To analyze the application value of artificial intelligence (AI)-based classification in the categorization of medical adverse events.

OBJECTIVE To analyze the quantity transfer rule in the processing of Astragalus membranaceus before and after moistening-soaking and steaming-soaking followed by cutting. METHODS Three batches of A. membranaceus decoction pieces processed through moistening-soaking and steaming-soaking followed by cutting were prepared. The HPLC overlapping fingerprints of A. membranaceus and its decoction pieces were established through the Similarity Evaluation System of Chromatographic Fingerprints of TCM （2012 edition）. Combined with the previous qualitative analysis results， the common peaks were identified， the changes of common peak area were analyzed， and the principal component analysis was carried out. The contents of calycosin-7-glucoside， astragaloside Ⅰ and astragaloside Ⅳ in A. membranaceus and its decoction pieces were determined by HPLC， and the content differences of each component in different samples were compared. RESULTS The results of fingerprint analysis showed that 17 common peaks were identified. After steaming-soaking and moistening-soaking of A. membranaceus， the proportion of common peak area in the decoction pieces changed compared with the original medicine （for example， in A. membranaceus steaming-soaking decoction pieces， the proportion of peak area of malonyl calycosin-7-glucoside and malonyl astragaloside Ⅰ decreased， while the proportion of peak area of calycosin-7-glucoside increased）. The results of principal component analysis showed that A. membranaceus， and its decoction pieces after moistening-soaking and steaming-soaking followed by cutting were all clustered into one category respectively. The results of content determination showed that， compared with A. membranaceus， the average content of calycosin-7-glucoside in A. membranaceus moistening-soaking decoction pieces was significantly reduced （P＜0.05）； the average contents of calycosin-7-glucoside and astragaloside Ⅳ in A. membranaceus steaming- soaking decoction pieces were significantly increased （P＜0.05）； there was no significant difference in the average content of astragaloside Ⅳ in A. membranaceus moistening-soaking decoction pieces and astragaloside Ⅰ in the two decoction pieces （P＞ 0.05）. CONCLUSIONS There are differences in the quantity transfer rules of A. membranaceus before and after moistening-soaking and steaming-soaking followed by cutting. Steaming-soaking followed by cutting may make the transformation of unstable components （such as malonyl calycosin-7-glucoside and malonyl astragaloside Ⅰ） more complete.

Objective To summarize the clinical features,characteristics of cerebrospinal fluid,electrophysiological manifestations,imaging changes,treatment strategies,and prognosis of patients with varicella zoster virus(VZV)complicated by neurological involvement.Methods A retrospective analysis was conducted on 33 patients diagnosed with VZV-associated neurological infections and treated at Beijing Jishuitan Hospital,Capital Medical University,between 2013 and 2024.The clinical characteristics of these patients were thoroughly examined.Results Among the 33 patients,22 were males(66.7%)and 11 were females(33.3%),with a mean age of(60.7±14.3)years.All patients presented with cutaneous herpes zoster,with 22 cases(66.7%)starting with herpes zoster and 11 cases(33.3%)starting with symptoms of neurological damage.Neurological involvement predominantly affected the cranial nerves in 27 cases(81.8%),with facial nerve being the most commonly involved(51.5%).The most common manifestation was facial paralysis(51.5%),followed by head and facial pain(33.3%).It could also be manifested as dizziness(12.1%),ophthalmoplegia(9.1%),hearing loss(9.1%),fever(3.0%),hoarseness(3.0%),and bucking(3.0%).Spinal nerve was involved in 3 cases(9.1%):2 with spinal radiculitis and 1 with Guillain-Barré syndrome,which was characterized by limb numbness,weakness,and dysuria.Additionally,spinal cord was involved in 3 cases(9.1%)including 2 involving the thoracic spinal cord and 1 involving the cervical spinal cord,which was presented as limb numbness,pain,and weakness.No cases of VZV-induced encephalitis,meningitis,or vasculitis were reported.14 patients underwent cerebrospinal fluid examination,and 5 patients(35.7%)had elevated pressure,11 patients(78.6%)had elevated white blood cells,and 5 patients(35.7%)had elevated protein.Neuroimaging did not revealed any responsible lesion in 21 patients with cranial nerve involvement who underwent cranial magnetic resonance image.Among the three patients with spinal cord involvement,the lesion segment was all one vertebral segment.Two cases(2/3)showed circular or mild enhancement after enhancement,while one case(1/3)had no enhancement.Except for one patient who was transferred to another hospital due to HIV infection,all other patients showed clinical improvement upon discharge following antiviral therapy,with or without adjunctive glucocorticoid treatment.Conclusions The primary neurological complications of VZV include cranial nerve paralysis,spinal radiculitis,Guillain-Barré syndrome and myelitis.Early initiation of antiviral therapy,particularly when combined with glucocorticoids,is associated with improved clinical outcomes.

