Objective:To construct a nomogram model for predicting the first pass effect (FPE) in mechanical thrombectomy for acute ischemic stroke with anterior circulation large vessel occlusion(AIS-LVO).Methods:Retrospectively controlled analyzed the clinical data of 146 patients with acute ischemic stroke due to anterior circulation large vessel occlusion who underwent mechanical thrombectomy in the Affiliated Suzhou Hospital of Nanjing Medical University (Suzhou Municipal Hospital) from January 2020 to January 2025. Among the 146 patients, there were 76 males and 70 females, with an age ranged from 39 to 88 years old and a median age of 75 years. According to whether FPE was obtained during the operation, the patients were divided into the FPE group ( n=47)and the non-FPE group ( n=99). The clinical data between the two groups were compared, and those with statistically significant differences ( P<0.05) throngh univariate analysis were included in the multivariate Logistic regression analysis to screen the independent risk factors affecting FPE and establish a nomogram model. The efficiency, goodness of fit and benefit of the established model were tested through internal validation. Results:The results of univariate analysis showed that there were statistically significant differences in the history of essential hypertension, clot burden score (CBS), internal carotid artery tortuosity, hyperdense vessel sign, serum D-dimer value, serum lymphocyte count, platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and systemic immune-inflammation index (SII) between the two groups ( P<0.05). Multivariate Logistic regression analysis showed that the history of essential hypertension ( OR=0.25, 95% CI: 0.09-0.67, P=0.006), high clot burden with CBS ≤ 6 points ( OR=0.25, 95% CI: 0.10-0.66, P=0.005), internal carotid artery tortuosity ( OR=0.38, 95% CI: 0.15-0.98, P=0.044), high PLR ( OR=0.98, 95% CI: 0.97-0.99, P=0.005), and high D-dimer ( OR=0.35, 95% CI: 0.15-0.81, P=0.015) were all independent risk factors affecting FPE in mechanical thrombectomy for acute ischemic stroke with anterior circulation large vessel occlusion ( P<0.05). A nomogram prediction model was established based on the above risk factors. The verification results showed that the area under the curve was 0.836, the Hosmer-Lemeshow test showed that χ2=5.105, P=0.746, and the decision curve showed that when the threshold probability was in the range of 0.01 to 0.87, there was a higher net benefit value. Conclusion:The nomogram model established according to the patient′s history of essential hypertension, clot burden score, whether there is internal carotid artery tortuosity, PLR, and D-dimer can predict the probability of obtaining FPE in mechanical thrombectomy for acute ischemic stroke with anterior circulation large vessel occlusion.

