Objective:Based on Logistic regression and XGBoost algorithm, the prediction model of malignant brain edema (MBE) after vascular recanalization of anterior circulation acute great vessel occlusive stroke (ALVOS) was constructed, and the prediction performance was compared.Methods:A retrospective selection of 382 patients with anterior circulation ALVOS who underwent early endovascular treatment (EVT) in our hospital from March 2014 to June 2020 and successfully recanalized the occluded blood vessel was selected. The patients were divided into the training group ( n=267) and the test group ( n=115) according to the ratio of 7∶3 by the random number table method. According to whether the patients had MBE after successful recanalization of the occluded blood vessels, the training group was divided into the MBE group ( n=41) and non-MBE group ( n=226). The baseline data, treatment and brain computed tomography perfusion(CTP) results of MBE group and non-MBE group in training group and test group were compared respectively, including age, admission score of National Institutes of Health Stroke Scale (NIHSS), grade of cerebral collateral circulation, cerebral blood volume, and so on. Logistic regression model and XGBoost algorithm model were used to screen the predictors of MBE in ALVOS patients with occluded vessels successfully recanalized, and the discrimination and calibration of the two models were compared. The measurement data conforming to the normal distribution were expressed as mean ± standard deviation ( ± s), and the independent sample t test was used for comparison between the two groups. Non-normally distributed measurement data were represented by M ( Q1, Q3), using independent sample Mann-Whitney U test. The chi-square test was used to compare the count data between groups. Results:There was no significant difference in baseline data, treatment status, and cranial computed tomography perfusion (CTP) imaging results of the training group and the test group ( P>0.05). The age, admission systolic blood pressure, admission NIHSS score, proportion of hypertension, proportion of cerebral collateral circulation 0-2, proportion of thrombus removal times> 3 times, time from onset to recanalization, and cerebral blood volume (CBV) of MBE group were (68.95±8.04) years old, (146.71±22.73) mmHg, 17(13, 21) min, 87.80%, 82.93%, 68.29%, (365.64±87.83) min, (32.56±5.73) mL/100 g, obvious higher than the non-MBE group [(60.27±7.13) years old, (137.92±19.58) mmHg, 14(10, 18) points, 73.01%, 60.62%, 2.65%, (307.59±74.05) min, (27.49±5.46) mL/100 g] ( P<0.05). The results of Logistic regression model showed that age, NIHSS on admission, grade of cerebral collateral circulation, times of thrombectomy and time from onset to recanalization were the predictors of MBE after successful recanalization of occluded vessels after EVT in patients with anterior circulation ALVOS ( P<0.05). The top five important feature scores of XGBoost algorithm model were cerebral collateral circulation classification 34, embolectomy times 27, onset to vascular recanalization time 25, admission NIHSS score 22, age 16.In the training set, the area under the curve of the Logistic regression model was 0.816(95% CI: 0.749-0.883), and the Hosmer-Lemeshow test showed that χ2=1.547, P=0.438. The area under the curve of the XGBoost algorithm model was 0.856(95% CI: 0.799-0.913), and the Hosmer-Lemeshow test showed that χ2=1.021, P=0.998. Conclusion:Logistic regression model and XGBoost algorithm model had similar prediction performance for MBE after successful recanalization of occluded vessels after EVT in patients with anterior circulation ALVOS, and collateral circulation classification, number of thrombolysis, time from onset to recanalization, NIHSS score on admission, and age could be used as predictors.

