BACKGROUND Traditional Chinese medicine(TCM)body constitution is a key factor in determining and influencing the occurrence,development,and variation of diseases.As the mind interact with the body,TCM body constitutio...BACKGROUND Traditional Chinese medicine(TCM)body constitution is a key factor in determining and influencing the occurrence,development,and variation of diseases.As the mind interact with the body,TCM body constitution is useful in preventing and treating psychiatric disorders and insomnia.AIM To investigate the interrelationship between TCM body constitution,psychiatric disorders and sleep quality.METHODS A total of 2441 participants were enrolled in our study.TCM body constitution was measured using the Constitution in Chinese Medicine Questionnaire,sleep quality was assessed using the Chinese version of the Pittsburgh Sleep Quality Index,and psychopathological symptoms were evaluated using Symptom Checklist-90.Logistic regression was used to estimate the interrelationship between TCM body constitution,psychiatric disorders and sleep quality.RESULTS The Pittsburgh Sleep Quality Index score and the proportions of participants with Qi-deficiency constitution,Qi-stagnation constitution,and blood-stasis constitution were significantly higher in the psychiatric symptoms group.Additionally,psychiatric symptoms were considerably associated with sleep quality,Qi-deficiency constitution,and Qi-stagnation constitution,but were inversely associated with male sex.Obsessive–compulsive symptoms were considerably associated with sleep quality,Qi-deficiency constitution and Qi-stagnation constitution.Depression was considerably associated with sleep quality,hyperuricemia,and Qi-stagnation constitution.Anxiety was considerably associated with sleep quality,diabetes,and Qi-stagnation constitution.Finally,poor sleep quality was considerably associated with Qi-deficiency constitution,Qi-stagnation constitution,dampness-heat constitution,phlegm-dampness constitution,and blood-stasis constitution but was inversely associated with male sex and body mass index>23.9.CONCLUSION TCM body constitutions are strongly associated with psychiatric symptoms and sleep quality.Further research is needed to verify whether TCM body constitution can be used to treat and prevent psychiatric conditions as well as enhance sleep quality.展开更多
This review aims to analyze the development and impact of Artificial Intelligence(AI)in the context of Saudi Arabia’s public healthcare system to fulfill Vision 2030 objectives.It is extensively devoted to AI technol...This review aims to analyze the development and impact of Artificial Intelligence(AI)in the context of Saudi Arabia’s public healthcare system to fulfill Vision 2030 objectives.It is extensively devoted to AI technology deployment relevant to disease management,healthcare delivery,epidemiology,and policy-making.However,its AI is culturally sensitive and ethically grounded in Islam.Based on the PRISMA framework,an SLR evaluated primary academic literature,cases,and practices of Saudi Arabia’s AI implementation in the public healthcare sector.Instead,it categorizes prior research based on how AI can work,the issues it poses,and its implications for the Kingdom’s healthcare system.The Saudi Arabian context analyses show that AI has increased the discreet prediction of diseases,resource management,and monitoring outbreaks during mass congregations such as hajj.Therefore,the study outlines critical areas for defining the potential for artificial intelligence and areas for enhancing digital development to support global healthcare progress.The key themes emerging from the review include Saudi Arabia:(i)the effectiveness of AI with human interaction for sustainable health services;(ii)conditions and quality control to enhance the quality of health care services using AI;(iii)environmental factors as influencing factors for public health care;(iv)Artificial Intelligence,and advanced decision-making technology for Middle Eastern health care systems.For policymakers,healthcare managers,and researchers who will engage with AI innovation,the review proclaims that AI applications should respect the country’s socio-cultural and ethical practices and pave the way for sustainable healthcare provision.More empirical research is needed on the implementation issues with AI,creating culturally appropriate models of AI,and finding new applications of AI to address the increasing demand for healthcare services in Saudi Arabia.展开更多
Objective: To evaluate a new management model using mobile health for senile hypertension. Methods: This medical service combined traditional medical treatment with Mobile Health. We use it to explore a new and effect...Objective: To evaluate a new management model using mobile health for senile hypertension. Methods: This medical service combined traditional medical treatment with Mobile Health. We use it to explore a new and effective model of elderly hypertension management and the most effective and lowest cost management crowd. According to the randomized controlled design of trial, 105 old hypertensive patients participated in the study voluntarily in the Qingdao Municipal Hospital were randomly divided into the experimental group (75 cases) and control group (30 cases). Experimental group is divided into geriatric specialist group (25 cases), general practitioner group (25 cases) and nurse group (25 cases). Blood pressure was administered in experimental (with the new model) and control groups (with the traditional model) for 2 months to compare their blood pressure and the decrease of them. Results: Blood pressure was compared between the two groups before and after administration. The systolic blood pressure (SBP) of experimental group is 162.44 ± 13.970 mmHg before administration. SBP of experimental group is 147.69 ± 13.509 mmHg after administration, the difference is statistically significant (P = 0.000). The diastolic blood pressure (DBP) of experimental group is 91.58 ± 10.822 mmHg before administration. DBP of experimental group is 84.64 ± 10.412 mmHg after administration, P = 0.003. SBP of control group is 159.93 ± 15.238 mmHg before administration. The systolic blood pressure of control group is 152.33 ± 14.115 (mmHg) after administration. P is 0.167 (P > 0.05). The difference was not statistically significant. DBP of control group is 94.73 ± 12.401 (mmHg) before administration. DBP of control group is 90.60 ± 11.115 (mmHg) after administration. P is 0.345 (P > 0.05). The difference was not statistically significant. The decrease of SBP of geriatric specialist group, general practitioner group and nurse group is 18.40 ± 11.764 mmHg, 14.47 ± 9.44 mmHg, 10.80 ± 6.026 mmHg. The difference was not statistically significant (P > 0.05). The decrease of DBP of geriatric specialist group, general practitioner group and nurse group is 9.33 ± 7.451 mmHg vs. 5.33 ± 6.287 mmHg vs. 6.13 ± 5.069 mmHg (P > 0.05). Conclusion: The new model is effective and it works well for controlling blood pressure of elderly hypertensive patients. Especially with the doctors and patients’ families, the management effect has been obviously improved. Medical interventions make the new model more scientific. The management of geriatric specialists, general practitioners and nurses is equally valid.展开更多
