BACKGROUND Necrotising enterocolitis(NEC)is a critical gastrointestinal emergency affecting premature and low-birth-weight neonates.Serum amyloid A(SAA),procalcitonin(PCT),and high-mobility group box 1(HMGB1)have emer...BACKGROUND Necrotising enterocolitis(NEC)is a critical gastrointestinal emergency affecting premature and low-birth-weight neonates.Serum amyloid A(SAA),procalcitonin(PCT),and high-mobility group box 1(HMGB1)have emerged as potential biomarkers for NEC due to their roles in inflammatory response,tissue damage,and immune regulation.AIM To evaluate the diagnostic value of SAA,PCT,and HMGB1 in the context of NEC in newborns.METHODS The study retrospectively analysed the clinical data of 48 newborns diagnosed with NEC and 50 healthy newborns admitted to the hospital.Clinical,radiological,and laboratory findings,including serum SAA,PCT,and HMGB1 Levels,were collected,and specific detection methods were used.The diagnostic value of the biomarkers was evaluated through statistical analysis,which was performed using chi-square test,t-test,correlation analysis,and receiver operating characteristic(ROC)analysis.RESULTS The study demonstrated significantly elevated levels of serum SAA,PCT,and HMGB1 Levels in newborns diagnosed with NEC compared with healthy controls.The correlation analysis indicated strong positive correlations among serum SAA,PCT,and HMGB1 Levels and the presence of NEC.ROC analysis revealed promising sensitivity and specificity for serum SAA,PCT,and HMGB1 Levels as potential diagnostic markers.The combined model of the three biomarkers demonstrating an extremely high area under the curve(0.908).CONCLUSION The diagnostic value of serum SAA,PCT,and HMGB1 Levels in NEC was highlighted.These biomarkers potentially improve the early detection,risk stratification,and clinical management of critical conditions.The findings suggest that these biomarkers may aid in timely intervention and the enhancement of outcomes for neonates affected by NEC.展开更多
BACKGROUND Human herpesvirus type 7(HHV-7)is a less common herpes virus that usually causes mild,self-limiting illnesses.However,in recent years,there have been increasing reports of HHV-7 causing serious central nerv...BACKGROUND Human herpesvirus type 7(HHV-7)is a less common herpes virus that usually causes mild,self-limiting illnesses.However,in recent years,there have been increasing reports of HHV-7 causing serious central nervous system infections,especially meningitis.The pathogenesis and clinical features of HHV-7 meningitis,particularly in adolescents with normal immune function,remain incompletely studied.Therefore,the purpose of this report is to share a case of HHV-7 meningitis in an immunocompetent adolescent with a view to deepening our understanding of the disease.CASE SUMMARY A 12-year-old female was admitted with fever,headache,and vomiting.4 d before admission,the patient developed a fever without obvious induction,with a temperature up to 39.5℃,no convulsions,accompanied by chills,headaches,fatigue,and no muscle aches.The patient was treated with fever reduction,which could be reduced to 38℃;repeated high fever,accompanied by vomiting 7-8 times;and no abdominal pain or diarrhea.The patient was diagnosed with"acute suppurative tonsillitis"in a local hospital,and the blood routine was generally normal.The patient was given symptomatic support treatment such as"ceftriaxone sodium"and antiemetic rehydration for 2 d,and his condition did not improve.The patient's physical examination showed pharyngeal congestion,bilateral tonsil grade I hypertrophy,regression of purulent secretions,and cervical resistance.Ocular B-ultrasound:Opacity of the vitreous body and edema of the optic disc in both eyes.Optical coherence tomography examination showed that the macular fovea was generally normal in both eyes,with edema of the optic disc.DNA virus monitoring results:HHV-7.We gave ganciclovir antiviral therapy,dexamethasone anti-inflammatory treatment,mannitol to reduce cranial pressure,omeprazole to protect gastrointestinal mucosa,and calcium and potassium supplementation.CONCLUSION This study reports a case of HHV-7 meningitis in an adolescent with normal immune function.Through comprehensive analysis of the clinical manifestations,laboratory tests,and treatment methods of the patient,it is found that early identification and antiviral treatment are essential for the outcome of the disease.This case suggests that despite normal immune function,adolescents may still suffer from herpes virus type 7 meningitis,so clinicians should be vigilant and take effective treatment measures in time.展开更多
