1.Analysis of unqualified ALT results in the initial screening and re-examination of blood donors in Changchun, China
Min HE ; Jingru CUI ; Zhiyong WANG ; Yang MA
Chinese Journal of Blood Transfusion 2025;38(4):495-501
[Objective] To investigate the non-pathological influencing factors of the unqualified alanine aminotransferase (ALT) in the initial screening of blood donors in Changchun and the laboratory re-examination, so as to provide evidence for reducing the deferral of blood donors and the discarding of blood due to ALT disqualification. [Methods] The unqualified results of ALT from the laboratory of our center from September 1, 2023 to October 31, 2024 were collected. The unqualified rates of ALT were statistically analyzed according to the blood collection sites and the initial screening detection equipment. The samples after ALT pre-donation screening were tested in the laborator, and the unqualified rates of ALT in the initial screening and the laboratory, the non-conformity rate of the results and the distribution range of ALT values were statistically analyzed according to the blood collection sites and the initial screening detection equipment. A questionnaire survey was conducted on the blood donors before blood collection to statistically analyze the influence of the blood donors' living habits and diet on ALT test results. [Results] The statistical analysis of the unqualified rate of ALT in the laboratory showed statistically significant differences in the ALT disqualification rates among different blood collection sites and different initial screening detection devices (P<0.05). Comparison of the ALT unqualified rate for the same type of equipment at different sites showed that for Equipment 1, there were differences between the combined blood collection house and the whole blood house, and between the combined blood collection house and the blood donation vehicle (P<0.05); for Equipment 2, there were differences between the combined blood collection house and the blood donation vehicle, and between the whole blood house and the blood donation vehicle (P<0.05); there were no significant differences among other groups with the same equipment. The initial screening and the laboratory test results for the same samples were compared, with unqualified rates of ALT of 16.29% and 13.01%, respectively. There were statistically significant differences in the unqualified rates of ALT among different blood collection sites (P<0.05), but no significant differences in the ALT test results among different detection equipment (P>0.05).. The non-conformity rate between the initial screening and the laboratory results was 5.26%, of which 81.15% (99/122) were unqualified in the initial screening but qualified in the laboratory. There were statistically significant differences in those unqualified in the initial screening but qualified in the laboratory among different blood collection sites and different detection equipment (P<0.05). The median ALT level in the initial screening was 29.0 U/L (with a 5%-95% range of 14-75 U/L), and the median ALT level in the laboratory was 19 U/L (with a 5%-95% range of 8-65 U/L). The results of the questionnaire survey showed that 33.3% (2/6) of those who consumed alcohol within 24 hours before blood donation had unqualified ALT, and 10% (1/10) of those who stayed up late the night before blood donation had unqualified ALT. [Conclusion] The unqualified rates of ALT in the initial screening before blood collection and the laboratory re-examination of blood donors in Changchun are closely related to the blood collection sites, detection equipment, detection environment, detection personnel, samples, ALT thresholds and detection time. Drinking alcohol and staying up late within 24 hours before blood donation increase the risk of unqualified ALT detection.
2.Revision and enlightenment of the 2024 version of the Declaration of Helsinki
Shiyu LIU ; Jingru MA ; Mingxu WANG
Chinese Medical Ethics 2025;38(4):412-419
In October 2024, the 75th World Medical Association General Assembly adopted the tenth revised version of the Declaration of Helsinki. Using textual analysis, this paper systematically compared the changes between the 2024 version and the 2013 version of the Declaration of Helsinki. This study found that, while maintaining the original framework, the new version incorporated the common achievements of the values and civilizational development of human society in recent years, mainly presenting changes in three aspects. First, the core terms were updated, and new concepts such as vulnerability, structural inequality, and environmental sustainability were introduced to further emphasize human dignity, rights and interests, and autonomy in terms of values. Second, the contents of the provisions were refined, especially focusing on the vulnerability of research subjects, free and full informed consent, ethical principles in public health emergencies, and the responsibilities of the ethics committee, as well as the standardization of implementation continued to be improved in the research process. Third, mandatory expressions were strengthened, and the justice of value pursuit was further reinforced in terms of research responsibilities. The revised contents reflected the “human-oriented” fundamental principle in medical research ethics, indicating the direction for future ethical development in medical research. In the future, China should strengthen the construction of ethics committees, actively build a protection system for research participants, and continuously promote international cooperation in medical ethics, to contribute Chinese wisdom to global medical research.
