One of the important approaches to structure analysis is protein fold recognition, which is oftenapplied when there is no significant sequence similarity between structurally similar proteins. A framework with athree-layer support vector machines fusion network (SFN) is presented. The framework is applied to 27-classprotein fold recognition from primary structure of proteins. SFN uses support vector machines as memberclassifiers, and adopts All-Versus-All as multi-class categorization. Six groups of features are divided into majorand minor ones by SFN, and several diversity fusion schemes are correspondingly built. The final decision is madeby dynamic selection of the results of all fusion schemes. When it is still difficult to know what kind of fusion offeature groups can achieve good prediction,SFN is a dependable solution by selecting the optimal fusion offeature groups automatically, which can ensure the best recognition. Overall recognition system achieves 61.04%fold prediction accuracy on the independent test dataset. The results and the comparison with other approachesdemonstrate the effectiveness of SFN, and thus encourage its further exploration.

Objective:The implementation of a multidisciplinary team (MDT) approach for palliative treatment of patients with multi-ple primary carcinomas (MPCs) was evaluated in Tianjin Medical University Cancer Institute and Hospital. Methods:A total of 40 pa-tients with MPCs who attended the consultation by MDT in our hospital from January 1, 2014 to April 21, 2016 were analyzed retro-spectively. Clinical data of the 40 cancer patients were reviewed. The essential characteristics and results of MDT treatment decisions were summarized and expected outcomes were evaluated. Results:A total of 40 cases with MPCs were included in MDT assessment, accounting for 6.4%of the 629 patients who were handled by the MDT. A total of 39 MDT decisions were followed up successfully. Among these MDT decisions, 26 (65%) were fully implemented, 7 (17.5%) were partially implemented, and 6 (15.0%) were unimple-mented. Expected outcomes were achieved in 25 (96.2%) patients of the fully implemented concordant group, 4 (57.1%) patients of the partially concordant group, and 1 (16.7%) patient from the unimplemented group. Conclusion:MDT specializing on palliative treat-ment can provide recommendations for standardized individualized comprehensive treatment of patients with MPCs. MDT modality should be further improved and widely used for palliative treatment.

Objective To summarize the experience in nursing patients with gut leak after liver transplantation. Methods Two patients with recurrent gut leakafter liver transplantation underwent surgical repair. The nursing measures included strict observation of postoperative disease, observation of drainage fluid and abdominal signs, early nutritional support, good psychological nursing and health education. Results Gut leak occurred in the two cases again after liver transplantation.One case was treated with repair again and the other with end-stage ileotomy and ileostomy. The patients were discharged after medication and nursing care. Conclusions The close postoperative observation of the disease, observation of drainage fluid and abdominal signs can prompt the discovery of intestinal re-perforation.The early nutritional support plays an important role in the rehabilitation of patients with gut leak after liver transplantation.Mental care and health education can enhance patient's confidence in treatment.

Objective To analyze the stress distributions under static loading and impact simulation in the process of tibial plateau fracture using finite element analysis,providing evidence for individualized diagnosis and treatment of tibial plateau fracture.Methods A healthy male volunteer was recruited.A 3D finite element model of a whole knee joint with ligaments,menisci and articular surfaces was generated using CT,MRI and 3D finite element software.The knee joint model was given the nature and parameters after reconstruction.According to the features of tibial plateau fracture,different operating conditions were designed.The stress distributions under static loading and impact simulation in the process of tibial plateau fracture were characterized by finite element analysis.Results Under static loads on the lateral condyle of the tibia,the stress was mainly concentrated on the front edge of the tibial plateau,especially the lateral stress.The stress on the medial condyle of the tibia was significantly increased,and the medial stress extended downwards to the tibial shaft.When the vertical stress moved towards outside,it extended from both sides of the internal and external condyles downwards to the tibia,and the value of lateral platform stress was slightly larger than that on the inside.In collisions,the stresses distributed on the neutral position were the same with the static loads.The stress on the medial condyle of the tibia was significantly increased,extending downwards the tibial shaft when it fell to the inside slope.When it fell to the outside slope,the stress on the tibial plateau was mainly distributed on most of the front edges of lateral and medial platforms,and the stress distributed on the fibula increased obviously.Conclusions The medial tibial plateau plays a major role in bearing stress loads.The stress is more concentrated on the lateral platform but distributed on a larger area of the medial platform,extending downwards the metaphysis.Therefore,small split fractures are likely to occur on the outer edge of the platform while fractures of a large fragment are likely to occur on the medial platform,even involving the metaphysis.

Objective:To observe the changes of LHX4 and DIS3L mRNA and protein expression in Nthy-ori-3-1 cells after the treatment of thyroid disruptor p, p'-DDE. Methods:Nthy-ori-3-1 cells in logarithmic growth phase were treated with 0, 0.5, 1.0, 2.0 and 5.0 μg/ml p, p'-DDE solution. The growth state and morphology of the cells were observed by microscope. The mRNA levels of LHX4 and DIS3L were detected by real-time fluorescent quantitative PCR, and the protein expression levels of LHX4 and DIS3L were detected by Western blot. Results:when the concentrations of p, p'-DDE were 0, 0.5, 1.0 and 2.0 μg/ml, Nthy-ori-3-1 cells grew normally. There were 33 differential genes in 2.0 μg/ml group, among which 13 genes were down regulated and 20 genes were up-regulated. Compared with the control group, the protein expression levels of LHX4 and DIS3L in 1.0 and 2.0 μg/ml groups were significantly decreased ( P<0.05) , and the relative expression levels of LHX4 and DIS3L protein mRNA in 1.0 μg/ml group were significantly decreased ( P<0.05) . Conclusion:p, p'-DDE can affect the protein expression of LHX4 and dis3l in nthy-ori-3-1 cells.

