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 efficacy of toric intraocular lens (IOL) combined with capsular tension rings (CTR) in the treatment of high myopia complicated by corneal astigmatism and cataract and its effects on visual acuity.Methods:A retrospective study was conducted on 80 eyes of 80 patients with high myopia complicated by corneal astigmatism and cataract who received treatment at Baoji People's Hospital from December 2021 to December 2023. Based on the treatment methods, the patients were divided into two groups. The study group was treated with toric IOL combined with CTR, while the control group was treated with toric IOL only. The best corrected visual acuity, corneal astigmatism, visual quality, the degree of intraocular lens rotation, and the incidence of postoperative complications were compared between the two groups before and after surgery.Results:After surgery, the best corrected visual acuity and corneal astigmatism in the study group were significantly better than those in the control group [(0.18 ± 0.24) LogMAR vs. (0.23 ± 0.16) LogMAR, t = 4.05, P < 0.001; (0.73 ± 0.22) D vs. (0.45 ± 0.26) D, t = 6.79, P = 0.001]. At 1 month post-surgery, the visual quality scores in the study group were significantly higher than those in the control group ( t = 5.36, 6.35, 7.14, 4.25, all P < 0.05). At 1 week, 1 month, 3 months, and 6 months after surgery, the degrees of intraocular lens rotation in the study group were less than those in the control group ( t = 5.59, 2.70, 4.22, 6.10, all P < 0.05). At 6 months post-surgery, the incidence of complications in the study group was lower than that in the control group [20.00% (8/40) vs. 45.00% (18/40), χ2 = 5.70, P = 0.017]. Conclusions:Toric IOL combined with CTR treatment can effectively improve the visual function in patients with high myopia complicated by corneal astigmatism and cataract. This approach reduces the incidence of postoperative complications and minimizes astigmatism, proving to be both safe and effective.

Ivonescimab is a humanized bispecific antibody targeting human vascular endothelial growth factor-A(VEGF-A)and programmed death protein-1(PD-1).It was approved by National Medi-cal Products Administration on May 24th,2024,and can be used in combination with pemetrexed and carboplatin for locally advanced or positive EG-FR gene mutation after treatment with epidermal growth factor receptor(EGFR)tyrosine kinase inhib-itor.This paper mainly introduces the research progress of the world's first PD-1/VEGF bispecific antibody ivonescimab,and summarizes the mecha-nism of action,pharmacokinetics,phase Ⅰ-Ⅲ clinical trials and drug safety.

Objective:To evaluate the incidence, clinical features, factors affecting initial diagnosis, efficacy, and safety of therapy and prognosis of small intestinal Dieulafoy lesions (DL).Methods:Clinical data including clinical background, diagnosis, and treatment details of patients who were admitted to the Department of Gastroenterology, Air Force Medical Center, for suspected small bowel bleeding, diagnosed as having small bowel DL and treated with balloon-assisted enteroscopy (BAE) were retrospectively analyzed from November 2017 to March 2024.Results:Among 800 patients, 30 cases (3.75%, 30/800, 17 males and 13 females) were diagnosed as having small intestine DL with the mean age of 60.90 years. Clinical symptoms included melena (56.67%, 17/30), hematochezia (43.33%, 13/30), and hemodynamic instability (30.00%, 9/30). Active bleeding occurred in 23 (76.67%) patients. Comorbidities existed in 70.00% (21/30) and 33.33% (10/30) used long-term antithrombotic agents. Diagnosis was confirmed after a single BAE in 63.33% (19/30) and after multiple BAEs (mean 1.6 procedures) in 36.67% (11/30). Lesions were predominantly located at jejunal. All patients achieved successful treatment with a single BAE procedure. The median follow-up period was 12.25 months (range: 5.25-23.00 months). Five cases (16.67%) experienced recurrent bleeding, with one case transfered to surgical intervention. Two cases (6.67%) reported post-operative symptoms of dizziness and fatigue, which resolved after symptomatic management. Multivariate analysis showed that long-term oral anticoagulant therapy ( OR=0.06, 95% CI: 0.01-0.73) was an independent predictor of single-session diagnosis. Conclusion:Small intestinal DL is rare and challenging to diagnose. Antithrombotic therapy may facilitate the diagnosis of DL at the first BAE. Jejunal localization is common, and combined endoscopic therapy (including clipping) is effective and safe.

