Objective To explore the efficiency of artificial intelligence and radiomics-assisted X-ray in diagnosis of lumbar osteoporotic vertebral compression fractures(OVCF).Methods The clinical data of 455 patients diagnosed as lumbar OVCF by MRI in our hospital were selected.The patients were divided into the training group(n=364)and the validation group(n=91),X-ray films were extracted,the image delineation,feature extraction and data analysis were carried out,and the artificial intelligence radiomics deep learning was applied to establish a diagnostic model for OVCF.After verifying the effectiveness of the model by receiver operating characteristic(ROC)curve,area under the curve(AUC),calibration curve,and decision curve analysis(DCA),the efficiencies of manual reading,model reading,and model-assisted manual reading of X-ray in the early diagnosis of OVCF were compared.Results The ROC curve,AUC and calibration curve proved that the model had good discrimination and calibration,and excellent diagnostic performance.DCA demonstrated that the model had a higher clinical net benefit.The diagnostic efficiency of the manual reading group:the accuracy rate was 0.89,the recall rate was 0.62.The diagnostic efficiency of the model reading group:the accuracy rate was 0.93,the recall rate was 0.86,the model diagnosis showed good predictive performance,which was significantly better than the manual reading group.The diagnostic efficiency of the model-assisted manual reading group:the accuracy rate was 0.92,the recall rate was 0.72,and the recall rate of the model-assisted manual reading group was higher than that of the manual reading group,but lower than that of the model reading group,indicating the superiority of the model diagnosis.Conclusion The diagnostic model established based on artificial intelligence and radiomics in this study has reached an ideal level of efficacy,with better diagnostic efficacy compared with manual reading,and can be used to assist X-ray in the early diagnosis of OVCF.

Objective To develop a clinical prediction model for predicting risk factors for prolonged hospital stay after anterior cervical discectomy and fusion(ACDF).Methods The clinical data of 914 patients underwent ACDF treatment for cervical spondylotic myelopathy(CSM)were retrospectively analyzed.According to the screening criteria,800 eligible patients were eventually included,and the patients were divided into the development cohort(n=560)and the validation cohort(n=240).LASSO regression was used to screen variables,and multivariate Logistic regression analysis was used to establish a prediction model.The prediction model was evaluated from three aspects:differentiation,calibration and clinical effectiveness.The performance of the model was evaluated by area under the curve(AUC)and Hosmer-Lemeshow test.Decision curve analysis(DCA)was used to evaluate the clinical effectiveness of the model.Results In this study,the five factors that were significantly associated with prolonged hospital stay were male,abnormal BMI,mild-to-moderate anemia,stage of surgery(morning,afternoon,evening),and alcohol consumption history.The AUC of the development cohort was 0.778(95%CI:0.740 to 0.816),with a cutoff value of 0.337,and that of the validation cohort was 0.748(95%CI:0.687 to 0.809),with a cutoff value of 0.169,indicating that the prediction model had good differentiation.At the same time,the Hosmer-Lemeshow test showed that the model had a good calibration degree,and the DCA proved that it was effective in clinical application.Conclusion The prediction model established in this study has excellent comprehensive performance,which can better predict the risk of prolonged hospital stay,and can guide clinical intervention as soon as possible,so as to minimize the postoperative hospital stay and reduce the cost of hospitalization.

Objective To explore the risk factors for surgical site infection(SSI)after transforaminal lumbar interbody fusion(TLIF)for the treatment of lumbar degenerative diseases.Methods A total of 1 000 patients who underwent TLIF for lumbar degenerative diseases in our hospital were included and divided into the infection group(n=23)and the non-infection group(n=977)according to whether the surgical incision was infected.General data,surgical and laboratory indicators of patients were collected,and potential risk factors of SSI were screened by univariate analysis and multivariate regression analysis,a nomogram model was established,and its predictive efficiency was validated by the receive operating characteristic(ROC)curve.Results The incidence of SSI in patients after TLIF was 2.3％.The results of univariate analysis showed that age,operative time,intraoperative blood loss,preoperative C-reactive protein(CRP),smoking,and diabetes mellitus were the significant risk factors for the occurrence of SSI.Multivariate regression analysis showed that older age,longer operation time,more intraoperative blood loss,smoking and diabetes mellitus were the independent risk factors for postoperative SSI.ROC curve showed that the nomogram model established in this study has good predictive efficiency.Conclusion Older age,longer operation time,more intraoperative blood loss,smoking,and diabetes mellitus were independent risk factors for postoperative SSI.For patients with these high risk factors,corresponding intervention measures should be taken before operation to reduce the incidence of SSI.

