BACKGROUND: Over 20 million colonoscopies are performed in China annually. An automatic clinical decision support system (CDSS) with accurate semantic recognition of colonoscopy reports and guideline-based is helpful to relieve the increasing medical burden and standardize the healthcare. In this study, the CDSS was built under a hierarchical-label interpretable classification framework, trained by a state-of-the-art transformer-based model, and validated in a multi-center style. METHODS: We conducted stratified sampling on a previously established dataset containing 302,965 electronic colonoscopy reports with pathology, identified 2041 patients' records representative of overall features, and randomly divided into the training and testing sets (7:3). A total of five main labels and 22 sublabels were applied to annotate each record on a network platform, and the data were trained respectively by three pre-training models on Chinese corpus website, including bidirectional encoder representations from transformers (BERT)-base-Chinese (BC), the BERT-wwm-ext-Chinese (BWEC), and ernie-3.0-base-zh (E3BZ). The performance of trained models was subsequently compared with a randomly initialized model, and the preferred model was selected. Model fine-tuning was applied to further enhance the capacity. The system was validated in five other hospitals with 3177 consecutive colonoscopy cases. RESULTS: The E3BZ pre-trained model exhibited the best performance, with a 90.18% accuracy and a 69.14% Macro-F1 score overall. The model achieved 100% accuracy in identifying cancer cases and 99.16% for normal cases. In external validation, the model exhibited favorable consistency and good performance among five hospitals. CONCLUSIONS The novel CDSS possesses high-level semantic recognition of colonoscopy reports, provides appropriate recommendations, and holds the potential to be a powerful tool for physicians and patients. The hierarchical multi-label strategy and pre-training method should be amendable to manage more medical text in the future.
Humans ; Colonoscopy/methods* ; Deep Learning ; Decision Support Systems, Clinical ; Female ; Male

Objective To analyze the prevalence and influencing factors of anxiety and depression among pregnant women in Jianyang City. Methods Convenience sampling method was used to select 322 pregnant women in Jianyang Maternal and Child Health Hospital of Jianyang City. The depression and anxiety of the participants were measured with self-rating anxiety scale(SAS) and self-rating depression scale(SDS)，and the degree of social support was measured with social support rating scale (SSRS). Pearson correlation analysis was used to analyze the relationship between anxiety, depression and social support. The chi square ( 2) test and the non-conditional Logistic regression model were used to analyze the influencing factors of anxiety and depression. Results Anxiety rate and depression rate of pregnant women in Jianyang city were 5.3% and 5.6% respectively. There was a negative correlation between anxiety, depression and social support (P<0.05). Absence of prenatal examination (OR=4.554, 95% CI: 1.063-19.510) was a risk factor for anxiety among pregnant women in Jianyang City. Late pregnancy (OR=5.381, 95% CI: 1.422-20.363) and medium degree of social support (OR=4.150, 95% CI: 1.198-14.375) were risk factors for depression among pregnant women in Jianyang City. Junior high school (OR=0.015, 95% CI: 0.001-0.275), high school or technical secondary school (OR=0.004, 95% CI: 0.001-0.128), junior college or above (OR=0.053, 95% CI: 0.003-0.851) were protective factors for depression. Conclusions The prevelance of anxiety and depression in pregnant women cannot be ignored. It is important to carry out mental health intervention according to the above factors.

