Regarding the challenge of early identification of critically ill patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD),a radiomics-clinical fusion model is proposed based on non-contrast CT images of accessory respiratory muscles to predict life-threatening conditions.A retrospective study is conducted involving 233 AECOPD patients(153 non-life-threatening and 80 life-threatening cases).Patients are divided into a training set(n=186)and a test set(n=47)at a 4:1 ratio.A total of 1 874 radiomic features are extracted from the erector spinae and pectoralis muscle regions delineated by radiologists on non-contrast CT images,and the features selection is performed using maximum relevance minimum redundancy and least absolute shrinkage and selection operator(LASSO)algorithms.Meanwhile,clinical data are analyzed with t-test and LASSO for variable screening.The selected features are input into C-support vector classification,Logistic regression,random forest,adaptive boosting(AdaBoost),and extreme gradient boosting(XGBoost)to construct radiomics model,clinical model,and fusion model.Predictive performance and clinical practicality are evaluated in the test set using receiver operating characteristic curve,area under the curve(AUC),and decision curve analysis.The radiomics-clinical fusion model built with XGBoost outperformed standalone radiomics and clinical models,achieving an AUC of 0.902(95％CI 0.846,0.994),with accuracy,sensitivity,specificity,and precision of 0.837,0.933,0.786,and 0.7,respectively.Results demonstrate that the fusion model based on the non-contrast CT radiomics of accessory respiratory muscles and clinical data exhibits promising diagnostic performance,highlighting its potential clinical significance for stratified management and preemptive critical care intervention in AECOPD patients.

Regarding the challenge of early identification of critically ill patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD),a radiomics-clinical fusion model is proposed based on non-contrast CT images of accessory respiratory muscles to predict life-threatening conditions.A retrospective study is conducted involving 233 AECOPD patients(153 non-life-threatening and 80 life-threatening cases).Patients are divided into a training set(n=186)and a test set(n=47)at a 4:1 ratio.A total of 1 874 radiomic features are extracted from the erector spinae and pectoralis muscle regions delineated by radiologists on non-contrast CT images,and the features selection is performed using maximum relevance minimum redundancy and least absolute shrinkage and selection operator(LASSO)algorithms.Meanwhile,clinical data are analyzed with t-test and LASSO for variable screening.The selected features are input into C-support vector classification,Logistic regression,random forest,adaptive boosting(AdaBoost),and extreme gradient boosting(XGBoost)to construct radiomics model,clinical model,and fusion model.Predictive performance and clinical practicality are evaluated in the test set using receiver operating characteristic curve,area under the curve(AUC),and decision curve analysis.The radiomics-clinical fusion model built with XGBoost outperformed standalone radiomics and clinical models,achieving an AUC of 0.902(95％CI 0.846,0.994),with accuracy,sensitivity,specificity,and precision of 0.837,0.933,0.786,and 0.7,respectively.Results demonstrate that the fusion model based on the non-contrast CT radiomics of accessory respiratory muscles and clinical data exhibits promising diagnostic performance,highlighting its potential clinical significance for stratified management and preemptive critical care intervention in AECOPD patients.

Dendrobium officinale is a Chinese herbal medicine with the same origin as medicine and food,and it is commonly used in making soup and tonic diet,etc.Dendrobium officinale and its compound preparations are widely used in clinical practice.This article used keywords such as"Dendrobium officinale"and"clinical"to search for relevant literature on clinical research on Dendrobium officinale in CNKI,Wanfang,VIP,PubMed and other databases over the past 10 years.It is found that Dendrobium officinale and its compound preparations were mainly used in the treatment of internal medicine(such as chronic gastritis,diabetes,bronchitis,hypertension,coronary heart disease,etc.),surgery,gynecology,pediatrics,ophthalmology and other diseases,and had good clinical effects.It is a Chinese herbal medicine with the development value.This article provides a comprehensive and systematic summary and analysis of the clinical application of Dendrobium officinale,aiming to provide reference for its rational clinical application and further development and research.

