Acute respiratory distress syndrome (ARDS) is a common respiratory emergency, but current clinical treatment remains at the level of symptomatic support and there is a lack of effective targeted treatment measures. Our previous study confirmed that inhalation of hydrogen gas can reduce the acute lung injury of ARDS, but the application of hydrogen has flammable and explosive safety concerns. Drinking hydrogen-rich liquid or inhaling hydrogen gas has been shown to play an important role in scavenging reactive oxygen species and maintaining mitochondrial quality control balance, thus improving ARDS in patients and animal models. Coral calcium hydrogenation (CCH) is a new solid molecular hydrogen carrier prepared from coral calcium (CC). Whether and how CCH affects acute lung injury in ARDS remains unstudied. In this study, we observed the therapeutic effect of CCH on lipopolysaccharide (LPS) induced acute lung injury in ARDS mice. The survival rate of mice treated with CCH and hydrogen inhalation was found to be comparable, demonstrating a significant improvement compared to the untreated ARDS model group. CCH treatment significantly reduced pulmonary hemorrhage and edema, and improved pulmonary function and local microcirculation in ARDS mice. CCH promoted mitochondrial peripheral division in the early course of ARDS by activating mitochondrial thioredoxin 2 (Trx2), improved lung mitochondrial dysfunction induced by LPS, and reduced oxidative stress damage. The results indicate that CCH is a highly efficient hydrogen-rich agent that can attenuate acute lung injury of ARDS by improving the mitochondrial function through Trx2 activation.

Objective To investigate the learning curve of CT-guided percutaneous lung biopsy.Methods Using cumulative sum(CUSUM)analysis method,the clinical data from 110 patients,who underwent CT-guided percutaneous lung biopsy performed by the same physician at the First Affiliated Hospital of Zhengzhou University of China between May 2024 and October 2024,were retrospectively analyzed.The CUSUM learning curve was fitted,and R2 was used to assess the goodness of fit.The baseline and perioperative data were compared between different stages of the learning curve so as to determine the number of accomplished surgical cases that was required for a physician to reach the proficiency stage from the learning stage in performing CT-guided percutaneous lung biopsy.Results Successful CT-guided percutaneous lung biopsy was accomplished in all patients,with a mean operation time of(20.2+3.4)minutes(range of 15-29 minutes).With the accumulation of surgical cases,the operation time showed a gradual downward trend.The learning curve was best fitted with a cubic equation,the equation was as follows:CUSUM(110)=0.000 3x3-0.081 3x2+5.597 9x+0.774 3(where x representing the number of cases),with a goodness-of-fit coefficient R2=0.991.The fitted curve reached its peak at the performance of the 46th case,which was used as the cutoff point to divide the learning curve into two phases.Compared with the learning phase,in the proficiency phase the incidence of complications was significantly lower(pneumothorax:18.8％vs 37.0％,P=0.033)and the mean operation time was obviously shorter[(18.33+2.31)min vs(22.80±3.02)min,P＜0.001].Conclusion Through precise CUSUM analysis of the learning curves obtained from 110 patients receiving CT-guided percutaneous lung biopsy,the results of this study indicates that it requires to accomplish 46 operations before a physician can skillfully master the technique of CT-guided percutaneous lung biopsy.

Objective:To evaluate the diagnostic performance of radiomics model based on contrast-enhanced ultrasound(CEUS) in predicting pathological complete response(pCR) after neoadjuvant chemoradiotherapy(nCRT) in patients with locally advanced rectal cancer(LARC).Methods:One hundred and six patients with LARC who underwent total mesorectal excision after nCRT between April 2018 and April 2023 in the First Affiliated Hospital of Guangxi Medical University were retrospectively included, the patients were randomly divided into a training set of 63(14 pCR patients) and a validation set of 43(12 pCR patients) in a 6∶4 ratios. Radiomics features were extracted from the tumors′ region of interest of CEUS images based on PyRadiomics. Intra-class correlation coefficient(ICC), Mann-Whitney U test, and least absolute shrinkage and selection operator(LASSO) algorithms were used to reduce features dimension. Finally, 7 radiomics features relevanted to pCR were selected to construct an ultrasomics model using elastic network regression, based on the R language. A combined model was constructed by jointing clinical feature. The performance of the models was assessed with the area under the ROC curve(AUC). Results:The AUC of the ultrasomics model and the combined model was 0.695(95% CI=0.532-0.859) and 0.726(95% CI=0.584-0.868) respectively in the training set. The AUC of the ultrasomics model and the combined model was 0.763(95% CI=0.625-0.902) and 0.790(95% CI=0.653-0.928) respectively in the validation set. Both univariate and multivariate Logistic regression analyses showed that CA199( P<0.05) and ultrasomics score( P<0.001) could be an independent predictor of pCR after nCRT in patients with LARC. Conclusions:The CEUS-based radiomics scores has certain predictive value for whether LARC patients achieve pCR after nCRT, and may provide a non-invasive imaging biomarker for predicting LARC patients achieve pCR after nCRT.