The aim of this study was to investigate the mechanism by which a diet inducing high hyperhomocysteinemia (HHcy) leads to the deterioration of erectile function in rats and whether this is inhibited by expression of the human tissue kallikrein-1 (hKLK1) gene. We established a rat model of HHcy by feeding methionine (Met)-rich diets to male Sprague-Dawley (SD) rats. Male wild-type SD rats (WTRs) and transgenic rats harboring the hKLK1 gene (TGRs) were fed a normal diet until 10 weeks of age. Then, 30 WTRs were randomly divided into three groups as follows: the control (n = 10) group, the low-dose (4% Met, n = 10) group, and the high-dose (7% Met, n = 10) group. Another 10 age-matched TGRs were fed the high-dose diet and designated as the TGR+7% Met group. After 30 days, in all four groups, erectile function was measured and penile tissues were harvested to determine oxidative stress, endothelial cell content, and penis fibrosis. Compared with the 7% Met group, the TGR+7% Met group showed diminished HHcy-induced erectile dysfunction (ED), indicating the improvement caused by hKLK1. Regarding corpus cavernosum endothelial cells, hKLK1 preserved endothelial cell-cell junctions and endothelial cell content, and activated protein kinase B/endothelial nitric oxide synthase (Akt/eNOS) signaling. Fibrosis assessment indicated that hKLK1 preserved normal penis structure by inhibiting apoptosis in the corpus cavernosum smooth muscle cells. Taken together, these findings showed that oxidative stress, impaired corpus cavernosum endothelial cells, and severe penis fibrosis were involved in the induction of ED by HHcy in rats, whereas hKLK1 preserved erectile function by inhibiting these pathophysiological changes.
Animals ; Apoptosis ; Diet ; Endothelial Cells ; Erectile Dysfunction/prevention & control* ; Fibrosis ; Humans ; Hyperhomocysteinemia/complications* ; Male ; Methionine ; Oxidative Stress ; Penis/pathology* ; Rats ; Rats, Sprague-Dawley ; Rats, Transgenic ; Signal Transduction/genetics* ; Tissue Kallikreins/genetics*

BackgroundSeveral studies have investigated the association between smoking and anal abscess and anal fistula (AA/F) diseases. However, the relationship between cigarette smoking and AA/F remains unclear. This study sought to assess the role of smoking in anorectal male patients in a Chinese population.

MethodsIn this retrospective study, a questionnaire, including smoking history, was completed over a 3-month period by male inpatients in the Proctology Department of China-Japan Friendship Hospital. "Cases" were patients who had AA/F, and "controls" were patients with other anorectal complaints. Mann-Whitney U-test and Chi-square test were carried out to examine differences in baseline characteristics between groups. Subsequently, multivariate logistic regression was used to explore any related factors.

ResultsA total of 977 patients aged from 18 to 80 years were included, excluding those diagnosed with inflammatory bowel disease or diabetes mellitus. Out of this total, 805 patients (82.4%) completed the entire questionnaire. Among the 805 patients, 334 (41.5%) were cases and 471 (58.5%) were controls. Results showed significant differences between cases and controls (χ = 205.2, P < 0.001), with smoking found to be associated with the development of AA/F diseases (odds ratio: 12.331, 95% confidence interval: 8.364-18.179, P < 0.001).

ConclusionsThis study suggested smoking to be a potential risk factor for the development of AA/F diseases in a Chinese population. Consequently, current smoking patients should be informed of this relationship, and further research should be conducted to explore and investigate this further.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anus Diseases ; epidemiology ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Odds Ratio ; Rectal Fistula ; epidemiology ; Retrospective Studies ; Risk Factors ; Smoking ; adverse effects ; Surveys and Questionnaires ; Young Adult

Objective To investigate the effect of autologous tissue breast reconstruction with microsurgical lymph node transfers and lymphatic-venous anastomoses for the treatment of mastectomy related axillary cavitydeformation and upper extremity lymphedema .Methods The donor sites of lymph node transfers were mainly chosen according to the donor site of breast reconstruction .Themicrosurgical lymph nodes were transferred to the axillary cavity .When the superficial lymph vessels could be detected in lymphangiography with indocyanine green , thelymphatic-venous anastomoses were done to improve the lymphatic drainage .The treatment effect was assessed by the perimeter changes of different parts of upper extremity, the isotope lymphangiography and associated symptoms . Results 20 cases involved in autologous tissue breast reconstruction with microsurgical lymph node transfers , 18 cases from ingruinallymph nodes and 2 cases from lateral thoracic lymph nodes .2 cases receivedlymphatic-venous anastomoses on their upper extremity .The perimeters of palm and wrist were found significantly decreased in 6 months postoperation , while the perimeters of midpoint forearm and upper arm also decreased .The cellulitis, pain and swell happened less during the follow-up from 6 months up to 4 years. The postoperation isotope lymphangiography showed functional transferred lymph nodes inaxillary cavity , better lymphatic drainage and less volume of upper extremity .The subcutaneous superficial lymphatic drainage signs could be observed by the isotope lymphangiography in cases who had lymphatic -venous anastomoseson upper extremity .Conclusions Autologous tissue breast reconstruction with microsurgical lymph node transfers and lymphatic-venous anastomoses is a promising option for the treatment of mastectomy related axillary cavitydeformation and upper extremity lymphedema .The long term results need longer follow-up and more research .

