Objective To explore the incidence and severity of diverse clinical symptoms in patients with severe acute pancreatitis (SAP), construct a symptom correlation network model, accurately identify core symptoms within the network, and classify symptom clusters. MethodsA convenience sampling method was adopted. A total of 211 patients with SAP admitted to the First Affiliated Hospital with Nanjing Medical University (Jiangsu Provincial People’s Hospital) from January 2024 to December 2025 were enrolled. The memorial symptom assessment scale was used for evaluation to investigate the composition of clinical symptoms in SAP patients. Exploratory factor analysis was performed to extract symptom clusters. R 4.4.2 software was applied to construct symptom clusters network. Centrality indicators including strength, betweenness and closeness were analyzed to identify core symptoms and core symptom clusters. ResultsA total of three symptom clusters were extracted in this study, including the gastrointestinal symptom cluster (abdominal pain, abdominal distension, dyspnea, dry mouth, nausea, vomiting, diarrhea, constipation, dizziness), the fatigue symptom cluster (lack of energy, difficulty concentrating, drowsiness), and the psychological symptom cluster (anxiety, sleep disturbance, irritability, sadness, distress). Among them, anxiety [95.7% (202/211)], difficulty concentrating [94.8% (200/211)], lack of energy [92.4% (195/211)], and abdominal pain [90.0% (190/211)] were identified as core symptoms. Symptoms with high strength values included anxiety (rs=2.2), difficulty concentrating (rs=1.2), and dyspnea (rs=1.0); symptoms with high closeness centrality values included drowsiness (rc=1.8), difficulty concentrating (rc=1.7), and anxiety (rc=1.1); symptoms with high betweenness centrality values included difficulty concentrating (rb=2.3), anxiety (rb=2.0), and drowsiness (rb=1.5). ConclusionsAnxiety, difficulty concentrating, lack of energy, and abdominal pain were identified as the core symptoms within the symptom clusters of SAP patients, with the fatigue symptom cluster being the core symptom cluster. It is recommended that medical staff pay close attention to the manifestations of core symptoms in SAP patients during treatment and formulate targeted symptom management plans.
Objective To investigate the feasibility and operation effect of endoscopic sentinel lymph node biopsy （SLNB） in breast cancer. Methods The data of 410 breast cancer patients who underwent SLNB （including 107 patients with endoscopy and 303 with open operation） were analyzed in our hospital from January 2009 to March 2012. SLNB was performed by using methylene blue staining or the combination of methylene blue and 99Tcm-sulfur colloid tracing. Results The successful rate of SLN detection with methylene blue and 99Tcm-sulfur colloid tracing was 94.56% （139/147） in open operation group and 94.25% （82/87） in endoscopy group. The successful rate of SLN detection with methylene blue was 88.46% （138/156）in open operation group and 85.00% （17/20） in endoscopy group. The mean of detected SLN number with combined method or methylene blue was 1.90/1.98 in open operation group and 1.91/1.82 in endoscopy group respectively. SLN-positive rate was 22.30% （31/139） and 25.36% （35/138） in open operation group， and 19.51% （16/82） and 23.53% （4/17） in endoscopy group， respectively. The rate of subcutaneous effusion in endoscopy group was higher than that in open operation group （P=0.001）, but other postoperative complications presented no significant difference. Conclusions Endoscopic SLNB can obtain the similar safety and the clinical efficacy with traditional SLNB， but superior cosmetic effect. So it is worthy of clinical application in breast cancer.