Objective To explore the comparative study of constructing prediction models for muscle invasive of bladder cancer based on different machine learning algorithms combined with MRI radiomic.Methods A total of 187 bladder cancer patients who underwent MRI examination and were confirmed by pathology were retrospectively selected.Patients were randomly divided into a training set and a test set in a 7∶3 ratio.The patients were divided into muscle invasive bladder cancer(MIBC)group and non-muscle invasive bladder cancer(NMIBC)group according to the surgical pathology results.Tumor volume of interest(VOI)was outlined on the images of T2 WI,diffusion weighted imaging(DWI),and apparent diffusion coefficient(ADC),and the radiomic features were extracted by A.K software,and dimensionality reduction was performed using the maximum relevance minimum redundancy(mRMR)algorithm combined with least absolute shrinkage and selection operator(LASSO).Six machine learning algorithms,including K-nearest neighbor(KNN),decision tree(DT),support vector machine(SVM),logistic regression(LR),random forest(RF),and explainable boosting machine(EBM)were used to construct the radiomic model and calculate the corresponding area under the curve(AUC),accuracy,sensitivity,and specificity,respectively.Results Six machine learning algorithms,including KNN,DT,SVM,LR,RF,and EBM were used to construct the radiomic model,and the AUC values for predicting MIBC in the training set were 0.863,0.838,0.853,0.866,0.977,0.997,and in the test set were 0.748,0.833,0.860,0.868,0.870,0.900.Among them,the MRI radiomic model constructed based on EBM had the highest predictive efficacy for MIBC,with AUC values,accuracy,sensitivity and specificity of 0.997,0.977,0.957 and 0.981 in the training set,and 0.900,0.877,0.800,and 0.894 in the test set,respectively.Conclusion Multiple machine learning algorithms combined with MRI radiomic to construct models have good predictive efficacy for MIBC,and the model constructed based on EBM shows the highest predictive value.

Small ubiquitin-related modifier(SUMOylation)is a dynamic post-translational modification that maintains cardiac function and can protect against a hypertrophic response to cardiac pressure overload.However,the function of SUMOylation after myocardial infarction(MI)and the molecular details of heart cell responses to SUMO1 deficiency have not been determined.In this study,we demonstrated that SUMO1 protein was inconsistently abundant in different cell types and heart regions after MI.However,SUMO1 knockout significantly exacerbated systolic dysfunction and infarct size after myocardial injury.Single-nucleus RNA sequencing revealed the differential role of SUMO1 in regulating heart cells.Among cardiomyocytes,SUMO1 deletion increased the Nppa+Nppb+Ankrd1+cardiomyocyte subcluster pro-portion after MI.In addition,the conversion of fibroblasts to myofibroblasts subclusters was inhibited in SUMO1 knockout mice.Importantly,SUMO1 loss promoted proliferation of endothelial cell subsets with the ability to reconstitute neovascularization and expressed angiogenesis-related genes.Computational analysis of ligand/receptor interactions suggested putative pathways that mediate cardiomyocytes to endothelial cell communication in the myocardium.Mice preinjected with cardiomyocyte-specific AAV-SUMO1,but not the endothelial cell-specific form,and exhibited ameliorated cardiac remodeling following MI.Collectively,our results identified the role of SUMO1 in cardiomyocytes,fibroblasts,and endothelial cells after Ml.These findings provide new insights into SUMO1 involvement in the patho-genesis of MI and reveal novel therapeutic targets.

