Objective:To construct prediction model based on particle swarm optimization long short-term memory(PSO-LSTM)algorithm for medical consumables,so as to predict the consumption of medical consumables and realize the fine management for medical consumables.Methods:The consumption of medical consumables was analyzed through constructed the PSO-LSTM prediction model,and then,the consumption of medical consumables was assessed.A total of 900 medical consumables which were clinically used in the Center of Endoscopy of Nanjing Tianyinshan Hospital Affiliated to China Pharmaceutical University from March to August 2024 were selected,and they were randomly divided into conventional management mode group(n=450 consumables)and PSO-LSTM management mode group(n=450 consumables)by random number table method,so as to conduct management for consumables.The management time,management timeliness,situation of monthly management of medical consumables,and predicted accuracy of consumption amount of medical consumables of two management mode in single diagnosis and treatment were compared.Results:The prepared time,delivered time,response time of temporary application,and the time of returning storehouse of medical consumables in PSO-LSTM model management mode were respectively(3.36±1.66),(9.54±2.69),(3.69±1.65)and(3.47±1.87)min,which were all less than those in conventional management mode,and the differences were statistically significant(t=7.76,13.811,28.147,39.105,P<0.05).The timeliness of supplementing medical consumables,shortage warning and proposing treatment methods of using PSO-LSTM model management mode were respectively(0.87±0.23),(3.26±0.87)and(14.98±2.65)min,which were all less than those of using conventional management mode,and the differences of them were statistically significant(t=4.228,15.482,13.420,P<0.05).In 450 medical consumables of the center of endoscopy,the amounts of the monthly average emergency purchasing and monthly average shortage were respectively 20 and 22 in using PSO-LSTM model management mode,accounting for 4.44%and 4.89%,all of which were lower than those of conventional management mode,and the differences of them were statistically significant(x2=10.364,11.835,P<0.05).The prediction results of using PSO-LSTM model management mode for disposable infusion device and disposable auxiliary kit of gastroscopy were closer to the actual consumption than the conventional management mode,while the differences of them were not significant(P>0.05).Conclusion:The application of the management mode of predictive model of medical consumables based on PSO-LSTM algorithm in the management of medical consumables of the center of endoscopy in hospital can accurately assess the consumption of medical consumables,and provide scientific basis for the procurement decision of medical consumables,and achieve fine management for various kinds of medical consumables,and reduce the cost of medical consumables in the center of endoscopy.

Objective:To construct prediction model based on particle swarm optimization long short-term memory(PSO-LSTM)algorithm for medical consumables,so as to predict the consumption of medical consumables and realize the fine management for medical consumables.Methods:The consumption of medical consumables was analyzed through constructed the PSO-LSTM prediction model,and then,the consumption of medical consumables was assessed.A total of 900 medical consumables which were clinically used in the Center of Endoscopy of Nanjing Tianyinshan Hospital Affiliated to China Pharmaceutical University from March to August 2024 were selected,and they were randomly divided into conventional management mode group(n=450 consumables)and PSO-LSTM management mode group(n=450 consumables)by random number table method,so as to conduct management for consumables.The management time,management timeliness,situation of monthly management of medical consumables,and predicted accuracy of consumption amount of medical consumables of two management mode in single diagnosis and treatment were compared.Results:The prepared time,delivered time,response time of temporary application,and the time of returning storehouse of medical consumables in PSO-LSTM model management mode were respectively(3.36±1.66),(9.54±2.69),(3.69±1.65)and(3.47±1.87)min,which were all less than those in conventional management mode,and the differences were statistically significant(t=7.76,13.811,28.147,39.105,P<0.05).The timeliness of supplementing medical consumables,shortage warning and proposing treatment methods of using PSO-LSTM model management mode were respectively(0.87±0.23),(3.26±0.87)and(14.98±2.65)min,which were all less than those of using conventional management mode,and the differences of them were statistically significant(t=4.228,15.482,13.420,P<0.05).In 450 medical consumables of the center of endoscopy,the amounts of the monthly average emergency purchasing and monthly average shortage were respectively 20 and 22 in using PSO-LSTM model management mode,accounting for 4.44%and 4.89%,all of which were lower than those of conventional management mode,and the differences of them were statistically significant(x2=10.364,11.835,P<0.05).The prediction results of using PSO-LSTM model management mode for disposable infusion device and disposable auxiliary kit of gastroscopy were closer to the actual consumption than the conventional management mode,while the differences of them were not significant(P>0.05).Conclusion:The application of the management mode of predictive model of medical consumables based on PSO-LSTM algorithm in the management of medical consumables of the center of endoscopy in hospital can accurately assess the consumption of medical consumables,and provide scientific basis for the procurement decision of medical consumables,and achieve fine management for various kinds of medical consumables,and reduce the cost of medical consumables in the center of endoscopy.

