BACKGROUND:The pathogenesis of moyamoya disease is unclear,and there is a lack of early diagnostic methods and effective medical treatments.OBJECTIVE:To identify biomarkers of moyamoya disease through machine learning,and analyze the therapeutic mechanism of Bu Huang Si Wu Tang in moyamoya disease.METHODS:Moyamoya disease gene dataset from gene expression omnibus database was retrieved.R language was used to screen differentially expressed genes and perform enrichment analysis on differentially expressed genes.Moyamoya disease biomarkers were screened using least absolute shrinkage and selection operator and support vector machine-recursive feature elimination machine learning algorithms.A diagnostic model was constructed by establishing a column chart,and its clinical utility and diagnostic value were evaluated and further validated through detecting clinical serum markers of patients with moyamoya disease.In vitro experiments were performed to observe the effect of Bu Huang Si Wu Tang on umbilical vein endothelial cells under oxygen glucose deprivation,and the main components of Bu Huang Si Wu Tang were selected for molecular docking and molecular dynamics simulation with the screened targets to explore its potential mechanism.RESULTS AND CONCLUSION:This study identified 76 differentially expressed genes,mainly enriched in immune and metabolic related pathways.Two potential biomarkers,complement factor D(CFD)and DKFZp434L192,were obtained through machine learning.The calibration curve,decision curve analysis,and clinical impact curve showed that the column chart had good predictive ability.qRT-PCR analysis showed that CFD and DKFZp434L192 expression levels were significantly upregulated in patients with moyamoya disease(P<0.001).In vitro experiments showed that Bu Huang Si Wu Tang significantly enhanced the activity and migration ability(P<0.01)of umbilical vein endothelial cells under oxygen glucose deprivation.Molecular docking results showed that all four active ingredients of Bu Huang Si Wu Tang could bind to the target site,and the dynamic simulation results further verified its binding stability.To conclude,CFD and DKFZp434L192 exhibit good diagnostic efficacy for moyamoya disease and can serve as potential diagnostic biomarkers and therapeutic targets for moyamoya disease.Bu Huang Si Wu Tang has a certain protective effect on vascular endothelial cells under ischemic conditions,which may be related to CFD.

BACKGROUND:The pathogenesis of moyamoya disease is unclear,and there is a lack of early diagnostic methods and effective medical treatments.OBJECTIVE:To identify biomarkers of moyamoya disease through machine learning,and analyze the therapeutic mechanism of Bu Huang Si Wu Tang in moyamoya disease.METHODS:Moyamoya disease gene dataset from gene expression omnibus database was retrieved.R language was used to screen differentially expressed genes and perform enrichment analysis on differentially expressed genes.Moyamoya disease biomarkers were screened using least absolute shrinkage and selection operator and support vector machine-recursive feature elimination machine learning algorithms.A diagnostic model was constructed by establishing a column chart,and its clinical utility and diagnostic value were evaluated and further validated through detecting clinical serum markers of patients with moyamoya disease.In vitro experiments were performed to observe the effect of Bu Huang Si Wu Tang on umbilical vein endothelial cells under oxygen glucose deprivation,and the main components of Bu Huang Si Wu Tang were selected for molecular docking and molecular dynamics simulation with the screened targets to explore its potential mechanism.RESULTS AND CONCLUSION:This study identified 76 differentially expressed genes,mainly enriched in immune and metabolic related pathways.Two potential biomarkers,complement factor D(CFD)and DKFZp434L192,were obtained through machine learning.The calibration curve,decision curve analysis,and clinical impact curve showed that the column chart had good predictive ability.qRT-PCR analysis showed that CFD and DKFZp434L192 expression levels were significantly upregulated in patients with moyamoya disease(P<0.001).In vitro experiments showed that Bu Huang Si Wu Tang significantly enhanced the activity and migration ability(P<0.01)of umbilical vein endothelial cells under oxygen glucose deprivation.Molecular docking results showed that all four active ingredients of Bu Huang Si Wu Tang could bind to the target site,and the dynamic simulation results further verified its binding stability.To conclude,CFD and DKFZp434L192 exhibit good diagnostic efficacy for moyamoya disease and can serve as potential diagnostic biomarkers and therapeutic targets for moyamoya disease.Bu Huang Si Wu Tang has a certain protective effect on vascular endothelial cells under ischemic conditions,which may be related to CFD.

