Objective To evaluate the predictive value of different machine learning models constructed in a multicenter environment for potential organ donors and verify their clinical application feasibility. Methods The study included 2 000 inpatients admitted to five domestic tertiary hospitals from January 2020 to December 2023, who met the criteria for potential organ donation assessment. They were randomly divided into a training set and an internal validation set (7∶3). Another 300 similar patients admitted to the First Affiliated Hospital of Harbin Medical University from January 2024 to April 2025 were included as an external validation set. The area under the curve (AUC), sensitivity, specificity, accuracy and F1-score of three models were compared, and the consistency of the potential organ donor determination process was tested. Multivariate logistic regression analysis was used to identify predictive factors of potential organ donors. Decision curve analysis (DCA) was employed to verify the resource efficiency of each model, and the threshold interval and intervention balance point were assessed. Results Apart from age, there were no significant differences in other basic characteristics among the centers (all P>0.05). The consistency of the potential organ donor determination process among researchers in each center was good [all 95% confidence interval (CI) lower limits >0]. In the internal validation set, the XGBoost model had the best predictive performance (AUC=0.92, 95% CI 0.89-0.94) and the best calibration (P=0.441, Brier score 0.099). In the external validation set, the XGBoost model also had the best predictive performance (AUC=0.91, 95% CI 0.88-0.94), outperforming logistic regression and random forest models. Multivariate logistic regression showed that mechanical ventilation had the greatest impact (odds ratio=2.06, 95% CI 1.54-2.76, P<0.001). DCA indicated that the XGBoost model had the highest net benefit in the threshold interval of 0.2-0.6. The “treat all” strategy only had a slight advantage at extremely low thresholds. The recommended threshold interval, which balances intervention costs and clinical benefits, considers ≥50% positive predictive value (PPV) and ≤50 referrals per 100 high-risk patients. Conclusions The XGBoost model established in a multicenter environment is accurate and well-calibrated in predicting potential organ donors. Combined with DCA, it may effectively guide the timing of clinical interventions and resource allocation, providing new ideas for the assessment and management of organ donation after brain death.

ObjectiveTo compare the clinical efficacy of traditional Chinese medicine （TCM） manipulative reduction combined with small splint fixation versus surgical treatment for type A distal radius fracture （DRF） and to explore the factors influencing the choice of treatment. MethodsA multi-center retrospective study was conducted， collecting data from 1237 type A DRF patients treated in 11 hospitals in Jiangsu province from September， 2023 to April， 2025. Among them， 851 patients in the TCM group received manipulative reduction combined with small splint fixation， and 386 patients in the surgical group underwent open reduction and internal fixation. Visual analog scale （VAS） scores for pain and radiographic indicators including palmar tilt， ulnar deviation， and radial height were compared before treatment， 5-7 days after treatment， and 4-6 weeks after treatment. The wrist joint function scores including Dienst and Gartland-Werley scores at 12 weeks after treatment were recorded. Subgroup analysis was conducted for the excellent rate of Dienst and Gartland-Werley scores， stratified by age （＜50， 50-59， 60-69， ≥70 years old） and AO subtypes （A1， A2， A3）. A multivariate logistic regression model was used to identify independent factors influencing treatment choice. ResultsOn 5-7 days after treatment， the surgical group had lower VAS scores than the TCM group， while 4-6 weeks after treatment， the TCM group showed lower VAS scores than the surgical group （P＜0.01）. In terms of radiographic indicators， except for the palmar tilt before treatment being higher in the surgical group than in the TCM group （P＜0.01）， there were no significant differences in palmar tilt， ulnar deviation， and radial height at other timepoints （P＞0.05）. Twelve weeks after treatment， the surgical group had a higher average Gartland-Werley score and the excellent rate than the TCM group （P＜0.01）. Subgroup analysis showed that in patients with A2 type DRF aged 50-59 and 60-69 years old， the excellent rates of Dienst and Gartland-Werley scores in the TCM group were higher than those in the surgical group （P＜0.05）. Multivariate logistic regression analysis revealed that age， palmar tilt， ulnar deviation， and the degree of swelling on the affected side were independent factors influencing the choice of treatment （P＜0.05）. ConclusionBoth TCM manipulative reduction combined with small splint fixation and surgical treatment for type A DRF can achieve good therapeutic effects. TCM manipulative reduction combined with small splint fixation has certain advantages in medium- and long-term pain relief， especially in elderly patients， where wrist joint function recovery is more stable. Age， palmar tilt， ulnar deviation， and swelling degree are the main factors influencing the treatment choice.

