Objective To evaluate the acute exacerbation of chronic obstructive pulmonary disease(COPD)(AECOPD)status via combining clinical data,lung function parameters with CT radiomic features based on machine learning method.Methods A total of 343 COPD patients,including 158 AECOPD patients and 185 non-AECOPD patients were retrospectively selected and randomly divided into training and testing sets at a ratio of 7∶3.The radiomics features were calculated after automatically delineating the whole lung volume of interest(VOI).Five machine learning methods were used to construct the AECOPD diagnostic model,then the corresponding Radiomics score(Rad-score)was calculated in the training set and was validated in the testing set.The logistic-combined model was established after integrating age,Global Initiative for Chronic Obstructive Lung Disease(GOLD)classification,vital capacity(VC),forced vital capacity(FVC),forced expiratory volume in one second(FEV1),FEV1％pred,FEV1/FVC％,peak expiratory flow(PEF),maximum ventilatory volume(MVV),and Rad-score value.The area under the curve(AUC)of receiver operating characteristic(ROC)curve was calculated to evaluate the evaluated performance of all models.Results The logistic regression model had the best diagnostic performance,with AUC of 0.724 and 0.758 in the training and testing sets,respectively.The performance of the logistic-combined model to diagnose AECOPD was superior to that of the single logistic regression model,with the AUC of 0.777 and 0.760 in the training and testing sets,respectively.Conclusion A combination strategy including clinical data,lung function parameters,and CT radiomics may be helpful to diagnose AECOPD status,with moderate diagnostic performance.

Urban traffic is closely related to the daily life of the public,and air pollution in the traffic microenvironment has become a public health problem that cannot be ignored.This paper reviews the comparative studies of air pollutant exposure levels among different modes of transportation in multiple cities in China.By com-paring the exposure levels of pollutants among different modes of transportation,this paper provides a reference for protecting the health of the public in daily transportation and selecting targeted control measures.

Objective:To analyze the influencing factors of the medical insurance balance of hospitalization expenses for gastric cancer surgery patients under DRG payment, for reference for promoting the reform of DRG payment in public hospitals and controlling hospitalization expenses reasonably.Methods:The gastric cancer patients enrolled in the gastroenterology department of a tertiary comprehensive hospital from January to July 2022 were selected as the research subjects. The indicators such as patient age, medical insurance balance, hospitalization expenses and their composition were extracted from the hospital information management system and the medical insurance settlement system a certain city. Descriptive analysis was conducted for all data, and stepwise multiple linear regression was used to analyze the influencing factors of patients′ medical insurance balance. Monte Carlo simulation method was used to simulate different combination scenarios of various influencing factors to analyze the probability of medical insurance balance.Results:A total of 205 patients were contained, including 117 in the medical insurance balance group and 88 in the loss group. The difference in hospitalization expenses and medical insurance balance between the two groups of patients were statistically significant ( P<0.05). The intervention of medical insurance specialists, correct DRG enrollment, parenteral nutrition preparation costs, anti infective drug costs, examination costs, and consumables costs were the influencing factors of patient medical insurance balance ( P<0.05). Through Monte Carlo simulation verification, patients with different cost parenteral nutrition preparations, or different anti infective drug schemes had the higher probability of medical insurance balance in the scenario where the medical insurance commissioner intervenes and the DRG enrollment was correct. Conclusions:The hospital adopted interventions from medical insurance specialists to ensure the correct DRG enrollment of patients, accurate use of parenteral nutrition and anti infective drugs, and reasonable control the cost of examinations and consumables, which could increase the probability of medical insurance balance for gastric cancer surgery patients. In the future, hospitals should further promote the procurement of drug consumables in bulk, reduce unnecessary examinations, develop standardized perioperative nutritional interventions and anti infection treatment pathways, ensure the accuracy of DRG enrollment, optimize clinical diagnosis and treatment pathways to improve the efficiency of medical insurance fund utilization and provide high-quality medical services for patients.