Objective:A nomogram model was constructed to predict poor prognosis and death risk of mechanical thrombectomy in patients with cardiogenic acute stroke.Methods:Selected 276 patients with cardiogenic acute stroke who were treated by Jiangyin Hospital of Traditional Chinese Medicine from January 2016 to June 2020 who underwent mechanical thrombectomy as the research objects, and recorded their general information and laboratory test results. On the 90th day, the subjects were divided into a good prognosis group ( n=122) and a poor prognosis group ( n=154) according to whether the prognosis was poor or not; according to whether they died, the subjects were divided into the survival group ( n=208) and the death group ( n=68). The differences in patient related data were compared, Logistic regression analysis was used to screen for risk factors for poor prognosis and death, the line chart prediction model was established, and the ability of the column chart model to predict poor prognosis and death was evaluated by using the subject work characteristic (ROC) curve. The independent factors selected by multivariate regression analysis were used as predictors to construct a nomogram model to predict the prognosis of mechanical thrombectomy surgery in patients with cardiogenic acute stroke. The degree of calibration and validity of the nomogram model established in this study Make an evaluation. The measurement data that obey the normal distribution were represented by the Mean ± standard deviation ( ± s), and the two independent sample t test was used for the comparison between groups; The comparison of enumeration data between groups adopted chi-square test. Results:Multivariate logistic regression analysis showed age ( OR=1.165; 95% CI: 1.046-1.284; P=0.001), diabetes ( OR=1.123; 95% CI: 1.021-1.225; P<0.001), hemorrhage transformation ( OR= 2.394; 95% CI: 1.857-2.931; P=0.001), recanalization ( OR=0.418; 95% CI: 0.410-0.552; P=0.001), NIHSS score ( OR=1.502; 95% CI: 1.373-1.631); P=0.001), neutrophil count (NEUT) ( OR=1.024; 95% CI: 1.009-1.139; P=0.001), NEUT/lymphocyte count (NLR) ( OR=1.235; 95% CI: 1.112-1.358; P=0.001), D-dimer ( OR=1.939; 95% CI: 1.328-2.551; P=0.001) was an independent risk factor for poor prognosis in patients with cardiogenic acute stroke; age ( OR=1.153; 95% CI: 1.080-1.226; P<0.001), hemorrhage transformation ( OR=6.330; 95% CI: 4.904-7.754; P=0.001), recanalization ( OR=0.418; 95% CI: 0.323-0.514; P=0.001), NIHSS score ( OR=2.051; 95% CI: 1.784-2.338; P=0.001), NEUT ( OR=1.399; 95% CI: 1.275-1.523; P=0.001), NLR ( OR=1.528; 95% CI: 1.414-1.642; P=0.001), D-dimer ( OR=2.391; 95% CI: 1.948-2.834; P=0.001) was an independent predictor of death in patients with cardiogenic acute stroke. The established nomogram model predicted poor prognosis and the area under the ROC curve of death were 0.814 (95% CI: 0.800-0.828) and 0.842 (95% CI: 0.828-0.857). Conclusions:Age, hemorrhage transformation, recanalization, NIHSS score, NEUT, NLR, and D-dimer are all important for the prognosis of patients with cardiogenic acute stroke by mechanical thrombectomy. Diabetes only has a suggestive effect on poor prognosis. The nomogram model established based on these factors can effectively help clinicians evaluate the prognosis of patients, formulate reasonable treatment plans for them, and improve the prognosis.

Objective:To systematically evaluate the risk of severe gastrointestinal events in patients with cancer caused by vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR-TKI).Methods:Randomized controlled trials of VEGFR-TKI in the treatment of tumors were collected by searching relevant databases at home and abroad (up to March 2, 2019). The patients who were treated with a VEGFR-TKI were enrolled into the trial group, and those who received placebo or another VEGFR-TKI were enrolled into the control group. The outcomes included the incidence of serious gastrointestinal events. The Jadad scoring method was used to assess the quality of included studies. The Review Manager 5.3 software was used for direct meta-analysis on the risk of severe gastrointestinal events. Stata 13.0 software and linear mixed model based on frequency framework were used for network meta-analysis on severe gastrointestinal events at the highest risk. The results were expressed by relative risk ( RR) and its 95% confidence interval ( CI). Results:A total of 38 studies were included in the analysis, all of which were high-quality studies (Jadad score 4-7), comprising a total of 15 217 patients (9 130 in the trial group and 6 087 in the control group). The results of direct meta-analysis showed that the risks of severe diarrhea, severe anorexia, and severe nausea in the trial group were higher than those in the control group respectively, and the differences were statistically significant [6.8% (602/8 894) vs. 0.7% (49/6 584), RR=6.62 (95 %CI: 5.00-8.76), P<0.001; 2.5% (201/7 937) vs. 0.7% (41/5 831), RR=2.14 (95 %CI: 1.40-3.25), P<0.001; 1.5% (92/6 343) vs. 0.4% (21/4 870), RR=1.95 (95 %CI: 1.23-3.12), P=0.005]; the risk of severe diarrhea was the highest [6.8% (602/8 894)]. There was no significant difference in the risk of severe vomiting and severe abdominal pain compared with the control group [1.4% (79/5 788) vs. 0.7% (32/4 428), RR=1.49 (95 %CI: 0.90-2.47), P=0.120; 1.7% (82/4 766) vs. 1.1% (40/3 628), RR=1.35 (95 %CI: 0.84-2.16), P=0.210]. The results of network meta-analysis on risk of severe diarrhea events showed that the relative risks of severe diarrhea caused by varieties of VEGFR-TKI were axitinib>anlotinib>cabozantinib≈vandetanib≈sunitinib≈lenvatinib≈sorafenib≈pazopanib>regorafenib>fruquintinib>apatinib in the order. Conclusion:The application of VEGFR-TKIs, especially axitinib, can increase the risk of severe diarrhea in patients with tumors, which deserves clinical attention and vigilance.

