Abstract To observe the effect of fibroblast growth factor (FGF) on wound healing, 50 mice were divided into 5 groups. On the back of every mouse, 2 wounds were made by operative cuts, one for experiment and the other for control. The wounds of the experimental group were covered with 0.5ml FGF solution (contented FGF 300 μg/ml, heparin 100 μg/ml), whereas the wounds of the control group were covered with 0.5ml 0.9% NaCl solution. All of the wounds were dressed by sterilized gauze, and received the same treatment once a day. After 1,3,5,7,10 days, the mice in every group were sacrificed and the tissues of the wounds were collected and prepared for microscopic examination. The results showed that the capillaries and fibroblasts in the experimental group were markedly increased and reached the peak 2～3 days earlier than those in the control group. It was suggested that FGF promoted the formation of granulation tissue and the wound healing.
目的 探討胃嗜酸性肉芽腫的診斷、誤診原因和治療方法。方法 對14例胃嗜酸性肉芽腫的臨床資料進行回顧性分析。結果 全部病例均有上腹疼痛和返酸史； 伴潰瘍形成11例，穿孔4例，上消化道出血3例； 術前行胃鏡檢查2例，X線鋇餐透視檢查6例，無1例獲確診； 其余病例亦全部誤診為胃潰瘍或癌腫。結論 胃鏡多部位取材，特別是在潰瘍與周邊粘膜移行處，采取挖掘式取材，能減少誤診率； 胃大部切除術是主要的治療方法。
ObjectiveTo predict the risk factors affecting postoperative recurrence of granulomatous lobular mastitis (GLM) in the mass stage by machine learning algorithm, and to provide a reference for the early identification and prevention of postoperative recurrence of GLM in the mass stage. MethodsThe electronic medical records and follow-up data of patients with GLM in the Department of Breast Disease Unit, the First Affiliated Hospital of Henan University of Traditional Chinese Medicine from October 2020 to January 2023 were selected. A total of 340 patients with GLM in the mass stage who met the inclusion and exclusion criteria were selected as the research subjects. According to whether the patients relapsed after surgery, they were divided into recurrence group and non-recurrence group. The collected cases were randomly divided into training set and test set according to the ratio of 7:3. In the training set, the recurrence prediction model was constructed by using traditional logistic regression and three machine learning algorithms: artificial neural network, random forest and XGBoost (extrem gradient boosting). In the test set, the performance of the model was evaluated by sensitivity, specificity, accuracy,positive predictive value, negative predictive value, F1 value and area under the curve (AUC) value. The Shapley Additive exPlanation (SHAP) method was used to explore the important variables that affect the optimal model in identifying postoperative recurrence in the GLM mass phase. The optimal risk cutoff value of the prediction model was determined by the Youden index. Based on this, the postoperative patients in the GLM mass phase of the external test set were divided into high-risk and low-risk groups. ResultsA total of 392 patients who met the GLM mass stage were included, and 52 cases were excluded according to the exclusion criteria, and 340 cases were finally included, including 60 cases in the recurrence group and 280 cases in the non-recurrence group. Based on the results of univariate analysis, correlation analysis and clinically meaningful influencing factors, 12 non-zero coefficient characteristic variables were screened for the construction of the prediction model, and these 12 characteristic variables included other disease history, number of miscarriages, breastfeeding duration of the affected breast, history of milk stasis, lesion location, nipple indentation, fluctuation sensation, low-density lipoprotein, testosterone, previous antibiotic therapy, previous oral hormone medication, and perioperative traditional Chinese medicine treatment duration. The logistic regression prediction model, artificial neural network, random forest and XGBoost prediction models were constructed, and the results showed that the accuracy, positive predictive value and negative predictive value of the four prediction models were all >75%, among which the XGBoost model had the best performance, with accuracy, specificity, sensitivity, AUC, positive predictive value, negative predictive value and F1 values of 0.93, 0.99, 0.65, 0.87, 0.92, 0.93 and 0.76, respectively. SHAP method found that the duration of traditional Chinese medicine treatment during perioperative period, the duration of breast-feeding on the affected side, low density lipoprotein, testosterone and previous hormone drugs were the top five factors affecting XGBoost model to identify postoperative recurrence of GLM in mass stage. ConclusionsCompared with the traditional Logistic regression prediction model, the models based on machine learning for identifying postoperative recurrence in the GLM mass phase showed better performance, among which the XGBoost model performed best. Targeted preventive measures can be given based on the above risk factors to improve the postoperative prognosis of the GLM mass phase.