Objective To evaluate the performance of two immunochromatography kits (lateral flow immunoassay) in detecting carbapenemases in carbapenem-resistant Enterobacterales (CRE).Methods A total of 390 nonduplicate clinical isolates of Enterobacterales were collected and tested.The carbapenemase gene was identified by polymerase chain reaction (PCR).The five common carbapenemases were tested by two immunochromatography kits.Results Overall,213 of the 390 Enterobacterales isolates were CRE and 177 strains were carbapenem-susceptible based on antimicrobial susceptibility testing.PCR assay confirmed that 207 of the 213 CRE strains carried carbapenemase genes,including KPC genotype in 119 strains,NDM genotype in 71 strains,IMP genotype in 9 strains,OXA-48-like genotype in 7 strains,both KPC and NDM genes in 1 strain,while none of the five common carbapenemases in 6 CRE strains.Two immunochromatography kits were used simultaneously to test the production of carbapenemases.The results of the two commercial kits were 100％ consistent with PCR results.The sensitivity and specificity of the two kits were 100％ (95％ CI,97.7％-100％) and 100％ (95％ CI,97.4％-100％) in detection of the five carbapenemases.Conclusions The immunochromatography method is rapid and easy to operate,and can be used to detect the production of carbapenmases in clinical isolates.

Objective To evaluate the performance of two immunochromatography kits (lateral flow immunoassay) in detecting carbapenemases in carbapenem-resistant Enterobacterales (CRE).Methods A total of 390 nonduplicate clinical isolates of Enterobacterales were collected and tested.The carbapenemase gene was identified by polymerase chain reaction (PCR).The five common carbapenemases were tested by two immunochromatography kits.Results Overall,213 of the 390 Enterobacterales isolates were CRE and 177 strains were carbapenem-susceptible based on antimicrobial susceptibility testing.PCR assay confirmed that 207 of the 213 CRE strains carried carbapenemase genes,including KPC genotype in 119 strains,NDM genotype in 71 strains,IMP genotype in 9 strains,OXA-48-like genotype in 7 strains,both KPC and NDM genes in 1 strain,while none of the five common carbapenemases in 6 CRE strains.Two immunochromatography kits were used simultaneously to test the production of carbapenemases.The results of the two commercial kits were 100％ consistent with PCR results.The sensitivity and specificity of the two kits were 100％ (95％ CI,97.7％-100％) and 100％ (95％ CI,97.4％-100％) in detection of the five carbapenemases.Conclusions The immunochromatography method is rapid and easy to operate,and can be used to detect the production of carbapenmases in clinical isolates.

Early detection and treatment are essential to improve the prognosis of patients with psoriatic arthritis. Nail psoriasis is a known risk factor and a predictive symptom for psoriatic arthritis. Assessment of clinical manifestations of nail psoriasis together with evaluation using advanced technology has made it possible to achieve early diagnosis of psoriatic arthritis. This review summarizes diagnostic methods of psoriatic arthritis and nail psoriasis in recent years, and analyzes the latest studies on the correlation between psoriatic arthritis and nail psoriasis, in order to facilitate early diagnosis of psoriatic arthritis through clues of nail psoriasis.

Tumor-associated macrophages (TAMs), one of the dominating constituents of tumor microenvironment, are important contributors to cancer progression and treatment resistance. Therefore, regulation of TAMs polarization from M2 phenotype towards M1 phenotype has emerged as a new strategy for tumor immunotherapy. Herein, we successfully initiated antitumor immunotherapy by inhibiting TAMs M2 polarization via autophagy intervention with polyethylene glycol-conjugated gold nanoparticles (PEG-AuNPs). PEG-AuNPs suppressed TAMs M2 polarization in both in vitro and in vivo models, elicited antitumor immunotherapy and inhibited subcutaneous tumor growth in mice. As demonstrated by the mRFP-GFP-LC3 assay and analyzing the autophagy-related proteins (LC3, beclin1 and P62), PEG-AuNPs induced autophagic flux inhibition in TAMs, which is attributed to the PEG-AuNPs induced lysosome alkalization and membrane permeabilization. Besides, TAMs were prone to polarize towards M2 phenotype following autophagy activation, whereas inhibition of autophagic flux could reduce the M2 polarization of TAMs. Our results revealed a mechanism underlying PEG-AuNPs induced antitumor immunotherapy, where PEG-AuNPs reduce TAMs M2 polarization via induction of lysosome dysfunction and autophagic flux inhibition. This study elucidated the biological effects of nanomaterials on TAMs polarization and provided insight into harnessing the intrinsic immunomodulation capacity of nanomaterials for effective cancer treatment.

