Objective To explore the value of dual-phase enhanced CT radiomics in predicting post-acute pancreatitis diabetes mellitus(PPDM-A).Methods A total of 145 patients with acute pancreatitis(AP)were retrospectively collected,including 62 patients in PPDM-A group and 83 patients in non-PPDM-A group.The patients were randomly divided into training set and test set at a ratio of 7︰3,the pancreatic parenchyma in arterial phase and venous phase was delineated and the radiomics features were extracted.Vari-ance threshold method,univariate selection method and least absolute shrinkage and selection operator(LASSO)were used to screen radiomics features.The prediction performance of the model was evaluated by the area under the curve(AUC).The DeLong test was used to compare the prediction efficiency between the models,and the calibration curve and decision curve were used to evaluate the prediction efficiency of the model.Results The AUC of arterial phase model,venous phase model,combined arterial venous phase model,clinical model and radiomics combined clinical model in the training set were 0.845,0.792,0.829,0.656 and 0.862,respec-tively.The DeLong test results showed that only the difference between the radiomics combined clinical model and the clinical model in the training set and the test set was statistically significant(P<0.05).The decision curve showed that the radiomics combined clinical model had high clinical practicability in a certain range,and the calibration curve showed that the radiomics combined clinical model had the best fitting degree with the actual observation value.Conclusion Based on the dual-phase enhanced CT radiomics combined clinical model,PPDM-A can be predicted more accurately,and it can provide a certain reference value for the clinical development of per-sonalized treatment programs.

AIM:To investigate the mechanism of action of Wenweiyang decoction(WWYD)in treating func-tional dyspepsia in rats based on mast cell activation and stem cell factor(SCF)/receptor tyrosine kinase c-Kit signaling pathway.METHODS:Sixty SD rats were randomly divided into control group,model group,ranitidine hydrochloride capsule group,and low-,medium-and high-dose WWYD groups,with 10 rats in each group.The rat model of functional dyspepsia was established by tail clamping and irregular feeding compound senna method.After modeling,the rats in con-trol group and model group were given normal saline,while those in low-,medium-and high-dose(0.743 g/mL,1.485 g/mL and 2.970 g/mL)WWYD groups and ranitidine hydrochloride capsule(3 g/L)group were treated with corresponding drugs by intragastric administration.After treatment,the propulsion rate of the small intestine was measured by the carbon ink propulsion method.Rat duodenal mast cells were observed and counted by toluidine blue staining.ELISA was used for determination of mast cell tryptase(MCT)and histamine(HA)content in rat duodenum.The mRNA levels of SCF and c-Kit in duodenum were detected by RT-qPCR.Western blot and immunohistochemistry were employed to determine the ex-pression levels of SCF and c-Kit in the duodenum.RESULTS:Compared with model group,WWYD treatment signifi-cantly increased the propulsion rate of the small intestine in rats(P<0.05).ELISA results showed that WWYD reduced the number of mast cells and the content of MCT and HA in the duodenal mucosa tissue of rats(P<0.05).Western blot and immunohistochemistry results suggested that WWYD up-regulated the protein expression levels of c-Kit and SCF in the duodenal tissue of rats(P<0.05),and increased the numbers of SCF and c-Kit positive cells.RT-qPCR results indicated that WWYD up-regulated the mRNA expression of c-Kit and SCF in the duodenum of rats(P<0.05).Moreover,the small intestinal propulsion rate was negatively correlated with MCT and HA content,and positively correlated with the expres-sion of SCF and c-Kit.CONCLUSION:Wenweiyang decoction promotes rat duodenal motility,and its mechanism may be related to the inhibition of rat duodenal MCT and HA production and activation of SCF/c-Kit signaling pathway.

