Objectives:To propose a method based on machine learning to predict the neurological function-al status of patients with traumatic cervical spinal cord injury(TCSCI).Methods:The clinical data of 180 pa-tients with TCSCI admitted to Shanghai Changzheng Hospital were retrospectively analyzed,including cervical spine MRI images and American Spinal Injury Association(ASIA)scores within 24 hours after injury and the ASIA scores at 1-year follow-up after injury.The 180 patients were randomly divided into a training set of 144 patients and a test set of 36 patients in a ratio of 8∶2.Overall,a new clinical-imaging prediction method was proposed using the two-stage integration concept,which used the ASIA scores and MRI images within 24 hours after TCSCI to achieve a full-feature prediction of the patient's sensory and motor function one year after injury.In the first stage,models such as GradentBoosting,GaussianNB,KNeighbors,Decision-Tree,RandomForest,and support vector classifier were used to independently predict the sensory-motor func-tion recovery of 132 skin nodes and muscle nodes.In the second stage,the optimal model for each feature prediction was screened out through horizontal and vertical comparison of performance indicators,so as to fi-nally achieve the best prognostic prediction of neurological function at 56 light touch and 56 acupuncture skin nodes,and 20 key muscle nodes.After the constructed prediction model is trained and verified,the pre-diction of the test set is evaluated using accuracy,precision,recall,average precision and F1 score.Results:In terms of the overall performance of this prediction model in predicting sensory-motor function in TCSCI patients 1 year after injury,all models in the test set achieved accuracy ≥0.886,recall ≥ 0.845,precision ≥0.875,average precision ≥0.853,and F1 score≥0.859,demonstrating that the correct prediction ability of each model and the quality and completeness of the actual prediction results were relatively high.Moreover,the two-stage prediction model can optimize the prediction effect of each model on each feature,and the prediction performance is better.Conclusions:This sensory-motor full-feature prediction method can effective-ly predict the neurological function recovery of TCSCI patients at 1-year follow-up after injury.Its predictive ability is significantly higher than that of a single model,and is expected to provide a useful reference for the personalized diagnosis,treatment and rehabilitation of TCSCI patients.

Objective To explore the early brain microstructural changes in patients with alcohol use disorder(AUD)and the correlations with cognitive function.Methods Totally 81 AUD patients(AUD group)and 75 healthy volunteers(control group)were retrospectively enrolled.Gray matter volume(GMV)and cortical thickness of brain regions were calculated with voxel-based morphometry and surface-based morphometry,and the correlations of the above indexes of brain regions being significantly different between groups and clinical cognitive function scale scores were analyzed.Results In AUD group,GMV of bilateral hippocampus,insula,inferior parietal angular gyrus,straight gyrus,central posterior gyrus and cerebellar angle 1 area,of left medial superior frontal gyrus,precuneus,anterior cingulated cortex,middle temporal gyrus and middle occipital gyrus,as well as of right lingual gyrus reduced significantly compared with those in control group.The cortical thickness of bilateral superior frontal gyrus,middle frontal gyrus,inferior frontal gyrus,supramarginal gyrus,superior parietal lobule,inferior parietal lobule,central posterior gyrus,central anterior gyrus,temporal superior gyrus and middle temporal gyrus reduced in AUD group.In AUD group,GMV of left medial superior frontal gyrus was positively correlated with Pittsburgh sleep quality index score(r=0.301,P=0.006),while of the left and right straight gyrus were positively correlated with Hopkins verbal learning test-revised score(r=0.328,0.326;both P=0.003)but negatively correlated with trail making test-B score(r=-0.295,-0.312;P=0.008,0.005),while the cortical thickness of the left central anterior gyrus and the lower part of the right middle frontal gyrus were positively correlated with Beck anxiety inventory score(r=0.323,0.289;P=0.003,0.009).Conclusion Prefrontal cortex atrophy could be observed in early stage AUD patients,which was correlated with cognitive function impaired.

