Objective To establish a prediction model for in-hospital mortality risk in patients with sepsis-induced coagulopathy based on LASSO regression.Methods Patients with sepsis-induced coagulopathy ad-mitted to intensive care unit(ICU)at Beth Israel Deaconess Medical Center during 2008 to 2019 were selected from the Medical Information Market for Intensive Care(MIMIC)-Ⅳ database(version 2.1)for retrospective study.The study subjects were randomly divided into modeling group and verification group,and the feature variables were screened by LASSO regression.The feature variables were analyzed by multivariate Logistic re-gression to determine independent risk factors,and the nomogram prediction model was established at the same time.The model performance was evaluated by drawing calibration curve and receiver operating charac-teristic(ROC)curve,as well as decision curve analysis.Results A total of 4 994 patients with sepsis-induced coagulopathy admitted to ICU for the first time were enrolled in this study.They were randomly divided into a model group(n=3 495)and a validation group(n=1 499)at a ratio of 7:3.Multivariate Logistic regres-sion analysis showed that age,mean respiratory rate,mean corpuscular hemoglobin concentration,red blood cell count,platelet count,prothrombin time,anion gap,acute physiological score Ⅲ and acute kidney injury were independent risk factors for in-hospital mortality of patients with sepsis-induced coagulopathy.Based on the above independent risk factors,a nomographic prediction model was constructed.The area under the ROC curve and 95％confidence interval of the nomogram in the modeling group and validation group were 0.864(0.849-0.880)and 0.877(0.852-0.901),respectively.The sensitivity was 0.795 and 0.763,and the speci-ficity was 0.779 and 0.843,respectively.The calibration curve suggested that the predicted probability was ba-sically consistent with the actual probability,and the decision curve analysis showed that it had good clinical net benefits within a wide range of threshold.Conclusion The nomogram model based on MIMIC-Ⅳ database has good predictive value for predicting the in-hospital mortality of patients with sepsis-induced coagulopathy and can be used to guide clinical work.

Objective:To explore the composition of oral microbiome in patients of long-term survival after liver transplantation, and compare the diversity and distribution of oral microbiome in liver transplant patients with or without liver cancer.Methods:This is a cross-sectional study. Clinical data of 20 patients of long-term survival after liver transplantation from Beijing Chaoyang Hospital Affiliated to Capital Medical University from July 2023 to October 2023 were continuously collected, including 13 males and 7 females, aged 55 (48, 60) years. There were eight patients with hepatocellular carcinoma (HCC) undergoing liver transplantation and 12 non-HCC liver transplant patients. Oral microbiome was analyzed by 16S rDNA gene sequencing, and the diversity analysis and LEfSe analysis were performed.Results:The top ten groups of bacteria in the HCC and non-HCC liver transplant patients were both Bacteroidota, Firmicutes, Proteobacteria, Actinobacteria, Fusobacteriota, Patescibacteria, Campylobacterota, Cyanobacteria, spirochaetota, and Aenigmarchaeota. The top ten genus levels of bacteria in the HCC and non-HCC liver transplant patients were both Haemophilus, Porphyromonas, Gemella, Fusobacterium, Actinomyces, Prevotella, Rothia, Streptococcus, Neisseria. By LEfSe analysis, we found the enrichment of Flavobacteriales, Flavobacteriaceae, Capnocytophaga, Mogibacterium_timidum, Capnocytophaga_leadbetteri, Campylobacter_showae in the HCC group, while the enrichment of Veillonella_atypica, Prevotella_histicola in the non-HCC group.Conclusion:The main microbiome was similar between HCC and non-HCC liver transplant patients, but there were also some differences in microbiome communities.

