Objective To explore the recognition capabilities of electronic nose combined with machine learning in identifying the breath odor map of benign and malignant pulmonary nodules and Traditional Chinese Medicine (TCM) syndrome elements. Methods The study design was a single-center observational study. General data and four diagnostic information were collected from 108 patients with pulmonary nodules admitted to the Department of Cardiothoracic Surgery of Hospital of Chengdu University of TCM from April 2023 to March 2024. The patients' TCM disease location and nature distribution characteristics were analyzed using the syndrome differentiation method. The Cyranose 320 electronic nose was used to collect the odor profiles of oral exhalation, and five machine learning algorithms including random forest (RF), K-nearest neighbor (KNN), logistic regression (LR), support vector machine (SVM), and eXtreme gradient boosting (XGBoost) were employed to identify the exhaled breath profiles of benign and malignant pulmonary nodules and different TCM syndromes. Results (1) The common disease locations in pulmonary nodules were ranked in descending order as liver, lung, and kidney; the common disease natures were ranked in descending order as Yin deficiency, phlegm, dampness, Qi stagnation, and blood deficiency. (2) The electronic nose combined with the RF algorithm had the best efficacy in identifying the exhaled breath profiles of benign and malignant pulmonary nodules, with an AUC of 0.91, accuracy of 86.36%, specificity of 75.00%, and sensitivity of 92.85%. (3) The electronic nose combined with RF, LR, or XGBoost algorithms could effectively identify the different TCM disease locations and natures of pulmonary nodules, with classification accuracy, specificity, and sensitivity generally exceeding 80.00%.Conclusion Electronic nose combined with machine learning not only has the potential capabilities to differentiate the benign and malignant pulmonary nodules, but also provides new technologies and methods for the objective diagnosis of TCM syndromes in pulmonary nodules.

Objective To analyze the differences in distribution of traditional Chinese medicine (TCM) syndrome elements and salivary microbiota between the individuals with pulmonary nodules and those without, and to explore the potential correlation between the distribution of TCM syndrome elements and salivary microbiota in patients with pulmonary nodules. Methods We retrospectively recruited 173 patients with pulmonary nodules (PN) and 40 healthy controls (HC). The four diagnostic information was collected from all participants, and syndrome differentiation method was used to analyze the distribution of TCM syndrome elements in both groups. Saliva samples were obtained from the subjects for 16S rRNA high-throughput sequencing to obtain differential microbiota and to explore the correlation between TCM syndrome elements and salivary microbiota in the evolution of the pulmonary nodule disease. Results The study found that in the PN group, the primary TCM syndrome elements related to disease location were the lung and liver, and the primary TCM syndrome elements related to disease nature were yin deficiency and phlegm. In the HC group, the primary TCM syndrome elements related to disease location were the lung and spleen, and the primary TCM syndrome elements related to disease nature were dampness and qi deficiency. There were differences between the two groups in the distribution of TCM syndrome elements related to disease location (lung, liver, kidney, exterior, heart) and disease nature (yin deficiency, phlegm, qi stagnation, qi deficiency, dampness, blood deficiency, heat, blood stasis) (P<0.05). The species abundance of the salivary microbiota was higher in the PN group than that in the HC group (P<0.05), and there was significant difference in community composition between the two groups (P<0.05). Correlation analysis using multiple methods, including Mantel test network heatmap analysis and Spearman correlation analysis and so on, the results showed that in the PN group, Prevotella and Porphyromonas were positively correlated with disease location in the lung, and Porphyromonas and Granulicatella were positively correlated with disease nature in yin deficiency (P<0.05). Conclusion The study concludes that there are notable differences in the distribution of TCM syndrome elements and the species abundance and composition of salivary microbiota between the patients with pulmonary nodules and the healthy individuals. The distinct external syndrome manifestations in patients with pulmonary nodules, compared to healthy individuals, may be a cascade event triggered by changes in the salivary microbiota. The dual correlation of Porphyromonas with both disease location and nature suggests that changes in its abundance may serve as an objective indicator for the improvement of symptoms in patients with yin deficiency-type pulmonary nodules.