Objective To explore the expression pattern and molecular function of ubiquitin-like containing PHD and RING finger domains 1(UHRF1)gene in soft tissue sarcoma(STS),as well as its correlation with clinical characteristics and prognosis of STS.Methods RNA data and related clinical data of 263 STS tissues were obtained from Cancer Genome Atlas(TCGA).Wilcoxon rank-sum test was used to analyze correlation between two groups of data;Spearman correlation coefficient analyzed the top 35 co-expressed genes positively and negatively correlated with UHRF1 expression in STS database,ggplot2 statistical package displayed co-expressed gene heatmap,Pearson correlation coefficient showed correlation between UHRF1 expression and expression of the top 10 genes in the heatmap;different UHRF1 gene expression groups in STS were analyzed using DESeq2 package,ggplot2 package was used to draw volcano plots,gene ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analyzed differentially expressed genes(DEGs)and protein functions,ggplot2 package for visualization,and cluster Profiler package for statistical analysis;STRING web was used to establish PPI network of DEGs,and the MCC algorithm in CytoHubba of Cytoscape was used to analyze hub genes.Results In STS,UHRF1 gene was significantly correlated with its histological type(liposarcoma 22.2％,synovial sarcoma 3.8％,leiomyosarcoma 40.7％,malignant peripheral nerve sheath tumor 3.8％,myxofibrosarcoma 9.6％,pleomorphic sarcoma 19.9％,P=0.001),tumor necrosis(none 38.8％,focal necrosis 20.8％,moderate necrosis 33.8％,extensive necrosis 6.6％,P=0.010),and tumor metastasis(no metastasis 67％,metastasis 33％,P＜0.001).In different clinical subgroups(age,gender,histological type,residual tumor,tumor necrosis,tumor depth,margin status,tumor multifocality,radiotherapy),high expression of UHRF1 led to poor prognosis of overall survival(OS),disease-specific survival(DSS),and progression-free interval(PFI);Three prognostic factors above were simultaneously shortened in the following five subgroups:namely residual tumor R0 and R1,tumor necrosis extensive,focal and moderate,tumor depth deep,positive margin status,tumor without multifocality.Analysis of the top 10 co-expressed genes associated with UHRF1 expression revealed that the associated positive genes were PAGE5,LINC01425,LCEP3,SERPINB7,AC074031.1,LCE3A,LCE2A,PAGE2B,MYF5,and AC037486.1(P＜0.05);the associated negative genes were CDH19,CSN1S1,TAC3,AC103563.7,SAA1,CHST8,PRLHR,MIR202HG,IGHV1-24,and ART4(P＜0.05).A total of 3 029 DEGs of UHRF1 in STS were obtained with a threshold of|log2 fold-change(FC)|＞1.0 and adjusted P value＜0.05,in which 1 228 genes were up-regulated and 1 801 genes were down-regulated;GO enrichment analyed primary biological processes(BP),original cellular components(CC),and original molecular functions(MF),and KEGG enrichment analyed signaling pathways.A total of 343 DEGs including 133 up-regulated genes and 210 down-regulated genes,were obtained with a threshold of|log2 fold-change(FC)|＞2.0 and adjusted P value＜0.05.The top 10 hub genes were analyzed.The top 3 hub genes were GCG,SST and SHH,respectively.Conclusion UHRF1 is significantly correlated with histological type,tumor necrosis,metastasis,OS,DSS,and PFI events in STS.In co expressed genes model and molecular functions of related positive and negative genes involved in multiple biological processes;The network of differentially expressed genes and protein product interactions involved in mechanisms of occurrence and development of the disease,and provided new ideas for in-depth researches on STS.

Objective To investigate the expression and clinical significance of long non-codingRNA HCG11 (lncRNA HCG11) mRNA and microRNA (miR)-4465 in patients with triple-negative breast cancer(TNBC). Methods The clinicopathological data of 110 TNBC patients hospitalized in Jiulong Hospital of Suzhou from June 2017 to June 2020 were collected,and the clinical significance of the expression of lncRNA HCG11mRNA and miR-4465 was analyzed. Results The expression of lncRNA HCG11 mRNA (1.81±0.53) in cancer tissues was higher than that in adjacent tissues (0.87±0.13),while the expression of miR-4465 (0.68±0.14) was lower than that in adjacent tissues (1.09±0.18),and the differences were statistically significant(t=18.066,18.857,all P<0.05). The results of Pearson analysis showed that lncRNA HCG11mRNA was negatively correlated with the expression of miR-4465 (r=-0.443,P<0.001). The proportion of patients with high expression of lncRNA HCG11mRNA and low expression of miR-4465 in cancer tissues with lymph node metastasis in TNM stage Ⅲ+Ⅳ was higher than that in TNM stage Ⅰ+Ⅱ,and the proportion of patients without lymph node metastasis was higher (x2=6.614,18.510;8.093,22.976,all P<0.05) The 3-year survival rate of lncRNA HCG11mRNA patients with high expression was lower than that of lncRNA HCG11mRNA patients with low expression,and the 3-year survival rate of patients with high expression of miR-4465 was higher than that of patients with low expression of miR-4465 (Log-rank x2=14.45,13.39,all P<0.05). The proportion of patients with clinical stage Ⅲ+Ⅳ in death group was higher than that in survival group (x2=12.667,18.026,all P<0.05). LncRNA HCG11mRNA(HR=2.623,95％CI:1.344～5.118) was risk factors for 3-year death in TNBC patients,while miR-4465(HR=0.891,95％CI:0.821～0.967) was a protective factor (P<0.05). Conclusion The high expression of lncRNA HCG11 mRNA and the low expression of miR-4465 in triple negatire breast cancer were related to the clinicopathological characteristics and prognosis of patients,and are expected to become prognostic marker for TNBC.

