Objective To construct machine learning models based on preoperative inflammatory and radiological features for the prediction of glioma grading and isocitrate dehydrogenase (IDH) mutation status, and to analyze application values of these models and identify the optimal predictive models. Methods A retrospective analysis was conducted on the data of pathologically confirmed glioma patients admitted to Tongji Hospital Affiliated to Tongji University from March 2019 to March 2023. LASSO regression was used to screen feature variables, and predictive models were constructed based on logistic regression (LR), random forest (RF), support vector machine (SVM), gradient boosting decision tree (XGBoost) and K-nearest neighbor (KNN) algorithms. The model performance was comprehensively evaluated using metrics including discrimination ability, area under the precision-recall curve (AUC), accuracy, F1 score and Brier score. The DeLong test was adopted to compare the AUC values among different models; Friedman rank-sum test was used to determine the overall performance differences of the models, with the Nemenyi test applied for multiple comparison correction. Results In the task of glioma grading prediction, the LR model achieved the highest comprehensive score (0.726), and no significant difference was observed between the LR model and the other four models; age was positively correlated with glioma grading (P=0.003). In the task of IDH mutation status prediction, the XGBoost model obtained the highest comprehensive score (0.832), which was superior to the LR (0.762, P=0.035) and KNN models (0.754, P=0.025), while no statistical differences were found between the XGBoost model and the RF or SVM models. Conclusions The LR model for glioma grading prediction and XGBoost model for IDH mutation prediction constructed based on a task-oriented strategy achieve a favorable interpretability while ensuring optimized performance, thereby providing reliable decision support for the individualized diagnosis and treatment of glioma.

ObjectiveTo establish a quality evaluation method for Zhuye Shigao granules（Zhuye Shigaotang） based on fingerprint and determination of index components， and to investigate the therapeutic effect of Zhuye Shigao granules on mice with cold-dampness pestilence attacking lung syndrome. MethodsThe fingerprint of Zhuye Shigao granules was established by high performance liquid chromatography（HPLC）， and the methods for determination of total calcium， orientin， isoorientin， ginsenosides Rg₁， Re and Rb₁ and other 2 index components were established. Fifty ICR mice were randomly divided into the blank group， model group， Zhuye Shigao granules low， medium and high dose groups（9.3， 18.6， 37.2 g·kg^-1·d^-1）， with 10 mice in each group. In addition to the blank group， the model mice with cold-dampness pestilence attacking lung syndrome was prepared by nasal drip of lipopolysaccharide combined with cold-dampness environment. Each administration group was given the corresponding liquid by gavage according to the dose， while the blank group and model group were given the same volume of normal saline by gavage. Then， the body temperature and organ index of mice in each group were measured， hematoxylin-eosin（HE） staining was used to investigate the lung tissue injury of mice in each group， and enzyme-linked immunosorbent assay（ELISA） was used to detect the changes of tumor necrosis factor-α（TNF-α）， interleukin（IL）-lβ， IL-6， IL-10 levels in serum and lung tissue， as well as immunoglobulin（Ig）A and IgM levels in serum. ResultsThe fingerprint similarity of 10 batches of Zhuye Shigao granules was>0.950， and 20 common peaks were calibrated. Seven of them were identified， including peak 11（isoorientin）， peak 12（orientin）， peak 14（apioside liquiritin）， peak 15（liquiritin）， peak 17（apioside isoliquiritin）， peak 19（isoliquiritin） and peak 20（liquiritigenin）. The results of quantitative analysis showed that the content range of each index component in 10 batches of Zhuye Shigao granules was as follows：Total calcium of 9.978-11.294 mg·g^-1， isoorientin of 0.033-0.041 mg·g^-1， orientin of 0.046-0.055 mg·g^-1， ginsenoside Rg₁+ginsenoside Re of 0.748-0.762 mg·g^-1， ginsenoside Rb₁ of 0.151-0.197 mg·g^-1， liquiritin of 1.106-1.366 mg·g^-1， glycyrrhizic acid of 0.904-1.182 mg·g^-1_. Compared with the blank group， the body temperature of mice in the model group was significantly increased， the organ indexes of liver， lung and spleen were significantly decreased， the organ index of thymus was significantly increased， HE staining of lung tissue showed infiltration of inflammatory cells， a small amount of serous exudation was observed in the alveoli， and lung tissue was damaged. After the intervention of Zhuye Shigao granules， the pathological changes were improved compared with the model group. The expression levels of IL-1β， IL-6 and TNF-α were significantly increased， the expression level of IL-10 was significantly decreased in serum and lung tissue. The levels of IgA and IgM in serum were significantly decreased（P<0.01）. Compared with the model group， the body temperature， the organ indexes and immune factor levels in serum and lung tissue of mice in the Zhuye Shigao granules medium and high dose groups were significantly reduced（P<0.05， P<0.01）. ConclusionIn this study， the quality evaluation of Zhuye Shigao granules was carried out based on fingerprint combined with determination of index components， and the fingerprint of four herbs（Lophatheri Herba， Ophiopogonis Radix， Pinelliae Rhizoma and Glycyrrhizae Radix et Rhizoma） in this formula and the determination of 8 index components were established. The therapeutic effect of Zhuye Shigao granules on mice with cold-dampness pestilence attacking lung syndrome may be related to inhibiting inflammatory response and mediating immune regulation.

