BACKGROUND Minimally invasive esophagectomy(MIE)is a widely accepted treatment for esophageal cancer,yet it is associated with a significant risk of surgical adverse events(SAEs),which can compromise patient recovery ...BACKGROUND Minimally invasive esophagectomy(MIE)is a widely accepted treatment for esophageal cancer,yet it is associated with a significant risk of surgical adverse events(SAEs),which can compromise patient recovery and long-term survival.Accurate preoperative identification of high-risk patients is critical for improving outcomes.AIM To establish and validate a risk prediction and stratification model for the risk of SAEs in patients with MIE.METHODS This retrospective study included 747 patients who underwent MIE at two centers from January 2019 to February 2024.Patients were separated into a train set(n=549)and a validation set(n=198).After screening by least absolute shrinkage and selection operator regression,multivariate logistic regression analyzed clinical and intraoperative variables to identify independent risk factors for SAEs.A risk stratification model was constructed and validated to predict the probability of SAEs.RESULTS SAEs occurred in 10.2%of patients in train set and 13.6%in the validation set.Patients with SAE had significantly higher complication rate and a longer hospital stay after surgery.The key independent risk factors identified included chronic obstructive pulmonary disease,a history of alcohol consumption,low forced expiratory volume in the first second,and low albumin levels.The stratification model has excellent prediction accuracy,with an area under the curve of 0.889 for the training set and an area under the curve of 0.793 for the validation set.CONCLUSION The developed risk stratification model effectively predicts the risk of SAEs in patients undergoing MIE,facilitating targeted preoperative interventions and improving perioperative management.展开更多
Herein, we demonstrate that silica films with perpendicular macroporous channels and accessible ordered mesopores can be conveniently prepared. The hierarchical macroporous–mesoporous silica films are synthesized by ...Herein, we demonstrate that silica films with perpendicular macroporous channels and accessible ordered mesopores can be conveniently prepared. The hierarchical macroporous–mesoporous silica films are synthesized by using zinc oxide nanorod array as macroporous template and CTAB surfactant as mesoporous template. In basic surfactant-containing solution, ordered mesoporous silica shells homogeneously grow on the zinc oxide nanorod array. The growth of the mesostructures do not require any chemical modification for the zinc oxide nanorod, which opens a new way for preparing hierarchical silica films with perpendicular mesochannels. The prepared hierarchical macroporous–mesoporous silica films possess a uniform thickness of 2μm, large perpendicular macropores with a length of 1.8μm and a width of 80 nm, and accessible ordered mesopores. Separation experiment demonstrates that this macroporous–mesoporous film can effectively separate biomolecules with different sizes.展开更多
Objective Intracranial aneurysm imaging artificial intelligence(AI)products have entered the clinical implementation phase,but the application status of them in Chinese hospitals remains unclear.A nationwide survey wa...Objective Intracranial aneurysm imaging artificial intelligence(AI)products have entered the clinical implementation phase,but the application status of them in Chinese hospitals remains unclear.A nationwide survey was conducted to explore the current status of intracranial aneurysm imaging AI products in hospitals across China.Methods Delphi method was used to develop a questionnaire,which was then distributed to the radiologists across China between September 3rd and 10th,2023.Independent predictors of the adoption of these AI products,radiologists’attitudes,concerns and knowledge about these AI products were evaluated using logistic regression.Participants were categorized into seven groups based on Chinese geographical regions to compare the performance of these AI products in different geographical regions.Results After 3 rounds of Delphi discussion by 29 radiologists,the questionnaire was derived.A total of 961 radiologists from 777 different hospitals in 31 provinces across China completed the questionnaire.Among these hospitals,45.4%(353/777)had introduced intracranial aneurysm imaging AI products.The most commonly reported concern with these AI products was poor specificity(265/446,59.4%).The majority of respondents had basic(310/961,42.0%)or intermediate(331/961,44.9%)knowledge of AI products and they held positive attitudes(913/961,95.0%)towards using them.Those who had received AI training were more likely to possess a higher level of knowledge about AI(odds ratio(OR)=1.80,P=0.04).For regional comparison,respondents in Central China and East China gave the highest ratings to the accuracy(OR=2.41,P=0.048 vs.OR=2.36,P=0.02)and specificity(OR=2.34,P=0.046 vs.OR=2.37,P=0.02)of these AI products.Conclusion The intracranial aneurysm imaging AI products may be widely used in Chinese hospitals but vary by clinical scenarios and geographic position.展开更多
基金Supported by Joint Funds for the Innovation of Science and Technology,Fujian Province,No.2023Y9187 and No.2021Y9057.
