Objective:To construct an explainable artificial intelligence(AI) model of risk characteristics of papillary thyroid carcinoma(PTC), and to explore its value of it combined with clinical features in predicting cervical lymph node metastasis(CLNM) in PTC patients.Methods:From January 2021 to September 2022, 422 patients(422 nodules) with pathologically confirmed PTC underwent thyroidectomy and neck lymph node dissection in the Second Affiliated Hospital of Xi′an Jiaotong University were retrospectively collected, the patients were randomly divided into training set and test set according to the ratio of 7∶3. Ultrasonographic features highly correlated with PTC risk characteristics were extracted by traditional machine learning method, and an intelligent prediction model with optimal probability of risk characteristics was established. Then, a risk model for predicting CLNM of PTC patients was constructed in combination with clinical features. The diagnostic effectiveness of the model was evaluated by drawing a ROC curve and calculating the area under curve (AUC).Results:In the AI explaineable model of PTC risk characteristics in the test set, the intelligent diagnosis model of calcification based on logistic regression classification showed the highest diagnostic efficiency, with an AUC of 0.87 ( P<0.05). Compared with the probability model of risk characteristic of PTC alone, the comprehensive model combined with clinical characteristics showed higher diagnostic efficiency in predicting CLNM of PTC patients, with AUC of 0.97, diagnostic critical value of 0.15, corresponding accuracy, sensitivity and specificity of 92.65%, 92.76% and 92.54%, respectively (all P<0.05). Conclusions:The explaineble risk characteristics of PTC AI model combined with clinical features can effectively predict the cervical lymph node metastasis of PTC, and then provide effective information for clinical decision-making of PTC patients.

Objective:To compare the aortic remodeling of the Fabulous stent system and standard thoracic aortic endovascular repair (TEVAR) on distal aorta type B aortic dissection (TBAD). Methods:The prospective data collected between Dec 2017 and Oct 2019 from 134 patients with type B aortic dissection (TBAD) who underwent treatment with the "Fabulous" stent system, and retrospective data from 159 TBAD patients receiving standard TEVAR from corresponding multicenter. By using propensity score matching analysis, we compared the prognosis and aortic remodeling outcomes in patients undergoing Fabulous and standard TEVAR treatments during a 1-year postoperative follow-up.Results:In this study, 62 patients in Fabulous group and 62 patients in standard TEVAR were included.There were no significant statistical differences in baseline characteristics between the two groups. In terms of aortic remodeling in bare stent region, Fabulous group had better change trends of diameter of true lumen [10.6 (4.4, 14.5) mm vs. 4.7 (0.9, 10.7) mm, P=0.001] and false lumen [-24.2 (-30.5, -4.9) mm vs. 0.7 (-11.8, 2.3) mm, P<0.001] than those in the standard TEVAR group. The rate of complete false lumen thrombosis was also higher in the Fabulous group (62.9% vs. 37.1%, P=0.042). Conclusion:The Fabulous stent system, when compared to standard TEVAR surgery, demonstrates good aortic remodeling outcomes in the distal aorta.

A patient with SARS-CoV-2 infection was adimitted to Shanghai Shibei hospital of Jing'an District in early 2023. According to the patient's complaits， clinical manifestations， physical symptoms， laboratory examination， radiological image results， plus lumbar puncture， the patient was diagnosed with novel coronavirus encephalitis. The patient was discharged from the hospital after a combined treatment of Chinese and western medicine.

Objective:To explore the risk factors and outcomes of central nervous system(CNS)complications associated with hematopoietic stem cell transplantation(HSCT).Methods:A total of 550 recipient after HSCT in the department of hematology of Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology from January 1 2019 to August 31 2021were enrolled.According to the occurrence of CNS complications, they were divided into the CNS group(24 cases)and the non CNS group(526 cases). The clinical information and prognosis were compared.We further analyzed the risk factors associated with CNS complications, and conducted multivariate logistic regression on statistically significant indicators.Cox regression analysis is conducted on prognostic factors such as age, gender and risk degree.Results:A total of 550 recipients were enrolled, of which 330 underwent allo-HSCT, and others received auto-HSCT.A total of 24 cases (4.36%)had CNS complications, of which 4 cases had 2 types of CNS complications.The type of CNS complications included intracranial infection(8 cases, 28.57%), transplantation-associated thrombotic microangiopathy(TA-TMA)(6 cases, 21.43%), central tumor invasion(4 cases, 14.29%), intracranial hemorrhage(4 cases, 14.29%), leucodystrophy(2 cases, 7.14%)and unexplained encephalopathy(4 cases, 14.29%). Logistic regression analysis of risk factors related to CNS complications showed that, Platelet implantation time( β=0.084, OR=1.088, P=0.048), CMV infection( β=1.295, OR=3.65, P=0.008)is positively correlated with the occurrence of CNS complications in HSCT recipients but age( β=-0.052, OR=0.949, P=0.004)is negatively correlated with it.Nine of the 24 cases(37.50%)who experienced CNS complications died, including 3 cases of intracranial infection, 3 cases of cerebral hemorrhage, 2 cases of TMA, and 1 case of unexplained encephalopathy.Platelet implantation time is an independent risk factor for poor prognosis of CNS complications in HSCT recipients. Conclusions:Our results indicated that, age, CMV infection and platelet implantation time were associated with the occurrence of CNS complications after HSCT.Platelet implantation time is an independent risk factor for poor prognosis of CNS complications in HSCT recipients.