Objective To explore the effectiveness and safety of polyglycolic acid(PGA)and hydroxypropyl methylcellulose(HPMC)composite materials for suturing after canine sleeve gastrectomy.Methods A total of 36 healthy Beagle dogs were randomly divided into experimental group and control group in a 1∶1 male-to-female ratio.The experimental group underwent gastric sleeve resection with PGA+HPMC composite material for suture reinforcement,while the control group used NV-ET-M60E-2 suture material.Postoperative monitoring included survival status,food intake,and body temperature changes.Venous blood samples were collected before surgery,3 days after surgery,and before euthanasia for routine blood tests.At 2,4,and 8 weeks postoperatively,six dogs were euthanized at each time point for histological examination,hard tissue pathological evaluation,and safety assessment of the heart,liver,spleen,lungs,and kidneys.Results There were no significant differences in blood routine test results between the control group and the experimental group(P＞0.05).Before dissection,the percentage of basophils was significantly higher in the control group than in the experimental group(P=0.015).At 2 weeks after surgery,the severity of liver cell edema in the control group was higher than in the experimental group(P=0.036).However,the two groups did not significantly differ in the histological examination results of the heart,liver,spleen,lungs,or kidneys at other time points(P＞0.05).Hard tissue pathological slice results at 2,4,and 8 weeks after surgery showed no material residue in either group by the 8th week,and there were no significant differences in inflammation and necrosis scores or fibrosis/fat infiltration totals between the two groups(P＞0.05).Inflammation scores and fibrosis/fat infiltration totals at 8 weeks post-operation were significantly lower than those at 2 weeks post-operation(P＜0.05).During the experiment,no near-death phenomena occurred in either group,and no fever or refusal to eat was observed within 3 days after surgery.At dissection,the Beagle dogs appeared normal with glossy fur and no abnormal secretions.Conclusion PGA+HPMC composite materials can be effectively degraded and used as non-toxic suture fixation materials for wound suturing after sleeve gastrectomy,providing a theoretical basis for their clinical application.

OBJECTIVE To provide scientific and reasonable recommendations for the identification of Anaerobio-spirillum succiniciproducens in clinical microbiology laboratories by comparing the effectiveness of biochemical methods,matrix-assisted laser desorption ionization time-of-flight mass spectrometry(MALDI-TOF MS),and 16S rRNA gene sequencing.METHODS Methodological evaluation was conducted.A strain of A.succiniciprodu-cens was isolated on Mar.27,2023 from a patient with sepsis caused by a dog bite,who was admitted to Guang-dong Nongken Central Hospital,and analyzed for the morphological characteristics,culture methods,and colony features.The identification of the isolated strain was conducted by the automated microbial identification and anal-ysis system(VITEK 2 Compact 2,bioMerieux),MALDI-TOF MS including VITEK MS,MALDI Biotyper,Au-tof ms 1000,and EX-Accuspec,as well as 16S ribosomal RNA(rRNA)gene sequencing.The performance of each method was evaluated.RESULTSA.succiniciproducens was a strictly anaerobic gram-negative spiral bacteri-um,characterized by slow growth,flat and colorless transparent colonies,and negative oxidase and catalase activ-ity.When using VITEK 2 Compact ANC card,it was not successfully recognized;however,through the identifi-cation by VITEK MS,MALDI Biotyper,Autof ms 1000 and EX-Accuspec,it was all confirmed as A.succinicip-roducens.Additionally,16S rRNA gene sequencing technology also identified it as A.succiniciproducens.CONCLUSIONS Current automated biochemical identification systems are unable to accurately identify A.succi-niciproducens.MALDI-TOF MS and 16S rRNA gene sequencing techniques can reliably confirm A.succinicipro-ducens.Clinical microbiologists should select the appropriate identification method based on their available re-sources.

Objective To develop an ultra-high performance liquid chromatography-mass spectrometry method(UPLC-MS/MS)for the determination of nirmatrelvir concentration in mouse plasma.Methods The ACQUITY UPLC system was used in tandem with an API 4000 triple quadrupole mass spectrometer.The analytical column was Waters BEH C18(2.1 mm×5.0 mm,1.7 μm)column,and the mobile phases consisted of water(containing 0.1％formic acid)and methanol(containing 0.1％formic acid)under gradient elution at the flow rate of 0.4 mL·min-1.The column temperature was set at 40 ℃,and the injection volume was 5 μL.Electrospray ionization was used as ion source,and positive multiple reaction monitoring mode was adopted to quantitatively analyze the ionization pairs m/z 500.3→110.3(nirmatrelvir)and m/z 237.3→193.3(carbamazepine).Carbamazepine was employed as an internal standard.Results The linear range of nirmatrelvir was from 10 ng·mL-1 to 2 560 ng·mL-1.For the quality control nirmatrelvir samples,the accuracies of intra-and inter-batch were less than±15％,and the precisions of intra-and inter-batch were lower than 15％.Nirmatrelvir in plasma was stable at room temperature for 24 h and remained stable after three freeze-thaw cycles.The extracted nirmatrelvir solution could be stored at 4℃ for 3 d without any visible change.Conclusion The method was characterized by good specificity,high sensitivity,and appropriate linear range.The methodological validation was in accordance with the 2020 edition of the Chinese Pharmacopoeia and could be applied to the quantitative detection of nirmatrelvir in plasma.

