BACKGROUND: Over 20 million colonoscopies are performed in China annually. An automatic clinical decision support system (CDSS) with accurate semantic recognition of colonoscopy reports and guideline-based is helpful to relieve the increasing medical burden and standardize the healthcare. In this study, the CDSS was built under a hierarchical-label interpretable classification framework, trained by a state-of-the-art transformer-based model, and validated in a multi-center style. METHODS: We conducted stratified sampling on a previously established dataset containing 302,965 electronic colonoscopy reports with pathology, identified 2041 patients' records representative of overall features, and randomly divided into the training and testing sets (7:3). A total of five main labels and 22 sublabels were applied to annotate each record on a network platform, and the data were trained respectively by three pre-training models on Chinese corpus website, including bidirectional encoder representations from transformers (BERT)-base-Chinese (BC), the BERT-wwm-ext-Chinese (BWEC), and ernie-3.0-base-zh (E3BZ). The performance of trained models was subsequently compared with a randomly initialized model, and the preferred model was selected. Model fine-tuning was applied to further enhance the capacity. The system was validated in five other hospitals with 3177 consecutive colonoscopy cases. RESULTS: The E3BZ pre-trained model exhibited the best performance, with a 90.18% accuracy and a 69.14% Macro-F1 score overall. The model achieved 100% accuracy in identifying cancer cases and 99.16% for normal cases. In external validation, the model exhibited favorable consistency and good performance among five hospitals. CONCLUSIONS The novel CDSS possesses high-level semantic recognition of colonoscopy reports, provides appropriate recommendations, and holds the potential to be a powerful tool for physicians and patients. The hierarchical multi-label strategy and pre-training method should be amendable to manage more medical text in the future.
Humans ; Colonoscopy/methods* ; Deep Learning ; Decision Support Systems, Clinical ; Female ; Male

Objective:To investigate the effect of mitochondrial division of GABAergic neurons in substantia nigra pars reticulata(SNr)on motor dysfunction in mice with acute hepatic encephalopathy(AHE).Methods:AHE mice model was established by intraperitoneal injection of thioacetamide(TAA).The changes of liver lobules in AHE mice were observed by hematoxylin-eosin(HE)staining.The changes of serum aspartate aminotransferase(AST),alanine aminotransferase(ALT)and blood ammonia in AHE mice were detected by biochemical detection kit.Then,the motor function of AHE mice was observed by rod fatigue test,elevated cross maze test and open field test.Furthermore,the changes of mitochondrial area,perimeter,roundness and other morphological indicators in SNr of AHE mice were ob-served and analyzed by transmission electron microscopy.The expression of mitochondrial division and fusion related molecules in SNr of AHE mice was observed by Western Blot.Then,the expression of mitochondrial dynamic related protein 1(DRP1)in SNr of AHE mice was targeted by AAV virus.The mitochondrial membrane potential(MMP),ATP and reactive oxygen species(ROS)in SNr were detected by fluorescence enzyme marker,and the changes of motor function of mice were observed.Results:Compared with the control group,the motor function of AHE mice was signifi-cantly decreased,the mitochondrial division of SNr was significantly enhanced,and the expression of mitochondrial divi-sion related proteins was significantly increased.The MMP in SNr of AHE mice was significantly decreased,the ATP of cells was decreased,and the ROS was increased.After targeted inhibition of DRP1 expression in SNr of AHE mice,the movement was improved;further observation found that after the mitochondrial division in SNr of AHE mice was inhibi-ted,the MMP was significantly increased,the ATP of cells was increased,and the ROS was decreased,which demon-strated that the mitochondrial function was significantly improved.Conclusion:Targeted inhibition of mitochondrial di-vision of GABAergic neurons in SNr of AHE mice can improve mitochondrial morphology and function,thus alleviating their movement disorders.