Objective:To study the clinical application value of the data security governance path and countermeasures of information-based medical equipment maintenance management. Methods:The User Service Two Context (US2C) model was used to divide data governance indicators of medical equipment maintenance management,and the indicators of governance capability,governance effect and governance efficiency were evaluated from the conditional factors of users,services,internal environment and external environment,the necessity of antecedent factors and the coverage rate of combination conditions were analyzed by fuzzy set qualitative comparative analysis (fsQCA),and the security governance management path of security,data volume and system standardization was developed. The maintenance management data of 285 sets of medical equipment in clinical use in The Sixth Affiliated Hospital of South China University of Technology (Foshan Nanhai District People's Hospital) from 2020 to 2023 were selected,and the maintenance management data of 256 sets of equipment in the period from 2020 to 2021 adopted conventional management mode,and the maintenance management data of 268 sets (including 239 sets in use in conventional management) of medical equipment during 2022-2023 adopted the security governance model. A self-made questionnaire was used to investigate whether the amount of maintenance management data met the actual needs of 120 participants who used the equipment. The security,frequency of use and operation quality of medical equipment maintenance management data of the two management modes were compared. Results:The average risk rate of medical equipment maintenance management data using security governance mode was (1.333±0.741)％,which was lower than that of conventional management mode,the average accuracy and effectiveness were (93.925±3.432)％and (88.500±4.404)％,respectively,Which were higher those of the conventional management mode,the differences was statistically significant (t=2.298,4.784,P<0.05). The average satisfaction rate of the 120 participants who used the equipment was (94.367±3.093)％ of the medical equipment maintenance management data using the safety governance model,which was higher than that of the conventional management mode,and the difference was statistically significant (t=4.365,P<0.05). The frequency of use of medical equipment failure data,maintenance item data and management input data of the security governance mode were (4.092±1.709) times/year,(4.341±1.397) times/year and (3.821±0.976) times/year,respectively,which were higher than those of the conventional management mode,the difference was statistically significant (t=2.101,4.400,6.386,P<0.05). The failure frequencies of medical electronic equipment,life support equipment,operating room equipment,medical laboratory equipment and other medical equipment using the security governance mode were (0.831±0.335) times/year,(0.927±0.293) times/year,(1.085±0.439) times/year,(0.702±0.047) times/year and (1.456±0.485) times/year,respectively 0.485),which were lower than those of the conventional management mode,and the difference was statistically significant (t=5.330,5.486,4.756,6.974,3.598,P<0.05). Conclusion:The data security governance path and management countermeasures of information-based medical equipment maintenance management can standardize the medical equipment maintenance management data collection process,improve data security performance,improve data application efficiency,and improve equipment operation quality.

Objective:To study the clinical application value of the data security governance path and countermeasures of information-based medical equipment maintenance management. Methods:The User Service Two Context (US2C) model was used to divide data governance indicators of medical equipment maintenance management,and the indicators of governance capability,governance effect and governance efficiency were evaluated from the conditional factors of users,services,internal environment and external environment,the necessity of antecedent factors and the coverage rate of combination conditions were analyzed by fuzzy set qualitative comparative analysis (fsQCA),and the security governance management path of security,data volume and system standardization was developed. The maintenance management data of 285 sets of medical equipment in clinical use in The Sixth Affiliated Hospital of South China University of Technology (Foshan Nanhai District People's Hospital) from 2020 to 2023 were selected,and the maintenance management data of 256 sets of equipment in the period from 2020 to 2021 adopted conventional management mode,and the maintenance management data of 268 sets (including 239 sets in use in conventional management) of medical equipment during 2022-2023 adopted the security governance model. A self-made questionnaire was used to investigate whether the amount of maintenance management data met the actual needs of 120 participants who used the equipment. The security,frequency of use and operation quality of medical equipment maintenance management data of the two management modes were compared. Results:The average risk rate of medical equipment maintenance management data using security governance mode was (1.333±0.741)％,which was lower than that of conventional management mode,the average accuracy and effectiveness were (93.925±3.432)％and (88.500±4.404)％,respectively,Which were higher those of the conventional management mode,the differences was statistically significant (t=2.298,4.784,P<0.05). The average satisfaction rate of the 120 participants who used the equipment was (94.367±3.093)％ of the medical equipment maintenance management data using the safety governance model,which was higher than that of the conventional management mode,and the difference was statistically significant (t=4.365,P<0.05). The frequency of use of medical equipment failure data,maintenance item data and management input data of the security governance mode were (4.092±1.709) times/year,(4.341±1.397) times/year and (3.821±0.976) times/year,respectively,which were higher than those of the conventional management mode,the difference was statistically significant (t=2.101,4.400,6.386,P<0.05). The failure frequencies of medical electronic equipment,life support equipment,operating room equipment,medical laboratory equipment and other medical equipment using the security governance mode were (0.831±0.335) times/year,(0.927±0.293) times/year,(1.085±0.439) times/year,(0.702±0.047) times/year and (1.456±0.485) times/year,respectively 0.485),which were lower than those of the conventional management mode,and the difference was statistically significant (t=5.330,5.486,4.756,6.974,3.598,P<0.05). Conclusion:The data security governance path and management countermeasures of information-based medical equipment maintenance management can standardize the medical equipment maintenance management data collection process,improve data security performance,improve data application efficiency,and improve equipment operation quality.

