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Analysis of risk factors of suicidal ideation in adolescent patients with depression and construction of prediction model

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World Journal of Psychiatry 2024年第3期14卷 388-397页

作者： Jun-Chao Zhou Yan Cao Xu-Yuan Xu Zhen-Ping Xian department of Psychosomatic Medicine The Affiliated Lianyungang Hospital of Xuzhou Medical UniversityThe First People's Hospital of LianyungangLianyungang 222000Jiangsu ProvinceChina

BACKGROUND Major depressive disorder is a common mental illness among adolescents and is the largest disease burden in this age group.Most adolescent patients with depression have suicidal ideation(sI);however,few studies have focused on the factors related to sI,and effective predictive models are lacking.AIM To construct a risk prediction model for sI in adolescent depression and provide a reference assessment tool for prevention.METHODs The data of 150 adolescent patients with depression at the first people's hospital of lianyungang from June 2020 to December 2022 were retrospectively analyzed.Based on whether or not they had sI,they were divided into a sI group(n=91)and a non-sI group(n=59).The general data and laboratory indices of the two groups were compared.Logistic regression was used to analyze the factors influencing sI in adolescent patients with depression,a nomogram prediction model was constructed based on the analysis results,and internal evaluation was performed.Receiver operating characteristic and calibration curves were used to evaluate the model’s efficacy,and the clinical application value was evaluated using decision curve analysis(DCA).REsULTs There were differences in trauma history,triggers,serum ferritin levels(sF),highsensitivity C-reactive protein levels(hs-CRP),and high-density lipoprotein(HDLC)levels between the two groups(Pstic regression analysis showed that trauma history,predisposing factors,sF,hs-CRP,and HDL-C were factors influencing sI in adolescent patients with depression.The area under the curve of the nomogram prediction model was 0.831(95%CI:0.763–0.899),sensitivity was 0.912,and specificity was 0.678.The higher net benefit of the DCA and the average absolute error of the calibration curve were 0.043,indicating that the model had a good fit.CONCLUsION The nomogram prediction model based on trauma history,triggers,ferritin,serum hs-CRP,and HDL-C levels can effectively predict the risk of sI in adolescent patients with depression.

关键词： Adolescents Depression suicidal ideation Risk factors Prediction model Ferritin

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Overexpression of vascular endothelial growth factor enhances the neuroprotective effects of bone marrow mesenchymal stem cell transplantation in ischemic stroke

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Neural Regeneration Research 2023年第6期18卷 1286-1292页

作者： Cui Liu Zhi-Xiang Yang si-Qi Zhou Ding Ding Yu-Ting Hu Hong-Ning Yang Dong Han shu-Qun Hu Xue-Mei Zong Institute of emergency Rescue Medicine Emergency Centerthe Affiliated Hospital of Xuzhou Medical UniversityXuzhouJiangsu ProvinceChina Emergency Department of Affiliated Lianyungang Hospital of Xuzhou Medical University/The First People’s Hospital of Lianyungang LianyungangLianyungangJiangsu ProvinceChina Laboratory of emergency Medicine Second Clinical Medical College of Xuzhou Medical UniversityXuzhou Medical UniversityXuzhouJiangsu ProvinceChina Key Laboratory of Brain Diseases Bioinformation Xuzhou Medical UniversityXuzhouJiangsu ProvinceChina

Although bone marrow mesenchymal stem cells(BMsCs)might have therapeutic potency in ischemic stroke,the benefits are limited.The current study investigated the effects of BMsCs engineered to overexpress vascular endothelial growth factor(VEGF)on behavioral defects in a rat model of transient cerebral ischemia,which was induced by middle cerebral artery occlusion.VEGF-BMsCs or control grafts were injected into the left striatum of the infarcted hemisphere 24 hours after stroke.We found that compared with the stroke-only group and the vehicle-and BMsCs-control groups,the VEGF-BMsCs treated animals displayed the largest benefits,as evidenced by attenuated behavioral defects and smaller infarct volume 7 days after stroke.Additionally,VEGF-BMsCs greatly inhibited destruction of the blood-brain barrier,increased the regeneration of blood vessels in the region of ischemic penumbra,and reducedneuronal degeneration surrounding the infarct core.Further mechanistic studies showed that among all transplant groups,VEGF-BMsCs transplantation induced the highest level of brain-derived neurotrophic factor.These results suggest that BMsCs transplantation with vascular endothelial growth factor has the potential to treat ischemic stroke with better results than are currently available.

