OBJECTIVE: To explore the predictive efficacy of the early lactic acid/albumin ratio (LAR) for the occurrence of acute skin failure (ASF) in patients with sepsis. METHODS: A retrospective study was conducted to collect the clinical data of 115 patients with sepsis admitted to the intensive care unit (ICU) of the First Affiliated Hospital of Dalian Medical University from June 2022 to March 2024. The patients' gender, age, length of ICU stay, past medical history, and severity scores, use of mechanical ventilation or vasoactive drugs, albumin (Alb), lactic acid (Lac), mean arterial pressure (MAP), and blood gas analysis indicators within 24 hours of ICU admission were collected, and LAR was calculated. The patients were divided into two groups based on whether they developed ASF, and the clinical data between the two groups were compared. Multivariate Logistic regression analysis was used to screen the risk factors for the occurrence of ASF in patients with sepsis. The receiver operator characteristic curve (ROC curve) was drawn to analyze the predictive value of LAR for the occurrence of ASF in patients with sepsis. RESULTS: A total of 115 patients with sepsis were enrolled in the final analysis, among whom 35 developed ASF and 80 did not. The incidence of ASF was 30.43%. Univariate analysis showed that compared with the non-ASF group, the ASF group had higher acute physiology and chronic health evaluation II (APACHE II) score, proportion of using vasoactive drugs, Lac, and LAR as well as lower Alb and MAP, with statistically significant differences. Multivariate Logistic regression analysis was conducted on the factors with statistical significance in the univariate analysis, and the results showed that Alb [odds ratio (OR) = 0.639, 95% confidence interval (95%CI) was 0.474-0.862, P = 0.003], Lac (OR = 17.228, 95%CI was 1.517-195.641, P = 0.022), MAP (OR = 0.905, 95%CI was 0.855-0.959, P = 0.001), and LAR (OR < 0.001, 95%CI was < 0.001-0.005, P = 0.033) were independent risk factors for the occurrence of ASF in patients with sepsis. ROC curve analysis showed that the area under the ROC curve (AUC) of LAR for predicting the occurrence of ASF in patients with sepsis was 0.867 (95%CI was 0.792-0.943), which was superior to Alb, Lac, and MAP [AUC (95%CI) was 0.739 (0.648-0.829), 0.844 (0.760-0.929), and 0.860 (0.783-0.937), respectively]. When the optimal cut-off value of LAR was 0.11, the sensitivity was 65.7%, the specificity was 96.3%, and the Youden index was 0.620. Patients were grouped based on the optimal cut-off value of LAR, and the results showed that the incidence of ASF in the LAR > 0.11 group was significantly higher than that in the LAR ≤ 0.11 group [88.89% (24/27) vs. 12.50% (11/88), P < 0.05]. CONCLUSIONS LAR has early predictive value for the occurrence of ASF in patients with sepsis, and its efficacy is superior to that of Lac or Alb alone.
Humans ; Sepsis/blood* ; Retrospective Studies ; Lactic Acid/blood* ; Male ; Female ; Intensive Care Units ; Middle Aged ; Risk Factors ; Predictive Value of Tests ; Serum Albumin/analysis* ; ROC Curve ; Aged

Objective: To investigate the effects of neonatal intensive care unit (NICU)-centered regional neonatal transport network (NTN) on the treatment of retinopathy of prematurity (ROP). Methods: A retrospective analysis was conducted to analyze the transfer, treatment and outcomes of 406 preterm infants with ROP who were transferred to the Bayi Children's Hospital Affiliated to the Seventh Medical Center of PLA General Hospital via the NTN from July 2008 to December 2014. Independent sample t-test, Chi-square test and Mann-Whitney nonparametric test were used for statistical analysis. Results: Among the 406 premature infants who were transferred to our hospital because of ROP, there were 257 males and 149 females with the gestational age of (29.5±1.9) weeks (24⁺⁵-36 weeks) and the birth weight of (1 234.8± 268.9) g (580-2 400 g). The age at transfer was (48.9±18.5) d (15-78 d) and the transport distance was (216.5±78.6) km (10-625 km). No death was reported during the transportation. Very preterm births and very low birth weight infants (VLBWI) accounted for 88.7% (360 cases) and 82.5% (335 cases), respectively. Lesions occurred in 1, 2 and 3 zones were detected in 98 (24.1%), 286 (70.4%) and 22 (5.4%) cases, respectively. Lesions of stage 1-5 were observed in 51 (12.6%), 156 (38.4%), 183 (45.1%), 12 (3.0%) and 4 (1.0%) cases. There were 186 cases (45.8%) with Plus lesions. A total of 252 cases (62.1%) underwent surgery which were achieving treatment standards, including 165 (65.5%) undergoing laser therapy, 93 (36.9%) receiving anti-vascular endothelial growth factor (VEGF) therapy, 16 (6.4%) having vitrectomy and two (0.8%) having scleral buckling. Eighteen infants were diagnosed with retinal structural abnormalities, among which 16 had retinal detachment before admission (12 in phase 4 and four in phase 5). Two without retinal detachment on admission developed to phase 4 after surgery. The incidence of retinal structural dysplasia was 0.9% (2/236) in infants receiving laser and/or anti-VEGF therapy in our hospital. Compared with the cured patients (n=234), those with retinal structural dysplasia (n=18) had a late transfer time [80 (38-270) vs 50 (19-150) d, Z=3.387, P<0.001]. Conclusions The NICU-centered and regional transfer-based ROP treatment network provides timely and effective treatment for infants with ROP.