Objective To observe the value of three-dimensional ultrasound combined with microvascular flow imaging for prenatal diagnosis of fetal intracranial anomalies.Methods Totally 118 fetuses with intracranial anomalies diagnosed through cranial MRI/induced labor specimen dissection who underwent prenatal ultrasound examination were retrospectively enrolled.Two-dimensional,three-dimensional ultrasound and microvascular flow imaging manifestations of fetal intracranial anomalies were observed,and the accuracy of three-dimensional ultrasound combined with microvascular flow imaging for prenatal diagnosis of fetal intracranial anomalies was analyzed.Results The accuracy of three-dimensional ultrasound combined with microvascular flow imaging for prenatal diagnosis of fetal intracranial anomalies was 93.22％(110/118),of isolated and non-isolated intracranial anomalies was 97.47％(77/79)and 84.62％(33/39),respectively.Six fetuses were missed diagnosis of malformations of cortical development(1 fetus of tuberous sclerosis,4 of abnormal morphology of the sulci gyrus and 1 of schizencephaly)and 1 fetus of intracranial softening lesion,while posterior fossa arachnoid cyst in 1 fetus was misdiagnosed as mega cisterna magna.Conclusion The accuracy of three-dimensional ultrasound combined with microvascular flow imaging for prenatal diagnosis of fetal intracranial anomalies was relatively high.