Objective To investigate the effect of Huangzhi oral liquid on ferroptosis and apoptosis of hepatocytes in acute hyperlipidemia mice based on abnormal lipid metabolism.Methods Forty SPF grade C57BL/6 mice were randomly assigned to the normal control group,the model group,Huangzhi oral liquid low-dose and high-dose groups,and fenofibrate group,with 8 mice in each group.All administration groups were given Huangzhi oral liquid and fenofibrate by gavage at corresponding doses,while the normal control group and the model group were given the same dose of distilled water for a period of 5 days.on the third day of administration,in addition to the normal control group,other groups were injected intramuscularly with Triton WR-1339 to establish a hyperlipidemia model.After the administration,the serum lipid levels and liver function in mice were detected.The pathological changes of liver were observed by HE staining and lipid accumulation was observed by oil red O staining.The iron content in liver tissues was detected by tissue iron assay kit.The changes in protein expression of ABCA1,ABCG5,LXRα,ASGR1,cleaved-PARP,cleaved-caspase 3,Bcl2,Bax,TFR1,SLC7A11,GCLM,GPX4 and FTH1 in liver were detected by Western Blot.Results Compared with the model group,Huangzhi oral liquid could reduce the lipid vacuoles in liver tissues,alleviate the degree of lipid degeneration,reduce the content of TC,TG,LDL-C,AST and ALT in serum,increase the content of HDL-C,increase the protein expression levels of ABCA1,ABCG5,LXRα,Bcl-2,SLC7A11,GCLM,GPX4 and FTH1 in mice liver tissues,reduce the protein expression levels of ASGR1,cleaved-PARP,cleaved-caspase 3,Bax and TFR1.Conclusion Huangzhi oral liquid can alleviate the abnormal lipid metabolism in acute hyperlipidemia mice,thus alleviates hepatocyte apoptosis and ferroptosis.

Background Mitochondrial dynamin-related protein 1 (DRP1) regulates mitochondrial division and plays an important role in maintaining hepatocyte function. However, the role of DRP1 in cadmium exposure-induced maternal liver damage in pregnant mice remains unclear. Objective To investigate the role and mechanism of DRP1 in maternal liver damage induced by cadmium exposure during pregnancy. Methods This study consisted of animal experiments and cell experiments. (1) Animal experiments. Mice at 14 days of gestation were randomly divided into three groups: a control group, a low-dose cadmium group (LCd group: 2.5 mg·kg⁻¹), and a high-dose cadmium group (HCd group: 5 mg·kg⁻¹). The pregnant mice were intraperitoneally injected with cadmium chloride (CdCl₂) for 6 and 24 h in the next morning. The weights of pregnant mice, uterus, maternal liver, and fetal mice were recorded after sacrifice. Serum and liver of pregnant mice were collected, the levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in serum were detected, and liver tissues were stained with HE to observe changes in liver function and liver tissue structure. The expressions of oxidative phosphorylation-related proteins, hypoxia inducible factor-1α (HIF-1α) and DRP1 proteins in liver of pregnant mice were detected by Western blotting. (2) Cell experiments. AML12 cells were treated with CdCl₂ (10 μmol·L⁻¹) for 0, 2, 6, 12, and 24 h. The expressions of oxidative phosphorylation-related proteins, DRP1, and hypoxia inducible factor-1α (HIF-1α) proteins were detected. AML12 cells were pretreated with DRP1 inhibitor Mdivi-1 for 1 h and then CdCl₂ (10 μmol·L⁻¹) for 12 h to detect the expression of oxidative phosphorylation-related proteins and DRP1 protein. AML12 cells were treated with Hif-1α siRNA for 48 h and CdCl₂ (10 μmol·L⁻¹) for 6 h to detect the expression of HIF-1α and DRP1 proteins. Results The results of animal experiments showed that cadmium exposure in pregnant mice had no effects on maternal liver weight and liver coefficient. However, the histomorphological changes and necrosis in hepatocytes were observed. Compared with the control group, the serum ALT and AST levels of pregnant mice in the LCd group were significantly increased after 6 h (P＜0.05), and the levels in the HCd group were significantly increased after 6 and 24 h (P＜0.05). Cadmium exposure during pregnancy significantly up-regulated HIF-1α and DRP1 expressions and down-regulated the expressions of oxidative phosphorylation-related proteins in maternal livers. In vitro cell experiments showed that the expressions of oxidative phosphorylation-related proteins was significantly decreased and HIF-1α and DRP1 protein expressions were significantly increased in the AML12 cells treated with CdCl₂ for 6 h. Mdivi-1 pretreatment significantly antagonized the inhibitory effect of cadmium on the expressions of oxidative phosphorylation-related proteins in AML12 cells, while Hif-1α siRNA pretreatment significantly antagonized the up-regulative effect of cadmium on DRP1 expression in AML12 cells. Conclusion Cadmium exposure in pregnant mice may up-regulate DRP1 expression by activating HIF-1α signaling, then inhibit oxidative phosphorylation level of hepatic cells, and ultimately lead to maternal liver damage.