Objective To evaluate the clinical efficacy and safety of endoscopic submucosal dissection (ESD) guided with endoscopic ultrasonography (EUS) for rectal neuroendocrine neoplasms(NENs).Methods A retrospective analysis was performed on 58 patients with rectal ENEs who underwent ESD from January 2011 to December 2015 in JiangSu Province Hospital.Manifestations of EUS, clinicopathological characteristics, proliferation activity grade, complete resection rate, complications and follow-up results of lesion were studied.Results Those treated by ESD included 58 patients with 64 lesions of rectal NENs.EUS results showed that 3 lesions originated from mucosa, 3 from muscularis mucosa and 58 from submucosa.A total of 34 lesions located within 5 cm from anus, 26 in 6-10 cm from anus and 4 more than 10 cm from anus.All 64 lesions were successfully treated by ESD.The mean maximum diameter of the lesions was 0.8 cm(0.2-3.5 cm), and the mean procedure time was 31 min(10-60 min).The complete resection rate was 93.8% (60/64).There were 4 patients with positive basal surgical margin, and two of them underwent additional surgery and two others were treated with argon plasma coagulation after rejecting surgery and ESD.Histological examination determined that 59 lesions were pathologic grade 1(G1) and 5 were pathologic grade 2(G2).Delayed bleeding occurred in 4 cases after ESD,which was managed by medicine in 1 case and endoscopic treatment in 3 cases.No perforation occurred after ESD.During a mean follow-up period of 22.9 months(3-48 months), no lymph node metastasis or distant metastasis was observed.Conclusion EUS is able to distinguish the origin of rectal NENs and aid determining the range and depth of ESD.ESD appears to be a safe, feasible and effective procedure for providing accurate histopathologica1 evaluations as well as curative treatments for rectal NENs limited to submucosa.

Objective To investigate the effects of shRNA interference (RNAi) targeting the histone lysine specific demethylase 1 (LSD1) on the proliferation and apoptosis in acute leukemia (AL) cells. Methods LSD1 shRNA vectors were constructed and transduced into HL-60 and SHI-1 AL cell lines. Inhibitory efficiency of LSD1 was detected by real-time quantitative PCR (RT-qPCR) and Western blot respectively. Cell proliferation was assessed by methyl thiazolyl tetrazolium (MTT), and cell apoptosis was measured by flow cytometry. Results After interference of LSD1, the expression levels of LSD1 mRNA and protein in HL-60 and SHI-1 cells (mRNA: 0.242 ±0.023, 0.207 ±0.006; Protein: 0.256 ±0.015, 0.486 ±0.042) were decreased compared with blank control group without transfection process (mRNA: 1.021 ±0.178, 1.039 ±0.395; Protein:0.552 ±0.026, 0.754 ±0.060) and empty vector negative control group (shNC group) (mRNA: 0.935 ±0.136, 1.016±0.203;Protein: 0.500±0.026, 0.750±0.049) (P<0.05). The levels of their cell proliferation (absorbance value: 0.712±0.010, 0.549±0.007) were inhibited compared with blank control group (absorbance value:0.823±0.010, 0.625±0.005) and shNC group(absorbance value: 0.818±0.019, 0.621±0.003) (P< 0.05). While cell apoptosis rates were increased [(32.80 ±1.35) %, (23.49 ±1.40) %] compared with blank control group [(8.08 ±0.62) %, (7.28 ±1.17) %] and shNC group [(8.08 ±0.62) %, (7.28 ±1.17) %] (P< 0.05). Conclusions Lentivirus-mediated shRNA interferencing LSD1 can inhibit cells ' proliferation and promote apoptosis of HL-60 and SHI-1 AL cell lines, indicating that LSD1 may be a potential biological molecular marker and a new treatment target for AL.

Compressed sensing (CS) is a novel theoretical framework for information acquisition and processing. Taking advantages of the sparsity or compressibility of the signals inherent in the real world, compressed sensing can collect compressed data at the sampling rate much lower than that needed in Shannon's theorem based on random measurement matrix. This technique is used in medical imaging to accelerate MRI's scanning speed, reduce radiation dosage and alleviate patients' suffering. The whole process of the proposed algorithm was as follows: firstly, the wavelet transform was applied to achieve sparse representation of medical images and reserve certain parts with maximal coefficients; secondly, the reconstruction based on CS theory were achieved according to the improved optimized orthogonal matching pursuit (OOMP) algorithm;finally, maximum intensity projection algorithm was used to achieve three-dimensional volume reconstruction. The experimental results demonstrated that our proposed two-dimensional reconstruction method was accurate and effective, which was verified qualitatively by the local detail magnification of images and quantitatively by peak signal-to-noise ratio and sectional comparison. Therefore, the three-dimensional reconstruction can be rather helpful in clinic diagnosis and treatment.

