Acute-on-chronic liver failure(ACLF)is a complex clinical syndrome of acute liver function deterioration on the basis of chronic liver diseases,characterized by hepatic and/or extra-hepatic organ failure and a high short-term mortality rate.At present,there is still a lack of effective treatment methods,and the mortality rate of ACLF reaches 50%-90%after comprehensive medical treatment.A simple,rapid,and accurate prognostic prediction model for ACLF can help clinicians accurately judge the prognosis of ACLF patients in the early stage,identify the patients with poor prognosis,and provide early interventions,which can improve patient prognosis to some extent and help to reduce mortality rates.With the continuous development of computer science and increasingly powerful data processing capabilities,artificial intelligence is gaining more attention and has been applied in various aspects of liver diseases including diagnosis,treatment,and prognostic prediction.With reference to the current status of research in China and globally,this article reviews the common prognostic models for ACLF and machine learning-based prognostic prediction models and summarizes the latest research advances,in order to provide new perspectives for the future development of prognostic prediction models for ACLF.

Effective budget management is crucial for the internal control of procurements in public hospitals.This paper investigates challenges such as unscientific budget preparation,insufficient market analysis,and inadequate procurement internal control in a tertiary hospital in Shenzhen.In addition,based on a budget inquiry mechanism,the study explores strategies to en-hance internal control management within procurements in public hospitals,focusing on the pilot implementation of budget price review mechanisms in the hospital.The paper proposes such rules as"whoever applies is responsible and conducts research,"departmental checks and balances,continuous feedback,and pre-budget inquiry.These measures are used to improve procure-ment cost control,enhance hospital operational efficiency,and increase economic benefits.

Objective:To analyze the current situation of pregnant women′s health promotion behavior in early pregnancy, and to explore the multiple mediating effects of self-efficacy and sense of coherence in family function and health promotion behavior.Methods:The convenience sampling method selected 208 early pregnant women who visited the obstetric clinic of the Affiliated Hospital of Qingdao University from August to December 2020 as the research object was used. The electronic questionnaires including self-made general information questionnaire, Family APGAR Questionnaire, General Self-Efficacy Scale (GSES), Sense of Coherence Scale (SOC-13), and the Health-Promoting Lifestyle ProfileⅡ (HPLP-Ⅱ) were provided to women.Results:The total score of health promotion behaviors for early pregnancy was (139.58 ± 17.27) points with a good level. The influencing factors such as exercise habits and medical payment methods had statistical significance in the effects of health-promoting behaviors in the first trimester of pregnancy ( t=4.68, -3.55, both P<0.05). Structural equation model revealed that the total effect value of family function on health-promoting behaviors was 2.654, the direct effect value was 1.729 and the indirect effect value was 0.925. Meanwhile, the mediating effects of self-efficacy, the sense of coherence and self-efficacy upon the sense of coherence accounted for 15.9%, 15.2% and 3.8% of the indirect effect respectively. Conclusions:Family function of pregnant women in early pregnancy can not only affect health promotion behavior through self-efficacy and sense of coherence, but also indirectly affect sense of coherence through self-efficacy, so as to affect health promotion behavior. Maternal related health workers can construct targeted intervention measures from the perspective of self-efficacy and sense of coherence to maintain and improve the health promotion behavior of pregnant women in the early stage of pregnancy.

Blast injury of the chest injury is the most common wound in modern war trauma and terrorist attacks, and is also the most fatal type of whole body explosion injury. Most patients with severe blast injury of the chest die in the early stage before hospitalization or during transportation, so first aid is critically important. At present, there exist widespread problems such as non-standard treatment and large difference in curative effect, while there lacks clinical treatment standards for blast injury of the chest. According to the principles of scientificity, practicality and advancement, the Trauma Society of Chinese Medical Association has formulated the guidance of classification, pre-hospital first aid, in-hospital treatment and major injury management strategies for blast injury of the chest, aiming to provide reference for clinical diagnosis and treatment.