3.Effect of moxibustion on small intestinal mucosal immune barrier in rats with diarrhea-predominant irritable bowel syndrome.
Kuiwu LI ; Haoran CHU ; Ling ZOU ; Jingru RUAN ; Lumin LIAO ; Xiaoyu HAN ; Wenli MA ; Ming FANG ; Jingwei ZHU ; Yucheng FANG ; Ziye WANG ; Tingting TONG
Chinese Acupuncture & Moxibustion 2025;45(7):935-944
OBJECTIVE:
To observe the effect of moxibustion on small intestinal mucosal immune barrier in rats with diarrhea-predominant irritable bowel syndrome (IBS-D) and explore its underlying mechanisms.
METHODS:
Of 38 newborn rats from 4 healthy SPF pregnant rats, 12 neonatal rats were randomly selected in a normal group. IBS-D model was prepared by the combined measures for the rest rats, including neonatal maternal separation, acetic acid enema and chronic restraint stress. Twenty-four successfully-modeled rats were randomized into a model group and a moxibustion group, 12 rats in each one. In the moxibustion group, suspending moxibustion was delivered at bilateral "Tianshu" (ST25) and "Shangjuxu" (ST37), 20 min each time, once daily and for 7 consecutive days. Separately, before acetic acid enema (aged 35 days), after modeling (aged 45 days) and after intervention (aged 53 days), the body mass, loose stool rate (LSR) and and the minimum volume threshold when abdominal withdrawal reflex (AWR) scored 3 were observed in the rats of each group. After intervention (aged 53 days), using HE and PAS staining, the morphology of duodenum was observed, the length of villus and the depth of crypt were measured, the ratio of the length of villus to the depth of crypt was calculated; and the numbers of mucosal intraepithelial lymphocytes (IELs) and goblet cells were counted. With ELISA adopted, the contents of γ-interferon (IFN-γ), interleukin-4 (IL-4) and secretory immunoglobulin A (sIgA) in duodenal mucosa of rats were detected. The proportion of T cell subsets in duodenal mucosa was detected using flow cytometry. The microvilli and tight junctions of duodenal mucosal epithelial cells were observed by transmission electron microscopy, and the integrity of duodenal mucosa observed by scanning electron microscopy.
RESULTS:
Compared with the normal group, for the rats in the model group, the body mass, the minimum volume threshold when AWR scored 3, the length of duodenal villus and the the ratio of the length of villus to the depth of crypt, as well as the proportion of CD8+ T subset were all reduced (P<0.01, P<0.05), the counts of goblet cells in duodenal mucosa decreased (P<0.01); LRS, the proportion of CD4+ T subset and CD4+/CD8+, as well as the contents of IFN-γ, IL-4 and sIgA in duodenal mucosa and IFN-γ/IL-4 were all elevated (P<0.01); and the numbers of IELs rose (P<0.01). The morphology of duodenal mucosa was irregular, the villi got shorter, sparse and scattered, with uneven density. The morphology of epithelial cells was destroyed and the tight junctions damaged, with larger spaces. When compared with the model group, in the moxibustion group, the body mass, the minimum volume threshold when AWR scored 3, the length of duodenal villus and the ratio of the length of villus to the depth of crypt, as well as the counts of goblet cells in duodenal mucosa increased (P<0.01); LRS, the proportion of CD4+ T subset, and CD4+/CD8+, as well as the contents of IFN-γ, IL-4 and sIgA in duodenal mucosa and IFN-γ/IL-4 were reduced (P<0.01); and the numbers of IELs was dropped (P<0.01). The morphology of duodenal mucosa was more regular, the villi were grew, got longer and arranged regularly, with even density. The morphology of epithelial cells was slightly destroyed, and the tight junctions partially damaged.