Objective To investigate the risk factors of anastomotic leakage after radical gastrectomy for gastric cancer and establish a risk prediction scoring model for postoperative anastomotic leakage.Methods The retrospective case-control study was conducted.The clinicopathological data of 1 757 patients who underwent radical gastrectomy for gastric cancer in the First People's Hospital of Yibin from February 2000 to December 2017 were collected.There were 1 207 males and 550 females,aged (59± 11) years,with a range from 48 to 70 years.Observation indicators:(1) follow-up situations;(2) risk factors analysis of anastomotic leakage after radical gastrectomy for gastric cancer;(3) establishment of risk prediction scoring model and verification;(4) risk prediction scores and probability of anastomotic leakage in patients with different scores.Follow-up using outpatient examination and telephone interview to detect anastomotic leakage after radical gastrectomy and reoperation or death caused by anastomotic leakage up to June 2018.Measurement data with normal distribution were represented as Mean±SD.Count data were described as absolute number.The univariate analysis and multivariate analysis were performed using the chi-square test and Logistic regression model respectively.The discrimination and fitting degree of the model were detected by the Hosmer-Lemeshow test and receiver operating characteristic (ROC) curve.Results (1) Follow-up situations:800 of 1 757 patients were followed up at 1 week,1 month,3 months and 6 months after discharge.During the follow-up,75 had anastomotic leakage,60 of which recovered after conservative treatment,9 recovered after reoperation,6 died of complications including septic shock and cardiac and respiratory failure.(2) Risk factors analysis of anastomotic leakage after radical gastrectomy for gastric cancer:results of univariate analysis showed that patients with diabetes,preoperative pulmonary insufficiency,preoperative level of albumin and volume of intraoperative blood loss were related factors affecting anastomotic leakage after radical gastrectomy for gastric cancer (x2=5.604,4.975,18.563,35.688,P＜0.05).Results of multivariate analysis showed that patients with diabetes,preoperative pulmonary insufficiency,preoperative level of albumin ＜ 30 g/L and volume of intraoperative blood loss ＞ 400 mL were independent risk factors affecting anastomotic leakage after radical gastrectomy for gastric cancer (odds ratio=2.337,1.946,3.478,4.357,95％ confidence interval:1.136-4.804,1.022-3.705,1.871-6.464,2.678-7.090,P＜0.05).(3) Establishment of risk prediction scoring model and verification.Risk prediction equation was established according to the multivariate Logistic regression results:P =1/1 +exp (4.092-0.666 * X1-0.849 * X2-1.246 * X3-1.472 * X4).The fitting degree of the model was detected by the Hosmer-Lemeshow test (P=0.287).The discrimination of the model was detected by the ROC curve,with the area under curve as 0.734 (95％ confidence interval:0.689-0.834,P=0.002).(4) Risk prediction scores and probability of anastomotic leakage in patients with different scores:the risk prediction scores of anastomotic leakage after radical gastrectomy for gastric cancer were 1,1,2,2 in patients with diabetes,preoperative pulmonary insufficiency,preoperative level of albumin ＜ 30 g/L and volume of intraoperative blood loss ＞400 mL,respectively.The incidence of anastomotic leakage of patients with risk prediction scores of 0,1,2,3,4,5,6 was 1.6％,3.2％,5.9％,10.1％,19.3％,31.8％ and 47.6％,respectively.The incidence of anastomotic leakage was 13.7％ of patients with score ≥3 and 3.5％ of patients with score ＜ 3.Conclusions Patients with diabetes,preoperative pulmonary insufficiency,preoperative level of albumin ＜ 30 g/L and volume of intraoperative blood loss ＞ 400 mL are independent risk factors affecting anastomotic leakage after radical gastrectomy for gastric cancer.Establishment of a risk prediction scoring model for anastomotic leakage after radical gastrectomy for gastric cancer can effectively identify high-risk patients with anastomotic leakage after radical gastrectomy.