Objective To investigate the effect of autologous tissue breast reconstruction with microsurgical lymph node transfers and lymphatic-venous anastomoses for the treatment of mastectomy related axillary cavitydeformation and upper extremity lymphedema .Methods The donor sites of lymph node transfers were mainly chosen according to the donor site of breast reconstruction .Themicrosurgical lymph nodes were transferred to the axillary cavity .When the superficial lymph vessels could be detected in lymphangiography with indocyanine green , thelymphatic-venous anastomoses were done to improve the lymphatic drainage .The treatment effect was assessed by the perimeter changes of different parts of upper extremity, the isotope lymphangiography and associated symptoms . Results 20 cases involved in autologous tissue breast reconstruction with microsurgical lymph node transfers , 18 cases from ingruinallymph nodes and 2 cases from lateral thoracic lymph nodes .2 cases receivedlymphatic-venous anastomoses on their upper extremity .The perimeters of palm and wrist were found significantly decreased in 6 months postoperation , while the perimeters of midpoint forearm and upper arm also decreased .The cellulitis, pain and swell happened less during the follow-up from 6 months up to 4 years. The postoperation isotope lymphangiography showed functional transferred lymph nodes inaxillary cavity , better lymphatic drainage and less volume of upper extremity .The subcutaneous superficial lymphatic drainage signs could be observed by the isotope lymphangiography in cases who had lymphatic -venous anastomoseson upper extremity .Conclusions Autologous tissue breast reconstruction with microsurgical lymph node transfers and lymphatic-venous anastomoses is a promising option for the treatment of mastectomy related axillary cavitydeformation and upper extremity lymphedema .The long term results need longer follow-up and more research .

Phenylalanine hydroxylase (PAH) is a member of aromatic amino acid hydroxylase (AAAHs) family, and catalyze phenylalanine (Phe) into tyrosine (Tyr). Using immunological and RT-PCR methods to prove the existence of phenylalanine hydroxylase (PAH) gene in the brain of Neanthes japonica in protein and nucleic acid level. Using Western blotting to detect the pah immunogenicity of Neanthes japonica. Making paraffin sections and using immunohistochemical technique to identify the presence and distribution of the phenylalanine hydroxylase gene in the brain of Neanthes japonica. Clone pah gene from the brain of Neanthes japonica by RT-PCR, constructing plasmid and transferring into E. coli to amplification, picking a single homogeneous colony, double digesting then making sequence and comparing homology. Western blotting results showed that the expression of the protein is present in Neanthes japonica brain, immunohistochemistry technique results showed that phenylalanine hydroxylase mainly expressed in abdominal of forebrain, dorsal and sides of midbrain. RT-PCR technique results showed that the phenylalanine hydroxylase exist in the brain of Neanthes japonica and has a high homology with others animals. PAH is present in the lower organisms Neanthes japonica, in protein and nucleic acid level. Which provide the foundation for further study the evolution of aromatic amino acid hydroxylase genes in invertebrate.
Animals ; Blotting, Western ; Brain ; enzymology ; Escherichia coli ; metabolism ; Phenylalanine Hydroxylase ; genetics ; metabolism ; Polychaeta ; enzymology ; genetics

OBJECTIVETo investigate the effects of 1,25-(OH)(2)D(3) on the airway remodeling and expression of high-mobility group box 1 (HMGB1) and Toll-like receptor 4 (TLR4) in the lungs among asthmatic mice.

