Objective:To construct and validate a depression risk prediction model for middle-aged and elderly patients with diabetes.Methods:Data were extracted from the fifth wave (2020) of the China Health and Retirement Longitudinal Study (CHARLS). A total of 900 diabetic patients were identified, and after excluding those with missing data or invalid questionnaires, 769 patients were included in the analysis. Patients were randomly divided into a training set and a validation set in a 7∶3 ratio. Univariate analysis and logistic regression analysis were performed to screen the optimal predictors of depression in diabetic patients, and a nomogram model was developed. The predictive performance of the model was assessed by the area under the receiver operating characteristic curve ( AUC). Model calibration and accuracy were evaluated using bootstrap resampling, calibration plots, and the Hosmer-Lemeshow test. The clinical utility was further assessed by decision curve analysis (DCA) and clinical impact curves (CIC) . Results:Among the 769 patients, 366 (47.59%) had depression. Logistic regression analysis showed that place of residence, pain, difficulty in toileting, difficulty in bathing, sleep duration, physical exercise, life satisfaction, and children's satisfaction were independent predictors of depression in diabetic patients. A nomogram was constructed based on these variables, yielding an AUC of 0.775. At the optimal cutoff value of 0.557, the model demonstrated a sensitivity of 59.1% and a specificity of 84.8%, indicating good discriminative ability. The Hosmer-Lemeshow test showed (χ 2=15.821, P=0.105), suggesting good agreement between predicted and observed outcomes. In the validation set, the AUC was 0.778, with Hosmer-Lemeshow (χ 2=8.557, P=0.575). DCA and CIC indicated favorable clinical applicability of the model. Conclusions:The depression risk prediction model constructed in this study demonstrated good predictive performance. It can assist clinicians in early identification of high-risk individuals with diabetes and provide a theoretical basis for targeted interventions.

Objective:To construct and validate a depression risk prediction model for middle-aged and elderly patients with diabetes.Methods:Data were extracted from the fifth wave (2020) of the China Health and Retirement Longitudinal Study (CHARLS). A total of 900 diabetic patients were identified, and after excluding those with missing data or invalid questionnaires, 769 patients were included in the analysis. Patients were randomly divided into a training set and a validation set in a 7∶3 ratio. Univariate analysis and logistic regression analysis were performed to screen the optimal predictors of depression in diabetic patients, and a nomogram model was developed. The predictive performance of the model was assessed by the area under the receiver operating characteristic curve ( AUC). Model calibration and accuracy were evaluated using bootstrap resampling, calibration plots, and the Hosmer-Lemeshow test. The clinical utility was further assessed by decision curve analysis (DCA) and clinical impact curves (CIC) . Results:Among the 769 patients, 366 (47.59%) had depression. Logistic regression analysis showed that place of residence, pain, difficulty in toileting, difficulty in bathing, sleep duration, physical exercise, life satisfaction, and children's satisfaction were independent predictors of depression in diabetic patients. A nomogram was constructed based on these variables, yielding an AUC of 0.775. At the optimal cutoff value of 0.557, the model demonstrated a sensitivity of 59.1% and a specificity of 84.8%, indicating good discriminative ability. The Hosmer-Lemeshow test showed (χ 2=15.821, P=0.105), suggesting good agreement between predicted and observed outcomes. In the validation set, the AUC was 0.778, with Hosmer-Lemeshow (χ 2=8.557, P=0.575). DCA and CIC indicated favorable clinical applicability of the model. Conclusions:The depression risk prediction model constructed in this study demonstrated good predictive performance. It can assist clinicians in early identification of high-risk individuals with diabetes and provide a theoretical basis for targeted interventions.

Objective:To elucidate the cytopathological characteristics,molecular subtypes,and clinical prognoses of metastatic breast car-cinoma with serosal effusions.Methods:Seventeen cases that included effusion cytology and clinical data were retrospectively analyzed.Two patients were diagnosed between April 2016 and September 2023 at the Suzhou Ninth Hospital Affiliated to Soochow University,and 15 patients were diagnosed at The First Affiliated Hospital of Soochow University.Cytopathological characteristics,molecular subtypes,and prognoses were analyzed.Results:The cytopathological features of metastatic breast carcinoma in serosal effusions were as follows:1)In-vasive ductal carcinoma:one cell type was relatively densely arranged in nests or colored spheres,which displayed an elevated nuclear/cyto-plasmic ratio,irregular nuclear membrane,and cytoplasmic mucin vacuoles.The other cell type was tiled,single scattered,and varied in size and shape,with enlarged nuclei and elevated nuclear/cytoplasmic ratio.2)Invasive lobular carcinoma:cells were scattered and uniform in size and shape.The nuclei had a relatively regular shape,but displayed an elevated nuclear-to-cytoplasmic ratio.Among the 17 breast can-cer cases,6 had transitioned in molecular subtyping,including 1 case from Luminal A to triple-negative type,1 case from Luminal B to hu-man epidermal growth factor receptor 2(HER-2)-overexpressing type,and 4 cases from Luminal B to triple-negative type.Conclusions:The cytopathological characteristics of serous effusion cells combined with immunocytochemical staining and fluorescence in situ hybridization(FISH)suggest that it is important to determine the origin and molecular typing of tumor cells.This provides an important basis for precise clinical treatment and prognosis.

