1.Differences in deltamethrin resistance and kdr gene mutation in Culex tritaeniorhynchus population in and outside the Yellow Sea wetland
Xiao-er ZHANG ; Zhi-ming WU ; Ye TIAN ; Qian CUI ; Yu-qian JI ; Huan WANG ; Shu-juan YANG ; Yi-chao ZHAO ; Yu WANG ; Hua-yu YIN ; Yu DING ; Guo-jin YAN ; Min-sen ZHAO ; Shou-gang ZHANG ; Bing-dong SONG ; Hong-na CHEN ; Jian GAO ; Wei-fang YANG ; Yu-fu ZHANG ; Hui LIU ; Hong-liang CHU
Acta Parasitologica et Medica Entomologica Sinica 2026;33(2):101-107
Objective To gain insights into the biological characteristics of different populations of Culex tritaeniorhynchus within and around the Yellow Sea wetland from the perspective of the occurrence of resistance, we investigated the levels of resistance to deltamethrin and kdr gene mutation in the wetland and its peripheral areas. Methods Specimens were collected from Cx. tritaeniorhynchus populations at two monitoring sites in the Rare Bird National Nature Reserve and Tiaozi Ni Wetland Scenic Area, and also from two populations in Yancheng City and the Liuhe District of Nanjing, and the resistance of these mosquitoes to deltamethrin was determined using the CDC biotest bottle method. For each concentration of deltamethrin assessed, a random subset of exposed specimens was selected for amplification of the kdr gene fragment, followed by Sanger sequencing to identify and analyze resistance-associated mutations. Results The LC50 levels of deltamethrin among mosquitoes from the four populations in Luhe, Yancheng, the Rare Bird National Nature Reserve and the Tiaozi Ni Wetland Scenic Area were 2.048 5, 7.798 2, 3.473 3, and 17.695 5 mg/mL, respectively, with corresponding concentrations of deltamethrin ranging from 0.005 to 5.000,0.050 to 50.000,0.050 to 25.000 and 0.050 to 50.000 mg/mL, respectively. Furthermore, the ranges of the KT50 values were 11.76-107.43, 67.05-216.30,29.77-107.43 and 28.40-329.51 min; the 1-h knockdown rates were 34.58%-99.15%, 9.52%-43.80%, 55.09%-73.01%, and 10.09%-68.07%; and the 24-h mortality rates were 12.15%-67.52%,9.52%-79.56%,13.17%-82.21%, and 11.01%-78.99%, respectively. With respect to kdr gene mutation, we assayed a total of 63,70,59, and 57 mosquitoes for the four populations, for which we detected L1014F mutation frequencies of 14.29%, 35.00%, 20.34%, and 31.58%, respectively, with a majority of these mutations being heterozygous for resistance. In addition, five adult mosquitoes were identified has having synonymous mutations at site 1011[i. e. , AAT(asparagine)mutation to AAC(asparagine)]. Conclusions Our findings revealed the clear resistance of Cx. tritaeniorhynchus to deltamethrin in the Yancheng region of the Yellow Sea wetland, and the resistance phenotype and kdr frequency of Cx. tritaeniorhynchus in the wetland environment were comparable to those of Cx. tritaeniorhynchus in the wetland environment, thereby indicating that the resistance of different populations of Cx. tritaeniorhynchus was homogeneous under the pressure of different insecticide selection within and around the wetland. However, the underlying mechanisms need to be further studied.