As a highly evolutionary conserved long non-coding RNA,metastasis associated lung adenocarcinoma transcript 1(MALAT1)was first demonstrated to be related to lung tumor metastasis by promoting angiogenesis.To investiga...As a highly evolutionary conserved long non-coding RNA,metastasis associated lung adenocarcinoma transcript 1(MALAT1)was first demonstrated to be related to lung tumor metastasis by promoting angiogenesis.To investigate the role of MALAT1 in traumatic brain injury,we established mouse models of controlled cortical impact and cell models of oxygen-glucose deprivation to mimic traumatic brain injury in vitro and in vivo.The results revealed that MALAT1 silencing in vitro inhibited endothelial cell viability and tube formation but increased migration.In MALAT1-deficient mice,endothelial cell proliferation in the injured cortex,functional vessel density and cerebral blood flow were reduced.Bioinformatic analyses and RNA pull-down assays validated enhancer of zeste homolog 2(EZH2)as a downstream factor of MALAT1 in endothelial cells.Jagged-1,the Notch homolog 1(NOTCH1)agonist,reversed the MALAT1 deficiency-mediated impairment of angiogenesis.Taken together,our results suggest that MALAT1 controls the key processes of angiogenesis following traumatic brain injury in an EZH2/NOTCH1-dependent manner.展开更多
AIM To determine the influence of Smoc2 on hepatocellular carcinoma(HCC) cell proliferation and to find a possible new therapeutic target for preventing HCC progression.METHODS We detected expression of Smoc2 in HCC t...AIM To determine the influence of Smoc2 on hepatocellular carcinoma(HCC) cell proliferation and to find a possible new therapeutic target for preventing HCC progression.METHODS We detected expression of Smoc2 in HCC tissues and corresponding non-tumor liver(CNL) tissues using PCR, western blot, and immunohistochemistry methods. Subsequently, we down-regulated and upregulated Smoc2 expression using siR NA and lentivirus transfection assay, respectively. Then, we identified the effect of Smoc2 on cell proliferation and cell cycle using CCK-8 and flow cytometry, respectively. The common cell growth signaling influenced by Smoc2 was detected by western blot assay. RESULTS The expression of Smoc2 was significantly higher in HCC tissues compared with CNL tissues. Overexpression of Smoc2 promoted HCC cell proliferation and cell cycle progression. Down-regulation of Smoc2 led to inhibition of cell proliferation and cell cycle progression. Smoc2 had positive effect on ERK and AKT signaling.CONCLUSION Smoc2 promotes the proliferation of HCC cells through accelerating cell cycle progression and might act as an anti-cancer therapeutic target in the future.展开更多
This study aimed to investigate the effect of fullerenol combined with cisplatin on the proliferation of cervical cancer HeLa cells in order to provide new ideas and laboratory theoretical basis for the clinical treat...This study aimed to investigate the effect of fullerenol combined with cisplatin on the proliferation of cervical cancer HeLa cells in order to provide new ideas and laboratory theoretical basis for the clinical treatment of cervical cancer. Cervical cancer cell line HeLa cells in vitro were treated with different concentrations of fullerenol, different concentrations of cisplatin, and different concentrations of fullerenol combined with cisplatin, after 24 h, 48 h, 72 h, microscope changes in cell morphology;MTT assay was used to determine the effect of drugs on the proliferation of HeLa cells. Fullerenol and cisplatin alone can inhibit the proliferation of HeLa cells in a dose-dependent and time-dependent manner;compared with cisplatin alone, different concentrations of fullerenol combined with cisplatin significantly increased the apoptosis rate of HeLa cells (P < 0.05). The inhibition of fullerenol combined with cisplatin on HeLa cells in vitro is more significant, resulting in a stronger anti-cancer effect.展开更多
Background:Myopic maculopathy(MM)has become a major cause of visual impairment and blindness worldwide,especially in East Asian countries.Deep learning approaches such as deep convolutional neural networks(DCNN)have b...Background:Myopic maculopathy(MM)has become a major cause of visual impairment and blindness worldwide,especially in East Asian countries.Deep learning approaches such as deep convolutional neural networks(DCNN)have been successfully applied to identify some common retinal diseases and show great potential for the intelligent analysis of MM.This study aimed to build a reliable approach for automated detection of MM from retinal fundus images using DCNN models.Methods:A dual-stream DCNN(DCNN-DS)model that perceives features from both original images and corresponding processed images by color histogram distribution optimization method was designed for classification of no MM,tessellated fundus(TF),and pathologic myopia(PM).A total of 36,515 gradable images from four hospitals were used for DCNN model development,and 14,986 gradable images from the other two hospitals for external testing.We also compared the performance of the DCNN-DS model and four ophthalmologists on 3000 randomly sampledfundus images.Results:The DCNN-DS model achieved sensitivities of 93.3%and 91.0%,specificities of 99.6%and 98.7%,areas under the receiver operating characteristic