Objective:To compare the prognostic performance of six trauma scoring systems—Injury Severity Score (ISS), Acute Physiology and Chronic Health EvaluationⅡ (APACHE Ⅱ), Sequential Organ Failure Assessment (SOFA), Prehospital Index (PHI), Revised Trauma Score (RTS), and the Circulation, Respiration, Abdomen, Motor, Speech (CRAMS) score—in predicting 28-day mortality among patients with severe trauma in Southwest China.Methods:A retrospective cohort study was conducted involving 479 patients with severe trauma admitted to the First Affiliated Hospital of Army Medical University between January 2018 and October 2023. Inclusion criteria were: ① age ≥16 years; ② Injury Severity Score (ISS) ≥16; ③ admission within 24 hours post-injury. Exclusion criteria included: ① severe underlying chronic conditions; ② burns or electrical injuries; ③ incomplete clinical data. Based on 28-day outcomes, patients were stratified into a survival group ( n=424) and a death group ( n=55). All patients received standardized resuscitation and damage control interventions. Prehospital scores (PHI, RTS, CRAMS) were recorded at admission. In-hospital scores (ISS, APACHE Ⅱ, SOFA) were calculated using the worst physiological parameters within the first 24 hours. The Mann-Whitney U test was used for group comparisons. Discriminative ability was assessed by the area under the receiver operating characteristic curve (AUC), with pairwise comparisons using DeLong's test. Decision curve analysis (DCA) was performed to evaluate net clinical benefit. Results:The RTS and CRAMS scores were significantly higher in the survival group, whereas ISS, APACHE Ⅱ, SOFA, and PHI scores were significantly lower in the death group (all P<0.05). The AUC values for predicting 28-day mortality, in descending order, were: APACHE Ⅱ (0.917), RTS (0.897), SOFA (0.873), PHI (0.848), CRAMS (0.831), and ISS (0.708). No significant difference in AUC was found between APACHE Ⅱ and RTS ( P=0.325). DCA showed that across most decision thresholds, both APACHE Ⅱ and RTS provided greater net clinical benefit than "treat-all" or "treat-none" strategies and other scores. Conclusions:Among the six scoring systems, APACHE Ⅱ demonstrated the highest predictive accuracy for 28-day mortality in severe trauma patients, though its efficacy was comparable to RTS. DCA confirmed their superior clinical utility. A two-phase assessment strategy—using prehospital RTS for rapid triage followed by in-hospital APACHE Ⅱ for dynamic monitoring—is recommended to optimize clinical decision-making and improve patient outcomes in Southwest China.

Physiologically based pharmacokinetic (PBPK) models have been widely used to predict various stages of drug absorption, distribution, metabolism and excretion. Models based on machine learning (ML) and artificial intelligence (AI) can provide better ideas for the construction of PBPK models, which can accelerate the prediction speed and improve the prediction quality of PBPK. ML and AL can complement the advantages of PBPK model to accelerate the progress of drug research and development. This review introduces the application of machine learning and artificial intelligence in pharmacokinetics, summarizes the research progress of physiological pharmacokinetic models based on machine learning and artificial intelligence, and analyzes the limitations of machine learning and artificial intelligence applications and their application prospects and prospects.

Objective: The study aims to explore the neural mechanism of cognitive differences in college students with posttraumatic stress disorder under verbal fluency task based on functional near infrared spectroscopy (fNIRS), so as to provide neuroimaging support for the evaluation, diagnosis and treatment of posttraumatic stress disorder(PTSD). Methods: Posttaumatic Stress Disorder Checklist Combat(PCL-C) was used to screen the subjects, including 21 students in PTSD group (PCL-C≥38) and 30 students in control group from September to Novenber in 2020. A 53 channel near infrared spectroscopy device was used to collect cerebral blood oxygen signals under the verbal fluency task, and correlation analysis, Mann Whitney U test and independent sample t test were performed on the results. Results: The difference in the total average score of PCL-C Scale between PTSD group and the control group(46.38±6.96，25.57±6.09) was statistically significant ( t=11.33, P <0.05). Correlation analysis showed that Avg-HbO in left dorsolateral prefrontal lobe was negatively correlated with PCL-C Score ( r=-0.37, P <0.05). Mann Whitney U test showed that in the left dorsolateral prefrontal lobe (Ch6), the Avg-HbO change in PTSD group [0.19(-0.09, 0.86)mmol/(L〖KG*7〗·mm)] was significantly lower than the control group [0.79( 0.37 , 1.47)mmol/(L ·mm)] ( Z=2.16, P <0.05), which was statistically significant. Conclusions The degree of PTSD was negatively correlated with the index of oxygenated hemoglobin in the left dorsolateral prefrontal lobe, and the oxygenated hemoglobin content in the PTSD group was lower than that in the normal group. In the future, fNIRS may be used to collect blood oxygen signals from the left dorsolateral prefrontal lobe in cognitive tasks to provide imaging evidence for the identification of PTSD.

