Objective·To develop a machine learning approach for early identification of metabolic syndromes associated with inflammatory metabolic state changes in breast cancer patients after neoadjuvant therapy,using common laboratory and transthoracic echocardiography indices.Methods·Female patients with primary invasive breast cancer diagnosed at the Department of Breast Surgery,Renji Hospital,Shanghai Jiao Tong University School of Medicine,between September 2020 and September 2022,were included.General patient information,laboratory test results,and transthoracic echocardiography data were collected.After feature extraction,five machine learning algorithms,including random forest(RF),gradient boosting(GB),support vector machine(SVM),K-nearest neighbor(KNN),and decision tree(DT),were applied to construct a prediction model for the changes of the patients' metabolic state after neoadjuvant therapy,and the prediction performances of the five models were compared.Results·A total of 232 cases with valid clinical data were included,comprising 135 cases before neoadjuvant therapy and 97 cases after completing 4 cycles of neoadjuvant therapy.Feature extraction identified five key features:white blood cell count,hemoglobin,high-density lipoprotein(HDL),interleukin-2 receptor,and interleukin-8.In the multi-feature analysis,the area under the receiver operating characferistic curve(AUC)was higher in the combination of white blood cell count,hemoglobin and HDL compared to the combination of interleukin-2 receptor and interleukin-8(RF:0.928 vs 0.772,GB:0.900 vs 0.792,SVM:0.941 vs 0.764,KNN:0.907 vs 0.762,DT:0.799 vs 0.714).The RF,SVM,and GB models showed higher AUC(0.928,0.941,0.900)and accuracy(0.914,0.897,0.776).The SVM model exhibited superior accuracy in the training data compared to the RF and GB models(P=0.394,0.122 and 0.097,respectively).Conclusion·The SVM model can be used to establish a prediction model for identifying breast cancer patients at high risk of developing inflammatory metabolic state-related metabolic syndrome after neoadjuvant therapy by incorporating five common clinical indicators,namely,white blood cell count,hemoglobin,high-density lipoprotein,interleukin-2 receptor,and interleukin-8.SVM modeling may be useful for clinicians to establish individualized screening protocols based on a patient's inflammatory metabolic state.

Enterotoxigenic Escherichia coli（ETEC）infection can induce watery diarrhea，leading to dehydration，electrolyte disturbance，and even death in severe cases. Recombinant B subunit/inactivated whole-cell cholera（rBS/WC）vaccine is effective in preventing ETEC infectious diarrhea. On the basis of the latest evidence on etiology and epidemiology of ETEC，as well as the effectiveness，safety，and health economics of rBS/WC vaccine，National Clinical Research Center for Child Health（The Children’s Hospital，Zhejiang University School of Medicine）and Zhejiang Provincial Center for Disease Control and Prevention invited experts to develop expert consensus on rBS/WC vaccine in prevention of ETEC infectious diarrhea. It aims to provide the clinicians and vaccination professionals with guidelines on using rBS/WC vaccine to reduce the incidence of ETEC infectious diarrhea.

Objective: To explore the application value of bispectral index(BIS) , specific protein 100β(S100β) combined with Copeptinin patients with acute severe carbon monoxide poisoning (ASCMP). Methods: A total of 256 patients with acute carbon monoxide poisoning admitted to Hengshui People's Hospital from June 2018 to June 2020 were collected, and they were divided into 30 mild cases, 40 moderate cases and 186 severe cases according to the degree of poisoning. Among them, patients with severe carbon monoxide poisoning were divided into a poor prognosis group (20 cases) and a good prognosis group (166 cases) according to whether adverse events occurred. The changes of creatine kinase isoenzyme (CK-MB) , N-terminal precursor B-type brain natriuretic peptide (NT-proBNP) , BIS, S100β, and Copeptin in poisoned patients were measured. Logistic regression analysis and receiver operating characteristic (ROC) curve were used to evaluate the significance of relevant indicators for ASCMP patients. Results: Compared with the mild-to-moderate group, CK-MB, NT-proBNP, S100β, Copeptin increased, and BIS value decreased in the severe group (P< 0.05). 24 hours after admission, compared with the good prognosis group, CK-MB, NT-proBNP, S100β, Copeptin in the poor prognosis group increased, and the BIS value decreased (P<0.05). In the poor prognosis group, CK-MB, NT-proBNP, S100β, and Copeptin at 72 hours after admission were all lower than those at 24 hours after admission, and the BIS value was higher than that at 24 hours after admission (P<0.05). Logistic regression analysis showed that ASCMP patients with increased S100β, Copeptin, and decreased BIS values had an increased risk of adverse events (P<0.05). The ROC curve showed that the area under the curve of the combined detection of BIS, S100β and Copeptin was 0.859, which had a great predictive value for the prognosis of ASCMP patients. Conclusion: BIS, S100β combined with Copeptin detection is of great value for early assessment of ASCMP disease and prognosis prediction.
