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 analyze the change trends and risk factors of mesothelioma disease burden in Jiangsu Province from 1990 to 2019.Methods:In January 2022, using the 2019 Global Burden of Disease Study Data, the Joinpoint regression model was used to analyze the change trends of incidence, mortality, disable-adjusted life years (DALY) and premature mortality of mesothelioma residents in Jiangsu Province from 1990 to 2019, and the attribution level of mesothelioma risk factors was estimated by population attributing fraction.Results:The standardized incidence rates of mesothelioma in Jiangsu Province from 1990 to 2019 ranged from 0.07/10 5 to 0.09/10 5, with an average annual percentage change (AAPC) of -1.1% ( t=-13.56, P<0.001). AAPCs in males and females were -0.3% ( t=-2.18, P=0.029) and -1.6% ( t=-11.39, P<0.001), respectively. The standardized mortality rates of mesothelioma ranged from 0.07/10 5 to 0.09/10 5, the AAPC was -1.1% ( t=-12.23, P<0.001), AAPC was -1.6% ( t=-14.09, P<0.001) for females, and there was no significant change in males ( t=-1.83, P=0.068). The premature mortality was 0.004%-0.006%, the AAPC was -1.0% ( t=-4.40, P<0.001), AAPC was -1.7% ( t=-13.72, P<0.001) for females, and there was no significant change in males ( t=-0.68, P=0.495). The standardized DALY rates ranged from 1.86/10 5 to 2.32/10 5, the AAPC was -0.9% ( t=-11.08, P<0.001), AAPC was -1.6% ( t=-11.05, P<0.001) for females, and there was no significant change in males ( t=-0.95, P=0.343). Both the standardized years of life lost (YLL) rate and the standardized years lived with disability (YLD) rate showed a decreasing trend, and the AAPCs were -0.9% ( t=-7.66, P<0.001) and -1.0% ( t=-12.88, P<0.001), respectively. The proportion of YLL in DALY was more than 98.5%. Among the risk factors for mesothelioma burden attribution, the AAPC attributed to occupational asbestos exposure of DALY was 1.4% ( t=3.43, P=0.001). The AAPC of DALY rate of standardized attribution was -1.7% ( t=-12.11, P<0.001) . Conclusion:The overall burden of mesothelioma in Jiangsu Province is decreasing, occupational asbestos exposure is still the main risk factor of mesothelioma in Jiangsu Province, and early diagnosis and treatment should be strengthened.

Objective:To analyze the change trends and risk factors of mesothelioma disease burden in Jiangsu Province from 1990 to 2019.Methods:In January 2022, using the 2019 Global Burden of Disease Study Data, the Joinpoint regression model was used to analyze the change trends of incidence, mortality, disable-adjusted life years (DALY) and premature mortality of mesothelioma residents in Jiangsu Province from 1990 to 2019, and the attribution level of mesothelioma risk factors was estimated by population attributing fraction.Results:The standardized incidence rates of mesothelioma in Jiangsu Province from 1990 to 2019 ranged from 0.07/10 5 to 0.09/10 5, with an average annual percentage change (AAPC) of -1.1% ( t=-13.56, P<0.001). AAPCs in males and females were -0.3% ( t=-2.18, P=0.029) and -1.6% ( t=-11.39, P<0.001), respectively. The standardized mortality rates of mesothelioma ranged from 0.07/10 5 to 0.09/10 5, the AAPC was -1.1% ( t=-12.23, P<0.001), AAPC was -1.6% ( t=-14.09, P<0.001) for females, and there was no significant change in males ( t=-1.83, P=0.068). The premature mortality was 0.004%-0.006%, the AAPC was -1.0% ( t=-4.40, P<0.001), AAPC was -1.7% ( t=-13.72, P<0.001) for females, and there was no significant change in males ( t=-0.68, P=0.495). The standardized DALY rates ranged from 1.86/10 5 to 2.32/10 5, the AAPC was -0.9% ( t=-11.08, P<0.001), AAPC was -1.6% ( t=-11.05, P<0.001) for females, and there was no significant change in males ( t=-0.95, P=0.343). Both the standardized years of life lost (YLL) rate and the standardized years lived with disability (YLD) rate showed a decreasing trend, and the AAPCs were -0.9% ( t=-7.66, P<0.001) and -1.0% ( t=-12.88, P<0.001), respectively. The proportion of YLL in DALY was more than 98.5%. Among the risk factors for mesothelioma burden attribution, the AAPC attributed to occupational asbestos exposure of DALY was 1.4% ( t=3.43, P=0.001). The AAPC of DALY rate of standardized attribution was -1.7% ( t=-12.11, P<0.001) . Conclusion:The overall burden of mesothelioma in Jiangsu Province is decreasing, occupational asbestos exposure is still the main risk factor of mesothelioma in Jiangsu Province, and early diagnosis and treatment should be strengthened.

