OBJECTIVES: To evaluate the performance of a multi-constraint representation learning classification model for identifying ovarian cancer with missing laboratory indicators. METHODS: Tabular data with missing laboratory indicators were collected from 393 patients with ovarian cancer and 1951 control patients. The missing ovarian cancer laboratory indicator features were projected to the latent space to obtain a classification model using the representational learning classification model based on discriminative learning and mutual information coupled with feature projection significance score consistency and missing location estimation. The proposed constraint term was ablated experimentally to assess the feasibility and validity of the constraint term by accuracy, area under the ROC curve (AUC), sensitivity, and specificity. Cross-validation methods and accuracy, AUC, sensitivity and specificity were also used to evaluate the discriminative performance of this classification model in comparison with other interpolation methods for processing of the missing data. RESULTS: The results of the ablation experiments showed good compatibility among the constraints, and each constraint had good robustness. The cross-validation experiment showed that for identification of ovarian cancer with missing laboratory indicators, the AUC, accuracy, sensitivity and specificity of the proposed multi-constraints representation-based learning classification model was 0.915, 0.888, 0.774, and 0.910, respectively, and its AUC and sensitivity were superior to those of other interpolation methods. CONCLUSIONS The proposed model has excellent discriminatory ability with better performance than other missing data interpolation methods for identification of ovarian cancer with missing laboratory indicators.
Female ; Humans ; Ovarian Neoplasms/diagnosis* ; Machine Learning ; ROC Curve

Early correction of childhood malocclusion is timely managing morphological, structural, and functional abnormalities at different dentomaxillofacial developmental stages. The selection of appropriate imaging examination and comprehensive radiological diagnosis and analysis play an important role in early correction of childhood malocclusion. This expert consensus is a collaborative effort by multidisciplinary experts in dentistry across the nation based on the current clinical evidence, aiming to provide general guidance on appropriate imaging examination selection, comprehensive and accurate imaging assessment for early orthodontic treatment patients.
Humans ; Malocclusion/diagnostic imaging* ; Child ; Consensus

Objective To quantify the association between obesity and erectile dysfunction (ED) risk through a meta-analysis. Methods Following PRISMA guidelines, systematic searches of Chinese and English databases (up to March 2025) were conducted to include observational studies (cohort, cross-sectional, case-control). Adjusted effect sizes (OR and 95% CI) were extracted. Study quality was assessed using the Agency for Healthcare Research and Quality(AHRQ) scale, and a random-effects model was applied to pool effect sizes. Subgroup analyses (geographic region, obesity definitions) and sensitivity analyses were performed to validate robustness. Results Ten studies (n=230 744), including nine cross-sectional studies, were included. The meta-analysis revealed that obesity significantly increased ED risk (random-effects OR=1.80, 95% CI: 1.29-2.51), with high heterogeneity (I2=99.9%). Subgroup analyses indicated stronger associations in USA populations (OR=2.10, 95% CI: 1.23-3.60) than in Chinese populations (OR=1.16, 95% CI: 1.05-1.28). The highest effect size was observed when using BMI≥25 kg/m3 as the obesity threshold (OR=3.05, 95% CI: 2.06-4.51). Sensitivity analyses confirmed robust results (OR: 1.60-1.94 after excluding any single study). Conclusions Obesity is a critical risk factor for ED, with effect strength influenced by geographic region and obesity definitions. Interventions targeting BMI≥30 kg/m2 in Western populations and metabolic risks at BMI≥25 kg/m3 in Asian populations are recommended.

