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Objectives:To evaluate the hemodynamic impact of different bypass grafting methods on the left anterior descending(LAD)artery using computational fluid dynamics,providing a theoretical basis for optimizing coronary artery bypass grafting.Methods:A patient-specific 3D coronary model was constructed using SimVascular software,including an in-situ internal mammary artery graft(model 1)and three free grafts of varying diameters(model 2:2 mm internal mammary artery free graft;model 3 and model 4:3 mm and 4 mm great saphenous vein free grafts).The hemodynamic parameters of the native artery and grafts were compared among the four bypass grafting models.Results:All four bypass grafting models supply sufficient blood flow for the severely stenosed LAD.LAD flow was slightly lower in the model 1.Free internal mammary artery grafts showed higher flow and wall shear stress.4 mm great saphenous vein free grafts presented with maximum flow but lowest shear stress,3 mm great saphenous vein free grafts offered better hemodynamic stability.Conclusions:Computational fluid dynamics analysis indicates that free internal mammary grafts could provide superior hemodynamics,while larger grafts result in lower shear stress,which might affect long-term graft patency.These findings thus provide experimental evidences useful for optimizing LAD bypass strategies.

Objective To investigate the clinical efficacy of national famous traditional Chinese medicine doctor prof.Wang Tan's application of Yang-assisting Lung Repairing and Paralysis Removing Soup combined with pulmonary rehabilitation on patients with idiopathic pulmonary fibrosis.Method A total of 79 patients with pulmonary arthralgia who met the inclusion criteria and visited the inpatient Department of Pulmonary Disease in the Affiliated Hospital of Changchun University of Traditional Chinese Medicine and Professor Wang Tan's Changjiang Scholar Studio from January 2024 to November 2024 were retrospectively analyzed.There were 30 cases in control group and 49 cases in treatment group.Among them,the control group received routine treatment and was given Zhuyang Bufei Chubi decoction and the observation group was added lung rehabilitation treatment on this basis(walking,dumbbell exercises,climbing stairs,resistance bands,breathing trainers,sandbags,abdominal breathing exercises),the course of treatment was 1 month.Compare the recovery of lung function,six-minute walking test(6MWT),C-reactive protein(CRP),quality of life assessment,and overall therapeutic efficacy of the two groups of patients before and after treatment.Result After treatment,the pulmonary function index,exercise endurance,total therapeutic effect,inflammatory response and quality of life of the two groups were analyzed,and the curative effect of the treatment group was better than that of the control group(P<0.05).Conclusion The treatment of idiopathic pulmonary fibrosis patients with Zhuyang Bufei Chubi decoction combined with pulmonary rehabilitation helps patients with various indexes to improve their lung function,exercise endurance,and quality of life.