Objective To identify factors that affect the occurrence of tuberculosis (TB) in the elderly over 60 years old in Urumqi, and to provide a basis for the prevention and treatment of tuberculosis in the elderly. Methods A 1:2 matched case-control study was conducted using a self-designed questionnaire from April 2016 to April 2017 in Urumqi, China. A conditional logistic regression analysis was carried out to identify the influencing factors for the occurrence of TB in the elderly. Results A total of 575 valid questionnaires were collected in the present study, and the age range was 60-89 years old. There were 302 males, accounting for 52.5% of the total. Multivariate logistic regression model analysis showed that an increase of one person per 100 square meters in a home elevated the risk of the development of TB by 67% (odds ratio (OR) 1.67; 95% confidence interval (CI) 1.36-2.06; P<0.001). Family income level was also important, and the risk of TB development was 4.72 times higher in families with less than 5,000 CNY a month than those with monthly incomes over 10 000 CNY (OR 4.72; 95%CI 2.29-9.75; P<0.001). The risk was significantly higher among people going out more than 3 to 7 days a week compared to those going out 0 to 2 days a week (OR 4.53; 95%CI 2.72-7.53; P<0.001). Compared with people who were not in contact with TB patients, the risk increased among those who had TB contacts (OR 3.72; 95%CI 1.45-9.70; P=0.006). In addition, the risk of TB onset in hypertension patients was significantly decreased (OR 0.57; 95%CI 0.35-0.91; P=0.018). Conclusion In the present study five factors are found to be associated with the occurrence of TB among the elderly in Urumqi, China. The future TB control program should pay special attention to the elderly population with the above risk factors.

Objective To investigate the value of cytokines in bile combined with clinical indices in predicting the degree of liver injury after liver transplantation. MethodsA total of 16 patients undergoing liver transplantation who were hospitalized in Center of Organ Transplantation, The Affiliated Hospital of Qingdao University, from January to December 2018 were enrolled, and according to the level of alanine aminotransferase (ALT) on day 1 after surgery, the patients were divided into mild liver injury (ALT ＜500 U/L) group with 10 patients and severe liver injury (ALT ＞500 U/L) group with 6 patients. Bile samples were collected on days 1, 3, 5, and 7 after surgery, and MILLIPLEX assay was used to measure the levels of 17 cytokines. R software was used to perform principal component analysis (PCA) of bile cytokines and clinical indices and gene ontology (GO) enrichment analysis of bile cytokines. The two-independent-samples t-test was used for comparison of normally distributed continuous data between two groups; The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups. A Spearman correlation analysis was performed to evaluate the correlation between clinical indices and bile cytokines. ROC curve analysis was used to evaluate the predictive value of cytokines in bile and clinical indices for liver injury after liver transplantation. ResultsCompared with the mild liver injury group, the severe liver injury group had significantly higher expression levels of bile Fractalkine (Z=-2.828, P=0.003), soluble CD40 ligand (sCD40L) (Z=-2.850, P=0.008), interleukin-4 (Z=-2.398, P=0.017), CXCL10 (Z=-2.475, P=0.023), and macrophage inflammatory protein-1α (Z=-1844, P=0.043). The correlation analysis showed that on day 1 after liver transplantation, aspartate aminotransferase, ALT, and lactate dehydrogenase were positively correlated with the levels of several cytokines in bile (all P＜0.05). The area under the ROC curve of Fractalkine, sCD40L and AST were 0.933 (0.812-1.000), 0.833 (0.589-1.000) and 0.917 (0.779-1.000), respectively, suggesting that AST and Fractalkine and sCD40L in bile on the first day after liver transplantation have significant predictive value for liver injury. The results of PCA showed that bile cytokines combined with clinical indices on day 1 after liver transplantation could better distinguish the patients with mild liver injury from those with severe liver injury. GO analysis showed that bile cytokines were associated with positive feedback regulation of external stimulus, cell chemotaxis, receptor ligand activity, cytokine activity, and cytokine-cytokine receptor interaction. ConclusionFractalkine and sCD40L in bile can predict the degree of liver injury after liver transplantation.