Biomarkers ; Carbon Monoxide Poisoning ; Creatine Kinase, MB Form ; Humans ; Natriuretic Peptide, Brain ; Peptide Fragments ; Prognosis ; ROC Curve ; S100 Calcium Binding Protein beta Subunit

Objective:To investigate the clinical effect of water-jet excision combined with skin graft in the treatment of giant congenital melanotic nevus.Methods:The patients with giant nevus who were admitted to the Department of Plastic Surgery, Chinese PLA General Hospital from January 2015 to May 2019 were retrospectively analyzed. All patients were treated by layer-by-layer cutting of giant nevus with water-jet, preserving the subcutaneous fascial layer and part of the dermis as much as possible, then following by skin graft transplantation. The patients visited the hospital 1-2 years after operation. The postoperative scar of skin graft area was scored by Patient and Observer Scar Assessment Scale (POSAS), and the satisfaction of skin graft area was evaluated by digital scoring method (1-10 points). The recurrence of nevus pigmentosus and implantation metastasis were observed. Descriptive method were used for statistical analysis.Results:A total of 7 children were included, 2 males and 5 females, aged 4 to 14 years. There were 3 cases on the trunk and 4 cases on the extremities. Giant nevi accounted for (7.4 ± 3.1)% of the body surface area. Then skin graft survived well after surgery in all 7 children. During the 1-year follow-up after operation, the POSAS score of skin graft scar showed that the sum of 1-3 points in the scores of scar pain, itching, hardness and thickness by the patients or their families was 6, 4, 4 and 5 cases, respectively, and the sum of 4-10 points in the pigmentation and irregularity was 5 and 5 cases, respectively. None of the 7 patients had functional limitation in the skin graft area; the physicians’, scores for vascularity, pigmentation, thickness, and flexibility of the scars in the skin graft area were low, with a sum of 6, 3, 4, and 4 for the number of cases with 1-3 points and 2 and 4 for the number of cases with 1-3 points and 4-6 points in the flatness score, respectively. The satisfaction of both doctors and patients (sum of 7-10 points) was 4 and 5 cases, respectively. 7 cases were reexamined 1 year after operation, with recurrence of 2 punctate nevus pigmentosus(less than 1 mm in diameter) in only one case. No implantation metastasis in the skin graft area of nevus pigmentosus happened.Conclusions:Water-jet excision combined with skin graft in the treatment of giant nevus is simple and only one procedure required. The donor site only needs to cut a split-thickness skin graft. The postoperative scar is not obvious and the skin elasticity is better. Patients were relatively satisfied with the postoperative effect. It is suitable for the resection of nevus pigmentosus in the trunk especially the nevus pigmentosus with good texture and lighter color but not for the lesion at articular area of limbs.