CONCLUSION
Moxibustion at "Tianshu" (ST25) and "Shangjuxu" (ST37) can reduce visceral hypersensitivity in IBS-D rats and relieve abdominal pain, diarrhea and other symptoms. Its effect mechanism may be related to the repair of small intestinal mucosal immune barrier and the improvement in the immune function in IBS-D.
Animals
;
Irritable Bowel Syndrome/immunology*
;
Rats
;
Moxibustion
;
Intestinal Mucosa/immunology*
;
Female
;
Diarrhea/therapy*
;
Intestine, Small/immunology*
;
Male
;
Humans
;
Rats, Sprague-Dawley
;
Disease Models, Animal
4.Facilitating microglial phagocytosis by which Jiawei Xionggui Decoction alleviates cognitive impairment via TREM2-mediated energy metabolic reprogramming.
Wen WEN ; Jie CHEN ; Junbao XIANG ; Shiqi ZHANG ; Jingru LIU ; Jie WANG ; Ping WANG ; Shijun XU
Chinese Journal of Natural Medicines (English Ed.) 2025;23(8):909-919
Triggering receptor expressed on myeloid cells 2 (TREM2)-mediated microglial phagocytosis is an energy-intensive process that plays a crucial role in amyloid beta (Aβ) clearance in Alzheimer's disease (AD). Energy metabolic reprogramming (EMR) in microglia induced by TREM2 presents therapeutic targets for cognitive impairment in AD. Jiawei Xionggui Decoction (JWXG) has demonstrated effectiveness in enhancing energy supply, protecting microglia, and mitigating cognitive impairment in APP/PS1 mice. However, the mechanism by which JWXG enhances Aβ phagocytosis through TREM2-mediated EMR in microglia remains unclear. This study investigates how JWXG facilitates microglial phagocytosis and alleviates cognitive deficits in AD through TREM2-mediated EMR. Microglial phagocytosis was evaluated through immunofluorescence staining in vitro and in vivo. The EMR level of microglia was assessed using high-performance liquid chromatography (HPLC) and enzyme-linked immunosorbent assay (ELISA) kits. The TREM2/protein kinase B (Akt)/mammalian target of rapamycin (mTOR)/hypoxia-inducible factor-1α (HIF-1α) signaling pathway was analyzed using Western blotting in BV2 cells. TREM2-/- BV2 cells were utilized for reverse validation experiments. The Aβ burden, neuropathological features, and cognitive ability in APP/PS1 mice were evaluated using ELISA kits, immunohistochemistry (IHC), and the Morris water maze (MWM) test. JWXG enhanced both the phagocytosis of EMR disorder-BV2 cells (EMRD-BV2) and increased EMR levels. Notably, these effects were significantly reversed in TREM2-/- BV2 cells. JWXG elevated TREM2 expression, adenosine triphosphate (ATP) levels, and microglial phagocytosis in APP/PS1 mice. Additionally, JWXG reduced Aβ-burden, neuropathological lesions, and cognitive deficits in APP/PS1 mice. In conclusion, JWXG promoted TREM2-induced EMR and enhanced microglial phagocytosis, thereby reducing Aβ deposition, improving neuropathological lesions, and alleviating cognitive deficits.
Drugs, Chinese Herbal/pharmacology*
;
Microglia/drug effects*
;
Phagocytosis
;
Cognitive Dysfunction/drug therapy*
;
Metabolic Reprogramming
;
Animals
;
Mice
;
Cell Line
;
Receptors, Immunologic/metabolism*
;
Membrane Glycoproteins/metabolism*
;
Signal Transduction
;
Amyloid beta-Peptides/metabolism*
;
Energy Metabolism
5.Mining, characterization, and expression of a fructan sucrase for efficient conversion of soybean oligosaccharides.
