BACKGROUND Delayed wound healing is a common clinical complication following gastric cancer radical surgery,adversely affecting patient prognosis.With advances in artificial intelligence,machine learning offers a prom...BACKGROUND Delayed wound healing is a common clinical complication following gastric cancer radical surgery,adversely affecting patient prognosis.With advances in artificial intelligence,machine learning offers a promising approach for developing predictive models that can identify high-risk patients and support early clinical intervention.AIM To construct machine learning-based risk prediction models for delayed wound healing after gastric cancer surgery to support clinical decision-making.METHODS We reviewed a total of 514 patients who underwent gastric cancer radical surgery under general anesthesia from January 1,2014 to December 30,2023.Seventy percent of the dataset was selected as the training set and 30%as the validation set.Decision trees,support vector machines,and logistic regression were used to construct a risk prediction model.The performance of the model was evaluated using accuracy,recall,precision,F1 index,and area under the receiver operating characteristic curve and decision curve.RESULTS This study included five variables:Sex,elderly,duration of abdominal drainage,preoperative white blood cell(WBC)count,and absolute value of neutrophils.These variables were selected based on their clinical relevance and statistical significance in predicting delayed wound healing.The results showed that the decision tree model outperformed the logistic regression and support vector machine models in both the training and validation sets.Specifically,the decision tree model achieved higher accuracy,F1 index,recall,and area under the curve(AUC)values.The support vector machine model also demonstrated better performance than logistic regression,with higher accuracy,recall,and F1 index,but a slightly lower AUC.The key variables of sex,elderly,duration of abdominal drainage,preoperative WBC count,and absolute value of neutrophils were found to be strong predictors of delayed wound healing.Patients with longer duration of abdominal drainage had a significantly higher risk of delayed wound healing,with a risk ratio of 1.579 compared to those with shorter duration of abdominal drainage.Similarly,preoperative WBC count,sex,elderly,and absolute value of neutrophils were associated with a higher risk of delayed wound healing,highlighting the importance of these variables in the model.CONCLUSION The model is able to identify high-risk patients based on sex,elderly,duration of abdominal drainage,preoperative WBC count,and absolute value of neutrophils can provide valuable insights for clinical decision-making.展开更多
The facts that H pylori infection is commoner in duodenal ulcer (DU) patients than in the normal population, and that eradication results in most cases being cured, have led to the belief that it causes DU. However, e...The facts that H pylori infection is commoner in duodenal ulcer (DU) patients than in the normal population, and that eradication results in most cases being cured, have led to the belief that it causes DU. However, early cases of DU are less likely than established ones to be infected. H pylori-negative cases are usually ascribed to specific associated factors such as non-steroidal anti-inflammatory drugs (NSAIDs), Crohn’s disease, and hypergastrinaemia, but even after excluding these, several H pylori-negative cases remain and are particularly common in areas of low prevalence of H pylori infection. Moreover, this incidence of H pylori negative DU is not associated with a fall in overall DU prevalence when compared with countries with a higher H pylori prevalence. In countries with a high H pylori prevalence there are regional differences in DU prevalence, but no evidence of an overall higher prevalence of DU than in countries with a low H pylori prevalence. There is no evidence that virulence factors are predictive of clinical outcome. After healing following eradication of H pylori infection DU can still recur. Medical or surgical measures to reduce acid output can lead to long-term healing despite persistence of H pylori infection. Up to half of cases of acute DU perforation are H pylori negative. These findings lead to the conclusion that H pylori infection does not itself cause DU, but leads to resistance to healing, i.e., chronicity. This conclusion is shown not to be incompatible with the universally high prevalence of DU compared with controls.展开更多
