Objective:This study aims to investigate the energy conduction mechanism of holmium laser lithotripsy based on the Gemini platform and validate the optimal lithotripsy parameters under this mechanism using an in vitro...Objective:This study aims to investigate the energy conduction mechanism of holmium laser lithotripsy based on the Gemini platform and validate the optimal lithotripsy parameters under this mechanism using an in vitro ureteral model.Methods:The Lumenis VersaPulse PowerSuite dual-wavelength laser system was employed,with a holmium laser wavelength of 2.1μm,power output of 0-80 W,pulse energy ranging from 0.2 to 3.5 J,and pulse frequency from 5 to 40 Hz.An in vitro thermal effect model of the holmium laser was established to simulate temperature changes in urinary stones under varying power levels,energy ranges,pulse frequencies,and irrigation rates.High-speed cameras and thermal imaging devices were used to observe and record the temperature of the stone and surrounding tissues during laser irradiation.Finite element analysis was integrated to simulate the energy conduction pathways of the holmium laser within the stone and ureteral wall,assessing whether localized high-temperature regions exceeded the thermal injury threshold.Results:Temperature in the stone fragmentation mode decreased significantly with increasing distance from the basket and higher irrigation rates,thereby reducing the risk of thermal injury.In fragmentation mode,both 276μm and 500μm core-diameter fibers generated significantly higher temperatures at the basket site compared to the free-running mode(P<0.05).No thermal injury was observed at irrigation rates≥15 ml/min across all parameter combinations;at 10 ml/min,only high-energy settings(3.5 J)approached the thermal injury threshold(50.3℃);at≤5 ml/min,high-energy settings(>1.5 J)consistently exceeded the danger threshold.The safest parameter combination was 0.5 J+5 Hz(at any irrigation rate).Within 5 min,temperatures at the stone surface-below,middle,and above the basket-reached 151.0℃±1.0℃,62.5℃±0.2℃,and 46.8℃±0.2℃,respectively,whereas the maximum temperature on the ureteral wall surface was only 49.5℃.The FEA results closely matched experimental observations,indicating that with 0.5 J+5 Hz(at any flow rate),laser energy is primarily confined within the stone,generating localized high-temperature zones(80℃-90℃)at the stone-ureter wall interface,which promotes stone fragmentation while effectively minimizing collateral tissue damage.Conclusion:The holmium laser energy conduction mechanism based on the Gemini platform is predominantly concentrated within the stone,exhibiting excellent directionality and depth penetration,enabling efficient lithotripsy while minimizing thermal damage to surrounding tissues.展开更多
Objective To investigate the influencing factors of mucosal healing under endoscopy in patients with Crohn's disease (CD) and to establish a predictive model.Methods From January 1,2023 to August 31,2024,124 patie...Objective To investigate the influencing factors of mucosal healing under endoscopy in patients with Crohn's disease (CD) and to establish a predictive model.Methods From January 1,2023 to August 31,2024,124 patients with CD were hospitalized at the Department of Gastroenterology,Renmin Hospital of Wuhan University were retrospectively enrolled as the modeling group.展开更多
ObjectiveeThisstudy used data-independent acquisition(DIA)proteomics to analyze plasma protein expression in sepsis-induced coagulopathy(SIC),identify key biomarkers,and develop a diagnostic model.Methods This prospec...ObjectiveeThisstudy used data-independent acquisition(DIA)proteomics to analyze plasma protein expression in sepsis-induced coagulopathy(SIC),identify key biomarkers,and develop a diagnostic model.Methods This prospective study included 46 adult sepsis patients from the intensive care unit.Patients were categorized into a general sepsis group(n=26)and an SIC group(n=20)based on established SIC criteria.Plasma samples underwent proteomic and bioinformatics analyses toidentifyydifferentiallyexpressed protein(DEP)using LASSO regression and Random Forest.A diagnostic model was constructed and assessedvia receiver operating characteristic(ROC)curve analysis.Results The baseline data revealed that SIC patients exhibited longer prothrombin times,lower platelet counts,and higher D-dimer,fibrin degradation products,blood lactate,SOFA scores,and APACHE II scores compared with general sepsis patients(P<0.05).DIA proteomics identified 2637 proteins,with 240 DEP meeting the criteria(fold change>1.5,P<0.05),including 81 upregulated and 159 downregulated DEP.Subcellular localization analysis revealed that DEPs were predominantly extracellular and nuclear.Gene ontology(GO)annotation showed that DEP were mainly involved in cellular physiology,biological regulation,and stress response processes in biological processes.Domain annotation revealed a predominance of immunoglobulin V regions in DEP,which are crucial for antigen recognition and binding.KEGG enrichment analysis showed significant enrichment of DEP in pathways related to natural killer cell-mediated cytotoxicity,glycosylphosphatidylinositol anchor biosynthesis,tumor necrosis factor signaling,and NF-kB signaling.LASSO regression identified angiogenin and C-type lectin domain family 10 member A as key DEP.The SIC diagnostic nomogram showed an area under the curve of 0.896,with 0.731 specificity and 0.900 sensitivity.Conclusion The nomogram incorporating angiogenin and C-type lectin domain family 10 member A provides an accurate tool for SIC diagnosis。展开更多