Bin WANG ; Jingru YING ; Yuanyuan CHEN ; Zemin FANG ; Yazhong XIAO ; Wei FANG ; Dongbang YAO
Chinese Journal of Biotechnology 2025;41(1):333-351
The high content of sucrose and raffinose reduces the prebiotic value of soybean oligosaccharides. Fructan sucrases can catalyze the conversion of sucrose and raffinose to high-value products such as fructooligosaccharides and melibiose. To obtain a fructan sucrase that can efficiently convert soybean oligosaccharides, we first mined the fructan sucrase gene from microorganisms in the coastal areas of Xisha Islands and Bohai Bay and then characterized the enzymatic and catalytic properties of the enzyme. Finally, recombinant extracellular expression of this gene was carried out in Bacillus subtilis. The results showed that a novel fructan sucrase, BhLS 39, was mined from Bacillus halotolerans. With sucrose and raffinose as substrates, BhLS 39 showed the optimal temperatures of 50 ℃ and 55 ℃, optimal pH 5.5 for both, and Kcat/Km ratio of 3.4 and 6.6 L/(mmol·s), respectively. When 400 g/L raffinose was used as the substrate, the melibiose conversion rate was 84.6% after 30 min treatment with 5 U BhLS 39. Furthermore, BhLS 39 catalyzed the conversion of sucrose to produce levan-type-fructooligosaccharide and levan. Then, the recombinant extracellular expression of BhLS 39 in B. subtilis was achieved. The co-expression of the intracellular chaperone DnaK and the extracellular chaperone PrsA increased the extracellular activity of the recombinant BhLS 39 by 5.2 folds to 17 U/mL compared with that of the control strain. BhLS 39 obtained in this study is conducive to improving the quality and economic benefits of soybean oligosaccharides. At the same time, the strategy used here to enhance the extracellular expression of BhLS 39 will also promote the efficient recombinant expression of other proteins in B. subtilis.
Oligosaccharides/metabolism*
;
Glycine max/metabolism*
;
Bacillus subtilis/metabolism*
;
Sucrase/biosynthesis*
;
Raffinose/metabolism*
;
Fructans/metabolism*
;
Sucrose/metabolism*
;
Bacillus/genetics*
;
Recombinant Proteins/biosynthesis*
;
Bacterial Proteins/biosynthesis*
6.Predictive value of combined detection of serum microRNA-374b-5p,P-selectin and tumor necrosis factor receptor-associated factor 6 for postoperative deep vein thrombosis in patients with traumatic lower limb fractures
Xue WANG ; Jingru WANG ; Yan CUI
Journal of Clinical Medicine in Practice 2025;29(19):19-25
Objective To investigate the correlations of the expression levels of serum microR-NA-374b-5p(miR-374b-5p),P-selectin and tumor necrosis factor receptor-associated factor 6(TRAF6)with deep vein thrombosis(DVT)in patients with traumatic lower limb fractures,and to construct a multi-indicator Logistic regression model to establish a postoperative DVT risk prediction tool.Methods A total of 160 patients with traumatic lower limb fractures were selected as the study subjects and divided into DVT group(n=55)and non-DVT group(n=105)based on postoperative color Doppler ultrasound examination results.Clinical data of the patients were collected,and their coagulation and blood lipid indicators were tested.Real-time fluorescent quantitative polymerase chain reaction was used to detect the serum miR-374b-5p expression level within 24 hours postopera-tively.Enzyme-linked immunosorbent assay(ELISA)was employed to measure serum P-selectin and TRAF6 levels,and their relationships with short-term postoperative DVT were analyzed.Logis-tic regression analysis was conducted to identify the influencing factors of postoperative DVT in pa-tients with traumatic lower limb fractures,and a relevant model was established to assess the pa-tients' DVT risk.Results There were no statistically significant differences in demographic charac-teristics(gender,age and body mass index),underlying diseases(hypertension,diabetes and vari-cose veins),treatment-related factors(postoperative hemostatic drug use and fracture site),and lif-estyle habits(smoking history and alcohol consumption history)between the two groups(P>0.05).The