Objectives:To propose a method based on machine learning to predict the neurological function-al status of patients with traumatic cervical spinal cord injury(TCSCI).Methods:The clinical data of 180 pa-tients with TCSCI admitted to Shanghai Changzheng Hospital were retrospectively analyzed,including cervical spine MRI images and American Spinal Injury Association(ASIA)scores within 24 hours after injury and the ASIA scores at 1-year follow-up after injury.The 180 patients were randomly divided into a training set of 144 patients and a test set of 36 patients in a ratio of 8∶2.Overall,a new clinical-imaging prediction method was proposed using the two-stage integration concept,which used the ASIA scores and MRI images within 24 hours after TCSCI to achieve a full-feature prediction of the patient's sensory and motor function one year after injury.In the first stage,models such as GradentBoosting,GaussianNB,KNeighbors,Decision-Tree,RandomForest,and support vector classifier were used to independently predict the sensory-motor func-tion recovery of 132 skin nodes and muscle nodes.In the second stage,the optimal model for each feature prediction was screened out through horizontal and vertical comparison of performance indicators,so as to fi-nally achieve the best prognostic prediction of neurological function at 56 light touch and 56 acupuncture skin nodes,and 20 key muscle nodes.After the constructed prediction model is trained and verified,the pre-diction of the test set is evaluated using accuracy,precision,recall,average precision and F1 score.Results:In terms of the overall performance of this prediction model in predicting sensory-motor function in TCSCI patients 1 year after injury,all models in the test set achieved accuracy ≥0.886,recall ≥ 0.845,precision ≥0.875,average precision ≥0.853,and F1 score≥0.859,demonstrating that the correct prediction ability of each model and the quality and completeness of the actual prediction results were relatively high.Moreover,the two-stage prediction model can optimize the prediction effect of each model on each feature,and the prediction performance is better.Conclusions:This sensory-motor full-feature prediction method can effective-ly predict the neurological function recovery of TCSCI patients at 1-year follow-up after injury.Its predictive ability is significantly higher than that of a single model,and is expected to provide a useful reference for the personalized diagnosis,treatment and rehabilitation of TCSCI patients.

The diagnosis of osteoporosis is mainly characterized by reduced bone mineral density(BMD).Commonly used BMD examination methods are dual-energy X-ray absorptiometry and quantitative CT,but their distribution is not enough.Routine clinical CT can also be used for BMD assessment,which mainly includes vertebral body CT values and BMD values obtained based on asynchronous calibration and internal calibration technology,which is expected to achieve opportunistic osteoporosis screening and fracture risk prediction.This paper reviews the application of routine clinical CT in assessing BMD of osteoporosis patients,in order to help clinicians and scholars understand the current status and future research directions of opportunistic osteoporosis screening.

