Background::Pulmonary embolism (PE) is a severe and acute cardiovascular syndrome with high mortality among patients with autoimmune inflammatory rheumatic diseases (AIIRDs). Accurate prediction and timely intervention play a pivotal role in enhancing survival rates. However, there is a notable scarcity of practical early prediction and risk assessment systems of PE in patients with AIIRD.Methods::In the training cohort, 60 AIIRD with PE cases and 180 age-, gender-, and disease-matched AIIRD non-PE cases were identified from 7254 AIIRD cases in Tongji Hospital from 2014 to 2022. Univariable logistic regression (LR) and least absolute shrinkage and selection operator (LASSO) were used to select the clinical features for further training with machine learning (ML) methods, including random forest (RF), support vector machines (SVM), neural network (NN), logistic regression (LR), gradient boosted decision tree (GBDT), classification and regression trees (CART), and C5.0 models. The performances of these models were subsequently validated using a multicenter validation cohort.Results::In the training cohort, 24 and 13 clinical features were selected by univariable LR and LASSO strategies, respectively. The five ML models (RF, SVM, NN, LR, and GBDT) showed promising performances, with an area under the receiver operating characteristic (ROC) curve (AUC) of 0.962-1.000 in the training cohort and 0.969-0.999 in the validation cohort. CART and C5.0 models achieved AUCs of 0.850 and 0.932, respectively, in the training cohort. Using D-dimer as a pre-screening index, the refined C5.0 model achieved an AUC exceeding 0.948 in the training cohort and an AUC above 0.925 in the validation cohort. These results markedly outperformed the use of D-dimer levels alone.Conclusion::ML-based models are proven to be precise for predicting the onset of PE in patients with AIIRD exhibiting clinical suspicion of PE.Trial Registration::Chictr.org.cn: ChiCTR2200059599.

Objective To compare the therapeutic effect of lauromacrogol combined with different concentrations of pingyangmycin in the treatment of low-flow venous malformations of limbs.Methods A total of 83 child patients with low-flow venous malformations of limb,who were admitted to the Xi'an Thoracic Surgery/Tumor(Hemangioma)Intervention Center of China between 1 January 2021 and 1 June 2022,were enrolled in this study.The child patients were randomly divided into group A(n=42)and group B(n=41).Under imaging guidance,lauromacrogol mixed together with pingyangmycin(2 mg/mL in group A,and 1 mg/mL in group B)was slowly injected into the cavity of venous malformations until the drug mixture filled the tumor cavity.The curative effect,number of treatments within 6 months,and the incidence of adverse reactions were compared between the two groups.Results Successful interventional sclerotherapy was accomplished in all the 83 child patients of both groups.During the follow-up period of 6 months,the effective rate in group A and group B was 92.9％(39/42)and 87.8％(36/41)respectively.A total of 88 interventional procedures were performed in group A and 137 interventional procedures in group B,the difference between the two groups was statistically significant(x2=3.282,P=0.047).Adverse reactions occurred in 10 child patients of group A and in 8 child patients of group B,the difference between the two groups was not statistically significant(P=0.709).Conclusion In treating low-flow venous malformations of limbs,the use of higher concentration pingyangmycin and lauromacrogol mixture has quite the same curative effect and incidence of adverse effects as the use of lower concentration pingyangmycin and lauromacrogol mixture,although the use of higher concentration pingyangmycin and lauromacrogol mixture can reduce the number of treatments in child patients.(J Intervent Radiol,2024,33:483-487)

To study the chemical constituents of petroleum ether extract from the stems and leaves of Humulus scandens (family of Moraceae), fifteen compounds were isolated from the stems and leaves of H.scandens by silica gel, Sephadex LH-20, ODS, and preparative HPLC chromatography.The structures were identified by physicochemical data and spectroscopic method as tectochrysin (1), chrysin (2), 5-hydroxy-3, 4'', 6, 7-tetramethoxyflavone (3), (2S)-5-hydroxy-7, 8-dimethoxyflavanone (4), imperatorin (5), phellopterin (6), ethyl 4-hydroxy-3-(3''-methyl-2''-butenyl)benzoate (7), p-hydroxy-phenylpropionic acid (8), ethyl p-hydroxycinnamate (9), p-hydroxybenzaldehyde (10), anofinic acid (11), 5,6-dehydrokavain (12), physcion (13), olean-12-ene-3,?11-dione (14) and ergosta-4, 6, 8 (14), 22-tetraen-3-one (15), respectively.All compounds were isolated from this plant for the first time.

