Objective To observe the correlations of chest CT quantitative parameters and one-year readmission in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods Totally 225 AECOPD patients were included and divided into the readmission group(group A,n=61)and non-readmission group(group B,n=164)according to whether readmitted due to acute exacerbation within one year or not.Quantitative CT parameters,including the percentage of low attenuation area volume to total lung volume(LAA％)and intrapulmonary vascular volume(IPVV)of the whole lung,left/right lung and each lobe,as well as the bronchial lumen area(LA)and percentage of bronchial wall area(WA％)of grades 3-8 were compared between groups.Spearman correlations were used to analyze the correlations between quantitative CT parameters and one-year readmission.Results LAA％of the whole lung,right lung,upper lobe of both lungs,middle lobe of the right lung,and lower lobe of the right lung in group A were higher than that in group B(all P＜0.05),which were weakly positively correlated with readmissions within one year(r=0.142-0.187,all P＜0.05).Significant differences of the upper lobe of right lung LAgrade 6,lower lobe of left lung LAgrade 6,lower lobe of left lung LAgrade 8,upper lobe of right lung WA％grade 5,upper lobe of right lung WA％grade 8 and lower lobe of left lung WA％grade 8 were found between groups,which were all correlated with readmissions within one year except for the lower lobe of the left lung LAgrade 6(all P＜0.05).Conclusion One-year readmission in AECOPD patients might be associated with severe airway remodeling and emphysema.

BACKGROUND: Postoperative pulmonary complications (PPCs) are major adverse events in neurosurgical patients. This study aimed to develop and validate machine learning models predicting PPCs after neurosurgery. METHODS: PPCs were defined according to the European Perioperative Clinical Outcome standards as occurring within 7 postoperative days. Data of cases meeting inclusion/exclusion criteria were extracted from the anesthesia information management system to create three datasets: The development (data of Huashan Hospital, Fudan University from 2018 to 2020), temporal validation (data of Huashan Hospital, Fudan University in 2021) and external validation (data of other three hospitals in 2023) datasets. Machine learning models of six algorithms were trained using either 35 retrievable and plausible features or the 11 features selected by Lasso regression. Temporal validation was conducted for all models and the 11-feature models were also externally validated. Independent risk factors were identified and feature importance in top models was analyzed. RESULTS: PPCs occurred in 712 of 7533 (9.5%), 258 of 2824 (9.1%), and 207 of 2300 (9.0%) patients in the development, temporal validation and external validation datasets, respectively. During cross-validation training, all models except Bayes demonstrated good discrimination with an area under the receiver operating characteristic curve (AUC) of 0.840. In temporal validation of full-feature models, deep neural network (DNN) performed the best with an AUC of 0.835 (95% confidence interval [CI]: 0.805-0.858) and a Brier score of 0.069, followed by Logistic regression (LR), random forest and XGBoost. The 11-feature models performed comparable to full-feature models with very close but statistically significantly lower AUCs, with the top models of DNN and LR in temporal and external validations. An 11-feature nomogram was drawn based on the LR algorithm and it outperformed the minimally modified Assess respiratory RIsk in Surgical patients in CATalonia (ARISCAT) and Laparoscopic Surgery Video Educational Guidelines (LAS VEGAS) scores with a higher AUC (LR: 0.824, ARISCAT: 0.672, LAS: 0.663). Independent risk factors based on multivariate LR mostly overlapped with Lasso-selected features, but lacked consistency with the important features using the Shapley additive explanation (SHAP) method of the LR model. CONCLUSIONS: The developed models, especially the DNN model and the nomogram, had good discrimination and calibration, and could be used for predicting PPCs in neurosurgical patients. The establishment of machine learning models and the ascertainment of risk factors might assist clinical decision support for improving surgical outcomes. TRIAL REGISTRATION ChiCTR 2100047474; https://www.chictr.org.cn/showproj.html?proj=128279 .
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Algorithms ; Lung Diseases/etiology* ; Machine Learning ; Neurosurgical Procedures/adverse effects* ; Postoperative Complications/diagnosis* ; Risk Factors ; ROC Curve

Hemoperfusion device is widely used in the field of blood purification because of its good adsorption properties to some substances in the body.By combing the principle,structure and other characteristics of the hemoperfusion device,searching the approval status of the currently listed products,this paper summarized the main application fields,application scenarios and research frontiers of the hemopoeia product,combined with the current status of the product declaration and product characteristics,and discussed the main concerns of product review,such as product chemical residue and its risk assessment methods,performance verification,etc.In order to provide reference for the product development of relevant product development institutions and the supervision of regulatory agencies.

