Objective To evaluate the predictive value of different machine learning models constructed in a multicenter environment for potential organ donors and verify their clinical application feasibility. Methods The study included 2 000 inpatients admitted to five domestic tertiary hospitals from January 2020 to December 2023, who met the criteria for potential organ donation assessment. They were randomly divided into a training set and an internal validation set (7∶3). Another 300 similar patients admitted to the First Affiliated Hospital of Harbin Medical University from January 2024 to April 2025 were included as an external validation set. The area under the curve (AUC), sensitivity, specificity, accuracy and F1-score of three models were compared, and the consistency of the potential organ donor determination process was tested. Multivariate logistic regression analysis was used to identify predictive factors of potential organ donors. Decision curve analysis (DCA) was employed to verify the resource efficiency of each model, and the threshold interval and intervention balance point were assessed. Results Apart from age, there were no significant differences in other basic characteristics among the centers (all P>0.05). The consistency of the potential organ donor determination process among researchers in each center was good [all 95% confidence interval (CI) lower limits >0]. In the internal validation set, the XGBoost model had the best predictive performance (AUC=0.92, 95% CI 0.89-0.94) and the best calibration (P=0.441, Brier score 0.099). In the external validation set, the XGBoost model also had the best predictive performance (AUC=0.91, 95% CI 0.88-0.94), outperforming logistic regression and random forest models. Multivariate logistic regression showed that mechanical ventilation had the greatest impact (odds ratio=2.06, 95% CI 1.54-2.76, P<0.001). DCA indicated that the XGBoost model had the highest net benefit in the threshold interval of 0.2-0.6. The “treat all” strategy only had a slight advantage at extremely low thresholds. The recommended threshold interval, which balances intervention costs and clinical benefits, considers ≥50% positive predictive value (PPV) and ≤50 referrals per 100 high-risk patients. Conclusions The XGBoost model established in a multicenter environment is accurate and well-calibrated in predicting potential organ donors. Combined with DCA, it may effectively guide the timing of clinical interventions and resource allocation, providing new ideas for the assessment and management of organ donation after brain death.

Objective To explore the prevalence of Helicobacter pylori (Hp) infection and its association with dietary and lifestyle habits among the adult physical examination population in Xuzhou area. Methods Retrospectively selected the physical examination population who underwent HP testing at our hospital's physical examination center from May 2021 to December 2023 as the research object. The prevalence of Hp infection in the population was analyzed based on the physical examination results. A questionnaire survey was used to collect information on the eating and living habits of all study subjects. Logistic regression was used to analyze the relationship between eating and living habits and Hp infection. Results A total of 1 354 physical examination people were included in the study, and the Hp infection rate was 37.30% (505/1354). The difference in Hp infection rates among people of different age groups is statistically significant (P<0.05), with the middle-aged population (41-59 years old) having the highest Hp positive infection rate (45.38%).High salt (41.11%), hot diet (40.56%), history of smoking (45.23%) and drinking (43.80%), less consumption of fruits and vegetables (43.73%), irregular exercise (41.29%), irregular diet People who frequently eat out (43.56%) and eat out frequently (42.57%) have a higher Hp infection rate (P<0.05).After adjusting for demographic factors such as gender, age, place of residence and education level, multivariate Logistic regression results showed that high-salt diet (OR=3.975, 95%CI: 2.670-5.917) and hot diet (OR=3.357, 95%CI: 2.291-4.919), smoking (OR=1.458, 95%CI: 1.082-1.964), drinking alcohol (OR=1.654, 95%CI: 1.279-2.138), eating fruits and vegetables (OR=1.759, 95%CI: 1.345-2.301), regular exercise (OR=1.822, 95%CI: 1.371-2.421), regular diet (OR=1.893, 95%CI: 1.391-2.575), eating out (OR=1.690, 95%CI: 1.277-2.237) were associated with the risk of Hp infection (P<0.05). Conclusion The positive infection rate of Hp among the physical examination population in Xuzhou is slightly lower than the average epidemic level in China. Cultivating healthy eating and living habits can effectively reduce the risk of Hp infection.