proportion of patients in the DVT group with a postoperative first ambulation time of less than 7 days was significantly lower than that in the non-DVT group,while the levels of D-dimer and fibrinogen degradation products were significantly higher in the DVT group than those in the non-DVT group(P<0.05).The high-density lipoprotein cholesterol level in the DVT group was signifi-cantly lower than that in the non-DVT group(P<0.05).The relative expression levels of serum miR-374b-5p and the levels of P-selectin and TRAF6 in the DVT group were significantly higher than those in the non-DVT group(P<0.05).Logistic regression analysis revealed that a postopera-tive ambulation time of≥7 days,D-dimer,fibrinogen degradation products,high-density lipopro-tein cholesterol,relative expression level of miR-374b-5p as well as levels of P-selectin and TRAF6 were influencing factors for postoperative DVT in patients.Based on these findings,a postoperative DVT prediction model was established,which showed an area under the curve(AUC)of 0.977(95%CI:0.953 to 0.992)for predicting postoperative DVT in patients.Conclusion The serum levels of miR-374b-5p,P-selectin and TRAF6 are closely related to postoperative DVT in patients with traumatic lower limb fractures,and the prediction model established based on these factors has high predictive value.
7.Relationship between insecure attachment and procrastination in college students: path analysis of mindfulness and self-control
Caini PENG ; Junyuan PENG ; Zhuoran LYU ; Liguo DAI ; Jingru WANG ; Jiayi ZHANG ; Yinya LIU ; Xi FAN
Sichuan Mental Health 2024;37(2):150-155
BackgroundPrevention and intervention of procrastination in college students are of great practical significance, and studies have illustrated a pairwise correlation among mindfulness, self-control, insecure attachment and procrastination, whereas the mechanism by which insecure attachment leads to procrastination remains unclear, and the related mediation path is quite understudied. ObjectiveTo investigate the effect of insecure attachment on procrastination among college students and the pathway of mindfulness and self-control, so as to inform the design of interventions for procrastination among college students. MethodsRandom and cluster sampling method were utilized to enroll 514 college students from 4 colleges in Guangdong Province From February to April 2023. Subjects were assessed using Irrational Procrastination Scale (IPS), Adult Attachment Scale (AAS), Mindful Attention Awareness Scale (MAAS) and Brief Self-Control Scale (BSCS). Pearson correlation analysis were adopted to identify the correlation among above scales, and the mediation effect was examined via Bootstrap procedure. ResultsAAS score was positively correlated with IPS score (r=0.382, P<0.01), and negatively correlated with MAAS and BSCS scores (r=-0.242, -0.353, P<0.01). IPS score was negatively correlated with MAAS and BSCS scores (r=-0.314, -0.682, P<0.01). MAAS score was positively correlated with BSCS score (r=0.439, P<0.01). Insecure attachment positively predicted procrastination (β=0.377, P<0.01), and the prediction of procrastination by insecure attachment was mediated by self-control, with an indirect effect value of 0.163 (95% CI: 0.105~0.223), accounting for 43.24% of the total effect value. The mindfulness and self-control exerted a chained mediation effect on the relationship between insecure attachment and procrastination, and the indirect effect value was 0.056 (95% CI: 0.028~0.089), accounting for 14.85% of the total effect value. ConclusionInsecure attachment can influence procrastination among college students both directly and indirectly through the single mediation of self-control or the chained mediation of mindfulness and self-control. [Funded by 2023 National College Student Innovation and Entrepreneurship Training Program (number, 202310570023)]
8.Analysis of the types and functions of CD34 + cells in full-thickness skin defect wounds of normal mice and diabetic mice by single-cell RNA sequencing
