Objective To construct a prediction model for the transfer-out rate of patients in the intensive care unit(ICU)based on frequent pattern growth(FP-Growth)algorithm and evaluate its application value.Methods A total of 4,000 ICU patients were selected as study subjects and divid-ed into model construction group and validation group.Clinical data from both groups were collected and compared.Association rule analysis based on the FP-Growth algorithm was performed in the model construction group.A prediction model for the ICU patient transfer-out rate was established by calcu-lating effective strong association rules among the elements in the final scanned set of the model con-struction group.In internal validation,the model's consistency was evaluated using calibration curves and other metrics.In external validation,the area under the receiver operating characteristic(ROC)curve(AUC)for predicting the ICU patient transfer-out rate was compared between the model con-struction group and the validation group.Results In the model construction group,with correspond-ing clinical data available,the transfer-out rates within 7 days,＞7 to14 days,and＞14 to 21 days were 71％,40％and 18％,respectively.During internal validation,the calibration curve demonstra-ted satisfactory consistency between predicted and observed values.In external validation,the AUC values for the model's predictions of transfer-out rates at 7 days,＞7 to14 days,and＞14 to 21 days in the model construction group were 0.880,0.861 and 0.654,respectively.Conclusion The pre-diction model for the ICU patient transfer-out rate exhibits favorable short-term(within 14 days)pre-dictive performance,and its application holds certain reference value for optimizing the overall treat-ment efficacy in the ICU and the allocation of medical resources.

Objective To investigate the biomechanical differences in plantar pressure,postural stability,and plantar Visual Analogue Scale(VAS)scores between normal feet and unilateral/bilat-eral pes cavus,reveal their unique neuromechanical compensation mechanisms,and construct a sta-bility early warning model based on the minimum center of pressure(COP)trajectory classification.Methods A total of 70 patients with pes cavus from December 2023 to October 2024 were selected as study subjects,including 33 patients in the unilateral pes cavus group and 37 patients in the bilat-eral pes cavus group.During the same period,32 normal feet were included as normal foot group.A flat-panel plantar pressure testing system was used to collect dynamic plantar pressure data and COP trajectories from three groups at a self-selected walking speed.There were no statistically significant differences in baseline data such as age,gender,and body mass index among the three groups(P＞0.05).One-way analysis of variance and the Wilcoxon rank-sum test were used to compare the differences in maximum pressure,contact area,VAS scores,and the 95％confidence ellipse area of the COP among the three groups in 10 plantar regions.Results Patients with pes cavus exhibited lower peak pressure in the MF region compared to normal feet,while higher peak pressure in the M2,M3,and MH regions.Patients with bilateral pes cavus showed lower peak pressure in the T1 region compared to normal feet,and patients with unilateral pes cavus had lower peak pressure in the LH region compared to the normal group(P＜0.05).The plantar contact area in patients with pes cavus was reduced in the T1,M2,M3,M4,MF,and MH regions compared to normal feet(P＜0.05).The 95％confidence ellipse area of the COP was larger in both the bilateral and uni-lateral pes cavus groups compared to the normal foot group(P＜0.001).Unilateral pes cavus pres-ented a specific lateral COP drift(amplitude of 3 to 4 cm),which is a biomechanical manifestation of compensatory eversion of the unaffected foot.Patients with bilateral pes cavus exhibited a"bimod-al oscillation"trajectory(amplitude of 6 to 8 cm),suggesting possible vestibular-spinal regulatory dysfunction and the poorest postural stability.In the pes cavus group,there was a significant in-crease in pressure in the M2,M3,and MH regions,with peak pressures exceeding 190 kPa in pa-tients with bilateral pes cavus,which was highly correlated with plantar pain and could serve as a pain early warning threshold.Conclusion Unilateral and bilateral pes cavus exhibit significantly different neuromechanical compensation patterns.The classification based on the"lateral drift"and"bimodal oscillation"characteristics of the COP trajectory can serve as a stability early warning indi-cator for assessing fall risk.Decompression interventions targeting the key pressure regions of M2,M3,and MH(such as customized orthotic insoles)are the core strategies for alleviating pain and optimizing dynamic gait stability.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective To investigate the role and mechanism of circular RNA(circRNA)has_circ_0003304(circAZIN1)in regulating chondrocyte degeneration in osteoarthritis(OA).Methods Gene chip was used to detect the expression level of circRNA during the chondrogenic differentiation of human adipose-de-rived stem cells(hADSC).The circAZIN1 was further screened through the chondrocyte inflammation model constructed with interleukin-β(IL-β)and tumor necrosis factor-α(TNF-α)from the top 10 circRNAs with the most differentiated expression detected by gene chip.Real-time fluorescence quantitative polymerase chain re-action PCR(qPCR)was used to detect the effect of circAZIN1 overexpression(transfected with pcDNA3.1-circAZIN1-EF1-ZsGreen plasmid)on the metabolism of chondrocyte extracellular matrix(ECM).RNA-Pull down test was conducted to detect the protein bound by circAZIN1,miRNA-circRNA Interactions predicted the microRNAs(miRNAs)and their sites that circAZIN1 may be sponge-adsorbed,further TargetMiner,miRDB and TargetScan databases were applied to predict miRNAs which circAZIN1 may sponge-adsorbed.circAZIN1,miRNA and downstream mRNA were detected to find whether there was mirror regulation phe-nomenon after overexpression of miRNA.Results CircAZIN1 had the most significant differential expression during the chondrogenic differentiation of hADSC(day 3 and day 21)and in the chondrocyty inflammation model constructed by IL-β,TNF-α(day 3 group vs.day 21 group,the conttrol group vs.the IL-β group,the control group vs.the TNF-α group).Overexpression of circAZIN1 could promote the ECM synthesis in chon-drocytes and inhibit its decomposition.RNA-Pull down test result showed that circAZIN1 obviously bound AGO2 protein,suggesting that circAZIN1 had a high possibility of sponge adsorbing miRNAs.Further data-base predicted that its downstream was hsa-miR-654-3p,and the downstream mRNA of hsa-miR-654-3p was CACNA1I.After the overexpression of hsa-miR-654-3p,qPCR test found that circAZIN1,hsa-miR-654-3p and CACNA1I had a mirror image regulation phenomenon.Conclusion circAZIN1 inhibits the silencing effect of CACNA1I through sponge adsorption of hsa-miR-654-3p and thus plays a role in inhibiting chondrocyte de-generation,which provides a reference for the study of the regulatory mechanism of circRNA in the develop-ment of OA.

