1.Explainable Machine Learning Model for Predicting Prognosis in Patients with Malignant Tumors Complicated by Acute Respiratory Failure: Based on the eICU Collaborative Research Database in the United States
Zihan NAN ; Linan HAN ; Suwei LI ; Ziyi ZHU ; Qinqin ZHU ; Yan DUAN ; Xiaoting WANG ; Lixia LIU
Medical Journal of Peking Union Medical College Hospital 2026;17(1):98-108
To develop and validate a model for predicting intensive care unit (ICU) mortality risk in patients with malignant tumors complicated by acute respiratory failure (ARF) based on an explainable machine learning framework. Clinical data of patients with malignant tumors and ARF were extracted from the eICU Collaborative Research Database in the United States, including demographic characteristics, comorbidities, vital signs, laboratory test indicators, and major interventions within the first 24 hours after ICU admission.The study outcome was ICU death.Enrolled patients were randomly divided into a training set and a validation set at a ratio of 7:3.Predictor variables were selected using least absolute shrinkage and selection operator (LASSO) regression.Five machine learning algorithms-extreme gradient boosting (XGBoost), support vector machine (SVM), Logistic regression, multilayer perceptron (MLP), and C5.0 Decision Tree-were employed to construct predictive models.Model performance was evaluated based on the area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, and other metrics.The optimal model was further interpreted using the Shapley additive explanations (SHAP) algorithm. A total of 3196 patients with malignant tumors complicated by ARF were included.The training set comprised 2, 261 patients and the validation set 935 patients; 683 patients died during ICU stay, while 2513 survived.LASSO regression ultimately selected 12 variables closely associated with patient ICU outcomes, including sepsis comorbidity, use of vasoactive drugs, and within the first 24 hours after ICU admission: minimum mean arterial pressure, maximum heart rate, maximum respiratory rate, minimum oxygen saturation, minimum serum bicarbonate, minimum blood urea nitrogen, maximum white blood cell count, maximum mean corpuscular volume, maximum serum potassium, and maximum blood glucose.After model evaluation, the XGBoost model demonstrated the best performance.The AUCs for predicting ICU mortality risk in the training and validation sets were 0.940 and 0.763, respectively; accuracy was 88.3% and 81.2%;sensitivity was 98.5% and 95.9%.Its predictive performance also remained optimal in sensitivity analyses.SHAP analysis indicated that the top five variables contributing to the model's predictions were minimum oxygen saturation, minimum serum bicarbonate, minimum mean arterial pressure, use of vasoactive drugs, and maximum white blood cell count. This study successfully developed a mortality risk prediction model for ICU patients with malignant tumors complicated by ARF based on a large-scale dataset and performed explainability analysis.The model aids clinicians in early identification of high-risk patients and implementing individualized interventions.
2.Effects of oral non-peptidic thrombopoietin receptor agonists on hepatic enzyme in adult patients with immune thrombocytopenia:a meta-analysis
Tiantian LU ; Nan SHEN ; Suyue ZHU ; Jingjing YAN
China Pharmacy 2026;37(4):510-515
OBJECTIVE To systematically evaluate the effects of oral non-peptidic thrombopoietin receptor agonists (TPO-RAs) on hepatic enzyme in adult patients with immune thrombocytopenia. METHODS A comprehensive literature search was conducted in PubMed, Web of Science, CNKI, Wanfang database and the Chinese Medical Association Journal Full-Text Database to collect randomized controlled trials (RCTs) comparing oral non-peptidic TPO-RAs (intervention group) with placebo or conventional therapy (control group). All databases were searched from their inception to June 2025. After literature screening, data extraction and quality assessment of the included studies, meta-analysis was conducted using RevMan 5.4.1 software. RESULTS Twelve RCTs comprising 1 388 patients were included, with 971 in the intervention group and 417 in the control group. Meta-analysis results showed that there were no significant differences between the two groups in terms of the incidence of hepatic enzyme elevation[OR=1.24, 95%CI (0.77, 1.99), P =0.37 ] , the incidence of hepatic enzyme elevation in patients treated for ≥6 weeks[OR=1.21, 95%CI (0.73, 1.99), P =0.46 ] , and the incidence of severe hepatic enzyme elevation[OR=1.39, 95%CI(0.46, 4.20), P =0.55 ] . Subgroup analysis showed that there were no significant differences in the incidence of hepatic enzyme elevation between the intervention group and control group among patients using eltrombopag[OR=1.57,95%CI(0.85,2.87), P =0.15 ] , avatrombopag[OR=0.88,95%CI (0.09,8.46), P =0.91 ] , and hetrombopag[OR=1.04,95%CI(0.30,3.65), P =0.95 ] , respectively. CONCLUSIONS Oral non-peptidic TPO-RAs do not significantly increase the risk of hepatic enzyme elevation in adult patients with immune thrombocytopenia, and show an overall favorable hepatic safety profile.