Primary aldosteronism (PA) is a kind of disease caused by excessive aldosterone secretion from the adrenal cortex, the reason of which include bilateral adrenal hyperplasia, aldosteronoma, unilateral adrenal hyperplasia, etc. Surgical treatment is the first choice for unilateral adrenal lesions. In this article, we report a patient who underwent left adrenal surgery but did not achieve the expected results. This case suggests that clinicians need to further improve the level of diagnosis and treatment of primary aldosteronism, especially the surgical methods.

Objective:To explore the accuracy of mpMRI combined with Partin table, MSKCC nomogram and CAPRA score in predicting extracapsular extension and seminal vesicle invasion of prostate cancer.Methods:From January 2016 to June 2021, a total of 178 patients who underwent laparoscopic radical prostatectomy were selected. The average age of patients was (68.3±3.5) years, the average preoperative PSA level was (24.5±7.1)ng/ml, and the average percentage of positive cores in biopsy was 44.3%. The clinical T 1c stage was determined in 67 cases (37.6%), T 2a in 69 cases (38.8%) and T 2b-2c in 42 cases(23.6%). Biopsy Gleason score of 3+ 3=6 was found in 45 cases(25.3%), 3+ 4=7 in 41 cases(23.0%), 4+ 3=7 in 26 cases(14.6%), 8 with different combinations in 36 cases(20.2%), and 9 or 10 in 30 cases(16.9%). According to preoperative PSA level, biopsy Gleason score, clinical stage, age, total biopsy cores and positive cores, the posibility of extracapsular extension and seminal vesicle invasion were predicted using 2012-version Partin table and MSKCC nomogram. CAPRA score of each patient was calculated. The prediction schemes were built as follows: ①mpMRI alone, ②mpMRI combined with Partin scale, ③mpMRI combined with MSKCC nomogram, ④mpMRI combined with CAPRA score. The results of each prediction scheme were compared with postoperative pathological reports. Logistic regression analysis was used to evaluate the relationship between predictive results and postoperative pathological outcomes. The receiver operating characteristic curve of each prediction scheme was drawn. The area under curve was used to compare the predictive accuracy of each combination scheme for the pathological results of prostate cancer. The decision analysis curve of each prediction scheme was drawn. The clinical benefits of each scheme were analyzed by comparing the net return under different risk thresholds. Results:mpMRI predicted extracapsular extension in 21 cases(11.8%) and seminal vesicle invasion in 16 cases(9.0%). The postoperative pathological results reported extracapsular extension in 27 cases(15.2%) and seminal vesicle invasion in 39 cases(21.9%). Logistic regression analysis showed that mpMRI and clinical scales were predictors related to the pathological results of prostate cancer( P<0.05). The receiver operating characteristic curve of each scheme showed that the area under curve for predicting extracapsular extension by using mpMRI, mpMRI combined with Partin table, mpMRI combined with MSKCC nomogram and mpMRI combined with CAPRA score were 0.599, 0.652, 0.763 and 0.780, respectively, and the area under curve for predicting seminal vesicle invasion were 0.607, 0.817, 0.826 and 0.820, respectively. Compared with simple application of mpMRI, except that the scheme of mpMRI combined with Partin table had no obvious advantage in predicting extracapsular extension( P=0.117), any other combined scheme had higher prediction accuracy( P<0.01). mpMRI combined with MSKCC nomogram or CAPRA score was better than mpMRI combined with Partin table in predicting extracapsular invasion ( P<0.01). There was no significant difference in predicting seminal vesicle invasion among these three combination schemes ( P>0.05). The net income of the combined prediction scheme was higher than that of using mpMRI alone under any risk threshold. The scheme of using mpMRI combined with MSKCC nomogram had the highest net income. Conclusions:mpMRI combined with clinical scales has good accuracy in predicting pathological characteristics of prostate cancer in Chinese population. Compared with other schemes in this study, the combination scheme of mpMRI combined with MSKCC nomogram has the highest prediction accuracy.

Eleven alkaloids were isolated from the twigs and leaves of Ervatamia pandacaqui using chromatographic methods of silica gel, Sephadex LH-20, ODS, and HPLC.Their structures were elucidated by physical,chemical and spectroscopic methods and determined as voacristine 7-hydroxyindolenine (1),iboxygaine (2), 19S-hydroxyibogamine (3), 3-oxotabersonine (4), perivine (5), pericyclivine (6), rhazinalinol (7), geissoschizol (8), 3, 14-dihydroolivacine (9), vallesamine (10), and conolobine A (11), respectively.All compounds were isolated from this plant for the first time.