Total Quality Management is not just an admirable phenomenon but it is any client’s right and can be done through contribution of the staff and the managers as well as the client’s of an organization. The purpose of...Total Quality Management is not just an admirable phenomenon but it is any client’s right and can be done through contribution of the staff and the managers as well as the client’s of an organization. The purpose of the present study is to investigate the feasibility of TQM model and the attitude of the managers of health field of Yazd medical sciences university towards it. The present study was a descriptive and analytical one which was cross-section ally conducted from 2010 to 2011. The population under study consisted of the managers of the unit of staff vice-chancellor for health and treatment, the managers of health system and centers of cities and also the managers of Yazd’s public hospitals. 64 people were chosen using the formula for calculating the number of samples. A questionnaire with 48 questions was used. The questionnaire’s validity was approved by the faculty members whose major is management and its reliability by using α-cronbach 87%. To analyze the data, the software SPSS V.17 was used. Scoring method was based on likert. The findings of the study show that, considering feasibility of TQM, there is a significant relation between the awareness and attitude of the managers of health and treatment field on one side and the variables, age and University degree, on the other side p = 0.001. Considering binary logistic regression and the results obtained in the form of inter and backward stepwise, the most important factors affecting the feasibility of TQM among the managers of health and treatment field are the level of awareness and attitude with the predicted accuracy 79.3% and 87.9% respectively.展开更多
Hospitals have always been the focal point of social systems identity. Thus, they acte as the mirror of the community and should be responsible for it. Hospitals have been recognized as a significant source of contami...Hospitals have always been the focal point of social systems identity. Thus, they acte as the mirror of the community and should be responsible for it. Hospitals have been recognized as a significant source of contamination all around the world, therefore helping to endanger public health on an unintentional process. Although, the main mission of the hospital is to promote human health, it cannot be assumed as an island apart from its urban environment. “Green Hospital”, as an approach to address environmental challenges and to meet communities need in health issues, has emerged recently as a try to improve the health, in line with its main mission. In this approach, all the environmental aspects of waste management are important and to be addressed. Hospitals’ administrators can manage wastes disposal through composting, recycling and better supplying methods (downsizing packaging, using reusable products instead of disposables and using recycled products). This article is a review of the subject matter, in nature, using many library and online sources;it discusses about the need to move towards the green hospital approach, the administration and leadership role in its establishment, the environmental impact of hospital operations and assessment of the effects, wastes management and control, and also the methods in wastes disposal and treatment.展开更多
1|THE FUTURE OF HEALTH IS DIGITAL.Digital health has shown significant promise in improving health outcomes.However,its transformation faces various challenges,including resource distribution disparities across countr...1|THE FUTURE OF HEALTH IS DIGITAL.Digital health has shown significant promise in improving health outcomes.However,its transformation faces various challenges,including resource distribution disparities across countries,varying definitions and standards for digital solutions,and a lack of coordination in digital health investments[1].展开更多
BACKGROUND Macrodactyly is a rare congenital malformation characterized by an increase in the size of all structures of a digit,accounting for less than 1%of all congenital upper extremity conditions.CASE SUMMARY We r...BACKGROUND Macrodactyly is a rare congenital malformation characterized by an increase in the size of all structures of a digit,accounting for less than 1%of all congenital upper extremity conditions.CASE SUMMARY We report a case involving a 49-year-old woman who presented for the first time with untreated,radial-sided hand macrodactyly.We performed soft tissue debulking,amputation,median nerve neurotomy and coaptation,and carpal tunnel release.At the 6-year follow-up,no significant growth was observed in the bone or soft tissue of the affected area.CONCLUSION Tissue overgrowth in patients with progressive macrodactyly can continue and progress excessively with age.Median nerve neurotomy and coaptation play a crucial role in preventing recurrence of the deformity.展开更多
BACKGROUND Anxiety and depression are prevalent among patients with chronic heart failure(CHF)and can adversely contribute to treatment adherence and clinical outcomes.Poor fluid restriction adherence is a widespread ...BACKGROUND Anxiety and depression are prevalent among patients with chronic heart failure(CHF)and can adversely contribute to treatment adherence and clinical outcomes.Poor fluid restriction adherence is a widespread challenge in the management of CHF.To effectively manage disease progression and alleviate symptoms,it is crucial to identify key influencing factors to facilitate the implementation of targeted interventions.AIM To investigate the status of anxiety and depression among patients with CHF and determine the factors contributing to poor fluid restriction adherence.METHODS Three hundred CHF patients seeking medical treatment at The First Hospital of Hunan University of Traditional Chinese Medicine between June 2021 and June 2023 were included in the study.Questionnaires,including the Psychosomatic Symptom Scale,Self-Rating Anxiety Scale,Self-Rating Depression Scale,and Fluid Restriction Adherence Questionnaire were administered to patients.Based on their anxiety and depression scores,patients were categorized into anxiety/depression and non-anxiety/depression groups,as well as fluid restriction adherence and fluid restriction non-adherence groups.General patient data were collected,and