The working principle and development of flexible semiconductor devices based on organic field effect transistor(OFET)technology were introduced.The current research status of OFET-based wearable flexible monitoring devices were reviewed,including biomechanical monitoring devices,tattoo biomonitoring devices and cellular detection devices and etc.The deficiencies of OFET-based wearable flexible monitoring devices were analyzed,and it's pointed out that miniaturization,personalization and diversification were the directions for the development of the future OFET-based wearable flexible moni-toring devices.[Chinese Medical Equipment Journal,2024,45(1):93-100]

Quaternary ammonium compounds (QACs) are widely used as fungicides and surfactants in daily products and disinfection products,and as additives in industrial process. The QACs can be deposited and accumulated in soil after long-term discharge. In the present study,based on ultrasonic-assisted extraction-liquid chromatography-tandem mass spectrometry (UAE-LC-MS/MS) technique,a sensitive analytical method was developed for rapid analysis of 11 kinds of QACs,including 4 kinds of benzylalkyldimethylammonium compounds,4 kinds of alkyltrimethylammonium compounds,and 3 kinds of dialkyldimethylammonium compounds. The results showed that QACs in soil and sediment could be effectively extracted with 5％acetonitrile at 60℃. The 11 kinds of QACs were baseline-separated on a ZORBAX SB-C18 column coupled with ternary mobile phases (0.1％formic-water,0.1％formic-methanol and 0.1％formic-acetonitrile),showing excellent linear relationship in the range of 0.001-0.5μg/mL (R2>0.9776). The limits of detection were 0.01-0.31 ng/g (S/N=3). The recoveries of 11 kinds of QACs in soil samples were 78.7％-99.3％ with relative standard deviations (RSDs)<12.9％,showing acceptable recoveries and repeatability. The results indicated that QACs could be extracted and cleaned-up within 4 h using this analytical method,with small volume of organic solvent consumed and less consumables materials.

Objectives: To investigated the safety and efficacy of treating patients with acute non-ST-segment elevation myocardial infarction (NSTEMI) and elevated levels of N-terminal pro-hormone B-type natriuretic peptide (NT-proBNP) with levosimendan within 24 hours of first medical contact (FMC). Methods: This multicenter, open-label, block-randomized controlled trial (NCT03189901) investigated the safety and efficacy of levosimendan as an early management strategy of acute heart failure (EMS-AHF) for patients with NSTEMI and high NT-proBNP levels. This study included 255 patients with NSTEMI and elevated NT-proBNP levels, including 142 males and 113 females with a median age of 65 (58-70) years, and were admitted in the emergency or outpatient departments at 14 medical centers in China between October 2017 and October 2021. The patients were randomly divided into a levosimendan group (n=129) and a control group (n=126). The primary outcome measure was NT-proBNP levels on day 3 of treatment and changes in the NT-proBNP levels from baseline on day 5 after randomization. The secondary outcome measures included the proportion of patients with more than 30% reduction in NT-proBNP levels from baseline, major adverse cardiovascular events (MACE) during hospitalization and at 6 months after hospitalization, safety during the treatment, and health economics indices. The measurement data parameters between groups were compared using the t-test or the non-parametric test. The count data parameters were compared between groups using the χ² test. Results: On day 3, the NT-proBNP levels in the levosimendan group were lower than the control group but were statistically insignificant [866 (455, 1 960) vs. 1 118 (459, 2 417) ng/L, Z=-1.25,P=0.21]. However, on day 5, changes in the NT-proBNP levels from baseline in the levosimendan group were significantly higher than the control group [67.6% (33.8%,82.5%)vs.54.8% (7.3%,77.9%), Z=-2.14, P=0.03]. There were no significant differences in the proportion of patients with more than 30% reduction in the NT-proBNP levels on day 5 between the levosimendan and the control groups [77.5% (100/129) vs. 69.0% (87/126), χ²=2.34, P=0.13]. Furthermore, incidences of MACE did not show any significant differences between the two groups during hospitalization [4.7% (6/129) vs. 7.1% (9/126), χ²=0.72, P=0.40] and at 6 months [14.7% (19/129) vs. 12.7% (16/126), χ²=0.22, P=0.64]. Four cardiac deaths were reported in the control group during hospitalization [0 (0/129) vs. 3.2% (4/126), P=0.06]. However, 6-month survival rates were comparable between the two groups (log-rank test, P=0.18). Moreover, adverse events or serious adverse events such as shock, ventricular fibrillation, and ventricular tachycardia were not reported in both the groups during levosimendan treatment (days 0-1). The total cost of hospitalization [34 591.00(15 527.46,59 324.80) vs. 37 144.65(16 066.90,63 919.00)yuan, Z=-0.26, P=0.80] and the total length of hospitalization [9 (8, 12) vs. 10 (7, 13) days, Z=0.72, P=0.72] were lower for patients in the levosimendan group compared to those in the control group, but did not show statistically significant differences. Conclusions: Early administration of levosimendan reduced NT-proBNP levels in NSTEMI patients with elevated NT-proBNP and did not increase the total cost and length of hospitalization, but did not significantly improve MACE during hospitalization or at 6 months.
Male ; Female ; Humans ; Aged ; Natriuretic Peptide, Brain ; Simendan/therapeutic use* ; Non-ST Elevated Myocardial Infarction ; Heart Failure/drug therapy* ; Peptide Fragments ; Arrhythmias, Cardiac ; Biomarkers ; Prognosis