Objective:To systematically evaluate the risk of severe gastrointestinal events in patients with cancer caused by vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR-TKI).Methods:Randomized controlled trials of VEGFR-TKI in the treatment of tumors were collected by searching relevant databases at home and abroad (up to March 2, 2019). The patients who were treated with a VEGFR-TKI were enrolled into the trial group, and those who received placebo or another VEGFR-TKI were enrolled into the control group. The outcomes included the incidence of serious gastrointestinal events. The Jadad scoring method was used to assess the quality of included studies. The Review Manager 5.3 software was used for direct meta-analysis on the risk of severe gastrointestinal events. Stata 13.0 software and linear mixed model based on frequency framework were used for network meta-analysis on severe gastrointestinal events at the highest risk. The results were expressed by relative risk ( RR) and its 95% confidence interval ( CI). Results:A total of 38 studies were included in the analysis, all of which were high-quality studies (Jadad score 4-7), comprising a total of 15 217 patients (9 130 in the trial group and 6 087 in the control group). The results of direct meta-analysis showed that the risks of severe diarrhea, severe anorexia, and severe nausea in the trial group were higher than those in the control group respectively, and the differences were statistically significant [6.8% (602/8 894) vs. 0.7% (49/6 584), RR=6.62 (95 %CI: 5.00-8.76), P<0.001; 2.5% (201/7 937) vs. 0.7% (41/5 831), RR=2.14 (95 %CI: 1.40-3.25), P<0.001; 1.5% (92/6 343) vs. 0.4% (21/4 870), RR=1.95 (95 %CI: 1.23-3.12), P=0.005]; the risk of severe diarrhea was the highest [6.8% (602/8 894)]. There was no significant difference in the risk of severe vomiting and severe abdominal pain compared with the control group [1.4% (79/5 788) vs. 0.7% (32/4 428), RR=1.49 (95 %CI: 0.90-2.47), P=0.120; 1.7% (82/4 766) vs. 1.1% (40/3 628), RR=1.35 (95 %CI: 0.84-2.16), P=0.210]. The results of network meta-analysis on risk of severe diarrhea events showed that the relative risks of severe diarrhea caused by varieties of VEGFR-TKI were axitinib>anlotinib>cabozantinib≈vandetanib≈sunitinib≈lenvatinib≈sorafenib≈pazopanib>regorafenib>fruquintinib>apatinib in the order. Conclusion:The application of VEGFR-TKIs, especially axitinib, can increase the risk of severe diarrhea in patients with tumors, which deserves clinical attention and vigilance.