Objective:To discusse the influencing factors of lung metastasis in elderly patients (≥60 years old) with clear cell renal cell carcinoma (ccRCC) based on Surveillance, Epidemiology, and End Results (SEER) database, and to construct and evaluate the nomogram prediction model.Methods:The SEER database was used to retrieve the data of elderly ccRCC patients from 2017 to 2021. The screened 8 183 ccRCC patients were randomly assigned to the training set ( n=5 728) and the validation set ( n=2 455) at a ratio of 7∶3 by using the software R4.4.1. The incidence of lung metastasis in elderly patients with ccRCC was calculated, and the influencing factors of lung metastasis in elderly patients with ccRCC were analyzed by univariate and multivariate logistic regression. According to the results of multivariate analysis, the nomogram prediction model was constructed, and the prediction efficiency of the model was evaluated by using the receiver operator characteristic (ROC) curve, the clinical application value of the prediction model was evaluated by calibration curve and decision curve analysis (DCA) . Results:A total of 8 183 elderly ccRCC patients were retrieved, including 620 patients with lung metastasis, and the incidence of lung metastasis was 7.58%. Univariate analysis showed that, race (white race: OR=1.58, 95% CI: 1.01-2.49, P=0.046; others: OR=1.85, 95% CI: 1.10-3.10, P=0.020), sex ( OR=1.32, 95% CI: 1.07-1.64, P=0.009), maximum tumor diameter (55-95 mm: OR=8.22, 95% CI: 6.11-11.07, P<0.001; >95 mm: OR=28.12, 95% CI: 20.81-37.99, P<0.001), T stage (T 2 stage: OR=15.62, 95% CI: 11.51-21.19, P<0.001; T 3 stage: OR=7.93, 95% CI: 6.06-10.36, P<0.001; T 4 stage: OR=28.65, 95% CI: 18.71-43.86, P<0.001), N stage ( OR=17.18, 95% CI: 13.36-22.10, P<0.001) and surgery situation ( OR=0.12, 95% CI: 0.09-0.14, P<0.001) were all influencing factors for lung metastasis in elderly patients with ccRCC. Multivariate analysis showed that, race (white race: OR=1.82, 95% CI: 1.07-3.09, P=0.027; others: OR=2.18, 95% CI: 1.17-4.05, P=0.014), maximum tumor diameter (55-95 mm, OR=4.63, 95% CI: 3.13-6.86, P<0.001; >95 mm, OR=8.29, 95% CI: 5.28-13.02, P<0.001), T stage (T 2 stage: OR=2.26, 95% CI: 1.45-3.51, P<0.001; T 3 stage: OR=3.38, 95% CI: 2.28-5.01, P<0.001; T 4 stage: OR=2.45, 95% CI: 1.39-4.31, P=0.002), N stage ( OR=3.81, 95% CI: 2.81-5.17, P<0.001) and surgery situation ( OR=0.10, 95% CI: 0.08-0.14, P<0.001) were independent influencing factors of lung metastasis in elderly patients with ccRCC. According to the results of multivariate analysis, a nomogram prediction model was constructed based on race, maximum tumor diameter, T stage, N stage and surgery situation. ROC curve analysis showed that the area under the curve (AUC) of the prediction model in the training set and the validation set for predicting lung metastasis in ccRCC patients was 0.91 (95% CI: 0.90-0.92) and 0.91 (95% CI: 0.89-0.93), respectively, which indicated that the prediction model had excellent distinguishing ability. Calibration curve showed that the actual occurrence probability of the training set and the validation set was consistent with the predicted probability, which showed that the calibration degree of the prediction model was good. DCA curve showed that the predictive model had good discrimination ability in both training set and validation set, which indicated that the predictive model had potential clinical application value. Conclusion:The incidence of lung metastasis in elderly patients with ccRCC is high. Race, maximum tumor diameter, T stage, N stage and surgery situation are all independent influencing factors of lung metastasis in elderly patients with ccRCC. The prediction model based on the above indexes has excellent prediction efficiency and clinical application value, and can be used to predict the risk of lung metastasis in elderly patients with ccRCC.

The minimally invasive cardiovascular surgery developed rapidly in last decades. In order to promote the development of minimally invasive cardiovascular surgery in China, the Chinese Minimally Invasive Cardiovascular Surgery Committee (CMICS) has gradually standardized the collection and report of the data of Chinese minimally invasive cardiovascular surgery since its establishment. The total operation volume of minimally invasive cardiovascular surgery in China has achieved substantial growth with a remarkable popularization of concepts of minimally invasive medicine in 2019. The data of Chinese minimally invasive cardiovascular surgery in 2019 was reported as a paper for the first time, which may provide reference to cardiovascular surgeons and related professionals.

Objective: To evaluate the progress and influence factors of asymptomatic osteonecrosis of the femoral head(ONFH). Methods: MRI was performed on the contralateral hips of 174 patients with unilateral symptomatic ONFH who admitted at Department of Orthopaedics, the Second Affiliated Hospital of Xi′an Jiaotong University from January 2012 to December 2018. Eighty-three of 174 patients with unilateral ONFH were found suffering from contralateral ONFH(47.7%), of which 77 patients were followed up.There were 28 males and 49 females with age of 48.6 years (range: 21-73 years). The pathogenesis, ARCO classfication, areas and position of osteonecrosis were collected.Independent sample t test, χ² test, Fisher exact test, multivariate Logistic regression were used to analyze the potential influence factors. Results: Patients were followed up for 36.7 months. During the following up period, ARCO classification of 28 patients (36.4%) progressed.The progress of asymptomatic ONFH was not related to the gender, age and original ARCO classification, but related to the pathogenesis, position and area of osteonecrosis (all P<0.05). Conclusion The progress of asymptomatic osteonecrosis is related to the pathogenesis, position and area of osteonecrosis,but most of asymptomatic ONFH will not progress.