univariate and logistic regression analyses were conducted to determine the occurrence of depression and anxiety.Logistic regression analysis was used to identify independent factors influencing fluid restriction adherence.RESULTS Statistically significant differences in age,New York Heart Association(NYHA)grading,marital status,educational attainment,and family support were observed between depressed and non-depressed CHF patients(P<0.05).Age,NYHA grading,marital status,educational attainment,and family support were identified as factors influencing the development of depression.The anxiety and non-anxiety groups differed statistically in terms of gender,age,NYHA grading,smoking history,alcohol consumption history,monthly income,educational attainment,and family support(P<0.05).Gender,smoking,alcohol consumption,monthly income,and educational attainment affected anxiety in these patients.The fluid restriction adherence rate was 28.0%,and thirst sensation,anxiety,and depression were identified as independent influencing factors.CONCLUSION CHF patients are susceptible to anxiety and depression,with multiple associated influencing factors.Moreover,anxiety and depression are independent factors that can influence fluid restriction adherence in these patients.展开更多
BACKGROUND At present,the existing internal medicine drug treatment can alleviate the high glucose toxicity of patients to a certain extent,to explore the efficacy of laparoscopic jejunoileal side to side anastomosis ...BACKGROUND At present,the existing internal medicine drug treatment can alleviate the high glucose toxicity of patients to a certain extent,to explore the efficacy of laparoscopic jejunoileal side to side anastomosis in the treatment of type 2 diabetes,the report is as follows.AIM To investigate the effect of jejunoileal side-to-side anastomosis on metabolic parameters in patients with type 2 diabetes mellitus(T2DM).METHODS We retrospectively analyzed the clinical data of 78 patients with T2DM who were treated via jejunoileal lateral anastomosis.Metabolic indicators were collected preoperatively,as well as at 3 and 6 months postoperative.The metabolic indicators analyzed included body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting blood glucose(FBG),2-hour blood glucose(PBG),glycated hemoglobin(HbA1c),fasting C-peptide,2-hour C-peptide(PCP),fasting insulin(Fins),2-hour insulin(Pins),insulin resistance index(HOMA-IR),βCellular function index(HOMA-β),alanine aminotransferase,aspartate aminotransferase,serum total cholesterol(TC),low-density lipoprotein cholesterol(L DL-C),triglycerides(TG),high-density lipoprotein,and uric acid(UA)levels.RESULTS SBP,DBP,PBG,HbA1c,LDL-C,and TG were all significantly lower 3 months postoperative vs preoperative values;body weight,BMI,SBP,DBP,FBG,PBG,HbA1c,TC,TG,UA,and HOMA-IR values were all significantly lower 6 months postoperative vs at 3 months;and PCP,Fins,Pins,and HOMA-βwere all significantly higher 6 months postoperative vs at 3 months(all P<0.05).CONCLUSION Side-to-side anastomosis of the jejunum and ileum can effectively treat T2DM and improve the metabolic index levels associated with it.展开更多
BACKGROUND The burden of mental disorders(MD)in the Western Pacific Region(WPR)re-mains a critical public health concern,with substantial variations across demogra-phics and countries.AIM To analyze the burden of MD i...BACKGROUND The burden of mental disorders(MD)in the Western Pacific Region(WPR)re-mains a critical public health concern,with substantial variations across demogra-phics and countries.AIM To analyze the burden of MD in the WPR from 1990 to 2021,along with associated risk factors,to reveal changing trends and emerging challenges.METHODS We used data from the Global Burden of Disease 2021,analyzing prevalence,incidence,and disability-adjusted life years(DALYs)of MD from 1990 to 2021.Statistical methods included age-standardisation and uncertainty analysis to address variations in population structure and data completeness.RESULTS Between 1990 and 2021,the prevalence of MD rose from 174.40 million cases[95%uncertainty interval(UI):160.17-189.84]to 234.90 million cases(95%UI:219.04-252.50),with corresponding DALYs increasing from 22.8 million(95%UI:17.22-28.79)to 32.07 million(95%UI:24.50-40.68).During this period,the burden of MD shifted towards older age groups.Depressive and anxiety disorders were predominant,with females showing higher DALYs for depressive and anxiety disorders,and males more affected by conduct disorders,attention-deficit hyperactivity disorder,and autism spectrum disorders.Australia,New Zealand,and Malaysia reported the highest burdens,whereas Vietnam,China,and Brunei Darussalam reported the lowest.Additionally,childhood sexual abuse and bullying,and intimate partner violence emerged as significant risk factors.CONCLUSION This study highlights the significant burden of MD in the WPR,with variations by age,gender,and nation.The coronavirus disease 2019 pandemic has exacerbated the situation,emphasizing the need for a coordinated response.展开更多
Objective:To explore the effect of cognitive intervention combined with aerobic limb rehabilitation exercise on neurological and limb functions in hemiplegic patients with hypertensive intracerebral hemorrhage.Methods...Objective:To explore the effect of cognitive intervention combined with aerobic limb rehabilitation exercise on neurological and limb functions in hemiplegic patients with hypertensive intracerebral hemorrhage.Methods:A prospective study was conducted with eighty-six hemiplegic patients with hypertensive intracerebral hemorrhage admitted to Taikang Xianlin Drum Tower Hospital from October 2021 to October 2023.The patients were randomly divided into a study group(43 cases)and a control group(43 cases).After 6 months of intervention,neurological function,motor and limb function,psychological state,and quality of life scores were compared between the two groups to assess the effects of the intervention.Results:After the intervention,neurological function indexes in the study group,including S100B protein,myelin basic protein and National Institutes of Health Stroke Scale score,were significantly lower than those in the control group(all P<0.05).In contrast,brain-derived neurotrophic factor and Mini-Mental State Examination scores were significantly higher in the study group(all P<0.05).Additionally,motor function,Barthel score,Fugl-Meyer score,and muscle strength(grades V and IV)were significantly higher in the study group compared to the control group(all P<0.05).Psychological resilience,including scores for toughness,optimism,and strength,as well as the total resilience score,were significantly higher in the study group(all P<0.05).Moreover,the Generic Quality of Life Inventory score was also significantly higher in the study group(P<0.05).Conclusion:Cognitive intervention combined with aerobic limb rehabilitation exercises can alleviate neurological damage in hemiplegic patients with hypertensive intracerebral hemorrhage,enhance muscle strength,promote limb and motor function recovery,and improve psychological state and quality of life.展开更多