Objective:To evaluate the efficacy and safety of nebulized inhalation of recombinant human interferon (IFN) α1b injection in the treatment of respiratory syncytial virus (RSV) associated lower respiratory tract infections (pneumonia and bronchiolitis) in children.Methods:A randomized, double-blind, parallel, placebo-controlled add-on design was used.Children with pneumonia or bronchiolitis aged 2 months to 5 years who tested positive for RSV antigen within 72 hours of onset from 30 clinical trial sites including Beijing Children′s Hospital, Capital Medical University between February 2021 and December 2022 were included in this study and randomly divided into 2 groups at a ratio of 1∶1 based on a stratified-block method.Both groups received basic treatments such as cough control, asthma relieving, expectorant treatment, fever reduction, oxygen therapy, etc.The experimental group received additional nebulized inhalation of IFN α1b injection at a dose of 2.0 μg/(kg·time), twice a day.The control group received nebulized inhalation of placebo twice a day.Clinical efficacy was evaluated based on indicators such as the duration of clinical symptoms and signs, and the Kaplan-Meier method was used to calculate the median and 95% CI of the duration of clinical symptoms and signs.The Log-rank test was used to compared data between groups.Safety was assessed through the incidence of adverse reactions and laboratory tests, and the Chi-square test was used to analyze the difference between groups. Results:There were 123 children in the experimental group and 122 children in the control group.The median durations of all the 5 clinical symptoms and signs [including shortness of breath, wheezing, dyspnea (visible retractions), decreased transcutaneous oxygen saturation, and abnormal mental state] in the experimental group after treatment were slightly shortened than those in the control group [2.7 d(95% CI: 1.9-3.0 d)] vs.[2.9 d(95% CI: 2.6-3.6 d), P=0.027].The improvement in dyspnea (retractions) was especially pronounced in the experimental group, with a relief rate of 50.0% (0, 100%) on the first day of administration[compared with 0 (0, 50.0%) in the control group ( Z=2.002, P=0.025)].The median duration of dyspnea in the experimental group was nearly 1 day shorter than that in the control group [1.0 d(95% CI: 0.7-1.7 d) vs.1.8 d(95% CI: 1.0-2.5 d), P=0.046].There were no significant difference in hospital stay [6.0(5.0, 8.0) d vs.6.5(5.0, 8.0) d, Z=0.675, P=0.500], oxygen therapy duration [32.0(14.0, 96.3) h vs.39.0 (24.0, 83.2) h, Z=0.094, P=0.925], the recovery rate from clinical symptoms during treatment [(105/106, 99.1%) vs.(96/101, 95.0%)], and recurrence rate [(0/106, 0) vs.(2/101, 2.0%)] between the 2 groups (all P>0.05).However, the above-mentioned four indicators in the experimental group showed a trend of clinical benefits.The quantitative virus detection results showed that the RSV viral load in both groups decreased after treatment compared to before treatment.After 2 days of treatment, the decline rate of RSV viral load from the baseline was 0.90 lg copies/(mL·d) in the experimental group and 0.25 lg copies/(mL·d)in the control group, with a statistically significant difference ( P<0.05).Furthermore, there was no statistically significant difference in the incidence of adverse reactions between the 2 groups ( P>0.05).Importantly, no drug-related serious adverse reactions occurred in both groups. Conclusions:The nebulized inhalation therapy of IFN α1b demonstrates efficacy and safety in treating pediatric RSV associated lower respiratory tract infections.It particularly offers outstanding clinical therapeutic value for severe children.

Objectives:To evaluate the hemodynamic impact of different bypass grafting methods on the left anterior descending(LAD)artery using computational fluid dynamics,providing a theoretical basis for optimizing coronary artery bypass grafting.Methods:A patient-specific 3D coronary model was constructed using SimVascular software,including an in-situ internal mammary artery graft(model 1)and three free grafts of varying diameters(model 2:2 mm internal mammary artery free graft;model 3 and model 4:3 mm and 4 mm great saphenous vein free grafts).The hemodynamic parameters of the native artery and grafts were compared among the four bypass grafting models.Results:All four bypass grafting models supply sufficient blood flow for the severely stenosed LAD.LAD flow was slightly lower in the model 1.Free internal mammary artery grafts showed higher flow and wall shear stress.4 mm great saphenous vein free grafts presented with maximum flow but lowest shear stress,3 mm great saphenous vein free grafts offered better hemodynamic stability.Conclusions:Computational fluid dynamics analysis indicates that free internal mammary grafts could provide superior hemodynamics,while larger grafts result in lower shear stress,which might affect long-term graft patency.These findings thus provide experimental evidences useful for optimizing LAD bypass strategies.

Objective To investigate the clinical efficacy of national famous traditional Chinese medicine doctor prof.Wang Tan's application of Yang-assisting Lung Repairing and Paralysis Removing Soup combined with pulmonary rehabilitation on patients with idiopathic pulmonary fibrosis.Method A total of 79 patients with pulmonary arthralgia who met the inclusion criteria and visited the inpatient Department of Pulmonary Disease in the Affiliated Hospital of Changchun University of Traditional Chinese Medicine and Professor Wang Tan's Changjiang Scholar Studio from January 2024 to November 2024 were retrospectively analyzed.There were 30 cases in control group and 49 cases in treatment group.Among them,the control group received routine treatment and was given Zhuyang Bufei Chubi decoction and the observation group was added lung rehabilitation treatment on this basis(walking,dumbbell exercises,climbing stairs,resistance bands,breathing trainers,sandbags,abdominal breathing exercises),the course of treatment was 1 month.Compare the recovery of lung function,six-minute walking test(6MWT),C-reactive protein(CRP),quality of life assessment,and overall therapeutic efficacy of the two groups of patients before and after treatment.Result After treatment,the pulmonary function index,exercise endurance,total therapeutic effect,inflammatory response and quality of life of the two groups were analyzed,and the curative effect of the treatment group was better than that of the control group(P<0.05).Conclusion The treatment of idiopathic pulmonary fibrosis patients with Zhuyang Bufei Chubi decoction combined with pulmonary rehabilitation helps patients with various indexes to improve their lung function,exercise endurance,and quality of life.