Objective:To explore the predictive value of transvaginal ultrasound measurement of cervical length (CL) in the first and second trimester on spontaneous preterm birth in singleton pregnant women.Methods:This study retrospectively recruited 2 254 singleton pregnancies without severe comorbidities at Peking University First Hospital from January 2019 to June 2019. CL was measured for all subjects using transvaginal ultrasound in the first (11-13 +6 weeks) and second trimester (21-23 +6 weeks). Differences in CL between women with preterm (preterm group) and full-term delivery (full-term group) as well as the CL during the first and second trimester were compared. The independent risk factors for preterm birth and the predictive value of CL in the first and second trimester for spontaneous preterm birth were also explored. Fisher's exact test, t-test, χ2 test, and logistic regression analysis, etc, were adopted for statistical analysis. Results:(1) For the 2 254 subjects, CL measured in the first trimester and second trimester were (36.1±4.2) mm (22.4-52.6 mm) and (36.9±5.3) mm (2.9-59.7 mm), respectively. The incidence of short cervix in the first trimester and second trimester were 0.31% (7/2 254) and 1.46% (33/2 254), respectively. When CL was ≤25.0 mm ( OR=43.92, 95% CI:6.83-282.49) or >25.0-≤30.3 mm ( OR=6.59, 95% CI:1.97-22.0) in the first trimester, the risk of short cervix increased in the second trimester (both P<0.05). (2) The total incidence of preterm delivery was 3.06% (69/2 254). CL and the incidence of short cervix did not differ significantly in the first trimester between the preterm and full-term group [(35.2±4.5) and (36.1±4.1) mm, t=－1.78, P=0.076; 1.5% (1/69) and 0.3% (6/2 185), χ 2=2.98, P=0.084]. Compared with the full-term group, CL was shorter and the incidence of short cervix was higher in the second trimester in the preterm group [(33.6±6.7) vs (37.0±5.2) mm, t=－5.12;8.7% (6/69) vs 1.2% (27/2 185), χ 2=25.80, P<0.001]. (3) Multivariate regression analysis showed that age ≥35 years ( OR=2.05, 95% CI:1.22-3.46), history of spontaneous preterm birth ( OR=25.25, 95% CI:5.01-127.28), conception assisted by reproductive technology ( OR=10.39, 95% CI:2.39-50.33), and short cervix during the second trimester were independent risk factors for premature delivery. (4) There was no significant difference in the risk of preterm delivery when comparing to those with CL≤25.0 mm, >25.0-≤30.3 mm, >30.3-≤33.0 mm, >33.0-≤35.7 mm, >35.7-≤38.7 mm women with CL>38.7 mm during the first trimester (all P>0.05). The risk of premature delivery was relatively increased for those with CL≤25.0 mm,>25.0-≤29.5 mm, >29.5-≤33.6 mm, >33.6~≤36.8 mm, >36.8~≤40.1 mm during the second trimester compared to those with CL>40.1 mm [ OR (95% CI):17.64 (4.99-62.32), 6.89 (2.11-22.55), 3.58 (1.34-9.59), 4.04 (1.58-10.32), 3.34 (1.28-8.67), respectively , all P<0.05]. (5) When CL≤25.0 mm and ≤29.5 mm in the second trimester were used as the cut-off value, the prediction of preterm delivery was with a sensitivity of 8.70% and 17.39%, specificity of 98.80% and 95.29%, positive predictive value of 18.20% and 10.43%, negative predictive value of 97.16% and 97.34%, and the accuracy rate of 96.01% and 92.90%, respectively. Conclusions:There were no significant differences in CL and the incidence of short cervix during the first trimester among women with preterm or full-term delivery. CL in the first trimester is not an independent risk factor for preterm birth, but the risk of short cervix in the second trimester is increased when CL≤30.3 mm in the first trimester. The shorter the cervix during the second trimester, the greater the risk of preterm birth.

Objective:To explore the effects of multidisciplinary rehabilitation nursing combined with "3C" intervention in the nursing of patients after knee surgery with manipulation under anesthesia (MUA) .Methods:From March 2018 to March 2020, convenience sampling was used to select 171 patients after knee surgery with MUA in a rehabilitation center in Shanghai, and patients were divided into experimental group (87 cases) and control group (84 cases) according to admission time. Experimental group implemented multidisciplinary rehabilitation nursing combined with "3C" intervention, and control group implemented conventional rehabilitation. The intervention effects of knee flexion angle, Hospital for Special Surgery (HSS) , rehabilitation knowledge, rehabilitation compliance were compared between the two groups of patients.Results:The passive knee flexion angle of experimental group in the first week of intervention and the active knee flexion angle in the second and tenth weeks of intervention were greater than those of control group, and the differences were statistically significant ( P<0.01) . The HSS score of experimental group after intervention was higher than that of control group, and the difference was statistically significant ( P<0.01) . The experimental group's mastery of rehabilitation knowledge and rehabilitation compliance were higher than those of control group, and the differences were statistically significant ( P<0.01) . Conclusions:The implementation of nurse-led multidisciplinary rehabilitation nursing combined with "3C" intervention for patients after knee surgery with MUA is conducive to improving the patient's grasp of rehabilitation knowledge, compliance with rehabilitation interventions, the patient's knee flexion angle and knee joint function, as well as increasing the patient's satisfaction with nursing work.