Objective:To explore the effectiveness of autologous fat grafting in the treatment of undesirable skin expansion.Methods:Patients' data were reviewed from 2011 to 2016, including the expanded regions with early signs of skin complications in face and neck. The effects of fat grafting group and control group were evaluated by follow-up records of expansion volume, skin thickness, skin texture and local capillary reaction.Results:Fat grafting could increase the thickness of expanded skin. It also improved the texture of expanded skin, with 0.83± 0.71 points before treatment and 1.30±0.66 points after treatment ( P=0.04). The local capillary reaction was also improved from 1.06±0.54 points before treatment and 1.45±0.51 points after treatment ( P=0.03). The expansion in the fat grafting group was 2.21±0.57 times before treatment and 2.94±0.83 times after treatment. In the control group, the expansion was 2.19 times when it showed early signs, and no obvious changes were observed during the follow-up period. Conclusions:Autologous fat grafting can effectively treat complications of skin expansion, prolong expansion process and promote tissue regeneration.

Objective:The purpose of this study is to establish the trajectory of targeted grafting for facial fat compartment based on anatomical research, and then bring it to clinical practice.Methods:The boundary of fat compartment and the relationship of adjacent vessel and nerve were clarified through autopsy. The recommended injection points and trajectory for targeted fat grafting were established on the anatomical findings. Retrospective clinical data of facial rejuvenation of 46 patients through targeted fat grafting were collected from June 2017 to June 2019 in Shanghai Ninth People’s Hospital. The result of 3D scanning were analyzed to evaluate the survival rate of fat grafts.Results:There were subcutaneous superficial fat compartments in the frontal region, and there were both deep and superficial fat compartments in the temporal and middle face. According to the anatomical characteristics, a targeted fat grafting technique was established with the frontal hairline and the oral commissure corner mucosa as the entry points. In the clinical study, 46 patients were evaluated by 3D scanning 6 months after the last fat grafting. The amount of fat grafts in the temporal region was (17.84±8.47) ml and (11.2±2.44) ml was left after operation, and the survival rate was 63%. The amount of fat grafts in mid-face was (26.81±10.36) ml and (16.09±4.48) ml was left after operation, and the survival rate was 60%. Overall satisfaction rate of patients was 93% (43/46).Conclusions:Compartment-based targeted fat grafting is an accurate injection method, which meets the requirement of physiological augmentation. The trajectory of targeted fat grafting will further improve the efficacy and safety of injection.