关键词： bone marrow mesenchymal stem cell brain-derived neurotrophic factor CD31 microtubule associated protein 2 middle cerebral artery occlusion stroke transplantation vascular endothelial growth factor

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Bilateral carotid cavernous fistula after trauma:a case report and literature review

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Chinese Neurosurgical Journal 2021年第4期7卷 300-305页

作者： Jingshan Liang Xiaoxiao Xie Yong sun Xiuli Wei Aimin Li department of Neurosurgery The Affiliated Lianyungang Hospital of Xuzhou Medical University/The First People’s Hospital of LianyungangNo.182Tongguan RoadLianyungang 222000JiangsuChina department of Neurointervention The Affiliated Lianyungang Hospital of Xuzhou Medical University/The First People’s Hospital of LianyungangLianyungangJiangsuChina department of Internal Nursing Lianyungang Higher Vocational Technical School of Chinese MedicineLianyungangChina

Background:Carotid cavernous fistula is a rare complication that is typically associated with head trauma and skull base fractures.The traumatic bilateral carotid cavernous fistula are significantly rarer.Case presentations:We report a case of a 61-year-old man presenting with unilateral exophthalmos,swollen eyelids,conjunctival congestion,and edema etiologically associated with severe trauma.Thereafter,the patient demonstrated symptoms of contralateral oculomotor nerve injury caused by skull base fracture,such as ptosis of eyelid,dilated pupils,and eye movement disorder,and was diagnosed with bilateral carotid cavernous fistula.Conclusions:The patient recovered after undergoing endovascular embolization of bilateral cavernous sinus fistulas.The patient demonstrated the classic symptoms of an extremely rare condition known as bilateral carotid cavernous fistula,in only one eye.Reporting and analyzing this case will help us elucidate the underlying mechanisms of this disease.

关键词： Carotid cavernous fistula Bilateral Trauma Endovascular embolization

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Preoperative and postoperative complications as risk factors for delayed gastric emptying following pancreaticoduodenectomy: A single-center retrospective study

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世界胃肠外科杂志:英文版(电子版) 2023年第9期15卷 1941-1949页

作者： Fang-Liang Xie Li-Jun Ren Wei-Dong Xu Tong-Lei Xu Xia-Qing Ge Wei Li Xu-Ming Ge Wen-Kai Zhou Kai Li Yun-Hai Zhang Zhong Wang department of Hepatobiliary surgery Xuzhou Medical University Affiliated Hospital of Lianyungang(The First People's Hospital of Lianyungang)Lianyungang 222061Jiangsu ProvinceChina Operating Theatre Xuzhou Medical University Affiliated Hospital of Lianyungang(The First People's Hospital of Lianyungang)Lianyungang 222061Jiangsu ProvinceChina department of Pain Xuzhou Medical University Affiliated Hospital of Lianyungang(The First People's Hospital of Lianyungang)Lianyungang 222061Jiangsu ProvinceChina

BACKGROUND Mortality rates after pancreaticoduodenectomy(PD)have significantly decreased in specialized centers.However,postoperative morbidity,particularly delayed gastric emptying(DGE),remains the most frequent complication following PD.AIM To identify risk factors associated with DGE after the PD procedure.METHODs In this retrospective,cross-sectional study,clinical data were collected from 114 patients who underwent PD between January 2015 and June 2018.Demographic factors,pre-and perioperative characteristics,and surgical complications were assessed.Univariate and multivariate analyses were performed to identify risk factors for post-PD DGE.REsULTs The study included 66 males(57.9%)and 48 females(42.1%),aged 33-83 years(mean:62.5),with a male-to-female ratio of approximately 1.4:1.There were 63 cases(55.3%)of PD and 51 cases(44.7%)of pylorus-preserving pancreatoduodenectomy.Among the 114 patients who underwent PD,33(28.9%)developed postoperative DGE.Univariate analysis revealed significant differences in four of the 14 clinical indexes observed:pylorus preservation,retrocolonic anastomosis,postoperative abdominal complications,and early postoperative albumin(ALB).Logistic regression analysis further identified postoperative abdominal complic-ations[odds ratio(OR)=4.768,P=0.002],preoperative systemic diseases(OR=2.516,P=0.049),and early postoperative ALB(OR=1.195,P=0.003)as significant risk factors.CONCLUsION Postoperative severe abdominal complications,preoperative systemic diseases,and early postoperative ALB are identified as risk factors for post-PD DGE.