2.Transcranial Focused Ultrasound Stimulation of the Primary Somatosensory Cortex Evokes Hand Tactile Perception: The Effect of Sonication Duration
Xu-Xu CHEN ; Huan-Jun XI ; Zhen LIANG ; Bo WANG ; Xu-Dong ZHAO
Progress in Biochemistry and Biophysics 2026;53(7):1942-1952
ObjectiveTranscranial focused ultrasound (tFUS) has emerged as a promising noninvasive neuromodulation technique capable of modulating neural activity with high spatial specificity. However, whether tFUS stimulation of the primary somatosensory cortex (S1) can reliably evoke conscious tactile perception without external peripheral sensory input remains unclear. Therefore, this study examined the feasibility of inducing hand-related tactile perception through targeted S1 stimulation and further investigated how sonication duration (SD), a key temporal parameter, influences the consistency of this perceptual response. The findings may provide empirical evidence for optimizing tFUS parameters in human somatosensory modulation. MethodsForty-eight healthy adults participated in the study and were assigned to two experiments. Experiment 1 included 24 participants and was designed to preliminarily examine whether S1-targeted tFUS could evoke hand-related tactile sensations. This experiment comprised two sub-experiments, Experiment 1a and Experiment 1b, with 12 participants in each. Specifically, Experiment 1a used a randomized active stimulation protocol targeting the bilateral S1 to assess the initial feasibility of inducing contralateral tactile perception, whereas Experiment 1b employed an alternating hemispheric design incorporating both active and sham stimulation to verify the specificity of the tFUS-induced sensations. Experiment 2 enrolled another 24 participants and used a real-sham dual-probe design to control for spatial tactile cues that might arise from probe-scalp contact. Five SD levels, including 200, 400, 600, 800, and 1 000 ms, were systematically tested to evaluate how stimulation duration influenced the behavioral response. The primary behavioral outcome was the perceptual consistency rate, quantified according to the accuracy of contralateral tactile localization. ResultsIn Experiment 1, 91.7% of participants reported reliable hand-related tactile sensations during active tFUS stimulation, including numbness, tingling, or similar sensory experiences. Contralateral localization accuracy under active stimulation was significantly higher than the0.50 chance level (P<0.05). In contrast, localization performance under sham stimulation did not differ from chance, suggesting that the observed tactile responses were mainly induced by active S1-targeted tFUS stimulation rather than nonspecific stimulation cues. In Experiment 2, perceptual consistency rates significantly exceeded the chance level under the 400 and 1 000 ms SD conditions(P<0.05), whereas no significant effect was observed at 200, 600, or 800 ms. Pairwise comparisons further showed that the 400 and 1 000 ms conditions produced significantly higher perceptual consistency rates than the 200 ms condition (P<0.05). ConclusiontFUS stimulation of S1 can elicit distinct hand-related tactile sensations without peripheral sensory input, demonstrating the feasibility of using targeted cortical ultrasound stimulation to induce conscious somatosensory perception. The reliability of this perceptual effect was modulated by sonication duration, indicating that temporal stimulation parameters play an important role in shaping both the occurrence and consistency of behavioral responses. Among the tested conditions, 400 ms appeared to provide a favorable temporal window for generating stable tactile perception, whereas excessively short stimulation may be insufficient to produce consistent responses. These findings highlight the sensitivity of somatosensory networks to ultrasonic modulation and provide useful parameter guidance for the application of tFUS in noninvasive sensory enhancement and cortical functional mapping.
3.Mechanism of Shengxian Yixin Granule (升陷益心颗粒) in the Treatment of Heart Failure with Preserved Ejection Fraction Based on Macrophage-Mediated Inflammatory Response
Zhengwei DONG ; Rui YU ; Qiaozhi LI ; Huan ZHAO ; Jingjing WEI ; Genhao FAN ; Xinlu WANG ; He WANG ; Yongxia WANG ; Mingjun ZHU
Journal of Traditional Chinese Medicine 2026;67(19):2086-2094
ObjectiveTo investigate the effect and mechanism of Shengxian Yixin Granule (升陷益心颗粒, SYG) in treating heart failure with preserved ejection fraction (HFpEF). MethodsExperiment 1: Forty male C57BL/6 mice were randomly divided into control group, model group, low-dose [25 mg/(kg·d)], medium-dose [50 mg/(kg·d)], and high-dose [(75 mg/(kg·d)] SYG groups, with 8 mice per group. Except for the control group, HFpEF was induced by a high-fat diet combined with Nω-nitro-L-arginine methyl ester in drinking water for 16 weeks. After 10 weeks of modeling, treatment groups received corresponding doses of SYG by gavage, while the control group and model group received equal volume of normal saline, for 6 weeks. After 6 weeks of administration, the body weight, blood pressure including systolic blood