1.Establishment of a predictive model for the risk of hypoalbuminemia after partial hepatectomy based on machine learning methods
Dongqing CAI ; Shanhua TANG ; Yuancan XIAO ; Xiru LEI ; Suicheng LI ; Jie ZHOU
Journal of Clinical Hepatology 2026;42(5):1109-1118
ObjectiveTo investigate the application value of a machine learning model based on preoperative clinical indicators in predicting the risk of hypoalbuminemia after partial hepatectomy. MethodsA retrospective analysis was performed for the clinical data of 700 patients who underwent partial hepatectomy in Nanfang Hospital, Southern Medical University, from January 2018 to January 2023, including demographic data, history of underlying diseases, tumor characteristics, preoperative laboratory markers, and perioperative indicators. The research data were divided into a training set and a test set at a ratio of 7∶3. The two-independent-samples t test was used for comparison of normally distributed continuous data between two groups; the two-independent-samples Wilcoxon rank-sum test was used for comparison of continuous data with skewed distribution between two groups; the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. The least absolute shrinkage and selection operator (LASSO) regression analysis was used to identify characteristic variables, and 7 machine learning algorithms were used to construct predictive models, i.e., logistic regression, decision tree, artificial neural network, K-nearest neighbors (KNN), support vector machine, eXtreme gradient boosting, and light gradient boosting machine. The receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC) were used to assess the discriminatory ability of models, and the DeLong test was used for comparison of AUC. The calibration curve and decision curve analysis were used to assess the calibration and clinical practicability of models, and the models were compared with albumin-bilirubin (ALBI) score and Model for End-Stage Liver Disease (MELD) score. SHapley Additive exPlanations (SHAP) were used to interpret the key influencing factors for the optimal model. ResultsA total of 700 patients were finally enrolled, 283 (40.42%) developed hypoalbuminemia after surgery. The LASSO regression analysis identified 8 predictive factors of age, hepatitis B, fatty liver, blockade time, preoperative albumin (Alb), time of operation, intraoperative blood loss, and preoperative aspartate aminotransferase (AST). Among the 7 machine learning models, the KNN model showed the best overall predictive performance, with an AUC of 0.835 (95% confidence interval: 0.781 — 0.889), a sensitivity of 84.0%, and a specificity of 65.5% in the test set. ALBI and MELD scores had an AUC of 0.652 and 0.524, respectively, and the KNN model had a better predictive performance than these two scores (Z=5.309 and 8.945, both P <0.001). The calibration curve showed good consistency between predicted probabilities and actual incidence rates, and the decision curve analysis showed that the KNN model had net clinical benefit across a wide threshold range. The SHAP analysis showed that preoperative Alb, hepatitis B, time of operation, and age were the most significant influencing factors, and a synergistic effect was observed between hepatitis B and age/time of operation. ConclusionThe KNN machine learning model constructed based on preoperative clinical indicators can effectively predict the risk of hypoalbuminemia after partial hepatectomy and has a better performance than traditional scoring models, which provides a reference for the early identification of high-risk patients in clinical practice.
2.Correlation between environmental factors and pediatric respiratory disease visits in a central hospital of Shanghai
ZHOU Shuangshuang, CAI Yizhou, MIAO Xueqin, ZHANG Lili, ZHOU Yibin, HE Dandan, LIU Jie, HU Yanqi
Chinese Journal of School Health 2025;46(5):708-711
Objective:
To explore the correlation and lag effects of environmental factors on pediatric respiratory disease visits at hospital, so as to provide scientific basis for disease prediction and optimizing clinical diagnosis and treatment.
Methods:
Data from 503 889 pediatric respiratory disease outpatient and emergency visits a central hospital in Minhang District of Shanghai between 2017 and 2019, along with concurrent meteorological data were collected. A distributed lag non-linear models (DLNM) was constructed to explore the specific relationship between pediatric respiratory disease consultations and various environmental factors and to quantify the cumulative lag effects of environmental factors on respiratory disease consultations.
