目的:探究胃癌全胃切除术后食管–空肠吻合口漏发生的危险因素。方法:回顾性分析2022年1月~2023年12月安徽医科大学附属第一医院收治的295例行全胃切除术的胃癌患者的临床资料,根据术后30天是否发生食管–空肠吻合口漏分为吻合口漏组和...目的:探究胃癌全胃切除术后食管–空肠吻合口漏发生的危险因素。方法:回顾性分析2022年1月~2023年12月安徽医科大学附属第一医院收治的295例行全胃切除术的胃癌患者的临床资料,根据术后30天是否发生食管–空肠吻合口漏分为吻合口漏组和无吻合口漏组,通过电子病历系统提取患者临床病理资料,采用logistic回归分析食管–空肠吻合口漏发生的危险因素。结果:单因素logistic回归结果显示体质指数(P = 0.001)、术中出血量(P = 0.011)、中性粒细胞数(P = 0.001)、全身炎症反应指数(P = 0.002)、中性粒细胞与淋巴细胞比值(P = 0.029)和吻合口漏的发生具有相关性,多因素logistic回归分析结果显示体质指数(P = 0.002)、全身炎症反应指数(P = 0.003)是其独立危险因素。结论:对于术前超重(体质指数 ≥ 24 kg/m2)、全身炎症反应指数偏高的胃癌患者,需更警惕全胃切除术后食管–空肠吻合口漏的发生。Objective: To investigate the risk factors of esophageal-jejunum anastomotic leakage after total gastrectomy for gastric cancer patients. Methods: A retrospective analysis was conducted on the clinical data of 295 gastric cancer patients who underwent total gastrectomy at the First Affiliated Hospital of Anhui Medical University from January 2022 to December 2023. Based on the occurrence of esophageal-jejunal anastomotic leakage within 30 days postoperatively, the patients were divided into an anastomotic leakage group and a non-leakage group. Clinical and pathological data were extracted from the electronic medical record system, and logistic regression analysis was performed to identify risk factors for esophageal-jejunal anastomotic leakage. Results: Univariate logistic regression analysis showed that esophageal-jejunum anastomotic fistula was related with five factors: body mass index (P = 0.001) intraoperative blood loss (P = 0.011), neutrophil count (P = 0.001), systemic inflammatory response index (P = 0.002), neutrophil to lymphocyte ratio (P = 0.029). Multivariate logistic regression analysis showed that body mass index (P = 0.002) and systemic inflammatory response index (P = 0.003) were relatively independent risk factors. Conclusion: For patients with gastric cancer who are overweight (body mass index ≥ 24 kg/m2) and have high systemic inflammatory response index, more attention should be given to the prevention of esophageal-jejunum anastomotic leakage after total gastrectomy.展开更多
Background:This study evaluates the ability of mobile AI voice assistants(AI-VAs)to provide accurate medical advice for early knee osteoarthritis(KOA)and compares their performance with conventional web searches and h...Background:This study evaluates the ability of mobile AI voice assistants(AI-VAs)to provide accurate medical advice for early knee osteoarthritis(KOA)and compares their performance with conventional web searches and human clinicians.Methods:From September to October 2024,two AI-VAs(Apple’s Siri and Huawei’s Xiaoyi)were tested on 15 KOA-related questions in Chinese and English.The assessment focused on the accuracy of voice recognition,response capabilities,and medical advice.Siri was further tested in four international regions(USA,UK,Germany,Hong Kong)using localized languages.Results:In Chinese-language tests,Siri and Xiaoyi showed comparable voice recognition(recognition accuracy:95.6%vs.93.3%)and response ability(speech response:88.9%vs.85.7%).However,Siri provided significantly more accurate medical advice(medical advice:95.6%vs.53.3%;Z=2.762,P<0.001).External validation via Global Quality Score further confirmed Siri’s superiority(mean Global Quality Score=4.0 vs.Xiaoai=0.9).Siri outperformed Xiaoyi in English-language tests(53.3%vs.0%).While Siri’s medical advice accuracy(95.6%)surpassed non-specialist clinicians(Z=2.685,P=0.007),it primarily reflects filtered search results(Baidu/Google)rather than clinical synthesis.Claims of equivalence to junior surgeons(98.2%)must be interpreted cautiously,as AI-VAs lack diagnostic reasoning capabilities.This distinction is critical to avoid overstating their role in clinical decision-making.Conclusion:Current AI-VAs offer limited value in providing precise medical advice for KOA,primarily serving as intermediaries for web search results.Their performance varies across languages,regions,and search engines.展开更多
In the budding yeast Saccharomyces cerevisiae, heterochromatin structure is found at three chromosome regions, which are homothallic mating-type loci, rDNA regions and telomeres. To address how telomere heterochromati...In the budding yeast Saccharomyces cerevisiae, heterochromatin structure is found at three chromosome regions, which are homothallic mating-type loci, rDNA regions and telomeres. To address how telomere heterochromatin is assembled under physiological conditions, we employed a de novo telomere addition system, and analyzed the dynamic chromatin changes of the TRPI reporter gene during telomere elongation. We found that integrating a 255-bp, but not an 81-bp telomeric sequence near the TRP1 promoter could trigger Sir2 recruitment, active chromatin mark（s）＇ removal, chromatin compaction and TRP1 gene silencing, indicating that the length of the telomeric sequence inserted in the internal region of a chromosome is critical for determining the chromatin state at the proximal region. Interestingly, Rill but not Rif2 or yKu is indispensable for the formation of intra-chromosomal silent chromatin initiated by telomeric sequence. When an internal short telomeric sequence （e.g., 81 bp） gets exposed to become a de novo telomere, the herterochromatin features, such as Sir recruitment, active chromatin mark（s）＇ removal and chromatin compaction, are detected within a few hours before the de novo telomere reaches a stable length. Our results recapitulate the molecular dynamics and reveal a coherent picture of telomere het- erochromatin formation.展开更多