ObjectiveTo investigate the effects of epidural analgesia plus dexmedetomidine infusion on postpartum depression in parturients with natural childbirth. MethodsWe selected 70 parturients aged between 22 and 36， with singleton， term， cephalic presentation， natural delivery and ASA class I or Ⅱ. The cases undergoing epidural analgesia with ropivacaine and sufentanil were randomly divided into two groups by using a random number table （n=35 for each group）. The control group （Group C） used intravenous infusion of normal saline， while the experimental group （Group D） used equivalent volumes of intravenous infusion of dexmedetomidine. Participants were followed up at 1， 6， 12 weeks after childbirth to assess the severity of postpartum depression. Blood samples were collected at 12 h and 48 h after childbirth to measure the serum prolactin levels. The hemodynamic （HR and MAP） changes， VAS scores， and Ramsay scores were recorded at five time points： before analgesia （T1）， 10 min after analgesia （T2）， 30 min after analgesia （T3）， 12 h （T4） and 24 h （T5） after delivery. The number of analgesia pump presses and adverse events were also documented. ResultsCompared with Group C， Group D showed significantly lower EPDS scores at 1 week after childbirth， significantly higher prolactin concentrations at 12 h and 48 h after childbirth， significantly lower VAS scores at T2， T3 and T4， significantly higher Ramsay score at T3 and significantly reduced number of analgesia pump presses （P < 0.05）. ConclusionEpidural analgesia plus intravenous infusion of dexmedetomidine can alleviate early postpartum depression in women undergoing natural delivery， promote early prolactin secretion and provide a safe and effective adjunctive analgesic and sedative effect.

Disintegration time is a key parameter that affects the palatability and compliance of oral soluble films. At present, there is no standard method to determine the disintegration time of oral soluble films. In this study, we compared the six methods (pharmacopoeial disintegration method, petri dish method, sponge surface method, slide frame and ball method, partially immersed into liquid (without weight attached) and partially immersed into liquid (with weight attached)) to determine the in vitro disintegration time of oral soluble films with different thickness, and evaluated the correlation with the in vivo disintegration time. The results showed that the repeatability and correlation of pharmacopoeial disintegration method and the partially immersed into liquid method (with weight attached) were excellent, with the endpoint of disintegration testing easy to determine. Partially immersed into liquid method (with weight attached), properly simulating the physiological condition in oral cavity, showed strong operability, good repeatability and in vitro-in vivo correlation, and was suitable for in vitro disintegration evaluation of oral soluble film dosage form. The adult sensory evaluation study was a research-based clinical trial conducted with informed consent from all subjects in accordance with the ethical requirements of Good Clinical Practice.

AIM: To investigate the effectiveness of panretinal photocoagulation(PRP)combined with intravitreal conbercept(IVC)for patients with different stages of proliferative diabetic retinopathy(PDR).METHODS: Retrospective study. The medical records for 100 patients(100 eyes)with PDR treated with PRP combined with IVC from January 2018 to June 2020 were reviewed, including 34 eyes with early PDR(group A), 43 with high-risk PDR(group B), and 23 with fibrovascular PDR(group C). The baseline information, best corrected visual acuity(BCVA), central macular thickness(CMT), the rate of vitrectomy and retinal detachment of the patients in the three groups at 1, 3, 6mo and the last follow-up after combination treatment were observed.RESULTS: The patients were followed up for 14.60±11.64mo(6-52mo), with a mean age of 54.22 ±9.32 years. We found 15 eyes(15.0%)who underwent vitrectomy after the combination treatment. The vitrectomy rates of the three groups were 2.9% in group A, 13.9% in group B, and 34.7% in group C. We found no instances of retinal detachment after the treatments. Most patients demonstrated improved BCVA and CMT values with the treatments.CONCLUSION: PRP combined with IVC is safe and effective in patients with different PDR stages.

Humans ; Adult ; Serum Albumin, Human ; Consensus ; Cardiac Surgical Procedures ; Thoracic Surgery