Objective To predict the risk of in-hospital death in patients with chronic heart failure(CHF)complicated by lung infections using interpretable machine learning.Methods The clinical data of 1415 patients diagnosed with CHF complicated by lung infections were obtained from the MIMIC-IV database.According to the pathogen type,the patients were categorized into bacterial pneumonia and non-bacterial pneumonia groups,and their risks of in-hospital death were compared using Kaplan-Meier survival curves.Univariate analysis and LASSO regression were used to select the features for constructing LR,AdaBoost,XGBoost,and LightGBM models,and their performance was compared in terms of accuracy,precision,F1 value,and AUC.External validation of the models was performed using the data from eICU-CRD database.SHAP algorithm was applied for interpretive analysis of XGBoost model.Results Among the 4 constructed models,the XGBoost model showed the highest accuracy and F1 value for predicting the risk of in-hospital death in CHF patients with lung infections in the training set.In the external test set,the XGBoost model had an AUC of 0.691(95%CI:0.654-0.720)in bacterial pneumonia group and an AUC of 0.725(95%CI:0.577-0.782)in non-bacterial pneumonia group,and showed better predictive ability and stability than the other models.Conclusion The overall performance of the XGBoost model is superior to the other 3 models for predicting the risk of in-hospital death in CHF patients with lung infections.The SHAP algorithm provides a clear interpretation of the model to facilitate decision-making in clinical settings.

Objective To predict the risk of in-hospital death in patients with chronic heart failure(CHF)complicated by lung infections using interpretable machine learning.Methods The clinical data of 1415 patients diagnosed with CHF complicated by lung infections were obtained from the MIMIC-IV database.According to the pathogen type,the patients were categorized into bacterial pneumonia and non-bacterial pneumonia groups,and their risks of in-hospital death were compared using Kaplan-Meier survival curves.Univariate analysis and LASSO regression were used to select the features for constructing LR,AdaBoost,XGBoost,and LightGBM models,and their performance was compared in terms of accuracy,precision,F1 value,and AUC.External validation of the models was performed using the data from eICU-CRD database.SHAP algorithm was applied for interpretive analysis of XGBoost model.Results Among the 4 constructed models,the XGBoost model showed the highest accuracy and F1 value for predicting the risk of in-hospital death in CHF patients with lung infections in the training set.In the external test set,the XGBoost model had an AUC of 0.691(95%CI:0.654-0.720)in bacterial pneumonia group and an AUC of 0.725(95%CI:0.577-0.782)in non-bacterial pneumonia group,and showed better predictive ability and stability than the other models.Conclusion The overall performance of the XGBoost model is superior to the other 3 models for predicting the risk of in-hospital death in CHF patients with lung infections.The SHAP algorithm provides a clear interpretation of the model to facilitate decision-making in clinical settings.

Active herbal ingredients are gaining recognition for their potent anti-tumor efficacy, attributable to various mechanisms including tumor cell inhibition, immune system activation, and tumor angiogenesis inhibition. Recent studies have revealed that numerous anti-tumor herbal ingredients, such as ginsenosides, ursolic acid, oleanolic acid, and Angelica sinensis polysaccharides, can be utilized to develop smart drug carriers like liposomes, micelles, and nanoparticles. These carriers can deliver active herbal ingredients and co-deliver anti-tumor drugs to enhance drug accumulation at tumor sites, thereby improving anti-tumor efficacy. This study provides a comprehensive analysis of the mechanisms by which these active herbal ingredients-derived carriers enhance therapeutic outcomes. Additionally, it highlights the structural properties of these active herbal ingredients, demonstrating how their unique features can be strategically employed to design smart drug carriers with improved anti-tumor efficacy. The insights presented aim to serve as a reference and guide future innovations in the design and application of smart drug carriers for cancer therapy that leverage active herbal ingredients.
Humans ; Neoplasms/drug therapy* ; Drug Delivery Systems ; Drug Carriers/chemistry* ; Animals ; Drugs, Chinese Herbal/therapeutic use* ; Antineoplastic Agents, Phytogenic/administration & dosage* ; Nanoparticles/chemistry* ; Antineoplastic Agents/administration & dosage*