curves(AUCs)of 0.998 and 0.994 for detecting PM,whereas sensitivities of 98.8%and 92.8%,specificities of 95.6%and 94.1%,AUCs of 0.986 and 0.970 for detecting TF in two external testing datasets.In the sampled testing dataset,the sensitivities of four ophthalmologists ranged from 88.3%to 95.8%and 81.1%to 89.1%,and the specificities ranged from 95.9%to 99.2%and 77.8%to 97.3%for detecting PM and TF,respectively.Meanwhile,the DCNN-DS model achieved sensitivities of 90.8%and 97.9%and specificities of 99.1%and 94.0%for detecting PMand T,respectively.Conclusions:The proposed DCNN-DS approach demonstrated reliable performance with high sensitivity,specificity,and AUC to classify different MM levels on fundus photographs sourced from clinics.It can help identify MM automatically among the large myopic groups and show great potential for real-life applications.展开更多
Objective To examine the independent risk factors of type-2 myocardial infarction(T2MI)elicited by acute upper gastrointestinal bleeding(AUGIB),and to establish a nomogram model for the prediction of AUGIB-induced T2M...Objective To examine the independent risk factors of type-2 myocardial infarction(T2MI)elicited by acute upper gastrointestinal bleeding(AUGIB),and to establish a nomogram model for the prediction of AUGIB-induced T2MI.Methods A nomogram model was established on the basis of a retrospective study that involved 533 patients who suffered from AUGIB in the Department of Critical Care Medicine(CCM)or Emergency Intensive Care Unit(EICU)of Renmin Hospital of Wuhan University,Wuhan,China,from January 2017 to December 2020.The predictive accuracy and discriminative power of the nomogram were initially evaluated by internal validation,which involved drawing the receiver operating characteristic(ROC)curve,calculating the area under the curve(AUC),plotting the calibration curve derived from 1000 resampled bootstrap data sets,and computing the root mean square error(RMSE).The predictive ability of the nomogram was further validated through the prospective and multicenter study conducted by the investigators,which enrolled 240 AUGIB patients[including 88 cases from Renmin Hospital of Wuhan University,73 cases from Qilu Hospital of Shandong University(Qingdao),and 79 cases from Northern Jiangsu People’s Hospital)],who were admitted to the Department of CCM or EICU,from February 2021 to July 2021.Results Among the 533 patients in the training cohort,78(14.6%)patients were assigned to the T2MI group and 455(85.4%)patients were assigned to the non-T2MI group.The multivariate analysis revealed that age>65,hemorrhagic shock,cerebral stroke,heart failure,chronic kidney disease,increased blood urea nitrogen,decreased hematocrit,and elevated D-Dimer were independent risk factors for AUGIB-induced T2MI.All these factors were incorporated into the nomogram model.The AUC for the nomogram for predicting T2MI was 0.829(95%CI,0.783-0.875)in the internal validation cohort and 0.848(95%CI,0.794-0.902)in the external validation cohort.The calibration curve for the risk of T2MI exhibited good consistency between the prediction by the nomogram and the actual clinical observation in both the internal validation(RMSE=0.016)and external validation(RMSE=0.020).Conclusion The nomogram was proven to be a useful tool for the risk stratification of T2MI in AUGIB patients,and is helpful for the early identification of AUGIB patients who are prone to T2MI for early intervention,especially in emergency departments and intensive care units.展开更多
Objective:Nurse’s dimission and attrition are globally considered as a public health issue.However,few studies have focused on the nurse shortage from the perspective of intent to stay,as previous studies have focuse...Objective:Nurse’s dimission and attrition are globally considered as a public health issue.However,few studies have focused on the nurse shortage from the perspective of intent to stay,as previous studies have focused only on why they left.The purpose of this study was to conduct an integrative review of the factors connected with why nurses in China,Japan,and Korea stay in their current workplace.Methods:The review was done using three databases namely CNKI,Wanfang,and Web of science.The relevant studies published by Chinese,Japanese,and Koreans from 2010 were also included in this review.Literature screening and data extraction were performed by the two researchers,and the qualitative research methods were used for analysis.Results:A total of 17 studies were analyzed in this review and of these two were qualitative and 15 were quantitative.Three themes and six sub-themes emerged from the synthesization of the data of 17 studies,which will help us to find the factors for nurses’intent to stay.The three aspects such as professional characteristics,nurses’individual characteristics,and organizational factors are the main contributing factors of nurses’intent to stay.Conclusions:This integrated review has thrown some important factors about nurses’intent to stay.It is increasingly clear that when(1)nurses have a good professional status,(2)nurses could enjoy a good working relationship,(3)the workplace could meet the needs of personal development,and(4)nurses have good organizational support and excellent leaders,they are inclined to stay in their current jobs.Managers need to adopt targeted measures to improve nurses’intent to stay and to provide a practical reference for health care institutions and managers in different countries and areas to increase the retention rate of nurses and to alleviate the current situation of nurse shortage.展开更多