Objective To investigate the influencing factors and predictive efficacy of joint function recovery in patients with tibial plateau fracture with intercondylar spine.Methods Fifty-eight patients with tibial plateau fracture with intercondylar spine admitted to the hospital from May 2020 to July 2022 were selected,all of whom were treated by surgery.The patients were followed up for 12 months after surgery,at the last follow-up,the patients were divided into two groups:poor prognosis group and good prognosis group according to Hospital for Special Surgery(HSS)score,and the clinical data of the two groups were compared.R software was used to build a nomogram prediction model based on the risk factors affecting the poor prognosis of postoperative joint function.Goodness of fit test,receiver operating characteristic(ROC)curve to assess risk nomogram model calibration and differentiation.Results All 58 patients were followed up for 12 months after operation.The HSS score at the last follow-up was 40-95 points,of which 19 were＜59 points.The results of univariate analysis showed that BMI,osteoporosis,preoperative ASA grade,skin and soft tissue injury,intercondylar spine fracture block free,and postoperative functional training may be correlated with poor prognosis of postoperative joint function(P＜0.05).Multivariate logistic regression analysis showed that BMI ≥23 kg/m2,osteoporosis,preoperative ASA grade Ⅲ to Ⅳ,skin and soft tissue injury,intercondylar spine fracture mass free and non-adherence to postoperative functional training were independent risk factors for poor prognosis of postoperative joint function(P＜0.05),there was no interaction among the risk factors(deviation=1.02,Pearson x2=0.98,R2=0.34,P＞0.05).A nomogram model was constructed based on BMI,osteoporosis,preoperative ASA grading,skin and soft tissue injury,intercondylar spine fracture block free,and postoperative functional training.Calibration results showed that the measured values were basically consistent with the predicted values.The results of the Bootstrap internal validation method showed that the sensitivity,specificity,and area under the ROC curve of this nomogram model for predicting poor postoperative joint function recovery in patients with tibial plateau fractures with intercondylar spinous fractures were 86.50％,72.40％,and 0.885,respectively.Conclusion BMI ≥ 23 kg/m2,osteoporosis,preoperative ASA grade,skin and soft tissue injury,intercondylar spine fracture fragment free,and non-adherence to postoperative functional training are risk factors for poor prognosis of postoperative joint function in patients with tibial plateau fracture with intercondylar spine fracture.The nomogram model constructed based on this has good accuracy and discrimination.

Objective:To investigate the expression of NADPH oxidase(Nox)in chronic obstructive pulmonary disease(COPD).Method:The rats were randomly divided into control group,COPD group,COPD medium exercise group and COPD intensive exercise group,with 10 rats in each group.The expression of NADPH oxidase,hypoxia induc-ible factor-1 alpha(HIF1α),inflammatory factors tumor necrosis——factor alpha(TNFα),interleukin-6(IL-6),matrix metalloproteinase 2(MMP-2)and matrix metalloproteinase 9(MMP-9)were detected by immunohistochemistry.Result:Compared with the control group,the expression of NADPH oxidase subtypes Nox1,Nox2,Nox5,HIF1α,TNFα,IL-6,MMP-2 and MMP-9 in COPD group increased significantly.Medium exercise reduced the expression of Nox2,Nox5,HIF1α and MMP-9 in COPD animal model,while intensive exercise reduced the expression of Nox1,Nox2,Nox5,HIF1α,TNFα,IL-6 and MMP-9.Conclusion:Rehabilitation exercise down regulated the expression of NADPH oxidases in lung,reduced the expression of downstream inflammatory factors and matrix metalloproteinase.The protective function of rehabili-tation exercise might achieve by inhibiting the expression of hypoxia inducible factor.

Objective:To retrieve, appraise and synthesize evidence regarding the prevention and management of high-output ileostomy in post-enterostomy patients, thereby providing a scientific reference for clinical practice.Methods:A computerized search was conducted, systematically exploring national and international databases, as well as the websites of pertinent associations, to gather evidence relevant to the topic. The literature types included clinical decision-making, evidence summaries, guidelines, expert consensus, and systematic reviews. The search timeframe was established from the date of database construction until 23 August 2024. The methodological quality assessment of the literature, along with the extraction and synthesis of the evidence, was performed by two independent researchers utilizing established criteria and adhering to rigorous standards.Results:A total of 13 papers were included in the review, comprising one clinical decision, four guidelines, and eight systematic reviews. Eighteen pieces of best evidence were distilled and summarized across six key areas: diagnosis and risk identification, fluid/diet/nutrition management, medication administration, skin management, monitoring and health education, and follow-up care.Conclusions:The clinical practice rationale for the prevention and management of high-output ileostomy in post-enterostomy patients, when summarized, would offer scientific and effective evidence-based support for practice changes by clinical care staff. The practical application and translation of this evidence should thoroughly consider the nuances of clinical practice in China, as well as individual patient differences, to ensure the effective implementation of the best evidence for maximizing patient benefit.

