Objective To explore the clinical value of artificial intelligence (AI) quantitative parameters in distinguishing pathological grades of stageⅠ invasive adenocarcinoma (IAC). Methods Clinical data of patients with clinical stageⅠ IAC admitted to Yantaishan Hospital Affiliated to Binzhou Medical University from October 2018 to May 2023 were retrospectively analyzed. Based on the 2021 WHO pathological grading criteria for lung adenocarcinoma, IAC was divided into gradeⅠ, grade Ⅱ, and grade Ⅲ. The differences in parameters among the groups were compared, and logistic regression analysis was used to evaluate the predictive efficacy of AI quantitative parameters for grade Ⅲ IAC patients. Parameters were screened using least absolute shrinkage and selection operator (LASSO) regression analysis. Three machine learning models were constructed based on these parameters to predict grade Ⅲ IAC and were internally validated to assess their efficacy. Nomograms were used for visualization. Results A total of 261 IAC patients were included, including 101 males and 160 females, with an average age of 27-88 (61.96±9.17) years. Six patients had dual primary lesions, and different lesions from the same patient were analyzed as independent samples. There were 48 patients of gradeⅠ IAC, 89 patients of grade Ⅱ IAC, and 130 patients of grade Ⅲ IAC. There were statitical differences in the AI quantitive parameters such as consolidation/tumor ratio (CTR), ect among the three goups. (P<0.05). Univariate analysis showed that the differences in all variables except age were statistically significant (P<0.05) between the group gradeⅠ+grade Ⅱand the group grade Ⅲ . Multivariate analysis suggested that CTR and CT standard deviation were independent risk factors for identifying grade Ⅲ IAC, and the two were negatively correlated. Grade Ⅲ IAC exhibited advanced TNM staging, more pathological high-risk factors, higher lymph node metastasis rate, and higher proportion of advanced structure. CTR was positively correlated with the proportion of advanced structures in all patients. This correlation was also observed in grade Ⅲ but not in gradeⅠand grade ⅡIAC. CTR and CT median value were selected by using LASSO regression. Logistic regression, random forest, and XGBoost models were constructed and validated, among which, the XGBoost model demonstrated the best predictive performance. Conclusion Cautious consideration should be given to grade Ⅲ IAC when CTR is higher than 39.48% and CT standard deviation is less than 122.75 HU. The XGBoost model based on combined CTR and CT median value has good predictive efficacy for grade Ⅲ IAC, aiding clinicians in making personalized clinical decisions.

Objective To investigate the correlation between serum iron and disease identification of community-acquired pneumonia(CAP)in middle-aged and elderly patients.Methods A total of 137 CAP patients hospitalized in Fuzhou First General Hospital Affiliated with Fujian Medical University from October 2019 to July 2024 were selected as objective.Logistic regression analysis were used to identify risk factors affecting serum iron levels.Receiver operating characteristic curve were used to evaluate predictive performance of independent influencing factors and combined applications.Results White blood cells,C-reactive protein,procalcitonin,D-dimer,infection site and range are risk factors for serum iron abnormalities.Area under the curve(AUC)of predicting serum iron abnormalities in CAP patients using above six indicators separately are 0.755,0.730,0.676,0.725,0.594,and 0.628.Combined applications predicted AUC was 0.883.Conclusion There is a certain correlation between changes in serum iron levels and recognition of CAP disease in middle-aged and elderly people.

Objective To investigate the correlation between serum iron and disease identification of community-acquired pneumonia(CAP)in middle-aged and elderly patients.Methods A total of 137 CAP patients hospitalized in Fuzhou First General Hospital Affiliated with Fujian Medical University from October 2019 to July 2024 were selected as objective.Logistic regression analysis were used to identify risk factors affecting serum iron levels.Receiver operating characteristic curve were used to evaluate predictive performance of independent influencing factors and combined applications.Results White blood cells,C-reactive protein,procalcitonin,D-dimer,infection site and range are risk factors for serum iron abnormalities.Area under the curve(AUC)of predicting serum iron abnormalities in CAP patients using above six indicators separately are 0.755,0.730,0.676,0.725,0.594,and 0.628.Combined applications predicted AUC was 0.883.Conclusion There is a certain correlation between changes in serum iron levels and recognition of CAP disease in middle-aged and elderly people.