Objective:To construct the quality evaluation scale of specification of management for humanistic caring in outpatients and test its reliability and validity.Methods:Referring to the group standards in Specification of Management for Humanistic Caring in Outpatients released by the China Association for Life Care,as well as relevant guidelines and literature,a pool of items for the quality evaluation scale of specification of management for humanistic caring in outpatients was formed.After expert consultation and expert argumentation,a quality evaluation scale of specification of management for humanistic caring in outpatients was constructed.From January to February 2024,243 hospital managers from 5 hospitals in Zhengzhou were selected as survey subjects to conduct item analysis,and reliability and validity testing on the scale.Results:Two rounds of expert inquiry and two rounds of expert argumentation were conducted,with questionnaire response rates of 92.00%and 100.00%,respectively,and expert authority coefficients of 0.952.In the second round of the expert inquiry scale,the mean importance score of the first-level indicators was 4.80 to 5.00,the full score ratio was 88.00%to 100.00%,the coefficient of variation was 0.04 to 0.17,and Kendall's coefficient of concordance was 0.857(P＜0.001);the mean importance score of the second-level indicators was 4.60 to 5.00,the full score ratio was 80.00%to 100.00%,the coefficient of variation was 0.00 to 0.21,and Kendall's coefficient of concordance was 0.775(P＜0.001);the mean importance score of the third-level indicators was 4.60 to 5.00,the full score ratio was 76.00%to 100.00%,the coefficient of variation was 0.00 to 0.21,and Kendall's coefficient of concordance was 0.830(P＜0.001).Finally,a quality evaluation scale of specification of management for humanistic caring in outpatients was formed,including 5 first-level indicators,25 second-level indicators,and 58 third-level indicators.Exploratory factor analysis produced 5 common factors with a cumulative variance contribution rate of 74.628%.The Pearson correlation coefficients between the five-factor scores ranged from 0.648 to 0.798,and the correlation coefficients between the factor scores and the total score of the scale ranged from 0.784 to 0.938.The scale-level content validity index(S-CVI)of the scale was 0.945,the item-content validity index(I-CVI)was 0.725 to 1.000,the Cronbach's alpha coefficient of the total scale was 0.973,and the retest reliability coefficient was 0.934.Conclusion:The constructed quality evaluation scale of specification of management for humanistic caring in outpatients has good scientific validity and reliability,and can be used as an evaluation tool for specification of management for humanistic caring in outpatients.

Objective A neuroblastoma(NB)liver transplantation model was established and compared with the adrenal orthotopic transplantation model to explore its characteristics.Methods 5× 105 SK-N-SH cells were implanted along the long axis of the left lobe of mouse livers with a micro-injection needle.The growth,metastasis,expression of related genes,and histopathological changes of tumors were detected after the modeling.Results The tumor formation rate in mice inoculated with tumor cells reached 100％after 21 days,and tumor growth,metastasis,related gene expression changes,and pathological characteristics were apparent.Conclusions In this study,a neuroblastoma liver transplantation model was successfully constructed via a relatively simple surgical method to provide a more suitable choice for future scientific NB experiments.

Objective:To study the risk factors for retinopathy of prematurity (ROP) in very low birth weight infants (VLBWIs).Methods:From October 2020 to December 2021, VLBWIs with gestational age(GA) ≤32 weeks admitted to the neonatal department of our hospital were retrospectively studied. According to the occurrence of ROP, they were assigned into ROP group and non-ROP group. The clinical data of the two groups were compared and the risk factors of ROP in VLBWI were analyzed.Results:A total of 251 VLBWIs were enrolled, including 60 cases (23.9%) in ROP group and 191 (76.1%) in non-ROP group. The GA and birth weight (BW) of ROP group were significantly lower than non-ROP group [28(26,30) w vs. 29(28,31) w, 1 035(840,1 285) g vs. 1 260(1 110,1 380) g, respectively, all P<0.001]. The ROP group had longer duration of oxygen therapy [42.0(26.0, 53.5) d vs. 24.0(18.0, 34.0) d], higher incidences of blood transfusion [2.5(1.0, 3.0) times vs. 2.0 (1.0, 2.0) times] and hyperglycemia (80.0% vs. 16.8%), higher average [(5.6±0.5) mmol/L vs. (5.1±0.5) mmol/L] and peak [10.4(7.8,13.2) mmol/L vs. 6.5(6.1,6.8) mmol/L] blood glucose levels in the first week than the non-ROP group (all P<0.001). Multivariate analysis showed that longer duration of oxygen therapy ( OR=1.047, 95% CI 1.008-1.087, P=0.018) and higher peak blood glucose level in the first week ( OR=1.268, 95% CI 1.092-1.474, P=0.002) were the independent risk factors for ROP. Conclusions:Longer duration of oxygen therapy and higher peak of blood glucose level in the first week are risk factors for ROP in VLBWIs.