Current guidelines encourage large studies in a diverse population to establish normal reference ranges for three-dimensional(3D)echocardiography for different ethnic groups.This study was designed to establish the no...Current guidelines encourage large studies in a diverse population to establish normal reference ranges for three-dimensional(3D)echocardiography for different ethnic groups.This study was designed to establish the normal values of 3D-left ventricular(LV)and left atrial(LA)volume and function in a nationwide,population-based cohort of healthy Han Chinese adults.A total of 1117 healthy volunteers aged 18–89 years were enrolled from 28 collaborating laboratories in China.Two sets of 3D echocardiographic instruments were used,and full-volume echocardiographic images were recorded and transmitted to a core laboratory for image analysis with a vendor-independent off-line workstation.Finally,866 volunteers(mean age of 48.4 years,402 men)were qualified for final analysis.Most parameters exhibited substantial differences between different sex and age groups,even after indexation by body surface area.The normal ranges of 3D-LV and 3D-LA volume and function differed from those recommended by the American Society of Echocardiography and the European Association of Cardiovascular Imaging guidelines,presented by the World Alliance Societies of Echocardiography(WASE)study,and from the 2D values in the EMINCA study.The normal reference values of 3D echocardiography-derived LV and LA volume and function were established for the first time in healthy Han Chinese adults.Normal ranges of 3D-LV and 3D-LA echocardiographic measurements stratified with sex,age,and race should be recommended for clinical applications.展开更多
Background：Conventional magnetic resonance imaging （MRI） is the preferred neuroimaging method in the evaluation ofneuropsychiatric systemic lupus erythematosus （NPSLE）.The purpose of this study was to investigate...Background：Conventional magnetic resonance imaging （MRI） is the preferred neuroimaging method in the evaluation ofneuropsychiatric systemic lupus erythematosus （NPSLE）.The purpose of this study was to investigate the association between clinical and immunological features with MRI abnormalities in female patients with NPSLE,to screen for the value of conventional MRI in NPSLE.Methods：A total of 59 female NPSLE patients with conventional MRI examinations were enrolled in this retrospective study.All patients were classified into different groups according to MRI abnormalities.Both clinical and immunological features were compared between MRI abnormal and normal groups.One-way analysis of variance was used to compare the systemic lupus erythematosus disease activity index （SLEDAI） score for MRI abnormalities.Multivariate logistic regression analysis investigated the correlation between immunological features,neuropsychiatric manifestations,and MRI abnormalities.Results：Thirty-six NPSLE patients （61%） showed a variety of MRI abnormalities.There were statistically significant differences in SLEDAI scores （P 〈 0.001）,incidence of neurologic disorders （P =0.001）,levels of 24-h proteinuria （P =0.001） and immunoglobulin M （P =0.004）,and incidence of acute confusional state （P =0.002）,cerebrovascular disease （P =0.004）,and seizure disorder （P =0.028） between MRI abnormal and normal groups.In the MRI abnormal group,SLEDAI scores for cerebral atrophy （CA）,cortex involvement,and restricted diffusion （RD） were much higher than in the MRI normal group （P 〈 0.001,P =0.002,P =0.038,respectively）.Statistically significant positive correlations between seizure disorder and cortex involvement （odds ratio [OR] =14.90;95% confidence interval [CI],1.50-151.70;P =0.023） and cerebrovascular disease and infratentorial involvement （OR =10.00;95% CI,1.70-60.00;P =0.012） were found.Conclusions：MRI abnormalities in NPSLE,especially CA,cortex involvement,and RD might be markers of high systemic lupus erythematosus activity.Some MRI abnormalities might correspond to neuropsychiatric manifestations and might be helpful in understanding the pathophysiology of NPSLE.展开更多
