Objective: Applying the proteomics technology to identify proteins differentially in serums of idiopathic pulmonary fibrosis patients and normal population. Methods: The study included serum samples from idiopathic pulmonary fibrosis group and normal controlled group with 30 cases of each, from the Second Hospital of Shandong University, between October 2014 and October 2015. Proteins differentially expressed in serums were quantified by the isobaric tags for relative and absolute quantization coupled with two-dimensional liquid chromatography/tandem mass spectrometry technology. The proteins were analyzed in terms of molecular function, cell location and biological processes for showing the key protein molecules which were related to the development of idiopathic pulmonary fibrosis. Results: A total of 490 kinds of proteins (with confidence coefficient above 95%) were identified by mass spectrometry and 25 kinds of differentially expressed proteins were found. Compared with the control group, we found 4 types of up-regulated proteins and 21 down-regulated ones in the serum of idiopathic pulmonary fibrosis patients. Data from the Gene ontology analysis showed that most differentially expressed proteins were in the extracellular region (92%) while pathway enrichment analysis showed that most proteins were involved in the complement and coagulation cascade pathway. Conclusion: Proteins related to the complement system coagulation cascade pathway, and the proteins function need to be further studied.
Biomarkers/metabolism* ; Blood Proteins/metabolism* ; Chromatography, Liquid/methods* ; Humans ; Idiopathic Pulmonary Fibrosis/metabolism* ; Proteins/metabolism* ; Proteomics/methods* ; Tandem Mass Spectrometry/methods*

OBJECTIVETo study the relationship between resting heart rate and single nucleotide polymorphisms (SNP) at 3 sites of nitric oxide synthase (NOS) gene including NOS3 -922A/G, NOS3 894G/T and NOS2 -1173C/T SNPs.

METHODSGenomic DNA was gained from 211 Chinese Han nationality population. The SNPs of NOS3 -922A/G, NOS3 894G/T and NOS2 -1173C/T were genotyped by allele-specific primer-polymerase chain reaction (ASP-PCR) technique.

RESULTSThe distribution frequencies of GG, GT and TT genotypes of NOS3 894G/T and AA, AG and GG genotypes of NOS3 -922A/G and CC, CT and TT genotypes of NOS2 -1173C/T were consistent with Hardy-Weinberg equilibrium (P> 0.05). The resting heart rate of Chinese Han nationality population with AA genotypes was higher than that with GG genotype of NOS3 -922A/G (P< 0.01). The resting heart rate of the sub-population with GG genotype was higher than that with TT genotype of NOS3 894G/T (P< 0.05). There were no difference among the resting heart rates of the sub-populations with the allele genotypes of NOS2 -1173C/T.

CONCLUSIONThe resting heart rate of Chinese Han nationality population with mutated genotype GG of NOS3 -922A/G and with mutated genotype TT of NOS3 894G/T were lower than those with wild genotype of NOS3 -922A/G and NOS3 894G/T. The finding suggests that resting heart rate is associated with SNP of NOS3 -922A/G and NOS3 894G/T.

Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; genetics ; China ; Female ; Gene Frequency ; Genotype ; Heart Rate ; Humans ; Male ; Middle Aged ; Nitric Oxide Synthase ; genetics ; Nitric Oxide Synthase Type II ; genetics ; Nitric Oxide Synthase Type III ; genetics ; Polymorphism, Single Nucleotide

Photoplethysmography (PPG) is a non-invasive technique to measure heart rate at a lower cost, and it has been recently widely used in smart wearable devices. However, as PPG is easily affected by noises under high-intensity movement, the measured heart rate in sports has low precision. To tackle the problem, this paper proposed a heart rate extraction algorithm based on self-adaptive heart rate separation model. The algorithm firstly preprocessed acceleration and PPG signals, from which cadence and heart rate history were extracted respectively. A self-adaptive model was made based on the connection between the extracted information and current heart rate, and to output possible domain of the heart rate accordingly. The algorithm proposed in this article removed the interference from strong noises by narrowing the domain of real heart rate. From experimental results on the PPG dataset used in 2015 IEEE Signal Processing Cup, the average absolute error on 12 training sets was 1.12 beat per minute (bpm) (Pearson correlation coefficient: 0.996; consistency error: -0.184 bpm). The average absolute error on 10 testing sets was 3.19 bpm (Pearson correlation coefficient: 0.990; consistency error: 1.327 bpm). From experimental results, the algorithm proposed in this paper can effectively extract heart rate information under noises and has the potential to be put in usage in smart wearable devices.
Algorithms ; Heart Rate/physiology* ; Photoplethysmography/methods* ; Signal Processing, Computer-Assisted ; Wearable Electronic Devices