Abstract Socioeconomic status is an important factor affecting all-cause mortality. Income, education and occupation alone or in combination have been employed as a measure of socioeconomic status; however, the study results vary in measures. Material mechanism, lifestyle mechanism, psychological mechanism and community neighborhood mechanism have been accepted as the main intermediate mechanisms for the impact of socioeconomic status on all-cause mortality; however, the contribution of these mechanisms remains controversial. Based on the international and national publications pertaining to the association between socioeconomic status and all-cause mortality from 2012 to 2021, this review summarizes the relationship between socioeconomic status and all-cause mortality in different metrics and the intermediate mechanism of the impact of socioeconomic status on all-cause mortality, so as to provide insights for further studies.

Objective To explore the effect of serpine1, α-serpine1 protein and KLF2 in patients with lower extremity venous thrombosis by Fufang Xueshuantong capsule.Methods 44 patients were diagnosed with lower extremity venous thrombosis were collected, and randomly divided into experimental group and control group, 22 cases in each group, giving the conventional antiplatelet therapy, on the basis of this, the experimental group was given Fufang Xueshuantong capsule 1.5 g, three times a day orally, and the control group was given context Shutong granules 20 g, three times a day orally.2 weeks for a course of treatment, three courses of treatment.Before and after treatment in the detection of two groups of patients with serum serpine1, α-serpine1 KLF2 and protein contents, blood rheology, coagulation function, and carries on the analysis.ResuIts Compared with the control group, experimental group patients has better curative effect, the performance of: serum serpine1and α-serpine1 protein content were significantly decreased(P<0.05).KLF2 expression was significantly higher (P<0.05).Blood viscosity, erythrocyte aggregation index, erythrocyte sedimentation rate decreased significantly (P<0.05).Fib, D-D content significantly decreased (P<0.05).ConcIusions Fufang Xueshuantong capsule can reduce serum serpine1, α-serpine1 protein content and promote KLF2 expression, decrease the blood viscosity, erythrocyte sedimentation rate, improve patients with hypercoagulable state in patients with lower extremity venous thrombosis, so as to achieve good clinical efficacy.

Background and objective Cisplatin-resistance in lung cancer cells is general in clinic, hence it is sig-niifcant to investigate the mechanisms of cisplatin-resistant and develop new methods of reversing drug-resistance. Recent researches showed that miRNA could regulate cell growth, apoptosis, migration and invasion even in drug therapy in cancer by its target gene. hTe aim of this study is to investigate the effects and molecular mechanisms of miR-503 on reversing the cisplatin-resistance in lung cancer DDP-resistant cell line A549/DDP. Methods MTS assay was employed to determine the effect of miR-503 on A549/DDP’ sensitivity to cisplatin. Apoptosis rate and intracellular concentration of rhodamine-123 (Rh-123) were determined by lfow cytometry, the expression of multi-drugs resistant proteins MDR1and MRP1, ERCC1, RhoE, Survivin and Bcl-2 were determined by Western blot and real time PCR. hTe phosphorylation of Akt was analyzed by Western blot, the transcriptional activities of NF-κB and AP-1were detected by dual-luciferase reporter gene systems. Results MiR-503 was able to increase the cisplatin sensitivity of A549/DDP. Atfer treatment with miR-503, the reverse folds (RF) to cisplatin was 2.48 fold, the intracellular level of Rh-123 was 2.49 fold, the apoptosis rate was10.3 fold, the expressions of several drug-resistant related proteins, such as MDR1, MRP1, ERCC1, Survivin and Bcl-2 were downregulated signiifcantly, as shown by WB, in contrast, the level of RhoE was elevated, the mRNA epression of MDR1was18.5%, the mRNA epression of MRP1was 22.3%, the mRNA epression of ERCC1was18.6%, the mRNA epression of Survivin was 42.8%, the mRNA expression of Bcl-2 was 68.1%, the mRNA epression of RhoE was 206.5%, in addition, the phosphorylation of Akt decreased and transcrip-tional activities of NF-κB was 53.7%, AP-1was 47.4%compared with control group. Conclusion MiR-503 was able to reverse the cisplatin resistance of A549/DDP. MiR-503 processed this kind of effect by inhibiting the drug effux, downregulating the expression of drug-resistant related proteins and promoting cell apoptosis.