关键词： Delayed gastric emptying Postoperation Pancreaticoduodenectomy Treatment

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Irisin-loaded electrospun core-shell nanofibers as calvarial periosteum accelerate vascularized bone regeneration by activating the mitochondrial sIRT3 pathway

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Regenerative Biomaterials 2024年第1期3卷 44-57页

作者： Xi Hua Mingzhuang Hou Lei Deng Nanning Lv Yong Xu Xuesong Zhu Huilin Yang Qin shi Hao Liu Fan He department of Orthopaedics The First Affiliated Hospital of Soochow UniversitySoochow UniversitySuzhou 215006China Orthopaedic Institute Suzhou Medical CollegeSoochow UniversitySuzhou 215000China department of Orthopedics Suzhou Wuzhong People’s HospitalSuzhouJiangsu Province 215128China department of Orthopedic surgery Lianyungang Clinical College of Xuzhou Medical UniversityLianyungang 222003China

The scarcity of native periosteum poses a significant clinical barrier in the repair of critical-sized bone defects.The challenge of enhancing regenerative potential in bone healing is further compounded by oxidative stress at the fracture site.However,the introduction of artificial periosteum has demonstrated its ability to promote bone regeneration through the provision of appropriate mechanical support and controlled release of proosteogenic factors.In this study,a poly(L-lactic acid)(PLLA)/hyaluronic acid(HA)-based nanofibrous membrane was fabricated using the coaxial electrospinning technique.The incorporation of irisin into the core-shell structure of PLLA/HA nanofibers(PLLA/HA@Irisin)achieved its sustained release.In vitro experiments demonstrated that the PLLA/HA@Irisin membranes exhibited favorable biocompatibility.The osteogenic differentiation of bone marrow mesenchymal stem cells(BMMsCs)was improved by PLLA/HA@Irisin,as evidenced by a significant increase in alkaline phosphatase activity and matrix mineralization.Mechanistically,PLLA/HA@Irisin significantly enhanced the mitochondrial function of BMMsCs via the activation of the sirtuin 3 antioxidant pathway.To assess the therapeutic effectiveness,PLLA/HA@Irisin membranes were implanted in situ into critical-sized calvarial defects in rats.The results at 4 and 8 weeks post-surgery indicated that the implantation of PLLA/HA@Irisin exhibited superior efficacy in promoting vascularized bone formation,as demonstrated by the enhancement of bone matrix synthesis and the development of new blood vessels.The results of our study indicate that the electrospun PLLA/HA@Irisin nanofibers possess characteristics of a biomimetic periosteum,showing potential for effectively treating critical-sized bone defects by improving the mitochondrial function and maintaining redox homeostasis of BMMsCs.

关键词： periosteum irisin mitochondrial function critical-sized bone defect redox homeostasis

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Activation of NRF2 by celastrol increases antioxidant functions and prevents the progression of osteoarthritis in mice

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Chinese Journal of Natural Medicines 2024年第2期22卷 137-145页

作者： LIU Mingming GUO Jiatian ZHAO Jing LI Hongye FENG Xiaoxiao LIU Haojun ZHANG Hao JIA Xuejun WEI Rushuai LI Fang CHEN Chong HOU Mingzhuang LV Nanning XU Haiyan department of human anatomy Xuzhou Medical UniversityXuzhou 221004China department of Orthopedic surgery The Affiliated Lianyungang Clinical College of Xuzhou Medical University(The Second People’s Hospital of Lianyungang)Lianyungang 222003China department of Orthopaedics The First Afliated Hospital of Soochow UniversitySoochow UniversitySuzhou 215006China Institute of Hematology Xuzhou Medical UniversityXuzhou 221004China