Artificial intelligence (AI) for science (AI4S) technology, the AI technology for scientific research, has shown tremendous potential and influence in the field of healthcare, redefining the research paradigm of medical science under the guidance of computational medicine. We reviewed the main technological trends of AI4S in reshaping healthcare paradigm: knowledge-driven AI, leveraging extensive literature mining and data integration, emerges an important tool for understanding disease mechanisms and facilitating novel drug development; data-driven AI, delving into clinical and human-related omics data, unveils individual variances and disease mechanisms, and further establishes patient-centric digital twins to guide drug development and personalized medicine. Meanwhile, based on authentic patient digital twin models, adaptable strategies are employed to further propel the development of "e-drugs" that mimic the authentic mechanisms. These digital twins of drugs are evaluated for drug efficacy and safety through large-scale cloud-based virtual clinical trials, and followed by rationally designed real-world clinical trials, thus notably reducing drug development costs and enhancing success rates. Despite encountering challenges such as data scale, quality control, model interpretability, the transition from science insights to engineering solutions, and regulatory hurdles, we anticipate the integration of AI4S technology to revolutionize drug development and clinical practices. This transformation brings revolutionary changes to the medical field, offering novel opportunities and challenges for the development of medical science, and more importantly, providing necessary but personalized healthcare solutions for humankind.

OBJECTIVE: To summarize the clinical features, surgical methods, and prognosis of bucket-handle meniscal tears (BHMTs), and provide guidance for clinical treatment. METHODS: The clinical data of 91 BHMTs patients (91 knees), who met the selection criteria and were admitted between January 2015 and January 2021, was retrospectively analyzed. There were 68 males and 23 females. Age ranged from 16 to 58 years with an average of 34.4 years. The injury was caused by sports in 68 cases, traffic accident in 15 cases, and falls or sprains in 8 cases. There were 49 cases of left knee injury and 42 cases of right knee injury. The time from the onset of symptoms to the admission ranged from 1 day to 13 months (median, 18 days), including >1 month in 35 cases and ≤1 month in 56 cases. Medial BHMTs occurred in 52 cases and lateral BHMTs in 39 cases. There were 36 cases with ACL rupture and 12 cases with discoid meniscus. The knee extension was limited more than 10° in 55 cases. According to the condition of meniscus injury, the meniscus suture with Inside-out combined with All-inside techniques (54 cases) or meniscoplasty (37 cases) under arthroscopy were selected. ACL reconstruction was performed in all patients with ACL rupture with autogenous hamstring tendon. Postoperative complications were observed. International Knee Documentation Committee (IKDC) score, Lysholm score, and Tegner score were used to evaluate knee function, and clinical failure was recorded. RESULTS: Two patients developed intermuscular venous thrombosis, which improved after oral anticoagulant therapy. No vascular injury, postoperative infection, joint stiffness, or other complications occurred in all patients. All patients were followed up 24-95 months, with a median of 64 months. A total of 12 cases (13.19%) failed the operation and were re-operated or given oral anti-inflammatory analgesics and rehabilitation therapy. At last follow-up, IKDC score and Lysholm score of 91 patients significantly increased when compared with those before operation ( P<0.05), while Tegner score significantly decreased ( P<0.05). The above indexes of patients treated with meniscus suture and meniscoplasty were also significantly different from those before operation ( P<0.05). CONCLUSION BHMTs occurs mostly in young men and is one of the important reasons for the limitation of knee extension after trauma. Arthroscopic meniscus suture and meniscoplasty can obtain good effectiveness according to individual conditions of patients. But the latter can better preserve the shape and function of meniscus, and theoretically can obtain better long-term outcomes, which needs to be confirmed by further research with larger sample size.
Male ; Female ; Humans ; Adolescent ; Young Adult ; Adult ; Middle Aged ; Treatment Outcome ; Retrospective Studies ; Meniscus ; Knee Joint/surgery* ; Menisci, Tibial/surgery* ; Knee Injuries/diagnosis* ; Rupture ; Tibial Meniscus Injuries/surgery* ; Arthroscopy/methods* ; Anterior Cruciate Ligament Injuries/surgery*