Objective To evaluate the risk factors and prognosis of high risk bladder recurrence developing after radical nephroureterectomy(RNU) for upper tract urothelial carcinoma (UTUC).Methods The data of 148 UTUC patients who developed bladder tumor after RNU between January 2000 and December 2013 was retrospectively studied.There were 69 males and 79 females,aged from 34 to 82 years old (average 68 years old).83 patients were accompanied with hydronephrosis.80 patients were renal pelvic carcinoma.32 patients had the history of smoking.24 patients had the history of ureteroscope.68 patients had the tumor larger than 3 cm.Logistic regression model was used to analyze the risk factors of muscle invasive and high grade bladder recurrence lesions.We compared the clinocopathologic characteristics between primary UTUC and bladder cancer recurrence by using Fisher' s exact test.Cancer specific survival was analyzed using the Kaplan-Meier method,with the log-rank test used to assess significance.A Cox proportional hazard model was used for multivariate analysis.Results Of the 148 patients,non-muscle invasive (Tis、Ta and T1) tumors of primary UTUC and bladder recurrence were 51 (34.5％) and 119 (80.4％),respectively.High grade (G3) tumors of primary UTUC and bladder recurrence were 41 (27.7％) and 53(35.8％),respectively.During follow-up,94 (63.5％) experienced bladder recurrence once and 54 (36.5％) experienced multiple bladder recurrence.The median follow-up time was 59.5 (rang 8-142) months,48 (32.4％) patients died of UTUC.The grade of bladder cancer recurrence correlated with the grade (P =0.046),muscle-invasion (P =0.002) and tumor architecture (P =0.034) of the primary UTUC;muscle-invasive bladder cancer recurrence associated with that of the primary UTUC (P =0.009);bladder multiple recurrence related to gender (P =0.007).On multivariate logistic regression analysis,the muscle-invasion of primary UTUC was an independent risk factor for muscle-invasive (HR =5.512,95％ CI 1.654-18.37,P =0.004) and high grade (HR =3.948,95％ CI 1.589-9.813,P =0.004) bladder recurrence tumor.The muscle invasion of primary UTUC (HR =3.498,95％ CI 1.569-7.803,P =0.002) was a prognostic factor for cancer specific survival on multivariate Cox regression analysis.Conclusions Muscle-invasive UTUC tend to predict high risk bladder recurrence tumor,and the female could be more likely to appear multiple recurrence tumor.The muscle invasion of primary UTUC could be an independent prognostic factor for cancer specific survival.

Objective To differentiate the renal angiomyolipoma with minimal fat (mf-RAML) from clear cell renal cell carcinoma (ccRCC) by Logistic regression analysis and CT quantitative analysis.Methods 25 patients with mf-RAML and 62 patients with ccRCC were collected and performed with enhanced CT scan.The CT signs,CT attenuation value and CT relative attenuation value were calculated and recorded.Results Pseudocapsule and enhancement pattern (OR=0.061,7.445,P=0.005,0.034) were the independent variables of Logistic regression equation.There were statistical difference between the unenhanced muscle％,CT relative attenuation value in renal cortical phase,CT attenuation value and CT relative attenuation value in renal medulla phase and CT relative attenuation value of the mf-RAML and those of the ccRCC (P =0.000-0.040).In addition,the two diseases had low positive correlation with the unenhanced muscle％ and CT attenuation value and CT relative attenuation value in renal medulla phase (r =0.221-0.343,P =0.001-0.040),and had low to middle negative correlation with CT relative attenuation value in renal cortical phase (r =-0.512,-0.225,P =0.000,0.036).The areas under the ROC curve of unenhanced muscle％ and CT relative attenuation value in renal medulla phase were relatively high (0.665-0.753).Conclusion Pseudocapsule and enhancement pattern were independent factors in differentiating mf-RAML from ccRCC.The CT attenuation value of the mf-RAML was similar to the erector spinae muscle.The enhanced degree of mf-RAML in renal cortical phase was lower than that of the ccRCC,while the reduced degree of the ccRCC was higher than that of the mf-RAML in renal medulla phase.The unenhanced muscle％ and the CT relative attenuation value in renal medulla phase are of great significance in diagnosing mf-RAML and ccRCC,especially the unenhanced muscle％.

BACKGROUND: The symptoms of allergic rhinitis (AR) greatly affect the quality of life (QoL) in the patients with AR. The correlations of nasal response to leukotriene D4 (LTD4) and histamine nasal provocation with health related QoL in AR are not clear. OBJECTIVE: To evaluate the correlations of nasal response to LTD4 and histamine nasal challenge with QoL in AR. METHODS: Patients randomly underwent LTD4 and histamine nasal challenge tests, completed the rhinoconjunctivitis quality of life questionnaire (RQoLQ), and rating the symptom severity score (total symptom score 4, TSS4) in the previous week. The correlations between nasal challenge tests induced nasal responses and QoL in RQoLQ were analyzed. RESULTS: A total of 25 eligible AR patients enrolled and finished both LTD4 and histamine nasal challenge and completed the questionnaire of RQoLQ. Histamine nasal challenge induced sneezing, increased nasal resistant were correlated with most of the dimensions (general, practical, nasal, eye problems, and quality of sleep, p < 0.05), while LTD4 nasal challenge induced sneeze, increased nasal resistant only correlated with nasal and ocular problems. On the contrary, the severity of the sneeze assessed by TSS4, was not correlated with QoL, while the severity of rhinorrhea, congestion, and nasal pruritus were correlated with nasal and practical problems, and nasal congestion was also correlated with ocular problems (r = 0.60, p = 0.01). CONCLUSION: LTD4 and histamine nasal challenge induced nasal responses were correlated with different clinical symptoms severity and QoL, which can be used as a good diagnosis and evaluation methods for the management of AR.
Diagnosis ; Estrogens, Conjugated (USP) ; Histamine ; Humans ; Leukotriene D4 ; Pruritus ; Quality of Life ; Rhinitis, Allergic ; Sneezing

