ObjectiveTo investigate the independent risk factors for decompensation in patients with liver cirrhosis， to construct a nomogram-based risk assessment model， and to assess its risk assessment performance and clinical value by comparing it with Model for End-Stage Liver Disease （MELD）， MELD combined with serum sodium concentration （MELD-Na）， and MELD 3.0 scoring system. MethodsA retrospective analysis was performed for 514 patients with liver cirrhosis who attended The First Hospital of Shanxi Medical University from January 2020 to May 2025， and related data were collected， including demographic data and laboratory markers. According to the presence or absence of decompensation， the patients were divided into compensation group with 275 patients and decompensation group with 239 patients. The Mann-Whitney U test was used for comparison of continuous data between two groups， and the chi-square test was used for comparison of categorical data between two groups. The least absolute shrinkage and selection operator regression analysis was used for screening of variables， and the multivariate logistic regression analysis was used to identify independent risk factors for decompensated liver cirrhosis and construct a nomogram model. The receiver operating characteristic （ROC） curve， calibration curve， and decision curve analysis were used to assess the discriminatory ability， calibration， and net clinical benefit of the model. ResultsThe multivariate logistic regression analysis showed that low hemoglobin （odds ratio ［OR］=0.984， 95% confidence interval ［CI］： 0.969　—　0.999， P<0.05）， low lymphocytes （OR=0.564， 95%CI： 0.383　—　0.830， P<0.05）， high international normalized ratio （OR=3.131， 95%CI： 1.242　—　7.891， P<0.05）， and low serum sodium （OR=0.922， 95%CI： 0.872　—　0.975， P<0.05） were independent risk factors for decompensation events in patients with liver cirrhosis. Construct the prediction model equation： Logit（P）=intercept value－0.016×hemoglobin－0.573×lymphocytes+1.141×INR－0.081×serum sodium. The nomogram constructed based on these factors had a good discriminatory ability， with an area under the ROC curve （AUC） of 0.787， a specificity of 77.8%， and a sensitivity of 67.4%， and it had significantly better predictive performance than MELD score （AUC=0.718）， MELD-Na score （AUC=0.719）， and MELD 3.0 score （AUC=0.725）. The calibration curve showed good consistency between the probability of risk assessed by the model and the observed probability. The decision curve analysis showed that compared with the MELD-based scores， this model provided higher net clinical benefit across a wide range of risk thresholds. ConclusionThis study successfully constructed and validated a nomogram risk assessment model incorporating hemoglobin， international normalized ratio， lymphocytes， and serum sodium. This model has good clinical practicability and can help to achieve early identification of high-risk patients with decompensated liver cirrhosis and optimize intervention strategies in clinical practice.

Objective:To explore an effective measurement method for the output power of high-frequency electrosurgical equipment,so as to provide a basis for improving the accuracy of measurement results of output power of this kind of equipment.Methods:Adopt a combined measurement method of voltage method and current method to verify the impedance characteristics of high-frequency resistors of the AJ-60 high-frequency surgical system at 4.2 MHz and 13.56 MHz.Through resistor modification,explore the measurement methods of output power under the two working modes of the system:monopolar pencil vaporization cutting(PV)and bipolar cutting(BC).Measure the power of the two working modes using both voltage method and current method,and analyze the influencing factors of their measurement accuracy.Results:The results of relative deviation between voltage method and current method for the measured power were significantly reduced through refit and comparison experiments.PV mode reduced from 40.58%to 1.11%,and BC mode reduced from 29.48%to 5.37%.In practical operation,the factors included limitation of prober's bandwidth,and mismatch of inputted impedance were important factors that affected the accuracy of measurement.Conclusions:In order to ensure accurate measurement for equipment's output power when operating frequencies exceed 4 MHz,it is essential to use non-inductive load resistance that is accurately calibrated at the specific operating frequency.It has great significance for enhancing the measured accuracy and reliability of output power of electrosurgical equipment with high-frequency.