Objective:To investigate the diagnosis and treatment of children with parainfluenza pneumonia complicated with rhabdomyolysis syndrome and acute kidney injury (AKI).Methods:The clinical manifestations, laboratory and imaging examination results and diagnosis and treatment process of a child with parainfluenza pneumonia complicated with rhabdomyolysis syndrome and AKI admitted to the department of intensive medicine of the Second Affiliated Hospital of Fujian Medical University on July 14th, 2014 were retrospectively analyzed to provide experience and methods for the treatment of such patients.Results:The patient, a Chinese 11-year-old boy, admitted to hospital with "sore throat, fever, and double lower limb pain for 2 days". The clinical manifestations were sore throat, fever, pain in both lower extremities, fatigue, and soy sauce urine. Limb muscle tenderness, bilateral lower limb was obvious. Laboratory examination showed that blood creatine kinase (CK), MB isoenzyme of creatine kinase (CK-MB), aspartate transaminase (AST), lactate dehydrogenase (LDH), α-hydroxybutyrate dehydrogenase (HBDH) and hematuria myoglobin (Mb) were significantly elevated, and blood parainfluenza viruses (1, 2, 3 types) was positive for immunoglobulin M (IgM) antibodies. Chest X-ray shown bronchial pneumonia in the right lower lung. Pneumonia with rhabdomyolysis syndrome was considered. Anti-infection, fluid hydration, alkalized urine, diuresis and other treatment was initially prescribed. However, the condition became worse, combined with secondary epilepsy, AKI, acute heart failure, transferred to the intensive care unit (ICU). The child was put on mechanical ventilation through oral tracheal intubation, continuous hemofiltration, anti-infection and anti-virus treatment. The child's condition gradually recovered, symptoms and signs disappeared, and finally he was discharged with full recovery.Conclusions:Children with parainfluenza pneumonia can induce rhabdomyolysis. If myalgia is progressively worsened and walking is difficult, we should be highly alert to the occurrence of rhabdomyolysis. And when soy sauce urine, hematuria were noticed, and blood CK, Mb increased significantly, rhabdomyolysis syndrome can be diagnosed. Once the diagnosis is established, rehydration, alkaline urine and diuresis should be carried out in a timely manner to increase myoglobin tubular excretion. Antiviral treatment can reduce the dissolution of striated muscles. If blood purification is needed, hemofiltration and/or plasma exchange can be selected.

Objective To investigate the screening strategy of group B streptococcus (GBS) in the reproductive tract of women in the third trimester and analyze its impact on pregnancy outcome. Methods A total of 85 461 pregnant women in 35-37 weeks of gestation from Bao′an Maternity and Child Health Hospital, Jinan University from January 2011 to June 2018 were enrolled. They were divided into 3 periods according to different GBS screening strategies, the unscreened period included 31 384 cases (36.72%), 33 267 cases (38.93%) were included in partial screening period, 20 810 cases (24.35%) were included in screening period. All GBS screening positive pregnant women were given intrapartum antibiotic prophylaxis (IAP). The impact on pregnancy outcomes, and the impact of different GBS collection transport and culture methods on the positive rate of GBS screening were analyzed. Results (1) The incidence of neonatal early onset GBS disease (EOGBSD) in unscreened period was 0.03% (11/31 773), in partial screening period was 0.02%(6/33 887), and in screening period, the incidence of neonatal EOGBSD decreased to 0, the difference was statistically significant (χ2=7.86, P=0.02).(2) The incidence of hematogenous infection of GBS in pregnant women was 0.02%(6/33 887) in partial screening period, and there was none in screening period, there was no significant difference (adjusted χ2=3.75, P=0.05). (3) In the screening period, the positive rate of GBS was 14.08%(2 719/19 306), which was significantly higher than the positive rate of GBS in the partial screening period (11.48%, 2 058/17 920; χ2=56.12, P=0.00). (4) Antibiotic sensitivity tests of 4 777 GBS strains showed that the antibiotics with higher resistance rate were tetracycline (81.52%, 3 896/4 777), erythromycin (66.59%, 3 181/4 777), and clindamycin (64.31%, 3 072/4 777). The combination of erythromycin, clindamycin and tetracycline was the most common resistant pattern, accounting for 48.80% (2 331/4 777). No penicillin, ceftriaxone or vancomycin resistant strains was found. Conclusions GBS screening strategy in different regions could combine the local neonatal EOGBSD incidence rate, maternal GBS colonization rate, and the socioeconomic factors to determine whether universal GBS screening or screening for high-risk maternal women. GBS screening positive rate is related to the population, scope of the investigation, the sample collection, delivery and culture methods. The multi-drug resistance rate of GBS is high.[Key words] Streptococcus agalactiae; Streptococcal infections; Neonatal sepsis; Prenatal diagnosis; Pregnancy trimester, third; Pregnancy outcome