At present,natural orifice specimen extraction surgery(NOSES)has attracted more and more attention worldwide,because of its great advantages including minimal cutaneous trauma and post-operative pain,fast post-operati...At present,natural orifice specimen extraction surgery(NOSES)has attracted more and more attention worldwide,because of its great advantages including minimal cutaneous trauma and post-operative pain,fast post-operative recovery,short hospital stay,and positive psychological impact.However,NOSES for the treatment of gastric cancer(GC)is still in its infancy,and there is great potential to improve its theoretical system and clinical practice.Especially,several key points including oncological outcomes,bacteriological concerns,indication selection,and standardized surgical procedures are raised with this innovative technique.Therefore,it is necessary to achieve an international consensus to regulate the implementation of GC-NOSES,which is of great significance for healthy and orderly development of NOSES worldwide.展开更多
文摘BACKGROUND Necrotising enterocolitis(NEC)is a critical gastrointestinal emergency affecting premature and low-birth-weight neonates.Serum amyloid A(SAA),procalcitonin(PCT),and high-mobility group box 1(HMGB1)have emerged as potential biomarkers for NEC due to their roles in inflammatory response,tissue damage,and immune regulation.AIM To evaluate the diagnostic value of SAA,PCT,and HMGB1 in the context of NEC in newborns.METHODS The study retrospectively analysed the clinical data of 48 newborns diagnosed with NEC and 50 healthy newborns admitted to the hospital.Clinical,radiological,and laboratory findings,including serum SAA,PCT,and HMGB1 Levels,were collected,and specific detection methods were used.The diagnostic value of the biomarkers was evaluated through statistical analysis,which was performed using chi-square test,t-test,correlation analysis,and receiver operating characteristic(ROC)analysis.RESULTS The study demonstrated significantly elevated levels of serum SAA,PCT,and HMGB1 Levels in newborns diagnosed with NEC compared with healthy controls.The correlation analysis indicated strong positive correlations among serum SAA,PCT,and HMGB1 Levels and the presence of NEC.ROC analysis revealed promising sensitivity and specificity for serum SAA,PCT,and HMGB1 Levels as potential diagnostic markers.The combined model of the three biomarkers demonstrating an extremely high area under the curve(0.908).CONCLUSION The diagnostic value of serum SAA,PCT,and HMGB1 Levels in NEC was highlighted.These biomarkers potentially improve the early detection,risk stratification,and clinical management of critical conditions.The findings suggest that these biomarkers may aid in timely intervention and the enhancement of outcomes for neonates affected by NEC.
文摘BACKGROUND Human herpesvirus type 7(HHV-7)is a less common herpes virus that usually causes mild,self-limiting illnesses.However,in recent years,there have been increasing reports of HHV-7 causing serious central nervous system infections,especially meningitis.The pathogenesis and clinical features of HHV-7 meningitis,particularly in adolescents with normal immune function,remain incompletely studied.Therefore,the purpose of this report is to share a case of HHV-7 meningitis in an immunocompetent adolescent with a view to deepening our understanding of the disease.CASE SUMMARY A 12-year-old female was admitted with fever,headache,and vomiting.4 d before admission,the patient developed a fever without obvious induction,with a temperature up to 39.5℃,no convulsions,accompanied by chills,headaches,fatigue,and no muscle aches.The patient was treated with fever reduction,which could be reduced to 38℃;repeated high fever,accompanied by vomiting 7-8 times;and no abdominal pain or diarrhea.The patient was diagnosed with"acute suppurative tonsillitis"in a local hospital,and the blood routine was generally normal.The patient was given symptomatic support treatment such as"ceftriaxone sodium"and antiemetic rehydration for 2 d,and his condition did not improve.The patient's physical examination showed pharyngeal congestion,bilateral tonsil grade I hypertrophy,regression of purulent secretions,and cervical resistance.Ocular B-ultrasound:Opacity of the vitreous body and edema of the optic disc in both eyes.Optical coherence tomography examination showed that the macular fovea was generally normal in both eyes,with edema of the optic disc.DNA virus monitoring results:HHV-7.We gave ganciclovir antiviral therapy,dexamethasone anti-inflammatory treatment,mannitol to reduce cranial pressure,omeprazole to protect gastrointestinal mucosa,and calcium and potassium supplementation.CONCLUSION This study reports a case of HHV-7 meningitis in an adolescent with normal immune function.Through comprehensive analysis of the clinical manifestations,laboratory tests,and treatment methods of the patient,it is found that early identification and antiviral treatment are essential for the outcome of the disease.This case suggests that despite normal immune function,adolescents may still suffer from herpes virus type 7 meningitis,so clinicians should be vigilant and take effective treatment measures in time.
