Objective:To construct a predictive model for postoperative delirium (POD) in patients undergoing gastrointestinal surgery using machine learning.Methods:This retrospective study used clinical data from patients who underwent gastrointestinal surgery at Subei People′s Hospital between September 2022 and April 2024. The entire dataset was randomly divided into the training and validation sets in an 8∶2 ratio. Multivariate logistic regression analysis was conducted to identify the factors influencing POD. Eleven machine learning models were established and compared. The performance of the models was validated using metrics, including accuracy, precision, recall, Youden′s index, F1 score, Matthews′ correlation coefficient, Kappa coefficient, log loss, and Brier score. Receiver operating characteristic and calibration curves were plotted to assess the discrimination and consistency of the model. Shapley additive explanations were used in Python for interpretative analysis of the model with the best predictive performance, and the importance of the feature parameters was ranked.Results:A total of 1, 785 patients were ultimately included, of which 833 (46.67%) experienced POD. The results of multivariate logistic regression analysis revealed that advanced age, lower preoperative serum calcium ion concentration, postoperative pulmonary infection, and higher preoperative systolic blood pressure were independent risk factors for POD in patients undergoing gastrointestinal surgery, while laparoscopic surgery was a protective factor ( P<0.05). Among the 11 machine learning models, the categorical feature gradient boosting model exhibited the best performance, with an area under the receiver operating characteristic curve of 0.82 (95% confidence interval 0.77-0.87). The ranking of feature importance indicated that age had the greatest contribution in predicting POD. Conclusions:The predictive model for POD established based on the categorical boosting algorithm has higher predictive efficacy and clinical application value in patients undergoing gastrointestinal surgery.

Objective:To construct a predictive model for postoperative delirium (POD) in patients undergoing gastrointestinal surgery using machine learning.Methods:This retrospective study used clinical data from patients who underwent gastrointestinal surgery at Subei People′s Hospital between September 2022 and April 2024. The entire dataset was randomly divided into the training and validation sets in an 8∶2 ratio. Multivariate logistic regression analysis was conducted to identify the factors influencing POD. Eleven machine learning models were established and compared. The performance of the models was validated using metrics, including accuracy, precision, recall, Youden′s index, F1 score, Matthews′ correlation coefficient, Kappa coefficient, log loss, and Brier score. Receiver operating characteristic and calibration curves were plotted to assess the discrimination and consistency of the model. Shapley additive explanations were used in Python for interpretative analysis of the model with the best predictive performance, and the importance of the feature parameters was ranked.Results:A total of 1, 785 patients were ultimately included, of which 833 (46.67%) experienced POD. The results of multivariate logistic regression analysis revealed that advanced age, lower preoperative serum calcium ion concentration, postoperative pulmonary infection, and higher preoperative systolic blood pressure were independent risk factors for POD in patients undergoing gastrointestinal surgery, while laparoscopic surgery was a protective factor ( P<0.05). Among the 11 machine learning models, the categorical feature gradient boosting model exhibited the best performance, with an area under the receiver operating characteristic curve of 0.82 (95% confidence interval 0.77-0.87). The ranking of feature importance indicated that age had the greatest contribution in predicting POD. Conclusions:The predictive model for POD established based on the categorical boosting algorithm has higher predictive efficacy and clinical application value in patients undergoing gastrointestinal surgery.

OBJECTIVE To analyze the chemical constituents from classical prescription Xiehuang San(XHS)standard decoc-tion by UPLC-Q-TOF-MS technology,and classify the chemical composition and analyze the representative components.METHODS Acquity HSS T3 column(2.1 mm×100 mm,1.8 μm)was used as the chromatographic column,with 0.1%formic acid solution-0.1%formic acid acetonitrile as the mobile phase for gradient elution.The volume flow rate was 0.4 mL·min-1 and the column tem-perature was 40℃.Mass spectrometry data of XHS were collected in positive and negative ion modes.The chemical constituents from classical prescription XHS were analyzed and identified by Masslynx 4.1 software comparison with reference materials,mass spectrome-try data analysis and reference to relevant literature.RESULTS A total of 107 compounds were analyzed and identified from XHS,including 45 flavonoids,27 triterpenoids,11 monoterpenoids,10 phenylpropanoids,6 chromogenic ketones,5 alkaloids and 3 other other compounds.CONCLUSION The study provides an experimental basis for the further research on the substance basis and qual-ity control of XHS.

