Objective     To construct a radiomics model for identifying clinical high-risk carotid plaques. Methods     A retrospective analysis was conducted on patients with carotid artery stenosis in China-Japan Friendship Hospital from December 2016 to June 2022. The patients were classified as a clinical high-risk carotid plaque group and a clinical low-risk carotid plaque group according to the occurrence of stroke, transient ischemic attack and other cerebrovascular clinical symptoms within six months. Six machine learning models including eXtreme Gradient Boosting, support vector machine, Gaussian Naive Bayesian, logical regression, K-nearest neighbors and artificial neural network were established. We also constructed a joint predictive model combined with logistic regression analysis of clinical risk factors. Results    Finally 652 patients were collected, including 427 males and 225 females, with an average age of 68.2 years. The results showed that the prediction ability of eXtreme Gradient Boosting was the best among the six machine learning models, and the area under the curve (AUC) in validation dataset was 0.751. At the same time, the AUC of eXtreme Gradient Boosting joint prediction model established by clinical data and carotid artery imaging data validation dataset was 0.823. Conclusion     Radiomics features combined with clinical feature model can effectively identify clinical high-risk carotid plaques.

The occurrence of cervical cancer in women is closely related to high-risk HPV infection, and timely and effective interruption of high-risk HPV infection is of great significance to prevent the occurrence of cervical cancer. Huang Yuanyou's theory of "circular flow of Qi" emphasizes on the harmonization of the overall Qi flow, which can explain the physiopathology of women. The occurrence of high-risk HPV infection is related to the loss of spleen and earth transportation in the middle Jiao, poor circulation of Qi, and the low resistance of the body to evil, resulting in the malfunctioning of clear and turbid. Based on the theory of "circular flow of Qi" combined with the idea of "prevention treatment of disease", the author proposes to "prevent the disease before it occurs, regulate the middle earth to preserve the correct Qi" and "prevent the disease before it occurs". The principles of prevention and treatment of high-risk HPV infection are "prevent before the disease, regulate the middle earth to preserve the righteousness", "promote and descend to dispel the poisonous evil", and "prevent recurrence after the disease, balance yin and yang and harmonize Qi and blood", in order to provide reference for clinical treatment.

Objective To investigate the differential expression of Acyl-CoA:cholesterol acyltransferase 1(ACAT1)in osteoarthritis(OA)and its genetic correlation.Methods The expression of ACAT1 in synovial tissues of OA patients and OA mice was analyzed by using GEO database.The OA model was verified by haematoxylin-eosin(H-E)staining.The expression of ACAT1 was detected by RT-PCR.The highly synergistic genes of ACAT1 were analyzed by genome-wide genetic correlation analysis.Results The expression of ACAT1 was down-regulated in synovial tissues of OA patients and OA mice.The changes of ACAT1 expression in cartilage tissues of different strains of BXD and BXH RI mice showed a linear trend,indicating that the expression of ACAT1 gene presented with a typical quantitative genetic trait and was regulated by multiple factors.About 500 genes were highly correlated with ACAT1(P<0.05),including genes related to cell membrane structure,cell-to-cell connectivity and signaling pathways,gene transcription regulation,and protein stability.Conclusion ACAT1 may be a new target for the treatment of OA.

Objective     To identify the preoperative risk factors for prolonged mechanical ventilation (PMV) after pulmonary thromboendarterectomy (PTE). Methods    The clinical data of patients who underwent PTE from December 2016 to August 2021 in our hospital were retrospectively analyzed. The patients were divided into two groups according to the postoperative mechanical ventilation time, including a postoperative mechanical ventilation time≤48 h group (≤48 h group) and a postoperative mechanical ventilation time>48 h (PMV) group (>48 h group). Univariable and logistic regression analysis were used to identify the preoperative risk factors for postoperative PMV. Results    Totally, 90 patients were enrolled in this study. There were 40 patients in the ≤48 h group, including 30 males and 10 females, with a mean age of 45.48±12.72 years, and there were 50 patients in the >48 h group, including 29 males and 21 females, with a mean age of 55.50±10.42 years. The results showed that in the ≤48 h group, the median postoperative ICU stay was 3.0 days, and the median postoperative hospital stay was 15.0 days; in the >48 h group, the median postoperative ICU stay was 7.0 days, and the median postoperative hospital stay was 20.0 days. The postoperative PMV was significantly correlated with tricuspid annular plane systolic excursion (TAPSE) [OR=0.839, 95%CI (0.716, 0.983), P=0.030], age [OR=1.082, 95%CI (1.034, 1.132), P=0.001] and pulmonary vascular resistance (PVR) [OR=1.001, 95%CI (1.000, 1.003), P=0.028]. Conclusion    Age and PVR are the preoperative risk factors for PMV after PTE, and TAPSE is the preoperative protective factor for PMV after PTE.