Aerosol removal using flame-retardant atomized fixatives, as a major means of aerosol control, has achieved remarkable results in the field of nuclear facility decommissioning and decontamination. Traditional atomized fixatives for aerosol removal have deficiencies in high-temperature resistance and flame retardancy, rendering them inadequate for operational scenarios involving high temperatures and flammability encountered during nuclear decommissioning. This paper investigates the current development of flame-retardant atomized fixatives for aerosol removal both domestically and internationally and presents a preliminary exploration of this technology. The experiments showed that atomized fixatives modified with flame-retardant properties not only maintained excellent aerosol capture efficiency, but also exhibited significantly improved flame-retardant performance. This confirmed the technical feasibility of the proposed approach. Finally, suggestions and reflections are proposed for the development of this technology and its application in nuclear facility decommissioning.

OBJECTIVE To investigate the protective effects and potential mechanism of alisol B 23-acetate on acute alcoholic liver injury in mice. METHODS Fifty male Kunming mice were divided into the blank group， model group， and alisol B 23-acetate low-， medium- and high-dose groups （10， 20， 40 mg/kg）， with 10 mice in each group. Each group was given relevant drug solution or normal saline intragastrically， once a day， for 2 consecutive weeks. On the 15th day， mice in the blank group were given normal saline intragastrically， while the other four groups were given 12 mL/kg white wine intragastrically， twice at six-hour intervals， to establish an acute alcoholic liver injury model. On the 16th day of the experiment， the liver indexes of mice in each group were calculated； the serum levels of alanine transaminase （ALT）， aspartate transaminase （AST）， total cholesterol （TC）， triglycerides （TG）， malondialdehyde （MDA） and glutathione （GSH） were also determined. The histopathological morphology of their liver tissues was observed and scored. The protein expressions of cytochrome P450 2E1 （CYP2E1）， Kelch-like ECH-associated protein 1 （Keap1）， nuclear factor erythroid 2-related factor 2 （Nrf2） and NAD（P）H： quinone oxidoreductase 1 （NQO1） were measured in liver tissue. RESULTS Compared with model group， mice in each dosage group of alisol B 23-acetate showed varying degrees of recovery in body weight， along with improvements in pathological changes in liver tissues such as inflammatory cell infiltration and fatty vacu oles. Their liver indexes， histopathological scores of liver tissue， serum levels of ALT， AST， TC， TG and MDA， as well as the protein expressions of CYP2E1 and Keap1 in liver tissue， were all significantly decreased （ P ＜0.05 or P ＜0.01）. The serum GSH levels and the protein expressions of Nrf2 （except for the alisol B 23-acetate low-dose group） and NQO1 in liver tissue were significantly increased （ P ＜0.05 or P ＜0.01）， and the changes in the above quantitative indicators showed a dose-dependent pattern. CONCLUSIONS Alisol B 23-acetate can ameliorate acute alcoholic liver injury in mice， and its mechanism may be related to improving antioxidant capacity by regulating the Keap1/Nrf2/NQO1 signaling pathway while simultaneously improving liver lipid metabolism-related indexes.

