Study on the Risk Prediction Models of Overweight and Obesity in Medical Students / 中国卫生统计

Objective To construct logistic regression,random forest and SVM models to predict the influencing factors of overweight and obesity in medical students,and the prediction performance of the three models was compared,so as to obtain the optimal model for the risk assessment of overweight and obesity.Methods Participants included 1 866 medical students from a city in Hebei Province from May to December 2020.The relevant data of overweight and obesity screening were collected through self-test questionnaire;three models of logistic regression,random forest and SVM are constructed by python.Results The test set showed that the accuracy of logistic regression,random forest and SVM models were 96.26%,98.66%and 98.13%respectively;the specificity were 99.77%,100%and 99.00%,respectively;and the AUC were 0.88,0.99 and 0.88 respectively.Random forest is the optimal prediction model;according to the random forest model results,subjective well-being,negative events and students'economic status are more than 10%of weight in the model.Conclusion Subjective well-being,negative events and students'economic status are the main factors affecting the incidence of overweight and obesity in medical students;the prediction performance of random forest model was better than logistic regression model and SVM model.

Pneumo-peritoneum helico-CT imaging in post-operative peritoneal adhesion / 中南大学学报(医学版)

OBJECTIVE@#To discuss the diagnostic value of pneumoperitoneum helico-CT imaging (PHCT) in cases of post-operative peritoneal adhesion (POPA).@*METHODS@#We retrospectively analyzed the PHCT scan pictures from 32 consecutive patients with chronic abdominal pain or recurrent mechanical intestinal obstruction after abdominal operation.@*RESULTS@#In a normal peritoneal cavity without adhesion, an air distended dome-like space would be demonstrated with the abdominal organs arranged smoothly on the bottom of the shadow. Any additional shadow appearing in the dome-space would suggest adhesion or something abnormal. Positive findings of peritoneal adhesion were found in 30 of the 32 patients (93.75%). A spot adhesion at the abdominal wall making a kinking of intestine usually showed a cuneiform bulging shadow pointed to the roof of the dome-space. Organs involved in the adhesion may be single or multiple, including the liver, stomach, small intestine, colon, uterus, and omentum. In all the 32 patients, PHCT diagnosis was confirmed by the subsequent laparoscopy treatment.@*CONCLUSION@#PHCT imaging is valuable in making a definite diagnosis of POPA, particularly before a blind laparoscopic exploration. It is a replacement for laparoscopy but much simpler, and may offer a valuable help in dealing with the difficult cases of suspected POPA. A negative imaging is sometimes very important to an undetermined postoperative chronic abdominal pain.

Treatment of severe complications after pancreatoduodenectomy under fiber choledochoscope through a subcutaneous jejunal blind loop: A report of 10 cases / 中国微创外科杂志

Objective To discuss the value of choledochoscopy via subcutaneous jejunal blind loop in the diagnosis and treatment of severe complications after pancreatoduodenectomy. Methods A fiber choledochoscope (FCC) was introduced through a subcutaneous jejunal blind loop. Under direct vision, the pancreatojejunal or choledochojejunal anastomotic leakages were coated with biological glue, or the anastomotic bleedings were stopped with hemostatic drugs. Results Five cases of intestinal leakage, 3 cases of biliary leakage and 2 cases of anastomotic bleeding were all cured. Follow-up for 1～3 years in the 10 cases found no recurrence of tumors. Choledochojejunal anastomotic stricture occurred in 1 case 1 year after the surgery and was cured by dilatation under fiber choledochoscope. In the remaining 9 cases, the pancreatic juice and bile fluid were excreted normally. Conclusions Application of FCC through the subcutaneous jejunal blind loop can be employed in the diagnosis and treatment of complications after pancreatoduodenectomy and in the long-term follow-up of pancreatojejunal or choledochojejunal anastomotic stoma under direct vision.

The use of subcutaneous jejunum blind loop in pancreatoduodenectomy / 中国普通外科杂志

Objective To improve the technique of pancreatoduodenectomy in order to facilitate the(management) of complications and direct observation on follow up.Methods Pancreatoduodenectomy and Child′s method of digestive tract reconstruction was performed in 42 paltents.A blind loop of jejunum 5 to 6 cm in length was constructed beyond the pancreatojejular anastomosis and it was fixed to the subcutaneous(tissue) of the adjacent abdominal wall.Results Thirty-two cases recovered uneventfully,and 10 cases had complications induding pancreatic and biliary leakage and hemorrhage.These complications were successfully treated under direct vision by choledochoscope passed into the blind jejunal loop.This method of observation was used for long-time follow up in 22 cases,and revealed ercurrent tumor(n=5),bile duct stricture(n=4) and bile duct ascariasis(n=1).Conclusions This operative method did not cause new(complications) and it can be combined with the traditional operation.Postoperatively,direct observation and management of leakage of pancreatojejular anastomosis and biliointestinal anastomosis and hemorrhage can be accomplished,and the anastomoses and pancreatic stump can be directly observed at followup.