Excessive oxidative stress impairs cartilage matrix metabolism balance,significantly contributing to osteoarthritis(OA)development.Celastrol(CsL),a drug derived from Tripterygium wilfordii,has recognized applications in the treatment of cancer and immune system disorders,yet its antioxidative stress mechanisms in OA remain underexplored.This study aimed to substantiate CsL’s chondroprotective effects and unravel its underlying mechanisms.We investigated CsL’s impact on chondrocytes under both normal and inflammatory conditions.In vitro,CsL mitigated interleukin(IL)-1β-induced activation of proteinases and promoted cartilage extracellular matrix(ECM)synthesis.In vivo,intra-articular injection of CsL ameliorated cartilage degeneration and mitigated subchondral bone lesions in OA mice.Mechanistically,it was found that inhibiting nuclear factor erythroid 2-related factor 2(NRF2)abrogated CsL-mediated antioxidative functions and exacerbated the progression of OA.This study is the first to elucidate the role of CsL in the treatment of OA through the activation of NRF2,offering a novel therapeutic avenue for arthritis therapy.

关键词： Osteoarthritis Celastrol Articular cartilage Extracellular matrix NRF2

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Cut-off values of lesion and vessel quantitative flow ratio in de novo coronary lesion post-drug-coated balloon therapy predicting vessel restenosis at mid-term follow-up

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Chinese medical Journal 2021年第12期134卷 1450-1456页

作者： Pei-Na Meng Bin Liu Long-Bo Li De-Lu Yin Heng Zhang De-Feng Pan Wei You Zhi-Ming Wu Xiang-Qi Wu Lei Zhao Zhi-Bo Li Jin-Peng Wang Zhi-Hui Wang Tian Xu Xiao-Yu Huang Ruo-Nan Gao Fei Ye department of Cardiology Nanjing First HospitalNanjing Medical UniversityNanjingJiangsu 210006China department of Cardiology The Second Hospital of Jilin UniversityChangchunJilin 130000China department of Cardiology The First People's Hospital of LianyungangLianyungangJiangsu 222000China department of Cardiovascular Medicine The First Affiliated Hospital of Bengbu Medical CollegeBengbuAnhui 233000China department of Cardiology The Affiliated Hospital of Xuzhou Medical UniversityXuzhouJiangsu 221006China

Background:Drug-coated balloons(DCBs)have emerged as potential alternatives to drug-eluting stents in specific lesion subsets for de novo coronary lesions.Quantitative flow ratio(QFR)is a method based on the three-dimensional quantitative coronary angiography and contrast flow velocity during coronary angiography(CAG),obviating the need for an invasive fractional flow reserve procedural.This study aimed to assess the serial angiographic changes of de novo lesions post-DCB therapy and further explore the cut-off values of lesion and vessel QFR,which predict vessel restenosis(diameter stenosis[Ds]≥50%)at mid-term follow-up.Methods:The data of patients who underwent DCB therapy between January 2014 and December 2019 from the multicenter hospital were retrospectively collected for QFR analysis.From their QFR performances,which were analyzed by CAG images at follow-up,we divided them into two groups:group A,showing target vessel Ds≥50%,and group B,showing target vessel Dss 287 days in group A and 227 days in group B.We compared the clinical characteristics,parameters during DCB therapy,and QFR performances,which were analyzed by CAG images between the two groups,in need to explore the cut-off value of lesion/vessel QFR which can predict vessel restenosis.student's t test was used for the comparison of normally distributed continuous data,Mann-Whitney U test for the comparison of non-normally distributed continuous data,and receiver operating characteristic(ROC)curves for the evaluation of QFR performance which can predict vessel restenosis(Ds≥50%)at mid-term follow-up using the area under the curve(AUC).Results:A total of 112 patients with 112 target vessels were enrolled in this study.Group A had 41 patients,while group B had 71.Vessel QFR and lesion QFR were lower in group A than in group B post-DCB therapy,and the cut-off values of lesion QFR and vessel QFR in the ROC analysis to predict target vessel Ds≥50%post-DCB therapy were 0.905(AUC,0.741[95%confidence interval,CI:0.645,0.837]

关键词： Quantitative flow ratio Drug-coated balloons De novo coronary lesions Cut-off value Receiver operating characteristic curves

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Common susceptibility variants of KDR and IGF-1R are associated with poststroke depression in the Chinese population

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General Psychiatry 2023年第1期36卷 36-42页