文摘BACKGROUND Minimally invasive esophagectomy(MIE)is a widely accepted treatment for esophageal cancer,yet it is associated with a significant risk of surgical adverse events(SAEs),which can compromise patient recovery and long-term survival.Accurate preoperative identification of high-risk patients is critical for improving outcomes.AIM To establish and validate a risk prediction and stratification model for the risk of SAEs in patients with MIE.METHODS This retrospective study included 747 patients who underwent MIE at two centers from January 2019 to February 2024.Patients were separated into a train set(n=549)and a validation set(n=198).After screening by least absolute shrinkage and selection operator regression,multivariate logistic regression analyzed clinical and intraoperative variables to identify independent risk factors for SAEs.A risk stratification model was constructed and validated to predict the probability of SAEs.RESULTS SAEs occurred in 10.2%of patients in train set and 13.6%in the validation set.Patients with SAE had significantly higher complication rate and a longer hospital stay after surgery.The key independent risk factors identified included chronic obstructive pulmonary disease,a history of alcohol consumption,low forced expiratory volume in the first second,and low albumin levels.The stratification model has excellent prediction accuracy,with an area under the curve of 0.889 for the training set and an area under the curve of 0.793 for the validation set.CONCLUSION The developed risk stratification model effectively predicts the risk of SAEs in patients undergoing MIE,facilitating targeted preoperative interventions and improving perioperative management.
基金the financial support from the Natural Science Foundation of Jiangsu Province(No.BK20160017)the National Natural Science Foundation of China(No.21603106)
文摘Herein, we demonstrate that silica films with perpendicular macroporous channels and accessible ordered mesopores can be conveniently prepared. The hierarchical macroporous–mesoporous silica films are synthesized by using zinc oxide nanorod array as macroporous template and CTAB surfactant as mesoporous template. In basic surfactant-containing solution, ordered mesoporous silica shells homogeneously grow on the zinc oxide nanorod array. The growth of the mesostructures do not require any chemical modification for the zinc oxide nanorod, which opens a new way for preparing hierarchical silica films with perpendicular mesochannels. The prepared hierarchical macroporous–mesoporous silica films possess a uniform thickness of 2μm, large perpendicular macropores with a length of 1.8μm and a width of 80 nm, and accessible ordered mesopores. Separation experiment demonstrates that this macroporous–mesoporous film can effectively separate biomolecules with different sizes.
基金supported by the Key Projects of the National Natural Science Foundation of China(Grant Nos.81830057 and 82230068)the Youth Fund of the National Natural Science Foundation of China(Grant No.82102155).
文摘Objective Intracranial aneurysm imaging artificial intelligence(AI)products have entered the clinical implementation phase,but the application status of them in Chinese hospitals remains unclear.A nationwide survey was conducted to explore the current status of intracranial aneurysm imaging AI products in hospitals across China.Methods Delphi method was used to develop a questionnaire,which was then distributed to the radiologists across China between September 3rd and 10th,2023.Independent predictors of the adoption of these AI products,radiologists’attitudes,concerns and knowledge about these AI products were evaluated using logistic regression.Participants were categorized into seven groups based on Chinese geographical regions to compare the performance of these AI products in different geographical regions.Results After 3 rounds of Delphi discussion by 29 radiologists,the questionnaire was derived.A total of 961 radiologists from 777 different hospitals in 31 provinces across China completed the questionnaire.Among these hospitals,45.4%(353/777)had introduced intracranial aneurysm imaging AI products.The most commonly reported concern with these AI products was poor specificity(265/446,59.4%).The majority of respondents had basic(310/961,42.0%)or intermediate(331/961,44.9%)knowledge of AI products and they held positive attitudes(913/961,95.0%)towards using them.Those who had received AI training were more likely to possess a higher level of knowledge about AI(odds ratio(OR)=1.80,P=0.04).For regional comparison,respondents in Central China and East China gave the highest ratings to the accuracy(OR=2.41,P=0.048 vs.OR=2.36,P=0.02)and specificity(OR=2.34,P=0.046 vs.OR=2.37,P=0.02)of these AI products.Conclusion The intracranial aneurysm imaging AI products may be widely used in Chinese hospitals but vary by clinical scenarios and geographic position.