Pinus koraiensis is the dominant and constructive species of the zonal vegetation in Northeast China,known as the mixed broadleaf-Korean pine forest.Although carbohydrate metabolism pathways in the seed embryo are kno...Pinus koraiensis is the dominant and constructive species of the zonal vegetation in Northeast China,known as the mixed broadleaf-Korean pine forest.Although carbohydrate metabolism pathways in the seed embryo are known to play crucial roles during seed dormancy and germination in P.koraiensis,it remains unclear whether these metabolic pathways function differentially across tissues.P.koraiensis seeds that had undergone different durations of moist chilling in their natural environment,yielding seeds with relatively deeper primary physiological dormancy(DDS)and seeds with released primary physiological dormancy(RDS).A non-targeted metabolomic analysis was conducted on the radicle and hypocotyl-cotyledon portions of both DDS and RDS,before and after a two-week incubation under favorable conditions.Under germination conditions,RDS and DDS showed divergent metabolic profiles,especially regarding carbohydrate metabolism.Specifically,RDS seeds showed significantly reduced substrates of respiratory metabolic pathways in both radicles and hypocotyl-cotyledons.Conversely,the intermediates of the carbohydrate metabolism pathway(particularly the tricarboxylic acid cycle)accumulating in radicles of DDS seeds under germination conditions.Moreover,in RDS,the carbohydrate metabolic pathways were more prevalent in the hypocotyl-cotyledon,while lysine degradation and ascorbate and aldarate metabolism were the dominant metabolic pathways in radicles.In contrast,the tricarboxylic acid cycle showed higher activity in DDS radicles compared to hypocotyl-cotyledons.We further demonstrated that carbohydratemetabolic pathways continue to play a dominant role in both dormancy maintenance and germination processes of P.koraiensis seeds.Notably,the carbohydratemetabolism in radicles likely exerts more critical regulatory functions in these two physiological processes compared to that in cotyledon and hypocotyl tissues.展开更多
Splenic histiocytic sarcoma(SHS)is a rare,aggressive hematological malignancy with unclear progression and management.Our case illustrates the progression and pathophysiological processes of SHS and provides key data ...Splenic histiocytic sarcoma(SHS)is a rare,aggressive hematological malignancy with unclear progression and management.Our case illustrates the progression and pathophysiological processes of SHS and provides key data for the diagnosis,treatment and management of SHS.A 60-year-old female with incidentally detected splenic mass(6.0 cm×5.7 cm)underwent splenectomy,confirmed as SHS in 2020.Post-op imatinib therapy was given.In 2022,hepatic metastases(2.4 cm×2.9 cm)with pancytopenia led to supportive care.Lesions enlarged to 4.3 cm×2.7 cm,leading to multi-organ failure and death at 33 months.The case was categorized into three distinct stages based on the pathophysiology of SHS:Early-stage splenic tumor growth,mid-stage liver metastasis with hematological abnormalities,and late-stage tumor infiltration leading to multiorgan failure.For SHS,this case highlights the pivotal role of early intervention and the value of personalized treatment strategies.展开更多
Hepatitis E virus(HEV)is the primary cause of acute viral hepatitis globally and is prevalent in many developing countries.Serological epidemiology studies[1,2]suggest that approximately onethird of the global populat...Hepatitis E virus(HEV)is the primary cause of acute viral hepatitis globally and is prevalent in many developing countries.Serological epidemiology studies[1,2]suggest that approximately onethird of the global population has been infected with HEV.There are an estimated 20 million new cases of HEV infection worldwide annually.World Health Organization(WHO)reported that HEV caused approximately 44000 deaths in 2015,which accounted for3.3%of deaths from viral hepatitis[3,4].Clinically,most cases of acute hepatitis E have a self-limiting course.However,co-infection with other viruses can increase the risk of acute or subacute liver failure.Hepatitis B virus(HBV)and HEV are highly prevalent in many regions worldwide,and these areas have high rates of coinfection with both viruses.The rate of co-infection with HEV among patients with chronic hepatitis B(CHB)is high,resulting in more severe health outcomes and a significantly elevated risk of liver failure and death.展开更多
Acute pancreatitis(AP)is a prevalent gastrointestinal disease necessitating hospitalization globally,with an annual incidence ranging from 13 to 45 per 100,000 individuals[1]and a mortality rate of 5%-10%.[2]While mos...Acute pancreatitis(AP)is a prevalent gastrointestinal disease necessitating hospitalization globally,with an annual incidence ranging from 13 to 45 per 100,000 individuals[1]and a mortality rate of 5%-10%.[2]While most cases follow a self-limiting course,approximately 20%-30%of cases progress to severe acute pancreatitis(SAP),characterized by pancreatic necrosis and multiorgan failure,with the mortality rate increasing to 36%-50%.展开更多
BACKGROUND Hepatocellular carcinoma(HCC)is the most common pathological type of liver cancer and was the third leading cause of cancer-related deaths worldwide in 2020.AIM To evaluate the diagnostic potential of key t...BACKGROUND Hepatocellular carcinoma(HCC)is the most common pathological type of liver cancer and was the third leading cause of cancer-related deaths worldwide in 2020.AIM To evaluate the diagnostic potential of key tumor markers in serum,bile,and fecal samples for detecting HCC.METHODS Blood,bile,and fecal samples were collected from patients(n=265)with HCC and cholecystitis from Guangxi Medical University’s First Affiliated Hospital.Immunohistochemistry was performed on 69 HCC samples,and 16S ribosomal RNA sequencing was conducted on 166 fecal samples.Tumor marker cut-off values in bile and feces were determined using the Youden index,while serum biomarkers followed hospital standards.Diagnostic performance was evaluated using receiver operating characteristic analysis.RESULTS The areas under the curve(AUCs)for distinguishing HCC were 0.898,0.904,and 0.859 for serum alpha-fetoprotein(AFP),prothrombin induced by vitamin K absence-II(PIVKA-II),and bile AFP,respectively.Serum AFP had the highest diagnostic value(80%)for early-stage HCC.Combination analysis found that bile AFP and serum PIVKAII achieved the highest AUC of 0.965(P<0.001),suggesting that bile AFP may serve as a valuable complementary biomarker,particularly in cases where serum AFP is not significantly elevated.Additionally,bile AFP was positively correlated with Actinomyces,which plays a significant role in promoting tumorigenesis;and was negatively correlated with Faecalibacterium,which was associated with robust anticancer immune responses(P<0.05).These findings suggest the potential role of gut microbiota in modulating AFP levels and HCC progression.CONCLUSION Bile AFP improved the sensitivity of HCC detection,with the combination of bile AFP and PIVKA-II demonstrating the highest AUC for HCC diagnosis.AFP is associated with poorer clinical outcomes.展开更多