Objective: To conduct a systematic review and meta-analysis of studies evaluating the oncological and fertility outcomes of early-stage endometrial cancer (EC) treated with the levonorgestrel-releasing intrauterine system (LIUS)-based regimens. Methods: The Meta-analyses Of Observational Studies in Epidemiology statement for meta-analyses was followed. Searches were conducted on MEDLINE, Embase, PubMed, Preprints, and the Cochrane Central Register of Controlled Trials from January 1990 to August 4, 2022. The Joanna Briggs Institute Critical Appraisal Checklist was used for quality assessment. The primary endpoint was the complete response (CR) rate and the secondary endpoints were relapse, pregnancy, and live birth rate. Results: A total of 25 studies (821 women) were included. The CR rate of LIUS-based regimens was 63.4% (95% confidence interval [CI]=52.3%–73.2%), with 29.6% (95% CI=23.3%–36.8%) of cases experiencing recurrence during follow-up. In sensitivity analyses, patients younger than 45 years of age with a body mass index <30 kg/m2 who were treated with LIUS-based regimens achieved a high CR rate of 84.6% (95% CI=80.3%–88.1%) over a median follow-up of more than 24 months. Overall pregnancy and live birth rates were 37.9% (95% CI=24.1%–53.9%) and 39.3% (95% CI=24.0%–57.0%), respectively. No statistical differences were apparent in CR or relapse rates among the LIUS+GnRH agonist, LIUS+oral progesterone, or hysteroscopic resection followed by LIUS subgroups. Conclusion LIUS-based therapies are viable for the conservative management of early-stage endometrioid EC on CR and fertility outcome.

Rabdosia serra(R.serra),an important component of Chinese herbal tea,has traditionally been used to treat hepatitis,jaundice,cholecystitis,and colitis.However,the chemical composition of R.serra and its effect against colitis remain unclear.In this study,the chemical composition of the water extract of R.serra was analyzed using ultra performance liquid chromatography coupled with a hybrid linear ion trap quadrupole-orbitrap mass spectrometer(UPLC-LTQ-Orbitrap-MS).A total of 46 compounds,comprising ent-kaurane diterpenoids,flavonoids,phenolic acids,and steroids,were identified in the water extract of R.serra,and the extract could significantly alleviate dextran sulfate sodium salt-induced colitis by improving colon length,upregulating anti-inflammatory factors,downregulating proinflammatory fac-tors,and restoring the balance of T helper 17/T regulatory cells.R.serra also preserved intestinal barrier function by increasing the level of tight junction proteins(zonula occludens 1 and occludin)in mouse colonic tissue.In addition,R.serra modulated the gut microbiota composition by increasing bacterial richness and diversity,increasing the abundance of beneficial bacteria(Muribaculaceae,Bacteroides,Lactobacillus,and Prevotellaceae_UCG-O01),and decreasing the abundance of pathogenic bacteria(Turi-cibacter,Eubacterium_fissicatena_group,and Eubacterium_xylanophilum_group).Gut microbiota depletion by antibiotics further confirmed that R.serra alleviated colitis in a microbiota-dependent manner.Overall,our findings provide chemical and biological evidence for the potential application of R.serra in the management of colitis.