Jia HE ; Jingru WANG ; Wenjun GAN ; Guiqiang LI ; Qi XIN ; Zepeng LIN ; Shubin RUAN ; Xiaodong CHEN
Chinese Journal of Burns 2024;40(3):230-239
Objective:To analyze the types and functions of CD34 + cells in full-thickness skin defect wounds of normal mice and diabetic mice by single-cell RNA sequencing. Methods:This study was an experimental study. The CD34 + cell lineage tracing mouse was produced, and the visualization of CD34 + cells under the fluorescent condition was realized. Six male CD34 + cell lineage tracing mice aged 7-8 weeks (designated as diabetic group) were intraperitoneally injected with streptozotocin to establish a diabetic model, and full-thickness skin defect wounds were prepared on their backs when they reached 13 weeks old. Another 6 male CD34 + cell lineage tracing mice aged 13 weeks (designated as control group) were also subjected to full-thickness skin defect wounds on their backs. On post-injury day (PID) 4, wound tissue was collected from 3 mice in control group and 2 mice in diabetic group, and digested to prepare single-cell suspensions. CD34 + cells were screened using fluorescence-activated cell sorting, followed by single-cell RNA sequencing. The Seurat 4.0.2 program in the R programming language was utilized for dimensionality reduction, visualization, and cell clustering analysis of CD34 + cell types, and to screen and annotate the marker genes for each CD34 + cell subpopulation. Kyoto encyclopedia of genes and genomes (KEGG) and gene ontology (GO) enrichment analysis was performed to analyze the differentially expressed genes (DEGs) of CD34 + fibroblasts (Fbs), smooth muscle cells (SMCs), keratinocytes (KCs), and chondrocyte-like cells (CLCs) in the wound tissue of two groups of mice for exploring cellular functions. Results:On PID 4, CD34 + cells in the wound tissue of both groups of mice were consisted of 7 cell types, specifically endothelial cells, Fbs, KCs, macrophages, T cells, SMCs, and CLCs. Among these, Fbs were further classified into 5 subpopulations. Compared with those in control group, the proportions of CD34 + endothelial cells, Fbs subpopulation 1, Fbs subpopulation 4, KCs, and CLCs in the wound tissue of mice were increased in diabetic group, while the proportions of CD34 + Fbs subpopulation 2, Fbs subpopulation 3, and SMCs were decreased. The marker genes for annotating CD34 + CLCs, endothelial cells, Fbs subpopulation 1, Fbs subpopulation 2, Fbs subpopulation 3, Fbs subpopulation 4, Fbs subpopulation 5, KCs, macrophages, SMCs, and T cells were respectively metastasis-associated lung adenocarcinoma transcript 1, fatty acid binding protein 4, Gremlin 1, complement component 4B, H19 imprinted maternally expressed transcript, Dickkopf Wnt signaling pathway inhibitor 2, fibromodulin, keratin 5, CD74 molecule, regulator of G protein signaling 5, and inducible T-cell co-stimulator molecule. KEGG and GO enrichment analysis revealed that, compared with those in control group, DEGs with significant differential expression (SDE) in CD34 + Fbs from the wound tissue of mice in diabetic group on PID 4 were significantly enriched in terms related to inflammatory response, extracellular matrix (ECM) organization, regulation of cell proliferation, and aging (with Pvalues all <0.05), DEGs with SDE in CD34 + SMCs were significantly enriched in terms related to cell migration, apoptotic process, positive regulation of transcription, and phagosome (with P values all <0.05), DEGs with SDE in CD34 + KCs were significantly enriched in terms related to mitochondrial function, transcription, and neurodegenerative diseases (with P values all <0.05), and DEGs with SDE in CD34 + CLCs were significantly enriched in terms related to rhythm regulation, ECM, and viral infection (with P values all <0.05). Conclusions:CD34 + cells display high heterogeneity in the healing process of full-thickness skin defect wounds in both normal mice and diabetic mice. The significantly enriched functions of DEGs with SDE in CD34 + cell subpopulations in the wound tissue of the two mouse groups are closely related to the wound healing process.