Objective To discuss the safety and effectiveness of ProGlide vascular stitching device in catheter-directed thrombolysis for patients with thrombosis of lower limb arteries.Methods The patients with arterial thrombosis of lower extremity,who received catheter-directed thrombolysis at the Department of Vascular Surgery of Weifang People's Hospital of China from January 2020 to December 2023,were collected for this study.In performing the vascular interventional surgery,a 6-Fr femoral artery sheath was used to accomplish the catheter-directed thrombolysis in all patients.When the catheter-directed thrombolysis was ended,ProGlide vascular stitching device was used to suture the femoral artery puncture point,or the femoral artery puncture point was oppressed with a finger.The hemostatic success rate and the incidence of relevant complications were compared between the two groups.Results A total of 156 patients who received catheter-directed thrombolysis of lower extremity were enrolled in this study.Of the 156 patients,ProGlide vascular stitching device was used to suture the femoral artery puncture point in 80(ProGlide device group)and finger-oppression was adopted in 76(finger-oppression group).Compared with finger-oppression group,in ProGlide device group the hemostatic success rate was obviously higher(96.25％vs.80.3％,P=0.002).Nine patients in finger-oppression group(11.8％)and 2 patients in ProGlide device group(2.5％)developed puncture site hematoma or pseudoaneurysm(P=0.023).Five patients in finger-oppression group(6.6％)had to receive surgical operation to repair the femoral artery,and one patient in ProGlide device group(1.25％)developed ProGlide device-related femoral artery occlusion.Adverse events occurred in 15 patients(19.7％)of finger-oppression group and 3 patients(3.75％)of ProGlide device group(P=0.002).Conclusion ProGlide vascular stitching device can be safely used in patients with arterial thrombosis of lower extremity receiving catheter-directed thrombolysis.This device carries high success rate for suturing the femoral artery puncture point,thus,the incidence of hematoma at the puncture site can be reduced.

Objective:s To investigate the risk factors for delayed encephalopathy after acute carbon monoxide poisoning (DEACMP) in patients with acute carbon monoxide poisoning (ACOP) and to develop predictive models based on machine learning algorithms.Methods:Patients with ACOP hospitalized at the First Affiliated Hospital of Zhengzhou University from August 2019 to October 2024 were included, with the occurrence of DEACMP as the outcome measure. The dataset was randomly divided into training and validation sets at a ratio of 7:3. Lasso regression was used to select features influencing the outcome in training sets. Nine machine learning models—including Random Forest (RF), Extreme Gradient Boosting (XGBoost), and Support Vector Machine (SVM)—were constructed. Receiver operating characteristic (ROC) curves were plotted and the area under the curve (AUC) calculated for each model. Calibration curves were used to assess accuracy, and decision curve analysis (DCA) was applied to evaluate clinical utility. The SHapley Additive exPlanations (SHAP) method was employed to visualize and interpret the best-performing model.Results:A total of 264 ACOP patients were included, of whom 54 (20.5%) developed DEACMP. Lasso regression identified eight key feature variables. Based on these factors, predictive models were constructed, showing good AUC stability across the nine machine learning models in both training (0.92–0.99) and validation sets (0.85–0.91). The RF model performed best, with an AUC of 0.99 in the training set and 0.90 in the validation set; its calibration curve and DCA curve also demonstrated excellent performance. SHAP analysis of the RF model revealed the importance ranking of factors from highest to lowest as follows: Glasgow Coma Scale (GCS) score, duration of coma, age, history of coronary heart disease, CK-MB level, monocyte count, diastolic blood pressure (DBP), and drinking history.Conclusions:The RF model exhibited the highest predictive performance for DEACMP occurrence in ACOP patients. The influencing factors, ranked in order of importance from highest to lowest, are as follows: GCS score, duration of coma, age, history of coronary heart disease, CK-MB level, monocyte count, DBP, and drinking history.