Objective To investigate the role of protein O-linked mannose β1,2-N-acetylglucosaminyltransferase 1 (POMGnT1) in the pathogenic process of Alzheimer's disease (AD).Methods The expression of POMGnT1 gene was examined in AD model cells (N2a/amyloid-precursor protein (APP) 695swe,n=3) and N2a/wt cells (n=3) using real-time PCR and Western blotting.This expression was also examined in AD model mice (APP/PS1,n=3) and wild-type mice (n=3) using immunofluorescence staining.Amyloid β-protein (Aβ) were examined in POMGnT1-gene-knockout mice (n=3) and wild-type mice (n=3) using immunochemistRy.Results The expression of POMGnT1 gene decreased in mRNA and protein levels in N2a/APP695swe cells compared to N2a/wt cells (mRNA:0.80±0.02 vs 1.00,t=10.52,P＜0.01;protein:0.50±0.02 vs 1.31±0.04,t=18.64,P＜0.01).Immunofluorescence results showed the reduced expression of POMGnT1 protein in neurons of APP/PS1 mice.Immunochemistry results showed more Aβ deposits in POMGnT1-gene-knockout mice (2 months old:0.358±0.014 vs 0.048±0.001,t=22.58,P＜0.01;1 year old:0.266±0.004 vs 0.229±0.003,t=7.771,P=0.002).Conclusion These findings suggest POMGnT1 gene may play an important role in the pathogenic process of AD.

Objective To identify mutations in the NEMO gene in a family with incontinentia pigmenti.Methods Clinical data were collected from the proband,and peripheral blood samples were obtained from the proband,her parents and 200 healthy controls.Multiplex PCR was performed to detect heterozygous deletion of exons 4-10 of the NEMO gene in the blood samples of the proband and her parents.Then,PCR was performed to amplify exons 2,3-10 of the NEMO gene in all the blood samples,and all exons in the gene coding region and their flanking sequences were subjected to DNA sequencing.DNA was extracted from paraffin-embedded lesional tissue of the proband's father,and PCR was performed to amplify exon 10 of the NEMO gene and its flanking sequence followed by DNA sequencing.Results The deletion of exons 4-10 of the NEMO gene was undetected in the peripheral blood of the proband or her father.Sanger sequencing showed that there was a heterozygous mutation c.1236dupA in exon 10 of the NEMO gene in the peripheral blood of the proband,which led to a mutation in amino acid residues (p.H413fs*7).The c.1236dupA mutation was not found in the peripheral blood of the proband's parents,while a mosaic mutation c.1236dupA was detected in the DNA from lesional tissues of the proband's father.Conclusion The mutation c.1236dupA in the NEMO gene may be the underlying cause of incontinentia pigmenti in the proband and her father.