OBJECTIVETo observe the effect of exosomes released by adenoid cystic carcinoma (ACC) cell line SACC-83 on the proliferation of ACC cells.

METHODSExosomes were isolated from SACC-83 cell culture supernatants using total exosome isolation reagents. The whole-mount exosomes were characterized using transmission electron microscope and Western blotting. The exosomes were labeled with green fluorescent dye PKH67 and co-cultured with SACC-83 cells for 48 h, followed by staining with Alexa Fluor 594 phalloidin and DAPI to observe exosome uptake by the cells using laser scanning confocal microscopy (LSCM). The cell proliferation was assessed using MTT assay and wound healing assay, and the expressions of ERK and P-ERK in the co-cultured SACC-83 cells were detected using Western blotting.

RESULTSThe exosomes isolated from SACC-83 cells showed a size range of 30-100 nm and expressed the exosomal markers CD9, CD63 and TSG101. LSCM showed exosome uptake by SACC-83 cells, which exhibited accelerated proliferation and significantly enhanced P-ERK expression ( < 0.05) without significant changes in ERK expression.

CONCLUSIONSSACC-83 cells produce exosomes that promote the tumor cell proliferation and enhances the cellular expression of P-ERK, suggesting a potential role of MAPK/ERK pathway activation in exosome-mediated acceleration of ACC cell proliferation.

Objective:To study the effects of exosomes (EXO) released by adenoid cystic carcinoma SACC-83 cells on the expression of fibroblast activation protein (FAP) in normal human salivary gland stromal fibroblasts (hSGSFs).Methods:ACC exosomes were isolated from SACC-83 cell culture supernatant by using Total Exosome Isolation Reagent.The whole-mount EXO were characterized and assessed by transmission electron microscope and Western Blot.The exosomes were labeled with green fluorescent dye PKH67 and co-cultured with hSGSFs for 48h,followed by staining with Alexa Fluor 594 Phalloidin and DAPI.Mterwards,exsosomes uptake was observed under a laser scanning confocal microscope.After a 48-hour co-culture of SACC-83 exosomes with hSGSFs,the expression of FAP in SACC-83-EXO-treated hSGSFs was investigated by qRT-PCR and Western Blot.Results:The vesicles isolated from SACC-83 cell culture supernatant had the reported size range of 30-100 nm,expressed the exosomal marker CD63 and TSG101.Mter co-culture of hSGSFs with PKH67 labeled SACC-83 exosomes,exosomes were taken up by hSGSFs and FAP expression was elevated in hSGSFs.Conclusion:Exosomes derived from SACC-83 cells can be taken up by hSGSFs and can induce the expression of FAP in hSGSFs.These results suggest that exosomes derived from SACC-83 cells might induce the transformation of normal salivary gland strormal fibroblasts to cancer associated fibroblasts.

Objective To explore the clinical values of applying contact-mode argon plasma coagulation (APC) for retroflex colonoscopic treatment of ultra-lower rectal polyps. Methods 46 wide outsole and applanate polyps smaller than 1.0 cm located at ultra-lower rectum in 17 cases of patients were treated by contact-mode APC under U-type retroflex colonoscopy after failure in regular colonoscopic treatment. Then observe the contacting rate of APC probe with polyps, success rate of curing polyps, rate of probe being adhered and blocked by the solidification structures, incidence of submucosal emphysemas, and incidence of colonoscope ambustion. Results Under U-type retroflex colonoscopy, the probe could contact with polyps in 17 patients. The polyps in every patient were cured by APC in the first time of colonoscopic treatment, whereas all 46 polyps were cured by 97 times of APC spurt. Mild adhesions occurred between the probe and solidification structures at 5 times (5.15 %) among 97 times of APC spurt, without injuries to the coagulation surface from which when the probe separated. The solidification structures blocked the probe only twice (2.06 %). When the solidification structures were cleared, efficiency of the probe restored. No sub-mucosal emphysemas and colonoscope ambustion happened. Conclusion Applying contact-mode APC for retroflex colonoscopic treatment of ultra-lower rectal polyps is safe and effective, it can prevent the damage of colonoscope from the argon knife.