BACKGROUND:Skeletal muscle aging is associated with various chronic diseases.Exercise is considered an important means to delay this process,but the multimechanism regulation of exercise intervention strategies still requires in-depth exploration.OBJECTIVE:To systematically outline the main physiological changes in skeletal muscle aging and explore the multiple mechanisms by which exercise regulates these changes,thereby providing a theoretical basis for basic research and clinical applications.METHODS:By searching databases such as Web of Science,PubMed,Embase,CNKI,WanFang,and VIP,relevant literature from database inception to October 2024 was retrieved by the first author,including original research articles and reviews.The search terms were"skeletal muscle aging,sarcopenia,exercise regulation,physical activity,chronic inflammation,inflammaging,mitochondrial dysfunction,extracellular matrix fibrosis,lipid mediators,satellite cells"in English and Chinese.Literature was screened based on inclusion and exclusion criteria,and the included 95 articles underwent quality assessment and data extraction.RESULTS AND CONCLUSION:(1)The core manifestations of skeletal muscle aging are the decline in muscle mass,strength,and function,closely related to various physiological changes.The decreased protein synthesis capacity and accelerated degradation rate in muscles lead to muscle atrophy and functional decline.Additionally,dysfunction of satellite cells is considered a key factor in the reduced regenerative capacity of muscles.Mitochondrial dysfunction is another important factor leading to muscle fatigue and energy metabolism disorders,directly affecting the metabolic activity and endurance of skeletal muscles.Chronic inflammatory responses and extracellular matrix fibrosis further exacerbate muscle aging.These factors interact synergistically,collectively resulting in skeletal muscle degeneration.(2)Exercise is widely recognized as an important means to delay skeletal muscle aging.Exercise alleviates chronic low-grade inflammatory responses in skeletal muscle by regulating the immune system,increasing the secretion of anti-inflammatory factors,and inhibiting the expression of pro-inflammatory factors,thereby mitigating the damage of inflammation to muscles.Exercise also enhances mitochondrial biogenesis and function,improves the muscle's energy metabolism capacity,and consequently increases endurance and strength.Furthermore,exercise regulates lipid metabolism and the synthesis of lipid mediators,reduces fat accumulation and alleviates fat-induced inflammatory responses,thereby further protecting skeletal muscles.The mechanical stimulation from exercise promotes the remodeling of the extracellular matrix,reduces fibrosis occurrence,and improves muscle structure and function.Additionally,exercise activates satellite cells,enhancing the regenerative capacity of skeletal muscles,especially notable with strength training and high-intensity interval training.(3)Future research should include large-scale,multicenter clinical trials to evaluate the comprehensive effects of long-term exercise interventions on skeletal muscle aging.By analyzing data from genomics,metabolomics,and other fields,exploring individual differences in responses to exercise interventions can provide more precise theoretical bases for personalized exercise strategies.Besides exercise,the impacts of other interventions such as nutritional supplementation and pharmacological treatments on skeletal muscle aging should not be overlooked.Future studies can explore the combined use of exercise with these interventions to achieve more significant effects.

Liver cirrhosis is the final stage of the progression of various chronic liver diseases， often accompanied by serious complications and high mortality rates. Recent studies have shown that the interaction between gut microbiota and bile acid metabolism （the gut microbiota-bile acid axis） is closely associated with liver cirrhosis. This article systematically reviews the mechanism of action of the gut microbiota-bile acid axis in the progression of liver cirrhosis， elaborates on the pathological features of liver cirrhosis and its harm to the body， and summarizes the association of the gut microbiota-bile acid axis with the development and progression of liver cirrhosis. It also analyzes the key regulatory role of this axis in the progression of liver cirrhosis and explores its potential application value as a therapeutic target for liver cirrhosis， in order to provide a theoretical basis for exploring more effective clinical intervention methods.