Objective To analyze the situation of blood lipid and blood routine parameters in patients with pneumoconiosis,and construct a column chart diagnostic model to explore their diagnostic value for pneumo-coniosis.Methods A total of 456 patients with pneumoconiosis admitted to the First Affiliated Hospital of Chongqing Medical and Pharmaceutical College from January 2022 to January 2024 were selected as the pneu-moconiosis group,while 462 healthy subjects exposed to dust during the same period were chosen as the con-trol group.Serum lipids and blood routine parameters related to pneumoconiosis were measured and compared between two groups.Univariate and multivariate Logistic regression analyzes were conducted to examine ser-um lipids and blood routine parameters associated with pneumoconiosis.A risk prediction model was construc-ted using logistic regression in machine learning,and the diagnostic efficacy of the column chart diagnostic model was evaluated by calculating the C-index through receiver operating characteristic(ROC)curve and plotting the model calibration curve based on Hosmer Lemeshow goodness of fit.Decision curve analysis(DCA)was used to assess the clinical practicality of the column chart diagnostic model.Results The levels of serum high-density ester protein cholesterol(HDL-C),cholesterol(TC),red blood cell(RBC),hematocrit(HCT),hemoglobin concentration(HGB),lymphocyte number(LYM),and lymphocyte percentage(LYM％)in the pneumoconiosis group were lower than those in the control group(P＜0.05).The levels of neutrophil-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),and systemic immune inflammation index(SII)were higher than those in the control group(P＜0.05).Multivariate Logistic regression analysis showed that HDL-C,LYM％,PLR,and SII were independent influencing factors for pneumoconiosis(P＜0.05).A column chart diagnostic model for the occurrence of pneumoconiosis was constructed using HDL-C,TC,LYM％,PLR,and SII as diagnostic factors.The ROC curve C-index of the diagnostic model was 0.84(95％CI:0.81-0.86),with sensitivity for diagnosing pneumoconiosis of 75.29％,specificity of 77.51％,posi-tive predictive value of 83.25％,and negative predictive value of 67.88％.Internal validation was conducted on the constructed column chart diagnostic model,with a validation set ROC curve C-index of 0.84(95％CI:0.80-0.87),sensitivity of 80.91％,specificity of 72.62％,positive diagnostic value of 79.46％,and negative diagnostic value of 74.39％.The calibration positive curve slope of the diagnostic model was close to 1,and in the fit test P＞0.05.DCA analysis showed that the diagnostic model had clinical practical value for risk diag-nosis of pneumoconiosis.Conclusion HDL-C,TC,LYM％,PLR and SII are independent influencing factors for pneumoconiosis.A column chart diagnostic model for the occurrence of pneumoconiosis is successfully constructed based on machine learning principles,and it has been verified to have high diagnostic efficiency.

BACKGROUND:Stem cells from human exfoliated deciduous teeth are widely used in the field of tissue repair and regeneration,but the tissue regeneration effect has limitations in practical applications.Using miRNA to intervene in the directional differentiation of stem cells from human exfoliated deciduous teeth is an important development direction fortissue repair and regeneration in the future.OBJECTIVE:To investigate the effect of miR-26b on the neurogenic and angiogenic differentiation of stem cells from human exfoliated deciduous teeth.METHODS:Dental pulp stem cells were isolated and extracted from human exfoliated deciduous teeth,and induced to differentiate into nerves and blood vessels.The expressions of neurogenic markers Nestin,NSE,βⅢ-Tubu lin,and angiogenic markers CD31,VEGFR2,ANG-1 and miR-26b were detected.Dental pulp stem cells were divided into blank control group,miR-26 overexpression group,and negative control group.RT-qPCR,cell immunofluorescence staining,and western blot assay were used to detect the expression changes of related markers of neurogenic and angiogenic induction of stem cells from human exfoliated deciduous teeth in each group.RESULTS AND CONCLUSION:(1)Stem cells from human exfoliated deciduous teeth had multi-directional differentiation potential and could differentiate into osteogenesis,adipogenesis,neurogenesis,and vasculogenesis.(2)The expression level of miR-26b increased during the neurogenic and angiogenic differentiation of stem cells from human exfoliated deciduous teeth.(3)Compared with the blank control group and negative control group,the mRNA expression of neuroblast-related genes βⅢ-Tubulin,Nestin,NSE and angiogenesis-related genes CD31,VEGFR2,and ANG-1 in stem cells from human exfoliated deciduous teeth in the miR-26b overexpression group was significantly increased(P＜0.01),βⅢ-Tubulin,Nestin,CD31,and VEGFR2 protein expression was significantly increased(P＜0.01).The above results show that overexpression of miR-26b can promote the neurogenic and angiogenic differentiation of stem cells from human exfoliated deciduous teeth.