OBJECTIVE To study the intervention effect and mechanism of Zhongfeng yure decoction on ischemic stroke model rats. METHODS Totally 85 rats were randomly divided into sham operation group （normal saline， n＝15）， model control group （normal saline， n＝18）， Nimodipine tablet group （positive control， 10.8 mg/kg， n＝18）， high-dose group of Zhongfeng yure decoction （20.52 g/kg， n＝17） and low-dose group of Zhongfeng yure decoction （5.13 g/kg， n＝17）， respectively. After 7 days of preventive continuous administration （once a day）， except for the sham operation group， the rats’ middle cerebral artery occlusion （MCAO） model was established by the modified suture method in other groups. After modeling， the rats in each group continued to be administered for 3 days. During experiment， general condition of the rats was observed， and the neurological function score was performed. After the last administration， the organ index was calculated， the cerebral infarction area and pathological changes of brain tissue were observed. The levels of tumor necrosis factor-α （TNF-α） and interleukin 6 （IL-6） in brain tissue and serum， and the average optical density value of caspase-3 and phosphorylated protein kinase B（p-AKT） protein in brain tissue were detected. RESULTS Three days after modeling， compared with sham operation group， the neurological function score， in brain tissue index， spleen tissue index， proportion of cerebral infarction area， the levels of TNF-α and IL-6 in brain tissue and serum， and the average optical density value of caspase-3 protein in brain tissue were significantly increased in the model control group （P＜0.05 or P＜0.01）； karyopyknosis， diffuse edema and other lesions appeared in brain tissue. Compared with the model control group， the above indexes in each administration group were improved to varying degrees. Among them， there were significant regression in brain tissue index， spleen tissue index， proportion of cerebral infarction area， TNF-α level in brain tissue and serum， and the average optical density values of caspase-3 protein and p-AKT protein in brain tissue of rats in high-dose group of Zhongfeng yure decoction （P＜0.05 or P＜0.01）. CONCLUSIONS Zhongfeng yure decoction has a certain intervention and therapeutic effect on MCAO model rats. The mechanism may be to reduce the secretion of inflammatory factors TNF-α and IL-6， down-regulate the expression of caspase-3 protein in ischemic brain tissue， up-regulate the expression of p-AKT protein， so as to protect the neurons.

Objective To investigate the safety and efficacy of the conservative laparoscopic operation in treatment of tubal pregnancy by drug water pressure embryo separation. Method 58 cases with tubal pregnancy without rup-ture, the first focus on internal injection of MTX dilution 5 ml to 3 ml, and then to the near corner of the uterus in-jection of 3 ml MTX dilution, and then the line to retain the fallopian tube laparoscopic embryo removal. Results After 2 weeks, the blood β-HCG was monitored, and the average follow-up was 18 months. There was no persistent ectopic pregnancy, the fallopian tube was unobstructed, 22 cases were married of 16 cases (72.73 %) in the in-trauterine pregnancy. Conclusion Separation of ectopic pregnancy and proximal tubal MTX injection method laparo-scopic conservative surgery in the treatment of fallopian tube pregnancy by methotrexate (MTX) dilution water pres-sure, curative effect is exact, retained the fallopian tube of the normal anatomy and physiological function treatment of tubal pregnancy is safe and effective method.

OBJECTIVETo detect pharmacokinetics of Danshensu Sodium in Danshen dripping solution in Beagles.

METHODDanshen dripping solution was dripped intravenously into healthy Beagles at a dose of 10 mL x kg(-1). Their plasma samples were extracted with acetic ether, the blood concentrations were determined by HPLC method.

RESULTDanshensu Sodium showed a good linear relationship within the range of 0.225-18.000 mg x L(-1), with the lowest detectable limit of 0.113 mg x L(-1). Its pharmacokinetic parameters were as follows: tmax was 30 min, Cmax was (9.5742 +/- 2.3715) mg x L(-1), t1/2 was (19.23 +/- 2.97) min, CL was (0.0127 +/- 0.0030) L x min(-1) x kg(-1), AUC(0-tn) was (474.954 +/- 95.483) mg x min x L(-1) and AUC(0-infinity) was (482.494 +/- 95.353) mg x min x L(-1).

CONCLUSIONThe accurate, stable and reliable blood concentration method shows a one-compartment mode of Danshensu Sodium in Beagles.

Animals ; Chromatography, High Pressure Liquid ; Dogs ; Drug Stability ; Drugs, Chinese Herbal ; pharmacokinetics ; Female ; Lactates ; pharmacokinetics ; Male ; Solutions

OBJECTIVETo study dynamic change of total ginkgolic acids in Ginkgo biloba leaves of the different aged trees and different collecting seasons.

METHODThe content of total ginkgolic acids in G. biloba leaves was determined by HPLC. A Alltima C18 (4.6 mm x 250 mm, 5 microm) and the mobile phase of methanol and 1% acetic acid (90:10) were used, the flow rate was 1.0 mL x min(-1), and the wavelength was 310 nm. The content were calculated with external standard method.

RESULTThe content of total ginkgolic acids in G. biloba leaves was in the range of 0.48% to 2.51% in different collecting seasons. The content reached maximum at the end of May and the beginning of June, and then declined gradually. In different aged trees, the content in the older ages was lower than that in the younger ages.

CONCLUSIONThe results provide scientific basis for the collecting season of G. biloba leaves.

Chromatography, High Pressure Liquid ; Ginkgo biloba ; growth & development ; metabolism ; Linear Models ; Plant Leaves ; growth & development ; metabolism ; Reproducibility of Results ; Salicylates ; metabolism ; Seasons ; Sensitivity and Specificity ; Trees ; growth & development ; metabolism

Object To define suitable gathering season of Ginkgo biloba L. leaves. Methods The content of total flavonoids and total terpene lactones in G. biloba leaves were determined by HPLC DAD and HPLC ELSD. Results The content of total flavonoids and total terpene lactones in G. biloba were distinct in different ages of tree and collecting seasons. Conclusion The content of total flavonoids and total terpene lactones in G. biloba are the highest in 2 3 ages of tree. The total flavonoid is the highest in May and total terpene lactone is the highest in September.