Objective To investigate the effect of leucine carboxyl methyltransferase 1(LCMT1)knockout on fructose-induced lipid deposition in primary mouse hepatocytes.Methods Primary hepatocytes were isolated from wild-type(WT)and hepatocyte-specific LCMT1 knockout(KO)mice via a two-step hepatic portal vein perfusion method.The cells were divided into four groups:WT-control group,WT-fructose group,KO-control group,and KO-fructose group.Cell viability was determined through Alamar-Blue assays.Hepatocyte injury was evaluated based on alanine aminotransferase and aspartate aminotransferase levels.Lipid deposition was visualized via Oil Red O staining and lipid droplet green fluorescence staining,and the cellular triglyceride content was quantified via a GPO-POD assay.The mRNA expression of lipid metabolism-related genes was detected via quantitative real-time PCR,and the protein expression of LCMT1 and PP2Ac was detected via Western blot.Results Fructose treatment did not alter cell viability significantly in any group,and no significant cell damage was observed(P＞0.05).The WT-fructose group exhibited greater accumulation of lipid droplets in hepatocytes than that in the WT-control group(P＜0.001),with significantly elevated triglyceride contents(P＜0.05).The mRNA levels of the de novo lipid synthesis genes ChREBP,SREBP-1c,and ACC1 were increased significantly(P＜0.05,P＜0.001,P＜0.001),whereas FAS expression did not differ significantly between groups(P＞0.05).The mRNA levels of the lipid uptake genes FABP1 and FATP2 also increased significantly(both P＜0.05).In contrast,the KO-fructose group presented a reduced number of lipid droplets(P＜0.01,P＜0.001),decreased triglyceride content(P＜0.05),and decreased mRNA levels of ChREBP,SREBP-1c,ACC1,FABP1,and FATP2(P＜0.01,P＜0.001,P＜0.001,P＜0.001,P＜0.05);CPT1 mRNA levels were markedly increased(P＜0.01).Total PP2Ac expression was significantly higher(P＜0.05)and PP2Ac demethylation was significantly lower(P＜0.01)in the WT-fructose group than in the WT-control group.In the KO-control group,total PP2Ac expression remained unchanged(P＞0.05),whereas PP2Ac demethylation was markedly elevated(P＜0.001).Compared with levels in the WT-fructose group,the KO-fructose group presented markedly lower total PP2Ac expression and significantly higher PP2Ac demethylation levels(P＜0.05,P＜0.01,respectively).Conclusions LCMT1 knockout alleviates fructose-induced lipid deposition in primary hepatocytes by inhibiting lipid uptake,increasing fatty acid oxidation,and downregulating de novo lipid synthesis.These effects are medicated by the LCMT1 knockout-mediated upregulation of PP2Ac demethylation,thereby modulating PP2A activity.

Objective:To retrieve and summarize the best evidence for cognitive function improvement in Alzheimer's disease patients, so as to provide reference for clinical practice.Methods:Following the "6S" evidence model, guidelines, expert consensus, clinical decision, and systematic reviews on cognitive function improvement in Alzheimer's disease patients were systematically retrieved from domestic and foreign databases and websites. The search keywords included "Alzheimer's disease, cognitive function, improvement". Evidence-based nursing methods were used to evaluate the quality of literature and extract evidence. The search period was from July 1, 2000 to July 31, 2024.Results:A total of 15 articles were included, including five guidelines, four expert consensus, two clinical decision, and four systematic reviews. Sixteen pieces of best evidence were summarized from four aspects of evaluation and identification, pharmacological intervention, non-pharmacological intervention, and caregiver support.Conclusions:Patients with Alzheimer's disease require timely identification of symptoms related to cognitive impairment and assessment using standardized scales. Multiple intervention methods, such as pharmacological intervention, non-pharmacological intervention, and caregiver support, should be used to enhance patients' quality of life. Evidence application should be tailored to each patient's specific circumstances through individualized selection and adjustment to ensure the effectiveness and scientific rigor of cognitive function improvement strategies, thereby facilitating the translation of optimal evidence into clinical practice.

Objective To explore the expression pattern and molecular function of ubiquitin-like containing PHD and RING finger domains 1(UHRF1)gene in soft tissue sarcoma(STS),as well as its correlation with clinical characteristics and prognosis of STS.Methods RNA data and related clinical data of 263 STS tissues were obtained from Cancer Genome Atlas(TCGA).Wilcoxon rank-sum test was used to analyze correlation between two groups of data;Spearman correlation coefficient analyzed the top 35 co-expressed genes positively and negatively correlated with UHRF1 expression in STS database,ggplot2 statistical package displayed co-expressed gene heatmap,Pearson correlation coefficient showed correlation between UHRF1 expression and expression of the top 10 genes in the heatmap;different UHRF1 gene expression groups in STS were analyzed using DESeq2 package,ggplot2 package was used to draw volcano plots,gene ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analyzed differentially expressed genes(DEGs)and protein functions,ggplot2 package for visualization,and cluster Profiler package for statistical analysis;STRING web was used to establish PPI network of DEGs,and the MCC algorithm in CytoHubba of Cytoscape was used to analyze hub genes.Results In STS,UHRF1 gene was significantly correlated with its histological type(liposarcoma 22.2％,synovial sarcoma 3.8％,leiomyosarcoma 40.7％,malignant peripheral nerve sheath tumor 3.8％,myxofibrosarcoma 9.6％,pleomorphic sarcoma 19.9％,P=0.001),tumor necrosis(none 38.8％,focal necrosis 20.8％,moderate necrosis 33.8％,extensive necrosis 6.6％,P=0.010),and tumor metastasis(no metastasis 67％,metastasis 33％,P＜0.001).In different clinical subgroups(age,gender,histological type,residual tumor,tumor necrosis,tumor depth,margin status,tumor multifocality,radiotherapy),high expression of UHRF1 led to poor prognosis of overall survival(OS),disease-specific survival(DSS),and progression-free interval(PFI);Three prognostic factors above were simultaneously shortened in the following five subgroups:namely residual tumor R0 and R1,tumor necrosis extensive,focal and moderate,tumor depth deep,positive margin status,tumor without multifocality.Analysis of the top 10 co-expressed genes associated with UHRF1 expression revealed that the associated positive genes were PAGE5,LINC01425,LCEP3,SERPINB7,AC074031.1,LCE3A,LCE2A,PAGE2B,MYF5,and AC037486.1(P＜0.05);the associated negative genes were CDH19,CSN1S1,TAC3,AC103563.7,SAA1,CHST8,PRLHR,MIR202HG,IGHV1-24,and ART4(P＜0.05).A total of 3 029 DEGs of UHRF1 in STS were obtained with a threshold of|log2 fold-change(FC)|＞1.0 and adjusted P value＜0.05,in which 1 228 genes were up-regulated and 1 801 genes were down-regulated;GO enrichment analyed primary biological processes(BP),original cellular components(CC),and original molecular functions(MF),and KEGG enrichment analyed signaling pathways.A total of 343 DEGs including 133 up-regulated genes and 210 down-regulated genes,were obtained with a threshold of|log2 fold-change(FC)|＞2.0 and adjusted P value＜0.05.The top 10 hub genes were analyzed.The top 3 hub genes were GCG,SST and SHH,respectively.Conclusion UHRF1 is significantly correlated with histological type,tumor necrosis,metastasis,OS,DSS,and PFI events in STS.In co expressed genes model and molecular functions of related positive and negative genes involved in multiple biological processes;The network of differentially expressed genes and protein product interactions involved in mechanisms of occurrence and development of the disease,and provided new ideas for in-depth researches on STS.

