Objective:To develop an economical,simple,and accessible method for early identification of high-risk pregnant women with gestational diabetes mellitus(GDM),this study developed and evaluated multiple machine learning models,identified the optimal prediction model,and constructed a clinical decision support sys-tem(CDSS)based on this model.Methods:A total of 464 pregnant women who visited the Second Affiliated Hospital of Dalian Medical University from January 1,2023 to December 30,2024 were included,of which 386 were used to establish a prediction model(231 in the training set and 155 in the testing set),and the remaining 78 were used as a validation.Adopting the methods of double-point sequence correlation and chi-square test,four machine learning models were constructed after selecting feature variables:Logistic Regression,Random Forest,Support Vector Machine,and eXtreme Gradient Boosting(XGBoost).Preliminary judgment of the maximum weight mod-el,further comparison of the discriminative ability,calibration ability,and clinical practicality of each model to evalu-ate and select the optimal model,develop its CDSS,and verify the accuracy of the model.Results:①Correlation analysis identified predictors of GDM:age,pre-pregnancy body mass index(BMI),systolic/diastolic blood pres-sure,white blood cell count,hemoglobin,lymphocyte ratio,fasting plasma glucose,uric acid,direct bilirubin,chronic hypertension complicating pregnancy,and assisted reproductive technology conception.②XGBoost dominated the ensemble model and demonstrated the best performance in discrimination(AUC 0.931,95%CI 0.910-0.967),cali-bration,and clinical utility among the four models.③The CDSS achieved an accuracy of 78.2%,sensitivity of 64.7%,and specificity of 82.0%in the XGBoost model.Conclusions:The XGBoost model has the highest ability to predict GDM in the early stage.Developing its CDSS not only facilitates doctors to quickly assess GDM risk,but also is suitable for promotion to remote areas,where high-risk population screening can be achieved through re-mote data.

Objective:To develop an economical,simple,and accessible method for early identification of high-risk pregnant women with gestational diabetes mellitus(GDM),this study developed and evaluated multiple machine learning models,identified the optimal prediction model,and constructed a clinical decision support sys-tem(CDSS)based on this model.Methods:A total of 464 pregnant women who visited the Second Affiliated Hospital of Dalian Medical University from January 1,2023 to December 30,2024 were included,of which 386 were used to establish a prediction model(231 in the training set and 155 in the testing set),and the remaining 78 were used as a validation.Adopting the methods of double-point sequence correlation and chi-square test,four machine learning models were constructed after selecting feature variables:Logistic Regression,Random Forest,Support Vector Machine,and eXtreme Gradient Boosting(XGBoost).Preliminary judgment of the maximum weight mod-el,further comparison of the discriminative ability,calibration ability,and clinical practicality of each model to evalu-ate and select the optimal model,develop its CDSS,and verify the accuracy of the model.Results:①Correlation analysis identified predictors of GDM:age,pre-pregnancy body mass index(BMI),systolic/diastolic blood pres-sure,white blood cell count,hemoglobin,lymphocyte ratio,fasting plasma glucose,uric acid,direct bilirubin,chronic hypertension complicating pregnancy,and assisted reproductive technology conception.②XGBoost dominated the ensemble model and demonstrated the best performance in discrimination(AUC 0.931,95%CI 0.910-0.967),cali-bration,and clinical utility among the four models.③The CDSS achieved an accuracy of 78.2%,sensitivity of 64.7%,and specificity of 82.0%in the XGBoost model.Conclusions:The XGBoost model has the highest ability to predict GDM in the early stage.Developing its CDSS not only facilitates doctors to quickly assess GDM risk,but also is suitable for promotion to remote areas,where high-risk population screening can be achieved through re-mote data.