Objective     To evaluate the methodological quality of clinical practice guidelines and consensuses of robot-assisted surgery. Methods     The guidelines and consensuses were screened according to the inclusion and exclusion criteria by searching the domestic and overseas guidelines network and electronic database from 1 January, 2000 to 29 December, 2021. The Appraisal of Guidelines for Research and EvaluationⅡ (AGREEⅡ) instrument was used independently by two evaluators to evaluate the guidelines and consensuses. The consistency test of intraclass correlation coefficient (ICC) was carried out for two evaluators, and the score of guidelines and consensuses in the six domains of AGREEⅡ were calculated. Results     A total of 34 guidelines and consensuses were included, including 10 guidelines and 24 consensuses. The ICC was all greater than 0.75, indicating that the consistency of the two evaluators was high. The average scores of the 34 guidelines and consensuses in the six domains of AGREEⅡ (scope and purpose, stakeholder involvement, rigor of development, clarity of presentation, applicability and editorial independence) were 81.0%, 43.5%, 28.2%, 81.5%, 12.7% and 51.7%, respectively. Conclusion     These evaluated guidelines and consensuses of robot-assisted surgery still need to be improved in the domains of rigor of development, applicability and editorial independence. With the continuous development of robot-assisted surgery, more guidelines and consensuses based on higher level of evidence will be developed to promote the standardized use of robot-assisted surgery.

Objective     To evaluate the early clinical effect of reimplantation in the treatment of bicuspid aortic valve (BAV) with aortic root aneurysm. Methods     The clinical data of 25 patients with BAV and aortic root aneurysm [mean diameter: 45-63 (52.68±5.55) mm] undergoing reimplantation in West China Hospital from November 2019 to May 2021 were retrospectively reviewed. There were 22 males and 3 females. The mean age was 15-65 (50.00±13.10) years and body surface area was 1.79±0.23 m2. Results    The pathological classification of BAV malformation was confirmed during the operation: Type 0 in 3 patients and Type 1 in 22 patients. There were 12 patients undergoing cusp central plication, and 2 patients were sutured with a closed fusion crest. Postoperative valve leaflet coaptation height was 0.78±0.15 cm, and effective height was 1.27±0.19 cm. In operation, maximum aortic valve flow velocity was 1.65±0.42 m/s, pressure difference was 5.46±3.05 mm Hg, and aortic valve annulus diameter was 21.32±0.95 mm. Cardiopulmonary bypass time was 225.84±35.34 min, and aortic block time was 189.60±26.51 min. In-hospital time was 11.64±3.07 d, ICU stay time was 2.64±0.99 d, and mechanical ventilation time was 1.48±0.87 d. The follow-up time was 17.20±4.70 months, and no death or major complications occurred during the follow-up in all patients. The cardiac function of the patients significantly improved postoperatively (P≤0.05). Echocardiography suggested that 12 patients had no aortic regurgitation, 10 minor aortic regurgitation, 3 mild aortic regurgitation, and no patients with moderate or more severe regurgitation. The diameter of the aortic sinus, left ventricular end-diastolic diameter and volume decreased during the follow-up, compared to preoperative ones (P≤0.05). The maximum flow velocity of the aortic valve was 1.54±0.36 m/s, and the pressure difference was 5.17±2.38 mm Hg during the follow-up. Conclusion    Reimplantation technology has a good clinical effect for highly selective BAV patients. It can effectively avoid long-term postoperative anticoagulation, but the maximum flow rate after surgery is slightly increased, which may be related to the configuration of BAV itself. While compared with valve replacement, the effect is still worthy of recognition.