3.LINC00657 Promotes Malignant Progression of Cervical Cancer by Sponging miR-30a-5p to Regulate Skp2 Expression
Changhui ZHOU ; Jingqin REN ; Zhen CHEN ; Qi YAN ; Nan YANG ; Jiaqi ZHAO ; Rong LI
Cancer Research on Prevention and Treatment 2026;53(2):103-111
Objective To investigate the role and regulatory mechanism of LINC00657 in the progression of cervical cancer. Methods Bioinformatics analysis predicted potential binding sites between LINC00657 and miR-30a-5p and between miR-30a-5p and Skp2. These sites were verified by using RNA immunoprecipitation and dual-luciferase reporter experiments. LINC00657, miR-30a-5p, and Skp2 mRNA expression levels in cervical cancer tissues and cell lines were assessed by utilizing RT-qPCR. Western blot analysis was employed to examine the protein levels of Skp2 in cells and subcutaneous xenograft tumor models in nude mice. Immunohistochemistry was applied to analyze Skp2 expression in animal tissues. The cellular processes of cervical cancer cell lines were evaluated through CCK-8, scratch, and Transwell assays. Results LINC00657 and Skp2 presented binding sites for miR-30a-5p. In cervical cancer, LINC00657 and Skp2 showed high expression levels (P<0.05), whereas miR-30a-5p displayed low expression (P<0.05). Functional experiments demonstrated that linc00657 upregulates Skp2 expression, a process that is dependent on its sequestration of miR-30a-5p. Conclusion LINC00657 promoted the malignant progression of cervical cancer by upregulating Skp2 expression through specifically sequestering miR-30a-5p, thereby relieving its inhibitory effect on the target gene Skp2.
4.Application Analysis of Rehmanniae Radix in Medical Cases of Qing Court
Yan JIN ; Tiegui NAN ; Yihan WANG ; Zhilai ZHAN
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(3):232-238
To gain an in-depth understanding of the clinical application of Rehmanniae Radix during the Qing Dynasty and to clarify its specifications and corresponding therapeutic effects, this study took Rehmanniae Radix in the prescriptions documented in Research on Medical Cases of the Qing Imperial Court as the research subject. According to historical medical literature, a comprehensive investigation was conducted on the specifications, therapeutic efficacy, frequency of use, dosage, and seasonal patterns of Rehmanniae Radix employed by imperial physicians. The findings revealed that Rehmanniae Radix in the medical cases of the Qing court was primarily classified into three categories: Xiaoshengdi, Zhongshengdi, and Dashengdi. Xiaoshengdi was also referred to as Xishengdi or Cishengdi, all denoting dried Rehmanniae Radix. The term Xishengdi was inconsistently defined in the literature. It should refer to the slender variant of dried Rehmanniae Radix and was utilized as a specific specification in the medical cases of the Qing court. In contrast, the wild fresh roots of Rehmanniae Radix, described as "as slender as fingers", were commonly documented as fresh Rehmanniae Radix in these medical cases. There were variations in Rehmanniae Radix size and grading between historical and contemporary standards. Furthermore, therapeutic differences were observed among Rehmanniae Radix specifications in the medical cases of the Qing court. Xiaoshengdi and Zhongshengdi exhibited slightly stronger blood-cooling and heat-clearing effects while maintaining a non-cloying Yin-nourishing property. In contrast, Dashengdi demonstrated a greater emphasis on Yin supplementation with relatively milder heat-clearing activity. In the medical cases of the Qing court, the dosage of Rehmanniae Radix in different specifications was usually 11.2-18.7 g per dose, typically administered twice daily. Rehmanniae Radix in different specifications exhibits variations in efficacy, which can provide evidence-based insights for precise clinical application.