Objective To summarize the clinical features,characteristics of cerebrospinal fluid,electrophysiological manifestations,imaging changes,treatment strategies,and prognosis of patients with varicella zoster virus(VZV)complicated by neurological involvement.Methods A retrospective analysis was conducted on 33 patients diagnosed with VZV-associated neurological infections and treated at Beijing Jishuitan Hospital,Capital Medical University,between 2013 and 2024.The clinical characteristics of these patients were thoroughly examined.Results Among the 33 patients,22 were males(66.7%)and 11 were females(33.3%),with a mean age of(60.7±14.3)years.All patients presented with cutaneous herpes zoster,with 22 cases(66.7%)starting with herpes zoster and 11 cases(33.3%)starting with symptoms of neurological damage.Neurological involvement predominantly affected the cranial nerves in 27 cases(81.8%),with facial nerve being the most commonly involved(51.5%).The most common manifestation was facial paralysis(51.5%),followed by head and facial pain(33.3%).It could also be manifested as dizziness(12.1%),ophthalmoplegia(9.1%),hearing loss(9.1%),fever(3.0%),hoarseness(3.0%),and bucking(3.0%).Spinal nerve was involved in 3 cases(9.1%):2 with spinal radiculitis and 1 with Guillain-Barré syndrome,which was characterized by limb numbness,weakness,and dysuria.Additionally,spinal cord was involved in 3 cases(9.1%)including 2 involving the thoracic spinal cord and 1 involving the cervical spinal cord,which was presented as limb numbness,pain,and weakness.No cases of VZV-induced encephalitis,meningitis,or vasculitis were reported.14 patients underwent cerebrospinal fluid examination,and 5 patients(35.7%)had elevated pressure,11 patients(78.6%)had elevated white blood cells,and 5 patients(35.7%)had elevated protein.Neuroimaging did not revealed any responsible lesion in 21 patients with cranial nerve involvement who underwent cranial magnetic resonance image.Among the three patients with spinal cord involvement,the lesion segment was all one vertebral segment.Two cases(2/3)showed circular or mild enhancement after enhancement,while one case(1/3)had no enhancement.Except for one patient who was transferred to another hospital due to HIV infection,all other patients showed clinical improvement upon discharge following antiviral therapy,with or without adjunctive glucocorticoid treatment.Conclusions The primary neurological complications of VZV include cranial nerve paralysis,spinal radiculitis,Guillain-Barré syndrome and myelitis.Early initiation of antiviral therapy,particularly when combined with glucocorticoids,is associated with improved clinical outcomes.