Objective To observe the correlations of chest CT quantitative parameters and one-year readmission in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods Totally 225 AECOPD patients were included and divided into the readmission group(group A,n=61)and non-readmission group(group B,n=164)according to whether readmitted due to acute exacerbation within one year or not.Quantitative CT parameters,including the percentage of low attenuation area volume to total lung volume(LAA％)and intrapulmonary vascular volume(IPVV)of the whole lung,left/right lung and each lobe,as well as the bronchial lumen area(LA)and percentage of bronchial wall area(WA％)of grades 3-8 were compared between groups.Spearman correlations were used to analyze the correlations between quantitative CT parameters and one-year readmission.Results LAA％of the whole lung,right lung,upper lobe of both lungs,middle lobe of the right lung,and lower lobe of the right lung in group A were higher than that in group B(all P＜0.05),which were weakly positively correlated with readmissions within one year(r=0.142-0.187,all P＜0.05).Significant differences of the upper lobe of right lung LAgrade 6,lower lobe of left lung LAgrade 6,lower lobe of left lung LAgrade 8,upper lobe of right lung WA％grade 5,upper lobe of right lung WA％grade 8 and lower lobe of left lung WA％grade 8 were found between groups,which were all correlated with readmissions within one year except for the lower lobe of the left lung LAgrade 6(all P＜0.05).Conclusion One-year readmission in AECOPD patients might be associated with severe airway remodeling and emphysema.

Hemoperfusion device is widely used in the field of blood purification because of its good adsorption properties to some substances in the body.By combing the principle,structure and other characteristics of the hemoperfusion device,searching the approval status of the currently listed products,this paper summarized the main application fields,application scenarios and research frontiers of the hemopoeia product,combined with the current status of the product declaration and product characteristics,and discussed the main concerns of product review,such as product chemical residue and its risk assessment methods,performance verification,etc.In order to provide reference for the product development of relevant product development institutions and the supervision of regulatory agencies.

OBJECTIVE To investigate the effects and potential mechanism of Qiangxin decoction on mitochondrion of rats with chronic heart failure(CHF).METHODS The CHF model was established by ligating the left anterior descending branch of the coronary artery.Modeled rats were divided into model group,Qiangxin decoction low-dose and high-dose groups(12.25,24.50 g/kg,calculated by crude drug),and chemical medicine group(Sacubitril valsartan sodium tablets,10.42 mg/kg),with 10 rats in each group;control group was set up without treatment.Each group of rats was orally administered with the corresponding medication or normal saline twice a day for 28 consecutive days.After the last medication,the contents of N-terminal pro-brain natriuretic peptide(NT-proBNP)and adenosine triphosphate(ATP)in serum and phosphatidic acid(PA)and cardiolipin(CL)in myocardial tissue were all detected;the pathological damage and collagen fibrosis of rat myocardial tissue were observed;the apoptosis of myocardial cells was determined;the ultrastructure of myocardial tissue was observed;the protein expressions of mitofusin 1(Mfn1),Mfn2,optic atrophy protein 1(OPA1)and dynamin-related protein 1(Drp1)were all detected in myocardial tissue.RESULTS Compared with control group,the serum content of NT-proBNP,apoptotic rate of myocardial cells,and relative expressions of S-OPA1 and Drp1 proteins were all increased significantly;serum content of ATP,contents of PA and CL,and relative expressions of Mfn1,Mfn2 and L-OPA1 proteins were all significantly reduced(P＜0.05).There were abnormal membrane tissue structure in various layers of myocardial tissue,degeneration and necrosis of myocardial cells,and severe fibrosis;the mitochondria were swollen,with reduced or absent cristae,and uneven matrix density.After intervention with Qiangxin decoction,the levels of the aforementioned quantitative indicators in serum and myocardial tissue of rats(excluding CL content in the Qiangxin decoction low-dose group)were significantly reversed(P＜0.05);the pathological damage of myocardial tissue had significantly improved,fibrosis had significantly reduced,mitochondrial morphology tended to be normal,cristae had increased,and matrix density was uniform.CONCLUSIONS Qiangxin decoction can regulate myocardial mitochondrial function and structural integrity of CHF rats,thereby improving myocardial energy metabolism and antagonizing myocardial fibrosis,the mechanism of which may be associated with activating PA/Mfn/CL signaling pathway.

Objective To construct lentiviral vector of p62 gene over-expression,and stably express p62 gene in human monocytic leukemia cells 1(THP-1),and to provide a way to study the role of p62 gene at the cellular lev-el.Methods The p62 gene fragment was amplified by polymerase chain reaction(PCR),and the amplified prod-uct was ligated to the linearized pcDNA3.1-Flag-PCDH10 lentiviral vector.After identifying with PCR,the PCR product was cotransfected with the packaging plasmid into human embryonic kidney cells 293(HEK 293T).THP-1 cells were infected with recombinant lentivirus.Positive cell clones were screened by ampicillin.Western blot and real-time fluorescence quantitative polymerase chain reaction(RT-qPCR)were used to detect THP-1 cell lines with high p62 expression(overexpression group)and THP-1 cell lines transfected with empty plasmid without p62 gene(control group).The expression levels of TNF-α,IL-1β and Cxcl1 after K.p.infection were detected by RT-qPCR.Results The p62 gene fragment was successfully obtained by PCR and ligated to pcDNA3.1-Flag-PCDH10 vector.PCR confirmed that p62-pcDNA3.1-Flag-PCDH10 recombinant plasmid was constructed successfully.Am-picillin-resistant cell lines were selected after lentiviral infection of THP-1 cells.The results of Western blot analysis showed that the THP-1 cells with drug sieve survival increased the expression of P62 protein compared with the con-trol cells(P<0.001),and RT-qPCR analysis showed that the relative mRNA expression of p62 increased(P<0.001).THP-1 cells with high expression of P62 were successfully constructed.The levels of TNF-α、IL-1β and Cxcl1 from THP-1 cells with high expression of P62 significantly increased after infection with K.p.(P<0.01).Conclusion P62-pcDNA3.1-Flag-PCDH10 vector and THP-1 cells with high expression of P62 can be successful-ly constructed by three-plasmid packaging system,which provides a basis for the study of p62.