Objective:To study the risk factors of secondary hydrocephalus after severe intraventricular hemorrhage (IVH) in preterm infants for prevention and early identification of post-hemorrhagic hydrocephalus (PHH).Methods:From June 2013 to June 2021, preterm infants with severe IVH admitted to our hospital were retrospectively analyzed. They were assigned into PHH group and non-PHH group. Rank sum test or chi-square test was used for comparison between the two groups and multivariate logistic regression analysis was used to analyze the risk factors of PHH in preterm infants.Results:A total of 246 preterm infants with severe IVH were enrolled, including 68 cases (27.6%) in the PHH group and 178 cases (72.4%) in the non-PHH group. Multivariate logistic stepwise regression analysis showed that male gender ( OR=2.014, 95% CI 1.063-3.817), gestational age ≤30 week ( OR=2.240, 95% CI 1.210-4.146), 5-min Apgar score ≤5 ( OR=3.980, 95% CI 1.483-10.685), placental abruption ( OR=2.940, 95% CI 1.324-6.531) were independent risk factors for PHH in preterm infants and thrombocytopenia was the protective factor for PHH in preterm infants ( OR=0.305, 95% CI 0.147-0.632). The incidence of moderate thrombocytopenia in non-PHH group was significantly higher than PHH group ( P<0.05). No significant differences existed in the incidences of mild and severe thrombocytopenia between the two groups ( P>0.05). Conclusions:Male gender, gestational age ≤30 week, 5-min Apgar score ≤5, placental abruption are risk factors for PHH in premature infants with severe IVH and moderate thrombocytopenia has protective effects.

Objective:To analyze the incidence and the related factors of umbilical vein catheter (UVC) tip migration within 7 d after umbilical vein catheterization.Methods:This prospective study involved neonates who were successfully indwelled with UVCs in the Department of Neonatology of Gansu Provincial Women and Child-care Hospital from June 2020 to December 2021. The position of the UVC tip, length of umbilical stump, body weight, and abdominal circumference were recorded after the UVCs were inserted successfully, and the changes in these four data at 2, 24, 48, 72 h, and 7 d after catheterization were analyzed and compared. All the subjects were divided into the non-migrate group, inward migration group, and outward migration group. Chi-square test, Mann-Whitney U test, or Kruskal Wallis H test were used for statistical analysis. Results:A total of 157 newborns were enrolled, with 51 cases in the inward migration group, 62 cases in the outward migration group, and 44 cases in the non-migrate group. There were no significant differences among the three groups regarding gestational age, birth weight, gender, born through cesarean section, age at the time of catheterization, use of sedation, and feeding modes (all P>0.05). The migration rates of UVCs tip at 2, 24, 48, 72 h, and 7 d after catheterization were 0, 27.4% (43/157), 27.2% (31/114), 25.3% (21/83), and 29.0% (18/62), respectively. The cumulative migration rates at 24, 48, 72 h, and 7 d were 27.4% (43/157), 47.1% (74/157), 60.1% (95/157), and 72.0% (113/157), respectively. Compared with the non-migrate group, the inward migration group had a shorter umbilical cord stump at 24 and 48 h [0.5 cm (0.4-0.5 cm) vs 0.6 cm (0.5-0.8 cm); 0.4 cm (0.3-0.5 cm) vs 0.5 cm (0.5-0.6 cm), Z=－5.55 and －3.69, both P<0.05], less abdominal circumference increment at 48 and 72 h [0.6 cm (0.5-1.0 cm) vs 0.9 cm (0.7-1.2 cm); 0.6 cm (0.3-0.9 cm) vs 0.9 cm (0.7- 1.3 cm), Z=－2.03 and －2.09, both P<0.05)], and more weight loss percentage [－4.7% (－6.0%-－3.6%) vs －3.1% (－3.7%-－2.2%); －6.0% (－7.5%-－5.0%) vs －3.9% (－5.1%-－2.4%), Z=－3.75 and －2.96, both P<0.05]. The abdominal circumference increased more in the outward migration group at 24, 48, 72 h, and 7 d than those in the non-migrate group [1.6 cm (0.9-1.9 cm) vs 0.7 cm (0.5-0.9 cm); 1.5 cm (1.2-1.8 cm) vs 0.9 cm (0.7-1.2 cm); 1.7 cm (1.3-1.9 cm) vs 0.9 cm (0.7-1.3 cm); 1.6 cm (1.1-1.9 cm) vs 0.9 cm (0.6-1.3 cm), Z=－4.82, －4.79, －3.74, and －3.09, all P<0.05]. Conclusion:The incidence of UVC tip migration is high, which could be affected by dryness and retraction of the umbilical cord stump and the change in neonatal abdominal circumference and body weight.