pressure (SBP) and diastolic blood pressure (DBP), and heart weight-to-tibia length ratio (HW/TL) were recorded. Echocardiography was used to evaluate left ventricular ejection fraction (LVEF) and the ratio of early to late diastolic transmitral flow velocity (E/A). Plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) and C-reactive protein (CRP) levels were measured by ELISA. The expression level of brain natriuretic peptide (BNP) in heart tissue was detected by qRT-PCR. Blood lipid levels, including low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), and total cholesterol (TC), were determined by a biochemical analyzer. Splenic proportions of M1 macrophages, M2 macrophages, T helper 17 (Th17) cells, and regulatory T (Treg) cells were analyzed by flow cytometry. Experiment 2: RAW 264.7 cells were stimulated with lipopolysaccharide (LPS) to establish an M1 macrophage polarization model, and then treated with SYG-containing serum for 24 h. The cells were divided into four groups, including blank serum group, high-dose SYG-containing serum group, LPS group, and LPS plus high-dose SYG-containing serum group. Combined with asignal transducer and activator of transcription 3 (Stat3) inhibitor for 24 h, the cells were divided into a lipopolysaccharide group, a high-dose SYG-containing serum group, an inhibitor group, and high-dose SYG-containing serum plus inhibitor group. The expression levels of inducible nitric oxide synthase (iNOS) and interleukin-1β (IL-1β) in each group were detected by qRT-PCR. The protein levels of iNOS, IL-1β, Stat3, and phosphorylated Stat3 (p-Stat3) were detected by Western Blotting. ResultsExperiment 1: Compared to the control group, the model group showed significantly decreased E/A ratio, and increased cardiac BNP expression, plasma NT-proBNP,HW/TL ratio, body weight, TC, LDL-C, SBP, and DBP, as well as shortened exhaustion distance and exhaustion time (P<0.05 or P<0.01). Compared to the model group, the E/A ratio increased in the low-, medium-, and high-dose SYG groups; cardiac BNP expression decreased in the low- and high-dose groups, and plasma NT-proBNP levels decreased in the high-dose group; the HW/TL ratio and body weight decreased, while exhaustion distance and exhaustion time increased in the medium- and high-dose groups; TG levels decreased in the low- and medium-dose groups, and LDL-C levels decreased in the medium- and high-dose groups; SBP and DBP decreased in the low-, medium-, and high-dose groups (P<0.05 or P<0.01). Compared to the low-dose SYG group, body weight decreased, and both exhaustion distance and exhaustion time increased in the medium- and high-dose groups (P<0.05 or P<0.01). Compared to the medium-dose SYG group, the exhaustion time increased in the high-dose SYG group (P<0.01). Experiment 2: In the LPS‑induced M1 macrophage polarization model, compared to the blank serum group, the LPS group showed significantly increased mRNA and protein expression of iNOS and IL‑1β, as well as the p‑Stat3/Stat3 ratio (P<0.01). Compared to the LPS group, the high‑dose SYG-containing serum plus LPS group showed significantly decreased mRNA and protein expression of iNOS and IL‑1β, as well as the p‑Stat3/Stat3 ratio (P<0.05 or P<0.01). Compared to the LPS group, the inhibitor group also showed significantly reduced these parameters (P<0.05 or P<0.01). ConclusionSYG can improve cardiac function, ventricular remodeling, exercise capacity, and lipid metabolism in HFpEF mice, while inhibiting inflammatory responses. Its mechanism may be related to the regulation of the Stat3 signaling pathway and inhibition of M1 macrophage polarization.
4.Mechanism of Shengxian Yixin Granule (升陷益心颗粒) in the Treatment of Heart Failure with Preserved Ejection Fraction Based on Macrophage-Mediated Inflammatory Response
Zhengwei DONG ; Rui YU ; Qiaozhi LI ; Huan ZHAO ; Jingjing WEI ; Genhao FAN ; Xinlu WANG ; He WANG ; Yongxia WANG ; Mingjun ZHU
Journal of Traditional Chinese Medicine 2026;67(19):2086-2094
ObjectiveTo investigate the effect and mechanism of Shengxian Yixin Granule (升陷益心颗粒, SYG) in treating heart failure with preserved ejection fraction (HFpEF). MethodsExperiment 1: Forty male C57BL/6 mice were randomly divided into control group, model group, low-dose [25 mg/(kg·d)], medium-dose [50 mg/(kg·d)], and high-dose [(75 mg/(kg·d)] SYG groups, with 8 mice per group. Except for the control group, HFpEF was induced by a high-fat diet combined with Nω-nitro-L-arginine methyl ester in drinking water for 16 weeks. After 10 weeks of modeling, treatment groups received corresponding doses of SYG by gavage, while the control group and model group received equal volume of normal saline, for 6 weeks. After 6 weeks of administration, the body weight, blood pressure including systolic blood pressure (SBP) and diastolic blood pressure (DBP), and heart weight-to-tibia length ratio (HW/TL) were recorded. Echocardiography was used to evaluate left ventricular ejection fraction (LVEF) and the ratio of early to late diastolic transmitral flow velocity (E/A). Plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) and C-reactive protein (CRP) levels were