BACKGROUND Currently,open reduction internal fixation is the conventional surgical method for treatment of double ulna and radius fracture.However,open reduction is associated with a high risk of complications.This ca...BACKGROUND Currently,open reduction internal fixation is the conventional surgical method for treatment of double ulna and radius fracture.However,open reduction is associated with a high risk of complications.This case of forearm double fracture involved a patient treated using an Acumed intramedullary nail.The patient experienced good follow-up outcomes.The Acumed forearm intramedullary nail enables early functional exercise and hastens healing of the fracture.Few studies have reported on the use of this approach for the treatment of fractures.CASE SUMMARY A 23-year-old male patient was admitted to hospital after 5 h of pain,swelling,and limited activity of left forearm caused by a careless fall.Physical examination showed stable basic vital signs,swelling of the left forearm,and severe pain when pressing on the injured part of the forearm.Further,friction was felt at the broken end of the bone;the skin was not punctured.Movement of the left hand was normal,and the left radial artery pulse was normal.Three-dimensional computed tomography examination showed an ulna fracture of the left forearm and comminuted fracture of the radius.The fracture was located in the upper third of the radius,with significant displacement on the fracture side.Clinical diagnosis further confirmed the left radius comminuted fracture and ulna fracture.After analyzing the fracture pattern,age,and other patient characteristics,we chose an Acumed nail for treatment and achieved good follow-up outcomes.CONCLUSION Acumed forearm intramedullary nail for fixation of ulna and radius fracture reduced complication risk and resulted in good follow-up outcomes.展开更多
<strong>Background:</strong> Breast reduction surgery is increasing in popularity, with so many techniques all around the world, and the community’s knowledge of the details of this procedure increases th...<strong>Background:</strong> Breast reduction surgery is increasing in popularity, with so many techniques all around the world, and the community’s knowledge of the details of this procedure increases thanks to the Internet and easy access to information, which increases breast reduction reviews for plastic surgery clinics. Reduction mammaplasty is an established and effective technique to treat symptomatic macromastia. Variable rates of complications have been reported, and there is a continued need for better outcome assessment studies. <strong>Aim:</strong> The purpose of this study was to identify the complications occurred during the first year of breast reduction surgery. <strong>Materials and Methods:</strong> A prospective study over a 1-year period from October 2018 to October 2019, that included 32 patients who underwent breast reduction surgery using the same technique (inferior pedicle and inverted T scar) in the Department of Plastic Surgery at Al-Mouassat University Hospital, Damascus, Syria. Patients were followed through a whole year after surgery and complications that occurred were recorded. <strong>Results:</strong> Complications that occurred in 14 patients (43%), and, and were more common in patients with larger breasts and worse symptoms before surgery. The most common complication was delayed wound healing, and it was associated with breast volume before surgery and with smoking. In general, the most relevant factor influencing the incidence of complications was the weight of the resected breast tissue, which is mainly related to the size of the breast before surgery. <strong>Conclusion:</strong> The weight of the resected breast tissue was the most important factor influencing the occurrence of complications after breast reduction surgery. The most prevalent complication was delayed wound healing and it was associated with the weight of the removed tissue.展开更多
Biofilm is the predominant mode of life for bacteria and today it is implicated in numerous human diseases. A growing body of scientific and clinical evidence now exists regarding the presence of biofilm in wounds. Th...Biofilm is the predominant mode of life for bacteria and today it is implicated in numerous human diseases. A growing body of scientific and clinical evidence now exists regarding the presence of biofilm in wounds. This review summarizes the clinical experiences and in vivo evidence that implicate biofilm in delayed wound healing. The various mechanisms by which biofilm may impede healing are highlighted, including impaired epithelialization and granulation tissue formation, and reduced susceptibilities to antimicrobial agents and host defenses. Strategies to manage biofilm and encourage progression to wound healing are discussed;these include debridement and appropriate antimicrobial therapies which may be improved upon in the future with the emergence of anti-biofilm technologies.展开更多
Subject Code:H10With the support by the National Natural Science Foundation of China,National Key Research and Development Program of China,and National Program for Support of Top-Notch Young Professionals,the researc...Subject Code:H10With the support by the National Natural Science Foundation of China,National Key Research and Development Program of China,and National Program for Support of Top-Notch Young Professionals,the research team led by Prof.Lai Yuping(赖玉平)at Shanghai Key Laboratory of Regulatory Biology,School of Life Sciences,East China Normal University,uncovered a critical role of regenerating islet-展开更多
基金Supported by the Shandong Province Traditional Chinese Medicine Technology Project,No.Q-2023147the Weifang Health Commission Research Project,No.WFWSJK-2023-033+3 种基金the Weifang City Science and Technology Development Plan(Medical Category),No.2023YX057the Weifang Medical University 2022 Campus Level Education and Teaching Reform and Research Project,No.2022YB051Norman Bethune Public Welfare Foundation,No.ezmr2023-037Special Research Project on Optimized Management of Acute Pain,Wu Jieping Medical Foundation.