Objective:To construct the core competence indicator system of newly recruited nurses based on the concept of safety and quality improvement, so as to provide a reference for the construction of the training system of the core competence and the formulation of evaluation standards of newly recruited nurses.Methods:Through literature retrieval and analysis, a framework of core competency indicator system of newly recruited nurses guided by the concept of safety and quality improvement was initially constructed. From November 2020 to March 2021, 15 nursing education and nursing practice experts across the country were consulted for 3 rounds through the Delphi expert consultation, and the expert opinions were collected to finally determine the indicator system.Results:Among 3 rounds of expert consultation, the response rates of the questionnaires were all 100%, and the expert authority coefficient was 0.90, and the Kendall coordination coefficient of the three-level indicators was from 0.14 to 0.20 ( P<0.05) . The finalized core competence indicator system of newly recruited nurses included 7 first-level indicators (professional knowledge and ability, patient-centered nursing, cooperative communication, quality promotion, safety, nursing information ability, professional development) , 18 second-level indicators and 103 third-level indicators. Conclusions:The indicators of the core competence indicator system of newly recruited nurses are good, which can provide a reference for optimizing the training courses for newly recruited nurses and improving the evaluation standards.

Objective    To explore the utility of machine learning-based radiomics models for risk stratification of severe asymptomatic carotid stenosis (ACS). Methods    The clinical data and head and neck CT angiography images of 188 patients with severe carotid artery stenosis at the Department of Cardiovascular Surgery, China-Japan Friendship Hospital from 2017 to 2021 were retrospectively collected. The patients were randomly divided into a training set (n=131, including 107 males and 24 females aged 68±8 years), and a validation set (n=57, including 50 males and 7 females aged 67±8 years). The volume of interest was manually outlined layer by layer along the edge of the carotid plaque on cross-section. Radiomics features were extracted using the Pyradiomics package of Python software. Intraclass and interclass correlation coefficient analysis, redundancy analysis, and least absolute shrinkage and selection operator regression analysis were used for feature selection. The selected radiomics features were constructed into a predictive model using 6 different supervised machine learning algorithms: logistic regression, decision tree, random forest, support vector machine, naive Bayes, and K nearest neighbor. The diagnostic efficacy of each prediction model was compared using the receiver operating characteristic (ROC) curve and the area under the curve (AUC), which were validated in the validation set. Calibration and clinical usefulness of the prediction model were evaluated using calibration curve and decision curve analysis (DCA). Results    Four radiomics features were finally selected based on the training set for the construction of a predictive model. Among the 6 machine learning models, the logistic regression model exhibited higher and more stable diagnostic efficacy, with an AUC of 0.872, a sensitivity of 100.0%, and a specificity of 66.2% in the training set; the AUC, sensitivity and specificity in the validation set were 0.867, 83.3% and 78.8%, respectively. The calibration curve and DCA showed that the logistic regression model had good calibration and clinical usefulness. Conclusion    The machine learning-based radiomics model shows application value in the risk stratification of patients with severe ACS.

Objective:To evaluate the effectiveness and safety of ultrasound-guided hydrostatic reduction for pediatric acute intussusception.Methods:One thousand eight hundred and thirty patients with acute intussusception diagnosed by ultrasound in Shenzhen Children′s Hospital from September 2017 to July 2020 were treated with ultrasound-guided hydrostatic reduction method. The therapeutic effects, complications and ultrasonic features were observed.Results:Among 1 830 cases, 1 791 cases were diagnosed as primary intussusception, and 39 cases were secondary intussusception. The overall rate of successful ultrasound enema reduction were 1 780/1 830(93.7%) patients. All 50/1 830(2.7%) patients underwent surgery after unsuccessful enema reduction, including 42 cases of primary intussusception, and 8 cases of secondary intussusception. The complication of intestinal perforation occurred in 3 cases (0.16%), and there were no deaths.Conclusions:Ultrasound-guided enema reduction for pediatric acute intussusception is an effective and safe method without radiation exposure, and can be used as the preferred method for non-operative treatment of intussusception.