Objective:To study the feasibility and efficacy of the modified posterolateral laparoscopic approach for resection of massive splenomegaly.Methods:The data of 48 patients who underwent laparoscopic splenectomy for massive splenomegaly at the Affiliated Hospital of Jiangnan University (Wuxi 4th People's Hospital) from January 2016 to July 2019 were retrospectively analyzed. There were 29 males and 19 females, with an average age of 55.8 years. These 48 patients were divided into two groups according to the operative approach, the study group ( n=26) using the modified posterolateral approach which treated the splenic pedicle as the last step; and the control group ( n=22) which used the posterior tunnel of splenic pedicle established by anterior approach to treat the splenic pedicle first. The operation time, gastrointestinal function, recovery time, intraoperative blood loss, rates of conversion to laparotomy and postoperative complications were compared between two groups. The follow-up data were also analyzed. Results:There were no significant differences in operation gastrointestinal function recovery and hospitalization time between the two groups (all P>0.05). The intraoperative blood loss, numbers of patients with convention to open surgery and intraoperative blood transfusion, were (50.2±15.1) ml vs (160.1±40.3) ml, 2 patients (7.7%) vs 7 patients (31.8%), and 1 patients (3.8%) vs 5 patients (22.7%), in study group and control group respectively. The differences between groups were significant (all P<0.05). The complications of the study group and control group were 9 patients (34.6%) vs 13 patients (59.1%), which were significantly in the two groups ( P<0.05). On follow-up which ranged from 1 to 15 months, the numbers of patients with thrombocytosis and portal vein thrombosis in the study group and the control group were 20 patients (76.9%) vs 17 patients (77.3%), and 7 patients (26.9%) vs 6 patients (27.3%), respectively. Conclusion:The modified posterolateral laparoscopic approach for resection of massive splenomegaly was safe and feasible. It should be promoted to treat massive splenomegaly.

Objective: To explore the treatment technique, occurrence and development patterns of such radiation injuries as in a major radiological accident in which a victim suffered mild bone marrow radiation sickness combined grade degree Ⅲ acute radiation induced skin injury, based on his dose estimation, clinical manifestations and disease treatments. Methods: History inquiry in detail, earlier physical dose estimation and biological dose estimation were conducted in conjunction with analyzing the chromosome aberration of peripheral blood lymphocytes. The physical dose was estimated by Monte Carlo method.The systematic laboratory and imaging examination was performed to evaluate the condition. The comprehensive analysis was conducted to determine the diagnosis and treatment plan. Results: At 3d after the exposure, "Ren" felt mild pain and discomfortable on the skin of the right index finger. The body of the right hand index finger was covered with blister at 21 d after exposure.The estimation of biological dose was 0.43 Gy (95%CI: 0.31-0.58 Gy), and the physical dose was estimated to be 36-164 Gy for each part of the right hand finger. The hematopoietic system, immune system and endocrine system were normal. The liver function index value was transiently increased. The liver damage resulted from the use of antibiotic-induced combined with the patient′s past medical history and admission examination result, and the relevant antibiotics were discontinued. The liver function returned to normal after liver protection treatment. At 22 d after irradiation, a right finger incision and decompression surgery were performed. The stem cells were extracted and implanted into the right index finger. After 59 days of hospitalization, there was no obvious discomfort in the body, and the right index finger recovered well, as well as the pain significantly relieved, and the knuckle activity was basically normal. Conclusions The patient with excessive radiation and grade Ⅲ acute radiation skin injury was successfully treated, and local application of autologous adipose-derived stem cell transplantation achieved good result .

