Objective:To explore a simplified and efficient early prediction model for severe acute pancreatitis (SAP) using the least absolute shrinkage and selection operator (LASSO) regression, and to construct both logistic regression and decision tree models. The aim is to identify high-risk individuals, guide clinical treatment, and improve patient outcomes.Methods:A retrospective analysis was conducted on the clinical data of 412 patients with acute pancreatitis admitted to the Emergency and Gastroenterology Departments of the First Affiliated Hospital of Anhui Medical University and its High-tech Branch from November 2020 to September 2023. LASSO regression was employed to identify factors significantly associated with SAP, followed by the construction of a multivariate logistic regression model and a decision tree model. The predictive performance of these models was evaluated and compared to the bedside index for severity in acute pancreatitis (BISAP).Results:Among the 412 patients, the incidence of SAP was 12.14% ( n=50). Seven variables significantly associated with SAP severity were identified by LASSO regression, including respiratory rate at admission, pain score at admission, pleural effusion, fibrin degradation products, C-reactive protein, serum creatinine, and serum albumin. The logistic regression model incorporated four variables: pleural effusion, pain score at admission, serum creatinine, and serum albumin. In the training set, the model demonstrated a sensitivity of 0.528, specificity of 0.984, accuracy (95% CI) of 0.928 (0.892-0.955), Kappa value of 0.606, and AUC (95% CI) of 0.920 (0.862-0.979). In the testing set, the model showed a sensitivity of 0.643, specificity of 0.925, accuracy (95% CI) of 0.891 (0.822-0.941), Kappa value of 0.519, and AUC (95% CI) of 0.923 (0.861-0.985). The decision tree model comprised three branches and four terminal nodes, indicating that serum creatinine, serum albumin, and pleural effusion could effectively predict SAP occurrence. In the training set, the decision tree model had a sensitivity of 0.500, specificity of 0.973, accuracy (95% CI) of 0.914 (0.876-0.944), Kappa value of 0.544, and AUC (95% CI) of 0.812 (0.731-0.894). In the testing set, the model exhibited a sensitivity of 0.500, specificity of 0.925, accuracy (95% CI) of 0.875 (0.802-0.928), Kappa value of 0.412, and AUC (95% CI) of 0.709 (0.565-0.853). The DeLong test revealed that in the training set, the AUC of the logistic regression model was significantly greater than that of the decision tree model ( P<0.01) and the BISAP score ( P<0.001), while the AUC difference between the decision tree model and the BISAP score was not statistically significant ( P=0.762). In the testing set, the AUC of the logistic regression model was again greater than that of the decision tree model ( P<0.01) and the BISAP score ( P=0.018), whereas the AUC of the decision tree model was lower than that of the BISAP score ( P=0.017). Conclusions:Both the logistic regression and decision tree models demonstrate good predictive value for SAP, and their combined use may provide valuable guidance for clinical practice.

Objective:To analyze the factors influencing the success rate of external cephalic version (ECV) and to create a preoperative scoring scale for stratified management of pregnant women who were preparing for ECV.Methods:This prospective study was conducted on singleton pregnant women who underwent ECV without anesthesia in Fujian Maternity and Child Health Hospital from January 1, 2017, to December 31, 2019. Univariate (two independent samples t-test, Mann-Whitney U test, and Chi-square test) and multivariate logistic regression were used to screen the clinical characteristics affecting the success of ECV, and receiver operating characteristic (ROC) curve was used to determine the cut-off value and convert quantitative variables into dichotomous variables. The independent variables were scored according to the regression coefficient in multivariate logistic regression analysis, and then a preoperative scoring scale was created. The ROC curve was used to calculate the cut-off value for the scoring scale. The subjects were divided into low and high score groups according to the cut-off value. The area under the ROC curve was used for evaluating the effectiveness of the scale in predicting the success of ECV. The success rate of ECV, difficulty of the operation and mode of delivery were compared between the two groups. Results:A total of 1 338 pregnant women met the inclusion criteria during the study period. After the exclusion of 885 women, 165 refused ECV in favor of direct cesarean section, 27 spontaneously converted to cephalic position before ECV, 261 who voluntarily accepted ECV were finally enrolled. ECV succeeded in 202 cases and failed in 59. (1) Favorable factors for ECV without anesthesia were the distance between the fetal breech and ischial spine <－3.5 cm ( OR=0.177, 95% CI: 0.071-0.438, P=0.009), the sum of the fundal height and the station of the fetal breech based on the ischial spine <30.25 cm ( OR=0.225, 95% CI: 0.094-0.537, P=0.001), amniotic fluid index ≥12 cm ( OR=0.399, 95% CI: 0.164-0.969, P=0.042), the surgeon's ability to hold the fetal head or breech with one hand ( OR=0.241, 95% CI: 0.098-0.589, P=0.002; OR=0.219, 95% CI: 0.087-0.546, P=0.001), and the fetal head located on the right or left upper abdomen of the mother ( OR=0.184, 95% CI: 0.059-0.568, P=0.003; OR=0.253, 95% CI: 0.084-0.760, P=0.014). (2) The area under the ROC curve of the preoperative score for predicting the success of ECV was 0.881 (95% CI: 0.821-0.941) and the cut-off value was 5.5. The subjects were divided into low (0-5 scores) and high (6-11 scores) score groups and the area under the ROC curve for predicting the success of ECV by grouping was 0.843 (95% CI: 0.774-0.912). Compared with the low score group, the high score group had a shorter ECV duration [2.0 min (0.5-10.0 min) vs 10.0 min (0.9-25.8 min), Z=－6.83, P<0.001], less attempts [1.0 times (1.0-4.0 times) vs 3.0 times (1.0-5.0 times), Z=－8.41, P<0.001], higher success rate [92.7% (190/205) vs 21.4% (12/56), χ2=127.64, P<0.001], higher rate of vaginal birth [75.4% (147/195) vs 18.5% (10/54)] and lower cesarean section rate [24.6% (48/195) vs 81.5% (44/54)] ( χ2=58.70, P<0.001). Conclusions:Preoperative scoring based on the factors influencing the success rate of ECV (the distance between the fetal breech and ischial spine, the sum of the fundal height and the station of the fetal breech based on the ischial spine <30.25 cm, amniotic fluid index ≥12 cm, the surgeon's ability to hold the fetal head or breech with one hand, and the fetal head locating on the right or left upper abdomen of the mother) is conducive to the individualized evaluation of the difficulty and the success rate of ECV as well as the success rate of vaginal delivery after ECV, which can provide a reference for clinical stratified management of ECV patients.