Objective:To explore the effect of pathway nursing under multidisciplinary collaboration on self-care ability and rehabilitation effect in patients with acute cerebral infarction.Methods:Using the convenient sampling method, a total of 294 patients with acute cerebral infarction who were admitted to the Department of Neurology in the Fengcheng Hospital, Fengxian District, Shanghai from January 2018 to December 2019 were selected as the research objects. A total of 147 patients with acute cerebral infarction admitted from January to December 2019 were included in the experimental group, while 147 patients with acute cerebral infarction admitted from January to December 2018 were included in the control group. The experimental group adopted pathway nursing under multidisciplinary collaboration, while the control group adopted neurology routine nursing. Scores of Exercise of Self-Care Agency (ESCA) , National Institutes of Health Stroke Scale (NIHSS) , Fugl-Meyer Assessment (FMA) , Barthel Index and nursing satisfaction of patients were compared between the two groups. Finally, 147 patients in the experimental group and 145 patients in the control group completed the experiment.Results:The scores of self-concept, self-responsibility, health knowledge level and self-care skills in ESCA of patients in the experimental group at discharge were respectively (25.36±4.86) , (20.43±3.21) , (53.37±5.89) and (40.02±3.78) and the nursing satisfaction score was (97.26±2.52) , which were higher than (21.48±4.33) , (16.24±3.25) , (46.44±5.47) , (30.08±3.81) and (90.65±3.16) in the control group, and the differences were statistically significant ( P<0.01) . The NIHSS score of the experimental group 60 days after discharge was (3.7±2.2) , lower than (6.9±2.3) of the control group. And FMA and Barthel Index scores were respectively (79.3±9.2) and (78.7±14.5) , higher than (65.6±8.4) and (60.3±16.6) of the control group, and the differences were statistically significant ( P<0.01) . Conclusions:The implementation of pathway nursing under multidisciplinary collaboration for patients with acute cerebral infarction can enhance the consciousness of self-management, contribute to the recovery of neurological function and limb motor function and improve the ability of self-care and nursing satisfaction of patients.

Mitochondrial diseases are maternally inherited heterogeneous disorders that are primarily caused by mitochondrial DNA (mtDNA) mutations. Depending on the ratio of mutant to wild-type mtDNA, known as heteroplasmy, mitochondrial defects can result in a wide spectrum of clinical manifestations. Mitochondria-targeted endonucleases provide an alternative avenue for treating mitochondrial disorders via targeted destruction of the mutant mtDNA and induction of heteroplasmic shifting. Here, we generated mitochondrial disease patient-specific induced pluripotent stem cells (MiPSCs) that harbored a high proportion of m.3243A>G mtDNA mutations and caused mitochondrial encephalomyopathy and stroke-like episodes (MELAS). We engineered mitochondrial-targeted transcription activator-like effector nucleases (mitoTALENs) and successfully eliminated the m.3243A>G mutation in MiPSCs. Off-target mutagenesis was not detected in the targeted MiPSC clones. Utilizing a dual fluorescence iPSC reporter cell line expressing a 3243G mutant mtDNA sequence in the nuclear genome, mitoTALENs displayed a significantly limited ability to target the nuclear genome compared with nuclear-localized TALENs. Moreover, genetically rescued MiPSCs displayed normal mitochondrial respiration and energy production. Moreover, neuronal progenitor cells differentiated from the rescued MiPSCs also demonstrated normal metabolic profiles. Furthermore, we successfully achieved reduction in the human m.3243A>G mtDNA mutation in porcine oocytes via injection of mitoTALEN mRNA. Our study shows the great potential for using mitoTALENs for specific targeting of mutant mtDNA both in iPSCs and mammalian oocytes, which not only provides a new avenue for studying mitochondrial biology and disease but also suggests a potential therapeutic approach for the treatment of mitochondrial disease, as well as the prevention of germline transmission of mutant mtDNA.
Animals ; DNA, Mitochondrial ; genetics ; Humans ; Induced Pluripotent Stem Cells ; cytology ; metabolism ; MELAS Syndrome ; genetics ; Male ; Mice ; Microsatellite Repeats ; genetics ; Mitochondria ; genetics ; metabolism ; Mutation ; genetics

