Objective:To construct a prediction model for the risk of sarcopenia in middle-aged and elderly patients with knee osteoarthritis (KOA) based on machine learning, and to provide a basis for carrying out the prevention of sarcopenia in patients with KOA.Methods:Clinical data of KOA patients from three tertiary hospitals in Guangdong Province were collected between December 2023 and September 2024 using a convenience sampling method. The data were randomly split into training and test sets at an 8:2 ratio, with the occurrence of sarcopenia as the outcome variable. Risk prediction models for sarcopenia were constructed using eight machine learning algorithms: logistic regression, K-nearest neighbors, support vector machine, decision tree, neural network, random forest, gradient boosting machine (GBM), and eXtreme gradient boosting. Model performance was evaluated based on metrics including the area under the receiver operating characteristic curve (AUC), accuracy, precision, sensitivity, specificity, and F1 score. The optimal model was selected, and feature importance was visualized using the Shapley Additive exPlanations (SHAP) method.Results:Data from 640 KOA patients were analyzed, 143 males and 497 females, (67.51± 7.72) years, with 136 cases (21.25%) developing sarcopenia. All eight prediction models showed high AUC values, with the GBM model demonstrating the best performance. Its metrics included an AUC of 0.926 (95% CI 0.874 - 0.965), accuracy of 0.852, precision of 0.611, sensitivity of 0.815, specificity of 0.861, and F1 score of 0.698. SHAP analysis identified body mass index, calf circumference, body fat percentage, WOMAC score, and age as the most important predictive features. Conclusions:The GBM-based risk prediction model for sarcopenia in middle- aged and elderly KOA patients demonstrated optimal performance, enabling healthcare professionals to accurately and promptly identify high-risk groups among these patients and to develop effective, evidence-based intervention strategies.

Objective:To construct a prediction model for the risk of sarcopenia in middle-aged and elderly patients with knee osteoarthritis (KOA) based on machine learning, and to provide a basis for carrying out the prevention of sarcopenia in patients with KOA.Methods:Clinical data of KOA patients from three tertiary hospitals in Guangdong Province were collected between December 2023 and September 2024 using a convenience sampling method. The data were randomly split into training and test sets at an 8:2 ratio, with the occurrence of sarcopenia as the outcome variable. Risk prediction models for sarcopenia were constructed using eight machine learning algorithms: logistic regression, K-nearest neighbors, support vector machine, decision tree, neural network, random forest, gradient boosting machine (GBM), and eXtreme gradient boosting. Model performance was evaluated based on metrics including the area under the receiver operating characteristic curve (AUC), accuracy, precision, sensitivity, specificity, and F1 score. The optimal model was selected, and feature importance was visualized using the Shapley Additive exPlanations (SHAP) method.Results:Data from 640 KOA patients were analyzed, 143 males and 497 females, (67.51± 7.72) years, with 136 cases (21.25%) developing sarcopenia. All eight prediction models showed high AUC values, with the GBM model demonstrating the best performance. Its metrics included an AUC of 0.926 (95% CI 0.874 - 0.965), accuracy of 0.852, precision of 0.611, sensitivity of 0.815, specificity of 0.861, and F1 score of 0.698. SHAP analysis identified body mass index, calf circumference, body fat percentage, WOMAC score, and age as the most important predictive features. Conclusions:The GBM-based risk prediction model for sarcopenia in middle- aged and elderly KOA patients demonstrated optimal performance, enabling healthcare professionals to accurately and promptly identify high-risk groups among these patients and to develop effective, evidence-based intervention strategies.

Objective:To analyze the changes in biological characteristics including infectivity, growth and pathogenicity of Chlamydia muridarum ( Cm) after serial passage in vitro in special conditions in order to provide reference for screening attenuated live vaccines and virulence-related genes. Methods:Wild-type Cm strain (G0) was cultured for several passages using conventional cell culture method under alternate unassisted and assisted culture conditions. Then, the 28th generation (G28) of Cm was selected and compared with the parental G0 strain in terms of centrifugation dependence, attaching ability, intracellular growth curve, plaque size and fallopian tube lesions after genital tract infection in a mouse model. Results:Compared with the parental G0 strain, the G28 strain showed significantly decreased dependence on centrifugation during cell infection ( P<0.05) and increased attachment capacity to cells ( P<0.05). No significant differences were observed in the growth curves 32 h after cell infection or in the plaque sizes between the parental G0 and G28 strains. In the in vivo virulence test, fallopian tube lesions were observed in 87.5% of G0-infected mice and 37.5% of G28-infected mice ( P<0.05). Conclusions:Compared with the parental G0 strain, the G28 strain showed significantly enhanced in vitro infection ability, but decreased in vivo pathogenicity, which brought hope for further identification of virulence genes, isolation of attenuated strains with single genotype and development of live attenuated Chlamydia vaccines.

