of-fit test,and the clinical utility of the model was evaluated and validated by the decision analysis curve.Finally,column line plots were drawn.Results:①A total of 386 patients with ruptured tubal pregnancy were included,of whom 124(32.12%)had blood loss≥750 ml.②The optimal predictors for predicting concomitant blood loss in patients with ruptured tubal preg-nancy were screened,including:days of abdominal pain,dizziness,pallor,fatigue,the maximum diameter of para-metrial mass,human chorionic gonadotropin(β-hCG),and hemoglobin(Hb)and the model and the column line graphswere constructed accordingly.③The prediction model AUC was 0.827(95%CI 0.781-0.873);the cut-off value was 0.391,at which point the specificity and sensitivity were 68.55%and 84.35%,respectively,and the AUC validated within the model by resampling was 0.804.Clinical decision curves showed that the threshold probability intervals for the maximum net benefit values ranged from 8.5%-97%,respectively.Conclusions:The constructed prediction model was validated to suggest good discriminatory efficacy and degree of consistency.As a tool,it has clinical application value in predicting the risk of hemorrhage in patients with ruptured tubal pregnan-cy.It can help to determine the occurrence of adverse events such as hemorrhagic shock at an early stage and improve the success rate of rescue treatment.
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Objective:To investigate the post-traumatic growth status of tumor patients receiving radiotherapy and analyze its influencing factors, aiming to provide theoretical basis for clinical doctors and nurses to formulate targeted intervention strategies.Methods:A cross-sectional survey of 170 tumor patients receiving radiotherapy admitted to Department of Radiotherapy of Sun Yat-sen Memorial Hospital was conducted by convenience sampling method, general information questionnaire and a post-traumatic growth inventory (PTGI).Results:The average PTGI score of 170 patients was 83.11±16.74, and 141 cases of them had significant post-traumatic growth, accounting for 82.9%(score ≥71). Logistic regression analysis showed that personality type, work status, and the times of hospitalization were the influencing factors of post-traumatic growth (all P<0.05). Conclusions:Tumor patients undergoing radiotherapy obtain a high level of post-traumatic growth. Medical staff should make full use of the patients’ potential for post-traumatic growth and implement interventions as soon as possible to promote the physical and mental health of tumor patients undergoing radiotherapy.
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Objective To explore the clinical effect of percutaneous osteoplasty with SKy bone expander system in the treatment of calcaneal fracture.Methods 63 feet of 55 patients with calcaneal fractures were involved in this study.According to Sanders fracture classification including 38 feet of Sanders Ⅱ,18 feet of Sanders Ⅲ,7 feet of Sanders Ⅳ.There were 6 to 16 days interval between the injuries and the surgeries.The patients were treated by percutaneous osteoplasty with the SKy bone expander system.The standard of operation was the satisfaction of reduction and Bohler's and Gissane's angles under X-ray.Results All of 63 feet of 55 patients were followed up for average 22 months.According to the criterion of therapeutic effect,the results were as follows:excellent in 30 cases,good in 26 cases,fair in 7cases,and no poor case.The excellent and good rate was 88.9％.Conclusion Percutaneous osteoplasty with SKy bone expander system in the treatment of calcaneal fracture,especially in reduction and fixation of Sanders type Ⅱ and Sanders type Ⅲ,can recover Bohler's and Gissane's angles,significantly shorten the duration of illness,and has fast recovery and can possess satisfactory curative effect,and it is worth popularizing.
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Objective To investigate the expression of XIAP and survivin and its significance in diffuse large B-cell lymphoma. Methods The expression of XIAP and survivin were detected by immunohistochemistry in 49 patients with diffuse large B-cell lymphomas. Results The positive rate of XIAP and survivin in cases of DLBCL were 40.8%(20/49) and 44.9%(22/49) respectively, which was higher than that of benign lymph node pathological changes (P ＜0.05). The expression of XIAP in DLBCL positively correlated with the expression of surviving (r =0.382, P =0.01). Moreover, the mean survival period in DLBCL expressing XIAP was shorter than the XIAP-negative group. Conclusion The up-regulation of expression of XIAP may play an important role in the development of DLBCL, and may cooperate with the expression of survivin in apoptosis pathway. Furthermore, the expression of XIAP might be a new unfavorable prognosis factor of DLBCL.
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Objective To investigate the expression of STAT3 and its clinicopathological characteristics in colorectal carcinomas. Methods The expression and location of STAT3 and VEGF protein were deterimined using MaxVisionTM immunohistochemistry and immunohistochemiscal S-P method in 50 colorectal carcinomas and 30 nor-real colorectal tissues. Results Positive expression rates of STAT3 protein in colorectal cancer tissues and normal colorectal mucosa tissues were 82.0% and 33.3%. The expression of STAT3 protein was related to differentiation, TNM stage and lymph node metastasis in colorectal carcinomas (P<0.05 ). VEGF in the expression of lower tumor differentiation and highter TNM stage was significantly higher than that in higher turner differentitation and lower TNM stage (P < 0.01 ). VEGF in the groups of serosa invasion and lymph node metastasis was higher than that in no serosa invasion and lymph node metastasis ( P < 0.05 ). Conclusions STAT3 protein expression is associated with the development of colorectal carcinoma, and its overexpression is an independent adverse prognosticator in colorectal cancer. STAT3 and VEGF protein may play an important role in colorectal tumorigenesis and disease progression.
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Objective To investigate the expression of NF-κB/p65 in nasal NK/T cell lymphomas. Methods Immunohistochemis-try and TUNEL were used to study the expression of NF-KB/p65 and cell apoptosis in 23 nasal NK/T cell lymphoma samples and 14 benign lymph node lesions. Results The NF-KB/p65 positive rates were 43.5% (10/23). The expression of NF-κB/p65 was negative correlated with apoptotic index among 23 nasal NK/T cell lymphomas(P <0. 05). The mean survival period in patients expressed NF-KB/p65 was sig-nificantly shorter than that in negative group(P <0. 05). Conclusions Apoptosis inhibited by overexpression of NF-κB/p65 might be in-volved in the development of nasal NK/T cell lymphoma. NF-κB/p65 expression may be an unfavorable prognostic factor of nasal NK/T cell lymphoma.