Uncovering the functionally essential variations related to tumorigenesis and tumor pro-gression from cancer genomics data is still challenging due to the genetic diversity among patients, and extensive inter-and intra-tumoral heterogeneity at different levels of gene expression regulation, including but not limited to the genomic, epigenomic, and transcriptional levels. To minimize the impact of germline genetic heterogeneities, in this study, we establish multiple primary cultures from the primary and recurrent tumors of a single patient with hepatocellular carcinoma (HCC). Multi-omics sequencing was performed for these cultures that encompass the diversity of tumor cells from the same patient. Variations in the genome sequence, epigenetic modification, and gene expression are used to infer the phylogenetic relationships of these cell cultures. We find the discrepancy among the relationships revealed by single nucleotide variations (SNVs) and transcriptional/epigenomic pro-files from the cell cultures. We fail to find overlap between sample-specific mutated genes and differ-entially expressed genes (DEGs), suggesting that most of the heterogeneous SNVs among tumor stages or lineages of the patient are functionally insignificant. Moreover, copy number alterations (CNAs) and DNA methylation variation within gene bodies, rather than promoters, are significantly correlated with gene expression variability among these cell cultures. Pathway analysis of CNA/DNA methylation-related genes indicates that a single cell clone from the recurrent tumor exhibits distinct cellular characteristics and tumorigenicity, and such an observation is further confirmed by cellular experiments both in vitro and in vivo. Our systematic analysis reveals that CNAs and epigenomic changes, rather than SNVs, are more likely to contribute to the phenotypic diversity among subpop-ulations in the tumor. These findings suggest that new therapeutic strategies targeting gene dosage and epigenetic modification should be considered in personalized cancer medicine. This culture model may be applied to the further identification of plausible determinants of cancer metastasis and relapse.

Outpatient humanistic care refered to providing a full process of caring medical services to outpatients. In order to standardize the human caring services for outpatients in medical institutions, promote the comprehensive service level of outpatient services, and improve the patient′s medical experience, Chinese Association for Life Care issued the group standard of Management Norms for Human caring of Outpatients in April 2023. This standard clarified the relevant terms and definitions of human caring for outpatients, specified the basic requirements for human caring, the humanistic quality and care responsibilities of outpatient staff, the outpatient care environment and facilities, the outpatient care process and measures, and quality management. It designed standardized and personalized full process care service norms, providing references for medical institutions at all levels to promote the development of human caring for outpatients.

ObjectiveTo explore the mechanism by which the ethanol extract of Epimedium brevicornu （EEBM） intervenes in mesenchymal adipose-derived stem cells （ADSCs） to delay aging in castrated rats. MethodsForty-five 3-month-old SPF female SD rats were ovariectomized and randomly divided into model group， ADSCs treatment group， and ADSCs groups treated with low， medium， and high concentrations of EEBM （1， 50， 100 μg·L^-1）， referred to as the AE low， medium， and high concentration groups， with 9 rats in each group. After tail vein injection of 200 μL of the corresponding stem cell suspension， aging-related indicators including cyclin-dependent kinase inhibitor （p21）， tumor suppressor gene （p53）， interleukin-6 （IL-6）， interleukin-8 （IL-8）， superoxide dismutase （SOD）， malondialdehyde （MDA）， B-cell lymphoma-2 （Bcl-2）， Bcl-2-associated X protein （Bax）， cysteine-aspartic acid protease-3 （Caspase-3）， and lipofuscin were measured using enzyme-linked immunosorbent assay （ELISA） and Western blot. ResultsCompared with the model group， the IL-6 content in the AE low， medium， and high concentration groups was significantly decreased （P<0.05）. Lipofuscin， MDA， and IL-8 levels in the ADSCs treatment group and AE low， medium， and high concentration groups were significantly reduced （P<0.01）， while SOD content was significantly increased （P<0.05， P<0.01）. Compared with the ADSCs treatment group， lipofuscin and IL-8 levels in the AE low， medium， and high concentration groups were significantly reduced （P<0.05， P<0.01）. The MDA content was significantly decreased in the AE medium concentration group （P<0.01）. Compared with the model group， protein levels of p21， p53， Bax， and Caspase-3 in the ADSCs treatment group and AE low， medium， and high concentration groups were significantly reduced （P<0.05， P<0.01）， while the Bcl-2 protein level was significantly increased （P<0.01）. Compared with the ADSCs treatment group， protein levels of p21， p53， Bax， and Caspase-3 in the AE low， medium， and high concentration groups were significantly reduced （P<0.05， P<0.01）， and the Bcl-2 protein level in the AE low concentration group was significantly increased （P<0.01）. ConclusionThe results of this experiment show that EEBM-treated ADSCs or ADSCs may delay aging in castrated rats by inhibiting cell apoptosis， reducing cell cycle inhibitors and pro-inflammatory factors， enhancing antioxidant capacity， and reducing oxidative reactions. Moreover， EEBM-treated ADSCs demonstrate stronger anti-aging effects than ADSCs alone. This study provides experimental evidence supporting the clinical use of EEBM to intervene in ADSCs and delay aging.

To investigate the risk factors for early relapse after curative resection of Siewert type Ⅱ/Ⅲ adenocarcinoma of esophagogastric junction (AEG) and construct a visual predictive model.