Objective:To explore the application effect of key node advanced nursing mode in the treatment of patients with acute myocardial infarction.Methods:In October 2020, the hospital established a Critical Control Point rescue mode management team.122 patients with acute myocardial infarction admitted to emergency department of the hospital were enrolled as the objects between October 2020 and October 2021. The healthcare failure mode and effect analysis model was applied to analyze the shortcomings of emergency process, so as to construct critical control point rescue mode in the treatment of patients with acute myocardial infarction and apply it to the clinic in November 2021. After clinical application, emergency nursing and cardiac function recovery were compared between the two groups. The mortality rate within 30 d after surgery and occurrence of complications during hospitalization were recorded.Results:The first medical contact to balloon time dropped from (81.9±6.54) min to (56.2±4.23)min. The time from first medical contact to diagnosis of acute myocardial infarction dropped from (47.3±5.68) min to (30.69±5.21) min, the door-balloon dilation time dropped from (49.79±13.84) min to (28.63±15.71) min, producing results time of myocardial injury markers dropped from (28.38±3.79)min to (19.26±2.17) min, reporting time of electrocardiogram dropped from (5.82±2.01) min to (5.14±1.89)min, and hospitalization time dropped from (7.25±2.18) min to (6.14±1.27) min, and the differences were statistically significant ( P<0.05). After treatment, left ventricular ejection fraction in observation group was higher than that in control group, left ventricular end-diastolic diameter and cardiac troponin were lower than those in control group ( P<0.05). The incidence of hypotension and malignant arrhythmia in observation group was lower than that in control group ( P<0.05). Conclusions:The critical control point rescue mode can shorten treatment time and hospitalization time in acute myocardial infarction patients, improve cardiac function, and reduce the risk of complications during hospitalization.

Objective: To investigate the factors affecting drug-induced liver injury among patients with pulmonary tuberculosis in Ningbo City from 2015 to 2019, so as to provide insights into the prevention of drug-induced liver injury. Methods: Demographic features, presence of drug-induced liver injury, and disease history prior to anti-tuberculosis therapy were captured from patients with pulmonary tuberculosis in Ningbo City from 2015 to 2019 through the Tuberculosis Management Information System of the Chinese Disease Control and Prevention Information System and Ningbo Regional Diagnosis and Treatment Information Platform. Factors affecting drug-induced liver injury was identified using the multivariable logistic regression analysis. Results: A total of 9 397 patients with pulmonary tuberculosis were enrolled, among whom 66.43% ( 6 242 case ) were male, 65.89% ( 6 192 cases ) were at ages of <60 years, and 92.35% ( 8 678 cases ) were treatment-naïve. There were 1 425 patients with drug-induced liver injury (15.16% incidence), including 729 cases with grade 1 (51.16%), 24 cases with grade 2 (1.68%), 7 cases with grade 3 (0.49%), 7 cases with grade 4 ( 0.49% ), and 658 cases with ungraded drug-induced liver injury ( 46.18% ). The median duration between drug administration and development of drug-induced liver injury was 24 ( interquartile range, 44 ) days. Multivariable logistic regression analysis identified treatment-naïve ( OR=1.464, 95%CI: 1.153-1.859 ) and history of liver disease ( OR=2.001, 95%CI: 1.709-2.342) as risk factors for drug-induced liver injury in patients with pulmonary tuberculosis. Conclusion The incidence of drug-induced liver injury was 15.16% among pulmonary tuberculosis patients in Ningbo City from 2015 to 2019. Treatment-naïve and a history of liver disease are associated with drug-induced liver injury among patients with pulmonary tuberculosis.

Objective:To establish and validate the prediction model for postoperative sleep disturbance (PSD) in patients undergoing non-cardiac surgery.Methods:A total of 454 patients of both sexes, aged≥18 yr, of American Society of Anesthesiologists physical statusⅠ-Ⅲ, underwent non-cardiac surgery under general anesthesia from November 2019 to September 2020 were selected.The perioperative data were collected.The patients were divided into training set and validation set with a ratio of 7∶3 by using a simple random sampling method.The characteristic variables of PSD were selected using LASSO regression analysis and the independent risk factors were identified using multivariate logistic regression analysis in training set.Akaike′s information criterion was used to evaluate the quality of fit of the model.The nomogram of PSD in non-cardiac surgery patients was constructed based on the identified factors.The discrimination of the model was evaluated using receiver operating characteristic (ROC) curve, and the agreement of the model was evaluated using Hosmer-Lemeshow goodness-of-fit test and Brier score.Results:Seven risk factors (gender, preoperative anxiety, satisfaction with the ward environment, anesthesia time, the intraoperative consumption of midazolam and sufentanil and numerical rating scale (NRS) score at 3 days after operation) and two related factors (preoperative NRS score and general anesthesia combined with nerve block) were used to establish and verify the PSD nomogram.The area under the ROC curve was 0.805 (95% confidence interval [CI] 0.721-0.848) in training set.The area under the ROC curve was 0.773 (95% CI 0.684-0.876) in validation set.In training and validation sets, the calibration curves were tested by Hosmer-Lemeshow good of fit test, the P values were 0.590 and 0.950, respectively, and the Brier scores were 0.154 and 0.156, respectively.The nomogram predicated that the sensitivity (95% CI) and specificity (95%CI) were 81.83% (60.32%-95.14%) and 78.15% (71.83%-83.25%), respectively, in training set, and the sensitivity (95% CI) and specificity (95%CI) were 77.86% (39.84%-97.25%) and 78.15% 77.86% (68.74%-85.48%), respectively, in validation set.The optimal cut-off value of nomogram score was 113. Conclusion:In this study, the nomogram prediction model for PSD in patients undergoing non-cardiac surgery has been successfully established, which can visually and individually predict the risk of PSD.