ObjectiveTo construct a prediction model for the postoperative recurrence risk of granulomatous lobular mastitis (GM) based on multiple systemic inflammatory indicators and clinicopathologic characteristics, with the aim of guiding clinical treatment. MethodsThe GM patients who underwent lesion resection at Sichuan Provincial Hospital for Women and Children from January 2017 to March 2024 were retrospectively collected. The univariate and multivariate logistic regression analyses were used to screen the risk factors for recurrence after GM lesion resection, and a nomogram prediction model was constructed based on the risk factors. The test level was set at α=0.05. ResultsA total of 533 patients with GM were included in this study, of whom 118 cases (22.1%) developed postoperative recurrence. The results of multivariate analysis showed that the not taking oral bromocriptine, having microabscess formation in postoperative pathological examination, systemic immune inflammation index (SII) >789.0×109/L, and immunoglobulin E (IgE) >64.4 U/mL were the independent risk factors for recurrence after GM lesion resection. Based on the risk factors, the nomogram predicting recurrence risk was constructed. The area under the receiver operating characteristic curve (95%CI) was 0.913 (0.895, 0.932), and its sensitivity and specificity were 90.5% and 88.9%, respectively. The calibration curve showed that the probability of recurrence after GM lesion resection predicted by using the nomogram was highly consistent with the actual recurrence probability. The decision curve analysis showed that the nomogram had a good clinical net benefit. ConclusionsThe findings of this study suggest that close postoperative monitoring for recurrence is warranted in patients who did not receive oral bromocriptine treatment, presented with microabscess formation on pathological examination, and exhibited elevated SII and IgE level. The postoperative GM recurrence prediction nomogram model constructed based on risk factors demonstrates a good predictive performance, providing a valuable reference for early treatment and management strategies of GM.
Objective To explore the mechanism of full-thickness burn wound healing with autoskin grafting in fault hypodermis wound of granulation excision and to evaluate its effect.Methods By the techniques of clinical observation, histopathology, immunohistochemistry,TEM and FCM,we observed changes of the activity andstructure of grafted skin and the granulation tissue,collagnous fiber,microvessels,the ultramicrostructure of fibroblasts and the expression of basic fibroblast growth factor(bFGF) in the base of autoskin grafting in fault hypodermis wound in burned adult minipigs(Group A), and compared with traditional method of autoskingrafting on the basilar fibrous tissue wound of scraped partly granulation being(Group B) and control group (Group C, without treatment except de-fur).Results The grafted skin survived after 3 days of operation, and it had less injury and higher proliferative index(PI) in group A than in group B. The hyperplasiaof granulation tissue and vascular endothelial and the expression of bFGF were more evident in group A. After 5 days, the proliferation of endothelial cells and granulation and the protein synthesis of fibroblasts were more active in groupA, and at this moment, fresh collagen appeared and proliferated more actively in group B. After 7-14 days, epidermic structure and dermic microvascular density became normal gradually, the granulation on grafting base matured and transformed into fibrous connective tissue in group A. The same change deferred about 2 days in group B. After 21 days, the above pathologic change in group A was less than that in group B. After 3060 days of operation, Group A achieved much less contraction and transfiguration than Group B, and the grafted skin was tender and movable. Conclusion Autoskin grafting in fault hypodermis wound of granulation excision has a better effect than traditional operation.
To investigate the diagnosis, pathological characteristics and clinical treatment of gastric eosinophilic granuloma (GEG). Twenty two cases with GEG diagnosed by operation and pathology were analyzed. In this series 14 cases subjected to partial gastrectomy, 6 cases to subtotal gastrectomy, 1 case to total gastrectomy, and 1 case to radical gastrectomy. After 1-10 years of follow-up, 1 case, who was combined with gastric carcinoma at the first operation, died of the recurrence and extensive metastasis of gastric carcinoma on the 4th year after operation, 2 cases were reoperated on the 2nd or 6th year respectively after operation for forward complication, and the others recoverd well. The authors consider that gastrofiberscopic diagnosis is key to lessen the preoperative misdiagnosis, and the scope of dissection mainly depends on the size and type of focus. It is no need for extensive dissection.
ObjectiveTo compare curative effect of catheter drainage following ultrasound-guided vacuum-assisted rotary excision and traditional excision in treatment of granulomatous mastitis in abscess stage. MethodsA total of 38 patients with granulomatous mastitis in abscess phase from December 2016 to March 2017 in the Third People’s Hospital of Chengdu City and from March 2017 to October 2017 in the Sichuan Provincial Hospital for Women and Children were included as a study group, who were received the catheter drainage following ultrasound-guided vacuum-assisted rotary excision. A total of 38 similar cases from July 2015 to November 2016 in the Third People’s Hospital of Chengdu City were collected as a control group according to the 1∶1 matching principle, who were received the traditional excision. The therapeutic period, postoperative appearance of breast, and recurrence rate were compared between these two groups. ResultsCompared with the control group, the therapeutic period was significantly shorter (t=74.000, P<0.001), the postoperative appearance of breast was significantly better (χ2=7.280, P=0.007) in the study group, while the recurrence rate had no significant difference (χ2=0.559, P=0.455) between these two groups. ConclusionsCatheter drainage following ultrasound-guided vacuum-assisted rotary excision shows advantages in postoperative therapeutic period and appearance of breast and doesn’t increase relapse rate as compared with traditional surgery for patients with granulomatous mastitis in abscess stage.