BACKGROUND:Stem cells from human exfoliated deciduous teeth are widely used in the field of tissue repair and regeneration,but the tissue regeneration effect has limitations in practical applications.Using miRNA to intervene in the directional differentiation of stem cells from human exfoliated deciduous teeth is an important development direction fortissue repair and regeneration in the future.OBJECTIVE:To investigate the effect of miR-26b on the neurogenic and angiogenic differentiation of stem cells from human exfoliated deciduous teeth.METHODS:Dental pulp stem cells were isolated and extracted from human exfoliated deciduous teeth,and induced to differentiate into nerves and blood vessels.The expressions of neurogenic markers Nestin,NSE,βⅢ-Tubu lin,and angiogenic markers CD31,VEGFR2,ANG-1 and miR-26b were detected.Dental pulp stem cells were divided into blank control group,miR-26 overexpression group,and negative control group.RT-qPCR,cell immunofluorescence staining,and western blot assay were used to detect the expression changes of related markers of neurogenic and angiogenic induction of stem cells from human exfoliated deciduous teeth in each group.RESULTS AND CONCLUSION:(1)Stem cells from human exfoliated deciduous teeth had multi-directional differentiation potential and could differentiate into osteogenesis,adipogenesis,neurogenesis,and vasculogenesis.(2)The expression level of miR-26b increased during the neurogenic and angiogenic differentiation of stem cells from human exfoliated deciduous teeth.(3)Compared with the blank control group and negative control group,the mRNA expression of neuroblast-related genes βⅢ-Tubulin,Nestin,NSE and angiogenesis-related genes CD31,VEGFR2,and ANG-1 in stem cells from human exfoliated deciduous teeth in the miR-26b overexpression group was significantly increased(P＜0.01),βⅢ-Tubulin,Nestin,CD31,and VEGFR2 protein expression was significantly increased(P＜0.01).The above results show that overexpression of miR-26b can promote the neurogenic and angiogenic differentiation of stem cells from human exfoliated deciduous teeth.

Objective:To analyze the clinical characteristics of patients with adverse reactions to facial skin-lightening cosmetics.Methods:A retrospective analysis was conducted on the adverse reaction reports caused by facial skin-lightening cosmetics in the cosmetic adverse reaction reporting system of Yantai city of Shandong province from July 2020 to December 2023. The general information of the patients (such as age, gender), reporting sources, clinical characteristics (types of adverse reactions, skin lesion morphology and subjective symptoms), and channels for purchasing cosmetics were summarized and analyzed.Results:A total of 450 cases of adverse reactions caused by facial skin-lightening cosmetics were identified, predominantly involving females (429 cases, 95.33%). Age distribution was most commonly found from 31 to 40 years (174 cases, 38.67%), followed by 21 to 30 years (130 cases, 28.89%), 41 to 50 years (71 cases. 15.78%), ≥51 years (46 cases, 10.22%), and ≤20 years (29 cases, 6.44%). The main sources of reporting were medical and health institutions (401 cases, 89.11%), followed by cosmetics operators (22 cases, 4.89%), patients (20 cases, 4.44%), business enterprises (3 cases, 0.67%), market supervision and administration bureaus (3 cases, 0.67%), and medical cosmetology hospital (1 case, 0.22%). Cosmetic contact dermatitis was the most common type of cosmetic adverse reaction (416 cases,91.43%), and the common skin lesions included erythema (342 cases,45.00%), papula (166 cases,21.84%), edema and so on. The common symptoms were pruritus (369 cases,49.20% ), burning sensation (158 cases,21.07%) and so on. Online sales was the main purchasing channel (333 cases, 74.01%).Conclusions:The adverse reactions caused by facial skin-lightening cosmetics are mainly found in women, and contact dermatitis is the most common type of cosmetic adverse reaction, predominantly presenting with erythema and manifesting as pruritus.

Objective:To explore an effective measurement method for the output power of high-frequency electrosurgical equipment,so as to provide a basis for improving the accuracy of measurement results of output power of this kind of equipment.Methods:Adopt a combined measurement method of voltage method and current method to verify the impedance characteristics of high-frequency resistors of the AJ-60 high-frequency surgical system at 4.2 MHz and 13.56 MHz.Through resistor modification,explore the measurement methods of output power under the two working modes of the system:monopolar pencil vaporization cutting(PV)and bipolar cutting(BC).Measure the power of the two working modes using both voltage method and current method,and analyze the influencing factors of their measurement accuracy.Results:The results of relative deviation between voltage method and current method for the measured power were significantly reduced through refit and comparison experiments.PV mode reduced from 40.58%to 1.11%,and BC mode reduced from 29.48%to 5.37%.In practical operation,the factors included limitation of prober's bandwidth,and mismatch of inputted impedance were important factors that affected the accuracy of measurement.Conclusions:In order to ensure accurate measurement for equipment's output power when operating frequencies exceed 4 MHz,it is essential to use non-inductive load resistance that is accurately calibrated at the specific operating frequency.It has great significance for enhancing the measured accuracy and reliability of output power of electrosurgical equipment with high-frequency.