基金supported by the National Natural Science Foundation of China,No.81571159(to XCS)the National Natural Science Foundation of China(Youth Program),No.81601072(to CJC)the Natural Science Foundation of Chongqing,China,No.cstc2019jcyj-msxmX0830(to CJC).
文摘As a highly evolutionary conserved long non-coding RNA,metastasis associated lung adenocarcinoma transcript 1(MALAT1)was first demonstrated to be related to lung tumor metastasis by promoting angiogenesis.To investigate the role of MALAT1 in traumatic brain injury,we established mouse models of controlled cortical impact and cell models of oxygen-glucose deprivation to mimic traumatic brain injury in vitro and in vivo.The results revealed that MALAT1 silencing in vitro inhibited endothelial cell viability and tube formation but increased migration.In MALAT1-deficient mice,endothelial cell proliferation in the injured cortex,functional vessel density and cerebral blood flow were reduced.Bioinformatic analyses and RNA pull-down assays validated enhancer of zeste homolog 2(EZH2)as a downstream factor of MALAT1 in endothelial cells.Jagged-1,the Notch homolog 1(NOTCH1)agonist,reversed the MALAT1 deficiency-mediated impairment of angiogenesis.Taken together,our results suggest that MALAT1 controls the key processes of angiogenesis following traumatic brain injury in an EZH2/NOTCH1-dependent manner.
基金Supported by National Natural Science Foundation of China,No.81330012
文摘AIM To determine the influence of Smoc2 on hepatocellular carcinoma(HCC) cell proliferation and to find a possible new therapeutic target for preventing HCC progression.METHODS We detected expression of Smoc2 in HCC tissues and corresponding non-tumor liver(CNL) tissues using PCR, western blot, and immunohistochemistry methods. Subsequently, we down-regulated and upregulated Smoc2 expression using siR NA and lentivirus transfection assay, respectively. Then, we identified the effect of Smoc2 on cell proliferation and cell cycle using CCK-8 and flow cytometry, respectively. The common cell growth signaling influenced by Smoc2 was detected by western blot assay. RESULTS The expression of Smoc2 was significantly higher in HCC tissues compared with CNL tissues. Overexpression of Smoc2 promoted HCC cell proliferation and cell cycle progression. Down-regulation of Smoc2 led to inhibition of cell proliferation and cell cycle progression. Smoc2 had positive effect on ERK and AKT signaling.CONCLUSION Smoc2 promotes the proliferation of HCC cells through accelerating cell cycle progression and might act as an anti-cancer therapeutic target in the future.
文摘This study aimed to investigate the effect of fullerenol combined with cisplatin on the proliferation of cervical cancer HeLa cells in order to provide new ideas and laboratory theoretical basis for the clinical treatment of cervical cancer. Cervical cancer cell line HeLa cells in vitro were treated with different concentrations of fullerenol, different concentrations of cisplatin, and different concentrations of fullerenol combined with cisplatin, after 24 h, 48 h, 72 h, microscope changes in cell morphology;MTT assay was used to determine the effect of drugs on the proliferation of HeLa cells. Fullerenol and cisplatin alone can inhibit the proliferation of HeLa cells in a dose-dependent and time-dependent manner;compared with cisplatin alone, different concentrations of fullerenol combined with cisplatin significantly increased the apoptosis rate of HeLa cells (P < 0.05). The inhibition of fullerenol combined with cisplatin on HeLa cells in vitro is more significant, resulting in a stronger anti-cancer effect.
基金The research has been supported by the Qingdao Science and Technology Demonstration and Guidance Project(Grant No.20-3-4-45-nsh)Academic Promotion Plan of Shandong First Medical University&Shandong Academy of Medical Sciences(Grant No.2019ZL001)National Science and Technology Major Project of China(Grant No.2017ZX09304010).