Objective To investigate the efficacy and safety of camrelizumab monoclonal antibody combined with molecular-targeted therapy in elderly patients with unresectable or advanced hepatocellular carcinoma(HCC).Methods A retrospective analysis was performed for the patients with unresectable/advanced HCC who attended six hospitals from January 1,2019 to March 31,2021,and all patients received camrelizumab monoclonal antibody treatment,among whom 84.8%also received targeted therapy.According to the age of the patients,they were divided into elderly group(≥65 years)and non-elderly group(＜65 years).The two groups were assessed in terms of overall survival(OS),progression-free survival(PFS),objective response rate(ORR),disease control rate(DCR),and immune-related adverse events(irAE).The chi-square test or the Fisher's exact test was used for comparison of categorical data between groups;the independent samples t-test was used for comparison of normally distributed continuous data,and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups.The Kaplan-Meier method was used for survival analysis,and the log-rank test was used for comparison of survival curves.Univariate and multivariate Cox proportional hazards regression analyses were used to determine the independent influencing factors for PFS and DCR at 6 months.Results A total of 99 HCC patients were enrolled,with 27 in the elderly group and 72 in the non-elderly group.The elderly group had an OS rate of 67.8%,an ORR of 44.4%,and a DCR of 74.1%at 12 months and a median PFS of 6.4(95%confidence interval[CI]:3.0-12.4)months,with no significant differences compared with the non-elderly group(all P＞0.05).The median OS was unavailable for the elderly group,while the non-elderly group had an OS of 18.9(95%CI:13.0-24.8)months;there was no significant difference between the two groups(P=0.485).The univariate and multivariate Cox regression analyses showed that major vascular invasion(MVI)was an independent risk factor for PFS(hazard ratio[HR]=2.603,95%CI:1.136-5.964,P=0.024)and DCR(HR=3.963,95%CI:1.671-9.397,P=0.002)at 6 months,while age,sex,etiology of HBV infection,presence of extrahepatic metastasis,Child-Pugh class B,and alpha-fetoprotein＞400 ng/mL were not associated with PFS or DCR at 6 months.For the elderly group,the incidence rates of any irAE and grade 3/4 irAE were 51.9%and 25.9%,respectively,with no significant differences compared with the non-elderly group(P＞0.05),and skin disease was the most common irAE in both groups(39.4%).Conclusion Camrelizumab monoclonal antibody combined with molecular-targeted therapy has similar efficacy and safety in patients with unresectable/advanced HCC aged≥65 years and those aged＜65 years.MVI is associated with suboptimal response to immunotherapy and poor prognosis.

Viral myocarditis(VMC)is the leading cause of dilated cardiomyopathy,which can lead to heart failure and sudden cardiac death.With the development of high-throughput sequencing technology,non-coding RNA(ncRNA)plays an important role in the occurrence and development of VMC.ncRNA promotes the occurrence and development of VMC by regulating viral replication,immune cell function,myocardial cell death,myocardial interstitial fibrosis,and other pathological processes.This article reviews the research progress of ncRNA in VMC and provides new ideas for the pathogenesis,diagnosis,and treatment of VMC.

Aim To explore the effects of NaAsO

AIM To analyze saponins from Panacis Quinquefolii Radix of different regions(Jilin,Liaoning,Heilongjiang,Shandong)based on UHPLC-Q-Orbitrap/MS technology.METHODS Panacis Quinquefolii Radix had its saponins qualitatively analyzed by UHPLC-Q-Orbitrap/MS;and its differential saponins revealing different regions screened by the principal component analysis,orthogonal partial least squares discriminant analysis and differential component analysis.RESULTS A total of 62 saponins were identified;saponin variations due to the growth areas verified by the principal component analysis;and 28 differential saponins including 13 protopanaxadiol,6 protopanaxatriol,4 oleanolane,2 oxytetracycline,and 3 C-17 side chain variants further screened by orthogonal partial least-squares discriminant analysis model.The relative contents of protopanaxadiol-type and protopanaxatriol-type saponins in the four producing areas reduced following the order of Liaoning,Jilin,Heilongjiang,and Shandong.CONCLUSION This simple,accurate and efficient method provides a theoretical basis for the quality evaluation of Panacis Quinquefolii Radix.

Humans ; Otosclerosis/surgery* ; Stapes ; Stapes Surgery/adverse effects* ; Arteries

The purpose of this study was to explore the clinical efficacy and safety of Gynostemma pentaphyllum (G. pentaphyllum) in the treatment of hyperlipidemia, and to provide systematic evaluation basis for clinical application. CNKI, Wanfang Data, VIP, Web of science, PubMed, Embase and Cochrane Library were searched for randomized controlled trials (RCTs) about G. pentaphyllum in the treatment of hyperlipidemia. Review Manager 5.4 were used for statistical analysis. Through reading topics, abstracts, and full texts, 27 papers with 2311 cases involved that met the inclusion and exclusion criteria were finally included for the analysis. In terms of curative effect, the effect of G. pentaphyllum alone in increasing high density lipoprotein (HDL) index was better than that of conventional treatment, and the effect of reducing total cholesterol (TC), triglyceride (TG) and low density lipoprotein (LDL) was similar to that of conventional treatment. There was a synergistic effect between G. pentaphyllum and conventional drugs, and the combination of G. pentaphyllum and conventional drugs was superior to conventional treatment in reducing TG and increasing HDL. G. pentaphyllum can also decrease the levels of serum glutamic pyruvic transaminase and glutamic oxaloacetic transaminase in the treatment of hyperlipidemia, indicating a certain protective function of the liver. In terms of safety, there were fewer cases of adverse reactions in the G. pentaphyllum treatment group, and the adverse reaction events reported in the literature was mild. According to the results of meta-analysis, G. pentaphyllum was effective in the treatment of hyperlipidemia, and it has the potential to be combined with traditional drugs, has a certain liver protection function, and was superior to traditional drugs in the treatment of hyperlipidemia.

