Medicine
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Endoscopic submucosal dissection (ESD) plays a pivotal role in treating early gastric cancer (EGC). Some patients require additional gastrectomy because of non-curative ESD. This study aimed to analyze the clinical factors associated with non-curative ESD and to re-evaluate the role of ESD according to its indication criteria. ⋯ Similarly, in 6 patients with a local residual tumor absolutely indicated for ESD, 2 had atypical glands and 1 had HGD. Positive vertical margin, lymphatic invasion, and deep submucosal invasion were identified as independent risk factors for LNM. ESD may play diagnostic and therapeutic roles in determining the optimal treatment of EGC when the diagnosis is equivocal or insufficient in endoscopic assessments for gastric cancer screening.
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The purpose of this study is to explore the diagnostic efficacy and value of ultrasound detection for testicular torsion in children with scrotal and testicular diseases. A total of 120 children with acute scrotal swelling and pain who were treated in our hospital from August 2017 to August 2022 were selected for preliminary diagnosis through color Doppler ultrasound diagnostic instrument examination. The final diagnosis was made through surgical or conservative treatment. ⋯ The sensitivity of ultrasound diagnosis was 95.24% (73/77), specificity was 78.57% (34/43), and accuracy was 89.29% (107/120). Ultrasound can effectively diagnose testicular torsion and evaluate the success rate of testicular reduction. Early treatment of patients with testicular torsion leads to better efficacy and higher survival rates.
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Insulin resistance is a key factor in diabetes development. This study aimed to investigate the association between baseline triglyceride-glucose (TyG) index, a surrogate marker of insulin resistance, and the onset of hyperglycemia in Chinese individuals with hypertension. Using the Rich Healthcare Group database, this retrospective cohort study included 28,687 hypertensive individuals without preexisting diabetes. ⋯ After adjusting for confounding variables, a statistically significant positive association was observed between the TyG index and the risk of hyperglycemia. Subgroup and sensitivity analyses further supported these findings, demonstrating consistent outcomes and reinforcing the robustness of our conclusions. The TyG index, which is significantly linked to hyperglycemia in hypertensives, can aid early risk identification and intervention.
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We aimed to investigate the related risk factors of depression in patients with chronic obstructive pulmonary disease (COPD) to detect depressed patients early and perform timely intervention to improve the disease prognosis of chronic obstructive pulmonary disease. This cross-sectional study included COPD patients who were discharged from the First People's Hospital of Hefei, China from October 2018 to October 2019, and all participants were diagnosed with COPD according to the Global Initiative for Chronic Obstructive Pulmonary Disease. There was no COPD exacerbation during follow-up 1 month after discharge. ⋯ Multivariate logistic regression analysis showed that high serum IFN-α level (OR = 1.099, 95% CI: 1.010-1.196; P = .028), high CAT score (OR = 1.250, 95% CI: 1.052-1.484; P = .011) and low smoking index (OR = 10.154, 95% CI: 1.886-54.664; P = .007) were significant risk factors for depression in patients with chronic obstructive pulmonary disease. Our findings suggest that high serum IFN-α levels, and high CAT scores are risk factors for comorbid depression in COPD patients. Continuous high-dose smoking may aggravate the primary disease and ultimately aggravate depression.
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It is yet unknown how spine fracture in adults relate to the triglyceride-glucose (TyG) index. This study investigated the link between TyG index and spine fracture in the adult population of the United States by analyzing information derived from the National Health and Nutrition Examination Survey. Ultimately, this study comprised 10,187 participants was drawn from the National Health and Nutrition Examination Survey (2005-2010, 2013-2014, and 2017-2020). ⋯ Eventually, we carried 10,187 individuals, of whom 211 (2.1%) had an incident spine fracture. The results of the adjusted multivariate logistic regression analysis shows that the TyG index increased the morbidity of spine fracture (odds ratios: 1.63, 95% confidence intervals: 1.15-2.30, P = .01) and the outcome of the stratified and sensitivity analyses remained stable and indicative of a nonlinear relationship. The findings of our study indicate that an elevated TyG index is associated with an increased susceptibility to spine fracture and demonstrates a moderate level of predictive capability.