文摘Background:Myopic maculopathy(MM)has become a major cause of visual impairment and blindness worldwide,especially in East Asian countries.Deep learning approaches such as deep convolutional neural networks(DCNN)have been successfully applied to identify some common retinal diseases and show great potential for the intelligent analysis of MM.This study aimed to build a reliable approach for automated detection of MM from retinal fundus images using DCNN models.Methods:A dual-stream DCNN(DCNN-DS)model that perceives features from both original images and corresponding processed images by color histogram distribution optimization method was designed for classification of no MM,tessellated fundus(TF),and pathologic myopia(PM).A total of 36,515 gradable images from four hospitals were used for DCNN model development,and 14,986 gradable images from the other two hospitals for external testing.We also compared the performance of the DCNN-DS model and four ophthalmologists on 3000 randomly sampledfundus images.Results:The DCNN-DS model achieved sensitivities of 93.3%and 91.0%,specificities of 99.6%and 98.7%,areas under the receiver operating characteristic curves(AUCs)of 0.998 and 0.994 for detecting PM,whereas sensitivities of 98.8%and 92.8%,specificities of 95.6%and 94.1%,AUCs of 0.986 and 0.970 for detecting TF in two external testing datasets.In the sampled testing dataset,the sensitivities of four ophthalmologists ranged from 88.3%to 95.8%and 81.1%to 89.1%,and the specificities ranged from 95.9%to 99.2%and 77.8%to 97.3%for detecting PM and TF,respectively.Meanwhile,the DCNN-DS model achieved sensitivities of 90.8%and 97.9%and specificities of 99.1%and 94.0%for detecting PMand T,respectively.Conclusions:The proposed DCNN-DS approach demonstrated reliable performance with high sensitivity,specificity,and AUC to classify different MM levels on fundus photographs sourced from clinics.It can help identify MM automatically among the large myopic groups and show great potential for real-life applications.
基金This work was supported by grants from the National Key Research and Development Plan(No.2020YFC0846600)the National Science Foundation of China(No.NSFC 81372020)+1 种基金Renmin Hospital of Wuhan University(No.RMYD 2018Z15)the Young Talent Physician Training Project in Wuhan City(No.2014ZX0001).
文摘Objective To examine the independent risk factors of type-2 myocardial infarction(T2MI)elicited by acute upper gastrointestinal bleeding(AUGIB),and to establish a nomogram model for the prediction of AUGIB-induced T2MI.Methods A nomogram model was established on the basis of a retrospective study that involved 533 patients who suffered from AUGIB in the Department of Critical Care Medicine(CCM)or Emergency Intensive Care Unit(EICU)of Renmin Hospital of Wuhan University,Wuhan,China,from January 2017 to December 2020.The predictive accuracy and discriminative power of the nomogram were initially evaluated by internal validation,which involved drawing the receiver operating characteristic(ROC)curve,calculating the area under the curve(AUC),plotting the calibration curve derived from 1000 resampled bootstrap data sets,and computing the root mean square error(RMSE).The predictive ability of the nomogram was further validated through the prospective and multicenter study conducted by the investigators,which enrolled 240 AUGIB patients[including 88 cases from Renmin Hospital of Wuhan University,73 cases from Qilu Hospital of Shandong University(Qingdao),and 79 cases from Northern Jiangsu People’s Hospital)],who were admitted to the Department of CCM or EICU,from February 2021 to July 2021.Results Among the 533 patients in the training cohort,78(14.6%)patients were assigned to the T2MI group and 455(85.4%)patients were assigned to the non-T2MI group.The multivariate analysis revealed that age>65,hemorrhagic shock,cerebral stroke,heart failure,chronic kidney disease,increased blood urea nitrogen,decreased hematocrit,and elevated D-Dimer were independent risk factors for AUGIB-induced T2MI.All these factors were incorporated into the nomogram model.The AUC for the nomogram for predicting T2MI was 0.829(95%CI,0.783-0.875)in the internal validation cohort and 0.848(95%CI,0.794-0.902)in the external validation cohort.The calibration curve for the risk of T2MI exhibited good consistency between the prediction by the nomogram and the actual clinical observation in both the internal validation(RMSE=0.016)and external validation(RMSE=0.020).Conclusion The nomogram was proven to be a useful tool for the risk stratification of T2MI in AUGIB patients,and is helpful for the early identification of AUGIB patients who are prone to T2MI for early intervention,especially in emergency departments and intensive care units.
文摘Objective:Nurse’s dimission and attrition are globally considered as a public health issue.However,few studies have focused on the nurse shortage from the perspective of intent to stay,as previous studies have focused only on why they left.The purpose of this study was to conduct an integrative review of the factors connected with why nurses in China,Japan,and Korea stay in their current workplace.Methods:The review was done using three databases namely CNKI,Wanfang,and Web of science.The relevant studies published by Chinese,Japanese,and Koreans from 2010 were also included in this review.Literature screening and data extraction were performed by the two researchers,and the qualitative research methods were used for analysis.Results:A total of 17 studies were analyzed in this review and of these two were qualitative and 15 were quantitative.Three themes and six sub-themes emerged from the synthesization of the data of 17 studies,which will help us to find the factors for nurses’intent to stay.The three aspects such as professional characteristics,nurses’individual characteristics,and organizational factors are the main contributing factors of nurses’intent to stay.Conclusions:This integrated review has thrown some important factors about nurses’intent to stay.It is increasingly clear that when(1)nurses have a good professional status,(2)nurses could enjoy a good working relationship,(3)the workplace could meet the needs of personal development,and(4)nurses have good organizational support and excellent leaders,they are inclined to stay in their current jobs.Managers need to adopt targeted measures to improve nurses’intent to stay and to provide a practical reference for health care institutions and managers in different countries and areas to increase the retention rate of nurses and to alleviate the current situation of nurse shortage.