ObjectiveTo analyze the clinical treatment plan and traditional Chinese medicine （TCM） medication rule of children with primary nephrotic syndrome （PNS） in the First Affiliated Hospital of Henan University of Chinese Medicine. MethodsThe gender and age of children firstly diagnosed with nephrotic syndrome in the pediatric nephrology department of the First Affiliated Hospital of Henan University of Chinese Medicine from November 2019 to December 2022 were collected， and the use of immunosuppressive agents and related frequencies were counted. According to the inclusion and exclusion criteria， an independent TCM prescription database for children with nephrotic syndrome was established. Excel was used to analyze the relevant information of the literature. The frequency counting， association rule analysis， and cluster analysis were carried out on TCM in the prescription， and the high-frequent drugs were analyzed. Results（1） General information： A total of 711 children were included， consisting of 522 males （73.42%） and 189 females （26.58%）. The ratio of male to female was about 2.76∶1. The disease mainly occurred in infants and preschool age， and the average age of onset was （4.74 ± 3.48） years old. （2） Clinical treatment plan and use of immunosuppressive agents： Of the 711 children with PNS， 237 were treated with hormone alone （32.33%）， and 474 （66.67%） received immunosuppressive agents combined with hormones. In the initial treatment， hormone combined with Tacrolimus （TAC） was the preferred treatment （32.91%）. For children with refractory PNS who exhibited poor clinical efficacy， Rituximab （RTX） was mostly used for treatment， with a ratio of up to 23.63%. （3） TCM syndrome and medication rule： In PNS syndrome differentiation， Qi and Yin deficiency was identified as the main syndrome. This involved a total of 477 cases， accounting for 67.09%. Yang deficiency of spleen and kidney was observed in 118 cases， accounting for 16.60%. A total of 711 children were included， of which 706 children were treated with TCM. This involved a total of 706 prescriptions， 226 TCM， and 9 793 frequencies. There were 30 herbs used more than 95 times. The top five TCM were Radix et Rhizoma Glycyrrhizae （81.16%）， Radix Astragali （71.81%）， Poria （68.84%）， Rhizoma Atractylodis Macrocephalae （63.60%）， and Fructus Corni （57.37%）. The drug association rules and network diagram showed that the combination of ''Radix Astragali-Rhizoma Atractylodis Macrocephalae-Poria'' was the closest， and five types of combinations were obtained by cluster analysis. ConclusionIn the diagnosis and treatment of PNS in children， TAC combined with hormones shows good clinical efficacy and high safety. For children with refractory PNS， RTX combined with hormones can be used. TCM medication for PNS should follow the basic principles of strengthening the body and vital Qi and make good use of drugs such as Radix Astragali， Poria， Rhizoma Atractylodis Macrocephalae， and cornus to regulate the Yin and Yang balance and achieve better clinical efficacy.