Cardiovascular diseases (CVDs) and metabolic disorders are major components of noncommunicable diseases, causing an enormous health and economic burden worldwide. There are common risk factors and developmental mechanisms among them, indicating the far-reaching significance in exploring the corresponding therapeutic targets. MST1/2 kinases are well-established proapoptotic effectors that also bidirectionally regulate autophagic activity. Recent studies have demonstrated that MST1/2 influence the outcome of cardiovascular and metabolic diseases by regulating immune inflammation. In addition, drug development against them is in full swing. In this review, we mainly describe the roles and mechanisms of MST1/2 in apoptosis and autophagy in cardiovascular and metabolic events as well as emphasis on the existing evidence for their involvement in immune inflammation. Moreover, we summarize the latest progress of pharmacotherapy targeting MST1/2 and propose a new mode of drug combination therapy, which may be beneficial to seek more effective strategies to prevent and treat CVDs and metabolic disorders.

Objective:To explore the effect of umbilical vein catheterization (UVC) on portal vein blood flow velocity (PBFVe) and its relationship with gastrointestinal (GI) complications in neonates.Methods:A prospective study was conducted on neonates with indications for UVC and achieving one-time successful catheterization at Gansu Provincial Women and Child-care Hospital from March 2019 to March 2021. Successful UVC was defined as the umbilical catheter reaching the entrance of the inferior vena cava and right atrium through the ductus venosus. PBFVe was measured by bedside ultrasound before and after UVC. All subjects were divided into two groups as those with GI complications anytime from insertion to withdrawal (complication group), and those with no GI complications (no complication group) to compare the PBFVe value before UVC and the percentage of decrease in PBFVe after UVC. Multivariate logistic regression analysis and receiver operating characteristic (ROC) curve were used to analyze the risk factors of GI complications and the predictive value of the percentage of decrease in PBFVe after UVC.Results:Of 91 subjects included, 59.3% (54/91) had no GI complications, and 40.7% (37/91) had. After UVC, PBFVe was decreased than before in neonates both with and without GI complications [(11.3±1.8) vs (14.7±2.4) cm/s; (12.4±1.7) vs (14.2±1.8) cm/s, t=－16.92 and－17.62, respectively, both P<0.05]. PBFVe before UVC were similar between the two groups. However, the complications group had a lower PBFVe after UVC ( t=－2.98, P=0.004) and a higher percentage of decrease in PBFVe [(22.5±6.0)% vs (12.6±4.9)%, t=8.65, P<0.001] when compared with the no complications group. Multivariate logistic regression analysis showed that the body weight was the protector of GI complications ( OR=0.294, 95% CI:0.089-0.974, P=0.045), and the percentage of decrease in PBFVe was the risk factor ( OR=1.478, 95% CI:1.249-1.749, P<0.001). The area under the curve of the percentage of decrease in PBFVe for predicting GI complications was 0.919 (95% CI:0.843-0.966, P<0.001). The cut-off value was 16.9% with a sensitivity of 89.2% and a specificity of 85.2%. Conclusions:UVC can reduce the PBFVe of neonates. The more the PBFVe decreases, the greater the possibility of GI complications.

In order to afford new antiplatelet agents with higher potency, a series of paeonol oxime derivatives (4a-4y) were designed and synthesized from paeonol.Their structures were confirmed by HRMS, 1H NMR spectra.The anti-platelet aggregation activity of the target compounds was evaluated.The results revealed that most of them had moderate to good anti-platelet aggregation activity.Among them, compound 4h and 4j were the most potent on adenosine diphosphate (ADP)-induced platelet aggregation and collagen-induced platelet aggregation. Furthermore, the target compound 4h not only showed strong antiplatelet aggregation activity, but also exhibited good water-solubility and drug-like properties, which can be used as a new antiplatelet active compound for further research.