Objective:To investigate the impact of uterine volume prior to fresh embryo transfer on reproductive outcomes in infertile patients with adenomyosis.Methods:A retrospective cohort study was conducted for the clinical data of patients diagnosed with adenomyosis and aged ≤40 years undergoing in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) with ultra-long downregulation stimulation protocol in Center for Reproductive Medicine, Department of Obstetrics and Gynecology of Peking University Third Hospital between January 2009 and December 2018. Logistic regression model was used to analyze the correlation between uterine volume and clinical outcomes. Study subjects were divided into three groups based on uterine volume before embryo transfer: group A 56-90 cm 3 (equivalent to uterine size within 6 weeks of pregnancy); group B 90-130 cm 3 (equivalent to 6-8 weeks gestation); group C ≥130 cm 3 (equivalent to uterine size greater than 8 weeks gestation), the effect of uterine volume on clinical outcomes was compared. Results:Totally 232 patients were included, 153 patients in group A, 52 patients in group B, 27 patients in group C. The data showed no statistical difference among the three groups in basic characteristics ( P>0.05). There was no significant difference in clinical pregnancy rate among three groups ( P>0.05). The incidence of miscarriage among three groups were significantly different [group A, 24.59% (15/61); group B, 64.71% (11/17); group C, 55.56% (5/9), P=0.018]. Compared with group A [30.07% (46/153)], the live birth rate of group B [11.54% (6/52)] was significantly reduced ( P=0.009). Logistic regression analysis showed that uterine volume before ET was not related to clinical pregnancy rate ( OR=0.762, 95% CI=0.481-1.208, P=0.248), and was positively related to miscarriage rate ( OR=2.822, 95% CI=1.165-6.835, P=0.022) while negatively correlated with live birth rate ( OR=0.458, 95% CI=0.238-0.881, P=0.019). Conclusion:An increased level of uterine volume prior to embryo transfer (especially larger than 90 cm 3) increases miscarriage rate and reduces the live birth rate in infertile patients with adenomyosis. Therefore, controlling uterine volume is still a key to improve the clinical outcome of IVF-ET in adenomyosis patients.

Objective:To investigate the impact of uterine volume prior to fresh embryo transfer on reproductive outcomes in infertile patients with adenomyosis.Methods:A retrospective cohort study was conducted for the clinical data of patients diagnosed with adenomyosis and aged ≤40 years undergoing in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) with ultra-long downregulation stimulation protocol in Center for Reproductive Medicine, Department of Obstetrics and Gynecology of Peking University Third Hospital between January 2009 and December 2018. Logistic regression model was used to analyze the correlation between uterine volume and clinical outcomes. Study subjects were divided into three groups based on uterine volume before embryo transfer: group A 56-90 cm 3 (equivalent to uterine size within 6 weeks of pregnancy); group B 90-130 cm 3 (equivalent to 6-8 weeks gestation); group C ≥130 cm 3 (equivalent to uterine size greater than 8 weeks gestation), the effect of uterine volume on clinical outcomes was compared. Results:Totally 232 patients were included, 153 patients in group A, 52 patients in group B, 27 patients in group C. The data showed no statistical difference among the three groups in basic characteristics ( P>0.05). There was no significant difference in clinical pregnancy rate among three groups ( P>0.05). The incidence of miscarriage among three groups were significantly different [group A, 24.59% (15/61); group B, 64.71% (11/17); group C, 55.56% (5/9), P=0.018]. Compared with group A [30.07% (46/153)], the live birth rate of group B [11.54% (6/52)] was significantly reduced ( P=0.009). Logistic regression analysis showed that uterine volume before ET was not related to clinical pregnancy rate ( OR=0.762, 95% CI=0.481-1.208, P=0.248), and was positively related to miscarriage rate ( OR=2.822, 95% CI=1.165-6.835, P=0.022) while negatively correlated with live birth rate ( OR=0.458, 95% CI=0.238-0.881, P=0.019). Conclusion:An increased level of uterine volume prior to embryo transfer (especially larger than 90 cm 3) increases miscarriage rate and reduces the live birth rate in infertile patients with adenomyosis. Therefore, controlling uterine volume is still a key to improve the clinical outcome of IVF-ET in adenomyosis patients.

Objective:The extensive development of anatomical pulnonary segmentectomy requires thoracic surgeons to be familiar with the anatomical variations of the lung segment. The purpose of this study is to analyze the anatomical patterns of the right upper lobe lung segment using three-dimensional reconstruction, and to count rare variant types.Methods:From October 2017 to March 2020, 101 patients with small pulmonary nodules who were undergo segmental resection in our center were subjected to preoperative three-dimensional reconstruction of the lung structure, and the reconstruction data was retained for the statistics and analysis of the anatomical structure in the right upper lung lobe.Results:The right upper lobe bronchus is the most common with three branches(77/101), followed by two branches(16/101) and four branches(7/101). The two branches(70/101) of the right upper lobe pulmonary artery are the most common, followed by single branch(19/101) and three branches(11/101). In rare cases, four branches(1/101 cases) can be seen. The two branches(63/101) of the right upper pulmonary vein were the most common, followed by three branches(32/101) and single branch(6/101). In addition, a total of 12 rare mutations were counted. There were 2 variants in the bronchus, totaling 2 cases; 4 rare variants in the pulmonary artery, 13 cases total; 6 rare variants in the pulmonary vein, 10 cases total.Conclusion:The lung anatomy is complex and has many variations. The surgeon should fully grasp the anatomical structure of the lung segment of the patient's operating area before surgery, the data in this article will be a valuable reference for thoracic surgeons to carry out the upper right lobe segmentectomy.