Objective:To develop the Proactive Health Behavior Scale for Population at High Risk of Type 2 Diabetes Mellitus to provide community healthcare workers with an assessment tool to measure proactive health behaviors in a multidimensional manner.Methods:Guided by the information-motivation-behavioral skills theory, a test version of the Proactive Health Behavior Scale for Population at High Risk of Type 2 Diabetes Mellitus was developed through literature research, semi-structured interviews, Delphi expert consultation, and pre-survey. Convenience sampling was used to select 696 cases of type 2 diabetes mellitus high-risk people in the community of Lubei District, Tangshan City, from February to June 2024 for the item analysis, reliability and validity test. A total of 696 questionnaires were distributed and 664 valid questionnaires were recovered, with a valid recovery rate of 95.40%.Results:The Proactive Health Behavior Scale for Population at High Risk of Type 2 Diabetes Mellitus included four dimensions, including prevention knowledge, prevention motivation, prevention skills, and prevention behaviors, with a total of 38 items. Exploratory factor analysis extracted four common factors, with a cumulative variance contribution rate of 64.203%. Confirmatory factor analysis showed good model fit. The total Cronbach's α coefficient for the scale was 0.940, the half fold reliability coefficient was 0.964, and the test-retest reliability coefficient was 0.859.Conclusions:The Proactive Health Behavior Scale for Population at High Risk of Type 2 Diabetes Mellitus has good reliability and validity, which can be used to evaluate the proactive health behaviors in population at high-risk of type 2 diabetes mellitus.

Objective:To evaluate the relationship between the mechanism of mild hypothermia-induced reduction of neuronal apoptosis during cerebral ischemia-reperfusion (I/R) and calcium/calmodulin-dependent protein kinase kinase 2 (CaMKK2)/adenosine monophosphate-activated protein kinase (AMPK) signaling pathway in rats.Methods:Forty SPF male Sprague-Dawley rats, aged 6-8 weeks, weighing 200-250 g, were divided into 5 groups ( n=8 each) using a random number table method: sham operation group (Sham group), cerebral I/R group (IR group), hypothermia + cerebral I/R group (HIR group), hypothermia + cerebral ischemia-reperfusion + solvent group (HIR-DMSO group) and hypothermia + ischemia-reperfusion + CaMKK2 inhibitor STO-609 group (HIR-STO609 group). A global cerebral I/R injury model was established using the four-vessel occlusion method. In HIR group, HIR-DMSO group, and HIR-STO609 group, an ice blanket was used to reduce the body temperature immediately after cerebral ischemia, bringing the core body temperature down to 32.5-33.5 ℃, and rewarming was carried out 4 h later. One hour before developing the model, STO-609 solution 4 μl was injected into the lateral ventricle in HIR-STO609 group, and the equal volume of dimethyl sulfoxide solution was given instead in HIR-DMSO group. At the end of reperfusion, the modified neurological severity score (mNSS) was performed. Then the rats were sacrificed under deep anesthesia, and the hippocampal tissues were taken to observe the pathological results of the hippocampal tissues (using HE staining and Nissl staining) and to determine the apoptosis rate of neurons (by TUNEL method) and expression of B-cell lymphoma 2(Bcl-2), Bcl-2-associated X (Bax), CaMKK2, phosphorylated AMPK (p-AMPK) and AMPK (by Western blot). Results:Compared with Sham group, the mNSS and apoptosis rate of neurons in the hippocampal tissues were significantly increased, the expression of Bax was up-regulated, the expression of Bcl-2, CaMKK2 and p-AMPK was down-regulated, and the ratio of p-AMPK/AMPK was decreased in IR group ( P<0.05). Compared with IR group, the mNSS and apoptosis rate of neurons in the hippocampal tissues were significantly decreased, the expression of Bax was down-regulated, the expression of Bcl-2, CaMKK2 and p-AMPK was up-regulated, and the ratio of p-AMPK/AMPK was increased in HIR group ( P<0.05). Compared with HIR group, the mNSS and apoptosis rate of neurons in the hippocampal tissues were significantly increased, the expression of Bax was up-regulated, the expression of Bcl-2, CaMKK2 and p-AMPK was down-regulated, the ratio of p-AMPK/AMPK was decreased ( P<0.05), and no significant change was found in the aforementioned parameters in HIR-DMSO group ( P>0.05). Conclusions:Mild hypothermia can inhibit neuronal apoptosis by up-regulating the CaMKK2/AMPK signaling pathway, thus reducing cerebral I/R injury in rats.