Breast cancer is the most common malignant tumor among women worldwide,with its incidence and mortality ranking first among all cancers.Early diagnosis and treatment significantly improve prognosis and reduce disease-...Breast cancer is the most common malignant tumor among women worldwide,with its incidence and mortality ranking first among all cancers.Early diagnosis and treatment significantly improve prognosis and reduce disease-related mortality.Chest computed tomography(CT),a routine examination for physical assessments and hospitalized patients,can screen for the presence of breast nodules and provide an initial assessment of malignancy risk.In recent years,artificial intelligence(AI)has advanced rapidly in the medical field.Studies have demonstrated that the sensitivity and accuracy of chest CT in diagnosing breast cancer are enhanced through the application of AI methods.This article explores the research progress in breast cancer diagnosis utilizing artificial intelligence based on chest CT examinations.展开更多
BACKGROUND Preoperative risk assessments are vital for identifying patients at high risk of postoperative mortality.However,traditional scoring systems can be time consuming.We hypothesized that the use of machine lea...BACKGROUND Preoperative risk assessments are vital for identifying patients at high risk of postoperative mortality.However,traditional scoring systems can be time consuming.We hypothesized that the use of machine learning models would enable rapid and accurate risk assessments to be performed.AIM To assess the potential of machine learning algorithms to develop predictive models of mortality risk after abdominal surgery.METHODS This retrospective study included 230 individuals who underwent abdominal surgery at the Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine between January 2023 and December 2023.Demographic and surgery-related data were collected and used to develop nomogram,decision-tree,random-forest,gradient-boosting,support vector machine,and naïve Bayesian models to predict 30-day mortality risk after abdominal surgery.Models were assessed using receiver operating characteristic curves and compared using the DeLong test.RESULTS Of the 230 included patients,52 died and 178 survived.Models were developed using the training cohort(n=161)and assessed using the validation cohort(n=68).The areas under the receiver operating characteristic curves for the nomogram,decision-tree,random-forest,gradient-boosting tree,support vector machine,and naïve Bayesian models were 0.908[95%confidence interval(CI):0.824-0.992],0.874(95%CI:0.785-0.963),0.928(95%CI:0.869-0.987),0.907(95%CI:0.837-0.976),0.983(95%CI:0.959-1.000),and 0.807(95%CI:0.702-0.911),respectively.CONCLUSION Nomogram,random-forest,gradient-boosting tree,and support vector machine models all demonstrate strong performances for the prediction of postoperative mortality and can be selected based on the clinical circumstances.展开更多
Hyperlipidemia is a risk factor for clinically significant thrombotic events in cardiovascular diseases.Platelet reactivity in hyperlipidemic conditions is enhanced when platelet scavenger receptor CD36 recognizes oxi...Hyperlipidemia is a risk factor for clinically significant thrombotic events in cardiovascular diseases.Platelet reactivity in hyperlipidemic conditions is enhanced when platelet scavenger receptor CD36 recognizes oxidized lipids in oxidized low-density lipoprotein(ox-LDL)particles,a process that induces atherothrombosis.Sulforaphane(SFN)is a dietary isothiocyanate enriched in cruciferous vegetables and exerts multiple biological activities.The current study sought to investigate the efficacy of SFN on platelet hyperreactivity under hyperlipidemic conditions in vitro and in vivo.Using a series of platelet functional assays in human platelets in vitro,we demonstrated that SFN attenuated ox-LDL-increased platelet aggregation and activation(surface CD62P expression).Mechanistically,studies using pharmacological inhibitors clarified that these inhibitory effects of SFN were mainly modulated by down-regulating CD36-mediated activation of Src kinases,leading to enhanced activation of cyclic adenosine monophosphate/protein kinase A(cAMP/PKA)signaling,and resultant inhibition of NADPH oxidase 2(NOX2)-dependent generation of reactive oxygen species(ROS).Moreover,12-week supplementation of SFN-enriched broccoli sprout extract(BSE,0.06%diet)in hyperlipidemic C57BL/6J mice also decreased platelet hyperreactivity.Studies using pharmacological inhibitors of CD36,protein kinase A(PKA)and NOX2 showed that the efficacy of BSE supplementation was mainly through modulating CD36-mediated the cAMP/PKA/NOX2 signaling.Thus,through modulating the cAMP/PKA/NOX2 pathway and attenuating CD36-mediated platelet hyperreactivity,SFN may play important protective roles in atherothrombosis under hyperlipidemic conditions.展开更多
Granulomatosis with polyangiitis(GPA)poses significant therapeutic challenges due to its susceptibility to concurrent infections and frequent relapses.Professor SHI Zaixiang proposed the therapeutic theory of lifting ...Granulomatosis with polyangiitis(GPA)poses significant therapeutic challenges due to its susceptibility to concurrent infections and frequent relapses.Professor SHI Zaixiang proposed the therapeutic theory of lifting depression and removing blood stasis,resolving phlegm and dispelling nodulation for GPA management.He identified the core pathogenesis as“Qi collapse with collateral obstruction and phlegm-stasis intermingling”,establishing the treatment principle of comprehensive intervention through ascending ancestral Qi,activating blood circulation,and resolving phlegm-stasis nodules.In clinical practice,Professor SHI emphasizes maintaining immune homeostasis with herbal medicine to enhance efficiency,while dynamically balancing Qi,blood,Yin,and Yang.Notably,he highlights the critical role of emotional factors in autoimmune disease progression.A representative case was provided to elucidate his clinical reasoning in GPA treatment.展开更多
基金Supported by the National Natural Science Foundation of China,No.82103022the Science Foundation of the Second Affiliated Hospital of Xi’an Jiaotong University,No.RC(XM)202012.