Objective:To explore whether the regular feedback system in opportunistic screening of colorectal cancer can improve the adenoma detection rate (ADR) of endoscopists.Methods:This study was an observational study, divided into three stages: the baseline stage before intervention (the pre-intervention period), the regular feedback stage (the intervention period) and the post-intervention stage (the post-intervention period). In the pre-intervention period, all patients who underwent opportunistic screening of colorectal cancer in Department of Gastroenterology in Beijing Shijitan Hospital Affiliated to Capital Medical University from June 2017 to May 2018 were reviewed, and the ADR of each endoscopist was calculated. In the intervention period from June 2018 to November 2018, colonoscopies were performed on patients for opportunistic screening of colorectal cancer by endoscopists who participated in the feedback. The ADR of each endoscopist during the previous month was calculated at the beginning of each month and feedback was provided in the form of a report. In the post-intervention period from December 2018 to January 2019, colonoscopies were performed on patients for opportunistic screening of colorectal cancer by endoscopists who participated in the feedback. The ADR of each endoscopist was calculated after the feedback stopped. ADR and polyp detection rate (PDR) of three stages were compared.Results:A total of 1 768, 1 308 and 344 patients were enrolled for opportunistic screening of colorectal cancer during the pre-intervention, the intervention and the post-intervention period respectively. Eight endoscopists participated in the whole process of this study. The total ADR increased from 23.70% (419/1 768) in the pre-intervention period to 33.72% (441/1 308) in the intervention period ( χ2=37.449, P<0.05). Two months after intervention, ADR decreased slightly to 33.14% (114/344), but was still higher compared with before ( χ2=13.602, P<0.05). The total PDR increased from 47.17% (834/1 768) in the pre-intervention period to 52.68% (689/1 308) in the intervention period ( χ2=9.111, P<0.05). Two months after the intervention, PDR increased slightly to 53.78% (185/344), and still higher compared with before ( χ2=5.035, P<0.05). Conclusion:Regular feedback to endoscopists can improve ADR in opportunistic screening of colorectal cancer.

Objective: To investigate the factors related to severe acute pancreatitis (SAP) with intestine functional disturbance (IFD) and to establish the multiple predictor models of SAP with IFD. Methods: Clinical data of consecutive SAP patients admitted to department of gastroenterology of Beijing Shijitan Hospital, Capital Medical University from January 2015 to March 2019 were retrospectively collected and analyzed. According to the occurrence of IFD at 48 hours after onset, the patients were divided into IFD group and control group. The clinical indicators within 4 hours after admission were compared between the two groups, and the independent predictive factors for SAP with IFD were screened by single factor analysis and multiple classified Logistic regression analysis. The unweighted predictive score (unwScore) and weighted predictive score (wScore) models were constructed by combining the independent predictors. The receiver operating characteristic (ROC) curves of SAP patients with IFD were plotted by independent predictive factors and predictive models, and the clinical predictive effect of each independent predictive index and predictive models were analyzed. Results: A total of 149 patients with SAP were enrolled, including 87 males and 62 females, with age of (52.8±18.1) years old. There were 45 patients in IFD group and 104 patients in control group.Univariate analysis and multiple classified Logistic regression analysis showed that high sensitive C-reactive protein (hs-CRP), blood urea nitrogen (BUN), serum creatinine (SCr), serum calcium (Ca), procalcitonin (PCT) and neutrophil-lymphocyte ratio (NLR) were independent predictive factors of SAP with IFD. The ROC curve was used to calculate the cut-off value of the above indexes to predict IFD, and unwScore model was established. The cut-off score of IFD prediction by the unwScore model was 3 points, and the probability of IFD increased with the increase of the score. The area under ROC curve (AUC) of unwScore was 0.944, the sensitivity was 95.6%, the specificity was 94.2%, the positive predictive value (PPV) was 87.8%, and the negative predictive value (NPV) was 98.0%. The binary Logistic regression analysis of hs-CRP, BUN, Ca, SCr, PCT and NLR were carried out, and wScore model was established. The AUC of wScore was 0.959, the sensitivity was 95.9%, the specificity was 96.2%, the PPV was 91.5%, and the NPV was 98.1%; predictive value was superior to each independent index and unwScore model. Conclusions hs-CRP, BUN, SCr, Ca, PCT and NLR were independent predictive factors of SAP with IFD. The multiple predictor models of SAP with IFD have a good predictive efficiency which may provide valuable clinical reference for prediction and treatment.