Systemic lupus erythematosus (SLE) complicated with acquired hemophilia A (AHA) is a rare condition with frequently delayed diagnosis and a high mortality rate, so it is necessary to strengthen the understanding of this disease. In this study, the characteristics and treatment in 1 case of SLE complicated by AHA is reported and analyzed, and a literature review is conducted. The patient was a 29-year-old young female with a 10-year history of SLE, the main clinical manifestation was severe abdominal bleeding. Laboratory tests revealed that the activated partial thromboplastin time (APTT) was notably prolonged (118.20 s), and the coagulation factor VIII activity (FVIII꞉C) was extremely decreased (0.20%) with high-titer of factor VIII (FVIII) inhibitor (31.2 BU/mL). After treating with high-dose glucocorticoid, immunoglobulin, cyclophosphamide, rituximab, blood transfusion, and intravenous infusion of human coagulation FVIII, the coagulation function and coagulation FVIII꞉C were improved, and FVIII inhibitor was negative without serious adverse reactions. During the next 5-year follow-up, the patient's condition was stable and no bleeding occurred. In the case of coagulation dysfunction in SLE, especially with isolated APTT prolongation, AHA should be screened. When the therapeutic effects of glucocorticoid combined with immunosuppressants are not desirable, rituximab could be introduced.
Female ; Humans ; Adult ; Hemophilia A/therapy* ; Rituximab ; Glucocorticoids ; Factor VIII ; Lupus Erythematosus, Systemic/complications* ; Hemorrhage/complications*

Objective:To explore the clinical characteristics of adult-onset non-radiographic axial spondyloarthritis (nr-axSpA) in different genders.Methods:A total of 662 patients with adult-onset nr-axSpA (age at disease onset ≥16 years) who visited the Rheumatology Department of the First Affiliated Hospital of Shantou University Medical College from 1999 to 2020 were included in the study. Comparisons of baseline demographic and clinical characteristics between different genders were performed.Results:Overall, the male-to-female ratio was 1.17∶1, and the prevalence of human leukocyte antigen-B27 (HLA-B27) positivity was 71.8%(475/662). The median baseline disease duration and age at diagnosis was 1.6 (0.5, 4.0) years and 25.0 (21.0, 33.0) years respectively. The males had a significantly earlier age at disease onset and diagnosis [21.0 (18.0, 28.0) vs 25.0 (21.0, 30.0), Z=5.63, P<0.001; 24.0 (19.0, 32.0) vs 27.0 (23.0, 34.5), Z=4.90, P<0.001, respectively] than females. HLA-B27 positivity was more frequent in males than in females [78.4% (280/357) vs 63.9%(195/305), χ2=17.06, P<0.001]. The prevalence of inflammatory back pain (IBP), morning stiffness, nocturnal pain, enthesitis, hip and groin pain were higher in males, whereas females showed a higher prevalence of small joint involvement of the hands. At baseline, males had higher median ankylosing spondylitis disease activity score (ASDAS)-C-reaction protein (CRP) [3.0(2.3, 3.8) vs 2.4(2.0, 3.0), Z=5.59, P<0.001] and a greater prevalence of high disease activity ASDAS-CRP>2.1 [81.9%(185/227) vs 67.9%(133/195), χ2=11.08, P=0.001] than females. The proportions of male patients with elevated CRP levels and erythrocyte sedimentation rate (ESR) were also higher than those of female patients [49.0%(175/357) vs 27.9%(85/305), χ2=30.85, P<0.001; 49.3%(176/357) vs 33.4%(102/305), χ2=16.98, P<0.001, respectively]. Conclusion:The adult-onset nr-axSpA in China is characterized by a comparable sex ratio. Males have an earlier age at disease onset and are higher HLA-B27 positivity with higher prevalence of IBP, enthesitis, hip and groin pain, as well as high disease activity.