measured by ELISA. The expression level of brain natriuretic peptide (BNP) in heart tissue was detected by qRT-PCR. Blood lipid levels, including low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), and total cholesterol (TC), were determined by a biochemical analyzer. Splenic proportions of M1 macrophages, M2 macrophages, T helper 17 (Th17) cells, and regulatory T (Treg) cells were analyzed by flow cytometry. Experiment 2: RAW 264.7 cells were stimulated with lipopolysaccharide (LPS) to establish an M1 macrophage polarization model, and then treated with SYG-containing serum for 24 h. The cells were divided into four groups, including blank serum group, high-dose SYG-containing serum group, LPS group, and LPS plus high-dose SYG-containing serum group. Combined with asignal transducer and activator of transcription 3 (Stat3) inhibitor for 24 h, the cells were divided into a lipopolysaccharide group, a high-dose SYG-containing serum group, an inhibitor group, and high-dose SYG-containing serum plus inhibitor group. The expression levels of inducible nitric oxide synthase (iNOS) and interleukin-1β (IL-1β) in each group were detected by qRT-PCR. The protein levels of iNOS, IL-1β, Stat3, and phosphorylated Stat3 (p-Stat3) were detected by Western Blotting. ResultsExperiment 1: Compared to the control group, the model group showed significantly decreased E/A ratio, and increased cardiac BNP expression, plasma NT-proBNP,HW/TL ratio, body weight, TC, LDL-C, SBP, and DBP, as well as shortened exhaustion distance and exhaustion time (P<0.05 or P<0.01). Compared to the model group, the E/A ratio increased in the low-, medium-, and high-dose SYG groups; cardiac BNP expression decreased in the low- and high-dose groups, and plasma NT-proBNP levels decreased in the high-dose group; the HW/TL ratio and body weight decreased, while exhaustion distance and exhaustion time increased in the medium- and high-dose groups; TG levels decreased in the low- and medium-dose groups, and LDL-C levels decreased in the medium- and high-dose groups; SBP and DBP decreased in the low-, medium-, and high-dose groups (P<0.05 or P<0.01). Compared to the low-dose SYG group, body weight decreased, and both exhaustion distance and exhaustion time increased in the medium- and high-dose groups (P<0.05 or P<0.01). Compared to the medium-dose SYG group, the exhaustion time increased in the high-dose SYG group (P<0.01). Experiment 2: In the LPS‑induced M1 macrophage polarization model, compared to the blank serum group, the LPS group showed significantly increased mRNA and protein expression of iNOS and IL‑1β, as well as the p‑Stat3/Stat3 ratio (P<0.01). Compared to the LPS group, the high‑dose SYG-containing serum plus LPS group showed significantly decreased mRNA and protein expression of iNOS and IL‑1β, as well as the p‑Stat3/Stat3 ratio (P<0.05 or P<0.01). Compared to the LPS group, the inhibitor group also showed significantly reduced these parameters (P<0.05 or P<0.01). ConclusionSYG can improve cardiac function, ventricular remodeling, exercise capacity, and lipid metabolism in HFpEF mice, while inhibiting inflammatory responses. Its mechanism may be related to the regulation of the Stat3 signaling pathway and inhibition of M1 macrophage polarization.
5.Analysis of factors for international normalized ratio levels>3.0 in patients undergoing warfarin anticoagulation therapy after mechanical heart valve replacement
Shengmin ZHAO ; Bo FU ; Fengying ZHANG ; Weijie MA ; Shourui HUANG ; Qian LI ; Huan TAO ; Li DONG ; Jin CHEN
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(05):655-662
Objective To investigate the factors influencing international normalized ratio (INR)>3.0 in patients undergoing warfarin anticoagulation therapy after mechanical heart valve replacement. Methods A retrospective analysis was performed on the clinical data of patients who underwent mechanical heart valve replacement surgery and received warfarin anticoagulation therapy at West China Hospital of Sichuan University from January 1, 2011 to June 30, 2022. Based on the discharge INR values, patients were divided into two groups: an INR≤3.0 group and an INR>3.0 group. The factors associated with INR>3.0 at the time of discharge were analyzed. Results A total of 8901 patients were enrolled, including 3409 males and 5492 females, with a median age of 49.3 (43.5, 55.6) years. The gender, body mass index (BMI), New York Heart Association (NYHA) cardiac function grading, INR, glutamic oxaloacetic transaminase, and preoperative prothrombin time (PT) were statistically different between the two groups (P<0.05). Multivariate logistic regression analysis revealed that lower BMI, preoperative PT>15 s, and mitral valve replacement were independent risk factors for INR>3.0 at discharge (P<0.05). Conclusion BMI, preoperative PT, and surgical site are factors influencing INR>3.0 at discharge in patients undergoing warfarin anticoagulation therapy after mechanical heart valve replacement. Special attention should be given to patients with lower BMI, longer preoperative PT, and mitral valve replacement to avoid excessive anticoagulation therapy.
