OBJECTIVE To construct a predictive model for evaluating the efficacy of a triple antiemetic regimen （neurokinin- 1 receptor antagonist+5-hydroxytryptamine 3 receptor antagonist+dexamethasone） for preventing nausea and vomiting induced by highly emetogenic chemotherapy （HEC） based on interpretable deep learning algorithms. METHODS Clinical data of cancer patients who received HEC and were treated with the standard triple antiemetic regimen in the oncology department of Tianjin Medical University General Hospital from January 2018 to December 2022 were collected retrospectively. Demographic， clinical and metabolism-related variables were integrated. After data pre-processing， two deep learning algorithms （deep random forest and dense neural network） and four machine learning algorithms （support vector machine， categorical boosting， random forest and decision tree） were used to build predictive models. Subsequently， model performance evaluation and model interpretability analysis were conducted. RESULTS Among the six candidate models， the deep random forest model demonstrated the best predictive performance on the test set， with an area under the receiver operating characteristic curve of 0.850， an accuracy of 0.911， a precision of 0.805， a recall of 0.783， an F1 score of 0.793， and a Brier score of 0.075. Interpretability analysis revealed that creatinine clearance rate （Ccr） was the key predictive factor， and low Ccr levels， female gender， younger age， highly emetogenic drugs （particularly cisplatin-containing chemotherapy regimens）， and anticipatory nausea and vomiting were positively correlated with the risk of HEC-related nausea and vomiting. CONCLUSIONS The deep random forest model exhibits the best performance in predicting the efficacy of triple antiemetic regimen for preventing HEC-related nausea and vomiting. The key predictors in this model primarily include Ccr，anticipatory nausea and vomiting， gender， age， and highly emetogenic drugs.

Tyrosine kinase inhibitors(TKIs)are the key agent in the treatment of renal cell carcino-ma(RCC)so far.Drugs such as sunitinib and sorafenib showed significant benefits RCC patients,however,the adverse effect,drug efficacy and drug resistance limited the use of these therapy.Espe-cially the drug resistant issue brings up a big chal-lenge for clinical practice,and the mechanisms un-derlying are still poorly understood.In recent years,new therapies have been combined with TKIs to improve the treatment outcome.Immuno-therapy,combination therapy with other TKIs,tar-geted nanoparticle delivery,and drug modification are widely studied to improve the efficacies of TKIs and regain the sensitivity.In this review,we sum-marizes the current understanding of TKI drug resis-tance and the approaches to regaining drug sensi-tivity.

Objective:To develop a Recurrence Fear Scale for Patients with Atrial Fibrillation after Catheter Ablation and conduct psychometric testing for its reliability and validity.Methods:Based on the common-sense model of self-regulation, the scale was developed through a literature review and semi-structured interviews to construct an item pool. The scale draft was formed through expert consultation and a pre-survey. Using convenience sampling, 361 patients with atrial fibrillation who had undergone catheter ablation and were either hospitalized or attending outpatient follow-up at the Department of Cardiology, Affiliated Hospital of Qingdao University, between January and March 2024, were selected for questionnaire survey. Item analysis and reliability and validity tests were performed on the scale.Results:Exploratory factor analysis identified five common factors, with a cumulative variance contribution rate of 74.375%. Confirmatory factor analysis showed good model fit. The final scale included five dimensions and 24 items: trigger factors, recurrence risk perception, disease uncertainty, psychological burden, and coping strategies. The content validity index at the scale level was 0.864, and the item-level content validity index ranged from 0.684 to 0.947. The Cronbach's α coefficient of the scale was 0.919, the split-half reliability coefficient was 0.834, and the test-retest reliability coefficient was 0.872.Conclusions:The development of the Recurrence Fear Scale for Patients with Atrial Fibrillation after Catheter Ablation is scientific and standardized, and the scale has good reliability and validity. It can effectively assess the level of recurrence fear in these patients.

Tyrosine kinase inhibitors(TKIs)are the key agent in the treatment of renal cell carcino-ma(RCC)so far.Drugs such as sunitinib and sorafenib showed significant benefits RCC patients,however,the adverse effect,drug efficacy and drug resistance limited the use of these therapy.Espe-cially the drug resistant issue brings up a big chal-lenge for clinical practice,and the mechanisms un-derlying are still poorly understood.In recent years,new therapies have been combined with TKIs to improve the treatment outcome.Immuno-therapy,combination therapy with other TKIs,tar-geted nanoparticle delivery,and drug modification are widely studied to improve the efficacies of TKIs and regain the sensitivity.In this review,we sum-marizes the current understanding of TKI drug resis-tance and the approaches to regaining drug sensi-tivity.