【Objective】 To develop an assay to determine β-lactam antibiotics using microcolumn gels and to study the β-lactam antibiotics present in the blood of patients and their clinical significances. 【Methods】 446 patients with a history of taking β-lactam antibiotics from January 2019 to June 2019 were randomly selected from Trauma Emergency Center, Department of Arthrosis, Department of Spine and Department of Bone Oncology of our hospital, and 4 mL(per capita) venous blood was collected. Irregular antibody screening, anti-globulin detection and drug antibody determination were performed by microcolumn gel method. The data of gender, age, disease, blood transfusion history and medication were collected. The test results and clinical data were retrospective analyzed. 【Results】 The yielding rate of antibody was 0.45%(2/446) in patients with a history of taking β -lactam antibiotics. 16.38%(73/446) of the samples were positive in direct antiglobulin test, and 64.38%(47/73) of them did not agglutinate with RBCs treated with drugs. The yielding rate of specific antibodies against drug was 4.93%(22/446), and the titer ranged from 2 to 128(8). 1 case of auto-IgM antibody, 1 case of blood group related antibody and 2 cases of non-specific protein adsorption were detected. The yielding rate of drug antibody in patients with blood transfusion history reached to 12.10 %(22/124), so it was also high in patients with bone tumor. 【Conclusion】 Direct antiglobulin assay is helpful for the detection of β-lactam antibodies. The negative results of antibody screening cannot completely exclude the presence of drug antibodies. The yielding rate of drug antibody can be greatly improved by specific drug antibody detection, and it was higher in transfused patients relative to non-transfused one.

Objective To report the clinical features, myopathological changes, and gene mutations in five Chinese patients with mitochondrial diseases caused by POLG gene mutations. Methods Clinical materials of five unrelated patients who were referred to Department of Neurology, Peking University First Hospital from April 2012 to January 2018, carrying POLG gene mutations, were retrospectively analyzed. Muscle/nerve biopsies and targeted second-generation gene sequencing were performed on the patients. Results Among the five patients, three were male and two were female. Two cases were dominant inheritance and three were sporadic or recessive inheritance. The ages of onset were from 15 to 40 years with disease course of one to 26 years. One of them showed atypical SANDO (sensory ataxic neuropathy, dysarthria, and ophthalmoparesis) syndrome accompanied by cardiac preexcitation syndrome. There were two cases with autosomal dominant and one case with recessive progressive external ophthalmoplegia plus syndrome. One case presented with cognitive delay and sensory neuropathy. The pathological changes of mitochondrial myopathy were observed in all four patients with muscle involvement. Sural nerve biopsy in the patient with cognitive delay and sensory ataxia revealed chronic axonal pathological changes. POLG gene mutations were found in all five patients by targeted next generation sequencing, including single heterozygous mutations in two dominant inherited patients (c. 914 G＞A and c. 2864A＞G, respectively), and compound heterozygous POLG gene mutations in the other three sporadic/recessive inherited patients (c. 2591 A＞G/c. 1790 G＞A, c. 924G＞T/c. 3002delG and c. 1613A＞T/c. 1612 G＞T, respectively). There were six novel mutations not reported before, i.e., c.914G＞A(p.S305N), c.924G＞T(p.Q308H), c.1613A＞T(p.E538V), c.1612G＞T(p.E538*), c.1790 G＞A(p.R597Q) and c.3002delG. Conclusions POLG gene mutations can lead to different clinical spectrums. Progressive external ophthalmoplegia, limb weakness and axonal sensory neuropathy are common presentations in this group of patients with POLG gene related mitochondrial neuromuscular diseases. Novel mutations found in this study expand the mutational spectrum of POLG gene.

Objective To evaluate of three-dimensional spiral CT cholangiography to bile duct configuration before laparoscopic cholecystectomy.Methods A retrospective analysis was performed for 60 patients with cholelithiasts concurrent with choledocholithiasis from May 2009 to April 2012,which were treated with endoscopic retrograde cholangiopancreatography (ERCP),endoscopic sphincterotomy (EST),and endoscopic nasobiliary drainage (ENBD),then three-dimensional spiral CT cholangiography(SCTC) was performed through endoscopic nasobiliary drainage (ENBD) tube,and the bile duct tree image of SCTC was evaluated,then laparoscopic cholecystectomy (LC) was carried out.Results Sixty cases were performed three-dimensional SCTC.The left and right hepatic bile ducts,the hepatic bile duct and the common bile duct were visible in 100％ patients,and cholecyst bile duct was visible in 75％patients,and three-dimensional SCTC can tell the position of cholecyst duct and the place where the cholecyst bile duct enteres into the common bile duct.Conclusion Three-dimensional SCTC can show the shape of bile duct tree,especially the cholecyst duct,and has some guidance values to judge the structure of the bile duct tree and the configuration of cholecyst bile duct during operation,which can decrease the possibility of bile duct injure.