Results:
Among the environmental factors, temperature, fine particulate matter (PM 2.5 ), inhalable particulate matter (PM 10 ), nitrogen dioxide (NO 2), and sulfur dioxide (SO 2) were associated with pediatric respiratory disease visits. After adjusting for temperature, PM 2.5 and PM 10 concentrations did not show significant immediate or lag effects. The relative risk (RR) of pediatric respiratory disease visits increased with rising NO 2 concentrations. When NO 2 concentration ≥55 μg/m 3, significant immediate and lagged effects (lag 3, 5, and 7 days) were observed. The RR values were 1.05, 1.13, 1.17, and 1.21( P <0.05). The RR values showed an inverted “U” shaped relationship with SO 2 concentrations. When SO 2 concentration ≥5 μg/m 3, significant lagged effects (lag 3, 5, and 7 days) were observed. The RR values were 1.03 , 1.03, and 1.04 ( P <0.05).
Conclusion
High concentrations of NO 2 and SO 2 increase the risk of pediatric respiratory disease visits, with observable lag effects.
3.Effect of Xianglian Huazhuo Prescription on Hedgehog Signaling Pathway in Rats with Chronic Atrophic Gastritis
Jinye ZHOU ; Haofeng ZHANG ; Ziwei LIU ; Yican WANG ; Yanru CAI ; Yuxi GUO ; Jie WANG ; Zheng ZHI ; Qian YANG ; Bolin LI
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(18):41-47
ObjectiveTo explore the therapeutic effect and mechanism of Xianglian Huazhuo prescription on chronic atrophic gastritis (CAG) in rats based on the Hedgehog signaling pathway. MethodsThe CAG rat model was established by sodium salicylate, N-methyl-N′-nitro-N-nitroguanidine (MNNG), and irregular feeding. The successfully modeled rats were randomly divided into a model group (180 mg·L-1), a moradan group (1.4 g·kg-1), and Xianglian Huazhuo Prescription groups with high, medium, and low doses (36, 9, 18 g·kg-1), followed by drug intervention. Hematoxylin-eosin (HE) staining was used to observe morphological changes in the gastric mucosa. Transmission electron microscopy was used to observe the ultrastructure of gastric mucosa cells. Real-time quantitative polymerase chain reaction (Real-time PCR) was used to detect the mRNA expression of Sonic Hedgehog (Shh), Patched 1 (Ptch1), and Glioma-associated oncogene homolog 1 (Gli1). Western blot was used to detect the protein expression levels of Shh, Ptch1, and Gli1 in the gastric mucosa. Immunohistochemistry was used to observe the protein expression of the epithelial marker E-cadherin. ResultsCompared with the normal group, the CAG model group showed a reduction in gastric mucosal intrinsic glands and infiltration of inflammatory cells. The ultrastructure of gastric mucosal cells showed nuclear pyknosis, fewer mitochondria, and abnormal mitochondrial structure. The mRNA and protein expression of Shh, Ptch1, and Gli1 in the gastric mucosa were significantly decreased (P<0.05), and E-cadherin protein expression was decreased. Compared with the model group, the intervention groups showed varying degrees of improvement in histopathological morphology and cellular ultrastructure. The mRNA and protein expression of Shh, Ptch1, Gli1, and E-cadherin increased to varying degrees. Xianglian Huazhuo Prescription upregulated the expression of key Hedgehog pathway factors and E-cadherin at both the mRNA and protein levels (P<0.05). ConclusionXianglian Huazhuo prescription has a therapeutic effect on CAG in rats, and its mechanism may be related to activation of the Hedgehog signaling pathway and inhibition of epithelial-mesenchymal transition (EMT).
4.Current situation of medicinal animal breeding and research progress in sustainable utilization of resources.