Objective To explore the acupoint selection law for acupoint stimulation to improve gastrointestinal function after colorectal cancer surgery based on data mining technology.Methods Literature about acupoint stimulation to improve gastrointestinal function was retrieved from CNKI,VIP,Wanfang Data,SinoMed,PubMed,Web of Science and Cochrane Library from the establishment of databases to July 1,2023.Data extraction and analysis were performed using Excel 2021.Association rule analysis and clustering analysis were conducted using R language.Results Totally 197 articles were collected,with 242 combinations of acupoints involving 69 acupoints and the total use frequency of acupoints was 878 times.The top 3 acupoints used in frequency were Zusanli(ST36),Shangjuxu(ST37),and Neiguan(PC6).The top 3 involved meridians were the stomach meridian,Conception Vessel,and spleen meridian.The acupoints were mainly distributed in the lower limbs,and the most commonly used intervention method was needle punching.The association analysis discovered a combination of acupoints centered around Zusanli(ST36),which included Shangjuxu(ST37),Neiguan(PC6),and Sanyinjiao(SP6).Clustering analysis identified 4 effective cluster combinations.Conclusion Acupoint stimulation improves gastrointestinal function after colorectal cancer surgery.Multiple acupoint selection ideas are used,and the summarized acupoint selection and compatibility law in this study can provide reference for clinical research and application.

Purpose To explore the application and clini-copathological significance of molecular classification in endome-trial cancer(EC)of WHO(2020)tumors of the female repro-ductive system.Methods Sixty-two EC patients were collected and categorized into four subgroups,namely POLE mutation type,mismatch repair deficient(MMRd)type,non-specific molecular spectrum(NMSP)type,and p53 mutation type,based on WHO molecular classification tested by PCR and im-munohistochemistry.The correlation among four molecular sub-groups and their clinicopathological features were analyzed.Re-sults The molecular classification was distributed as follows:3(4.8％)cases were POLE-mutated,15(24.2％)cases MMRd,36(58.1％)cases NSMP and 8(12.9％)cases p53 abnormal expression.There were no significant differences a-mong POLE-mutated and infiltration depth,grade,lymph vascu-lar space invasion and other pathological factors such as lymph node metastasis and FIGO stage(P＞0.05).Among 15 patients with MMRd,the proportion of FIGO stage Ⅱ+Ⅲ significantly increased.One case showed abnormal overexpression of p53 pro-tein,while two cases showed complete loss of expression in MMRd subgroup.36 cases of NSMP were associated with low histopathological grade(Grade Ⅰ+Ⅱ)(P＜0.05),and no significant differences were observed among NSMP and other clinicopathological factors(P＞0.05).The p53 abnormal ex-pression in 8 cases was related to high histopathological grade(Grade Ⅲ)(P＜0.05),and the rate of lymph node metastasis and FIGO stage Ⅱ+Ⅲ significantly increased in patients with p53 abnormal expression,and although the difference was not statistically significant(P＞0.05).Conclusion The molecu-lar subgroups of EC have certain clinical application value,the cases with MMRd and p53 abnormal expression may have poor prognosis than these with POLE-mutated and NSMP.

The surveillance data of new cases of acute myocardial infarction (AMI) from January 1, 2013, to December 31, 2021, in Tengzhou City, Shandong Province, were used to analyze the incidence rate of AMI and its change trend among residents. The age and gender standardized incidence rate was calculated based on the 7th National Population Census 2020. The Cochran-Armitage trend test was used to analyze the trend of onset time and age. From 2013 to 2021, the crude and standardized incidence rate of total AMI in Tengzhou City declined from 130.07/100 000 and 161.12/100 000 to 76.15/100 000 and 72.77/100 000 ( Z=-13.785 and -20.822, both P<0.001). The crude and standardized incidence rates of males were higher than those of females. In 2016, males aged 45-54 years old and females aged 35-64 years old increased by 33.33%, 103.65%, 106.30%, and 95.75% compared to 2015, and the differences were statistically significant ( χ2=6.512, 4.965, 25.115, and 46.004, all P<0.05). The incidence rate of AMI in men aged<35 and 35-44 years old had an upward trend. From 2013 to 2021, the incidence rate of AMI decreased by 55.15% in urban areas and 36.59% in rural areas ( Z=-8.529 and -11.235, both P<0.001).