OBJECTI VE To optimize the extraction technology of the leaves of Dimocarpus longan according to flavonoids and phenolic acids. METHODS The contents of gallic acid ，protocatechuic acid ，ethyl gallate ，quercetin，luteolin and kaempferol in the leaves of D. longan were determined by HPLC. Based on single factor test ，with the ethanol volume fraction ，solid-liquid ratio and extraction time as factors ，using comprehensive scores of the contents of above six components as indexes ，the extraction technology of the leaves of D. longan was optimized by Box-Behnken response surface methodology. RESULTS The optimal extraction technology included ethanol volume fraction of 100％，solid-liquid ratio of l ∶ 7（g/mL），extraction time of 90 min， extraction temperature of 80 ℃. After 3 times of validation tests ，the average comprehensive score was 97.54（RSD＝0.33％，n＝ 3），relative error of which with predicted score （99.05）was 1.55％. CONCLUSIONS Box-Behnken response surface methodology combined with multi-index comprehensive score can be used for the extraction technology of the leaves of D. longan ，and the optimized extraction technology is stable and feasible.

OBJECTIVE To study the metabolites derived from the ethanol extract from the leaves of Dimocarpus longan preliminarily in rats in vivo ，and to provide reference for elucidating the possible metabolic mechanism of the leaves of D. longan in lowering blood glucose . METHODS Ultra high performance liquid chromatography quadrupole time -of-flight mass spectrometry （UPLC-Q-TOF-MS/MS） was adopted by taking ethanol extract of D. longan leaves，the feces and urine of rats at 0-72 h and 0-48 h after intragastric administration of 33.8 g/kg ethanol extract of D. longan leaves（by extract ），the feces and urine of rats at the corresponding time after intragastric administration of normal saline （blank control ） as samples . The accurate relative molecular weight ，formula and fragment information of the compounds were collected ， and the compounds were speculated and i dentified by matching with the database and spectrum library of the instrument ，and comparing with the reference substance and relevant literature . RESULTS A total of eight compounds were identified in urine and feces of rats ，including 2 prototype components and 6 metabolites. Three compounds （including two prototype components as quercetin ，luteolin and one metabolite as luteolin or kaempferol） in feces of rats were identified ；five compounds （all metabolites ） in urine of rats were identified ，involving metabolites of quercetin ，luteolin or kaempferol . Metabolites mainly included the products of methylation ，glucuronidation and oxidation. CONCLUSIONS After intragastric administration ，the ethanol extract from the leaves of D. longan is mainly metabolized in rats through methylation ，glucuronidation and other pathways . The identified compounds are mostly metabolites of quercetin and luteolin .