BACKGROUND:Skeletal muscle aging is associated with various chronic diseases.Exercise is considered an important means to delay this process,but the multimechanism regulation of exercise intervention strategies still requires in-depth exploration.OBJECTIVE:To systematically outline the main physiological changes in skeletal muscle aging and explore the multiple mechanisms by which exercise regulates these changes,thereby providing a theoretical basis for basic research and clinical applications.METHODS:By searching databases such as Web of Science,PubMed,Embase,CNKI,WanFang,and VIP,relevant literature from database inception to October 2024 was retrieved by the first author,including original research articles and reviews.The search terms were"skeletal muscle aging,sarcopenia,exercise regulation,physical activity,chronic inflammation,inflammaging,mitochondrial dysfunction,extracellular matrix fibrosis,lipid mediators,satellite cells"in English and Chinese.Literature was screened based on inclusion and exclusion criteria,and the included 95 articles underwent quality assessment and data extraction.RESULTS AND CONCLUSION:(1)The core manifestations of skeletal muscle aging are the decline in muscle mass,strength,and function,closely related to various physiological changes.The decreased protein synthesis capacity and accelerated degradation rate in muscles lead to muscle atrophy and functional decline.Additionally,dysfunction of satellite cells is considered a key factor in the reduced regenerative capacity of muscles.Mitochondrial dysfunction is another important factor leading to muscle fatigue and energy metabolism disorders,directly affecting the metabolic activity and endurance of skeletal muscles.Chronic inflammatory responses and extracellular matrix fibrosis further exacerbate muscle aging.These factors interact synergistically,collectively resulting in skeletal muscle degeneration.(2)Exercise is widely recognized as an important means to delay skeletal muscle aging.Exercise alleviates chronic low-grade inflammatory responses in skeletal muscle by regulating the immune system,increasing the secretion of anti-inflammatory factors,and inhibiting the expression of pro-inflammatory factors,thereby mitigating the damage of inflammation to muscles.Exercise also enhances mitochondrial biogenesis and function,improves the muscle's energy metabolism capacity,and consequently increases endurance and strength.Furthermore,exercise regulates lipid metabolism and the synthesis of lipid mediators,reduces fat accumulation and alleviates fat-induced inflammatory responses,thereby further protecting skeletal muscles.The mechanical stimulation from exercise promotes the remodeling of the extracellular matrix,reduces fibrosis occurrence,and improves muscle structure and function.Additionally,exercise activates satellite cells,enhancing the regenerative capacity of skeletal muscles,especially notable with strength training and high-intensity interval training.(3)Future research should include large-scale,multicenter clinical trials to evaluate the comprehensive effects of long-term exercise interventions on skeletal muscle aging.By analyzing data from genomics,metabolomics,and other fields,exploring individual differences in responses to exercise interventions can provide more precise theoretical bases for personalized exercise strategies.Besides exercise,the impacts of other interventions such as nutritional supplementation and pharmacological treatments on skeletal muscle aging should not be overlooked.Future studies can explore the combined use of exercise with these interventions to achieve more significant effects.

Objective: To investigate the characteristics of hospitalized injury cases in Huangpu District, Guangzhou City in 2022, so as to provide evidence for optimizing injury prevention interventions. Methods: Data on hospitalized injury cases admitted between January to December 2022 were collected through the hospitalization registry system from 17 healthcare institutions in Huangpu District. The population distribution characteristics, causes of injury, injury sites, duration of hospital stay, and hospitalization costs were descriptively analyzed. Results: A total of 6 729 hospitalized injury cases were reported in Huangpu District in 2022, including 4 277 males and 2 452 females, with a male-to-female ratio of 1.74∶1. The average age was (49.57±19.82) years, with 2 064 cases (30.67%) aged 45 to <60 years and 1 921 cases (28.55%) aged ≥60 years. The median length of hospitalization was 9.00 (interquartile range, 11.00) days, with median hospitalization costs of 15 968.93 (interquartile range, 25 786.69) yuan. In the months of June to August, there were more cases of injury hospitalization,with 1 904 cases accounting for 28.30%. The top three causes of injury were falls (2 895 cases, 43.02%), transportation accidents (1 247 cases, 18.53%) and exposure to inanimate mechanical forces (1 104 cases, 16.41%). The top three injured sites were lower limb injuries (1 850 cases, 27.49%), upper limb injuries (1 596 cases, 23.72%) and other sites (1 178 cases, 17.51%). The three leading causes of injury with longest hospitalization duration were burns and scalds, transport accidents and falls, with the median duration being 12.00 (interquartile range, 8.00) days, 10.00 (interquartile range, 13.00) days and 10.00 (interquartile range, 11.00) days, respectively. The top three injury sites associated with the longest hospitalization duration were others, lower limb injuries, and head and neck injuries, with the median duration being 11.00 (interquartile range, 13.00) days, 11.00 (interquartile range, 11.00) days, and 10.00 (interquartile range, 12.00) days, respectively. The causes of injury associated with higher hospitalization costs were falls and transportation accidents, with the median hospitalization cost being 23 550.13 (interquartile range, 30 087.76) yuan for falls and 20 301.94 (interquartile range, 30 589.86) yuan for transportation accidents. The injury sites associated with higher hospitalization costs were lower limb injuries and upper limb injuries, with the median hospitalization cost being 24 257.32 (interquartile range, 34 145.54) yuan for lower limb injuries and 16 506.33 (interquartile range, 20 052.27) yuan for upper limb injuries. Conclusions In Huangpu District, hospitalized injury mainly occurred among males and individuals aged ≥45 years, with the higher incidence observed between June and August. Fall was the primary cause of injury, while lower limb injuries was the main injury sites. The injury resulted in substantially higher hospitalization costs.