6.Serological detection of anti-Mur and the distribution of the Mur antigen among voluntary blood donors
Qunfeng SHU ; Ji ZHOU ; Huan ZHAO ; Dong LIU ; Dongju PENG ; Zhiping YANG ; Yingying TANG
Chinese Journal of Blood Transfusion 2025;38(10):1403-1407
Objective: To analyze the serological characteristics of anti-Mur antibodies and investigate the distribution frequency of the Mur antigen among voluntary blood donors in Shiyan, thereby providing a basis for guiding clinical transfusion and establishing a Mur blood type database. Methods: ABO blood grouping of donors and patients was performed using an automated blood typing analyzer and the gel card method, respectively. Unexpected antibody screening and identification were performed using the saline, tube anti-human globulin, and polybrene methods. The specificity of anti-Mur antibodies was confirmed using Fisher's exact probability test. Plasma treated with 2-mercaptoethanol was used to distinguish IgM and IgG antibodies. IgM and IgG anti-Mur titers were determined by the saline tube method and the anti-human globulin tube method, respectively, at 4℃, room temperature, and 37℃. A total of 1 659 donor red blood cell samples were initially screened for the Mur antigen phenotype using three samples of human-derived anti-Mur plasma by the micro-tube method. Donors who tested positive for Mur antigen were further tested by the direct antiglobulin test (DAT); those with negative results were confirmed for Mur antigen by the gel card and polybrene methods. Results: Three blood samples were identified to contain mixed IgG and IgM anti-Mur antibodies. The titers of both IgM and IgG anti-Mur antibodies were highest at 4℃, intermediate at room temperature, and lowest at 37℃. The positive frequency of the Mur antigen among voluntary blood donors in Shiyan was 1.99% (33/1 659). Conclusion: anti-Mur antibodies were detected in both blood donors and patients in our region. The Mur antigen shows a certain distribution frequency among voluntary blood donors in Shiyan. Screening for the Mur blood type and establishing a corresponding database could enhance transfusion safety.
7.Application Progress of Lipidomics in Diabetic Nephropathy
Zhengwei DONG ; Kang YANG ; Yubo LI ; Huan ZHAO
World Science and Technology-Modernization of Traditional Chinese Medicine 2025;27(2):321-328
Diabetic nephropathy(DN)is a chronic complication that leads to the high mortality of diabetes mellitus(DM)patients.Many researchers are devoted to the diagnosis,etiology,process and molecular mechanism of treatment of DN.At present,the regulation of small molecular lipids on renal function and the role in the pathogenesis of DN are gradually becoming clear,and lipidomics has also become a powerful tool in DN research.DN is characterised by disorders of lipid metabolism,and lipidomics plays an important role in the characterisation of lipid metabolic profiles,diagnosis,mechanistic investigation and treatment of DN because of its unique relevance.But at the same time,the lipids in the body are complex,which brings great challenges to the detection and analysis of lipids.In the future,multidisciplinary crossover and multi-omics association is the direction of lipidomics breakthrough.This article outlines the progress of the application of lipidomics in DN research strategies,lipid metabolic profiling,early diagnosis,drug efficacy and mechanism exploration,and histological co-analysis,and further discusses the opportunities and challenges of the future application of lipidomics in DN,with the aim of providing a clear picture of the current status of the research and the prospects for researchers in the relevant directions.