Tripartite motif (TRIM) family proteins are important effectors of innate immunity against viral infections. Here we identified TRIM35 as a regulator of TRAF3 activation. Deficiency in or inhibition of TRIM35 suppressed the production of type I interferon (IFN) in response to viral infection. Trim35-deficient mice were more susceptible to influenza A virus (IAV) infection than were wild-type mice. TRIM35 promoted the RIG-I-mediated signaling by catalyzing Lys63-linked polyubiquitination of TRAF3 and the subsequent formation of a signaling complex with VISA and TBK1. IAV PB2 polymerase countered the innate antiviral immune response by impeding the Lys63-linked polyubiquitination and activation of TRAF3. TRIM35 mediated Lys48-linked polyubiquitination and proteasomal degradation of IAV PB2, thereby antagonizing its suppression of TRAF3 activation. Our in vitro and in vivo findings thus reveal novel roles of TRIM35, through catalyzing Lys63- or Lys48-linked polyubiquitination, in RIG-I antiviral immunity and mechanism of defense against IAV infection.
A549 Cells ; Animals ; Apoptosis Regulatory Proteins/immunology* ; DEAD Box Protein 58/immunology* ; Dogs ; HEK293 Cells ; Humans ; Influenza A Virus, H1N1 Subtype/immunology* ; Madin Darby Canine Kidney Cells ; Mice ; Mice, Knockout ; Orthomyxoviridae Infections/pathology* ; Proteolysis ; RAW 264.7 Cells ; Signal Transduction/immunology* ; THP-1 Cells ; TNF Receptor-Associated Factor 3/immunology* ; Ubiquitination/immunology* ; Viral Proteins/immunology*

Objective:To evaluate the image quality (IQ) of 18F-fluorodeoxyglucose (FDG) PET/CT imaging and identify its influenfial factors in diabetes mellitus (DM) and non-DM patients with coronary artery disease (CAD). Methods:A total of 196 consecutive CAD patients (174 males, 22 females, 68 DM; age: (57±10) years) in Beijing Anzhen Hospital between June 2016 and February 2018 were retrospectively analyzed. All patients underwent 18F-FDG myocardial PET/CT imaging. The standardized fasting+ oral glucose loading (OGL) and intravenously injection of insulin protocol was performed. According to the FDG uptake by myocardium, background activity in blood and other visceral organ nearby the heart, the IQ was visually evaluated and scored by 0-4. Zero-two was considered as good IQ, 3-4 was regarded as poor IQ. Patients were divided into three groups: group 1 (non-DM+ good IQ), group 2 (DM+ good IQ), group 3 (DM+ poor IQ). Factors which may affect IQ were analyzed, which including OGL, the injection dose of insulin, fasting blood glucose (FBG), peak blood glucose (PBG), blood glucose (BG) level at 18F-FDG injection (BG injnection), BG increasing rate ((PBG-FBG)/FBG, %), and BG decreasing rate ((PBG-BG injection)/PBG, %). One-way analysis of variance, Spearman correlation analysis and logistic regression analysis were used for data analysis. Results:There were significant differences ( F values: 13.074-38.371, all P<0.05) of FBG, PBG, OGL, BG decreasing rate and the injection dose of insulin among group 1 ( n=132, 67.3%), group 2 ( n=53, 27.1%), group 3 ( n=11, 5.6%). All those parameters, except for OGL, were positively correlated with FDG PET/CT IQ ( r s values: 0.142-0.262, all P<0.05). OGL was negatively correlated with IQ ( r s=-0.324, P<0.05). Logistic regression analysis showed that FBG (odds ratio ( OR)=0.687, 95% CI: 0.633-0.746), PBG( OR=0.786, 95% CI: 0.746~0.829), BG injection( OR=0.631, 95% CI: 0.595-0.716), OGL( OR=0.897, 95% CI: 0.873-0.922), the injection dose of insulin( OR=0.680, 95% CI: 0.618-0.748) were predictive factors (all P<0.01) for good IQ in all patients. For DM patients, OGL was the only predictive factor for good IQ( OR =0.940, 95% CI: 0.904-0.960; P<0.01). Conclusions:FBG, PBG, BG injection, OGL, the injection dose of insulin can predict IQ for all patients with CAD. For DM patients with CAD, OGL is the only predictive factor for good IQ. A good IQ of 18F-FDG PET/CT could be obtained in majority of CAD patients, with the standardized fasting + OGL and intravenously injection of insulin protocol and adjust according to the personal status, and prevent the hypoglycemia from happening.

BACKGROUND:It remains controversial about the clinical outcomes of bone fil ing mesh containers (BFMCs) and percutaneous kyphoplasty (PKP) in pain relief, kyphosis correction, vertebral height restoration and reduction of cement leakage. OBJECTIVE:To compare the clinical outcomes of BFMCs and PKP for osteoporotic vertebral compressive fracture. METHODS:A total of 90 patients with osteoporotic vertebral compressive fracture were equivalently randomized into two groups, fol owed by treated with BFMCs or PKP, respectively. During a more than 3-month fol ow-up, pain relief, kyphotic angle, the vertebral height and cement leakage were observed in the two groups to assess the therapeutic effects. RESULTS AND CONCLUSION:Pain in al patients was relieved at 24 hours after operation. There was no significant difference in pain relief between two groups (P>0.05). PKP was more effective to restore the vertebral height (P<0.05), while BMCFs significantly reduced the leakage rate of bone cement (P<0.05). These results suggest that BFMCs and PKP have their own advantages in the treatment of osteoporotic vertebral compressive fracture, but both exert analgesic effects.