Objective To evaluate the efficacy and safety of obinutuzumab(OBZ)in the treatment of refractory primary membranous nephropathy(pMN).Methods The clinical data of 15 patients with refractory pMN who received OBZ treatment in Department of Nephrology of The First Affiliated Hospital of Naval Medical University between Jan.2022 and Sep.2024 were retrospectively analyzed,and they included basic information,relevant laboratory indexes,clinical and immunological outcomes,and adverse events.Results Among the 15 patients with refractory pMN,14(93.3％)were phospholipase A2 receptor(PLA2R)-associated membranous nephropathy(10 cases with positive PLA2R by renal biopsy and 4 cases with no recorded PLA2R results by renal biopsy but with positive serum PLA2R antibodies).During the follow-up period,all 15 patients achieved clinical remission,with 4(26.7％)patients achieving complete remission and 11(73.3％)patients achieving partial remission.Of the 12 patients with positive serum PLA2R antibodies,11 patients had continuously positive serum PLA2R antibodies before OBZ treatment,and 9(81.8％)patients achieved immunological remission after OBZ treatment.All the 15 patients had previously received immunosuppressive therapy,and all of them were classified as refractory pMN,with 7(46.7％)patients having been treated with cyclophosphamide combined with corticosteroids,2(13.3％)patients having been treated with calcineurin inhibitor combined with corticosteroids,11(73.3％)patients having received rituximab.During the treatment,2(13.3％)cases of adverse events were observed:1 patient experienced transient liver dysfunction,and the transaminase returned to normal after discontinuing atorvastatin;another patient developed a positive T-cell spot test for Tuberculosis infection during the intertreatment interval and successfully completed the subsequent OBZ treatment and achieved clinical remission after treatment with isoniazid and rifampicin.Conclusion OBZ demonstrates favorable clinical efficacy in the treatment of refractory pMN,with a low incidence of adverse events.

Ivonescimab is a humanized bispecific antibody targeting human vascular endothelial growth factor-A(VEGF-A)and programmed death protein-1(PD-1).It was approved by National Medi-cal Products Administration on May 24th,2024,and can be used in combination with pemetrexed and carboplatin for locally advanced or positive EG-FR gene mutation after treatment with epidermal growth factor receptor(EGFR)tyrosine kinase inhib-itor.This paper mainly introduces the research progress of the world's first PD-1/VEGF bispecific antibody ivonescimab,and summarizes the mecha-nism of action,pharmacokinetics,phase Ⅰ-Ⅲ clinical trials and drug safety.

Objective:To evaluate the incidence, clinical features, factors affecting initial diagnosis, efficacy, and safety of therapy and prognosis of small intestinal Dieulafoy lesions (DL).Methods:Clinical data including clinical background, diagnosis, and treatment details of patients who were admitted to the Department of Gastroenterology, Air Force Medical Center, for suspected small bowel bleeding, diagnosed as having small bowel DL and treated with balloon-assisted enteroscopy (BAE) were retrospectively analyzed from November 2017 to March 2024.Results:Among 800 patients, 30 cases (3.75%, 30/800, 17 males and 13 females) were diagnosed as having small intestine DL with the mean age of 60.90 years. Clinical symptoms included melena (56.67%, 17/30), hematochezia (43.33%, 13/30), and hemodynamic instability (30.00%, 9/30). Active bleeding occurred in 23 (76.67%) patients. Comorbidities existed in 70.00% (21/30) and 33.33% (10/30) used long-term antithrombotic agents. Diagnosis was confirmed after a single BAE in 63.33% (19/30) and after multiple BAEs (mean 1.6 procedures) in 36.67% (11/30). Lesions were predominantly located at jejunal. All patients achieved successful treatment with a single BAE procedure. The median follow-up period was 12.25 months (range: 5.25-23.00 months). Five cases (16.67%) experienced recurrent bleeding, with one case transfered to surgical intervention. Two cases (6.67%) reported post-operative symptoms of dizziness and fatigue, which resolved after symptomatic management. Multivariate analysis showed that long-term oral anticoagulant therapy ( OR=0.06, 95% CI: 0.01-0.73) was an independent predictor of single-session diagnosis. Conclusion:Small intestinal DL is rare and challenging to diagnose. Antithrombotic therapy may facilitate the diagnosis of DL at the first BAE. Jejunal localization is common, and combined endoscopic therapy (including clipping) is effective and safe.