METHODSThirty female mice (BALB/c strain) were randomly divided into control, asthma and 1,25-(OH)(2)D(3) intervention groups. An asthmatic mouse model was established by intraperitoneal injection and aerosol inhalation of ovalbumin. The intervention group was given 1,25-(OH)(2)D(3) by intraperitoneal injection 0.5 hour before each aerosol inhalation, while the control group used normal saline instead. The hematoxylin-eosin staining was used to observe the mouse airway structural changes. The mRNA and protein expression of HMGB1 and TLR4 was measured by RT-PCR and immunohistochemistry, respectively. Pearson correlation analysis was performed.

RESULTSThe asthma group had a significantly increased airway wall thickness compared with the control group (P<0.05); the intervention group had a significantly lower increase in airway wall thickness than the asthma group (P<0.05). The mRNA and protein expression of HMGB1 and TLR4 was significantly higher in the asthma group than in the control group (P<0.05); the mRNA and protein expression of HMGB1 and TLR4 in the intervention group was significantly lower than that in the asthma group, but still higher than that in the control group (P<0.05). A positive correlation was found between the protein expression of HMGB1 and TLR4 (P<0.01), and so was their mRNA expression (P<0.01).

CONCLUSIONSHMGB1 and TLR4 may be involved in asthmatic airway remodeling. 1,25-(OH)(2)D(3) can reduce the airway remodeling in asthmatic mice, which may be related to the downregulation of HMGB1 and TLR4 expression in the lungs of asthmatic mice.

Airway Remodeling ; drug effects ; Animals ; Asthma ; drug therapy ; metabolism ; Calcitriol ; pharmacology ; therapeutic use ; Female ; HMGB1 Protein ; genetics ; Lung ; metabolism ; Mice ; Mice, Inbred BALB C ; RNA, Messenger ; analysis ; Toll-Like Receptor 4 ; genetics

OBJECTIVETo establish a mouse model of asthmatic airway remodeling and investigate the effects of 1,25-(OH)2D3 on airway structure and T cell immunoglobulin mucin protein-4 (TIM-4) expression in asthmatic mice.

METHODSThirty female mice (BALB/c strain) were randomly divided into control, asthma and 1,25-(OH)2D3 intervention groups. An asthmatic mouse model was induced using ovalbumin. Lung tissue of the mice was collected, mRNA expression of TIM-4 was evaluated by RT-PCR and airway remodeling and protein expression of TIM-4 were observed by hematoxylineosin staining and immunohistochemistry.

RESULTSTypical airway remodeling was found in the asthma group, and TIM-4 expression in this group was significantly higher than in the control group (105±9 vs 42±5; P<0.05). Compared with the asthma group, the 1,25-(OH)2D3 intervention group showed improvement in airway remodeling and a decrease in TIM-4 expression (78±6) (P<0.05).

CONCLUSIONSTIM-4 may be involved in the airway remodeling of mice. As a new type of immunoregulator, 1,25-(OH)2D3 can downregulate expression of TIM-4 in the lungs and improve airway remodeling in asthmatic mice.

Airway Remodeling ; Animals ; Asthma ; metabolism ; Calcitriol ; pharmacology ; Female ; Gene Expression Regulation ; drug effects ; Lung ; metabolism ; Membrane Proteins ; analysis ; genetics ; physiology ; Mice ; Mice, Inbred BALB C ; RNA, Messenger ; analysis

Objective To observe the efficacy and adverse reaction of the test drug hepatitis B immunoglobin on the post market.Method Employed by the methods of multiple center's clinical trials and using the recommended dosage of hepatitis B immunoglobulin for intravenous administration,the clinical efficacy of either prevention or treatment for hepatitis B recurrence and drug related adverse reactions were observed.This consisted of 22.1 months,13 hospitals,and 525 patients with hepatitis B related liver transplantation.Result The results showed a contrasting probability of adverse reactions for different doses among the observation period.Within 6 months postoperatively with a greater or equal to recommended drug dose,the infection rate was less than 4％.In contrast,the infection rate was greater than 12％ in the group with less than the recommended drug dose.Conclusion There was an obvious dose effect relationship,and the drug safety and recommended treatment rationality were verified.