Objective To observe the effect of Xuebijing on coagulation function in patients with sepsis. Methods Sixty-two patients with severe sepsis were admitted to Department of Emergency and Intensive Care Unit (ICU) of Kunming Municipal Hospital of Traditional Chinese Medicine from February 2015 to June 2017, and they were divided into Xuebijing group and routine treatment control group according to the random number table method, 31 cases in each group. Both groups were treated with symptomatic supportive therapy, and the Xuebijing group was treated with Xuebijing injection 50 mL intravenous drip on the basis of routine treatment, twice a day for consecutive 7 days. The differences in platelet count (PLT), 5 items of coagulation: D-dimer, fibrinogen (Fib), activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT) and acute physiology and chronic health evaluationⅡ (APACHE Ⅱ) score were compared between the two groups before and after treatment. Results After treatment, in both groups, the levels of PLT and Fib were significantly higher than those before treatment, the level of D-dimer, APACHE Ⅱ were obviously lower than those before treatment, APTT, PT and TT were significantly shorter than those before treatment, and the changes in Xuebijing group were more marked than those in the routine treatment control group [PLT (×109/L):186.63±45.29 vs. 119.96±59.76, Fib (g/L): 3.88±1.82 vs. 2.33±1.33, D-dimer (mg/L): 0.40±0.11 vs. 0.65±0.14, APTT (s): 30.95±8.48 vs. 42.25±7.73, PT (s): 10.97±1.51 vs. 13.16±2.22, TT (s): 16.17±1.28 vs. 18.98±1.12, APACHE Ⅱ score: 6.62±2.91 vs. 12.87±4.54, all P ＜ 0.05]. Conclusion Xuebijing can regulate coagulation disorder in patients with severe sepsis, ameliorate the disease condition of patients, block the deterioration of disease development, and improve the prognosis of patients.

Objective To investigate ventricular remodeling and glucose transporter 4(GLUT4) expression in rat with type 2 diabetes mellitus(DM) complicated with myocardial infarction (MI), as well as the effects of ramipril on ventricular remodeling and CLUT4 expression. Method Diabetic animal model (DM) was produced by cholesterol-diet and intraperitoneal injedtion of streptozotocin (STZ,30 mg/kg). The successful model was identified based on the blood gulcose value > 6.7 mmol/L. Left anterior descending coronary artery was ligated to produce the model of MI. 46 wistar rats were randomly(random number) divided into 5 groups: DM + MI + placebo group(placebo group, n = 9), DM + MI + ramipril group(ramipril group, n = 10), DM + sham-operation group (DM group, n = 10),non-DM group + MI (MI group, n = 9), and non-DM + sham-operation group (n = 8). After six weeks, echocardiographic studies was performed ; Left ventricular mass index (LVMI), myocardial infarct size and myocardial collagen volume fraction(CVF) of non-infarction area were also detected. GLUT4 mRNA in the myocardium away from infarction region was measured with real-time fluorescent quantitative RT-PCR and the expression of GLUT4 protein was measured with western blot. Analysis of variance was used to compare the groups. P -values< 0.05 were considered to indicate statistically significant differences. Results Compared with Ml group and DM group,EF[(32 ±3)% vs. (65 ±4)%, P <0.01 and (32 ±3)% vs. (38 ±4)%, P <0.05 respectively] significantly decreased,while E/A ratio (P < 0.01), LVMI (P < 0.05) and CVF (P < 0.05) obviously increased in placebo group. The expression of GLUT4 mRNA and protein were similar between placebo group and DM group, however, much lower than those in MI group(P<0.01).In rampiril group, E/A ratio (P < 0.01), LVMI(3.1±0.2 vs.4.2±0.4, P <0.01) and CVF(P < 0.05) significantly decreased compared with placebo group, while EF[(45±3)% vs.(32±3)%, P <0.01] and the expression of GLUT4 mRNA and protein (P < 0.05) increased. Conclusions Rampiril could improve left ventricular hypertrophy and systolic/di-astolic dysfunction, increase the expression of GLUT4 mRNA and protein in diabetic rats complicated with MI.

The informed consent right of people who are investigated should be respected during the epidemiology survey,and there're many ethical problems about the way of inquiry,the fund of investigation,the protection of personal secrets and the compensation to people who are investigated.We should strengthen the training of investigators in order to promote the development of epidemiblogy survey.

Anordrin, which has been widely used as an oral contraceptive tablet in China, administered intra-vaginally at different levels of dose possessed marked antifertiiity effects in Sprague Dawley rats. The anti-implantation efficiency of the compound given intra-vaginally was superior to that of oral dosing in some respects. This kind of medication was feasible, convenient to use and with no serious side effects. Our investigation provides the experimental date for clinical study of using this drug vaginally.