文摘Objective:This study aims to investigate the energy conduction mechanism of holmium laser lithotripsy based on the Gemini platform and validate the optimal lithotripsy parameters under this mechanism using an in vitro ureteral model.Methods:The Lumenis VersaPulse PowerSuite dual-wavelength laser system was employed,with a holmium laser wavelength of 2.1μm,power output of 0-80 W,pulse energy ranging from 0.2 to 3.5 J,and pulse frequency from 5 to 40 Hz.An in vitro thermal effect model of the holmium laser was established to simulate temperature changes in urinary stones under varying power levels,energy ranges,pulse frequencies,and irrigation rates.High-speed cameras and thermal imaging devices were used to observe and record the temperature of the stone and surrounding tissues during laser irradiation.Finite element analysis was integrated to simulate the energy conduction pathways of the holmium laser within the stone and ureteral wall,assessing whether localized high-temperature regions exceeded the thermal injury threshold.Results:Temperature in the stone fragmentation mode decreased significantly with increasing distance from the basket and higher irrigation rates,thereby reducing the risk of thermal injury.In fragmentation mode,both 276μm and 500μm core-diameter fibers generated significantly higher temperatures at the basket site compared to the free-running mode(P<0.05).No thermal injury was observed at irrigation rates≥15 ml/min across all parameter combinations;at 10 ml/min,only high-energy settings(3.5 J)approached the thermal injury threshold(50.3℃);at≤5 ml/min,high-energy settings(>1.5 J)consistently exceeded the danger threshold.The safest parameter combination was 0.5 J+5 Hz(at any irrigation rate).Within 5 min,temperatures at the stone surface-below,middle,and above the basket-reached 151.0℃±1.0℃,62.5℃±0.2℃,and 46.8℃±0.2℃,respectively,whereas the maximum temperature on the ureteral wall surface was only 49.5℃.The FEA results closely matched experimental observations,indicating that with 0.5 J+5 Hz(at any flow rate),laser energy is primarily confined within the stone,generating localized high-temperature zones(80℃-90℃)at the stone-ureter wall interface,which promotes stone fragmentation while effectively minimizing collateral tissue damage.Conclusion:The holmium laser energy conduction mechanism based on the Gemini platform is predominantly concentrated within the stone,exhibiting excellent directionality and depth penetration,enabling efficient lithotripsy while minimizing thermal damage to surrounding tissues.
文摘Objective To investigate the influencing factors of mucosal healing under endoscopy in patients with Crohn's disease (CD) and to establish a predictive model.Methods From January 1,2023 to August 31,2024,124 patients with CD were hospitalized at the Department of Gastroenterology,Renmin Hospital of Wuhan University were retrospectively enrolled as the modeling group.
文摘ObjectiveeThisstudy used data-independent acquisition(DIA)proteomics to analyze plasma protein expression in sepsis-induced coagulopathy(SIC),identify key biomarkers,and develop a diagnostic model.Methods This prospective study included 46 adult sepsis patients from the intensive care unit.Patients were categorized into a general sepsis group(n=26)and an SIC group(n=20)based on established SIC criteria.Plasma samples underwent proteomic and bioinformatics analyses toidentifyydifferentiallyexpressed protein(DEP)using LASSO regression and Random Forest.A diagnostic model was constructed and assessedvia receiver operating characteristic(ROC)curve analysis.Results The baseline data revealed that SIC patients exhibited longer prothrombin times,lower platelet counts,and higher D-dimer,fibrin degradation products,blood lactate,SOFA scores,and APACHE II scores compared with general sepsis patients(P<0.05).DIA proteomics identified 2637 proteins,with 240 DEP meeting the criteria(fold change>1.5,P<0.05),including 81 upregulated and 159 downregulated DEP.Subcellular localization analysis revealed that DEPs were predominantly extracellular and nuclear.Gene ontology(GO)annotation showed that DEP were mainly involved in cellular physiology,biological regulation,and stress response processes in biological processes.Domain annotation revealed a predominance of immunoglobulin V regions in DEP,which are crucial for antigen recognition and binding.KEGG enrichment analysis showed significant enrichment of DEP in pathways related to natural killer cell-mediated cytotoxicity,glycosylphosphatidylinositol anchor biosynthesis,tumor necrosis factor signaling,and NF-kB signaling.LASSO regression identified angiogenin and C-type lectin domain family 10 member A as key DEP.The SIC diagnostic nomogram showed an area under the curve of 0.896,with 0.731 specificity and 0.900 sensitivity.Conclusion The nomogram incorporating angiogenin and C-type lectin domain family 10 member A provides an accurate tool for SIC diagnosis。