Objective:To investigate the effect of extraction of mandibular third molar (M3) tooth germ on the development of the mandible in orthodontic patients, with a view to providing a reference for clinical M3 tooth germ extraction.Methods:One hundred and twenty-nine Angel class Ⅰ malocclusion patients aged 10-16 years who attended the Department of Orthodontics Division 1, School & Hospital of Stomatology, Wuhan University from 1 January 2013 to 30 December 2021 and fulfilled the criteria for nativity were included. Those who had their M3 extracted in the Department of Oral and Maxillofacial Surgery were included in the study group, with a total of 66 cases; and those who did not have their M3 extracted were included in the control group, with a total of 63 cases. The average annual growth was calculated by tracing point measurements on cephalometric films before and after orthodontic treatment according to the Jarabak and McNamara methods, with measurements of the mandibular ramus height (Ar-Go′), mandibular body length (Go′-Me), and overall mandibular length (Co-Gn) values, respectively. The average annual growth of Ar-Go′, Go′-Me, and Co-Gn were compared between the two groups for the overall sample of patients, patients of the same sex (male/female), patients of the same age group (>10 and ≤12 years old, >12 and ≤14 years old, >14 and ≤16 years old), and patients of the same cervical vertebral maturation stage (stages Ⅱ, Ⅲ, and Ⅳ), respectively, to see if there was any difference in the average annual growth of Ar-Go′, Go′-Me, and Co-Gn.Results:There was no statistically significant difference in the average annual growth of Ar-Go′, Go′-Me, and Co-Gn between the study group [0.88 (0.40, 1.80), 0.67 (0.15, 1.18), and 0.86 (0.40, 1.90) mm, respectively] and the control group [1.08 (0.45, 1.60), 0.53 (0.25, 1.13), and 1.20 (0.46, 2.28) mm, respectively] ( P>0.05). In addition, there was no significant difference in the average annual growth in the Ar-Go′, Go′-Me, and Co-Gn between the groups for patients of the same sex group, patients of the same age group, and patients of the same cervical vertebral maturation stage group( P>0.05). Conclusions:Extraction of the mandibular third molar tooth germ has no significant effect on the development of the mandible in Angle class Ⅰ malocclusion patients.

Objective:To analyze the clinical characteristics of invasive klebsiella pneumoniae liver abscess syndrome (IKPLAS), and compare it with common pyogenic liver abscess (CPLA). Methods:The social demography and clinical data of inpatients with pyogenic liver abscess from January 2011 to December 2021 in the Peking University People's Hospital were collected. Based on the presence or absence of invasive infections and the results of bacterial etiology, IKPLAS was diagnosed and compared with CPLA. The general information, symptoms, past medical history, auxiliary examinations and prognosis indicators of the two groups of patients were compared.Results:Total of 172 patients with pyogenic liver abscess were collected, including 25 cases of IKPLAS. Compared with CPLA group, the proportion of fever in IKPLAS group was lower, the proportion of diabetes history was higher, the proportion of monocytes was lower, and procalcitonin and urea nitrogen were higher(all P<0.05), the proportion of multiple abscesses is higher, and the positive rate of blood culture and the cultivation of klebsiella pneumoniae are both higher (all P<0.05).A total of 9 cases (5.2%) of patients developed septic shock, of which 2 cases (1.2%) died. The IKPLAS group had a higher proportion of ICU admissions ( P<0.05),but but the difference of mortality between the two groups was not statistically significant ( P>0.05). The most common sites of invasion infection in the IKPLAS group are the lungs(22/25), brain(9/25), and eyes(9/25). Conclusions:There are differences in clinical characteristics between IKPLAS and CPLA, the most common sites of invasion infection are the lungs, brain, and eyes, but there is no difference in mortality in this study. For PLA with pathogenic Klebsiella pneumoniae, it is necessary to carefully evaluate the presence of invasive lesions and provide targeted local treatment to better improve prognosis.