Objective:To investigate the efficacy of azacitidine combined with CAG regimen in the treatment of acute myeloid leukemia (AML) patients who are not suitable for intensive chemotherapy.Methods:A retrospective case-series study was conducted. A total of 67 AML patients with newly diagnosed elderly, treatment-related secondary and myelodysplastic syndromes or myeloproliterative neoplasms primary transformation who were not suitable for intensive chemotherapy were selected from Heze Municipal Hospital from January 2020 to December 2023. Azacitidine combined with CAG regimen was given for treatment, and the efficacy and adverse reactions of the patients were observed.Results:Among the 67 patients, there were 32 females and 35 males with the median age [ M ( Q1, Q3)] of 68 (65, 72) years old. There were 40 cases in the high-risk group, 13 cases in the medium-risk group, and 14 cases in the low-risk group. After 1 course of treatment with azacitidine combined with CAG regimen, the overall response rate (ORR) was 38.8% (26/67), with a complete remission (CR) rate of 20.9% (14/67), a complete remission rate with incomplete recovery of blood cell count (CRi) of 11.9% (8/67), and a partial remission (PR) rate of 6.0% (4/67). After 4 courses of treatment, the ORR was 59.7% (40/67), with a CR rate of 56.7% (38/67) and a CRi rate of 3.0% (2/67). There were no PR patients. All patients in the low-risk and medium risk groups achieved at least CRi, while the ORR in the high-risk group was 40.0% (16/40). There was a statistically significant difference in efficacy between different risk groups ( P < 0.001). The patient had mild adverse reactions, mainly pain and grade 1-2 hematological adverse reactions. Conclusions:AML patients who are intolerant to intensive chometherapy are effectively treated with azacitidine combined with CAG regimen, and the adverse reactions are mild.

Objective To investigate the expression of microRNA(miR)-143-3p and signal transduction and transcriptional activator protein(STAT)3 in serum of patients with hepatocellular carcinoma(HCC)and its clinical significance.Methods A total of 110 HCC patients admitted to Rugao People's Hospital from Jan-uary 2022 to February 2023 were selected as HCC group,and 40 healthy people who underwent physical ex-amination during the same period were selected as healthy control group.The expression of miR-143-3p and STAT3 mRNA was compared in the serum of two groups.In addition,they were divided into good prognosis group(n=82)and poor prognosis group(n=28),according to the prognosis of HCC patients followed up for 1 year.Multivariate Logistic regression analysis was used to analyze the the influencing factors of poor prog-nosis in HCC patients.The predictive efficacy of serum miR-143-3p and STAT3 mRNA expression on poor prognosis of HCC patients was analyzed by receiver operating characteristic(ROC)curve.Results Compared with healthy control group,the expression level of miR-143-3p in serum of HCC group was lower(P＜0.05),while the expression level of STAT3 mRNA was higher(P＜0.05).Multivariate Logistic regression analysis showed that microvascular invasion,maximum diameter of tumor＞5 cm,down-regulated serum miR-143-3p expression and up-regulated STAT3 mRNA expression were independent risk factors for poor prognosis of HCC patients(P＜0.05).ROC curve showed that the area under the curve of serum miR-143-3p,STAT3 mR-NA and their combined detection for predicting the poor prognosis of HCC patients were 0.888,0.810 and 0.922,respectively,and the combined detection had the best predictive value(P＜0.05).Conclusion The ex-pression of miR-143-3p is abnormally down-regulated in the serum of HCC patients,while the mRNA of STAT3 is abnormally up-regulated.The combined detection of miR-143-3p and STAT3 has good predictive value for the poor prognosis of HCC patients.