Objective: This study investigated the factors influencing, take out meal consumption among college students in Shanxi Province and explored the relationship between the frequency of take out meal consumption and BMI. Methods: A total of 1 631 college students from five universities in Shanxi Province were studied by means of a questionnaire and multi stage random sampling. Logistic regression was used to analyze the factors influencing college students take out meal consumption. The factors influencing overweight and obesity among college students were analyzed with binary Logistic regression. Results: A total of 1 456 college students had some takeout meal consumption. Gender average monthly cost of living, grade, and major were the factors influencing the frequency of college students take out meal consumption( χ 2=72.26, 242.89, 351.52, 222.35, P <0.01). The overall overweight and obesity rate among the college students were 12.3%, 19.2% in male students, and 6.6% in female students. After controlling for gender, binary Logistic regression showed that monthly cost of living, grade, major, and permanent residence influenced the frequency of college students weekly consumption of out of home meals, and this led to a higher the rate of overweight and obesity( P <0.05). Conclusion Take out meal consumption is relatively common among college students, and controlling its frequency could help to reduce the occurrence of overweight and obesity.

Objective To explore whether Forkhead O transcription factor-3a (FoxO3a) activity affects the capability of sphere-formation of ovarian cancer SKOV3 cell line.Methods Sphere-forming cells (SFCs) were obtained and amplified through suspended culture with conditioned medium of the stem cells in SKOV3 cell line.After SKOV3 cells were transfected with FoxO3a specific siRNA,the protein expressions of FoxO3a and Bmi1 and the ratio of sphere-formation were compared with Western blot and sphere-forming assay,respectively.Results Compared to parental cells,SFCs from SKOV3 cell line had higher ratio of sphere-formation and over-expressed Bmi1 and pFoxO3a.Transfection of FoxO3a specific siRNA down-regulated the protein expression of FoxO3a and upregulated expression of Bmi1 in SKOV3 cells,and enhanced the capability of sphere-formation.Conclusions Silence of FoxO3a leads to enhanced capability of sphere-formation in SKOV3 cell line.

BACKGROUND:A few studies have reported that autologous chondrocyte implantation is better than microfracture for treating cartilage defects of the knee. But there are few meta-analyses on the clinical outcomes of autologous chondrocyte implantation versus microfracture. OBJECTIVE:To evaluate the effects of autologous chondrocyte implantation versus microfracture in the treatment of cartilage defects of the knee based on existing clinical data. METHODS:A systematic search for control ed clinical trials or control ed prospective observational studies published from 1979 to January 2015 was done in electronic databases MEDLINE, EMBASE, CINAHL, the Cochrane Central Register, Wanfang, CNKI and VIP. The literatures about the effects of autologous chondrocyte implantation versus microfracture in the treatment of cartilage defects of the knee were retrieved. We screened the retrieved literature according to the inclusion and exclusion criteria and performed a Meta-analysis with the software RevMan 5.2 after identification of the relevant data. RESULTS AND CONCLUSION:Eight studies were enrol ed according to the selection criteria, which revealed a statistical y significant difference, representing a clinical y relevant superiority of autologous chondrocyte implantation over microfracture, in IKDC scores at final fol ow-up [weighted mean difference (WMD),-9.93;95%confidence interval (CI):-13.16 to-5.43;P<0.000 01] and available scores at 5-year fol ow-up [standard mean difference (SMD),-0.30;95%CI: -0.55 to-0.05;P=0.02). In contrast, there were no significant differences, thus representing no clinical relevant superiority of microfracture versus autologous chondrocyte implantation, in Tegner scores at final fol ow-up (WMD=0.44;95%CI:0.04 to 0.84;P=0.03), Lysholm scores at final fol ow-up (WMD=-10.21;95%CI:-33.68 to 13.26;P=0.39), and available scores at 2-year fol ow-up (SMD=-0.25;95%CI:-0.92 to 0.43;P=0.47). These findings demonstrate that autologous chondrocyte implantation can result in a better long-term outcome than microfracgure. However, whether autologous chondrocyte implantation has a better treatment effect than microfracture in general needs more research.

