Objective:To investigate the construction and empirical study of the risk predic-tion model of postoperative complications in patients with acute cholecystitis undergoing laparo-scopic cholecystectomy(LC).Method:The clinical data of 101 patients with acute cholecystitis treated by LC from January 2021 to January 2023 were retrospectively analyzed.According to the occurrence of postoperative complications(the following symptoms occurred within 30 days after surgery,such as abdominal hemorrhage,bile leakage,biliary tract injury and wound infection),pa-tients were divided into complication group(26 cases)and non-complication group(75 cases).Uni-variate analysis and multivariate Logistic regression were used to analyze the affecting factors of complications after LC in patients with acute cholecystitis,and the risk prediction model was con-structed,and the predictive value of the model was analyzed by receiver operating characteristic curve(ROC curve).Result:Univariate analysis showed that gender,BMI,cirrhosis,gallstone,gall-bladder atrophy and CCI grade were not correlated with postoperative complications in patients with acute cholecystitis after LC treatment(P＞0.05).Age,gallbladder wall thickness,triangular ana-tomic variation,ASA-PS grade,TG13/TG18 grade were associated with postoperative complica-tions of LC in patients with acute cholecystitis(P＜0.05).Multivariate Logistic regression analysis showed that age＞70 years old,gallbladder wall thickness ≥5mm,triangular anatomical variation,ASA-PS grade Ⅲ～Ⅵ,TG13/TG18 grade Ⅲ were all independent risk factors for postoperative complications(P＜0.05).ROC analysis showed that the AUC of the risk prediction model constructed based on the above five indicators was 0.836,and the sensitivity and specificity were 80.8％and 82.7％,which were all higher than the single indicators in the model,and the degree of fit of the risk prediction model was good(Hosmer-Lemeshow x2=0.998,P=0.986).Conclusion:Age＞70 years old,gallbladder wall thickness ≥5mm,triangular anatomic variation,ASA-PS grade Ⅲ～Ⅵand TG13/TG18 grade Ⅲ were independent risk factors for postoperative complications in patients with acute cholecystitis undergoing LC treatment.The risk prediction model constructed based on the above five indicators has high predictive value for postoperative complications in patients with acute cholecystitis undergoing LC treatment.

Objective To explore the protective mechanism of icariin on neuronal oxidative damage,providing a basic pharmacological basis for the treatment of cognitive impairment.Methods Glutamate was used to induce oxidative stress injury in HT22 cells.HT22 cells were divided into control group(normal cultured cells),model group(glutamate injury model)and experimental-L,-M,-H groups(5,10 and 20 μmol·L-1 icariin pretreatment for modeling,respectively).Cell proliferation was detected by cell counting kit-8(CCK-8)method;cytotoxicity was detected by lactate dehydrogenase(LDH)method;reactive oxygen species(ROS)levels were detected by flow cytometry;superoxide dismutase(SOD)levels were detected by biochemical kits;the expression levels of Kelch-like epichlorohydrin-related protein-1(Keap1),nuclear factor E2-related factor 2(Nrf2)were detected by Western blotting;the corresponding mRNA expression was detected by real-time fluorescence quantification polymerose chain reaction.Results The cell viability of control group,model group and experimental-L,-M,-H groups were(100.00±1.31)％,(66.38±2.44)％,(72.07±4.95)％,(82.41±3.57)％and(87.97±4.98)％;LDH release were(0.48±0.52)％,(18.82±2.09)％,(15.32±1.17)％,(10.37±1.39)％and(6.51±0.87)％;ROS level were(14.23±1.13)％,(41.74±1.60)％,(35.69±1.08)％,(33.28±1.69)％and(30.32±2.03)％;SOD levels were(54.84±1.17),(37.95±1.13),(48.02±1.28),(50.56±1.34)and(52.55±1.04)U·mg-1;Keap1 protein levels were 0.36±0.01,0.52±0.03,0.46±0.04,0.39±0.09 and 0.35±0.12;Nrf2 protein levels were 0.29±0.02,0.13±0.08,0.18±0.03,0.21±0.11 and 0.26±0.04;catalase(CAT)mRNA levels were 1.01±0.08,0.81±0.06,0.90±0.04,1.05±0.15 and 1.33±0.26;SOD mRNA levels were 1.09±0.12,0.83±0.03,0.86±0.08,0.94±0.08 and 1.09±0.16.Among the above indicators,the differences between the model group and the control group were statistically significant(all P＜0.01);the differences between the experimental-M,-H groups and the model group were statistically significant(P＜0.01,P＜0.05).Conclusion Icariin may activate the Keap1/Nrf2/antioxidant response element(ARE)signaling pathway,regulate the expression of related proteins,and reduce the level of ROS to effectively alleviate oxidative stress injury in neuronal cells.