Objective To summarize and analyze the clinical effect of allogeneic hematopoietic stem cell transplantation(alloHSCT) for treating acute myeloid leukemia(AML) in this center.Methods The clinical data of 87 patients with AML receiving allo-HSCT in this hospital from January 2008 to June 2015 were retrospectively analyzed on the overall survival rate(OS) after transplantation,leukemia-free survival rate (LFS) and relapse rate (RR),transplant-related mortality (TRM),moreover the efficacies of HLA-matched (kinship and unrelated) and haploidentical transplantation were compared.Meanwhile the influence of different transplantation of pre-leukemia remission status on transplantation curative effect was analyzed.Results Among 87 cases,OS after 2 years was (73.6±4.7)％ and 2-year LFS was (62.1±5.8)％.During the follow-up period,27 cases (31.3％) relapsed and 23 cases (26.4％) died.The 2-year OS in HLA-matched (kinship and unrelated) and haploidentical transplantation were (76.3± 5.3)％ and (68.5±7.2)％ respectively(P＜0.05) and the 2-year LFS were (60.2±4.8)％ and (56.3±5.7)％ respectively (P＜ 0.05).The incidence rate of aGVHD and infection in haploidentical transplantation group was significantly higher than that in the HLA matched group (kinship and unrelated),but their RR were 26.9 ％ and 29.2 ％ respectively (P＞0.05).The transplantation effect analysis in different leukemia remission state showed that RR in the unreaching CR before transplantation group,reaching CR but minimal residual(MRD) positive group and negative group were 68.7 ％,34.7 ％ and 16.6 ％ respectively.The 2-year LFS were (18.7±5.2)％,(56.5± 6.3)％ and (79.2％ ±5.7)％ respectively (P＜0.05).The 2-year OS were (31.2± 5.3)％,(69.6± 7.2) ％ and (89.6±5.3)％ respectively (P＜0.05).Conclusion allo-HSCT is an effective method for treating AML.Recurrence is the main cause of failure after transplantation therapy.

The roots of Glycyrrhiza uralensis are widely used in Chinese medicine for their action of clearing heat, detoxicating, relieving cough, dispelling sputum and tonifying spleen and stomach. The reason why Glycyrrhiza uralensis has potent and significant actions is that it contains various active secondary metabolites, especially glycyrrhizic acid. In the present study, we cloned the cDNA coding 3-hydroxy-3-methylglutary CoA reductase (HMGR) involved in glycyrrhizic acid biosynthesis in Glycyrrhiza uralensis. The corresponding cDNA was expressed in Escherichia coli as fusion proteins. Recombinant HMGR exhibited catalysis activity in reduction of HMG-CoA to mevalonic acid (MVA) just as HMGR isolated from other species. Because HMGR gene is very important in the biosynthesis of glycyrrhizic acid in Glycyrrhiza uralensis, this work is significant for further studies concerned with strengthening the efficacy of Glycyrrhiza uralensis by means of increasing glycyrrhizic acid content and exploring the biosynthesis of glycyrrhizic acid in vitro.

OBJECTIVETo distinguish the ginseng and American ginseng pieces accurately and rapidly by electronic nose technology and principal component analysis (PCA) method.

METHODThe optimum conditions of electronic nose for ginseng and American ginseng pieces, such as sample size and volume, headspace volume, incubation time and temperature were determined by the orthogonal test, the data were processed by the normalization method and the preprocessed data were analyzed PCA.