Objective:To investigate the efficacy of toric intraocular lens (IOL) combined with capsular tension rings (CTR) in the treatment of high myopia complicated by corneal astigmatism and cataract and its effects on visual acuity.Methods:A retrospective study was conducted on 80 eyes of 80 patients with high myopia complicated by corneal astigmatism and cataract who received treatment at Baoji People's Hospital from December 2021 to December 2023. Based on the treatment methods, the patients were divided into two groups. The study group was treated with toric IOL combined with CTR, while the control group was treated with toric IOL only. The best corrected visual acuity, corneal astigmatism, visual quality, the degree of intraocular lens rotation, and the incidence of postoperative complications were compared between the two groups before and after surgery.Results:After surgery, the best corrected visual acuity and corneal astigmatism in the study group were significantly better than those in the control group [(0.18 ± 0.24) LogMAR vs. (0.23 ± 0.16) LogMAR, t = 4.05, P < 0.001; (0.73 ± 0.22) D vs. (0.45 ± 0.26) D, t = 6.79, P = 0.001]. At 1 month post-surgery, the visual quality scores in the study group were significantly higher than those in the control group ( t = 5.36, 6.35, 7.14, 4.25, all P < 0.05). At 1 week, 1 month, 3 months, and 6 months after surgery, the degrees of intraocular lens rotation in the study group were less than those in the control group ( t = 5.59, 2.70, 4.22, 6.10, all P < 0.05). At 6 months post-surgery, the incidence of complications in the study group was lower than that in the control group [20.00% (8/40) vs. 45.00% (18/40), χ2 = 5.70, P = 0.017]. Conclusions:Toric IOL combined with CTR treatment can effectively improve the visual function in patients with high myopia complicated by corneal astigmatism and cataract. This approach reduces the incidence of postoperative complications and minimizes astigmatism, proving to be both safe and effective.

Standards are the technical support for economic activities and social development. The construction and standardization of the pathogenic microorganism preservation standard system is an important technical foundation for the high-quality development of preservation work. Establishing a pathogenic microorganism resource standard system is also important to the national biosafety standards. Through the standardization of pathogenic microbial resource preservation, we can ensure the effective management and sustainable utilization of pathogenic microbial resources, promote the transformation of resources, and serve as an important new element of new productivity to assist the innovative development of biosafety science and technology. This article elaborates and analyzes the establishment background, construction framework, standardization process, and application effects of the standard system for preserving pathogenic microbial resources, providing stronger support for further improving the standard system and promoting the standardization of pathogenic microbial resource preservation.

Objective We investigated the effects of Xueguan Ruanhua Pills(XGRHW) on ferroptosis in ApoE-/- atherosclerotic mice through the nuclear factor E2 related factor 2 (Nrf2)/xCT/glutathione peroxidase 4 (GPX4) signaling pathway.Methods Ten male C57BL/6J mice in the normal group were fed normal chow. Additionally, 50 ApoE-/- mice were fed high-fat chow for 12 weeks, and were divided into the following five groups (10 mice per group): the model group, the XGRHW low-dose (2.34g/kg) group, the XGRHW high-dose (4.68 g/kg) group, the XGRHW high-dose combined with the Nrf2 inhibitor ML385 (0.03 g/kg) group, and the ferrostatin-1 (1 mg/kg) group. Drugs were administered for 6 weeks. The blood levels of four types of lipids were detected by an automatic lipid analyzer, lipid deposition in the aorta was observed by Oil Red O staining, histomorphological changes in the aortic sinus were observed by HE staining, the serum levels of Fe2+, MDA, GSH, and SOD were determined by colorimetric assays, and the expression levels of FTH1 and FTL in the aortic sinus were observed by immunofluorescence. The protein levels of Nrf2, xCT, and GPX4 in mouse aortic tissues were detected by Western blotting. The ultrastructural changes of aortic mitochondria were observed by transmission electron microscopy.Results Compared with the normal group, mice in the model group showed obvious lipid plaque deposition in the aorta, severely calcified lesions in the aortic sinus, elevated serum levels of TC, TG, LDL-C, Fe2+, and MDA, decreased levels of HDL-C, SOD, and GSH (P<0.01), and decreased protein expressions of aortic Nrf2, xCT, and GPX4 as well as the iron storage proteins FTH1 and FTL (P<0.01), and serve damage to mitochondrial structure and morphology. Compared with the model group, the relative aortic plaque area was decreased, calcified lesions in the aortic sinus were decreased, serum levels of TC, TG, LDL-C, Fe2+, and MDA were decreased, and HDL-C, SOD, and GSH levels were increased in the XGRHW low-dose and high-dose and ferrostatin-1 groups (P<0.05 or P<0.01), and Nrf2, xCT, GPX4, and the iron storage proteins FTH1 and FTL were upregulated in aortic tissues (P<0.05 or P<0.01), and mitochondrial structure approaching normal. In the XGRHW high-dose+ML385 group, compared with the XGRHW high-dose group, the levels of blood lipids and lipid peroxidation were increased and the protein levels of Nrf2, xCT, and GPX4 in aortic tissue and the iron storage proteins FTH1 and FTL were decreased (P<0.01), and mitochondrial structure was damaged indicating that ML385 could inhibit the therapeutic effect of the XGRHW in atherosclerotic mice.Conclusion The XGRHW can improve blood lipid levels and reduce the degree of arterial plaque lesions in atherosclerotic mice, and its mechanism of action may be related to activation of the Nrf2/xCT/GPX4 pathway to inhibit ferroptosis.