Coronary heart disease (CHD) and stroke are the most well-known cardiovascular diseases, which share many common pathological basis. Yindan Xinnaotong soft capsule (YDXNT) is a commonly used Chinese patent medicine in the treatment of stroke and CHD. However, its action of mechanism of co-treatment for stroke and CHD is still unclear. The aim of this study was to explore the common mechanism of YDXNT in co-treatment of CHD and stroke using network pharmacology, experimental verification and molecular docking. An integrated literature mining and databases of IPA, ETCM, HERB, Swiss Target Prediction, OMIM and GeneCards were used to screen and predict active ingredients and potential targets of YDXNT in co-treatment of CHD and stroke. The protein-protein interaction network, GO analysis and pathway analysis were analyzed by IPA software. The effect of YDXNT on core targets was verified by immunofluorescence. UPLC-QTOF/MS and molecular docking were used to screen and predict the main active constituents of YDXNT and their interactions with core targets. A total of 151 potential targets are predicted for YDXNT in co-treatment of CHD and stroke. Hypoxia-inducible factor-1α (HIF1α)-matrix metalloproteinase-9 (MMP9)-mediated HIF1α signaling pathway serves as one of the common mechanisms. YDXNT could reduce the increase of mitochondrial fluorescence intensity and the protein expression of HIF1α and MMP9 in HL-1 and HA induced by oxygen and glucose deprivation/reperfusion (OGD/R) in a dose-dependent manner. Baicalin may be the material basis for treating stroke and CHD with YDXNT. In conclusion, the HIF1α signaling pathway is one of the common key mechanisms of YDXNT in the co-treatment of stroke and CHD. The study provides support and basis for the in-depth scientific connotation of the traditional Chinese medicine theory of "same treatment to different diseases".

OBJECTIVE: To develop a few-shot learning (FSL) approach for classifying optical coherence tomography (OCT) images in patients with inherited retinal disorders (IRDs). METHODS: In this study, an FSL model based on a student-teacher learning framework was designed to classify images. 2,317 images from 189 participants were included. Of these, 1,126 images revealed IRDs, 533 were normal samples, and 658 were control samples. RESULTS: The FSL model achieved a total accuracy of 0.974-0.983, total sensitivity of 0.934-0.957, total specificity of 0.984-0.990, and total F1 score of 0.935-0.957, which were superior to the total accuracy of the baseline model of 0.943-0.954, total sensitivity of 0.866-0.886, total specificity of 0.962-0.971, and total F1 score of 0.859-0.885. The performance of most subclassifications also exhibited advantages. Moreover, the FSL model had a higher area under curves (AUC) of the receiver operating characteristic (ROC) curves in most subclassifications. CONCLUSION This study demonstrates the effective use of the FSL model for the classification of OCT images from patients with IRDs, normal, and control participants with a smaller volume of data. The general principle and similar network architectures can also be applied to other retinal diseases with a low prevalence.
Humans ; Tomography, Optical Coherence ; Deep Learning ; Retinal Diseases/diagnostic imaging* ; Retina/diagnostic imaging* ; ROC Curve