文摘BACKGROUND Traditional Chinese medicine(TCM)body constitution is a key factor in determining and influencing the occurrence,development,and variation of diseases.As the mind interact with the body,TCM body constitution is useful in preventing and treating psychiatric disorders and insomnia.AIM To investigate the interrelationship between TCM body constitution,psychiatric disorders and sleep quality.METHODS A total of 2441 participants were enrolled in our study.TCM body constitution was measured using the Constitution in Chinese Medicine Questionnaire,sleep quality was assessed using the Chinese version of the Pittsburgh Sleep Quality Index,and psychopathological symptoms were evaluated using Symptom Checklist-90.Logistic regression was used to estimate the interrelationship between TCM body constitution,psychiatric disorders and sleep quality.RESULTS The Pittsburgh Sleep Quality Index score and the proportions of participants with Qi-deficiency constitution,Qi-stagnation constitution,and blood-stasis constitution were significantly higher in the psychiatric symptoms group.Additionally,psychiatric symptoms were considerably associated with sleep quality,Qi-deficiency constitution,and Qi-stagnation constitution,but were inversely associated with male sex.Obsessive–compulsive symptoms were considerably associated with sleep quality,Qi-deficiency constitution and Qi-stagnation constitution.Depression was considerably associated with sleep quality,hyperuricemia,and Qi-stagnation constitution.Anxiety was considerably associated with sleep quality,diabetes,and Qi-stagnation constitution.Finally,poor sleep quality was considerably associated with Qi-deficiency constitution,Qi-stagnation constitution,dampness-heat constitution,phlegm-dampness constitution,and blood-stasis constitution but was inversely associated with male sex and body mass index>23.9.CONCLUSION TCM body constitutions are strongly associated with psychiatric symptoms and sleep quality.Further research is needed to verify whether TCM body constitution can be used to treat and prevent psychiatric conditions as well as enhance sleep quality.
基金funded by the Scientific ResearchDeanship at theUniversity ofHa’il-Saudi Arabia through project number-RG-23251.
文摘This review aims to analyze the development and impact of Artificial Intelligence(AI)in the context of Saudi Arabia’s public healthcare system to fulfill Vision 2030 objectives.It is extensively devoted to AI technology deployment relevant to disease management,healthcare delivery,epidemiology,and policy-making.However,its AI is culturally sensitive and ethically grounded in Islam.Based on the PRISMA framework,an SLR evaluated primary academic literature,cases,and practices of Saudi Arabia’s AI implementation in the public healthcare sector.Instead,it categorizes prior research based on how AI can work,the issues it poses,and its implications for the Kingdom’s healthcare system.The Saudi Arabian context analyses show that AI has increased the discreet prediction of diseases,resource management,and monitoring outbreaks during mass congregations such as hajj.Therefore,the study outlines critical areas for defining the potential for artificial intelligence and areas for enhancing digital development to support global healthcare progress.The key themes emerging from the review include Saudi Arabia:(i)the effectiveness of AI with human interaction for sustainable health services;(ii)conditions and quality control to enhance the quality of health care services using AI;(iii)environmental factors as influencing factors for public health care;(iv)Artificial Intelligence,and advanced decision-making technology for Middle Eastern health care systems.For policymakers,healthcare managers,and researchers who will engage with AI innovation,the review proclaims that AI applications should respect the country’s socio-cultural and ethical practices and pave the way for sustainable healthcare provision.More empirical research is needed on the implementation issues with AI,creating culturally appropriate models of AI,and finding new applications of AI to address the increasing demand for healthcare services in Saudi Arabia.