OBJECTIVE:To systematically review the efficacy and safety of glipiaide versus repaglinide in treatment of type 2 diabetes and provide evidence-based reference for the clinical treatment. METHODS:PubMed,EMBase,Medline,Cochrane Li-brary,CJFD,VIP and WanFang database were retrieved to collect the randomized controlled trials(RCT)of the efficacy and safety of glipizide(test group)versus repaglinide(control group)in the treatment of type 2 diabetes. After the quality evaluation and in-formation collection of clinical studies with inclusion criteria,Rev Man 5.2 software was conducted for Meta-analysis. RESULTS:There were totally 10 RCTs,involving 1 022 patients. Meta-analysis results showed that the HbA1c levels [MD=0.43,95%CI (0.20,0.65),P<0.001],2 h postprandial plasma glucose levels [MD=0.49,95% CI(0.04,0.94),P=0.03] and hypoglycemia inci-dence [OR=2.99,95%CI(1.83,4.88),P<0.001] in test group were significantly higher than control group. There was no signifi-cant difference in the fasting plasma glucose level in 2 groups[MD=-0.14,95%CI(-0.44,0.16),P=0.35]. CONCLUSIONS:Re-paglinide has better efficacy and safety than glipizide in the treatment of type 2 diabetes. Limited by the methodological quality and sample amount of included studies,it remains to be verified by RCT with large sample,strict design and long-term follow-up.

This study was aimed to optimize the extraction conditions of polysaccharides from Rhizoma Coptidis.With the R.Coptidis of extraction yield,polysaccharide yield and uronic acid yield as evaluation indexes,the impact of extraction temperature,extraction times,extraction duration and liquid-to-solid ratio on the process of R.Coptidis polysaccharides reflux extraction were investigated by the Box-Behnken design-response surface methodology.The results showed that the optimal extraction conditions were achieved and listed as follows:extraction temperature at 100℃,extracted 3 times with 3.8 h per each time,liquid-to-solid ratio of 1:15.7.It was concluded that the Box-Behnken design-response surface methodology was accurate,rational and feasible to optimize the extraction method of polysaccharides fromR.Coptidis.

Objective To investigate the application of quality control circle ( QCC) intravenous therapy to enhance the quality and reduce the PICC complication rate. Methods Established QCC team and the theme of“Reduce the incidence of PICC complications”, we surveyed, analyzed, set goals, developed and implemented measures to further confirm the effectiveness and standardization. Results After QCC application, PICC overall complication rate, the incidence of plugging and thrombosis were significantly lower than before the application, the differences were statistically significant (χ2 =21. 338,12. 032,7. 684;P<0. 01). After QCC application, quality control practices of QCC members, team cohesion, communication and coordination, degree of harmony, job motivation, self-confidence were higher than these of before activities (P <0. 01). Conclusions The application of QCC can reduce overall complication rate of PICC plugging and thrombosis, and promote continuous intravenous therapy quality improvement, improved nurses motivation, personal values, team cohesion and communication skills. It is worthy of promotion.

Purpose To propose a novel compression method for region of interest (ROI) based on Curvelet transform and SPIHT algorithm. Materials and Methods The ROI was firstly extracted without compression, and Curvelet transform was applied for the background regions. The Curvelet coefifcients were coded using SPIHT algorithm. Then the images after compression are obtained by inverse Curvelet transform. The ROI and the background were ifnally overlapped to get the full compressed image. Effect of ROI compression and overall compression were compared, as well as the Curvelet transform and wavelet transform, based on peak signal noise ratio. Results The ROI compression highlighted the region of interest and the visual effect was superior to the overall compression. The peak signal to noise of Curvelet transform was higher than that of wavelet transforms, and the compressed images were more clear for the same proportion. Conclusion ROI compression based on Curvelet transform and SPIHT algorithm can achieve efficient compression images without losing important diagnostic information, which complies with the requirement of high precision and high quality of medical image compression.

Objective To investigate the effect and mechanism of cell differentiation agent Ⅱ (CDA-Ⅱ) on the differentiation of human acute mycloid leukemia (APL) HL-60 cells.Methods The cell morphology and differentiation was detected by Wright-Giemsa staining,the expression of cell surface differentiation antigen CD11b of HL-60 was detected by flow cytometry,the differentially expressed genes were screened by gene expression profile chip (NimbleGen).Results The result of Wright-Giemsa staining showed that CDA-Ⅱ induced HL-60 differentiation towards mature stages in a time-dependent manner.After treated with CDA-Ⅱ,the percentage of CD11b-positive HL-60 cells significantly increased in a time-and dose-dependent manner.The result of gene expression profiling indicated differentially expressed genes including 113 up-regulation genes and 140 down-regulation genes.The up-regulation expression genes involved in six pathways including mineral absorption,complement and coagulation cascades,down-regulation expression genes involved in nine pathways including pyrimidine metabolism,RNA polymerase,purine metabolism and so on.Conclusion CDA-Ⅱ can induce HL-60 differentiation and make gene differentially expressed.The data provide the feasibility of CDA-Ⅱ in differentiation induction therapy for APL.