Objective:To evaluate the value of MAGiC STIR sequence inassessing bone marrow edema (BME) of the sacroiliac joint (SIJ) in ankylosing spondylitis (AS) patients.Methods:Twenty two AS patients from the Affiliated Fifth Hospital of Sun Yat-sen University from September 2019 to January 2020 underwent MR scanning, consisting of T 2WI fat-suppressed (FS) sequence and MAGiC sequence. Each SIJ was divided into four quadrants for analysis on oblique coronal MR image. Two radiologists [middle-higher seniority levels (radiologist 1 and radiologist 2) reviewed image sets of two sequences [T 2WI FS and MAGiC short T 1 inversion recovery (STIR) sequence] independently at separate times, using Hermann-Braun scoring system for degree of BME and summing numbers of quadrants based on BME findings. Disagreements were resolved to reach an agreement for final results.Assessments were repeated two weeks later by radiologist 2. Intra-class correlation coefficients (ICC) were calculated to assess the inter-and intra-observer agreement for the degree of BME and numbers of positive BME quadrants in the MAGiC STIR sequence, respectively. The differences between the two sequences for the degree of BME and numbers of positive BME quadrants were analyzed with Wilcoxon signed-rank test and Chi-square test, respectively. Taking the results of T 2WI FS sequence as a reference standard, the ROC curve was drawn, sensitivity, specificity, positive predictive value and negative predictive value in the detection of BME were calculated for the MAGiC STIR sequence. Results:Nineteen AS patients including 38 sacroiliac joints were enrolled in our study, being divided into 152 quadrants. Inter-and intra-observer agreement for the degree of BME and inter-observer agreement for numbers of positive BME quadrants in the MAGiC STIR sequence were all good (ICC=0.936, 95%CI 0.912-0.953, P<0.001; ICC=0.910, 95%CI 0.878-0.934, P<0.001; ICC=0.876, 95%CI 0.833-0.909, P<0.001). The difference between the two sequences for the degree of BME in quadrants was statistically significant ( Z=-3.132, P=0.002). But there was no statistically significant difference between sequences for numbers of quadrants in detecting BME (χ2=0.244, P=0.622). Area under the ROC curve of MAGiC STIR sequence in diagnosis of BME was 0.920 ( P<0.001). Sensitivity, specificity, positive predictive value and negative predictive value for the MAGiC STIR sequence in the detection of BME were 82.0%, 95.1%, 89.1% and 91.5%, respectively. Conclusion:MAGiC STIR sequence can be used to evaluate bone marrow edema of SIJ in AS patients with high sensitivity and specificity.

OBJECTIVE: To develop and validate radiomics models based on non-enhanced magnetic resonance (MR) imaging for differentiating chondrosarcoma from enchondroma. METHODS: We retrospectively evaluated a total of 68 patients (including 27 with chondrosarcoma and 41 with enchondroma), who were randomly divided into training group (=46) and validation group (=22). Radiomics features were extracted from TWI and TWI-FS sequences of the whole tumor by two radiologists independently and selected by Low Variance, Univariate feature selection, and least absolute shrinkage and selection operator (LASSO). Radiomics models were constructed by multivariate logistic regression analysis based on the features from TWI and TWI-FS sequences. The receiver-operating characteristics (ROC) curve and intraclass correlation coefficient (ICC) analyses of the radiomics models and conventional MR imaging were performed to determine their diagnostic accuracy. RESULTS: The ICC value for interreader agreement of the radiomics features ranged from 0.779 to 0.923, which indicated good agreement. Ten and 11 features were selected from the TWI and TWI-FS sequences to construct radiomics models, respectively. The areas under the curve (AUCs) of TWI and TWI-FS models were 0.990 and 0.925 in training group and 0.915 and 0.855 in the validation group, respectively, showing no significant differences between the two sequence-based models (>0.05). In all the cases, the AUCs of the two radiomics models based on TWI and TWI-FS sequences and conventional MR imaging were 0.955, 0.901 and 0.569, respectively, demonstrating a significantly higher diagnostic accuracy of the two sequence-based radiomics models than conventional MR imaging (<0.01). CONCLUSIONS The radiomics models based on TWI and TWI-FS non-enhanced MR imaging can be used for the differentiation of chondrosarcoma from enchondroma.
Chondroma ; Chondrosarcoma ; Humans ; Magnetic Resonance Imaging ; ROC Curve ; Retrospective Studies

Objective Early evaluate the feasibility and reproducibility of sorafenib-targeted therapy for hepatocellular carcinoma by RECIST1.1, mRECIST and three-dimensional volume measurement. Methods Seventy patients with pathology or typical imaging findings confirmed as hepatocellular carcinoma along with the sorafenib-targeted treatment for more than 2 months between October 2004 to April 2017 in the Fifth Affiliated Hospital of Sun Yat-sen University were retrospectively analyzed. Patients underwent chest, abdominal and pelvic CT scans and enhanced scans before and after 2 weeks of sorafenib treatment. Two physicians used RECIST 1.1, mRECIST, and volume measurement criteria to evaluate the efficacy of treatment. According to their averaged results, the patients were divided into two groups (control group and non-control group). Kaplan-Meier survival analysis was used to compare the prognostic values between different response evaluation criterias for early predicting the efficacy of sorafenib-targeted therapy in advanced hepatocellular carcinoma. Kappa test was used to assess the efficacy response consistency in intra-group and inter-group. Results Based on mRECIST and RECIST 1.1 measurements, the control group included 34 cases, and the non-control group included 36 cases. Based on semi-automatic volume measurement, the control group included 38 cases, and the non-control group included 32 cases. Before the treatment with sorafenib, the RECIST 1.1 and mRECIST methods were used. There was a high degree of consistency between the two doctors (Kappa values were 0.79 and 0.71, respectively), and the semi-automatic volume measurement method was extremely consistent (Kappa value was 0.90); the consistency in intra-observer by three different methods was extremely high (Kappa values were 0.91, 0.85, 0.97, respectively). After the treatment with sorafenib, the consistency between the two radiologists using RECIST 1.1 measurement was high (Kappa value was 0.65), the consistency of mRECIST measurement was moderate (Kappa value was 0.52), and the consistency of tumor volume measurement was extremely high (Kappa The value was 0.83), the consistency in intra-observer using the above three methods was high or very high (Kappa values were 0.86, 0.74, 0.90, respectively). The RECIST 1.1 and mRECIST measurements were less sensitive in early evaluation of sorafenib-targeted treatment, and there was no significant difference between the control group and the non-control group (P=0.578 and 0.613) while the semi-automatic volumetric measurement was sensitive (P=0.004). Conclusion Semi-automated three-dimensional volume measurement which has better intra-and inter-group consistency and reproducibility can reflect the efficacy of sorafenib-targeted therapy for hepatocellular carcinoma in early stage.