Objective:To investigate the role of HIV-1 negative regulator (Nef) in HIV-1 neuropathogenicity.Methods:Five different HIV-1 nef genes were obtained from the central nervous system (CNS) and peripheral regions (basal ganglia, frontal cortex, meninges, temporal cortex and spleen) of a patient with HIV-1-associated dementia (HAD). The recombinant pcDNA3.1- nef eukaryotic expression vectors were constructed by connecting them with pcDNA3.1 vector and transfected into human glioma cell line U87 respectively. The expression of Nef protein was detected by immunohistochemistry and Western blotting at 22ndhour, 27 th hour, 32nd hour, 37th and 42nd hour after transfection. The result were analyzed quantitatively by JEDA801D and JD-801 software. The supernatant of U87 cells was collected every 5 hours from 27th hour to 62nd hour after transfection. The levels of TNF-α and IL-1 β in the supernatant were determined by ELISA, and the dynamic expression of the two cytokines was analyzed. Results:Five recombinant pcDNA3.1- nef eukaryotic expression vectors of nef genes from different tissues of an HAD patient were successfully constructed and transfected into U87 cells. The result of immunohistochemistry showed that Nef protein began to express at 42nd hour after transfection, which was further confirmed by Western blot. The result of ELISA showed that the levels of cytokines in the supernatant of each group increased gradually with time from 22ed hour to 37th hour after transfection, but there was no significant difference among the groups (TNF-α: F=0.445, P=0.837; F=0.579, P=0.742; F=0.617, P=0.714; F=2.728, P=0.057. IL-1β: F=2.656, P=0.062; F=0.485, P=0.809; F=0.165, P=0.982; F=2.463, P=0.093); The levels of TNF-α and IL-1 β in the experimental group were significantly higher than those in the control group from the 42nd hour ( P<0.05); after 42nd hour, the levels of cytokines in each group gradually decreased, and the levels of TNF-α and IL-1 β remained stable from the 57th hour to the 62nd hour, while the levels of TNF-α and IL-1 β in the experimental group were higher than those in the control group from the 42nd hour to the 62nd hour, the difference was still statistically significant (TNF-α: F=241.310, P<0.001; F=242.638, P<0.001; F=250.114, P<0.001; F=143.877, P<0.001; F=146.172, P<0.001. IL-1β: F=251.578, P<0.001; F=188.816, P<0.001; F=276.240, P<0.001; F=238.136, P<0.001; F=163.361, P<0.001), and there was no significant difference among the experimental groups ( P>0.05). Conclusions:HIV-1 Nef protein can induce and enhance the secretion of TNF-α and IL-1 β in U87 cells. However, the amino acid variation of HIV-1 Nef protein from different sources in an HAD patient had no effect on the secretion of TNF-α and IL-1 β.