Objective:To analyze the willingness and related factors of pregnant women in Shanghai City to receive influenza vaccines during pregnancy.Methods:An online questionnaire survey was conducted among pregnant women who registered in maternal and child health hospitals in 16 districts of Shanghai. The basic information, health status during pregnancy, attitude towards influenza vaccination, and knowledge of influenza and influenza vaccine were collected, and χ2 test and multivariate logistic regression analysis were used to analyze the willingness and related factors of pregnant women to receive influenza vaccines during pregnancy. Results:A total of 3 219 valid questionnaires were received, with 10.90% of pregnant women willing to receive influenza vaccination during pregnancy, 57.50% unwilling to receive vaccination and 31.59% holding an uncertain attitude. Among the pregnant women who were willing to receive the vaccine, 82.91% would take the initiative to know the relevant information about the influenza vaccine, and 87.18% understood the transmission routes of the flu. 32.09% believed that pregnant women could receive the influenza vaccination at any stage of pregnancy. Among those who were unwilling and held an uncertain attitude, the proportions of the above three questions were 47.06%, 83.95% and 17.80%, respectively. Among pregnant women who were unwilling to receive vaccination and held an uncertain attitude, the main reason for their vaccine hesitation was the concern about the safety of the vaccine for pregnant women and fetuses during pregnancy. Multivariate logistic regression analysis showed that pregnant women with higher education ( OR=3.278, 95% CI: 1.678-6.406, P=0.001), second trimester ( OR=1.542, 95% CI: 1.159-2.054, P=0.003), third pregnancy ( OR=2.318, 95% CI: 1.008-5.331, P=0.048), and previous influenza vaccination ( OR=1.552, 95% CI: 1.119-2.152, P=0.008) had a higher willingness to receive influenza vaccines during pregnancy. Conclusion:Pregnant women in Shanghai have a relatively low willingness to receive influenza vaccines during pregnancy, mainly due to concerns about vaccine safety.

Objective:To investigate the expression of NADPH oxidase(Nox)in chronic obstructive pulmonary disease(COPD).Method:The rats were randomly divided into control group,COPD group,COPD medium exercise group and COPD intensive exercise group,with 10 rats in each group.The expression of NADPH oxidase,hypoxia induc-ible factor-1 alpha(HIF1α),inflammatory factors tumor necrosis——factor alpha(TNFα),interleukin-6(IL-6),matrix metalloproteinase 2(MMP-2)and matrix metalloproteinase 9(MMP-9)were detected by immunohistochemistry.Result:Compared with the control group,the expression of NADPH oxidase subtypes Nox1,Nox2,Nox5,HIF1α,TNFα,IL-6,MMP-2 and MMP-9 in COPD group increased significantly.Medium exercise reduced the expression of Nox2,Nox5,HIF1α and MMP-9 in COPD animal model,while intensive exercise reduced the expression of Nox1,Nox2,Nox5,HIF1α,TNFα,IL-6 and MMP-9.Conclusion:Rehabilitation exercise down regulated the expression of NADPH oxidases in lung,reduced the expression of downstream inflammatory factors and matrix metalloproteinase.The protective function of rehabili-tation exercise might achieve by inhibiting the expression of hypoxia inducible factor.