OBJECTIVES: The incidence of infertility is increasing, more than 30% of them having related abnormal tubal patency. Four-dimensional (4D) hysterosalpingo-contrast sonography (HyCoSy) overcomes the shortcomings of 3D HyCoSy in the diagnosis of tubal patency, showing high specificity and accuracy. In addition, 4D HyCoSy discards iodine allergy and X-ray radiation and possesses easy-operating, contributing to good acceptance in clinical practice. However, there is no research to explore the imaging standards related to the possibility of natural pregnancy after 4D HyCoSy. If a predictive model of postoperative natural pregnancy was established using the analysis of clinical data combined with imaging characteristics of 4D HyCoSy of patients with tubal factor infertility, clinical decision-making can be wisely guided in the future. This study aims to establish a predictive model of natural pregnancy after 4D HyCoSy based on clinical data and imaging characteristics of patients with tubal factor in fertility. METHODS: A retrospective study was conducted for patients who were diagnosed with tubal factor infertility in Hunan Guangxiu Hospital from February 2017 to May 2018. The patients ought to possess complete 4D HyCoSy imaging data and at least one-side-unobstructed fallopian tube. General clinical data and imaging data were collected. Pregnancy outcome was followed up till 3 months after 4D HyCoSy. According to pregnancy outcome, patients were divided into a pregnancy group and a non-pregnancy group. Binary logistic regression was used to analyze the correlation between various variables and natural pregnancy after 4D HyCoSy. The variables with significant difference (P<0.05) in single-factor logistic regression were included in the natural pregnancy probability prediction model. The classification accuracy was further verified with 10-fold cross-validation. RESULTS: A total of 1 085 patients with clinically suspected tubal factor infertility who met the requirements and followed the doctors' prescription were collected. Clinical characteristics (age and duration of infertility) and 4D HyCoSy imaging characteristics (thickness of endometrium from the 3rd to the 7th day after the end of menstruation, visualization of the left fallopian tube, the diffusion of contrast agent around the left ovary, and the diffusion of contrast agent around the right ovary) were independent predictors for natural pregnancy 3 months after 4D HyCoSy. A natural pregnancy probability prediction model was established with the area under the curve (AUC) verified by the 10-fold cross-validation all greater than 0.75, and the best AUC was 0.868. The Q value obtained by the prediction model was the probability of natural pregnancy, and the cutoff value was 0.5. When the Q value was greater than 0.5, it was recommended to attempt natural pregnancy for 3 months, and when the Q value was less than 0.5, in vitro fertilization was adviced. CONCLUSIONS A predictive model for the evaluating probability of natural pregnancy in women with tubal factor infertility after 4D HyCoSy is successfully established based on the analysis for clinical data and imaging characteristics. This model shows a great potential in assisting clinical decision making.
Humans ; Female ; Pregnancy ; Contrast Media ; Retrospective Studies

Mesalamine (5-aminosalicylic acid, 5-ASA) is used for ulcerative colitis, mild Crohn′s disease. The orally taken mesalamine is excreted primarily as N-acetyl-5-aminosalicylic acid (N-acetyl-5-ASA) via urine, renal damage and hematuria are rare. However, red-brown urine discoloration has been noted by some patients, which is associated with the reaction between N-acetyl-5-ASA and remaining hypochlorite in the disinfectant-containing water. This article reports a case of mesalamine-associated red-brown urine discoloration and reviews related literatures.

Mesalamine (5-aminosalicylic acid, 5-ASA) is used for ulcerative colitis, mild Crohn′s disease. The orally taken mesalamine is excreted primarily as N-acetyl-5-aminosalicylic acid (N-acetyl-5-ASA) via urine, renal damage and hematuria are rare. However, red-brown urine discoloration has been noted by some patients, which is associated with the reaction between N-acetyl-5-ASA and remaining hypochlorite in the disinfectant-containing water. This article reports a case of mesalamine-associated red-brown urine discoloration and reviews related literatures.