Cheng-Cai ZHANG ; Jia WANG ; Yu-Jie ZHOU ; Xiao-Yu DAI ; Xiu-Fu WAN ; Chuan-Zhi KANG ; De-Hua WU ; Jia-Hui SUN ; Sheng WANG ; Lan-Ping GUO
China Journal of Chinese Materia Medica 2025;50(16):4397-4406
Traditional Chinese medicine(TCM) is the pillar for the development of motherland medicine, and animal medicine has a long history of application in China, characterized by wide resources, strong activity, definite efficacy, and great benefits. It has significant potential and important status in the consumption market of raw materials of TCM. In the context of global climate change, farming system alterations, and low renewability, the depletion of wild medicinal animal resources has accelerated. Accordingly, the conservation and sustainable utilization of wild resources of animal medicinal materials has become a problem that garners increasing attention and urgently needs to be solved. This paper summarizes the current situation of domestic and foreign medicinal animal breeding and research progress in industrial application in recent years and points out the issues related to standardized breeding, germplasm selection and breeding, and quality evaluation standards for medicinal animals. Furthermore, this paper discusses standardized breeding, quality standards, resource protection and utilization, and the search for alternative resources for rare and endangered medicinal animals. It proposes that researchers should systematically carry out in-depth basic research on animal medicine, improve the breeding scale and level of medicinal animals, employ modern technology to enhance the quality standards of medicinal materials, and strengthen the research and development of alternative resources. This approach aims to effectively address the relationship between protection and utilization and make a significant contribution to the sustainable development of medicinal animal resources and the animal-based Chinese medicinal material industry.
Animals
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Breeding
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China
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Medicine, Chinese Traditional
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Conservation of Natural Resources
5.The role of polyunsaturated fatty acid lipid peroxidation in ferroptosis after intracerebral hemorrhage: a review of mecha-nisms and therapeutic implications.
Man GUO ; Guohui ZHAO ; Zhibiao CAI ; Zhenyu ZHANG ; Jie ZHOU
Journal of Zhejiang University. Medical sciences 2025;54(5):694-704
Ferroptosis, a regulated cell death process distinct from apoptosis, is characterized by iron dysregulation and reactive oxygen species (ROS) accumulation. After intracerebral hemorrhage (ICH), decreased cerebral blood flow and iron released from erythrocytes trigger lipid peroxidation-particularly of polyunsaturated fatty acids (PUFAs)-through a cascade of reactions in local brain tissues, promoting ferroptosis. Mitochondrial dysfunction and neuroinflammation further elevate ROS, exacerbating lipid peroxidation and accelerating neuronal ferroptosis. Thus, PUFA peroxidation and associated metabolic pathways play a critical role in ICH-related neuronal damage. This review summarizes current understanding of how PUFA peroxidation contributes to ferro-ptosis after ICH, discusses key regulatory mechanisms involving lipid and iron metabolism, and highlights potential therapeutic strategies targeting ferroptosis to improve neurological outcomes.
Ferroptosis/physiology*
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Humans
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Cerebral Hemorrhage/pathology*
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Lipid Peroxidation
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Fatty Acids, Unsaturated/metabolism*
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Reactive Oxygen Species/metabolism*
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Iron/metabolism*
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Animals
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Mitochondria/metabolism*
6.Dimeric natural product panepocyclinol A inhibits STAT3 via di-covalent modification.
Li LI ; Yuezhou WANG ; Yiqiu WANG ; Xiaoyang LI ; Qihong DENG ; Fei GAO ; Wenhua LIAN ; Yunzhan LI ; Fu GUI ; Yanling WEI ; Su-Jie ZHU ; Cai-Hong YUN ; Lei ZHANG ; Zhiyu HU ; Qingyan XU ; Xiaobing WU ; Lanfen CHEN ; Dawang ZHOU ; Jianming ZHANG ; Fei XIA ; Xianming DENG
Acta Pharmaceutica Sinica B 2025;15(1):409-423
Homo- or heterodimeric compounds that affect dimeric protein function through interaction between monomeric moieties and protein subunits can serve as valuable sources of potent and selective drug candidates. Here, we screened an in-house dimeric natural product collection, and panepocyclinol A (PecA) emerged as a selective and potent STAT3 inhibitor with profound anti-tumor efficacy. Through cross-linking C712/C718 residues in separate STAT3 monomers with two distinct Michael receptors, PecA inhibits STAT3 DNA binding affinity and transcription activity. Molecular dynamics simulation reveals the key conformation changes of STAT3 dimers upon the di-covalent binding with PecA that abolishes its DNA interactions. Furthermore, PecA exhibits high efficacy against anaplastic large T cell lymphoma in vitro and in vivo, especially those with constitutively activated STAT3 or STAT3Y640F. In summary, our study describes a distinct and effective di-covalent modification for the dimeric compound PecA to disrupt STAT3 function.