文摘目的:探究胃癌全胃切除术后食管–空肠吻合口漏发生的危险因素。方法:回顾性分析2022年1月~2023年12月安徽医科大学附属第一医院收治的295例行全胃切除术的胃癌患者的临床资料,根据术后30天是否发生食管–空肠吻合口漏分为吻合口漏组和无吻合口漏组,通过电子病历系统提取患者临床病理资料,采用logistic回归分析食管–空肠吻合口漏发生的危险因素。结果:单因素logistic回归结果显示体质指数(P = 0.001)、术中出血量(P = 0.011)、中性粒细胞数(P = 0.001)、全身炎症反应指数(P = 0.002)、中性粒细胞与淋巴细胞比值(P = 0.029)和吻合口漏的发生具有相关性,多因素logistic回归分析结果显示体质指数(P = 0.002)、全身炎症反应指数(P = 0.003)是其独立危险因素。结论:对于术前超重(体质指数 ≥ 24 kg/m2)、全身炎症反应指数偏高的胃癌患者,需更警惕全胃切除术后食管–空肠吻合口漏的发生。Objective: To investigate the risk factors of esophageal-jejunum anastomotic leakage after total gastrectomy for gastric cancer patients. Methods: A retrospective analysis was conducted on the clinical data of 295 gastric cancer patients who underwent total gastrectomy at the First Affiliated Hospital of Anhui Medical University from January 2022 to December 2023. Based on the occurrence of esophageal-jejunal anastomotic leakage within 30 days postoperatively, the patients were divided into an anastomotic leakage group and a non-leakage group. Clinical and pathological data were extracted from the electronic medical record system, and logistic regression analysis was performed to identify risk factors for esophageal-jejunal anastomotic leakage. Results: Univariate logistic regression analysis showed that esophageal-jejunum anastomotic fistula was related with five factors: body mass index (P = 0.001) intraoperative blood loss (P = 0.011), neutrophil count (P = 0.001), systemic inflammatory response index (P = 0.002), neutrophil to lymphocyte ratio (P = 0.029). Multivariate logistic regression analysis showed that body mass index (P = 0.002) and systemic inflammatory response index (P = 0.003) were relatively independent risk factors. Conclusion: For patients with gastric cancer who are overweight (body mass index ≥ 24 kg/m2) and have high systemic inflammatory response index, more attention should be given to the prevention of esophageal-jejunum anastomotic leakage after total gastrectomy.
文摘Background:This study evaluates the ability of mobile AI voice assistants(AI-VAs)to provide accurate medical advice for early knee osteoarthritis(KOA)and compares their performance with conventional web searches and human clinicians.Methods:From September to October 2024,two AI-VAs(Apple’s Siri and Huawei’s Xiaoyi)were tested on 15 KOA-related questions in Chinese and English.The assessment focused on the accuracy of voice recognition,response capabilities,and medical advice.Siri was further tested in four international regions(USA,UK,Germany,Hong Kong)using localized languages.Results:In Chinese-language tests,Siri and Xiaoyi showed comparable voice recognition(recognition accuracy:95.6%vs.93.3%)and response ability(speech response:88.9%vs.85.7%).However,Siri provided significantly more accurate medical advice(medical advice:95.6%vs.53.3%;Z=2.762,P<0.001).External validation via Global Quality Score further confirmed Siri’s superiority(mean Global Quality Score=4.0 vs.Xiaoai=0.9).Siri outperformed Xiaoyi in English-language tests(53.3%vs.0%).While Siri’s medical advice accuracy(95.6%)surpassed non-specialist clinicians(Z=2.685,P=0.007),it primarily reflects filtered search results(Baidu/Google)rather than clinical synthesis.Claims of equivalence to junior surgeons(98.2%)must be interpreted cautiously,as AI-VAs lack diagnostic reasoning capabilities.This distinction is critical to avoid overstating their role in clinical decision-making.Conclusion:Current AI-VAs offer limited value in providing precise medical advice for KOA,primarily serving as intermediaries for web search results.Their performance varies across languages,regions,and search engines.
基金supported by the National Natural Science Foundation of China (Nos.31230040,31461143003 and 31521061 to J.Q.Z.)Ministry of Science and Technology of the People's Republic of China(No. 2013CB910403 toJ.Q.Z.)
文摘In the budding yeast Saccharomyces cerevisiae, heterochromatin structure is found at three chromosome regions, which are homothallic mating-type loci, rDNA regions and telomeres. To address how telomere heterochromatin is assembled under physiological conditions, we employed a de novo telomere addition system, and analyzed the dynamic chromatin changes of the TRPI reporter gene during telomere elongation. We found that integrating a 255-bp, but not an 81-bp telomeric sequence near the TRP1 promoter could trigger Sir2 recruitment, active chromatin mark（s）＇ removal, chromatin compaction and TRP1 gene silencing, indicating that the length of the telomeric sequence inserted in the internal region of a chromosome is critical for determining the chromatin state at the proximal region. Interestingly, Rill but not Rif2 or yKu is indispensable for the formation of intra-chromosomal silent chromatin initiated by telomeric sequence. When an internal short telomeric sequence （e.g., 81 bp） gets exposed to become a de novo telomere, the herterochromatin features, such as Sir recruitment, active chromatin mark（s）＇ removal and chromatin compaction, are detected within a few hours before the de novo telomere reaches a stable length. Our results recapitulate the molecular dynamics and reveal a coherent picture of telomere het- erochromatin formation.