Objective:To investigate the predictive value of refeeding syndrome (RFS) and its influencing factors for 30-day intensive care unit (ICU) readmission in critically ill patients.Methods:A prospective cohort study was conducted. Critically ill patients admitted to the department of critical care medicine, department of respiratory and critical care medicine, and department of neurology at Tianjin Medical University General Hospital from January to April in 2025 were enrolled. Patients were assessed for RFS according to the American Society for Parenteral and Enteral Nutrition (ASPEN) criteria. General information within 24 hours of ICU admission was collected via the electronic medical record system. Treatment details and 30-day ICU readmission status were dynamically recorded. Participants were divided into readmission and non-readmission groups based on whether ICU readmission occurred within 30 days. Intergroup comparisons were performed to identify differences. Multivariate Logistic regression was used to analyze the relationship between RFS and its influencing factors with 30-day ICU readmission. Receiver operator characteristic curve (ROC curve) was plotted to evaluate the predictive performance of risk factors.Results:A total of 196 critically ill patients were enrolled, among whom 25 (12.76%) were readmitted to ICU within 30 days and 171 (87.24%) were not. Significant differences were observed in the readmission group compared with the non-readmission group, including significantly higher rates of nasogastric decompression, higher acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score, a higher incidence of RFS, and a longer duration of nasogastric decompression. Multivariate Logistic regression analysis showed that RFS was an independent risk factor for 30-day ICU readmission [odds ratio ( OR) = 5.756, 95% confidence interval (95% CI) was 1.603-20.670, P = 0.007]. APACHEⅡ score showed a positive correlation trend with 30-day ICU readmission ( OR = 1.057, 95% CI was 0.991-1.127, P = 0.092). ROC curve analysis showed that the combined prediction model incorporating RFS and APACHEⅡ score had an area under the ROC curve (AUC) of 0.766 (95% CI was 0.668-0.864), with a sensitivity of 88.0% and a specificity of 62.0%, which was significantly superior to a single indicator (the AUC of RFS and APACHEⅡ score was 0.639 and 0.624, respectively). Conclusions:RFS significantly increases the risk of 30-day ICU readmission in critically ill patients. A combined model incorporating RFS and APACHEⅡ score demonstrates good predictive efficacy for 30-day ICU readmission in critically ill patients.

Tumor-related insomnia is one of the common complications of tumor patients,which is secondary to tumor disease and related to tumor disease itself or tumor treatment.Combined with the unique pathogenesis of"heat-toxicity internal stagnation"of tumor-related insomnia,the important treatment methods are to clear away heat,attack toxicity,regulate qi and supplement healthy qi.This article explained the research status,etiology and pathogenesis,treatment principles of the disease,in order to provide new ideas and methods for the differentiation and treatment of tumor-related insomnia in TCM.

Objective:To summarize and analyze the clinical characteristics of pediatric pulmonary hypertension (PH) and the related factors affecting the prognosis，to provide a basis for the early diagnosis and treatment of the disease.Methods:The clinical data of 80 PH children hospitalized in the intensive care department of Children's Hospital of Capital Pediatric Research Institute from January 1,2019 to December 31,2022 were retrospectively analyzed,and general data,clinical symptoms, echocardiography, laboratory examination and treatment indicators were collected. According to survival death groups, multivariate Logistic regression was applied to analyze independent associated risk factors for PH death.Results:（1）Clinical characteristics of childhood PH: more common in infants, the average age of treatment was 0.9(0.3-5.3)years, the male to female ratio was 1.3∶1, and the average time from first symptoms to first diagnosis was 6.5 (2,14) days. The etiology of PH in children was complex, with arterial PH (PAH) (40%), pulmonary disease and(or) hypoxia (33.8%) being the most common. The main clinical manifestations were dyspnea, decreased activity endurance, poor appetite, and positive heart examination. Severe PH accounted for 53.8%, 30% of pulmonary hypertensive crisis.（2）Factors affecting the prognosis of childhood PH: childhood PH mortality was 20.8%, compared with the survival group, ICU length of stay, loss of appetite, decreased urine volume, cardiac function classification, right heart size, main pulmonary artery diameter/ascending aorta diameter ratio(MPAD/MAD), vasoactive inotropic score(VIS), use of invasive ventilator treatment had statistical significance (all P<0.05). A Logistic regression analysis of death-related factors showed that right heart enlargement ( OR=0.193,95% CI 0.040-0.919, P=0.039), higher MPAD/MAD value ( OR =11.883,95% CI 1.347-104.869, P=0.026), and higher VIS score ( OR= 1.029,95% CI 1.003-1.056, P=0.028) were independent risk factors for poor prognosis. Conclusion:（1）Children PH is mainly infants, the causes of PAH and pulmonary diseases, severe PH accounted for 53.8%, 30% of which have pulmonary hypertensive crisis.（2）An enlarged right heart, higher MPAD/MAD values, and higher VIS score are independent risk factors for death in children with PH.