Objective: To describe the status of cognition about colorectal cancer and the screening and its relevant factors among first degree relatives of hereditary colorectal cancer patients in Guangzhou. Methods: Totally 274 subjects were investigated by a self-designed demographic questionnaire and the Chinese version of Cognitive Questionnaire for Colorectal Cancer and were analyzed by chisquare test, rank sum test and logistic regressive. Results: 60.2% (165/274) cases had a high level of cognition about colorectal cancer, 23.7% (65/274) had middle level of cognition about colorectal cancer and 16.0% (44/274) had a low level of cognition about colorectal cancer. Multivariate logistic regression analysis showed that age, sex, degree of education, marital status, family income, medical insurance and the number of cancer patients in his family were related factors (P<0.05). People who were young, female, highly educated, high family income, single, public/urban health insurance, commercial insurance and with more than 4 relatives suffering from colorectal cancer have higher cognitive level. Conclusions The level of cognition about colorectal cancer among first degree relatives of hereditary colorectal cancer patients was a little high. Medical staff should pay attention to relevant factors of health belief in subjects and develop targeted intervention to improve the level of cognition among these subjects and to promote their screening behavior.

Objective To retrospectively study the influence of Shenmai injection on clinical effects and cellular immune function of patients with severe acute pancreatitis (SAP).Methods A total of 70 patients with SAP in our hospital was retrospectively analyzed,and were randomly divided into observation group (traditional therapy and Shenmai injection) and control group (traditional therapy),with 35 cases per group.The general information,the clinical effects,acute physiology and chronic health evaluation Ⅱ scores (the APACHE Ⅱ scores),the immunity indicators (levels of NK T cells,CD4+ T cells,CD8+ T cells,CD4+/CD8+) before and after treatment,the adverse reaction rates in two groups were compared.Results The general information in two groups had no statistically significant difference (P ＞ 0.05).The disappearance of abdominal pain and distension,the time that returned to normal temperature,the first defection,normal levels of amylase in blood and urine,the length of stay in observation group were obviously shorter than that in the control group (P ＜ 0.05).The APACHE Ⅱ scores in two groups after treatment were obviously lower than treatment before,and the levels of immunity indicators after treatment were obviously higher than treatment before (P ＜ 0.05).After treatment,the APACHE Ⅱ score in observation group was obviously lower,and the immunity indicators in observation group were obviously higher than that in the control group (P ＜ 0.05).The adverse reaction rate in observation group was obviously lower than that in control group (5.9％ vs.27.3％,x2 =5.584,P =0.02).Conclusion Shenmai injection can improve the cellular immune function of SAP patients.

Objective To retrospectively study the influence of Shenmai injection on clinical effects and cellular immune function of patients with severe acute pancreatitis (SAP).Methods A total of 70 patients with SAP in our hospital was retrospectively analyzed,and were randomly divided into observation group (traditional therapy and Shenmai injection) and control group (traditional therapy),with 35 cases per group.The general information,the clinical effects,acute physiology and chronic health evaluation Ⅱ scores (the APACHE Ⅱ scores),the immunity indicators (levels of NK T cells,CD4+ T cells,CD8+ T cells,CD4+/CD8+) before and after treatment,the adverse reaction rates in two groups were compared.Results The general information in two groups had no statistically significant difference (P ＞ 0.05).The disappearance of abdominal pain and distension,the time that returned to normal temperature,the first defection,normal levels of amylase in blood and urine,the length of stay in observation group were obviously shorter than that in the control group (P ＜ 0.05).The APACHE Ⅱ scores in two groups after treatment were obviously lower than treatment before,and the levels of immunity indicators after treatment were obviously higher than treatment before (P ＜ 0.05).After treatment,the APACHE Ⅱ score in observation group was obviously lower,and the immunity indicators in observation group were obviously higher than that in the control group (P ＜ 0.05).The adverse reaction rate in observation group was obviously lower than that in control group (5.9％ vs.27.3％,x2 =5.584,P =0.02).Conclusion Shenmai injection can improve the cellular immune function of SAP patients.

It is difficult to select the appropriate ventilation mode in clinical mechanical ventilation. This paper presents a nonlinear multi-compartment lung model to solve the difficulty. The purpose is to optimize respiratory airflow patterns and get the minimum of the work of inspiratory phrase and lung volume acceleration, minimum of the elastic potential energy and rapidity of airflow rate changes of expiratory phrase. Sigmoidal function is used to smooth the respiratory function of nonlinear equations. The equations are established to solve nonlinear boundary conditions BVP, and finally the problem was solved with gradient descent method. Experimental results showed that lung volume and the rate of airflow after optimization had good sensitivity and convergence speed. The results provide a theoretical basis for the development of multivariable controller monitoring critically ill mechanically ventilated patients.
Exhalation ; Humans ; Lung ; physiology ; Models, Biological ; Nonlinear Dynamics ; Pulmonary Ventilation ; Respiration ; Respiration, Artificial ; Tidal Volume