Objective: The compare the safety and efficacy between cryoablation (CRYO) and radiofrequency catheter ablation (RFCA) for treating the patients with atrio-ventricular nodal reentrant tachycardia (AVNRT) by meta-analysis.
Methods: We systemically searched the Medline, Cochrane library and Embase database to fulifll our pre-deifned criteria until the publication of May 2014.
Results: There were 5 randomized controlled trials (RCTs) and 14 retrospective trials enrolled in our study with 2900 patients. The patients were allocated into 2 groups:CRYO group, n=1384 and RFCA group, n=1516. The overall pool-analysis demonstrated that compared with RFCA group, CRYO group had the lower risk of permanent atrio-ventricular nodal block (OR:0.27, 95%CI 0.11 to 0.62, P<0.01) and shorter X-ray exposure time (WMD:-3.36, 95%CI-5.58 to-1.15, P<0.01);while CRYO group had the lower immediate procedural success rate (OR:0.63, 95%CI 0.42 to 0.96, P<0.05), longer procedural time (WMD:10.97, 95%CI 3.35 to 18.58, P<0.01), and higher long-term arrhythmia recurrence rate (OR:2.89, 95%CI 2.05 to 4.06, P<0.01).
Conclusion: Although CRYO could decrease the risk of permanent atrio-ventricular nodal block, while its effectiveness was lower than RFCA for AVNRT treatment in relevant patients.

Objective Biodegradable polycaprolactone (PCL)/poly D,L-lactic/glycolic acid (PLGA) scaffold is a promising modality for diffuse coronary atherosclerosis diseases unavailable to bypass graft.The purpose of this study was to evaluate the long-term performance of PCL/PLGA scaffold in vivo following polymer degradation.Methods Two scaffolds with and without heparin modification [Heparinized Scaffold (HS) and Blank Scaffold (BS)] were implanted.Except for control group,bone marrow mesenchymal stem cells (MSCs) were also transplanted around the scaffold.Animals were grouped into control BS group,BS-MSCs group and HS-MSCs group (each n =6) and survived 6 months.Patency and integrity of scaffold were evaluated by echocardiography and 3D-DOCTOR software.Endothelium coverage of the lumen was evaluated by scanning electron microscopy.Neovessles and collagen fiber within the scaffold were identified by histological staining.Prostacyclin (PGI2) and thromboxane (TXA2) production in the plasma were measured by ELISA.The expression of cyclooxygenase (COX-1,COX-2) and prostacyclin synthase PGIS was detected by Western blot.Results The heparinized scaffold kept patent up to 6 months and the lumen was covered by confluent endothelial cells.Histological staining revealed remodeling of collagen fiber and reconstruction of neovascular network immediately around the lumen.PGI2 production and PGIS expression in BSMSCs group and HS-MSCs group significantly increased compared with BS group (P ＜ 0.05 and P ＜ 0.01,respectively).Nonetheless,TXA2 production and COX-1 expression in BS-MSCs group was more pronounced than HS-MSCs group (P ＜ 0.01),showing no difference between BS-MSCs and BS group (P ＞ 0.05).Conclusion Despite polymer degradation and entire heparin release,the scaffold could continuously keep the structual integrity and lumen patency until 6 months by reinforcement of host collagen fiber and PGI2 expression.

Objective To study the efficiency of the first time platelet transfusion in patients with blood diseases.Methods Investigate the effect of platelet transfusion in 87 patients with blood diseases.All the patients were transfused 10U platelet (platelet≥2.5×1011 ).Observe CCI after platelet transfusion and analyse the influence factors to the efficiency of the first time platelet transfusion such as the kind of diseases,splenomegaly,fever,age and sex.Results After platelet transfusion,66 patients (75.9 ％) were effective.The efficancy rates were 80.0 ％,78.1％,65.2 ％,82.3 ％ in AA,ITP,AL,MDS (x2=2.88,P＞0.05).In 31 patients with a fever and infaction the efficancy rate was 58.1％,but it was 85.7％ in 56 patients without a fever and infaction (x2=8.3308,P＜0.01).The efficancy rate in 59 patients with non-splenomegaly was 86.4 ％.It was higher than that in 28 patients with splenomegaly which was 53.6％(x2=11.2033,P＜0.01).The efficancy rate was 76.0％ in male patients and it was 75.7 ％ in female patients (x2=- 0.0012,P＞0.05).The efficancy rate was 74.5 ％ in young group (＜60 years old)and 77.8 ％ in old group (≥60 years old)(x2=0.1231,P＞0.05).Conclusion Fever and splenomegaly are the influence factors to the efficiency of the first time platelet transfusion.