Cold atmospheric plasma (CAP), a redox modulation tool, is capable of inhibiting a wide spectrum of cancers and has thus been proposed as an emerging onco-therapy. However, with incremental successes consecutively reported on the anticancer efficacy of CAP, no consensus has been made on the types of tumours sensitive to CAP due to the different intrinsic characteristics of the cells and the heterogeneous design of CAP devices and their parameter configurations. These factors have substantially hindered the clinical use of CAP as an oncotherapy. It is thus imperative to clarify the tumour types responsive to CAP, the experimental models available for CAP-associated investigations, CAP administration strategies and the mechanisms by which CAP exerts its anticancer effects with the aim of identifying important yet less studied areas to accelerate the process of translating CAP into clinical use and fostering the field of plasma oncology.

Objective:To explore the effect of setting up an internal-cross disciplinary team (ICDT) in the intensive care unit (ICU) on a new model of overall treatment for patients with chronic critical illness (CCI).Methods:A 60-year-old male patient with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) admitted to ICU in the Second Affiliated Hospital of Fujian Medical University was introduced. The role of ICDT composed of physicians, nurses, respiratory therapists, physiotherapists, clinical dietitians and patients' family members in ventilator withdrawal and super-early rehabilitation was analyzed in this case.Results:The patient was diagnosed as AECOPD, type Ⅱ aspiration penumonia respiratory failure, septic shock. The ICDT in ICU carried out early rehabilitation treatment for the patient on the basis of traditional infection control and supportive treatment. Under the care of the ICDT, peripheral blood white blood cell count (WBC), neutrophil count (NEU), procalcitonin (PCT), arterial partial pressure of carbon dioxide (PaCO 2), maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), right excursion of diaphragm, sputum viscosity, tidal volume (VT) and respiratory rate (RR) were improved. Subsequently, the ventilator mode was gradually changed and the ventilator parameters were down-regulated. The ventilator was successfully weaned on the 10th day of treatment. After weaning, the patient's bedside pulmonary function indicators improved, and he was transferred out of ICU on the 15th day of treatment and discharged on the 20th day. The mental state of the patients was good and the quality of life was greatly improved in CCI outpatient follow-up. Conclusions:ICDT cooperation is very important for monitoring and treatment of CCI patients, which is beneficial to the super-early rehabilitation and prognosis improvement of critically ill patients.