9.Superconducting magnetocardiography signal measurement technology and coronary heart disease screening
Haiming AI ; Zhe DONG ; Jingru GE ; Wang MI ; Wei LIU
Chinese Journal of Medical Physics 2024;41(10):1265-1272
Objective To research superconducting magnetocardiography signal measurement technology and coronary heart disease screening for solving the difficulties in weak magnetocardiography signal measurement,and to verify the value of clinical application.Methods The principle of superconducting magnetocardiography signal measurement technology was analyzed for constructing a framework for superconducting magnetocardiography signal measurement technology.Then,the key circuits such as the host controller,magnetic flux-locked loop,and signal conditioning module were designed,and software systems and core algorithms were developed.Finally,a total of 255 volunteers with healthy hearts,mild myocardial ischemia and severe myocardial ischemia were enrolled in the study,and a comparative experiment was performed between synchronous magnetocardiography and coronary angiography(CAG).Results The peer-to-peer bipolar structure was only observed in the current density vector distribution of healthy subjects instead of myocardial ischemia subjects.The overall coincidence rate,total Kappa value,severe ischemia coincidence rate,mild ischemia coincidence rate and negative coincidence rate of magnetocardiography with CAG were 86.22%,78.21%,86.79%,84.09%and 86.67%,respectively.Magnetocardiography had a sensitivity,specificity,positive rate,negative rate,positive likelihood ratio and negative likelihood ratio of 87.16%,84.41%,86.00%,86.67%,5.98 and 0.08,respectively.Conclusion Magnetocardiography has a high coincidence rate and consistency with CAG in the diagnosis of myocardial ischemia.Superconducting magnetocardiography signal measurement technology can be served as an accurate and reliable screening method for coronary heart diseases.
10.The machine learning algorithm screened the characteristic variables of prolonged hospital stay after hip fracture and constructed the prediction model
Changying SU ; Lisha HUANG ; Jiesi ZHONG ; Lanmei PENG ; Jingru WANG ; Hui GAO ; Jun YANG
Chinese Journal of Practical Nursing 2024;40(19):1454-1461
Objective:To identify risk variables for prolonged postoperative length of stay (PPOLOS) in hip fracture patients by machine learning algorithms and construct Nomogram models.Methods:A retrospective case-control study was conducted to select 248 patients with hip fracture diagnosed and treated in Yingtan 184th Hospital from June 2019 to June 2023 by convenient sampling method. Two machine learning algorithms were used (least absolute shrinkage and selection operator, LASSO and support vector machine-Recursive Feature Elimination, SVM-RFE) to screen PPOLOS risk variables. Construct a Nomogram model to predict the risk of PPOLOS in patients with hip fracture based on intersection risk variables. The model was validated using internal data sets.Results:Among the 248 patients with hip fracture, there were 79 males and 169 females, aged (64.49 ± 8.02). The mean postoperative length of hospital stay of 248 patients was (7.98 ± 5.68) d, and the median was 7 d. LASSO algorithm identifies 7 risk variables, the SVM-RFE algorithm identified 8 risk variables. Intersectional risk variables were age, body mass index (BMI), Charlson comorbidity index (CCI), type of surgery, and central granulocytocyte ratio (NLR). Multivariate Logistic regression analysis(intersection risk variables) showed that age [ OR=1.649(1.235-2.202)], BMI [1.603(1.204-2.134)], CCI [ OR=1.670(1.236-2.258)], type of surgery [ OR=1.620(1.209-2.170), 1.699(1.243-2.321)], and NLR [ OR=3.258(2.299-4.617)] were independently associated with the risk of PPOLOS (all P<0.05). The results showed that the conformity index of the Nomogram model was 0.865 (95% CI=0.768-0.945). The area under the curve was 0.852 (95% CI=0.748-0.962). When the risk threshold was >0.08, it could provide significant clinical net benefit. The clinical impact curve showed effective identification of PPOLOS patients in high-risk groups. Conclusions:This Nomogram model can guide medical staff to make clinical diagnosis and treatment decisions as soon as possible to avoid risks, allocate medical resources rationally, and improve nursing quality.

Result Analysis
Print
Save
E-mail