Objective:To investigate the short-term efficacy of bevacizumab combined with chemotherapy in patients with advanced cervical cancer, as well as its effects on tumor markers and immune function.Methods:A retrospective analysis was conducted on 60 patients with advanced cervical cancer who received treatment at Yiwu Central Hospital from January 2020 to March 2024. The patients were divided into an observation group and a control group ( n = 30 per group) based on whether they received bevacizumab. Patients in the observation group received bevacizumab in combination with chemotherapy, while those in the control group received chemotherapy alone. The two groups were evaluated over two consecutive treatment cycles, with each cycle lasting 21 days. Short-term efficacy was compared between the two groups. The Karnofsky score, tumor markers, and immune function were assessed before and after treatment in both groups. Additionally, the incidence of adverse reactions was compared between the two groups. Results:The objective response rate in the observation group was significantly higher than that in the control group [73.33% (22/30) vs. 46.67% (14/30), χ2 = 4.44, P<0.05]. After treatment, the Karnofsky score in the observation group was significantly higher than that in the control group [(83.39 ± 4.43) vs. (75.48 ± 4.06), t = 7.21, P<0.001]. The serum levels of carbohydrate antigen 125, carcinoembryonic antigen, and carbohydrate antigen 19-9 in the observation group were all significantly lower than those in the control group ( t = -11.27, -8.91, -13.33, all P<0.001). CD 3+, CD 4+, and CD 4+/CD 8+ were significantly higher in the observation group compared with the control group ( t = 10.20, 10.74, 10.17, all P<0.001). The incidence of adverse reactions did not differ significantly between the two groups (all P>0.05). Conclusions:In patients with advanced cervical cancer, bevacizumab combined with chemotherapy demonstrates better efficacy than chemotherapy alone. The combined therapy is more effective in lowering serum levels of carbohydrate antigen 125, carcinoembryonic antigen, and carbohydrate antigen 19-9, as well as enhancing immune function, without increasing adverse reactions compared with chemotherapy alone.

Objective To explore the effectiveness and safety of polyglycolic acid(PGA)and hydroxypropyl methylcellulose(HPMC)composite materials for suturing after canine sleeve gastrectomy.Methods A total of 36 healthy Beagle dogs were randomly divided into experimental group and control group in a 1∶1 male-to-female ratio.The experimental group underwent gastric sleeve resection with PGA+HPMC composite material for suture reinforcement,while the control group used NV-ET-M60E-2 suture material.Postoperative monitoring included survival status,food intake,and body temperature changes.Venous blood samples were collected before surgery,3 days after surgery,and before euthanasia for routine blood tests.At 2,4,and 8 weeks postoperatively,six dogs were euthanized at each time point for histological examination,hard tissue pathological evaluation,and safety assessment of the heart,liver,spleen,lungs,and kidneys.Results There were no significant differences in blood routine test results between the control group and the experimental group(P＞0.05).Before dissection,the percentage of basophils was significantly higher in the control group than in the experimental group(P=0.015).At 2 weeks after surgery,the severity of liver cell edema in the control group was higher than in the experimental group(P=0.036).However,the two groups did not significantly differ in the histological examination results of the heart,liver,spleen,lungs,or kidneys at other time points(P＞0.05).Hard tissue pathological slice results at 2,4,and 8 weeks after surgery showed no material residue in either group by the 8th week,and there were no significant differences in inflammation and necrosis scores or fibrosis/fat infiltration totals between the two groups(P＞0.05).Inflammation scores and fibrosis/fat infiltration totals at 8 weeks post-operation were significantly lower than those at 2 weeks post-operation(P＜0.05).During the experiment,no near-death phenomena occurred in either group,and no fever or refusal to eat was observed within 3 days after surgery.At dissection,the Beagle dogs appeared normal with glossy fur and no abnormal secretions.Conclusion PGA+HPMC composite materials can be effectively degraded and used as non-toxic suture fixation materials for wound suturing after sleeve gastrectomy,providing a theoretical basis for their clinical application.