OBJECTIVE:To investigate the application of fuzzy comprehensive evaluation in formulation screening. METH-ODS:Taking Compound paracetamol and chlorphenamine maleate granules as model drug,based on single factor experiment,L9(34) orthogonal test was used to screen the formulation with the amount of aspartame,hawthorn powder essence,milk powder essence and saccharose as factors,using dissolution rate of caffeine as index. The granules prepared by 9 kinds of formulation in orthogonal test were evaluated with fuzzy comprehensive evaluation in terms of taste,aroma,color and dissolubility. The optimized formula-tion was validated and compared with original formulation. RESULTS:The formulation 5 was the optimal choice in both orthogo-nal test and fuzzy comprehensive evaluation,and obtained same results. Compared with sensory comprehensive score (63.12) and dissolution rate of caffeine (91.3%) in original formulation,two indicators of optimized formulation in 3 tests were 84.00 and 99.07% in average (RSD<2.0%,n=3). CONCLUSIONS:Fuzzy comprehensive evaluation can be used for the formulation screening of sensory evaluation index. It is scientific and accurate.

Aim To evaluate the effects of notoginsen-oside R1 on store-operated calcium entry ( SOCE ) in pulmonary arterial smooth muscle cells ( PASMCs ) of chronic hypoxia ( CH)-and monocrotaline ( MCT)-in-duced pulmonary hypertension ( PH) rats. Methods Mn2+ quenching of Fura-2 and measurement of intra-cellular free calcium concentration ( [ Ca2+] i ) using fluo-3 were examined in PASMCs of CH-exposed and MCT-treated rats. Results ①CH-exposed and MCT-treated rats exhibited profound PH when examined 3 weeks after hypoxia exposure or MCT injection, respec-tively. ②In the presence of 3 μmol·L-1 nifedipine, 10 μmol · L-1 notoginsenoside R1 significantly re-duced cyclopiazonic acid ( CPA )-induced the percent reduction in Fura-2 fluorescence measured 500 sec af-ter application of Mn2+, the maximal rate of Mn2+quenching, the amplitude of the Ca2+ influx transient and the resting [ Ca2+] i in PASMCs of CH-exposed and MCT-treated rats. Conclusion Notoginsenoside R1 inhibits SOCE and reduces resting [ Ca2+] i in PASMCs of CH-and MCT-induced PH rats.

OBJECTIVETo study the association between reasons for smoking and results related to successful smoking cessation.

METHODSA community-based case-control study was conducted with 642 male adults recognized as successful spontaneous smoking quitters being the subject cases while another 700 male adults who had failed to quit smoking were served as the controls. Russell Reason for Smoking Questionnaire (RRSQ) was used to investigate the reasons for smoking. Dominance logistic regression was performed to determine the relative importance of reasons for starting smoking and the endpoint of successful quit smoking.

RESULTSAfter adjusting the potential confounders of age, age of smoking initiation, marital status, profession, and education, the adjusted means of sedative and stimulation of RRSQ in the successful quitters were significant lower than that in the failed quitters. Results from the dominance logistic regression showed that the first two important factors for smoking cessation were sedative and stimulation of RRSQ, followed by psychological image, automatic, hand-mouth activity, indulgence, and addiction.

CONCLUSIONThis study demonstrated that factors as dependence-addiction showed more important impacts than the social-psychological ones on the endpoint of successful smoking cessation.

Adult ; Behavior, Addictive ; Case-Control Studies ; Humans ; Male ; Smoking ; psychology ; Smoking Cessation ; statistics & numerical data ; Smoking Prevention ; Surveys and Questionnaires