Objective: To analyze the clinical epidemiological characteristics including composition of pathogens , clinical characteristics, and disease prognosis acute bacterial meningitis (ABM) in Chinese children. Methods: A retrospective analysis was performed on the clinical and laboratory data of 1 610 children <15 years of age with ABM in 33 tertiary hospitals in China from January 2019 to December 2020. Patients were divided into different groups according to age,<28 days group, 28 days to <3 months group, 3 months to <1 year group, 1-<5 years of age group, 5-<15 years of age group; etiology confirmed group and clinically diagnosed group according to etiology diagnosis. Non-numeric variables were analyzed with the Chi-square test or Fisher's exact test, while non-normal distrituction numeric variables were compared with nonparametric test. Results: Among 1 610 children with ABM, 955 were male and 650 were female (5 cases were not provided with gender information), and the age of onset was 1.5 (0.5, 5.5) months. There were 588 cases age from <28 days, 462 cases age from 28 days to <3 months, 302 cases age from 3 months to <1 year of age group, 156 cases in the 1-<5 years of age and 101 cases in the 5-<15 years of age. The detection rates were 38.8% (95/245) and 31.5% (70/222) of Escherichia coli and 27.8% (68/245) and 35.1% (78/222) of Streptococcus agalactiae in infants younger than 28 days of age and 28 days to 3 months of age; the detection rates of Streptococcus pneumonia, Escherichia coli, and Streptococcus agalactiae were 34.3% (61/178), 14.0% (25/178) and 13.5% (24/178) in the 3 months of age to <1 year of age group; the dominant pathogens were Streptococcus pneumoniae and the detection rate were 67.9% (74/109) and 44.4% (16/36) in the 1-<5 years of age and 5-<15 years of age . There were 9.7% (19/195) strains of Escherichia coli producing ultra-broad-spectrum β-lactamases. The positive rates of cerebrospinal fluid (CSF) culture and blood culture were 32.2% (515/1 598) and 25.0% (400/1 598), while 38.2% (126/330)and 25.3% (21/83) in CSF metagenomics next generation sequencing and Streptococcus pneumoniae antigen detection. There were 4.3% (32/790) cases of which CSF white blood cell counts were normal in etiology confirmed group. Among 1 610 children with ABM, main intracranial imaging complications were subdural effusion and (or) empyema in 349 cases (21.7%), hydrocephalus in 233 cases (14.5%), brain abscess in 178 cases (11.1%), and other cerebrovascular diseases, including encephalomalacia, cerebral infarction, and encephalatrophy, in 174 cases (10.8%). Among the 166 cases (10.3%) with unfavorable outcome, 32 cases (2.0%) died among whom 24 cases died before 1 year of age, and 37 cases (2.3%) had recurrence among whom 25 cases had recurrence within 3 weeks. The incidences of subdural effusion and (or) empyema, brain abscess and ependymitis in the etiology confirmed group were significantly higher than those in the clinically diagnosed group (26.2% (207/790) vs. 17.3% (142/820), 13.0% (103/790) vs. 9.1% (75/820), 4.6% (36/790) vs. 2.7% (22/820), χ²=18.71, 6.20, 4.07, all P<0.05), but there was no significant difference in the unfavorable outcomes, mortility, and recurrence between these 2 groups (all P>0.05). Conclusions: The onset age of ABM in children is usually within 1 year of age, especially <3 months. The common pathogens in infants <3 months of age are Escherichia coli and Streptococcus agalactiae, and the dominant pathogen in infant ≥3 months is Streptococcus pneumoniae. Subdural effusion and (or) empyema and hydrocephalus are common complications. ABM should not be excluded even if CSF white blood cell counts is within normal range. Standardized bacteriological examination should be paid more attention to increase the pathogenic detection rate. Non-culture CSF detection methods may facilitate the pathogenic diagnosis.
Adolescent ; Brain Abscess ; Child ; Child, Preschool ; Escherichia coli ; Female ; Humans ; Hydrocephalus ; Infant ; Infant, Newborn ; Male ; Meningitis, Bacterial/epidemiology* ; Retrospective Studies ; Streptococcus agalactiae ; Streptococcus pneumoniae ; Subdural Effusion ; beta-Lactamases