Objective To develop an ultra-high performance liquid chromatography-mass spectrometry method(UPLC-MS/MS)for the determination of nirmatrelvir concentration in mouse plasma.Methods The ACQUITY UPLC system was used in tandem with an API 4000 triple quadrupole mass spectrometer.The analytical column was Waters BEH C18(2.1 mm×5.0 mm,1.7 μm)column,and the mobile phases consisted of water(containing 0.1％formic acid)and methanol(containing 0.1％formic acid)under gradient elution at the flow rate of 0.4 mL·min-1.The column temperature was set at 40 ℃,and the injection volume was 5 μL.Electrospray ionization was used as ion source,and positive multiple reaction monitoring mode was adopted to quantitatively analyze the ionization pairs m/z 500.3→110.3(nirmatrelvir)and m/z 237.3→193.3(carbamazepine).Carbamazepine was employed as an internal standard.Results The linear range of nirmatrelvir was from 10 ng·mL-1 to 2 560 ng·mL-1.For the quality control nirmatrelvir samples,the accuracies of intra-and inter-batch were less than±15％,and the precisions of intra-and inter-batch were lower than 15％.Nirmatrelvir in plasma was stable at room temperature for 24 h and remained stable after three freeze-thaw cycles.The extracted nirmatrelvir solution could be stored at 4℃ for 3 d without any visible change.Conclusion The method was characterized by good specificity,high sensitivity,and appropriate linear range.The methodological validation was in accordance with the 2020 edition of the Chinese Pharmacopoeia and could be applied to the quantitative detection of nirmatrelvir in plasma.

Objective:To investigate the short-term efficacy of bevacizumab combined with chemotherapy in patients with advanced cervical cancer, as well as its effects on tumor markers and immune function.Methods:A retrospective analysis was conducted on 60 patients with advanced cervical cancer who received treatment at Yiwu Central Hospital from January 2020 to March 2024. The patients were divided into an observation group and a control group ( n = 30 per group) based on whether they received bevacizumab. Patients in the observation group received bevacizumab in combination with chemotherapy, while those in the control group received chemotherapy alone. The two groups were evaluated over two consecutive treatment cycles, with each cycle lasting 21 days. Short-term efficacy was compared between the two groups. The Karnofsky score, tumor markers, and immune function were assessed before and after treatment in both groups. Additionally, the incidence of adverse reactions was compared between the two groups. Results:The objective response rate in the observation group was significantly higher than that in the control group [73.33% (22/30) vs. 46.67% (14/30), χ2 = 4.44, P<0.05]. After treatment, the Karnofsky score in the observation group was significantly higher than that in the control group [(83.39 ± 4.43) vs. (75.48 ± 4.06), t = 7.21, P<0.001]. The serum levels of carbohydrate antigen 125, carcinoembryonic antigen, and carbohydrate antigen 19-9 in the observation group were all significantly lower than those in the control group ( t = -11.27, -8.91, -13.33, all P<0.001). CD 3+, CD 4+, and CD 4+/CD 8+ were significantly higher in the observation group compared with the control group ( t = 10.20, 10.74, 10.17, all P<0.001). The incidence of adverse reactions did not differ significantly between the two groups (all P>0.05). Conclusions:In patients with advanced cervical cancer, bevacizumab combined with chemotherapy demonstrates better efficacy than chemotherapy alone. The combined therapy is more effective in lowering serum levels of carbohydrate antigen 125, carcinoembryonic antigen, and carbohydrate antigen 19-9, as well as enhancing immune function, without increasing adverse reactions compared with chemotherapy alone.

OBJECTIVE To provide scientific and reasonable recommendations for the identification of Anaerobio-spirillum succiniciproducens in clinical microbiology laboratories by comparing the effectiveness of biochemical methods,matrix-assisted laser desorption ionization time-of-flight mass spectrometry(MALDI-TOF MS),and 16S rRNA gene sequencing.METHODS Methodological evaluation was conducted.A strain of A.succiniciprodu-cens was isolated on Mar.27,2023 from a patient with sepsis caused by a dog bite,who was admitted to Guang-dong Nongken Central Hospital,and analyzed for the morphological characteristics,culture methods,and colony features.The identification of the isolated strain was conducted by the automated microbial identification and anal-ysis system(VITEK 2 Compact 2,bioMerieux),MALDI-TOF MS including VITEK MS,MALDI Biotyper,Au-tof ms 1000,and EX-Accuspec,as well as 16S ribosomal RNA(rRNA)gene sequencing.The performance of each method was evaluated.RESULTSA.succiniciproducens was a strictly anaerobic gram-negative spiral bacteri-um,characterized by slow growth,flat and colorless transparent colonies,and negative oxidase and catalase activ-ity.When using VITEK 2 Compact ANC card,it was not successfully recognized;however,through the identifi-cation by VITEK MS,MALDI Biotyper,Autof ms 1000 and EX-Accuspec,it was all confirmed as A.succinicip-roducens.Additionally,16S rRNA gene sequencing technology also identified it as A.succiniciproducens.CONCLUSIONS Current automated biochemical identification systems are unable to accurately identify A.succi-niciproducens.MALDI-TOF MS and 16S rRNA gene sequencing techniques can reliably confirm A.succinicipro-ducens.Clinical microbiologists should select the appropriate identification method based on their available re-sources.