Objective:To investigate the clinical effect of water-jet excision combined with skin graft in the treatment of giant congenital melanotic nevus.Methods:The patients with giant nevus who were admitted to the Department of Plastic Surgery, Chinese PLA General Hospital from January 2015 to May 2019 were retrospectively analyzed. All patients were treated by layer-by-layer cutting of giant nevus with water-jet, preserving the subcutaneous fascial layer and part of the dermis as much as possible, then following by skin graft transplantation. The patients visited the hospital 1-2 years after operation. The postoperative scar of skin graft area was scored by Patient and Observer Scar Assessment Scale (POSAS), and the satisfaction of skin graft area was evaluated by digital scoring method (1-10 points). The recurrence of nevus pigmentosus and implantation metastasis were observed. Descriptive method were used for statistical analysis.Results:A total of 7 children were included, 2 males and 5 females, aged 4 to 14 years. There were 3 cases on the trunk and 4 cases on the extremities. Giant nevi accounted for (7.4 ± 3.1)% of the body surface area. Then skin graft survived well after surgery in all 7 children. During the 1-year follow-up after operation, the POSAS score of skin graft scar showed that the sum of 1-3 points in the scores of scar pain, itching, hardness and thickness by the patients or their families was 6, 4, 4 and 5 cases, respectively, and the sum of 4-10 points in the pigmentation and irregularity was 5 and 5 cases, respectively. None of the 7 patients had functional limitation in the skin graft area; the physicians’, scores for vascularity, pigmentation, thickness, and flexibility of the scars in the skin graft area were low, with a sum of 6, 3, 4, and 4 for the number of cases with 1-3 points and 2 and 4 for the number of cases with 1-3 points and 4-6 points in the flatness score, respectively. The satisfaction of both doctors and patients (sum of 7-10 points) was 4 and 5 cases, respectively. 7 cases were reexamined 1 year after operation, with recurrence of 2 punctate nevus pigmentosus(less than 1 mm in diameter) in only one case. No implantation metastasis in the skin graft area of nevus pigmentosus happened.Conclusions:Water-jet excision combined with skin graft in the treatment of giant nevus is simple and only one procedure required. The donor site only needs to cut a split-thickness skin graft. The postoperative scar is not obvious and the skin elasticity is better. Patients were relatively satisfied with the postoperative effect. It is suitable for the resection of nevus pigmentosus in the trunk especially the nevus pigmentosus with good texture and lighter color but not for the lesion at articular area of limbs.

Objective:To investigate the expression and effect of microRNA-205 (miR-205) in hypertrophic scar.Methods:The experimental research method were applied. From October 2019 to January 2020, hypertrophic scar tissue from 6 patients with hypertrophic scar [1 male and 5 females, aged (36±7) years], and remaining normal skin tissue from 6 trauma patients [2 males and 4 females, aged (38±9) years] after flap transplantation operation were collected. The above-mentioned 12 patients were admitted to the General Hospital of Northern Theater Command and met the inclusion criteria. Real time fluorescent quantitative polymerase chain reaction was used to detect the mRNA expressions of miR-205 and thrombospondin-1 (TSP-1). The hypertrophic scar tissue was taken to culture the 3rd to 5th passage of fibroblasts (Fbs) for the follow-up experiments. Fbs of hypertrophic scar was divided into TSP-1+miR-205 control group, TSP-1+miR-205 mimic group, TSP-1 mutant+miR-205 control group, TSP-1 mutant +miR-205 mimic group, which were transfected with the corresponding sequences. At 48 h after transfection, the expressions of luciferase and renal luciferase were detected by luciferase reporter gene detection kit, and the luciferase/renal luciferase ratio was calculated to indicate the activity of TSP-1. Two batches of hypertrophic scar Fbs were collected and divided into miR-205 control group, miR-205 mimic group, and miR-205 inhibitor group and miR-205 control group, miR-205 mimic group, and miR-205 mimic+TSP-1 group, respectively, which were transfected with the corresponding sequences. At 0 (immediately), 12, 24, 36, and 48 h after transfection, the cell viability was detected by microplate reader. Two batches of hypertrophic scar Fbs were collected, grouped, and treated as the cell viability detecting experiment. At 24 h after transfection, Hoechst 33258 staining was performed to observe the nuclear shrinkage, so as to reflect the apoptosis