7.The effectiveness and safety of a percutaneous controllable curved plasma radiofrequency ablation device of nucleus pulposus
Hao ZHOU ; Qianyi ZHANG ; Jiajie LU ; Tao WU ; Yituo CHEN ; Qichen ZHANG ; Xilei LI ; Haikang CAI ; Jie TANG
Chinese Journal of Clinical Medicine 2025;32(4):659-664
Objective To verify the safety and effectiveness of a new percutaneous controllable curved plasma radiofrequency instrument for nucleus pulposus ablation. Methods A new percutaneous controllable curved plasma radiofrequency instrument were designed (controllable curved group), and its ablation effect was compared with the currently used straight head non-bendable plasma ablation instrument (non-bendable group) on gross specimens. The ablation instrument was placed through the right intervertebral foramen, and continuous ablation on the same intervertebral disc was conducted for three times. The ablation range and trajectory were recorded, and the temperature changes in the front, back, left, and right of the ablation center during and 15 seconds after ablation were monitored by the inserted temperature probe. Results There were no difference in temperature changes in the front, back, right regions of the ablation center during and 15 seconds after ablation between the two groups. The temperature changes in the left region of the ablation center both during and 15 seconds after 3rd ablation were larger than those in the non-bendable group (P<0.01). Compared with the non-bendable group, the controllable curved group achieved angle control and larger single ablation area (2.282 5 mm² vs 1.135 8 mm², P<0.000 1). Conclusions This new percutaneous controllable curved plasma ablation instrument can achieve angle control and ablation on the side opposite to the puncture site, increase ablation volume, and is safe.
8.Network Pharmacology Study of Tongguanteng Injection Inhibits the Proliferation and Migration in Cervical Cancer Cells via Targeting FGF2/MAPK
Dongxu ZHU ; Zhaoying CAI ; Jie XIANG ; Ruoyu ZHOU ; Qiong XU ; Yayun QIAN ; Hongmei LU
World Science and Technology-Modernization of Traditional Chinese Medicine 2025;27(4):1179-1187
Objective To explore the targets and mechanisms of Tongguanteng Injection in inhibiting the proliferation and migration of cervical cancer.Methods The biological activity of Tongguanteng Injection in inhibiting human cervical cancer SiHa cells was determined by MTT method.Detecting the effect of Tongguanteng Injection on SiHa cell migration through wound healing assay.Using network pharmacology to collect the key targets for treating cervical cancer,and perform molecular docking and enrichment analysis on the targets.Immunohistochemistry and Western blot were used to detect the key proteins to validate the network pharmacology predictions.Result Tongguanteng Injection significantly inhibited the proliferation and migration in a dose-dependent manner in human cervical cancer SiHa cells.Based on the main active ingredients of Marsdenia tenacissima,81 therapeutic targets for cervical cancer were obtained,which may treat cervical cancer by affecting key proteins such as FGF2,MAPK1,and MAPK3.Immunohistochemical results indicated that FGF2,MAPK1 and MAPK3 were expressed in cervical cancer tissues.The western bolt assays showed that Tongguanteng Injection could significantly reduce the FGF2 protein expression.Meanwhile,the MAPK1 and MAPK3 protein expressions were significantly increased.Conclusion Tongguanteng Injection may regulate the FGF2,MAPK1 and MAPK3,effectively impede the proliferation and migration of cervical cancer.