Objective:This study was to investigate the expression of long noncoding RNA (lncRNA) KCNQ1OT1 during the differentiation program of human preadipocyte and to look for the changes of its expression in adipose tissue in obese subject, as well as to clarify the correlation between KCNQ1OT1 and obesity, and to provide clues for further understanding the role of lncRNA in the development of obesity.Methods:Quantitative PCR was used to detect the expression of KCNQ1OT1 in human preadipocyte at day 0, 1, 3, 5, 9, and 12 during differentiation program, quantitative PCR was also used to detect KCNQ1OT1 expression in white adipose tissue of obese and normal people, which related to PPIA internal reference gene. Pearson correlation analyses were used to explore the relationships of KCNQ1OT1 with body mass index, triglyceride, and total cholesterol.Results:During differentiation program, the relative expression of KCNQ1OT1 levels at day of 1, 3, 5, 9, and 12 were (25.89±3.10), (24.78±5.58), (15.53±2.11), (6.75±0.71), (4.81±0.84), which showed an upward trend compared with day 0. This difference was significant ( P<0.01), especially in the early stage of differentiation (day 1 and day 3). The relative expression of KCNQ1OT1 in visceral adipose tissue of obese subjects was 0.79±0.05, which was significantly higher than that of normal people ( P<0.01). KCNQ1OT1 was positively correlated with body mass index ( r=0.569, P<0.01), triacylglycerol content ( r=0.489, P<0.05), and total cholesterol content( r=0.591, P<0.01). Conclusion:KCNQ1OT1 expression level, which was up-regulated in adipose tissue from obese subjects, increased during the differentiation program of preadipocytes, and also positively correlated with body mass index and serum triglyceride content. These results suggest that KCNQ1OT1 may be an important regulator of human preadipocyte differentiation and a potential target for prevention and treatment of obesity.

Objective: To identify and characterize the 4 strains of Prototheca isolated from the clinical samples of skin or ascites samples in China. Methods: The taxonomic position of 4 yeast-like organisms was revealed by polyphasic taxonomic approach, i.e., cultural and morphologic characteristics, commercial biochemical systems of Vitek 2 (YST kit) and Vitek matrix-assisted laser desorption/ionization time of flight (MALDI-TOF) mass spectrometry (MS) systems in combination with phylogenetic analysis based on the gene sequences of 16S and 28S rRNA. Results: The 4 strains of Prototheca were characterized as cream-white, smooth, moist yeast-like colonies on Sabouraud gentamicin chloramph agar after incubation for 3 days. However, round, oval-shaped or elliptical sporangiums with mulberry-like or strawberry-like endospores were observed by optical microscope, which showed distinct differences from the general yeast species. The 4 isolates were identified as Prototheca wickerhamii with Vitek YST kits by Vitek 2 systems and Vitek MALDI-TOF MS systems. The genome for the 4 isolates was characterized with the existence of the prokaryotic 16S rRNA gene and eukaryotic 28S rRNA gene. The 16S rRNA gene sequence of the 4 strains showed more than 99.7% similarity to that of P. wickerhamii. Sequence analysis of 28S rRNA gene showed that the organisms included multiple copies of different sequences, which showed sequence similarities of 91.9% to 100% even in the same strain. The phylogenetic dendrogram based on 16S rRNA and 28S rRNA gene sequences showed that the 4 strains of Prototheca formed a cluster along with P. wickerhamii. Conclusion The 4 yeast-like organisms could be identified as P. wickerhamii, and 16S rRNA gene should be the suitable molecular target for the identification.

Objective: To evaluate the clinical characteristics and prognosis of 3q26 rearrangements in chronic myeloid leukemia (CML) patients. Methods: The clinical and laboratory data of 1 075 patients with CML diagnosed from 2010 to 2016 were retrospectively analyzed, and they were divided into 3q26 rearrangement positive group (n=19) and 3q26 rearrangement negative group (n=1 056). The expression of EVI1, ABL kinase region mutation and survival time between the two groups were compared. Meanwhile, the prognostic effects of three treatment methods, including tyrosine kinase inhibitors (TKIs), TKIs combined with chemotherapy and allogeneic hematopoietic stem cell transplantation, on the patients with 3q26 rearrangements were compared. Results: Most of the patients with 3q26 rearrangements were in the advanced phase (χ 2 =181.233, P＜0.01), and the median time to enter the acute phase was shorter (9.5 months). The mutation ratio of ABL kinase region and expression levels of EVI1 in 3q26 rearrangement positive group were significantly higher than that in the negative group (χ 2 =16.758, P＜0.01; Z/U=-0.331 9, P＜0.01). After treatment with TKIs, the median survival time of the 3q26 rearrangement positive group was significantly shorter than that of the negative group (χ 2 =313.229, P＜0.01). The prognosis of the patients treated with hematopoietic stem cell transplantation was better than that with TKIs (P=0.049). Conclusion The CML patients with 3q26 rearrangements have a higher risk of sudden change, shorter survival time and poor prognosis. Hematopoietic stem cell transplantation may improve their prognosis.