5.Application Analysis of Rehmanniae Radix in Medical Cases of Qing Court
Yan JIN ; Tiegui NAN ; Yihan WANG ; Zhilai ZHAN
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(3):232-238
To gain an in-depth understanding of the clinical application of Rehmanniae Radix during the Qing Dynasty and to clarify its specifications and corresponding therapeutic effects, this study took Rehmanniae Radix in the prescriptions documented in Research on Medical Cases of the Qing Imperial Court as the research subject. According to historical medical literature, a comprehensive investigation was conducted on the specifications, therapeutic efficacy, frequency of use, dosage, and seasonal patterns of Rehmanniae Radix employed by imperial physicians. The findings revealed that Rehmanniae Radix in the medical cases of the Qing court was primarily classified into three categories: Xiaoshengdi, Zhongshengdi, and Dashengdi. Xiaoshengdi was also referred to as Xishengdi or Cishengdi, all denoting dried Rehmanniae Radix. The term Xishengdi was inconsistently defined in the literature. It should refer to the slender variant of dried Rehmanniae Radix and was utilized as a specific specification in the medical cases of the Qing court. In contrast, the wild fresh roots of Rehmanniae Radix, described as "as slender as fingers", were commonly documented as fresh Rehmanniae Radix in these medical cases. There were variations in Rehmanniae Radix size and grading between historical and contemporary standards. Furthermore, therapeutic differences were observed among Rehmanniae Radix specifications in the medical cases of the Qing court. Xiaoshengdi and Zhongshengdi exhibited slightly stronger blood-cooling and heat-clearing effects while maintaining a non-cloying Yin-nourishing property. In contrast, Dashengdi demonstrated a greater emphasis on Yin supplementation with relatively milder heat-clearing activity. In the medical cases of the Qing court, the dosage of Rehmanniae Radix in different specifications was usually 11.2-18.7 g per dose, typically administered twice daily. Rehmanniae Radix in different specifications exhibits variations in efficacy, which can provide evidence-based insights for precise clinical application.
6.Quantitative analysis on microvasculature in the optic disc area of patients with unilateral branch retinal vein occlusion
Jia SUN ; Jian LIU ; Peng YAN ; Nan LU ; Zhiming SHAN ; Dongni YANG
International Eye Science 2025;25(1):152-156
AIM: To observe the changes of retinal nerve fiber layer(RNFL)thickness and radial peripheral capillary(RPC)density in patients with unilateral branch retinal vein occlusion(BRVO), and further analyze the correlation between RPC density and RNFL thickness.METHODS: Observational study. Totally 37 patients with unilateral BRVO diagnosed at the ophthalmology department of First Hospital of Qinhuangdao from October 2020 to January 2022 were selected, the 37 affected eyes were the unilateral BRVO group, and 37 fellow healthy eyes were the contralateral unaffected group, and 35 healthy individuals(35 right eyes were selected)without ocular diseases during the same period were selected as the normal control group. The best corrected visual acuity, intraocular pressure, anterior segment, fundus and optical coherence tomography angiography(OCTA)were examined in both eyes of all BRVO patients and healthy individuals. The central macular thickness(CMT), the RNFL thickness, and the optic disc-AV crossing distance(DAVD)were measured by built-in software of the OCTA equipment. The optimized U-net algorithm was used to eliminate the large blood vessels, and then the RPC density was calculated. The CMT, RNFL thickness and RPC density were compared among the three groups. And the correlations of the RPC density with the CMT, RNFL thickness, and the DAVD were investigated.RESULTS: Compared with the contralateral unaffected group and the normal control group, the CMT and the RNFL thickness were significantly thickened in the unilateral BRVO group(all P<0.05); there were no statistical differences in the CMT and the RNFL thickness between the contralateral unaffected group and the normal control group(all P>0.05). The RPC density in the unilateral BRVO group increased compared with the contralateral unaffected group and decreased compared with the normal control group, but there was no statistically difference(all P>0.05). However, the RPC density in the contralateral unaffected group decreased compared with the normal control group(P<0.05). The RPC density in the unilateral BRVO group was not correlated with the CMT(P=0.960), but positively correlated with the RNFL thickness(r=0.401, P=0.014)and negatively correlated with the DAVD(r=-0.339, P=0.040).CONCLUSION: The RNFL thickened significantly and the RPC density did not change significantly in the optic disc area of BRVO patients. The RPC density is positively correlated with the RNFL thickness, indicating that the RNFL thickness can be used as a monitoring indicator to analyze and study the damage degree of the RPC density.