BACKGROUND:Numerous clinical studies have suggested a close relationship between obesity and osteoporosis,but whether there is a genetic causal effect between obesity and osteoporosis remains unclear. OBJECTIVE:To explore the association between obesity and osteoporosis using summary data from a large-scale genome-wide association study(GWAS)through Mendelian randomization analysis. METHODS:Obesity data were derived from summary statistics of the Genetic Investigation of Anthropometric Traits(GIANT)and the UK Biobank(UKBB).Osteoporosis data were obtained from the Genetic Factors for Osteoporosis(GeFOS)consortium,including two bone density phenotypes:total body bone mineral density(BMD)and heel BMD.The inverse variance-weighted method was the primary analysis,with the Mendelian randomization method based on Egger regression(MR-Egger)and weighted median method as supplementary approaches to calculate the causal association between genetic variations related to obesity and osteoporosis.Sensitivity analyses were conducted to validate the reliability of the results.Heterogeneity was assessed using Cochran's Q test.Horizontal pleiotropy was assessed through the MR-Egger intercept test.Leave-one-out analysis was performed to evaluate the potential influence of single nucleotide polymorphisms on the combined inverse variance-weighted estimates. RESULTS AND CONCLUSION:(1)Impact of obesity on osteoporosis:In addition to body mass index and forearm BMD,body mass index,waist-to-hip ratio,body mass index-adjusted waist-to-hip ratio,and whole-body body mass index,heel BMD,forearm BMD,lumbar spine BMD,and femoral neck BMD were causally related to each other.Further Meta-analysis revealed that obesity increased the risk of BMD(odds ratio=1.07,95%confidence interval:1.03-1.12,P<0.01).(2)Impact of osteoporosis on obesity:Apart from arm BMD and lumbar spine BMD as exposure factors showing causal relationships with obesity,other datasets indicated no causal effect between total body BMD,heel BMD,femoral neck BMD,and obesity.Additional meta-analysis demonstrated that BMD did not increase the risk of obesity(odds rate=0.99,95%confidence interval:0.98-1.01,P<0.01).There is a causal relationship between obesity and osteoporosis,suggesting that obesity may be a risk factor for osteoporosis.However,no causal association is found between osteoporosis and obesity.

[Objective]To summarize the results,value and advantages of demand-driven school dissemination of ancient books of traditional Chinese medicine.[Methods]By employing methods such as literature research and empirical studies,this paper,on the basis of reviewing the deficiencies in the current dissemination of ancient books,emphasizes the decisive value of the "demand" factor and further introduces practical measures for on-campus dissemination of ancient medical texts based on a demand-driven approach.These measures include the implantation of concepts,resolution of technical difficulties in reading ancient books,proactive integration with teaching and research,and platform construction.[Results]The supply-driven dissemination,which has a problem that there is a heat supply side and cold demand side,is relatively indifferent to the needs of elite groups.And its communication mode is ultimately inefficient.After the implementation of the demand-driven dissemination strategy for three years,the annual borrowing volume of medical literature among college students,the number and quality of research papers published by teachers and students sharp have increased.Therefore,the construction of the library's ancient books and related popular science platforms has reached a new level.[Conclusion]Through the case study of campus dissemination of ancient books in Zhejiang Chinese Medical University,explore the implementation of the demand-driven dissemination strategy,give the dissemination endogenous impetus,embodies its unique advantages,and effectively improves the communication efficiency.

[Objective]To summarize the results,value and advantages of demand-driven school dissemination of ancient books of traditional Chinese medicine.[Methods]By employing methods such as literature research and empirical studies,this paper,on the basis of reviewing the deficiencies in the current dissemination of ancient books,emphasizes the decisive value of the "demand" factor and further introduces practical measures for on-campus dissemination of ancient medical texts based on a demand-driven approach.These measures include the implantation of concepts,resolution of technical difficulties in reading ancient books,proactive integration with teaching and research,and platform construction.[Results]The supply-driven dissemination,which has a problem that there is a heat supply side and cold demand side,is relatively indifferent to the needs of elite groups.And its communication mode is ultimately inefficient.After the implementation of the demand-driven dissemination strategy for three years,the annual borrowing volume of medical literature among college students,the number and quality of research papers published by teachers and students sharp have increased.Therefore,the construction of the library's ancient books and related popular science platforms has reached a new level.[Conclusion]Through the case study of campus dissemination of ancient books in Zhejiang Chinese Medical University,explore the implementation of the demand-driven dissemination strategy,give the dissemination endogenous impetus,embodies its unique advantages,and effectively improves the communication efficiency.