作者： Yingying Yue Linlin You Fuying Zhao Kezhong Zhang Yanyan shi Hua Tang Jianxin Lu shenghua Li Jinxia Cao Deqin Geng Aiqin Wu Yonggui Yuan department of Psychosomatics and Psychiatry ZhongDa HospitalSoutheast UniversityNanjingChina department of Psychiatry Suzhou High-Tech Development District Yangshan Community HospitalSuzhouChina department of Neurology The First Affiliated Hospital of Nanjing Medical UniversityNanjingChina department of Neurology Nanjing First HospitalNangjingChina department of Neurology The Third People's Hospital of Huai'anHuai'anChina department of Neurology People's Hospital of Gaochun CountyNanjingChina department of Neurology The Affiliated Nanjing Jiangning Hospital of Nanjing Medical HospitalNanjingChina department of Neurology The Second People's Hospital of LianyungangLianyungangChina department of Neurology The Affiliated Hospital of Xuzhou Medical UniversityXuzhouChina department of Psychosomatics The Affiliated First Hospital of Soochow UniversitySoochowChina

Background Depression,one of the most frequent complications after stroke,increases the disease’s burden and physical disability.Poststroke depression(PsD)is a multifactorial disease with genetic,environmental and biological factors involved in its occurrence.Genetic studies on PsD to date have mainly focused on the monoamine system and brain-derived neurotrophic factors.However,understanding is still limited about the influence of the single nucleotide polymorphism(sNP)of other neurotrophic factors on PsD.Aims The present study aimed to investigate the relationship between seven vascular endothelial growth factor(VEGF)family gene variants that occur with PsD.Methods A multicentre candidate gene study from five hospitals in Jiangsu Province from June 2013 to December 2014 involved 121 patients with PsD and 131 patients with non-PsD.Demographic characteristics and neuropsychological assessments were collected.Theχ^(2)test was used to evaluate categorical variables,while the independent t-test was applied to continuous variables.sNPs in seven genes(VEGFA,VEGFB,KDR,FLT-1,IGF-1,IGF-1R and PlGF)were genotyped.single-marker association for PsD was analysed byχ^(2)tests and logistic regression using sPss and PLINK software.Results Patients with PsD included more women and those with lower education levels,lower body mass indexes,lower Mini-Mental state Examination scores,and higher scores on the 17-item Hamilton Depression Rating scale than non-PsD patients.Ninety-two sNPs with seven genes were genotyped and passed quality control.The rs7692791 CC genotypes,the C allele of KDR and the rs9282715 T allele of IGF-1R increased the risk for PsD(χ^(2)=7.881,p=0.019;χ^(2)=4.259,p=0.039;χ^(2)=4.222,p=0.040,respectively).In addition,the sNP rs7692791 of KDR was significantly associated with PsD by the logistic regression of an additive model(p=0.015,OR=9.584,95%CI:1.549 to 59.31).Conclusions Patients with rs7692791 C allele carriers or the CC genotype of KDR and the rs9282715 T allele of IGF-1R may have PsD susceptibility.Findin

关键词： KDR susceptibility additive

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Effects of diquafosol sodium in povidone iodine-induced dry eye model

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International Journal of Ophthalmology(English edition) 2023年第12期16卷 1919-1927页

作者： Can Zhang He Wang Dong-Yan Chen Kai Zhao Wei Wang Ming-Xin Li department of Ophthalmology the First People’s Hospital of LianyungangLianyungang 222000Jiangsu ProvinceChina department of Ophthalmology the Affiliated Hospital of Xuzhou Medical UniversityXuzhou 221000Jiangsu ProvinceChina department of Ophthalmology Zhang Ye People’s Hospital Affiliated to Hexi UniversityZhangye 734000Gansu ProvinceChina