7.Research Progress on Electrochemical Sensors for Monoamine Neurotransmitters
Yu ZHONG ; Yu ZHANG ; Xiu-Zhi KANG ; Jing SUN ; Cheng DONG ; Hong-Wei WU ; Yan-Zhao LI ; Nan LI
Chinese Journal of Analytical Chemistry 2025;53(9):1411-1421
Monoamine neurotransmitters mainly include serotonin,dopamine,epinephrine,and norepinephrine.They play an indispensable regulatory role in key physiological activities such as emotion,sleep,and memory within the central nervous system.Precise detection of these neurotransmitters holds great significance in the field of neuroscience research.Detection methods for monoamine neurotransmitters encompass high-performance liquid chromatography,mass spectrometry,capillary electrophoresis,fluorescence spectroscopy,and electrochemical methods,etc.Compared with other methods,electrochemical methods offer advantages such as high sensitivity,good selectivity,low cost,strong portability,convenient operation,and capability for in vivo real-time detection.This article reviewed recent research progress in electrochemical detection of monoamine neurotransmitters,focusing on a retrospective and summary from three aspects:sensor electrode materials,detection of various monoamine neurotransmitters,and in vivo real-time analysis.Furthermore,the future development of electrochemical sensors for monoamine neurotransmitters was prospected.
8.Malonylation Proteomics Study of Hepatocellular Carcinoma Tissues Using Liquid Chromatography-Mass Spectrometry
Meng ZHANG ; Xiao LONG ; Yan-Nan WU ; Hao SI ; Hong-Xia WANG
Chinese Journal of Analytical Chemistry 2025;53(9):1546-1554
Malonylation is an important post-translational modification of proteins.In this work,a comprehensive malonylation proteomics study on hepatocellular carcinoma(HCC)tumorous and non-tumorous tissues using antibody enrichment combined with high performance liquid chromatography-mass spectrometry for discovery of early diagnostic biomarkers or potential new drug targets of HCC was performed.A total of 1299 malonylated peptides containing 1064 malonylated sites were identified from HCC tissues,corresponding to 511 malonylated proteins.Quantitative results showed that 56 and 80 malonylated proteins were up-regulated and down-regulated in HCC tissues,including 60 and 101 malonylated sites,respectively.Kyoto encyclopedia of genes and genomes(KEGG)pathway analysis showed that these differentially modified proteins were involved in various important pathways such as metabolic pathways,fatty acid degradation,and glycolysis/gluconeogenesis.As a key enzyme in glycolysis/gluconeogenesis,phosphoenolpyruvate carboxykinase 1(PCK1)was malonylated at lysine 244(K244)and the malonylation was only detected in HCC tumorous tissues.More importantly,the K244 site served as a binding site for Mn2+and highly conserved across different species.Therefore,it could speculate that the malonylation of K244 would affect its activity and played a role in liver cancer by affecting its binding with Mn2+,which requied further verification through site mutation experiments.Western blot analysis by malonylation pan antibody showed that the malonylation level reduced markedly in HCC tumorous tissues compared with adjacent non-tumorous tissues,which was consistent with mass spectrometry data.In addition,the proliferation and invasion of PLC/PRF/5 cell was significantly inhibited and protein malonylation level was increased obviously when treated with sodium malonate.All the evidence indicated that protein malonylation played an important role in HCC pathogenesis,and its molecular mechanism deserved further investigation.Furthermore,the 136 differentially malonylated proteins provided rich source of candidate targets for further research on HCC pathogenesis.