Objective    To explore the treatment strategies for patients with fever and pulmonary complications after thoracic surgery during COVID-19 epidemic. Methods    The clinical data of 537 patients who ungerwent selective surgery at the Department of Thoracic Surgery, Shangjin Branch of West China Hospital between February and December 2020 were retrospectively analyzed, including 242 (45.1%) males and 295 (54.9%) females aged 53.3±13.4 years. We have established a procedure for the patients with fever and pulmonary complications after thoracic surgery to investigate the cause of the disease and track risk factors. Results    The overall postoperative complication rate was 16.4% (88/537), and 1 (0.2%) patient died. Of 537 patients, 179 (33.3%) patients were enrolled in our model according to the inclusion criteria: ratio of males [112 (62.6%) vs. 130 (36.3%), P<0.010], patients with a history of smoking [74 (41.3%) vs. 87 (24.3%), P<0.010], or with esophageal cancer surgery [36 (20.1%) vs. 15 (4.2%)], or with traditional thoracotomy [14 (7.8%)  vs. 4 (1.1%)] was higher than that of the other patients. Patients in our process due to fever or pulmonary complications had longer ICU stay and postoperative hospital stay (P=0.010). Logistic regression multivariate analysis showed that gender was an independent risk factor for postoperative fever or pulmonary complications. Conclusion    In low-risk areas of the epidemic, the treatment process is simple and feasible, and the cause traceability and corresponding treatment can basically be completed within 24 hours. At the same time, the treatment process has been running stably for a long time.

In transcranial magnetic stimulation (TMS), the conductivity of brain tissue is obtained by using diffusion tensor imaging (DTI) data processing. However, the specific impact of different processing methods on the induced electric field in the tissue has not been thoroughly studied. In this paper, we first used magnetic resonance image (MRI) data to create a three-dimensional head model, and then estimated the conductivity of gray matter (GM) and white matter (WM) using four conductivity models, namely scalar (SC), direct mapping (DM), volume normalization (VN) and average conductivity (MC), respectively. Isotropic empirical conductivity values were used for the conductivity of other tissues such as the scalp, skull, and cerebrospinal fluid (CSF), and then the TMS simulations were performed when the coil was parallel and perpendicular to the gyrus of the target. When the coil was perpendicular to the gyrus where the target was located, it was easy to get the maximum electric field in the head model. The maximum electric field in the DM model was 45.66% higher than that in the SC model. The results showed that the conductivity component along the electric field direction of which conductivity model was smaller in TMS, the induced electric field in the corresponding domain corresponding to the conductivity model was larger. This study has guiding significance for TMS precise stimulation.
Transcranial Magnetic Stimulation ; Diffusion Tensor Imaging ; Electric Conductivity ; Electricity ; Scalp

OBJECTIVETo develop a method for evaluating the feasibility of prenatal screening using local median value and determining the cut-off value.

METHODSWith receiver operating characteristic curve (ROC) analysis, results of second trimester prenatal screening calculated by a local median value in a new model and the built-in median value in 2T software were compared. The cut-off value was set by serial analysis of true and false positive rates and other relevant data.

RESULTSThe ROC curve has accurately estimated the difference in the screening efficacy between a local median value and that embedded in the 2T model, and established a reasonable cut-off value for the laboratory based on false positive rate and detection rate.

CONCLUSIONThe method of ROC curve can be used to evaluate the performance of local median value in prenatal screening and to test the rationality of cut-off value established in the laboratory. As the result, a better cut-off value may be derived.

China ; epidemiology ; Down Syndrome ; diagnosis ; epidemiology ; genetics ; Female ; Humans ; Male ; Pregnancy ; Pregnancy Trimester, Second ; genetics ; Prenatal Diagnosis ; instrumentation ; methods ; standards ; ROC Curve ; Software