AIM:To investigate the effects of diquafosol sodium(DQs)for dry eye model induced with povidone-iodine(PI)solution.METHODs:Ten sprague Dawley rats as the control group.Thirty sprague Dawley rats were used to establish the dry eye model with stimulation of 10 g/L PI for 14d,then divided rats into three groups:dry eye group with no treatment(DED group,n=10);phosphate buffer saline treated group(PBs group,n=10);diquafosol treated group(DQs group,n=10).Clinical changes were observed by tear production test,fluorescein staining,tear breakup time(TBUT)test,corneal confocal microscope and ocular surface comprehensive analyzer.Eyeballs were collected on day 10 of treatment for hematoxylin-eosin(HE),periodic acid-schiff(PAs),and alcian blue staining.TUNEL assay,polymorphonuclear(PMN)and mucin 1(MUC1)immunofluorescence were performed and corneal ultrastructural changes were detected by electron microscopy.REsULTs:Compared with DED and PBs groups,tear production(7.26±0.440 vs 4.07±0.474 mm;7.26±0.440 vs 3.74±0.280 mm;all Ps vs 1.49±0.260s;7.37±0.383s vs 1.42±0.437s;all Psignificantly increased in DQs group.HE,PAs,and alcian blue staining and MUC1 immunofluorescence showed mucins and conjunctival goblet cells density(8.45±0.718 vs 5.21±0.813 cells/0.1 mm^(2);8.45±0.718 vs 5.36±0.615 cells/0.1 mm^(2);all Psed in DQs group.Confocal microscopy,PMN immunofluorescence and TUNEL staining showed inflammatory infiltration and corneal epithelial cells apoptosis decreased in DQs group.The increased number of microvilli in corneal epithelial and the recovered cell junction were observed in DQs group.CONCLUsION:PI instillation can induce goblet cells and mucin loss,epithelial cell apoptosis and inflammation,which are consistent with the pathological manifestations of dry eye.Diquafosol can repair the ocular surface damage caused by PI,reduce corneal inflammation,inhibit corneal epithelial cell apoptosis,promote mucin secretion and maintain tear film stability.

关键词： diquafosol povidone iodine dry eye mucin inflammation tear film rats

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Predictive value of frailty assessment tools in patients undergoingsurgery for gastrointestinal cancer: An observational cohort study

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World Journal of Gastrointestinal surgery 2023年第11期15卷 2525-2536页

作者： Hui-Pin Zhang Hai-Lin Zhang Xiao-Min Zhou Guan-Jie Chen Qi-Fan Zhou Jie Tang Zi-Ye Zhu Wei Wang department of Gastrointestinal surgery The Affiliated Lianyungang Hospital of Xuzhou Medical UniversityLianyungang 222061Jiangsu ProvinceChina department of Gastrointestinal surgery The First People’s Hospital of ChangzhouChangzhou 213000Jiangsu ProvinceChina department of Nursing The Affiliated Lianyungang Hospital of Xuzhou Medical UniversityLianyungang 222061Jiangsu ProvinceChina department of Invasive Technology Zhongda Hospital Southeast UniversityNanjing 210003Jiangsu ProvinceChina department of Hemopurification Center Lianyungang Clinical College of Nanjing Medical UniversityLianyungang 222061Jiangsu ProvinceChina

BACKGROUND Few studies have simultaneously compared the predictive value of various frailty assessment tools for outcome measures in patients undergoing gastrointestinal cancer surgery.Therefore,it is difficult to determine which assessment tool is most relevant to the prognosis of this population.AIM To investigate the predictive value of three frailty assessment tools for patient prognosis in patients undergoing gastrointestinal cancer surgery.METHODs This single-centre,observational,prospective cohort study was conducted at the affiliated lianyungang hospital of xuzhou medical university from August 2021 to July 2022.A total of 229 patients aged≥18 years who underwent surgery for gastrointestinal cancer were included in this study.We collected baseline data on the participants and administered three scales to assess frailty:The comprehen-sive geriatric assessment(CGA),Fried phenotype and FRAIL scale.The outcome measures were the postoperative severe complications and increased hospital REsULTs The prevalence of frailty when assessed with the CGA was 65.9%,47.6%when assessed with the Fried phenotype,and 34.9%when assessed with the FRAIL scale.Using the CGA as a reference,kappa coefficients were 0.398 for the Fried phenotype and 0.291 for the FRAIL scale(both Pstoperative severe complications and increased hospital costs were observed in 29(12.7%)and 57(24.9%)patients,respectively.Multivariate logistic analysis confirmed that the CGA was independently associated with increased hospital costs(odds ratio=2.298,95%confidence interval:1.044-5.057;P=0.039).None of the frailty assessment tools were associated with postoperative severe complications.CONCLUsION The CGA was an independent predictor of increased hospital costs in patients undergoing surgery for gastro-intestinal cancer.

关键词： Gastrointestinal cancer Frailty Assessment tools Prognostic Complication hospital costs

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