Objective? To explore the reliability and validity of critical-care pain observation tool (CPOT) in pain assessment in resting state among neurosurgery patients undergoing craniotomy. Methods? From May 2017 to May 2018, we selected 200 neurosurgery patients undergoing craniotomy at Beijing Tiantan Hospital with the method of prospective and observational study. The Chinese version of CPOT was used to pain assessment in resting state of patients and its scores were recorded. At the same time, the Changhai Pain Rating Scale was used to pain assessment by themselves as a gold standard. We drew the receiver operating characteristic (ROC), calculated the area under curve and confirmed the score of CPOT to determine the sensitivity and specificity of pain. The intraclass correlation coefficient (ICC) was used to evaluate the reliability among CPOT reviewers. Results? A total of 200 patients undergoing craniotomy back to intensive care unit (ICU) were included including 100 patients without and 100 patients with trachea cannula. The Chinese version of CPOT had good reliability in patients between two groups with 0.857 (95%CI: 0.787-0.904) for the ICC of patients without trachea cannula and with 0.851 (95%CI: 0.778-0.899) for the ICC of patients with trachea cannula. Among patients without trachea cannula, when the cut-off value of CPOT was equal or greater than 2, CPOT showed the highest Youden index in assessing pain with 58% for the sensitivity and 86% for the specificity. Among patients with trachea cannula, the cut-off value of CPOT being equal or greater than 3 showed the highest Youden index in assessing pain with 74% for the sensitivity and 91% for the specificity. There was no statistical difference in the area under curve of pain assessed by CPOT between patients with and without trachea cannula (0.866 vs. 0.777, P＞0.05). Conclusions? CPOT has the good reliability and validity in pain assessment in resting state among neurosurgery patients undergoing craniotomy.

Seven compounds in the 95% ethanol extract of Galla Chinensis were isolated by silica gel, ODS, Toyopearl HW-40(s)and RP-HPLC. Their structures were identified on the basis of spectral data and physicochemical properties as benzoic acid, 3, 4-dihydroxy-5-［(3, 4, 5-trihydroxybenzoyl)oxy］-, 5-ethoxycarbonyl-2, 3-dihydroxyphenyl ester(1), trigallic acid(2), 1, 2, 3, 4, 6-penta-O-galloyl-β-D-glucose(3), shikimic acid(4), gallic acid(5), methyl gallate(6)and ethyl gallate(7). Among them, compound 1 was a novel compound, and compound 2 was firstly isolated from the Galla Chinensis. The inhibition tests of the constituents showed that compound 3 exhibited in vitro antiviral activity against HSV-1 and RSV A strain, RSV Long strain with IC50 values of 13. 3, 3. 3, 3. 3 mmol/L, respectively.

This study was performed to investigate the chemical constituents in the twigs and leaves of Harrisonia perforate. Six compounds were isolated from the 95% EtOH extract of the twigs and leaves of Harrisonia perforate by silica gel, ODS, Sephadex LH-20 column chromatographies and preparative HPLC. On the basis of chemical properties and spectra data, these compounds were identified as harriperfin E (1), kihadanin A (2), kihadanin B (3), 6α-acetoxyobacunol acetate (4), gardaubryone C (5), and β-sitosterol methyl ether (6), respectively. Compound 1 is a new chromone, and compounds 2-6 are isolated from this plant for the first time.

Aim To investigate the effects of Guaveno-ic acid (GA)on proliferation,insulin synthesis and secretion in INS-1 cells and their possible mechanism. Methods INS-1 βcells were cultured in vitro.Control group,medium group,model group,drug groups and positive group were set.INS-1 cells were treated with GA (0.3,1 ,3,1 0,30 nmol·L -1 )for 48 h.The cell proliferation was tested by MTT assay.Acid-alco-hol was used to extract the insulin in the cells and the amount of insulin synthesis of INS-1 cells was tested by RIA.5.6,1 6.7 mmol·L -1 glucose was used to chal-lenge INS-1 cells for 1 h to the insulin secretion model (BIS and GSIS)was tested,and the insulin secretion of INS-1 cells was tested via RIA.The mRNA expres-sion of insulin gene,PDX-1 and MafA was tested by q-PCR.Results Compared with medium group,GA could promote the proliferation of INS-1 cells signifi-cantly (P <0.01 )and promote the synthesis of insulin in INS-1 cells significantly (P <0.01 ).GA(0.3 ~30 nmol· L -1 )could promote the BIS,GSIS of INS-1 cells significantly (P <0.05 or P <0.01 ).GA (3,30 nmol·L -1 )could up-regulate the mRNA expression of insulin gene,PDX-1 ,MafA in INS-1 cells signifi-cantly (P <0.01 ).Conclusions GA could signifi-cantly improve the proliferation of INS-1 cells and pro-mote the insulin synthesis and secretion of INS-1 cells, which may be associated with up-regulation of insulin gene,PDX-1 ,MafA mRNA expression.