Objective To investigate the current status of job burnout among anesthetists in Ningxia and to analyze its related risk factors.Methods A total of 310 anesthetists from 30 public hospitals in Ningxia were conducted to collect data on the job burnout by Maslach Burnout InventoryHuman Services Survey (MBI-HSS).The factors associated with severe job burnout and its three domains (high emotional exhaustion,high depersonalization and low personal accomplishment) were included in the multinomial logistic regression analysis.Results The incidence of job burnout and its three domains (high emotional exhaustion,depersonalization and low personal accomplishment) were 18 (5.81％) cases,134 (43.22％) cases,35 (11.29％) cases and 128 (41.29％) cases,respectively.Multinomial logistic regression analysis results indicated that the risk degree associated with job burnout was master and higher degree (OR=4.695,95％CI 1.556-4.172).The risk facts associated with three components of job burnout were work time per week [40-60 h (OR=4.420,CI 2.504-7.802);≥60 h (OR =7.469,95％CI 1.758-31.733)] and tertiary hospital (OR =1.847,95％oCI 1.112-3.069);master and higher degree (OR=2.306,95％CI 1.032-5.155),working years [6-15 years (OR=0.358,95％CI 0.135-0.949)] and cases of anesthesia per year [≥390 cases (OR =3.352,95％CI 1.301-8.639)];secondary hospital (OR =1.717,95％CI 1.045-2.823).Conclusion This survey indicates that job burnout exists among anesthetists in Ningxia and is mainly displayed in emotional exhaustion and low personal accomplishment domains.Master and higher degree tend to occur serve job burnout.

Objective To report a case of X-linked ichthyosis complicated by Mal de Meleda,and to identify the gene mutations.Methods Clinical data were collected from the patient,and peripheral blood samples were obtained from the patient,his parents and 100 unrelated healthy people who served as controls.Genomic DNA was extracted from these blood samples,and PCR was performed to amplify all the exons and their flanking sequences of the SLURP-1 and STS genes.All the amplification products were analyzed by agarose gel electrophoresis,and amplification products of the SLURP-1 gene were analyzed by DNA sequencing.Results The patient presented with regularly-arranged polygonal brown or black scales all over the trunk and limbs,erythematous hyperkeratotic lesions on the palms and soles,elbows and knees,inguinal and perianal regions,which extended to the dorsa of the hands and feet.Then,the patient was diagnosed with X-linked ichthyosis complicated by Mal de Meleda.Genetic testing showed complete deletion of the STS gene,and a homozygous mutation (c.286C ＞ T) at position 286 in exon 3 of the SLURP-1 gene,which led to the formation of a premature termination codon at amino acid position 96 (p.R96*).His parents were heterozygous carriers of the mutation (c.286C ＞ T).No mutation was found in the unrelated healthy controls.Conclusion The complete deletion of the STS gene and the homozygous nonsense mutation in the SLURP-1 gene may be the reason for X-linked ichthyosis complicated by Mal de Meleda in the patient.

Objective:To evaluate the actual measurement accuracy of 2 three-dimensional(3D)facial scanners for real person. Methods:3D digital face models of 1 0 volunteers with normal ficial form were obtained by 3dMD and FaceScan facial scanners respec-tively.The measurement values of 1 0 feature lengths and 5 feature angles were measured on each 3D model by the software respective-ly.The reference values of all characteristics were acquired by line laser scanner (Faro)with high accuracy.Statistical and surveying analysis were taken between the measurement values and reference values.Facial morphology measurement error and actual accuracy of facial scanners were obtained finally.Data were statistically analysed.Results:The length measurement accuracy of 3dMD and FaceS-can was(-0.37 ±0.68)mm and (-0.29 ±0.53)mm(P =0.223),the angle measurement accuracy was (-0.22 ±2.1 4)°and (0.1 2 ±2.69)°(P =0.428),respectively.Conclusion:The 3D data of ficial morphology obtained by the 2 scanners are not signifi-cantly different.