文摘Objective: To evaluate a new management model using mobile health for senile hypertension. Methods: This medical service combined traditional medical treatment with Mobile Health. We use it to explore a new and effective model of elderly hypertension management and the most effective and lowest cost management crowd. According to the randomized controlled design of trial, 105 old hypertensive patients participated in the study voluntarily in the Qingdao Municipal Hospital were randomly divided into the experimental group (75 cases) and control group (30 cases). Experimental group is divided into geriatric specialist group (25 cases), general practitioner group (25 cases) and nurse group (25 cases). Blood pressure was administered in experimental (with the new model) and control groups (with the traditional model) for 2 months to compare their blood pressure and the decrease of them. Results: Blood pressure was compared between the two groups before and after administration. The systolic blood pressure (SBP) of experimental group is 162.44 ± 13.970 mmHg before administration. SBP of experimental group is 147.69 ± 13.509 mmHg after administration, the difference is statistically significant (P = 0.000). The diastolic blood pressure (DBP) of experimental group is 91.58 ± 10.822 mmHg before administration. DBP of experimental group is 84.64 ± 10.412 mmHg after administration, P = 0.003. SBP of control group is 159.93 ± 15.238 mmHg before administration. The systolic blood pressure of control group is 152.33 ± 14.115 (mmHg) after administration. P is 0.167 (P > 0.05). The difference was not statistically significant. DBP of control group is 94.73 ± 12.401 (mmHg) before administration. DBP of control group is 90.60 ± 11.115 (mmHg) after administration. P is 0.345 (P > 0.05). The difference was not statistically significant. The decrease of SBP of geriatric specialist group, general practitioner group and nurse group is 18.40 ± 11.764 mmHg, 14.47 ± 9.44 mmHg, 10.80 ± 6.026 mmHg. The difference was not statistically significant (P > 0.05). The decrease of DBP of geriatric specialist group, general practitioner group and nurse group is 9.33 ± 7.451 mmHg vs. 5.33 ± 6.287 mmHg vs. 6.13 ± 5.069 mmHg (P > 0.05). Conclusion: The new model is effective and it works well for controlling blood pressure of elderly hypertensive patients. Especially with the doctors and patients’ families, the management effect has been obviously improved. Medical interventions make the new model more scientific. The management of geriatric specialists, general practitioners and nurses is equally valid.
文摘Total Quality Management is not just an admirable phenomenon but it is any client’s right and can be done through contribution of the staff and the managers as well as the client’s of an organization. The purpose of the present study is to investigate the feasibility of TQM model and the attitude of the managers of health field of Yazd medical sciences university towards it. The present study was a descriptive and analytical one which was cross-section ally conducted from 2010 to 2011. The population under study consisted of the managers of the unit of staff vice-chancellor for health and treatment, the managers of health system and centers of cities and also the managers of Yazd’s public hospitals. 64 people were chosen using the formula for calculating the number of samples. A questionnaire with 48 questions was used. The questionnaire’s validity was approved by the faculty members whose major is management and its reliability by using α-cronbach 87%. To analyze the data, the software SPSS V.17 was used. Scoring method was based on likert. The findings of the study show that, considering feasibility of TQM, there is a significant relation between the awareness and attitude of the managers of health and treatment field on one side and the variables, age and University degree, on the other side p = 0.001. Considering binary logistic regression and the results obtained in the form of inter and backward stepwise, the most important factors affecting the feasibility of TQM among the managers of health and treatment field are the level of awareness and attitude with the predicted accuracy 79.3% and 87.9% respectively.
文摘Hospitals have always been the focal point of social systems identity. Thus, they acte as the mirror of the community and should be responsible for it. Hospitals have been recognized as a significant source of contamination all around the world, therefore helping to endanger public health on an unintentional process. Although, the main mission of the hospital is to promote human health, it cannot be assumed as an island apart from its urban environment. “Green Hospital”, as an approach to address environmental challenges and to meet communities need in health issues, has emerged recently as a try to improve the health, in line with its main mission. In this approach, all the environmental aspects of waste management are important and to be addressed. Hospitals’ administrators can manage wastes disposal through composting, recycling and better supplying methods (downsizing packaging, using reusable products instead of disposables and using recycled products). This article is a review of the subject matter, in nature, using many library and online sources;it discusses about the need to move towards the green hospital approach, the administration and leadership role in its establishment, the environmental impact of hospital operations and assessment of the effects, wastes management and control, and also the methods in wastes disposal and treatment.
基金The Science and Technology Innovation 2030 Major Project,Grant/Award Number:2023ZD0508506National Key Research and Development Program of China,Grant/Award Numbers:2022YFC2705001,2023YFC2706305。
文摘1|THE FUTURE OF HEALTH IS DIGITAL.Digital health has shown significant promise in improving health outcomes.However,its transformation faces various challenges,including resource distribution disparities across countries,varying definitions and standards for digital solutions,and a lack of coordination in digital health investments[1].
基金Supported by Special TCM Innovation Project of Hebei Provincial Department of Science and Technology,No.223777130DScientific Research Project of Hebei Province Administration of Traditional Chinese Medicine,No.2024215.
文摘BACKGROUND Macrodactyly is a rare congenital malformation characterized by an increase in the size of all structures of a digit,accounting for less than 1%of all congenital upper extremity conditions.CASE SUMMARY We report a case involving a 49-year-old woman who presented for the first time with untreated,radial-sided hand macrodactyly.We performed soft tissue debulking,amputation,median nerve neurotomy and coaptation,and carpal tunnel release.At the 6-year follow-up,no significant growth was observed in the bone or soft tissue of the affected area.CONCLUSION Tissue overgrowth in patients with progressive macrodactyly can continue and progress excessively with age.Median nerve neurotomy and coaptation play a crucial role in preventing recurrence of the deformity.
基金Huxiang TCM Physique Intervention Clinical Research Center,No.2023SK4061Traditional Chinese Medicine Research Project of Hunan Province,No.B2023065+4 种基金Hunan Province"14th Five-Year Plan"key specialty of TCM,No.[2023]4Hunan University of Chinese Medicine and Hospital Joint Foundation,No.2023XYLH019 and 2024XYLH365R&D Plan for Key Areas of Hunan Provincial Department of Science and Technology,No.2019SK2321Excellent Youth Program of Hunan Education Department,No.24B0346Hunan Provincial Natural Science Foundation for Young Scientists,No.2025JJ60626.