Objective To evaluate the role of heat shock protein 70 (HSP70) in ozone preconditioning-induced reduction of hepatic ischemia-reperfusion (I/R) injury in rats.Methods Twenty-four pathogen-free healthy male Sprague-Dawley rats,aged 8 weeks,weighing 250-300 g,were divided into 4 groups (n=6 each) using a random number table:sham operation group (group S),group I/R,ozone preconditioning group (group OP) and HSP70 inhibitor quercetin group (group Q).Hepatic I/R injury was induced by clamping the branches of hepatic artery supplying left and middle lobes of the liver,portal vein and bile vessel for 45 min,followed by 2 h of reperfusion.In group OP,the mixture of ozone and oxygen was intraperitoneally injected at the concentration of ozone 50 μg/ml and bolus dose 1 mg/kg once a day for 5 consecutive days before operation.In group Q,quercetin 7 mg/kg was intraperitoneally injected at 1 h before injecting the mixture of ozone and oxygen.Blood samples from the abdominal aorta were collected at 2 h of reperfusion for determination of serum alanine transaminase (ALT) and aspartate transaminase (AST) activities and concentrations of interleukin-1beta (IL-1β),IL-6 and tumor necrosis factor-alpha (TNF-α) in serum (by enzyme-linked immunosorbent assay).The animals were sacrificed after blood sampling,and hepatic tissue specimens were collected for detection of activated caspase-3 expression (by Western blot) and cell apoptosis (by TUNEL).Apoptotic index (AI) was calculated.Results Compared with group S,the serum ALT and AST activities,concentrations of IL-1β,IL-6 and TNF-α in serum and AI were significantly increased,and the expression of activated caspase-3 was up-regulated in group I/R (P＜0.05 or 0.01).Compared with group I/R,the serum ALT and AST activities,concentrations of IL-1β,IL-6 and TNF-α in serum and AI were significantly decreased,and the expression of activated caspase-3 was downregulated in group OP (P＜0.05 or 0.01).Compared with group OP,the serum ALT and AST activities,concentrations of IL-1β,IL-6 and TNF-α in serum and AI were significantly increased,and the expression of activated caspase-3 was up-regulated in group Q (P＜0.05 or 0.01).Conclusion The mechanism by which ozone preconditioning reduces hepatic I/R injury is related to activating HSP70 and inhibiting inflammatory responses and cell apoptosis in rats.

Objective To investigate the changes of the immunological factors in subcutaneous exudate and blood components of the rats receiving cutaneous scraping method,and to compare the changes of skin histopathological features before and after cutaneous scraping under microscope.Methods SD rats were randomly divided into two groups,cutaneous-scraping group and non-cutaneous-scraping group.And then each group was divided into three subgroups.The observation indexes included the levels of interleukin (IL)-1β,IL-6 and interferon gamma (IFN-γ) in the blood and the skin,routine blood examination,and skin histopathological features.Results In cutaneous-scraping group,the number of white blood cells in the blood and the levels of IL-1 β and IFN-γ in skin tissues were increased (P ＜ 0.05),the hemolysis rate was increased (P ＜ 0.05).However,the levels of IL-1β,IL-6 and IFN-γin the blood showed no obvious changes.Under the microscope,severe skin edema,vascular congestion and dilatation,and infiltration of inflammatory cells were found in the skin after cutaneous scraping.Conclusion The cutaneous scraping method can activate the immune response rapidly,and the immunological components of the subcutaneous exudate after cutaneous scraping are helpful to the disease treatment.

Objective To explore the protective effect of ozone oxidative preconditioning on hepatic ischemia reperfusion injury in rats.Methods Eighteen 8-week-old SPF Sprague-Dawley male rats weighting 250 ～300 g were randomly divided into three groups (n =6 each):sham operation group (group S),ischemia/reperfusion group (group I/R) and ozone oxidative preconditioning group (group O3 + I/R).In Group O3 + I/R,rats received five-day preconditioning treatments by intraperitoneal injection of ozone and oxygen mixed gases (ozone concentration 50 mg/L,1 mg · kg-1 · d-1),and then experienced the procedure of hepatic ischemia/reperfusion injury.Model of hepatic ischemia/reperfusion injury was established by clamping the branches of hepatic artery and portal vein in the median and left lateral hepatic lobes for 45 min,followed by 3-h reperfusion.After reperfusion,blood samples were taken from the aorta abdominalis for detecting serum aminotransferases (ALT & AST).These rats were executed and the hepatic tissue samples were collected for measuring hepatic malondialdehyde (MDA) and superoxide dismutase (SOD) level.Results Compared with group S,concentrations of serum ALT,AST and hepatic MDA were increased in group I/R and O3 + I/R;concentrations of hepatic SOD were decreased (P ＜ 0.05) in group I/R,but concentration of hepatic SOD was increased in group O3 + I/R.Compared with group IR,concentrations of serum ALT,AST and hepatic MDA were decreased,while concentration of hepatic SOD was increased in group O3 + I/R (P ＜ 0.05).Conclusion Ozone oxidative preconditioning could inhibit the lipid peroxidation to protect the rats against hepatic ischemia/reperfusion injury.