9.Recent Advances in Surface-Enhanced Raman Spectroscopy for Detection of Nano/Microplastics
Ayimureke ASIKAER ; Zhou ZHANG ; Sen-Sen ZHOU ; Ya-Nan XU ; You-Xin WANG ; Yan-Rong LI ; Dan LI
Chinese Journal of Analytical Chemistry 2025;53(10):1587-1596
Nano/microplastics(NMPs),due to their environmental persistence and resistance to degradation,have emerged as a major contributor to global pollution.NMPs are capable of adsorbing various hazardous chemicals and heavy metals,thereby posing threats to aquatic ecosystem health,which may ultimately cause potential risks to human health.Conventional analytical methods suffered from limited resolution,insufficient chemical information,or destruction of sample,invalidating these assays for on-site detection of NMPs.Surface-enhanced Raman scattering(SERS)offers distinct advantages such as high sensitivity,superior specificity,rich fingerprint information,and non-destructive analysis,thus facilitating the on-site analysis of NMPs in complex matrices.This review summarized recent advances in SERS substrates for detection of NMPs,discussed the construction and applications of SERS-based multimodal detection strategies,and introduced the research progress of SERS detection of NMPs in food safety,environmental pollution,and bioanalysis.Moreover,the main challenges and future directions of SERS-based NMP detection were outlined.
10.Construction of A Chiral Separation Method Using Polystyrene-cyclodextrin Metal-organic Framework Coating for Open-tubular Capillary Electrochromatography
Yan ZHANG ; Hao-Yu LI ; Cai LIU ; Rong-Yue ZHANG ; Xiao-Nan HE ; Juan QIAO
Chinese Journal of Analytical Chemistry 2025;53(10):1751-1760
By using a strategy of leveraging the ability of metal-organic frameworks(MOFs)materials to precisely regulate the spatial orientation of cyclodextrins(CD),a polystyrene-modified γ-cyclodextrin metal-organic frameworks(PS-CD-MOFs)capillary coating was established and applied to the chiral separation of amino acids in open-tubular capillary electrochromatography(OT-CEC)based on the excellent film-forming property of polystyrene(PS).Characterization results by Fourier transform infrared spectroscopy(FT-IR),X-ray diffraction(XRD)indicated that PS was successfully grafted onto the surface of CD-MOFs.The modification significantly improved the structural stability and thermal stability of CD-MOFs while maintaining the integrity of the MOFs.The PS-CD-MOFs coated capillary electrophoresis system exhibited excellent performance in separating dansylated amino acid enantiomers(Dns-D,L-AAs).Specifically,under the optimal separation conditions(Sodium dodecyl sulfate/boric acid buffer system,20 cm capillary,and 10 kV effective voltage),good separation was achieved for D,L-methionine(D,L-Met)and D,L-serine(D,L-Ser).Further quantitative analysis showed that Dns-D,L-Met presented a good linear relationship in the concentration range of 10.0-1500.0 μmol/L,with a correlation coefficient close to 0.998,demonstrating high sensitivity and repeatability.Not only did it overcome the problem that traditional CD(used as additives in capillary electrophoresis)could not precisely control the spatial orientation of chiral resolvents,but also it solved the issues of insufficient stability and bonding amount of CD-MOFs coatings by utilizing the excellent film-forming property of polymers on the inner wall of capillaries.This study provided an efficient and controllable new strategy for construction of chiral separation stationary phases.

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