of Fbs. The number of samples in cell experiment was 3. Data were statistically analyzed with analysis of variance for factorial design, one-way analysis of variance, and t test.Results:The mRNA expression of miR-205 in hypertrophic scar tissue was 0.54±0.05, which was significantly lower than 1.26±0.07 in normal skin tissue (t=8.213, P<0.01). The expression of TSP-1 mRNA in hypertrophic scar tissue was 1.46±0.07, which was significantly higher than 0.68±0.11 in normal skin tissue (t=6.031, P<0.01). At 48 h after transfection, the luciferase/renal luciferase ratio reflecting the TSP-1 activity of cells in TSP-1+miR-205 mimic group was 0.532±0.028, which was significantly lower than 0.998±0.012 in TSP-1+miR-205 control group (t=26.500, P<0.01), and the luciferase/renal luciferase ratio of cells in TSP-1 mutant+miR-205 mimic group was 0.963±0.012, which was close to 0.976±0.010 in TSP-1 mutant+miR-205 control group (t=0.816, P>0.05). At 12, 24, 36, and 48 h after transfection, the cell viability in miR-205 mimic group was significantly lower than that in miR-205 control group (t=6.169, 12.670, 27.130, 12.670, P<0.05 or P<0.01). At 0, 12, 24, 36, and 48 h after transfection, the cell viability in miR-205 inhibitor group was significantly higher than that in miR-205 control group (t=6.169, 7.221, 7.787, 7.835, 13.030, P<0.05 or P<0.01). At 12, 24, 36, and 48 h after transfection, the cell viability in miR-205 mimic group was significantly lower than that in miR-205 control group and miR-205 mimic+TSP-1 group (t=8.118, 26.970, 39.550, 42.490, 14.570, 12.240, 36.830, 45.220, P<0.05 or P<0.01). At 24 h after transfection, compared with miR-205 control group, the cell apoptosis in miR-205 mimic group was increased, and the cell apoptosis in miR-205 inhibitor group was decreased. At 24 h after transfection, compared with miR-205 mimic group, the cell apoptosis in miR-205 control group miR-205 mimic+TSP-1 group were decreased.Conclusions:miR-205 can inhibit the proliferation and promote the apoptosis of Fbs in hypertrophic scar by inhibiting the expression of TSP-1, which has the potential to be the therapeutic target for hypertrophic scar.

Objective:To investigate the expression and effect of microRNA-205 (miR-205) in human hypertrophic scar.Methods:The experimental research method was applied. From October 2019 to January 2020, hypertrophic scar tissue from 6 patients with hypertrophic scar (1 male and 5 females, aged (36±7) years) and remaining normal skin tissue from 6 trauma patients (2 males and 4 females, aged (38±9) years) after flap transplantation operation were collected. The above-mentioned 12 patients were admitted to the General Hospital of Northern Theater Command and met the inclusion criteria. Real-time fluorescent quantitative reverse transcription polymerase chain reaction was used to detect the mRNA expressions of miR-205 and thrombospondin-1 (TSP-1). The hypertrophic scar tissue was taken to culture the 3rd to 5th passage of fibroblasts (Fbs) for the follow-up experiments. Two batches of hypertrophic scar Fbs were divided into TSP-1+ miR-205 control group, TSP-1+ miR-205 mimic group, and TSP-1 mutant+ miR-205 control group, TSP-1 mutant+ miR-205 mimic group, which were transfected with the corresponding sequences. At 48 h after transfection, the expressions of luciferase and renal luciferase were detected by luciferase reporter gene detection kit, and the luciferase/renal luciferase ratio was calculated to indicate the activity of TSP-1. Two batches of hypertrophic scar Fbs were collected and divided into miR-205 control group, miR-205 mimic group, and miR-205 inhibitor group and miR-205 control group, miR-205 mimic group, and miR-205 mimic+ TSP-1 group, respectively, which were transfected with the corresponding sequences. At 0 (immediately), 12, 24, 36, and 48 h after transfection, the cell viability was detected by microplate reader. Two batches of hypertrophic scar Fbs were grouped and treated as described in the cell viability detecting experiment. At 24 h after transfection, Hoechst 33258 staining was performed to observe the nuclear shrinkage, so as to reflect the apoptosis of Fbs. The number of samples in cell experiment was three. Data were statistically analyzed with analysis of variance for factorial design, one-way analysis of variance, t test, and chi-square test. Results:The mRNA expression of miR-205 in hypertrophic scar tissue was 0.54±0.05, which was significantly lower than 1.26±0.07 in normal skin tissue ( t=8.213, P<0.01). The expression of TSP-1 mRNA in hypertrophic scar tissue was 1.46±0.07, which was significantly higher than 0.68±0.11 in normal skin tissue ( t=6.031, P<0.01). At 48 h after transfection, the