文摘Current guidelines encourage large studies in a diverse population to establish normal reference ranges for three-dimensional(3D)echocardiography for different ethnic groups.This study was designed to establish the normal values of 3D-left ventricular(LV)and left atrial(LA)volume and function in a nationwide,population-based cohort of healthy Han Chinese adults.A total of 1117 healthy volunteers aged 18–89 years were enrolled from 28 collaborating laboratories in China.Two sets of 3D echocardiographic instruments were used,and full-volume echocardiographic images were recorded and transmitted to a core laboratory for image analysis with a vendor-independent off-line workstation.Finally,866 volunteers(mean age of 48.4 years,402 men)were qualified for final analysis.Most parameters exhibited substantial differences between different sex and age groups,even after indexation by body surface area.The normal ranges of 3D-LV and 3D-LA volume and function differed from those recommended by the American Society of Echocardiography and the European Association of Cardiovascular Imaging guidelines,presented by the World Alliance Societies of Echocardiography(WASE)study,and from the 2D values in the EMINCA study.The normal reference values of 3D echocardiography-derived LV and LA volume and function were established for the first time in healthy Han Chinese adults.Normal ranges of 3D-LV and 3D-LA echocardiographic measurements stratified with sex,age,and race should be recommended for clinical applications.
基金This study was supported by the Provincial Natural Science Foundation of Shandong
文摘Background：Conventional magnetic resonance imaging （MRI） is the preferred neuroimaging method in the evaluation ofneuropsychiatric systemic lupus erythematosus （NPSLE）.The purpose of this study was to investigate the association between clinical and immunological features with MRI abnormalities in female patients with NPSLE,to screen for the value of conventional MRI in NPSLE.Methods：A total of 59 female NPSLE patients with conventional MRI examinations were enrolled in this retrospective study.All patients were classified into different groups according to MRI abnormalities.Both clinical and immunological features were compared between MRI abnormal and normal groups.One-way analysis of variance was used to compare the systemic lupus erythematosus disease activity index （SLEDAI） score for MRI abnormalities.Multivariate logistic regression analysis investigated the correlation between immunological features,neuropsychiatric manifestations,and MRI abnormalities.Results：Thirty-six NPSLE patients （61%） showed a variety of MRI abnormalities.There were statistically significant differences in SLEDAI scores （P 〈 0.001）,incidence of neurologic disorders （P =0.001）,levels of 24-h proteinuria （P =0.001） and immunoglobulin M （P =0.004）,and incidence of acute confusional state （P =0.002）,cerebrovascular disease （P =0.004）,and seizure disorder （P =0.028） between MRI abnormal and normal groups.In the MRI abnormal group,SLEDAI scores for cerebral atrophy （CA）,cortex involvement,and restricted diffusion （RD） were much higher than in the MRI normal group （P 〈 0.001,P =0.002,P =0.038,respectively）.Statistically significant positive correlations between seizure disorder and cortex involvement （odds ratio [OR] =14.90;95% confidence interval [CI],1.50-151.70;P =0.023） and cerebrovascular disease and infratentorial involvement （OR =10.00;95% CI,1.70-60.00;P =0.012） were found.Conclusions：MRI abnormalities in NPSLE,especially CA,cortex involvement,and RD might be markers of high systemic lupus erythematosus activity.Some MRI abnormalities might correspond to neuropsychiatric manifestations and might be helpful in understanding the pathophysiology of NPSLE.
文摘At present,natural orifice specimen extraction surgery(NOSES)has attracted more and more attention worldwide,because of its great advantages including minimal cutaneous trauma and post-operative pain,fast post-operative recovery,short hospital stay,and positive psychological impact.However,NOSES for the treatment of gastric cancer(GC)is still in its infancy,and there is great potential to improve its theoretical system and clinical practice.Especially,several key points including oncological outcomes,bacteriological concerns,indication selection,and standardized surgical procedures are raised with this innovative technique.Therefore,it is necessary to achieve an international consensus to regulate the implementation of GC-NOSES,which is of great significance for healthy and orderly development of NOSES worldwide.
