Objective To explore the application of combined optimized machine learning algorithm for predicting the risk model of postoperative infectious complications of gastric cancer and to compare the accuracy with other algorithms, so as to find reliable biomarkers for early diagnosis of postoperative infection of gastric cancer. Methods The clinical data of 420 patients with gastric cancer at the Third Affiliated Hospital of Anhui Medical University from May 2018 to April 2023 were retrospectively analyzed and the patients were randomly divided into training set and validation set. Univariate analysis was used to determine the risk factors of postoperative infectious complications. Six conventional machine learning models are constructed using the training set: linear regression, random forest, SVM, BP, LGBM, XGBoost, and MGA-XGBoost model. The validation set was used to evaluate the seven models through evaluation indicators such as ACC, precision, ROC and AUC. Results Postoperative infectious complications were significantly correlated with age, operation time, diabetes, extent of resection, combined resection, stage, preoperative albumin, perioperative blood transfusion, preoperative PNI, LCR and LMR. Among the seven machine learning models, the MGA-XGBoost model performed best. Among the seven machine learning models, the MGA-XGBoost model performed best, with AUC of 0.936, ACC of 0.889, recall of 0.6, F1-score of 0.682, and precision of 0.79 on the validation set. Diabetes had the greatest influence on the internal structure of the model. Conclusion This study proves that the MGA-XGBoost model incorporating comprehensive inflammation indicators can predict postoperative infectious complications in patients with gastric cancer.
Objective To compare the effectiveness and advantages of the double reverse traction reduction technique versus open reduction internal fixation for treating complex tibial plateau fractures. Methods A clinical data of 25 patients with Schatzker type Ⅴ or Ⅵ tibial plateau fractures, who met the selection criteria and were admitted between January 2019 and January 2023, was retrospectively analyzed. Thirteen patients underwent double reverse traction reduction and internal fixation (double reverse traction group), while 12 patients underwent open reduction and internal fixation (traditional open group). There was no significant difference in the baseline data (age, gender, injury mechanism, Schatzker classification, interval between injury and operation) between the two groups (P>0.05). The effectiveness were evaluated and compared between the two groups, included operative time, intraoperative blood loss, incision length, hospital stay, full weight-bearing time, complications, fracture healing, Rasmussen radiological score (reduction quality), knee Hospital for Special Surgery (HSS) score, and knee flexion/extension range of motion. Results The double reverse traction group demonstrated superior outcomes in operative time, blood loss, hospital stay, incision length, and time to full weight-bearing (P<0.05). Two patients in traditional open group developed incisional complications, while the double reverse traction group had no complications. There was no significant difference in the incidence of complication between the two groups (P>0.05). All patients were followed up 24-36 months (mean, 30 months), with no intergroup difference in follow-up duration (P>0.05). Fractures healed in both groups with no significant difference in healing times (P>0.05). At 6 months after operation, Rasmussen radiological scores and grading showed no significant difference (P>0.05); the double reverse traction group had significantly higher HSS scores and grading compared to the traditional open group (P<0.05). At 12 months after operation, knee flexion/extension range of motion were significantly greater in double reverse traction group than in traditional open group (P<0.05). Conclusion Double reverse traction reduction offers advantages over traditional open reduction internal fixation, including shorter operative time, reduced blood loss, minimized soft tissue trauma, and improved joint functional recovery. It is a safe and reliable method for complex tibial plateau fractures.