8.Risk factors of bladder stones in patients with benign prostatic hyperplasia and development of a SHAP-based interpretable predictive model
Huan ZHAO ; Song OUYANG ; Hongchao DONG ; Qinzhang WANG
Journal of Modern Urology 2025;30(8):653-661
Objective To explore the independent risk factors of bladder stones(BS)in patients with benign prostatic hyperplasia(BPH),and to construct a predictive model and an easy-to-use website.Methods The clinical data of 460 BPH patients treated during Jan.2022 and Jan.2025 in the First Affiliated Hospital of Shihezi University were retrospectively analyzed.The independent risk factors of BS in the training set were identified with univariate logistic regression and the Boruta algorithm,based on which a nomogram was constructed.The predictive performance of the model was evaluated with receiver operating characteristic(ROC)curve,sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV),F1 index,calibration curve and clinical decision curve analysis(DCA).The contribution of different variables to BS was evaluated with SHapley Additive exPlanations(SHAP)algorithm.A web page was established.Results Among the 460 BPH patients,144(31.3%)had BS,and 6 independent risk factors were identified,including neutrophil level,urine culture results,intravesical prostatic protrusion(IPP),urine nitrite test results,urine leukocytes test results,and urine occult blood results.In the test set,the area under the ROC curve(AUC)was 0.887(95%CI:0.816-0.947),sensitivity 0.705,specificity 0.968,PPV 0.912,NPV 0.876,and F1 score 0.795.Calibration and DCA indicated good discrimination and clinical applicability.SHAP results showed that the risk factors mentioned above were the most important for concurrent BS.The resulting website(https://wutiaowu2.shinyapps.io/bladderrrr/)was publicly accessible.Conclusion The neutrophil level,urine culture results,IPP,urinary nitrite test results,urinary leukocytes test results,and urinary occult blood test results were identified as the independent risk factors of BPH complicated with BS.The model and website developed based on these factors demonstrate high usability and accuracy,possessing significant clinical value.
9.Application Progress of Lipidomics in Diabetic Nephropathy
Zhengwei DONG ; Kang YANG ; Yubo LI ; Huan ZHAO
World Science and Technology-Modernization of Traditional Chinese Medicine 2025;27(2):321-328
Diabetic nephropathy(DN)is a chronic complication that leads to the high mortality of diabetes mellitus(DM)patients.Many researchers are devoted to the diagnosis,etiology,process and molecular mechanism of treatment of DN.At present,the regulation of small molecular lipids on renal function and the role in the pathogenesis of DN are gradually becoming clear,and lipidomics has also become a powerful tool in DN research.DN is characterised by disorders of lipid metabolism,and lipidomics plays an important role in the characterisation of lipid metabolic profiles,diagnosis,mechanistic investigation and treatment of DN because of its unique relevance.But at the same time,the lipids in the body are complex,which brings great challenges to the detection and analysis of lipids.In the future,multidisciplinary crossover and multi-omics association is the direction of lipidomics breakthrough.This article outlines the progress of the application of lipidomics in DN research strategies,lipid metabolic profiling,early diagnosis,drug efficacy and mechanism exploration,and histological co-analysis,and further discusses the opportunities and challenges of the future application of lipidomics in DN,with the aim of providing a clear picture of the current status of the research and the prospects for researchers in the relevant directions.
10.Risk factors of bladder stones in patients with benign prostatic hyperplasia and development of a SHAP-based interpretable predictive model
Huan ZHAO ; Song OUYANG ; Hongchao DONG ; Qinzhang WANG
Journal of Modern Urology 2025;30(8):653-661
Objective To explore the independent risk factors of bladder stones(BS)in patients with benign prostatic hyperplasia(BPH),and to construct a predictive model and an easy-to-use website.Methods The clinical data of 460 BPH patients treated during Jan.2022 and Jan.2025 in the First Affiliated Hospital of Shihezi University were retrospectively analyzed.The independent risk factors of BS in the training set were identified with univariate logistic regression and the Boruta algorithm,based on which a nomogram was constructed.The predictive performance of the model was evaluated with receiver operating characteristic(ROC)curve,sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV),F1 index,calibration curve and clinical decision curve analysis(DCA).The contribution of different variables to BS was evaluated with SHapley Additive exPlanations(SHAP)algorithm.A web page was established.Results Among the 460 BPH patients,144(31.3%)had BS,and 6 independent risk factors were identified,including neutrophil level,urine culture results,intravesical prostatic protrusion(IPP),urine nitrite test results,urine leukocytes test results,and urine occult blood results.In the test set,the area under the ROC curve(AUC)was 0.887(95%CI:0.816-0.947),sensitivity 0.705,specificity 0.968,PPV 0.912,NPV 0.876,and F1 score 0.795.Calibration and DCA indicated good discrimination and clinical applicability.SHAP results showed that the risk factors mentioned above were the most important for concurrent BS.The resulting website(https://wutiaowu2.shinyapps.io/bladderrrr/)was publicly accessible.Conclusion The neutrophil level,urine culture results,IPP,urinary nitrite test results,urinary leukocytes test results,and urinary occult blood test results were identified as the independent risk factors of BPH complicated with BS.The model and website developed based on these factors demonstrate high usability and accuracy,possessing significant clinical value.


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