BACKGROUND: Hepatitis B is a viral infection that attacks the liver and can cause both potentially life-threatening acute and chronic liver disease. China has the world's largest burden of hepatitis B and is considered to be a major contributor toward the goal of World Health Organization (WHO) of eliminating hepatitis B virus (HBV) as a global health threat by 2030. This study aimed to analyze data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to determine the trends in mortality of liver disease due to hepatitis B in China between 1990 and 2019 and the gap with the WHO's goal. METHODS: Annual deaths and age-standardized mortality rates (ASMRs) of liver disease due to hepatitis B in China between 1990 and 2019 were collected from GBD 2019. We calculated the percentage changes in deaths and estimated annual percentage changes (EAPCs) of ASMRs of liver disease due to hepatitis B. RESULTS: In China, deaths of total liver disease due to hepatitis B decreased by 29.13% from 229 thousand in 2016 to 162 thousand in 2019, and ASMR decreased by an average of 4.92% (95% confidence interval [CI]: 4.45-5.39%) per year in this period. For the spectrum of liver disease due to hepatitis B, deaths decreased by 74.83%, 34.71%, and 23.34% for acute hepatitis, cirrhosis and other chronic liver diseases, and liver cancer from 1990 to 2019, respectively, and ASMRs of acute hepatitis (EAPC = -7.63; 95% CI: -8.25, -7.00), cirrhosis and other chronic liver diseases (EAPC = -4.15; 95% CI: -4.66, -3.65), and liver cancer (EAPC = -5.17; 95% CI: -6.00, -4.33) decreased between 1990 and 2019. The proportions of older adults aged ≥70 years among all deaths of the spectrum of liver disease due to hepatitis B increased from 1990 to 2019. Deaths of liver cancer due to hepatitis B increased by 7.05% from 2015 to 2019. CONCLUSIONS Although a favorable trend in the mortality of liver disease due to hepatitis B was observed between 1990 and 2019, China still faces challenges in achieving the WHO's goal of eliminating HBV as a public threat by 2030. Therefore, efforts to increase the coverage of diagnosis and treatment of liver disease due to hepatitis B, especially of liver cancer due to hepatitis B, are warranted in China.
Humans ; Aged ; Global Burden of Disease ; Hepatitis B/complications* ; Hepatitis B virus ; Liver Cirrhosis/complications* ; China/epidemiology* ; Liver Neoplasms/etiology*

Intervertebral disc degeneration (IDD) is an age-related degenerative disease and a major cause of low back pain. IDD greatly impairs the quality of life of patients and dramatically increases the economic burden of patient families. There are currently no effective intervention and treatment for IDD, partly due to a lack of understanding of its pathogenesis. The establishment and characterization of IDD animal models are critical for defining mechanisms underlying its pathogenesis. IDD is a complex process, which is affected by mechanical stress, injury, biochemistry and gene expression. In this review article, we summarize several IDD animal models generated by utilizing abnormal mechanical stress, injury, biochemical and chemical induction and gene knockout. Biomechanics play a key role in maintaining intervertebral disc homeostasis, and abnormal mechanical stress can cause IDD. Usually, IDD is accompanied by structural injury which exacerbates IDD. In addition, biochemical and chemical induction and knockout of key genes can also lead to IDD. Among the different factors causing abnormal mechanical stress, there are two mechanical stress models: pressure model and instability model. According to the structure of intervertebral disc, there are two structural injury models: the nucleus pulposus and annulus fibrosus injury model and the cartilage endplate injury model. The biochemical and chemical induction model and the gene knockout model are summarized, and the applications and limitations of different IDD animal models are discussed.

Objective:To summarize the methods and results of human motion intention recognition based on the surface electromyography. Methods:Literatures were retrieved and reviewed from the databases of PubMed, Web of Science, CNKI, Wanfang and VIP until December, 2020. The experimental researches about human motion intention recognition based on surface electromyography were summarized. Results:The methods of motion intention recognition were divided into three models: musculoskeletal model, traditional machine learning model and deep learning model. Conclusion:It is difficult to fully estimate human motion intention using surface electromyography in a single way. More researches are needed to develop more accurate and real-time human motion intention recognition methods.

Objective:To compare the clinical outcomes and safety of haploidentical donor (HID)and HLA-matched sibling donor(MSD)hematopoietic stem cell transplantation(HSCT)for severe aplastic anemia(SAA).Methods:From January 1, 2012 to December 31, 2019, retrospective review of clinical data was performed for 75 SAA patients undergoing HSCT at Department of Hematology, Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology.Based upon donor sources, they were divided into two groups of MSD(49 cases)and HID (26 cases). And two groups were compared with regards to hematopoietic recovery, graft-versus-host disease(GVHD)infection and overall survival(OS).Results:Time of platelet and neutrophil engraftment of two groups was comparable(11 d vs.11 d, P=0.84; 11 d vs.12 d, P=0.08). Compared with HID group, MSD group had a lower incidence of acute GVHD(46.2% vs.18.4%, P=0.01)with a comparable incidence of grade Ⅱ-Ⅳ acute GVHD(26.9% vs.14.3%, P=0.24), grade Ⅲ-Ⅳ acute GVHD(15.4% vs.4.1%, P=0.09)and chronic GVHD(23.9% vs.23.1 %, P=0.71). A reactivation of CMV occurred in 27(55.1%)MSD and 22(84.6%)HID recipients( P=0.01). And the incidence of EB viremia was 69.4% and 61.5% respectively.After a median follow-up period of 54.0 and 18.5 months, the estimated 3-year OS rate of MSD and HID groups were 94.0% and 88.0% respectively ( P=0.35). Conclusions:HID HSCT is an effective and relatively safe option for SAA patients, especially for those in urgent need of treatment without MSD or refractory/relapse to immunosuppressive therapy.