Objective:To observe the changes of LHX4 and DIS3L mRNA and protein expression in Nthy-ori-3-1 cells after the treatment of thyroid disruptor p, p'-DDE. Methods:Nthy-ori-3-1 cells in logarithmic growth phase were treated with 0, 0.5, 1.0, 2.0 and 5.0 μg/ml p, p'-DDE solution. The growth state and morphology of the cells were observed by microscope. The mRNA levels of LHX4 and DIS3L were detected by real-time fluorescent quantitative PCR, and the protein expression levels of LHX4 and DIS3L were detected by Western blot. Results:when the concentrations of p, p'-DDE were 0, 0.5, 1.0 and 2.0 μg/ml, Nthy-ori-3-1 cells grew normally. There were 33 differential genes in 2.0 μg/ml group, among which 13 genes were down regulated and 20 genes were up-regulated. Compared with the control group, the protein expression levels of LHX4 and DIS3L in 1.0 and 2.0 μg/ml groups were significantly decreased ( P<0.05) , and the relative expression levels of LHX4 and DIS3L protein mRNA in 1.0 μg/ml group were significantly decreased ( P<0.05) . Conclusion:p, p'-DDE can affect the protein expression of LHX4 and dis3l in nthy-ori-3-1 cells.

The finite element method is a new method to study the mechanism of brain injury caused by blunt instruments. But it is not easy to be applied because of its technology barrier of time-consuming and strong professionalism. In this study, a rapid and quantitative evaluation method was investigated to analyze the craniocerebral injury induced by blunt sticks based on convolutional neural network and finite element method. The velocity curve of stick struck and the maximum principal strain of brain tissue (cerebrum, corpus callosum, cerebellum and brainstem) from the finite element simulation were used as the input and output parameters of the convolutional neural network The convolutional neural network was trained and optimized by using the 10-fold cross-validation method. The Mean Absolute Error (MAE), Mean Square Error (MSE), and Goodness of Fit ( R ²) of the finally selected convolutional neural network model for the prediction of the maximum principal strain of the cerebrum were 0.084, 0.014, and 0.92, respectively. The predicted results of the maximum principal strain of the corpus callosum were 0.062, 0.007, 0.90, respectively. The predicted results of the maximum principal strain of the cerebellum and brainstem were 0.075, 0.011, and 0.94, respectively. These results show that the research and development of the deep convolutional neural network can quickly and accurately assess the local brain injury caused by the sticks blow, and have important application value for understanding the quantitative evaluation and the brain injury caused by the sticks struck. At the same time, this technology improves the computational efficiency and can provide a basis reference for transforming the current acceleration-based brain injury research into a focus on local brain injury research.
Brain ; Brain Injuries ; Computer Simulation ; Finite Element Analysis ; Humans ; Neural Networks, Computer

Objective:To investigate the value of systemic inflammatory response syndrome (SIRS), pediatric sequential organ failure assessment (pSOFA) and pediatric critical illness score (PCIS) in predicting mortality of pediatric sepsis in pediatric intensive care units (PICU) from Southwest China.Methods:This was a prospective multicenter observational study. A total of 447 children with sepsis admitted to 12 PICU in Southwest China from April 2022 to March 2023 were enrolled. Based on the prognosis, the patients were divided into survival group and non-survival group. The physiological parameters of SIRS, pSOFA and PCIS were recorded and scored within 24 h after PICU admission. The general clinical data and some laboratory results were recorded. The area under the curve (AUC) of the receiver operating characteristic curve was used to compare the predictive value of SIRS, pSOFA and PCIS in mortality of pediatric sepsis.Results:Amongst 447 children with sepsis, 260 patients were male and 187 patients were female, aged 2.5 (0.8, 7.0) years, 405 patients were in the survival group and 42 patients were in the non-survival group. 418 patients (93.5%) met the criteria of SIRS, and 440 patients (98.4%) met the criteria of pSOFA≥2. There was no significant difference in the number of items meeting the SIRS criteria between the survival group and the non-survival group (3(2, 4) vs. 3(3, 4) points, Z=1.30, P=0.192). The pSOFA score of the non-survival group was significantly higher than that of the survival group (9(6, 12) vs. 4(3, 7) points, Z=6.56, P<0.001), and the PCIS score was significantly lower than that of the survival group (72(68, 81) vs. 82(76, 88) points, Z=5.90, P<0.001). The predictive value of pSOFA (AUC=0.82) and PCIS (AUC=0.78) for sepsis mortality was significantly higher than that of SIRS (AUC=0.56) ( Z=6.59, 4.23, both P<0.001). There was no significant difference between pSOFA and PCIS ( Z=1.35, P=0.176). Platelet count, procalcitonin, lactic acid, albumin, creatinine, total bilirubin, activated partial thromboplastin time, prothrombin time and international normalized ratio were all able to predict mortality of sepsis to a certain degree (AUC=0.64, 0.68, 0.80, 0.64, 0.68, 0.60, 0.77, 0.75, 0.76, all P<0.05). Conclusion:Compared with SIRS, both pSOFA and PCIS had better predictive value in the mortality of pediatric sepsis in PICU.