Objective:To explore the key genes and pathways that may play an important role in the pathogenesis of acne by bioinformatics analysis.Methods:GSE6475 and GSE53795 datasets were collected from GEO database, and 18 acne lesions tissues and 18 normal skin tissues were compared. David database was used to analyze the gene ontology (GO) and the key pathway (Kyoto Encyclopedia of genes and genomes, KEGG) of the differential genes, to establish the protein interaction network of the differential genes, and to obtain the most relevant key genes and important clusters.Results:A total of 314 up-regulated genes and 62 down-regulated genes were filtered from those GEO profiles. KEGG pathway analysis showed that these differential genes were mainly enriched in Staphylococcus aureus infection, osteoclast differentiation, pentose and glucuronate interconversions. In addition, 379 nodes and ten key genes (CXCL8, PTPRC, IL1B, ITGB2, CXCR4, ICAM1, CCR5, SELL, C3AR1 and PLEK) were screened out by protein interaction network.Conclusions:The key genes and pathways identified in this study may be new targets for intervention in the development of acne.

Objective:To analyze the correlation and diagnostic value of serum homocysteine (Hcy), methionine (Met) and cysteine (Cys) in patients with chronic heart failure (CHF).Methods:One hundred and seventy-eight patients with acute decompensation CHF (CHF group) and 70 healthy persons (healthy control group) from October 2018 to September 2019 in Affiliated Zhongshan Hospital of Dalian University were continuously enrolled. In CHF group, heart failure with reduced ejection fraction (HFrEF) was in 53 cases, heart failure with mid-range ejection fraction (HFmrEF) was in 50 cases, and heart failure with preserved ejection fraction (HFpEF) was in 75 cases. Serum levels of Hcy, Met and Cys were detected by tandem mass spectrometry. Serum level of N-terminal brain natriuretic peptide precursor (NT-proBNP) was detected by electrochemical luminescence immunity. The left ventricular end-diastolic diameter (LVEDd), left ventricular end-systolic diameter (LVESd) and early diastolic peak blood flow velocity of mitral valve annulus/early diastolic peak velocity of mitral annulus (E/e′) were detected by echocardiography, then left ventricular eject fraction (LVEF) was calculated. Correlation was analyzed by Pearson correlation analysis. The receiver operator characteristic (ROC) curve was drawn, and the area under curve (AUC) was used to evaluate the efficacy of serum Hcy, Met, Cys, NT-proBNP and LVEF in the diagnosis of CHF.Results:The Hcy, Met, Cys, NT-proBNP, LVEDd and E/e′ in CHF group were significantly higher than those in healthy control group: (12.64 ± 5.02) μmol/L vs. (8.71 ± 3.47) μmol/L, (23.38 ± 5.75) μmol/L vs. (20.52 ± 4.18) μmol/L, (343.45 ± 44.49) μmol/L vs. (290.53 ± 48.38) μmol/L, (5 759.43 ± 3 806.22) pg/L vs. (40.24 ± 31.91) pg/L, (52.67 ± 12.27) mm vs. (46.41 ± 12.27) mm and (17.32 ± 5.61)% vs. (9.54 ± 2.64)%, the LVEF was significantly lower than that in healthy control group: (45.27 ± 4.93)% vs. (62.37 ± 5.41)%, and there were statistical differences ( P<0.01 or <0.05). The Hcy and Cys in patients with HFmrEF and HFrEF were significantly higher than those in patients with HFpEF: (16.29 ± 8.18) and (18.68 ± 8.99) μmol/L vs. (13.75 ± 6.48) μmol/L, (346.64 ± 51.85) and (361.40 ± 52.34) μmol/L vs. (329.35 ± 55.16) μmol/L, and there were statistical differences ( P<0.05); there were no statistical differences between patients with HFmrEF and patients with HFrEF ( P>0.05). The serum Met in patients with HFrEF was significantly higher than that in patients with HFpEF and HFmrEF: (28.74 ± 8.22) μmol/L vs. (24.76 ± 7.60) and (25.15 ± 6.96) μmol/L, and there was statistical difference ( P<0.05); there was no statistical difference between patients with HFpEF and patients with HFmrEF ( P>0.05). Pearson correlation analysis result showed that serum Hcy, Met and Cys were positively correlated with NT-proBNP ( r = 0.632, 0.206 and 0.455; P<0.01), positively correlated with E/e′( r = 0.463, 0.198 and 0.346; P<0.01), and negatively correlated with LVEF ( r = -0.491, -0.152 and -0.330; P<0.05 or <0.01). ROC curve analysis result showed that ROC the cut-off value for the diagnosis of CHF with serum NT-proBNP based on the maximum Youden index (0.994) was 120 pg/L, and AUC was 0.994 (95% CI was 0.997 to 1.000); the cut-off value for the diagnosis of CHF with serum Hcy based on the maximum Youden index (0.646) was 10.56 μmol/L, and AUC was 0.899 (95% CI 0.859 to 0.939); the cut-off value for the diagnosis of CHF with serum Met based on the maximum Youden index (0.218) was 25.58 μmol/L, and AUC was 0.637 (95% CI 0.563 to 0.711); the cut-off value for the diagnosis of CHF with serum Cys based on the maximum Youden index (0.391) was 298.05 μmol/L, and AUC was 0.765 (95% CI 0.700 to 0.830); the AUC of LVEF less than 0.5. Conclusions:Serum Hcy, Met and Cys levels in patient with CHF are significantly increased, which are positively correlated with NT-proBNP and E/e′, negatively correlated with LVEF. Moreover, serum Hcy has certain application value in the diagnosis of CHF.