Objective:To evaluate the efficacy and safety of nebulized inhalation of recombinant human interferon (IFN) α1b injection in the treatment of respiratory syncytial virus (RSV) associated lower respiratory tract infections (pneumonia and bronchiolitis) in children.Methods:A randomized, double-blind, parallel, placebo-controlled add-on design was used.Children with pneumonia or bronchiolitis aged 2 months to 5 years who tested positive for RSV antigen within 72 hours of onset from 30 clinical trial sites including Beijing Children′s Hospital, Capital Medical University between February 2021 and December 2022 were included in this study and randomly divided into 2 groups at a ratio of 1∶1 based on a stratified-block method.Both groups received basic treatments such as cough control, asthma relieving, expectorant treatment, fever reduction, oxygen therapy, etc.The experimental group received additional nebulized inhalation of IFN α1b injection at a dose of 2.0 μg/(kg·time), twice a day.The control group received nebulized inhalation of placebo twice a day.Clinical efficacy was evaluated based on indicators such as the duration of clinical symptoms and signs, and the Kaplan-Meier method was used to calculate the median and 95% CI of the duration of clinical symptoms and signs.The Log-rank test was used to compared data between groups.Safety was assessed through the incidence of adverse reactions and laboratory tests, and the Chi-square test was used to analyze the difference between groups. Results:There were 123 children in the experimental group and 122 children in the control group.The median durations of all the 5 clinical symptoms and signs [including shortness of breath, wheezing, dyspnea (visible retractions), decreased transcutaneous oxygen saturation, and abnormal mental state] in the experimental group after treatment were slightly shortened than those in the control group [2.7 d(95% CI: 1.9-3.0 d)] vs.[2.9 d(95% CI: 2.6-3.6 d), P=0.027].The improvement in dyspnea (retractions) was especially pronounced in the experimental group, with a relief rate of 50.0% (0, 100%) on the first day of administration[compared with 0 (0, 50.0%) in the control group ( Z=2.002, P=0.025)].The median duration of dyspnea in the experimental group was nearly 1 day shorter than that in the control group [1.0 d(95% CI: 0.7-1.7 d) vs.1.8 d(95% CI: 1.0-2.5 d), P=0.046].There were no significant difference in hospital stay [6.0(5.0, 8.0) d vs.6.5(5.0, 8.0) d, Z=0.675, P=0.500], oxygen therapy duration [32.0(14.0, 96.3) h vs.39.0 (24.0, 83.2) h, Z=0.094, P=0.925], the recovery rate from clinical symptoms during treatment [(105/106, 99.1%) vs.(96/101, 95.0%)], and recurrence rate [(0/106, 0) vs.(2/101, 2.0%)] between the 2 groups (all P>0.05).However, the above-mentioned four indicators in the experimental group showed a trend of clinical benefits.The quantitative virus detection results showed that the RSV viral load in both groups decreased after treatment compared to before treatment.After 2 days of treatment, the decline rate of RSV viral load from the baseline was 0.90 lg copies/(mL·d) in the experimental group and 0.25 lg copies/(mL·d)in the control group, with a statistically significant difference ( P<0.05).Furthermore, there was no statistically significant difference in the incidence of adverse reactions between the 2 groups ( P>0.05).Importantly, no drug-related serious adverse reactions occurred in both groups. Conclusions:The nebulized inhalation therapy of IFN α1b demonstrates efficacy and safety in treating pediatric RSV associated lower respiratory tract infections.It particularly offers outstanding clinical therapeutic value for severe children.