Objective To investigate the expression of nuclear factor kappa B (NF-κB),tumor necrosis factor α (TNF-α) and interleukin6 (IL-6) in human colorectal carcinoma tissues,and to explore their clinical significances in the genesis and development of colorectal cancer.Methods Sixty cases of colorectal cancer tissues and 36 cases of colorectal adenoma tissues were collected,60 cases of paracancerous normal colorectal tissues were the controls.Immunohistochemistry SABC method was used to detect the expression of NF-κB,TNF-α and IL-6 in each group respectively.The correlation of NF-κB,TNF-α and IL-6 with clinical pathologic features of colorectal cancer was analyzed.Results In colorectal carcinoma,adjacent normal colorectal tissues and colorectal adenoma tissues the positive expression rates of NF-κB were 76.7 ％ (46/60),46.7 ％ (28/60),83.3 ％ (30/36),the positive rates of TNF-α were 70.0 ％ (42/60),36.7 ％ (22/60),66.7 ％(24/36),the positive rates of IL-6 were 80.0 ％ (48/60),43.3 ％ (26/60),61.1％ (22/36).The differences were significant in each group (all P ＜ 0.05).The expression of NF-κB was closely associated with the expression of TNF-α and IL-6 respectively.In addition,the expression of NF-κB and TNF-α were correlated with vascular invaded,lymphnode metastasis and different stages.The expression of IL-6 was correlated with lymphnode metastasis and different stages.Conclusion The over expression of NF-κB and the downriver inflammation factors have close relationship with biological behaviors of colorectal cancer.It may be considered that the pathway of NF-κB play an important role in the genesis and development of colorectal cancer.

ObjectiveTo study the preoperative evaluation of three-dimensional spiral CTcholangiography(SCTC) in patients with bile duct obstruction.MethodsA retrospective analysis was performed for 60patients with bile duct obstruction from May 2008 to April 2011,who were treated with endoscopic retrograde cholangiopancreatography( ERCP),then SCTC was performed through endoscopic nasobiliary drainage( EN-BD) tube,and the bile duct tree image of SCTC of bile duct obstruction was evaluated.ResultsIn 60 cases of bile duct obstruction who performed three-dimensional SCTC,the left and right hepatic bile ducts,the hepatic bile duct and the common bile duct were visible in 100％ patients,cholecyst bile duct was visible in 80％ patients,and three-dimensional SCTC can tell the position of cholecyst duct and the place where the cholecyst bile duct enters into the common bile duct.ConclusionThree-dimensional SCTC can show the shape of bile duct tree,especially the cholecyst duct,and has some guidance values in judging the structure of the bile duct tree and the shape of cholecyst bile duct during operation.

Objective To study the preventive effect of biliary duct injury(BDI)of three-dimensional spiral CT cholangiography(SCTC)before laparoscopic cholecystectomy(LC).Methods A retrospective analysis was carried out for 30 patients suffering from cholelithiasts concurrent with choledocholithiasis from July 2007 to June 2009.EAndoscopic sphincterotomy(EST),then three-dimensional SCTC was carried out through endoscop-ic nasobiliary drainage(ENBD)before IX,and the preventive effect of BDI was evaluated.Results The visibility of intra-hepatic bile duct,the hepatic bile duct and the common bile duct were 100% the visibility of chol-ecyst bile duct was 73% ,and three-dimensional SCTC can tell the position of cholecyst duct,BDI was not happened in all these patients.Conclusion Three-dimensional SCTC before LC can decrease the possibility of BDI.