Mycoplasma capricolum subsp. capripneumoniae (Mccp) is the cause of contagious caprine pleuropneumonia (CCPP) in goats. Inactivated vaccines and capsular polysaccharide (CPS) indirect hemagglutination reagents are available for prevention and serological detection, but high culture costs and complex antigen quantification have been plagued by production staff. In order to solve these problems in production practice, a sugar fermentation medium with an initial pH value of 7.8, which could improve the production of two antigens simultaneously, was screened out by changing the initial pH value based on previous Mccp metabolomics analysis. Since phenol red can be identified by UV absorption spectrum and cetyltrimethylammonium bromide (CTAB) can bind to anionic capsular polysaccharide, a UV spectrum measurement method for analyzing the culture stage reached by Mccp and a CTAB precipitation test for relative quantification of capsular polysaccharide antigen content in the fermentation broth were established. The UV spectrum observation method can guide the production of Mccp according to the growth curve of Mccp, which greatly reduces the monitoring time of the traditional CCU method and improves the accuracy of the original eye-observation method. The established CTAB precipitation test can complete the monitoring of CPS content within 5 hours, which greatly reduces the time required compared with the traditional differential technique, and its accuracy was verified by the phenol-sulfuric acid method. The optimized culture medium and the two correlation comparison methods established in this study can effectively reduce the production cost of Mccp and improve the production efficiency. The two assays have been used in the research at our laboratory, which provides experimental data for further improvement of the production process of CCPP inactivated vaccine and capsular polysaccharide as well as rapid quantification.
Humans ; Animals ; Goats ; Cetrimonium ; Mycoplasma ; Polysaccharides

OBJECTIVE To optimize the pr eparation technology of the baicalin lipid nano foam aerosol （BC-LN-FA）. METHODS Baicalin lipid nanoparticle （BC-LN）and BC-LN-FA were prepared by the thin film dispersion method and homogeneous emulsification method ，respectively，using baicalin （BC） as the model drug. The preparation technology was optimized by Box-Behnken design-response surface methodology using particle size and encapsulation efficiency （EE）as indexes ，with dosage ， emulsifier dosage ，co-emulsifier dosage and homogenization time as factors. The morphology ，particle size ，polymerdispersity index（PDI），EE，the viscosity ，the foam dissolution rate and in vitro transdermal release of BC-LN-FA were characterized. RESULTS The optimal technology included 25 mg BC ，40 mg emulsifier （mass ratio of stearic acid-soybean lecithin-glycerol was 1∶1∶1），30 mg co-emulsifier （mass ratio of octadecanol-lactic acid was 1∶1），homogenization time of 20 min. Results of 3 times of validation tests showed that particle size of prepared BC-LN-FA was （151.70±2.40）nm，EE was （68.62±1.16）％；the deviation of them from the predicted value （particle size of 150.80 nm，EE of 67.02％）were 0.60％ and 2.39％ respectively. The BC-LN-FA prepared by the optimal process was light yellow opalescence ，uniform in particle size and round-like in shape. The viscosity，the foam dissolution rate ，the content of BC and PDI were （122.92±5.09）mPa·s，（65.32±3.22）％，（7.01±0.12）％ and（0.199±0.006），respectively. At 48 h，the cumulative release rates of BC-LN-FA in phosphate buffer saline （PBS）at pH 7.4， 6.8，5.0 were（54.12±2.69）％，（57.85±4.25）％ and（59.47±1.83）％，respectively；those of free BC in PBS at pH 7.4 was only （15.04±1.43）％. CONCLUSIONS The optimized technology is stable and feasible. Prepared BC-LN-FA has a uniform particle size，high digestion rate and certain viscosity.

Objective To evaluate the effect of family doctor contracted service system in Shenzhen and explore the influencing factors for families to contract their family doctors. Methods A total of 480 residents were selected from 12 first-class community medical rehabilitation centers in Luohu, Futian and Nanshan districts of Shenzhen. The contents of the survey included the contracting status between the contracted and non-contracted residents, the utilization of four basic public health services, and the difference of satisfaction with community medical rehabilitation centers.Meanwhile, logistic regression was used to explore the important influencing factors of the contracted family doctors. Results The overall contracting rate of residents was 51.9% (248/478), and the lowest contracting rate was 23.1% (27/117) (P<0.05), found among patients under 40 years old.The utilization rate of contracted residents for growth and development examination, maternal health care as well as guidance of chronic disease prevention and treatment was higher than that of non-contracted residents ( P <0.05 ). fees and medical environment, service attitude,medical fees was higher than that of non-contracted residents(P<0.05).The satisfaction for convenience in medical environment, service attitude,medical fees and access to medical service was higher than that of non-contracted residents(P<0.05).The results of binary logistic regression analysis showed that age, education level, occupation ( retirement ) and chronic diseases were important factors affecting the signing of contracts.Conclusions The family doctors tend to be embraced by residents better than before. Family doctors contracted service system is conducive to improving the utilization rate of basic health services, acceptance rate of health services and satisfaction of residents. At the same time, the young population at large requires greater efforts before they can embrace the family doctor system.