Uric acid (UA) is the final product of purine metabolism in human body,and its metabolic disorder will induce hyperuricemia (HUA).The occurrence and development of HUA are associated with a variety of pathological mechanisms such as oxidative stress injury,activation of inflammatory cytokines,and activation of renin-angiotensin-aldosterone system.These mechanisms directly or indirectly affect the bioavailability of endogenous nitric oxide (NO).The decrease in NO bioavailability is common in the diseases with high concentration of UA as an independent risk factor.In this review,we summarize the mechanisms by which high concentrations of UA affect the endogenous NO bioavailability,with a focus on the mechanisms of high-concentration UA in decreasing the synthesis and/or increasing the consumption of NO.This review aims to provide references for alleviating the multisystem symptoms and improving the prognosis of HUA,and lay a theoretical foundation for in-depth study of the correlations between HUA and other metabolic diseases.
Humans ; Nitric Oxide ; Uric Acid ; Hyperuricemia ; Biological Availability ; Cytokines

AIM: To evaluate the clinical efficacy of adalimumab(ADA)with dose-reduced glucocorticoid for the treatment of Vogt-Koyanagi-Harada disease(VKH).METHODS: A total of 21 patients(37 eyes)with VKH who received ADA therapy in the Department of Ophthalmology of our hospital from August 2020 to December 2021 were included. The interval of ADA administration was progressively extended after intraocular inflammation controlled and lasted for 3mo, and it returned to the initial treatment interval once the inflammation recurred. After follow-up for 12mo, anterior chamber cell(ACC)grade, vitreous haze(VH)grade, retinal/choroidal lesions, serous retinal detachment(SRD), best corrected visual acuity(BCVA), central macular thickness(CMT)and doses of glucocorticoid and immunosuppressant were compared before and after the first ADA injection. Treatment failure events and adverse reactions were recorded.RESULTS: Compared with baseline, the proportion of eyes with ACC grade ≤1+ and VH grade ≤1+ increased(P<0.05), the proportion of eyes with retinal/choroidal lesions decreased significantly(P<0.01), BCVA and CMT were significantly improved(P<0.01), and the average dose of glucocorticoid reduced significantly(P<0.01)at 2wk, 1, 3 and 6mo after treatment. At the final follow-up, 82% of patients received glucocorticoid ≤5 mg, and all patients stopped using immunosuppressant. There were 13 treatment failure events during the follow-up period, and 12 patients(57%)extended the ADA treatment interval, with no serious adverse events related to ADA treatment observed.CONCLUSION: ADA is effective and safe for the treatment of VKH, reducing the need for glucocorticoid and immunosuppressant. In addition, extending the interval of ADA treatment is effective, which has a lower recurrence rate.

Cardiology ; China ; Consensus ; Heart Failure/therapy* ; Humans ; Self-Management ; United States

Antibodies, Monoclonal, Humanized ; China ; Humans ; Pilot Projects ; Psoriasis/drug therapy* ; Severity of Illness Index ; Treatment Outcome

Many clinical studies on Cheezheng Xiaotong Tiegao have been accumulated since it was launched in 1993,but they have not been comprehensively analyzed and evaluated. This study systematically retrieved relevant studies in six databases at home and abroad as of December 2017. This study analyzed the statistics of the included studies in several aspects,including publication time,region,fund,disease category and type of study. In this study,various tools were used to evaluate the methodological quality of included studies,such as the Cochrane collaboration's tool for assessing the risk of bias in randomized trials,MINORS,IHE,AMSTAR2.The results showed that the literatures were mainly published from 2010 to 2011,and a total of 28 projects were financially supported.The most involved disease was arthropathy. The randomized controlled trials were the majority in the included studies,but the quality was low,and most of the literatures didn't report the allocation concealment and blinding. This study comprehensively reflected the current situations and shortcomings of the clinical studies of Cheezheng Xiaotong Tiegao,and put forward several suggestions,in the expectation of providing a reference for the future clinical research direction of Cheezheng Xiaotong Tiegao.
Bibliometrics ; Drugs, Chinese Herbal

Altitude ; Animals ; Bacteria ; classification ; genetics ; Feces ; microbiology ; Gastrointestinal Microbiome ; Hypoxia ; microbiology ; Male ; Rats, Sprague-Dawley