Medicine
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Randomized Controlled Trial
Development and validation of prognostic nomogram for patients with metastatic gastric adenocarcinoma based on the SEER database.
The aim of this study was to investigate the prognostic factors affecting overall survival in patients with metastatic gastric adenocarcinoma and to establish a nomogram prediction model for comprehensive clinical application. Data from 2370 patients with metastatic gastric adenocarcinoma between 2010 and 2017 were retrieved from the surveillance, epidemiology, and end results database. They were randomly divided into a training set (70%) and a validation set (30%), univariate and multivariate Cox proportional hazards regressions were used to screen important variables that may affect overall survival and to establish the nomogram. ⋯ The prognostic nomogram showed good overall survival risk stratification ability for the area under the curve, calibration plots, and decision curve analysis in both the training and validation sets. Kaplan-Meier curves further showed that patients in the low-risk group had better overall survival. This study synthesizes the clinical, pathological, therapeutic characteristics of patients with metastatic gastric adenocarcinoma, establishes a clinically effective prognostic model, and that can help clinicians to better evaluate the patient's condition and provide accurate treatment.
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With WeChat platform as the carrier, we explored the effect of online and offline mixed teaching mode applied to Biochemistry teaching. One hundred and eighty-three students from the 4-year nursing major of Xinglin College of Nantong University in 2018 and 2019 were used as the observation group, using online and offline hybrid teaching methods, and 221 students majoring in 4-year nursing from Xinglin College of Nantong University in 2016 and 2017 were the control group, where the traditional classroom teaching method was adopted. The usual stage scores and final scores of the observation group were significantly higher than those of the control group (P < .01). The micro-lecture videos, animations, and periodic assessment methods of the WeChat platform under "Internet+" can greatly stimulate students' interest in learning, thereby significantly improving academic performance and autonomous learning ability.
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Mid-urethral sling is a gold-standard procedure for stress urinary incontinence because of its high efficacy and low complication incidence. Moreover, mesh erosion into the bladder is a rare complication. ⋯ Pelvic ultrasound could accurately evaluate the location and shape of the tape, which is important for a reasonable surgical plan.
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Case Reports
Ruptured small pancreaticoduodenal artery aneurysm-clinical features similar to pancreatitis: A case report.
Pancreaticoduodenal artery aneurysm (PDAA) is rare and has high rupture risks. PDAA rupture has a wide range of clinical symptoms, including abdominal pain, nausea, syncope, and hemorrhagic shock, which is difficult to differentiate from other diseases. ⋯ The clinical manifestations of PDAA rupture were significantly correlated with the aneurysm diameter. Because of small aneurysms, the bleeding is limited around the peripancreatic and duodenal horizontal segments, accompanied by abdominal pain, vomiting, and elevated serum amylase, similar to the clinical manifestations of acute pancreatitis but accompanied by the decrease of hemoglobin. This will help us to improve our understanding of the disease, avoid misdiagnosis, and provide the basis for clinical treatment.
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Trigeminal neuralgia is a recurrent unilateral transient electroshock-like pain. Fu's subcutaneous needling (FSN), used to treat the musculoskeletal problems, has not been reported in this field. ⋯ This case report suggested that FSN can relieve postsurgical trigeminal neuralgia safely and effectively. Clinical randomized controlled studies are needed to be further conducted.