Objective:To develop a Recurrence Fear Scale for Patients with Atrial Fibrillation after Catheter Ablation and conduct psychometric testing for its reliability and validity.Methods:Based on the common-sense model of self-regulation, the scale was developed through a literature review and semi-structured interviews to construct an item pool. The scale draft was formed through expert consultation and a pre-survey. Using convenience sampling, 361 patients with atrial fibrillation who had undergone catheter ablation and were either hospitalized or attending outpatient follow-up at the Department of Cardiology, Affiliated Hospital of Qingdao University, between January and March 2024, were selected for questionnaire survey. Item analysis and reliability and validity tests were performed on the scale.Results:Exploratory factor analysis identified five common factors, with a cumulative variance contribution rate of 74.375%. Confirmatory factor analysis showed good model fit. The final scale included five dimensions and 24 items: trigger factors, recurrence risk perception, disease uncertainty, psychological burden, and coping strategies. The content validity index at the scale level was 0.864, and the item-level content validity index ranged from 0.684 to 0.947. The Cronbach's α coefficient of the scale was 0.919, the split-half reliability coefficient was 0.834, and the test-retest reliability coefficient was 0.872.Conclusions:The development of the Recurrence Fear Scale for Patients with Atrial Fibrillation after Catheter Ablation is scientific and standardized, and the scale has good reliability and validity. It can effectively assess the level of recurrence fear in these patients.

Objective:To gain a deeper understanding of the fear of recurrence in patients with atrial fibrillation during the "blanking period" after catheter ablation.Methods:The interview outline was developed based on common-sense model of self-regulated. From July to September 2023, purposive sampling was used to select 15 patients with atrial fibrillation in the "blanking period" after catheter ablation at the Cardiovascular Outpatient of the Affiliated Hospital of Qingdao University as research subjects, and semi-structured interviews were conducted. The targeted content analysis method was used to analyze data.Results:Four themes were extracted, namely triggering factors of fear of recurrence, perception of atrial fibrillation recurrence, negative emotional distress, and insufficient ability to cope with atrial fibrillation recurrence.Conclusions:For patients with atrial fibrillation during the "blanking period" after catheter ablation, medical and nursing staff should closely monitor the patient's cognitive level and psychological state, and carry out targeted health education to meet the patient's needs for postoperative disease management, life adaptation, and other aspects, so as to reduce the fear of recurrence in atrial fibrillation patients during the "blanking period" after surgery.

Objective:To investigate the protective effect of racanisodamine (654-2) on lung epithelial cell injury induced by X-ray in mice and unravel the underlying mechanism.Methods:Mouse alveolar epithelial cells MLE-12 were used to establish radiation-induced lung injury (RILI) model in vitro and divided into 4 groups as follows: control (no irradiation), radiation (16 Gy radiation), treatment 1 (16 Gy radiation + 2 μmol/L 654-2), treatment 2 (16 Gy radiation + 10 μmol/L 654-2), and inhibitor (16 Gy radiation + 10 μmol/L 654-2 + 2 μmol/L ML385), respectively. Cells were sampled at different time points after radiation. Cell senescence was detected with senescence-associated β-galactosidase (SA-β-Gal) staining. Cell colony-forming ability was detected to observe the recovery capability of cells after treatment. The expression levels of p21, p16, phosphorylated histone H2AX(γH2AX), nuclear factor erythroid-2 related factor 2 (Nrf2), Nrf2 Ser40 site phosphorylation (p-Nrf2), p62, heme oxygenase-1 (HO-1) and NAD(P)H quinone oxidoreductase 1 (NQO1) proteins were measured by Western blot. Cell apoptosis and the production of intracellular reactive oxygen species (ROS) were determined by flow cytometry. The expression levels of glutathione (GSH) and superoxide dismutase (SOD) were detected according to the manufectuer instructions. The expression levels of glutamate-cysteine ligase catalytic subunit (GCLC) and glutamate-cysteine ligase modifier subunit (GCLM) mRNA were determined by real time reverse transcription PCR. Measurement data were expressed as Mean ±SD. Comparison between two groups was conducted by independent sample t-test, and comparison among multiple groups was performed by one-way ANOVA. Results:Compared with the radiation group, the proportion of cells with positive staining of SA-β-Gal was significantly lower and cell senescence were alleviated in the treatment 1 and 2 groups (all P<0.001). Compared with the radiation group, the expression level of γH2AX protein was significantly down-regulated ( P=0.037), cell apoptosis rate was significantly decreased ( P=0.026), the proliferation capacity of MLE-12 was enhanced ( P=0.004), GSH ( P=0.002) and SOD ( P<0.001) activity was enhanced and ROS production was declined ( P=0.001) in the treatment 2 group. The expression levels of Nrf2 and p-Nrf2 in total protein were up-regulated over the time of 654-2 intervention. Meanwhile, the expression levels of antioxidant proteins of NQO1 and HO-1 were up-regulated and that of GCLC and GCLM mRNA was also up-regulated. There were no significant differences in the number of cells with positive staining of SA-β-Gal ( P=0.145) and ROS production ( P=0.317) between the inhibitor and radiation groups after supplement of ML385, small-molecule inhibitor of Nrf2. Conclusion:654-2 can activate the Nrf2 pathway, enhance cell antioxidant capacity and inhibit cell senescence, thereby playing a protective role on radiation- induced lung injury.