Objective To observe the changes of brain oxygenation in patients with extremely severe craniocerebral injury and the therapeutic effect of early normobaric hyperoxia.Methods Sixtyeight patients with extremely severe craniocerebral injury treated from January 2011 to January 2013 were assigned to two groups according to the random number table:50％ oxygen breathing for one week in control group (34 cases) and 80％ oxygen breathing for one week in treatment group (34 cases).Blood samples from jugular vein and radial artery were collected at 1,3,5,and 7 days to measure indices of blood gas analysis,i.e.,PaO2,PjvO2,CaO2,CjvO2,Da-jvO2,CERO2 and Djv-a Lac.GCS and content of neuron-specific enolase (NSE) were recorded as well.Results Values of PaO2 at each time point and GCS at 5 and 7 days were significantly higher in treatment group than in control group (P ＜0.05).Djv-a Lac at 3,5 and 7 days and NSE at 7 days revealed significantly higher levels in treatment group than in control group(P ＜ 0.05).Whereas at each time point,there were no significant differences between the two groups in aspects of PjvO2,CaO2,CjvO2,Da-jvO2 and CERO2 (P ＞ 0.05).Conclusion Early use of 100％ oxygen in patients with extremely severe craniocerebral injury may be beneficial to the prognosis.

Objective To investigate whether rosuvastatin has the effects of anti-oxidative stress and attenuates vascular endothelial adhesiveness on the vessel wall in apolipoprotein E(apoE)knockedout mice. Methods Eighty 8-week-old apolipoprotein E-deficient mice and twenty 8-week-old C57BL/6 mice,were fed a normal chow diet for 12 weeks,and were divided into 2 weeks treatment group and 6 weeks treatment group.apoE knocked-out mice were subcutaneously injected with rosuvastatin at a dose of 1, 5, or 20 mg/kg daily for 2 or 6 weeks prior to sacrifice.Blood sample was taken by cardiopuncture and the aorta was obtained at the end of the 2th or 6th weeks. Results Total cholesterol level was significantly decreased after 2 or 6 weeks of 5,or 20 mg/kg rosuvastatin treatment[2 weeks:(480.7±35.3)mmol/L,(371.5±27.1)mmol/L;6 weeks:(400.1±37.6)mmol/L,(305.0±19.3)mmol/L],compared with 0 mg/kg group(20 weeks:(675.0±42.0)mmol/L;6weeks:(660.0±44.3)mmol/L](P＜0.05 or 0.01).But the changes of triglyceride and high-density lipoprotein were not like the above.The endothelial adhesiveness for monocytes was significantly attenuated after 2 weeks in 20 mg/kg group versus 0 mg/kg group[(2.24±0.72)%vs.(3.76 ±2.53)%](P＜0.05),and even more significantly after 6 weeks in 5,20 mg/kg groups[(1.94±0.40)%,(3.95±2.61)%](P＜0.01).In addition,rosuvastatin inhibited vascular expression of p22phox and superoxide production[0 mg/kg for 6 weeks group:(3.22±1.53)%,(4.75±2.62)μg/L;20 mg/kg for 6 weeks group:(1.41±0.72)%,(2.72±0.88)μg/L](all P＜0.05). Conclusions Rosuvastatin has a role of anti-oxidative stress and attenuates vascular endothelial adhesiveness on the vessel wall.