Objective To investigate the analgesic and anti-inflammatory effects of diuretic mixture and its bacteriostasis effect in vitro,and to provide scientific basis for clinical application.Methods Ear swelling test induced by xylene,twisting reaction test induced by acetic acid,capillary permeability increase in abdominal cavity of mice induced by acetic acid,and pain test induced by formalin were used to observe the analgesic and anti-inflammatory effects of diuretic mixture at high,middle and low doses (crude drug 18.0,9.0,and 4.5 g/kg).Bacteriostatic activities of diuretic mixture were tested by K-B paper disc diffusion method.Results Diuretic mixture alleviated ear edema in mouse model at high dose (P ＜ 0.01).Diuretic mixture at high,middle,and low dose could effectively decrease the twisting reaction (P ＜ 0.01),inhibit capillary permeability (P ＜ 0.05 or 0.01),and ease the ache degree of mice induced by formalin in the first phase (P ＜ 0.01),but there was no significant difference in the degree of pain intensity of phase Ⅱ.The inhibitory rates of diuretic mixture on Staphylococcus aureus and Escherichia coli were 95.04％ and 37.44％,respectively.Conclusion Diuretic mixture has significant effects on analgesia and anti-inflammation and against S.aureus and E.coli in vitro.

Objective To investigate a dose response curve based on a genetic workstation with automatic analysis system of dicentric chromosome assay (DCA) for establishing a high speed dose estimation method.Methods Peripheral blood from three healthy volunteers was irradiated in vitro using 60Co γ-rays,and then lymphocytes were cultured and fixed on slides using the standard protocol for DCA.Dicentric chromosome in metaphase cells was analyzed automatically with the genetic workstation and confirmed manually,and the dose response curve of automated dicentric chromosome was fitted.Dicentric chromosome of another peripheral blood sample irradiated with different doses was manually analyzed to verify the accuracy of the above automated DCA.Results The yield of automated DCA was well fitted by an equation Y =0.018 06D2 + 0.012 79D + 0.000 489 1 with a correlation coefficient R2 =0.961.The biological dose of radiation could be accurately estimated by this dose response curve within a few minutes.Conclusions We had successfully established a new dosimetry method by analyzing dicentric chromesome automatically,which can save a lot of manual analysis time and hence has important significance for emergency rescue in nuclear accidents.

Objective:To study the effects of compound preparation of Fanshiliu on lipid metabolism and pancreatic pathological changes in type 2 diabetes mellitus(T2DM)rats with insulin resistance. Methods:After fed with high-calorie food for 8 weeks,the rats received intraperitoneal injection with low dose of streptozotocin(STZ)to induce T2DM animal model,and then the rats were randomly divided into the model group,metformin group,high and low dose group of compound preparation of Fanshiliu. The normal group was given ordinary feed. The rats were sacrified after intragastric administration for six weeks,and fasted for 12 hours after the last administration. The lipid and lipoprotein indices were detected,and pathological morphology of pancreatic tissue was observed. Results:Compared with those in the model group,TC,TG,LDL-C and FFA in each treatment group were reduced,and HDL-C was increased(P < 0. 05). Fanshiliu high dose group and metformin group had obvious hypoglycemic and lipid-lowering effects. The results of pathological morphology of pancreatic tissue under a light microscope showed that the damage was the most obvious in the model group. Compound preparation of Fanshiliu groups and metformin group showed damage in varying degrees. Conclusion:Fanshiliu preparation can effectively adjust blood lipid levels,enhance the insulin sensitivity and reduce damage in pancreas in T2DM rats.