Objective:To investigate the protective effect of racanisodamine on lung injury in mice exposed to irradiation.Methods:C57BL/6 mice were randomly divided into control group, racanisodamine group, 18 Gy irradiation group (model group) and racanisodamine combined with 18 Gy irradiation group (treatment group), with 5 mice in each group. The mice in the treatment group received racanisodamine (5 mg/kg) intraperitoneally 3 d before irradiation and contained the whole experiments. Then, single chest irradiation of 18 Gy X-rays was performed both in the model and treatment groups. The racanisodamine group and treatment group received racanisodamine intraperitoneally once a day until 6 weeks after irradiation. The mice were killed at 6 weeks after irradiation. The lung histopathology was observed by HE staining. Serum and bronchial alveolar lavage fluid (BALF) inflammatory cytokines such as TNF-α, IL-1β and IL-6 were determined by ELISA method. Cell senescence was detected by SA-β-Gal staining. The expressions of Nrf2, p-Nrf2 and p62 in lung tissue were performed by immunehistochemistry and Western blot assays.Results:Compared with the model group, the scores of HE staining were decreased ( t=8.66, P<0.01), the number of infiltrated inflammatory cells in BALF were decreased ( t=10.70, P<0.01), and protein concentration in BALF had lower levels ( t=6.75, P<0.01), the serum TNF-α, IL-1β and IL-6 were decreased significantly ( t=8.17, 4.58, 6.54, P<0.01), the activity of SA-β-gal was decreased, and the expressions of Nrf2, p-Nrf2 were enhanced ( t=6.42, 7.30, P<0.01), while the expression of p62 was reduced ( t=4.62, P<0.01) in the treatment group. Conclusions:Racanisodamine plays the protective effect of radiation-induced lung injury by alleviating inflammation associating with the activating of Nrf2-related pathway, which reversed radiation-induced cell senescence.

Background With the change of the national energy development layout, Qingyang has seen a situation where oil exploitation and agriculture go hand in hand, which may lead to local soil pollution if not taken seriously. Objective To evaluate the distribution characteristics, possible sources, and ecological risks of heavy metals in farmland soils around the main production areas of Changqing Oilfield. Methods A total of 60 farmland soil samples were collected from Zhengning County, Zhenyuan County, and Qingcheng County of Qingyang City, and the contents of heavy metals such lead (Pb), mercury (Hg), chromium (Cr), cadmium (Cd), and arsenic (As) in farmland soil were detected according to GB 15618-2018 Soil environmental quality—Risk control standard for soil contamination of agricultural land (on trial). The soil background value of Gansu Province was used as the denominator in the calculation of pollution index, and the pollution characteristics and ecological characteristics of selected five heavy metals in farmland soil were evaluated by single-factor pollution index (P_i), Nemerow comprehensive pollution index (P_N), and potential ecological risk index. Results The levels of Pb, As, and Hg in farmland soils around Changqing Oilfield, the levels of Cr and Cd in Qingcheng County, and the level of Cd in Zhengning County were higher than the corresponding soil background values of Gansu Province, but lower than the national soil environmental quality standard. The single-factor pollution indexes (P_i) were: Hg, 2.14; Pb, 1.24; As, 1.13; Cr, 0.78; Cd, 0.67, which indicated that Hg were graded as moderate pollution, Pb and As were slight pollution, and Cd and Cr were not polluted. The Nemerow comprehensive pollution indexes (P_N) were: Cr, 0.92; Cd, 1.08; As, 1.20; Pb, 1.68; Hg, 3.85, which indicated that Cr was graded as no pollution, Cd, Pb and As were mild pollution, and Hg was severe pollution. The variation coefficients of Hg and Cd in Zhenyuan County and that of Hg in Qingcheng County were 60.00%, 50.00%, and 50.00%, respectively, which were all greater than 50%, indicating that the pollution of above heavy metals in the location was subject to human activities. The potential ecological risk indexes (E_r) of Pb, Cr, Cd, As, and Hg were 6.20, 1.55, 20.05, 11.28, and 81.64, respectively, indicating that Hg was graded as strong ecological risk, and the other four heavy metals were mild ecological risk. The comprehensive potential ecological risk index (R_RI) was 124.48. Combined with the potential ecological risk index of Hg, the comprehensive potential ecological risk of the five heavy metals in local farmland soils was considered to be at a strong ecological risk level. Conclusion Although the average values of selected five heavy metals in farmland soils surrounding the main production areas of Changqing Oilfield are qualified with the national soil environmental quality standards, they exceed corresponding soil background values of Gansu Province, and there are signs of human influence and potential ecological risks of different degrees.