OBJECTIVE: To investigate the factors related to severe acute pancreatitis (SAP) with intestine functional disturbance (IFD) and to establish the multiple predictor models of SAP with IFD. METHODS: Clinical data of consecutive SAP patients admitted to department of gastroenterology of Beijing Shijitan Hospital, Capital Medical University from January 2015 to March 2019 were retrospectively collected and analyzed. According to the occurrence of IFD at 48 hours after onset, the patients were divided into IFD group and control group. The clinical indicators within 4 hours after admission were compared between the two groups, and the independent predictive factors for SAP with IFD were screened by single factor analysis and multiple classified Logistic regression analysis. The unweighted predictive score (unwScore) and weighted predictive score (wScore) models were constructed by combining the independent predictors. The receiver operating characteristic (ROC) curves of SAP patients with IFD were plotted by independent predictive factors and predictive models, and the clinical predictive effect of each independent predictive index and predictive models were analyzed. RESULTS: A total of 149 patients with SAP were enrolled, including 87 males and 62 females, with age of (52.8±18.1) years old. There were 45 patients in IFD group and 104 patients in control group.Univariate analysis and multiple classified Logistic regression analysis showed that high sensitive C-reactive protein (hs-CRP), blood urea nitrogen (BUN), serum creatinine (SCr), serum calcium (Ca), procalcitonin (PCT) and neutrophil-lymphocyte ratio (NLR) were independent predictive factors of SAP with IFD. The ROC curve was used to calculate the cut-off value of the above indexes to predict IFD, and unwScore model was established. The cut-off score of IFD prediction by the unwScore model was 3 points, and the probability of IFD increased with the increase of the score. The area under ROC curve (AUC) of unwScore was 0.944, the sensitivity was 95.6%, the specificity was 94.2%, the positive predictive value (PPV) was 87.8%, and the negative predictive value (NPV) was 98.0%. The binary Logistic regression analysis of hs-CRP, BUN, Ca, SCr, PCT and NLR were carried out, and wScore model was established. The AUC of wScore was 0.959, the sensitivity was 95.9%, the specificity was 96.2%, the PPV was 91.5%, and the NPV was 98.1%; predictive value was superior to each independent index and unwScore model. CONCLUSIONS hs-CRP, BUN, SCr, Ca, PCT and NLR were independent predictive factors of SAP with IFD. The multiple predictor models of SAP with IFD have a good predictive efficiency which may provide valuable clinical reference for prediction and treatment.
Acute Disease ; Adult ; Aged ; Female ; Humans ; Intestines ; Male ; Middle Aged ; Pancreatitis/diagnosis* ; Prognosis ; ROC Curve ; Retrospective Studies

Objective: To examine endoscopic features of early colorectal carcinomas smaller than 2 cm. Methods: A total of 191 pa-tients (201 early colorectal carcinomas) who were definitely diagnosed with early colorectal cancer smaller than 2 cm between Janu-ary 2014 and December 2017 in Beijing Shijitan Hospital, Capital Medical University were enrolled. The patients'clinical characteris-tics, endoscopic and pathological data were retrospectively analyzed. Results: There were more male patients than female patients (1.81:1) in the study population; distribution of lesions was higher in the left colon than in the right colon (141/201). Group 1 had a higher number of IIa lesions (20/67, P=0.037) and a lower number of Ip lesions than Group 2 (52/134, P<0.01). Conclusions: There are special characteristics in distribution and endoscopic manifestations of early colorectal carcinoma. Lesion size was less than 1 cm in 67 (191 cases of early colorectal cancer) early colorectal carcinoma cases; however, a high-risk adenoma is defined as a lesion larger than 1 cm in size. Therefore, regardless of lesion size, if fractionation, echinodermata, congestion, erosion, expansion, and depression are observed, the lesion should be assessed in detail for the sake of carcinogenesis.