luciferase/renal luciferase ratio reflecting the TSP-1 activity of cells in TSP-1+ miR-205 mimic group was 0.532±0.028, which was significantly lower than 0.998±0.012 in TSP-1+ miR-205 control group ( t=26.500, P<0.01), and the luciferase/renal luciferase ratio of cells in TSP-1 mutant+ miR-205 mimic group was 0.963±0.012, which was close to 0.976±0.010 in TSP-1 mutant+ miR-205 control group ( t=0.816, P>0.05). At 12, 24, 36, and 48 h after transfection, the cell viability in miR-205 mimic group was significantly lower than that in miR-205 control group ( t=6.169, 12.670, 27.130, 12.670, P<0.05 or P<0.01). At 0, 12, 24, 36, and 48 h after transfection, the cell viability in miR-205 inhibitor group was significantly higher than that in miR-205 control group ( t=6.169, 7.221, 7.787, 7.835, 13.030, P<0.05 or P<0.01). At 12, 24, 36, and 48 h after transfection, the cell viability in miR-205 mimic group was significantly lower than that in miR-205 control group and miR-205 mimic+ TSP-1 group ( t=8.118, 26.970, 39.550, 42.490, 14.570, 12.240, 36.830, 45.220, P<0.05 or P<0.01). At 24 h after transfection, compared with miR-205 control group, the cell apoptosis in miR-205 mimic group was increased, and the cell apoptosis in miR-205 inhibitor group was decreased. At 24 h after transfection, compared with miR-205 mimic group, the cell apoptosis in miR-205 control group and miR-205 mimic+ TSP-1 group were decreased. Conclusions:miR-205 can inhibit the proliferation and promote the apoptosis of Fbs in human hypertrophic scar by inhibiting the expression of TSP-1, which has the potential to be a therapeutic target for hypertrophic scar.

OBJECTIVE: To investigate the relevance ratio of osteoporosis and bone mass of middle aged and elderly people in Beijing communities, in order to understand occurrence and development trend of abnormality of bone mass in high-risk population from community. METHODS: Based on the method of cross-sectional investigation, the information data of 1 540 middle-aged and elderly people from 10 communities were collected, including 415 males and 1 125 females, aged from 45 to 80 years old with the average of (63.02±7.15) years old; the height was (161.34±7.24) cm, the weight was (65.90±10.19) kg, body mass index was (25.29±3.32) kg /m2. Bone mineral density (BMD) of lumbar vertebrae (L RESULTS: The level of β-CTX was(0.27±0.12) ng /ml, procollanen type 1 N-terminal propeptide(P1NP) was(51.03± 22.36) ng /ml, 25(OH) D3 was (16.68±6.24) ng /ml, serum calcium was(2.34±0.09) mmol / L, blood phosphorus was (1.43± 0.37) mmol / L, and blood magnesium was (0.94±0.07) mmol / L, alkaline phosphatase was (79.28±20.48) U/ L, parathyroid hormone was (3.09±1.60) pmol / L, osteocalcin was (13.29±6.65) ng /ml. Except for blood magnesium, the other indexes had significant differences between different sex groups( CONCLUSION There are obvious differences in relevance ratio of osteoporosis and low bone mass among different sites. It is suggested that the clinical diagnosis of osteoporosis should be combined with bone mineral density and bone metabolic markers. With the increasing prevalence of osteoporosis among middle aged and elderly people in Beijing community, continuous follow-up research based on community primary health care units could promote early examination, early diagnosis, and early treatment of middle aged and elderly people at high risk of osteoporosis in community.
Absorptiometry, Photon ; Aged ; Aged, 80 and over ; Beijing/epidemiology* ; Bone Density ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Osteoporosis/epidemiology*

Palladium hydrogel capped by β-cyclodextrins (Pdβ-CD) was prepared by a facile method with β-cyclodextrins and palladium(II) chloride,which were then modified onto the surface of gold electrode. The morphology and structure of the as-prepared palladium hydrogel were characterized by X-ray powder diffraction (XRD), scanning electron microscopy (SEM) and transmission electron microscopy (TEM), while the electrochemistry behaviors of gold electrode modified by Pdβ-CDwere investigated by cyclic voltammetry (CV) and differential pulse voltammetry(DPV). The results indicated the sensor had high electrochemistry response to hydrazine hydrate in the presence of K+,Na+,Mg2+,NH+4,Ni+2,Mn2+,Cl-,NO-3,SO2-4,PO3-4,HCOO-, C6H5O-3. Under the optimized conditions, the oxidized peak current showed linear relationship with the concentration of hydrazine hydrate in the concentration range of 25-950 μmol/L and the limit of detection (LOD) of 1.6 μmol/L(S/N=3).Owing to the facile preparation,high sensitivity and selectivity,the sensor has potential applications in determination of hydrazine hydrate in real water samples