9.Network Pharmacology Study of Tongguanteng Injection Inhibits the Proliferation and Migration in Cervical Cancer Cells via Targeting FGF2/MAPK
Dongxu ZHU ; Zhaoying CAI ; Jie XIANG ; Ruoyu ZHOU ; Qiong XU ; Yayun QIAN ; Hongmei LU
World Science and Technology-Modernization of Traditional Chinese Medicine 2025;27(4):1179-1187
Objective To explore the targets and mechanisms of Tongguanteng Injection in inhibiting the proliferation and migration of cervical cancer.Methods The biological activity of Tongguanteng Injection in inhibiting human cervical cancer SiHa cells was determined by MTT method.Detecting the effect of Tongguanteng Injection on SiHa cell migration through wound healing assay.Using network pharmacology to collect the key targets for treating cervical cancer,and perform molecular docking and enrichment analysis on the targets.Immunohistochemistry and Western blot were used to detect the key proteins to validate the network pharmacology predictions.Result Tongguanteng Injection significantly inhibited the proliferation and migration in a dose-dependent manner in human cervical cancer SiHa cells.Based on the main active ingredients of Marsdenia tenacissima,81 therapeutic targets for cervical cancer were obtained,which may treat cervical cancer by affecting key proteins such as FGF2,MAPK1,and MAPK3.Immunohistochemical results indicated that FGF2,MAPK1 and MAPK3 were expressed in cervical cancer tissues.The western bolt assays showed that Tongguanteng Injection could significantly reduce the FGF2 protein expression.Meanwhile,the MAPK1 and MAPK3 protein expressions were significantly increased.Conclusion Tongguanteng Injection may regulate the FGF2,MAPK1 and MAPK3,effectively impede the proliferation and migration of cervical cancer.
10.Chinese experts' consensus on principles of preoperative hair removal
Yiping MAO ; Jun ZHENG ; Lei LI ; Deyan YANG ; Bing ZHANG ; Lei YANG ; Wang JIA ; Peng KANG ; Hui JIAO ; Yun YANG ; Qi QI ; Shiqing FENG ; Xiao LONG ; Yuewei ZHANG ; Xiaohui WANG ; Lize WANG ; Yuan WEI ; Jichao ZHOU ; Minghui MAO ; Pengju XIN ; Hongyu TAN ; Dahong ZHANG ; Lianxin LIU ; Lei TAO ; Xietong WANG ; Xiaoning YUAN ; Mang CAI ; Li MU ; Fang DU ; Rongzhu CHEN ; Fengmao ZHAO ; Jiuzuo HUANG ; Mingzi ZHANG ; Jie ZHANG ; Baoguo WANG ; Kun WANG ; Fang LUO ; Jinhua ZHANG ; Nong HE ; Ling LYU ; Zhiyong ZONG
Chinese Journal of Nosocomiology 2025;35(10):1441-1449
To formulate an expert consensus on the principles of preoperative hair removal and provide scientific guidance for standardized removal of hair before surgical procedures so as to reduce the incidence of surgical site infections.METHODS Led by the Hospital Management Institute of National Health Commission of the People's Republic of China,this consensus was reached with the joint efforts from the expects of relevant fields such as surgeries,interventional therapies,nursing,and infection prevention and control.The consensus facilitates the classification and evaluation of literatures by following the evidence grade formulated by Oxford Evidence-based Medicine Center and focuses on the association of preoperative hair removal with surgical site infection,it reaches the evidence grade of expert consensus and recommendation intensity by integrating with discussions on meetings and clinical experience of the expects from relevant fields.RESULTS A total of 6 items of consensus were reached by summarizing the latest evidence on the aspects including the indications for preoperative hair removal,tools,range,timing and places.CONCLUSION The consensus,to some extent,make supplements to and complete the exiting regulations and standards.It provides guidance for the medical institutions to carry out the preoperative hair removal.


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