文摘BACKGROUND Delayed wound healing is a common clinical complication following gastric cancer radical surgery,adversely affecting patient prognosis.With advances in artificial intelligence,machine learning offers a promising approach for developing predictive models that can identify high-risk patients and support early clinical intervention.AIM To construct machine learning-based risk prediction models for delayed wound healing after gastric cancer surgery to support clinical decision-making.METHODS We reviewed a total of 514 patients who underwent gastric cancer radical surgery under general anesthesia from January 1,2014 to December 30,2023.Seventy percent of the dataset was selected as the training set and 30%as the validation set.Decision trees,support vector machines,and logistic regression were used to construct a risk prediction model.The performance of the model was evaluated using accuracy,recall,precision,F1 index,and area under the receiver operating characteristic curve and decision curve.RESULTS This study included five variables:Sex,elderly,duration of abdominal drainage,preoperative white blood cell(WBC)count,and absolute value of neutrophils.These variables were selected based on their clinical relevance and statistical significance in predicting delayed wound healing.The results showed that the decision tree model outperformed the logistic regression and support vector machine models in both the training and validation sets.Specifically,the decision tree model achieved higher accuracy,F1 index,recall,and area under the curve(AUC)values.The support vector machine model also demonstrated better performance than logistic regression,with higher accuracy,recall,and F1 index,but a slightly lower AUC.The key variables of sex,elderly,duration of abdominal drainage,preoperative WBC count,and absolute value of neutrophils were found to be strong predictors of delayed wound healing.Patients with longer duration of abdominal drainage had a significantly higher risk of delayed wound healing,with a risk ratio of 1.579 compared to those with shorter duration of abdominal drainage.Similarly,preoperative WBC count,sex,elderly,and absolute value of neutrophils were associated with a higher risk of delayed wound healing,highlighting the importance of these variables in the model.CONCLUSION The model is able to identify high-risk patients based on sex,elderly,duration of abdominal drainage,preoperative WBC count,and absolute value of neutrophils can provide valuable insights for clinical decision-making.
文摘The facts that H pylori infection is commoner in duodenal ulcer (DU) patients than in the normal population, and that eradication results in most cases being cured, have led to the belief that it causes DU. However, early cases of DU are less likely than established ones to be infected. H pylori-negative cases are usually ascribed to specific associated factors such as non-steroidal anti-inflammatory drugs (NSAIDs), Crohn’s disease, and hypergastrinaemia, but even after excluding these, several H pylori-negative cases remain and are particularly common in areas of low prevalence of H pylori infection. Moreover, this incidence of H pylori negative DU is not associated with a fall in overall DU prevalence when compared with countries with a higher H pylori prevalence. In countries with a high H pylori prevalence there are regional differences in DU prevalence, but no evidence of an overall higher prevalence of DU than in countries with a low H pylori prevalence. There is no evidence that virulence factors are predictive of clinical outcome. After healing following eradication of H pylori infection DU can still recur. Medical or surgical measures to reduce acid output can lead to long-term healing despite persistence of H pylori infection. Up to half of cases of acute DU perforation are H pylori negative. These findings lead to the conclusion that H pylori infection does not itself cause DU, but leads to resistance to healing, i.e., chronicity. This conclusion is shown not to be incompatible with the universally high prevalence of DU compared with controls.