Objective To construct a prognostic risk model for exploring the prognostic value of copper metabolism related genes(CMRGs)in lung adenocarcinoma(LUAD),thereby providing a reference for personalized treatment of LUAD patients.Methods The RNA-seq data of LUAD tissues and adjacent or normal lung tissues were downloaded from the Cancer Genome Atlas(TCGA)database and Genotype-tissue Expression(GTEx)database.The risk scoring model was established using univariate Cox regression analysis,Lasso analysis and multivariate Cox regression analysis,and the receiver operating characteristic(ROC)curves and nomogram were used to evaluate the model performance.The LUAD data in the Gene Expression Omnibus(GEO),the Tumor Immune Single-cell Hub(TISCH)single-cell sequencing analysis,and the Human Protein Atlas(HPA)immunohistochemistry analysis were used for external validation.Additionally,the immune microenvironment and drug sensitivity of high-and low-risk groups were analyzed.Results A risk model consisting of 6 genes was constructed.The overall survival rate of low-risk group was higher than that of high-risk group(P<0.001).ROC analysis showed that the area under curve of the risk model in training set reached 0.729,0.749 and 0.707 at 1-,3-and 5-year,respectively,and the C index of C-index curve was 0.721(95%CI:0.678-0.764).The immune microenvironment differed significantly between high-and low-risk groups(P<0.001),and the drug sensitivity analysis in high-and low-risk groups revealed that there was statistically significant for gemcitabine,gefitinib,crizotinib and savolitinib(P<0.001).Conclusion The risk model constructed with 6 CMRGs enable the prediction of the prognosis of LUAD patients.The immune microenvironment differs in high-and low-risk group,and high-risk patients are more sensitive to drugs such as gemcitabine,gefitinib,crizotinib and savolitinib,which provide a reference for the personalized treatment of LUAD patients.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in tertiary hospitals in major regions of China in 2022.Methods Clinical isolates from 58 hospitals in China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2022 Clinical &Laboratory Standards Institute(CLSI)breakpoints.Results A total of 318 013 clinical isolates were collected from January 1,2022 to December 31,2022,of which 29.5％were gram-positive and 70.5％were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species(excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi)was 28.3％,76.7％and 77.9％,respectively.Overall,94.0％of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 90.8％of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis showed significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 94.2％in the isolates from children and 95.7％in the isolates from adults.The resistance rate to carbapenems was lower than 13.1％in most Enterobacterales species except for Klebsiella,21.7％-23.1％of which were resistant to carbapenems.Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.1％to 13.3％.The prevalence of meropenem-resistant strains decreased from 23.5％in 2019 to 18.0％in 2022 in Pseudomonas aeruginosa,and decreased from 79.0％in 2019 to 72.5％in 2022 in Acinetobacter baumannii.Conclusions The resistance of clinical isolates to the commonly used antimicrobial agents is still increasing in tertiary hospitals.However,the prevalence of important carbapenem-resistant organisms such as carbapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a downward trend in recent years.This finding suggests that the strategy of combining antimicrobial resistance surveillance with multidisciplinary concerted action works well in curbing the spread of resistant bacteria.

Objective To investigate the distribution and antimicrobial resistance profiles of the common pathogens isolated from urine from 2015 to 2021 in the CHINET Antimicrobial Resistance Surveillance Program.Methods The bacterial strains were isolated from urine and identified routinely in 51 hospitals across China in the CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021.Antimicrobial susceptibility was determined by Kirby-Bauer method,automatic microbiological analysis system and E-test according to the unified protocol.Results A total of 261 893 nonduplicate strains were isolated from urine specimen from 2015 to 2021,of which gram-positive bacteria accounted for 23.8％(62 219/261 893),and gram-negative bacteria 76.2％(199 674/261 893).The most common species were E.coli(46.7％),E.faecium(10.4％),K.pneumoniae(9.8％),E.faecalis(8.7％),P.mirabilis(3.5％),P.aeruginosa(3.4％),SS.agalactiae(2.6％),and E.cloacae(2.1％).The strains were more frequently isolated from inpatients versus outpatients and emergency patients,from females versus males,and from adults versus children.The prevalence of ESBLs-producing strains in E.coli,K.pneumoniae and P.mirabilis was 53.2％,52.8％and 37.0％,respectively.The prevalence of carbapenem-resistant strains in E.coli,K.pneumoniae,P.aeruginosa and A.baumannii was 1.7％,18.5％,16.4％,and 40.3％,respectively.Lower than 10％of the E.faecalis isolates were resistant to ampicillin,nitrofurantoin,linezolid,vancomycin,teicoplanin and fosfomycin.More than 90％of the E.faecium isolates were ressitant to ampicillin,levofloxacin and erythromycin.The percentage of strains resistant to vancomycin,linezolid or teicoplanin was＜2％.The E.coli,K.pneumoniae,P.aeruginosa and A.baumannii strains isolated from ICU inpatients showed significantly higher resistance rates than the corresponding strains isolated from outpatients and non-ICU inpatients.Conclusions E.coli,Enterococcus and K.pneumoniae are the most common pathogens in urinary tract infection.The bacterial species and antimicrobial resistance of urinary isolates vary with different populations.More attention should be paid to antimicrobial resistance surveillance and reduce the irrational use of antimicrobial agents.