Objective:A comparative study of non-invasive hemodynamics and echocardiography in 139 cases of heart failure patients with preserved ejection fraction (HFpEF) at baseline and one year follow-up to explore its value on diagnosis, monitoring and prognosis in patients with HFpEF.Methods:The baseline and one year follow-up data of 139 patients with HFpEF in Affiliated Zhongshan Hospital of Dalian University patients who had been enrolled in the China PEACE 5P-HF from June 2016 to May 2018 were analyzed retrospectively. The general data were collected which contented age of the study subjects is (30 - 80) y, average age (64.0 ± 12.3) y, and 63.31% male, (88/139) and 36.69% female (51/139), 56.8% smokers (79/139). t-test way was used to analyze the baseline and one year follw-up data, The indexs included blood pressure (BP), estimated glomerular filtration rate (eGFR) and 6-munites walk test (6MWT). Non-invasive hemodynamic indicators included stroke volume (SV), ejection fractions (EF), cardiac index (CI), index of contratility (IC), pulmonary artery wedge pressure (PCWP), maximum angiectatic velocity(AMPC), left ventricular ejection time (LVET), left ventricular isovolumetric relaxation time (LVLVIVRT), pre-ejection period/left ventricular ejection fractions (PEP/LVET), left ventricular end diastolic pressure (LVEDP) and left cardiac work index (LCWI). Hemodynamic indicators included left ventricular end diastolic dimension(LVEDd), left ventricular end systolic dimension (LVEDs), interventricular septal thickness at diastole (IVSD), left ventricular ejection fractions (LVEF) and E/e′.Results:There was no significant difference between the baseline and one year follow-up data in SBP, DBP, NT-proBNP, eGFR, 6MWT ( P>0.05). There were significant increase in SV, EF, CI, IC in one year′ follow-up compared with that in baselinee [(73.39 ± 29.47) ml vs. (63.39 ± 30.08) ml, (64.87 ± 9.16)% vs. (61.81 ± 9.02)%, (3.06 ± 1.10) ml/(min·m 2) vs. (2.62 ± 1.06) ml/(min·m 2), (0.039 ± 0.037) L/s vs. (0.028 ± 0.015) L/s] ( P<0.05). PCWP in one year′ follow-up was significantly decreased compared with that in baselin [(9.21 ± 3.34) mmHg (1 mmHg = 0.133 kPa) vs. (9.87 ± 3.13) mmHg]( P<0.05), However, AMPC, LVE, LVLVIVRT, PEP/LVET, LVEDP, LCWI in baseline and one year′ follow-up showed no significant difference ( P>0.05). The Hemodynamic indicators in baseline and one year′s follow-up were as followed: LVEF in one year′ follow-up was significantly elevated compared with that in the baseline [(63.53 ± 8.39)% vs. (61.02 ± 7.16)%]; E/e′ in one year′s follow-up was significantly decresed compared with that in the baseline [12.89 ± 5.86 vs. 14.32 ± 6.61]( P<0.05); there were no significant differences in LVEDd, LVEDs and IVSD in baseline compared with those in one year′s followed-up ( P>0.05). Conclusions:Hemodynamic indicators including SV, EF, CI, IC and PCWP could be new reflections of early diagnosis, monitoring and prognosis on HFpEF. The combination of non-invasive hemodynamics and echocardiography on HFpEF can be more significant in reflecting the changes of myocardial remodeling and cardiac function.