Background and objective It has been proven that video assited thoracoscopic surgery (VATS) achieved the same survival rates compared with traditional open chest operation in the treatment of early stage of lung cancer. but it is unclear if there is any difference of body inlfammatory reaction between the two operation. hTe aim of this study is to investigate the changes of inlfammatory state of thoracoscopic radical lobectomy in early peripheral lung cancer patients. Meth-ods Senventy-one early peripheral lung cancer patients who have underwent radical lobectomy were divided into two groups based on the different operation method. hTe VATS group was treated by thoracoscopic lobectomy. hTe thoracotomy group was treated by traditional thoracotomy. hTen the level of serum C-reactive protein (CRP), tumor necrosis factor-α(TNF-α), in-terleukin-6 (IL-6) and IL-10 at 1-day before operation and 3-day, 7-day postoperation were measured and compared between the two groups. Results No signiifcant difference was found in the level of serum CRP, TNF-α, IL-6 and IL-10 before opera-tion. Compared to the thoracotomy group, the level of serum CRP, TNF-α, IL-6 and IL-10 in the VATS group were signiifcant-ly lower atfer operation. Conclusion Compared with thoracotomy lobectomy, thoracoscopic lobectomy for early peripheral lung cancer patients is associated with lower inlfammatory responses .

OBJECTIVETo study the stability and degradation kinetics of Ketoprofen-Paeonol conjugate (Ket-Pae).

METHODRP-HPLC method was used to determine the solubility and partition coefficient of Ket-Pae. Stability test was carried out to investigate the factors affecting Ket-Pae. The kinetic studies of Ket-Pae degradation were conducted in different pH buffer solutions and 80% rat plasma at 37 degrees C.

RESULTKet-Pae showed significant degradation phenomenon at high temperature. The solubility of Ket-Pae was decreased about 200 to 300 times compared with parent drugs in water while the lnP increased about 4 times. The degradation curve displayed a V-shape, and kept maximum stability at week acidic (pH 5.0, t(1/2) = 11.4 d). Ket-Pae degraded quickly with very short half life of 1.3 min in plasma, therefore easily released ketoprofen and paeonol.

CONCLUSIONThe lipophilicity of Ket-Pae is increased, its stability is affected by temperature and pH value.

Acetophenones ; chemistry ; Drug Stability ; Drugs, Chinese Herbal ; chemistry ; Hydrogen-Ion Concentration ; Ketoprofen ; chemistry ; Kinetics ; Solubility

Objective To study the current situation of reproductive tract infection among bearing age mar-fled women in countryside and influence factors. Methods We had examined 4916 women. Questionnaire investiga-tion,gynecologic examination,the inspection of pathogen and the B-ultrasound were collected by face to face in the clinic. Results The general prevalence rate of RTI was 53.93%. The prevalence rates of pelvic infection and cervici-tis were 3.97% and 51.12%. The prevalence rates of germs, trichomonal and candiclal vaginitis were 12.51%, 3.60% and 7.71% respectively. The infection rate for only one,two or three kind of RTI were 33.08% ,19.73% and 1.08% respectively. The influence factors were : age, education, family economy, sanitary habits, graviclity, frequent in-tercourse,induced abortion and knowledge towards RTI. Conclusion Among bearing age married women in country-side province the prevalence rate of RTI was higher and also showed evidence of some influence factors.

Objective To investigate the feasibility and clinical efficacy of laparoscopic disc hand assisted laparoscopic splenectomy(LDHALS) for patients with ruptured spleen.Methods LDHALS was performed in 14 patients with ruptured spleen,and among them,8 cases were combined with other visceral trauma.Results All cases were performed successfully by using LDHALS.The median operation time was 70 min(45～100 min).The average hospital stay was 7 days in 6 cases with only spleen trauma and 13.5 days in 8 cases combined with other injuries.No major operative complications and mortality occurred.Conclusion The LDHALS is safe,effective,simple and flexible performed for patients with ruptured spleen.