A facial allotransplanted patient presented hyperglycemia with blood glucose ranged 14. 3 -33. 3 mmol/L after receiving immunosuppressive drugs and glucocorticoids. To control the blood glucose level, the patient was treated with two subcutaneous doses of 10 U human neutral protamine hagedorn (NPH) insulin, and the fasting glucose level came down to 3. 6 - 9. 4 mmol/L. Then the continuous subcutaneous infusion of insulin aspart ( Novo Industri) was administrated (from 96 to 21 U/d) , and the fasting blood glucose levels were 3. 9 -4. 6 mmol/L. With oral administration of Metformin and Repaglinide, the fasting blood glucose was maintained to 4. 3 -5.9 mmol/L. With these medications, the blood glucose level of the patient was under good control and the acute and chronic complications of hyperglycemia were effectively prevented.

Objective To explore the early diagnosis of lower extremity deep venous thrombosis (LDVT)and evaluate the therapeutic effect of anticoagulant therapy in hospitalized patients with acute ischemic stroke. Methods　According to Wells model for suspecting lower extremity deep venous thrombosis,patients with suspected LDVT were confirmed by compression ultrasonography. If the patients diagnosed with LDVT had no contraindications to anticoagulant therapy,they were treated with low molecular weight heparin(LMWH)subcutaneous injection and oral warfarin at the same time.The dosage of oral warfarin was determined by Roberts'age adjusted warfarin loading protocol.LMWH was stopped when the patients'international normalized ratio(INR)was 2.0～3.0 for two consecutive days. Results From January 2003 to August 2007,2067 cases with acute ischemic stroke were admitted to the department of neurology in Huizhou Municipal Central Hospital including 18 cases with LDVT and the incidence was 0.9%.The patients with LDVT all had paralytic extremities including 13 left legs and 5 right legs with deep vein thrombosis.All the 18 cases were treated by anticoagulant including 17 cases with oral warfarin treatment for 3 months.Symptoms in all LDVT patients were eliminated.12 cases had been observed for one year and 5 cases for three months after they stopped taking warfatin.There were no patients with pulmonary thromboembolism and LDVT recurrence. Conclusions　By using Wells model for suspecting LDVT,patients with acute ischemic stroke-complicated LDVT can be timely diagnosed.The goal of prompt and enough anticoagulant can be achieved according to Roberts'age adjusted warfarin loading protocol.Because of racial difference,population difference and other unknown factors,the incidence of acute ischemic stroke patients with complicated LDVT is much lower in Huizhou.It suggests that it should be unnecessary to use LMWH in patients with acute ischemic stroke to prevent LDVT in Huizhou.

Objective To detect mutations of the RET proto-oncogene in a family with multiple endocrine neoplasia type 2A (MEN2A). Methods Nineteen family members were recruited in the study. The phenotype of the members with MEN2A were observed. PCR was performed to amplify exans 10 and 11 of the RET proto-oncogene. The PCR products were purified and a direct DNA sequence analysis was performed. Results The Cys (TGC)634Arg(CGC) missense mutation and Gly( GGT)691Ser(AGT) in exon 11 of the RET proto-oncogene were both detected in four members of the family. Only the pelymorphism Gly691Ser in exon 11 of the RET proto-oncogene was detected in one member. The results of the ultrasound examination were shown as follows: two members with bilateral thyroid, one side of parathyroid and adrenal solid lesions; one member with bilateral thyroid and one side of adrenal solid lesions; one member with bilateral thyroid and adrenal and one side of parathyroid solid lesions; and one member with multiple thyroid small nodules. Additionally, another three members with abnormal findings on ultrasound examinations had no gene mutation. Conclusion Analysis of RET gene identifies a TGC to CGC mutation at codan 634 and the polymorphism Gly691 Set in exon 11 in this family with MEN2A. Direct DNA sequencing analysis is useful in diagnosis of MEN2A at gene level.

Objectives:To determine the expressions of decoy receptors (DcR1 and DcR2) of TRAIL in carcinoma of endometrium. Methods:The expressions of DcR1 and DcR2 in endometrium tissues from 13 carcinoma of endometrium and 7 normal endometrium were detected by immunohistochemical staining.Results: The expressions of DcR1 and DcR2 in carcinoma of endometrium were much lower than in normal endometrium. Conclusions:The decreasing of DcR1 and DcR2 in carcinoma of endometrium may be concerned with its pathogenesis, which may be related to the prevention of endometrium from carcinomatous change.