Objective:The purpose of this study is to establish the trajectory of targeted grafting for facial fat compartment based on anatomical research, and then bring it to clinical practice.Methods:The boundary of fat compartment and the relationship of adjacent vessel and nerve were clarified through autopsy. The recommended injection points and trajectory for targeted fat grafting were established on the anatomical findings. Retrospective clinical data of facial rejuvenation of 46 patients through targeted fat grafting were collected from June 2017 to June 2019 in Shanghai Ninth People’s Hospital. The result of 3D scanning were analyzed to evaluate the survival rate of fat grafts.Results:There were subcutaneous superficial fat compartments in the frontal region, and there were both deep and superficial fat compartments in the temporal and middle face. According to the anatomical characteristics, a targeted fat grafting technique was established with the frontal hairline and the oral commissure corner mucosa as the entry points. In the clinical study, 46 patients were evaluated by 3D scanning 6 months after the last fat grafting. The amount of fat grafts in the temporal region was (17.84±8.47) ml and (11.2±2.44) ml was left after operation, and the survival rate was 63%. The amount of fat grafts in mid-face was (26.81±10.36) ml and (16.09±4.48) ml was left after operation, and the survival rate was 60%. Overall satisfaction rate of patients was 93% (43/46).Conclusions:Compartment-based targeted fat grafting is an accurate injection method, which meets the requirement of physiological augmentation. The trajectory of targeted fat grafting will further improve the efficacy and safety of injection.

Objective Quality control procedure based on the patient data in clinical chemistry was set up in laboratory information system (LIS). Methods Clinical chemistry tests results of outpatients and inpatients were collected from January 2016 to March 2017 in Zhejiang Provincial People's Hospital. Statistical results of daily patient data, including Xˉ, P2.5, P5, P10, P25, P50, P75, P90, P95 and P97.5 were calculated. Secondly, cumulative coefficients of variation (CV) of these statistical datawere calculated and compared to different criterions. Optimal analytes and related control concentrations were chosen. The minimum number of patient sample which use Xˉ as control point was calculated by PASS 11.0 software. Finally, the quality control procedure was set up base on the LIS and was verified by patient data. Results In outpatients, Xˉwas chosen as control point in AFU, APOA, APOB, CA, CL, HDL, K, MG, NA, NEFA, TP and URIC and the minimum number of sample needed were 23, 23, 30, 8, 10, 24, 34, 8, 8, 20, 13 and 22. P25 was chosen in ALP and TBIL. P50 was chosen in AST, GLU, GPDA and PHOS.P75 was chosen in ALB, CHE, CREA and DBIL. In inpatients, Xˉ was chosen as control point in AFU, ALB, APOA, APOB, CA, CL, HDL, K, Lpa, MG, NA, NEFA, TP and URIC and the minimum number of sample needed were 73, 19, 34, 18, 10, 30, 36, 21, 87, 12, 17, 51, 26 and 52;P25 was chosen in ALP, ALT, AST, CREA, DBIL, LDH, TBIL and TG. P50 in PHOS, P75 in GPDA, and P90 in CHE. 200 samples were needed in the tests which used percentiles as control points. Most CVs of these control points were higher than the commercial quality control used every day. Finally, a quality control procedure based on patient data were set up in LIS. L-J and Z score charts were used to find out systematic bias. Conclusion Patient data used in internal quality control was an economical and practical way, which can make up for the deficiency of traditional method.

Objective:To understand the recent and long‐term effects of post‐abortion family planning service (PAFPS ) on contraception and provide a basis for a high quality and durable service mode . Methods:A total of 937 women seeking for induced abortion were recruited in four general hospitals in Xuhui District of Shanghal from July to November ,2013 .All of the women were surveyed by a questionnalre and divided into intervention group and palred control group .Intervention group received PAFPS and control group received routine abortion service .A follow‐up was performed on contraception 1 month and at 1 year after abortion .Results:Contraception utilization rates at 1 month after abortion in intervention group and control group were 88 .0% and 65 .5% ,respectively (P< 0 .001) ,While effective contraception utilization rates at 1 month after abortion were 88 .0% and 40 .4% ,respectively (P<0 .001) .Effective contraception utilization rates as 1 year after abortion in intervention group and control group were 64 .3% and 26 .4% ,respectively (P< 0 .001) .Condom was the most optimal adherence to effective contraception utilization at 1 year after abortion , second was intrauterine device and the last was compound oral contraceptives . Conclusions:PAFPS can improve the contraception usage rate and effective contraception usage rate ,but effective contraception usage rate may decline at 1 year after abortion .The continuous utilization rate of condom in women received PAFPS after 1 year is the highest and that of compound contraceptives is the lowest .