Objective To construct and validate a risk prediction model for enteral nutrition feeding intolerance (FI) in patients with severe cerebral hemorrhage based on machine learning algorithms. Methods The clinical data of 485 patients with cerebral hemorrhage admitted to the neurological intensive care unit of Northern Jiangsu People's Hospital Affiliated to Yangzhou University from January 2020 to December 2022 were retrospectively analyzed. The patients were randomly divided into training set (n=339) and validation set (n=146) in a 7 to 3 ratio. Five machine learning algorithms were used to construct FI risk prediction models. The receiver operating characteristic (ROC) curve was plotted, and the model with the best predictive performance was selected based on the area under the curve (AUC). A nomogram model was constructed based on the optimal model. The calibration curve and decision curve analysis (DCA) were used to evaluate the calibration and clinical net benefit of the nomogram model. Results The incidence of enteral nutrition FI in patients with severe cerebral hemorrhage was 38.4%(186/485). Among the five machine learning algorithm models, the Logistic regression model had the best predictive performance(AUC=0.88). The analysis results of the Logistic regression model showed that the use of diuretics, mechanical ventilation, Glasgow Coma Scale score ≤5, vasoactive drugs, and albumin level<35 g/L were risk factors for enteral nutrition FI in patients with severe cerebral hemorrhage. A nomogram model was further constructed based on these five risk factors. The calibration curve analysis showed that the calibration curve fitted well with the ideal curve, indicating a high calibration degree of the nomogram model. The DCA results showed that when the threshold probability was 5% to 73%, the application of the nomogram model for screening could clinically benefit patients. Conclusion The construction of a nomogram model for predicting the risk of enteral nutrition FI in patients with severe cerebral hemorrhage based on machine learning methods can help to early screen high-risk patients for enteral nutrition FI and timely formulate preventive measures, thereby reducing the incidence of enteral nutrition FI in patients with severe cerebral hemorrhage.

Objective To retrieve relevant literature on risk prediction model for methicillin-resistant Staphylococcus aureus (MRSA) infection among hospitalized patients from databases and evaluate the predictive model. Methods The literature on risk prediction models for MRSA infection among hospitalized patients was retrieved from PubMed, Embase, Scopus, Cochrane library, China National Knowledge Infrastructure (CNKI), WanFang data, and VIP database, with a time range from the inception of the database to January 1, 2024. Two researchers independently screened the literature, extracted data. The Prediction Model Risk of Bias Assessment Tool (PROBAST) was applied to evaluate the risk of bias and applicability of the prediction model in the literature, and descriptive analysis was conducted. Results A total of 12 articles (15 prediction models) were included in this study, with significant differences in the total sample size, the number of MRSA infection events, sample size of modeling, and sample size of validation among the studies. Common predictors in the prediction models were admission to the intensive care unit, antibiotic use, history of residence in nursing facilities, age, chronic kidney disease, and previous hospitalization history. Nine articles conducted internal validation, and three articles conducted both internal and external validation. Nine articles reported the area under the receiver operating characteristic curve, and only three articles reported the calibration of the model based on the Hosmer-Lemeshow test. PROBAST analysis showed that 10 articles were assessed as high risk bias, mainly stemming from statistical analysis. Conclusion Most of the MRSA infection risk prediction models in the current literature have good predictive efficacy for MRSA infection, but they all have higher overall risk of bias, and only a few models have undergone external validation. Researchers should follow PROBAST standards to construct and externally validate models in the future so as to develop models suitable for clinical practice.

Objective To explore the effect of attachment wear on tooth movement in clear Aligner treatment, and to provide references for improving the efficiency of orthodontic treatment. Methods The tooth cone bean computed tomography (CBCT) scanning data were obtained, and the tooth model was established and assembled with the worn and complete attachment, respectively. When the appliance applied 2° distal torsion, 0.25 mm distal displacement, 0.1 mm depression displacement and 0.1 mm elongation displacement to the teeth, the changes of tooth displacement, periodontal ligament stress and root equivalent stress in the worn and complete attachment groups were compared. Results When the clear Aligner was used to apply distal torsion and elongation displacement to the teeth, the maximum tooth displacement decreased significantly, and the worn attachment caused the teeth to move obliquely when the distal translation and elongation displacement occurred. When the tooth was subjected to distal torsion, distal translation, depression and elongation, the maximum principal stress of periodontal ligament and the equivalent stress of tooth root decreased when the worn attachment caused the tooth to be subjected to distal torsion, distal translation, depression and elongation. Conclusions Attachment wear will affect the efficiency of tooth rotation and elongation.When the attachments are obviously worn, they should be replaced in time to ensure normal function of the attachments.