Objective To investigate the prevalence of nutritional risk and malnutrition in hospitalized lung cancer patients in a tertiary A hospital in Chongqing.Methods From December 2013 to July 2017,2 735 consecutive lung cancer patients were admitted to the Department of Pneumology at Daping Hospital for planned anti-cancer treatment.Patients who did not complete a nutritional status assessment and who had repeated admission wcrc excluded from the study.The demographic and tumor characteristics were investigated in the 548 lung cancer inpatients who completed the study.The nutritional risk screening 2002 (NRS 2002) was used to evaluate the nutritional risk.The individual nutritional status was also evaluated using the patient-generated subjective global assessment (PG-SGA) questionnaire,anthropometry measurements and hematological measurements.The physical status was assessed by the Karnofsky performance status (KPS).Results According to the NRS 2002 score,29.56％ (162/548) of the cancer patients had nutritional risk (score ≥3).The prevalence of nutritional risk was 17.39％,15.00％,22.00％ and 36.86％,respectively,for patients with stage Ⅰ,Ⅱ,Ⅲ and Ⅳ lung cancer.Forty-four patients (9.67％) had a body mass index＜ 18.5 kg/m2 and poor general condition,and the prevalence was 6.52％,5.00％,8.67％ and 11.22％,respectively,for stages I,Ⅱ,Ⅲ and Ⅳ.A total of 107 cases (19.53％) had impaired nutritional status (indicated by a severity score of 3 in the NRS 2002).The prevalence by different stages was 10.87％ (stage Ⅰ),5.00％ (stage Ⅱ),14.67％ (stage Ⅲ) and 25.00％ (stage Ⅳ).One hundred and twenty-five patients (22.81％) had PG-SGA scores ≥ 9,with 2.19％,2.50％,12.67％,and 33.33％ of patients in stages Ⅰ,Ⅱ,Ⅲ and Ⅳ having these high scores.The KPS scores were lower in the patients with nutritional risk and malnutrition than in the patients with a normal nutritional status.Conclusions The prevalence of nutritional risk and malnutrition in patients with lung cancer were mediom.Nutritional risk screening and nutritional status assessment should be considered at the time of admission for lung cancer patients in order to ensure better outcomes of treatment.

OBJECTIVE:To optimize the extraction technology of Duoxuekang. METHODS:Using comprehensive score of salidroside,gallic acid content and extraction yield as indexes,U6(63)uniform design was designed to optimize the liquid-solid ra-tio,ethanol volume fraction and extraction time of Duoxuekang,then optimize extraction times,and verification test was conduct-ed. RESULTS:The optimal extraction technology was as follows as 50% ethanol,liquid-solid ratio of 1:14,soaking time of 1.5 h,reflux extraction for 1 h and repeated twice;the average extraction yield in 3 tests was 50.18%,contents of salidroside and gal-lic acid were 1.82 mg/g,16.54 mg/g (RSD≤0.84%,n=3). CONCLUSIONS:The optimized extraction technology for Duox-uekang is reasonable,simple and feasible.

Objective To explore the influence and it′s mechanism of workplace mindfulness on thriving at work of nursing staffs. Methods A cross-section survey was conducted to collect data with an online method, the multiple line hierarchical regression analysis method was performed to test the relations between variables. Results The mean workplace mindfulness score of nursewas 4.74±0.63, the mean thriving score was 3.07 ± 0.71. Workplace mindfulness had a significantly positive prediction on thriving at work (β=0.344, P<0.01) of nurses. Conclusions Workplace mindfulness could affect nurses′thriving at work, which is beneficial to improve the growth and vitality of nursing staffs, which in turn to enhance them to abundant and vigorous life.

At present,most of the scholars of traditional Chinese medicine (TCM) considered that climacteric syndrome was caused by yin-deficiency,as the therapy of nourishing yin and clearing heat was the most common treatment,neglecting the pathologic role of yang-deficiency in climacteric syndrome.This paper redefined the pathogensis of climacteric syndrome and its syndromes based on differentiation in Gynecology of Traditional Chinese Medicine of various versions and in accordance with previous syndrome epidemiological results over it.The emerge of hot flushes and sweating,forgetful and hyposexuality was prevalent.The inaccurate description of hot flash and sweating in climacteric syndrome was rectified.The therapeutic effects of nourishing yin therapy on vasomotion were discussed based on the understanding of etiology,pathology and treatment of climacteric syndrome in ancient Chinese medical books.The phytoestrogens action of warming kidney-yang drugs was summarized from the aspect of modern pharmacology for exploring the significance of the role of yang-deficiency in climacteric syndrome.The treatment against yang-deficiency would be an innovative clinical pathway of climacteric syndrome.