RESULTThe detection methods of ginseng and American ginseng pieces was established by electronic nose, and the odor fingerprint figures of ginseng and American ginseng pieces were obtained, and ginseng and American ginseng pieces were distinguished by PCA recognition pattern.

CONCLUSIONA new accurate and rapid method to distinguish ginseng and American ginseng pieces was established by electronic nose detection.

Artificial Organs ; Electronics ; methods ; Nose ; Panax ; classification ; Principal Component Analysis ; methods

Objective To assess the risk factors of the in-hospital mortality of acute type A aortic dissection after operation. Method From January 2003 to June 2008,185 patients, 144 males and 41 females, with acute type A aortic dissection operated on were enrolled. The average age of patients was (49.46 ± 11.04 ) years old.The patients' demographics, history, clinical features, and some laboratory examinations were reviewed. Univariate and multivariate analysis followed by logistic regression analysis were carried out to identify the predictors of inhospital mortality. Results The in-hospital mortality rate was 9.1%. The results of univariate and multivariate analyses as follows: pre-operation positive neurological symptom (Univariate OR = 5.084,95%CI:1.792 -14.426, P = 0.002; Multivariate OR = 5.538,95%CI: 1.834 - 16.721, P = 0.002, respectively), hypotension (Univariate OR = 6.986,95%CI:1.510- 32.323,P =0.013; multivariate OR = 1.998,95%CI:0.315-12.679,P = 0.463, respectively) and renal failure (Univariate OR = 3.594,95%CI:1.237 - 10.438,P =0.019; Multivariate OR = 3.254,95%CI:1.034- 10.242, P= 0.044, respectively). Conclusions There are two predictors, pre-operation positive neurological symptom and renal failure, of pre-hospital mortality found in current analyses. Our results may improve the regimen made by cardiac surgeons and emergency doctors so as to help patients and their relatives to make correct decision.

OBJECTIVETo estimate the level of blood lead and some haematological parameters in the workers occupationally exposed to lead so as to know the effect of lead exposure on hematopoietic system in exposed workers.

METHODSThe graphite furnace atomic absorption spectrocopy was used to determine blood lead (BPb). The haematological parameters were determined by Sysmex KX-21 automated haematology analyzer.

RESULTSHemoglobin (Hb) in the lead-absorption group[male: (129.3 +/- 12.3) g/L, female: (112.2 +/- 9.4) g/L], and hematocrit (HCT) in the lead-absorption group[male: (0.338 +/- 0.030) L/L, female: (0.302 +/- 0.028) L/L] were significantly lower than those in normal people group and lead-exposed group (P < 0.05, P < 0.01). The relationships between BPb and Hb, HCT were weakly negative correlation. Red cell distribution width (RDW) in the lead-absorption group(male: 16.68% +/- 0.80%, female: 16.98% +/- 0.98%) were significantly higher than those in normal people group and lead exposed group, and RDW in lead exposed group (male: 14.77% +/- 0.83%, female: 14.92% +/- 1.13%) were higher than that in normal people group. BPb was weakly positively correlated with RDW.

CONCLUSIONHb, HCT and RDW were three indices which may reflect the occurrences and degrees of anaemia in lead exposed workers.

Anemia ; chemically induced ; Erythrocytes ; drug effects ; Female ; Hematocrit ; Hemoglobins ; analysis ; Humans ; Lead ; blood ; toxicity ; Male ; Occupational Exposure ; adverse effects

Objective To evaluate the therapeutic effect of low-dose herringtonine in lupus nephritis.Methods Harringtonine1mg,which was dissolved in500ml normal saline,was infused intravenously everyday for5to7days as a single course.The total therapeutic period was consisted of3to6courses.Each course was given every2to3weeks.12patients with lupus nephritis were treated in this study.Results Seven patients(58%)achieved complete clinical remission while5(42%)had partial clinical remission.The overall response rate was100%.Conclusion This study suggests that low-dose harringtonine is an effective therapeutic regimen for lupus nephritis with relatively low toxicity and low price.It has the potential to be used widely in treating lupus nephri-tis.