OBJECTIVETo explore the differences in sensitivity to rapamycin of five esophageal squamous cell carcinoma cell lines with different differentiation and the changes of sensitivity of the cells after siRNA-interfered expression of p70S6K.

METHODSEffects of rapamycin on proliferation of ESCC cell lines with different differentiation, EC9706, TE-1, Eca109, KYSE790 and KYSE450 cells, were investigated using cell counting kit 8 (CCK-8) assay, and according to the above results, the EC9706 cells non-sensitive to rapamycin were chosen to be transfected with p70S6K-siRNA. The changes in sensitivity of cells to rapamycin were measured in vitro and in vivo using CCK-8 kit, flow cytometry and tumor formation in nude mice.

RESULTSCCK-8 results showed that all the five cell line cells were sensitive to low concentration of rapamycin (<100 nmol/L), but TE-1 and EC9706 cells, which were with poor differentiation, showed resistance to high concentration of rapamycin. After EC9706 cells were treated with 50, 100, 200, 500 and 1 000 nmol/L rapamycin and p70S6K-siRNA, the proliferation rates of EC9706 cells were (48.67 ± 1.68)%, (15.45 ± 1.54)%, (14.00 ± 0.91)%, (10.97 ± 0.72)% and (2.70 ± 0.32)%, respectively, and were significantly lower than that of cells treated with 50, 100, 200, 500 and 1 000 nmol/L rapamycin and control siRNA [(74.53 ± 1.71)%, (68.27 ± 1.35)%, (71.74 ± 2.44)%, (76.23 ± 1.02)% and (80.21 ± 2.77)%] (P<0.05 for all). The results of flow cytometry showed that the ratios of cells in G1 phase of the p70S6K-siRNA, rapamycin and p70S6K-siRNA+ rapamycin groups were (53.82 ± 1.78)%, (57.87 ± 4.01)% and (73.73 ± 3.68)%, respectively, significantly higher than that in the control group (46.09 ± 2.31)% (P<0.05 for all). The results of tumor formation test in vivo showed that the inhibitory effect of rapamycin on tumor growth was stronger after the cells were transfected with p70S6K-siRNA, and the inhibition rate was 96.5%.

CONCLUSIONESCC cells with different differentiation have different sensitivity to rapamycin, and p70S6K-siRNA can improve the sensitivity of cells to rapamycin in vitro and in vivo.

Animals ; Antibiotics, Antineoplastic ; pharmacology ; Carcinoma, Squamous Cell ; drug therapy ; metabolism ; pathology ; Cell Differentiation ; Cell Line, Tumor ; Cell Proliferation ; Esophageal Neoplasms ; drug therapy ; metabolism ; pathology ; Humans ; Mice ; Mice, Nude ; RNA, Small Interfering ; Ribosomal Protein S6 Kinases, 70-kDa ; genetics ; metabolism ; Signal Transduction ; Sirolimus ; pharmacology ; Transfection

OBJECTIVE: To assess the relationship between the prognosis of the patients with diffuse traumatic brain swelling (DTBS) and the changes of the ventricles and the cisterns in CT scans. METHODS: The outcome of the patients with DTBS and the changes of the ventricles and the cisterns in CT scans were studied and analyzed in a group of 268 cases. We focused on the changes of the third ventricle and the basal cistern, age and Glasgow Coma Scale (GCS). RESULTS: Of 268 cases, there were changes of the third ventricle and/or the basal cistern in 124, 65 died. In l8 cases, the third ventricle and the basal cistern were both absent and l6 died (88.9%). The third ventricle changed significantly in 59 cases, 33 died (55.9%), while the basal cistern changed in 47 cases and 16 died (34%). Of the 124 patients with changes of the third ventricle and/or the basal cistern, 26 were children, 8 died; 98 adults, 57 died. CONCLUSIONS: For patients with DTBS, the outcome was in direct correlation with the change of the third ventricle and/or the basal cistern, the change of the third ventricle was much more important in assessment of the outcome than that of basal cisterns. There is no significant difference in, the incidence of DTBS between children and adults while the outcome of children is much better than that of adults. The patients with the changes of the third ventricle and the basal cistern accompanied with lower GCS scores have poor outcome.