OBJECTlVE To estabIish a simpIe,sensitive and quick method for determination of B7011 in rat pIasma. METHODS The method of protein precipitation with methanoI was used for pre-treatment of pIasma sampIes determined by Iiquid chromatography mass spectrometer. The Iinear reIa-tionship,intra-batch and inter-batch precision,specificity,matrix effect,recovery rate,the accuracy and stabiIity of the pIasma sampIes were vaIidated. The concentration of B7011 in pIasma was determined by LC-mS/ mS foIIowing a singIe intravenous injection of B7011 0.5 mg·kg-1 to rats. RESULTS The Iinear range of B7011 was 30-20 000 μg·L-1 ,the Iower Iimit of quantification was 30 μg·L-1 in pIasma,the in-tra-batch precision of 60,1000,16 000 and 10 000 ng·mL-1 was 5.61% -13.31%,2.31% -8.35%, 2.02%-9.47% and 4.0%-15.0% respectiveIy,and inter-batch precision was 10.05%,2.55%,3.75% and 8.58% respectiveIy. The recovery of 60,1000,and 16 000 μg·L-1 was 114.12%,109.2% and 101.06%respectiveIy. The average peak concentrations were 8373.28 and 8564.59 μg·L-1 ,the mean AUC was 98 400 and 104 000 μg·L-1·h and the t1/ 2z for B7011 was 41.7 and 63.6 h in bIood of maIe and femaIe rats, respectiveIy. CONCLUSlON The estabIished method is sensitive, fast and simpIe and concentration of B7011 in pIasma is determined by LC-mS/ mS foIIowing a singIe intravenous injection of B7011 0.5 mg·kg-1 to rats. It can satisfy the requirements of pharmacokinetic and toxicokinetic studies.

Poly-N-isopropylacrylamide (PNIPAAm) is a new kind of intelligent material. It shows favorable thermo sensitivity because of the structure of hydrophilic acrylamino and hydrophobic isopropyl. PNIPAAm also shows good biocompatibility and non-toxicity. All the characters as above make it an ideal extra cellular matrix material for tissue engineering. This paper reviews its application in tissue engineering.
Acrylamides ; chemistry ; Acrylic Resins ; Animals ; Biocompatible Materials ; Hot Temperature ; Humans ; Polymers ; chemistry ; Tissue Engineering ; Tissue Scaffolds

The aim of this study was to evaluate the changes in the expression of Bax, Bcl-2 and P53 when HeLa cells were induced by free cytokines or co-immobilized cytokines. The cells were induced for 24 hrs,72 hrs, 120 hrs and 168 hrs. Then, the expression of Bax, Bcl-2 and P53 was observed by immunohistochemistry. The average optic density of reaction products was tested by image analysis. Lastly, data were analyzed statistically. After the HeLa cells were induced for 120 hrs, the average optic denisity of Bcl-2 was much decreased. However, the average optic Bax was much increased. The average optic density of P53 also increased with the increase of time. The results suggest that HeLa apoptosis was induced by tumor necrosis factor-a and interferon -gamma, and the increasing expression of P53 may induce the expression of Bax and prevent the expression of Bcl-2, via the mitochondrial induction of cell apoptosis.
Apoptosis ; drug effects ; HeLa Cells ; Humans ; Immobilized Proteins ; pharmacology ; Interferon-gamma ; pharmacology ; Photochemistry ; methods ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Tumor Necrosis Factor-alpha ; pharmacology ; Tumor Suppressor Protein p53 ; metabolism ; bcl-2-Associated X Protein ; genetics ; metabolism

This study inquired into the mechanisms of co-immobilized cytokines and free cytokines-induced apoptosis on HeLa cells. With the use of photochemical fixed method, TNF-alpha/IFN-gamma were co-immobilized on a 24-well polystyrene culture plate. HeLa cells were stained with fluorescent probe JC-1 to detect the changes of mitochondrial membrane potential (deltapsim), and then were examined by flow cytometry. The results showed that co-immobilized cytokines could induce the apoptosis of HeLa cells in a dose-independent manner. When treated with low-dose of co-immobilized cytokines (20ng/ml), the mitochondrial membrane potential (deltapsim) of HeLa cells continually decreased in 6 days. These indicate that low dose co-immobilized cytokines have a long-term of apoptosis-inducing effect on HeLa cells. We assume that there is close relationship between the mitochondrial membrane potential decrease and the apoptosis of HeLa cells.
Apoptosis ; drug effects ; Dose-Response Relationship, Drug ; HeLa Cells ; Humans ; Immobilized Proteins ; pharmacology ; Interferon-gamma ; pharmacology ; Membrane Potential, Mitochondrial ; drug effects ; Mitochondrial Membranes ; drug effects ; physiology ; Tumor Necrosis Factor-alpha ; pharmacology