文摘BACKGROUND Currently,open reduction internal fixation is the conventional surgical method for treatment of double ulna and radius fracture.However,open reduction is associated with a high risk of complications.This case of forearm double fracture involved a patient treated using an Acumed intramedullary nail.The patient experienced good follow-up outcomes.The Acumed forearm intramedullary nail enables early functional exercise and hastens healing of the fracture.Few studies have reported on the use of this approach for the treatment of fractures.CASE SUMMARY A 23-year-old male patient was admitted to hospital after 5 h of pain,swelling,and limited activity of left forearm caused by a careless fall.Physical examination showed stable basic vital signs,swelling of the left forearm,and severe pain when pressing on the injured part of the forearm.Further,friction was felt at the broken end of the bone;the skin was not punctured.Movement of the left hand was normal,and the left radial artery pulse was normal.Three-dimensional computed tomography examination showed an ulna fracture of the left forearm and comminuted fracture of the radius.The fracture was located in the upper third of the radius,with significant displacement on the fracture side.Clinical diagnosis further confirmed the left radius comminuted fracture and ulna fracture.After analyzing the fracture pattern,age,and other patient characteristics,we chose an Acumed nail for treatment and achieved good follow-up outcomes.CONCLUSION Acumed forearm intramedullary nail for fixation of ulna and radius fracture reduced complication risk and resulted in good follow-up outcomes.
文摘<strong>Background:</strong> Breast reduction surgery is increasing in popularity, with so many techniques all around the world, and the community’s knowledge of the details of this procedure increases thanks to the Internet and easy access to information, which increases breast reduction reviews for plastic surgery clinics. Reduction mammaplasty is an established and effective technique to treat symptomatic macromastia. Variable rates of complications have been reported, and there is a continued need for better outcome assessment studies. <strong>Aim:</strong> The purpose of this study was to identify the complications occurred during the first year of breast reduction surgery. <strong>Materials and Methods:</strong> A prospective study over a 1-year period from October 2018 to October 2019, that included 32 patients who underwent breast reduction surgery using the same technique (inferior pedicle and inverted T scar) in the Department of Plastic Surgery at Al-Mouassat University Hospital, Damascus, Syria. Patients were followed through a whole year after surgery and complications that occurred were recorded. <strong>Results:</strong> Complications that occurred in 14 patients (43%), and, and were more common in patients with larger breasts and worse symptoms before surgery. The most common complication was delayed wound healing, and it was associated with breast volume before surgery and with smoking. In general, the most relevant factor influencing the incidence of complications was the weight of the resected breast tissue, which is mainly related to the size of the breast before surgery. <strong>Conclusion:</strong> The weight of the resected breast tissue was the most important factor influencing the occurrence of complications after breast reduction surgery. The most prevalent complication was delayed wound healing and it was associated with the weight of the removed tissue.
文摘Biofilm is the predominant mode of life for bacteria and today it is implicated in numerous human diseases. A growing body of scientific and clinical evidence now exists regarding the presence of biofilm in wounds. This review summarizes the clinical experiences and in vivo evidence that implicate biofilm in delayed wound healing. The various mechanisms by which biofilm may impede healing are highlighted, including impaired epithelialization and granulation tissue formation, and reduced susceptibilities to antimicrobial agents and host defenses. Strategies to manage biofilm and encourage progression to wound healing are discussed;these include debridement and appropriate antimicrobial therapies which may be improved upon in the future with the emergence of anti-biofilm technologies.
文摘Subject Code:H10With the support by the National Natural Science Foundation of China,National Key Research and Development Program of China,and National Program for Support of Top-Notch Young Professionals,the research team led by Prof.Lai Yuping(赖玉平)at Shanghai Key Laboratory of Regulatory Biology,School of Life Sciences,East China Normal University,uncovered a critical role of regenerating islet-