文摘BACKGROUND Anxiety and depression are prevalent among patients with chronic heart failure(CHF)and can adversely contribute to treatment adherence and clinical outcomes.Poor fluid restriction adherence is a widespread challenge in the management of CHF.To effectively manage disease progression and alleviate symptoms,it is crucial to identify key influencing factors to facilitate the implementation of targeted interventions.AIM To investigate the status of anxiety and depression among patients with CHF and determine the factors contributing to poor fluid restriction adherence.METHODS Three hundred CHF patients seeking medical treatment at The First Hospital of Hunan University of Traditional Chinese Medicine between June 2021 and June 2023 were included in the study.Questionnaires,including the Psychosomatic Symptom Scale,Self-Rating Anxiety Scale,Self-Rating Depression Scale,and Fluid Restriction Adherence Questionnaire were administered to patients.Based on their anxiety and depression scores,patients were categorized into anxiety/depression and non-anxiety/depression groups,as well as fluid restriction adherence and fluid restriction non-adherence groups.General patient data were collected,and univariate and logistic regression analyses were conducted to determine the occurrence of depression and anxiety.Logistic regression analysis was used to identify independent factors influencing fluid restriction adherence.RESULTS Statistically significant differences in age,New York Heart Association(NYHA)grading,marital status,educational attainment,and family support were observed between depressed and non-depressed CHF patients(P<0.05).Age,NYHA grading,marital status,educational attainment,and family support were identified as factors influencing the development of depression.The anxiety and non-anxiety groups differed statistically in terms of gender,age,NYHA grading,smoking history,alcohol consumption history,monthly income,educational attainment,and family support(P<0.05).Gender,smoking,alcohol consumption,monthly income,and educational attainment affected anxiety in these patients.The fluid restriction adherence rate was 28.0%,and thirst sensation,anxiety,and depression were identified as independent influencing factors.CONCLUSION CHF patients are susceptible to anxiety and depression,with multiple associated influencing factors.Moreover,anxiety and depression are independent factors that can influence fluid restriction adherence in these patients.
文摘BACKGROUND At present,the existing internal medicine drug treatment can alleviate the high glucose toxicity of patients to a certain extent,to explore the efficacy of laparoscopic jejunoileal side to side anastomosis in the treatment of type 2 diabetes,the report is as follows.AIM To investigate the effect of jejunoileal side-to-side anastomosis on metabolic parameters in patients with type 2 diabetes mellitus(T2DM).METHODS We retrospectively analyzed the clinical data of 78 patients with T2DM who were treated via jejunoileal lateral anastomosis.Metabolic indicators were collected preoperatively,as well as at 3 and 6 months postoperative.The metabolic indicators analyzed included body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting blood glucose(FBG),2-hour blood glucose(PBG),glycated hemoglobin(HbA1c),fasting C-peptide,2-hour C-peptide(PCP),fasting insulin(Fins),2-hour insulin(Pins),insulin resistance index(HOMA-IR),βCellular function index(HOMA-β),alanine aminotransferase,aspartate aminotransferase,serum total cholesterol(TC),low-density lipoprotein cholesterol(L DL-C),triglycerides(TG),high-density lipoprotein,and uric acid(UA)levels.RESULTS SBP,DBP,PBG,HbA1c,LDL-C,and TG were all significantly lower 3 months postoperative vs preoperative values;body weight,BMI,SBP,DBP,FBG,PBG,HbA1c,TC,TG,UA,and HOMA-IR values were all significantly lower 6 months postoperative vs at 3 months;and PCP,Fins,Pins,and HOMA-βwere all significantly higher 6 months postoperative vs at 3 months(all P<0.05).CONCLUSION Side-to-side anastomosis of the jejunum and ileum can effectively treat T2DM and improve the metabolic index levels associated with it.
基金Supported by National Key Research and Development Program of China,No.2022YFC3600903Key Discipline Project under Shanghai's Three-Year Action Plan for Strengthening the Public Health System(2023-2025),No.GWVI-11.1-44.
文摘BACKGROUND The burden of mental disorders(MD)in the Western Pacific Region(WPR)re-mains a critical public health concern,with substantial variations across demogra-phics and countries.AIM To analyze the burden of MD in the WPR from 1990 to 2021,along with associated risk factors,to reveal changing trends and emerging challenges.METHODS We used data from the Global Burden of Disease 2021,analyzing prevalence,incidence,and disability-adjusted life years(DALYs)of MD from 1990 to 2021.Statistical methods included age-standardisation and uncertainty analysis to address variations in population structure and data completeness.RESULTS Between 1990 and 2021,the prevalence of MD rose from 174.40 million cases[95%uncertainty interval(UI):160.17-189.84]to 234.90 million cases(95%UI:219.04-252.50),with corresponding DALYs increasing from 22.8 million(95%UI:17.22-28.79)to 32.07 million(95%UI:24.50-40.68).During this period,the burden of MD shifted towards older age groups.Depressive and anxiety disorders were predominant,with females showing higher DALYs for depressive and anxiety disorders,and males more affected by conduct disorders,attention-deficit hyperactivity disorder,and autism spectrum disorders.Australia,New Zealand,and Malaysia reported the highest burdens,whereas Vietnam,China,and Brunei Darussalam reported the lowest.Additionally,childhood sexual abuse and bullying,and intimate partner violence emerged as significant risk factors.CONCLUSION This study highlights the significant burden of MD in the WPR,with variations by age,gender,and nation.The coronavirus disease 2019 pandemic has exacerbated the situation,emphasizing the need for a coordinated response.
文摘Objective:To explore the effect of cognitive intervention combined with aerobic limb rehabilitation exercise on neurological and limb functions in hemiplegic patients with hypertensive intracerebral hemorrhage.Methods:A prospective study was conducted with eighty-six hemiplegic patients with hypertensive intracerebral hemorrhage admitted to Taikang Xianlin Drum Tower Hospital from October 2021 to October 2023.The patients were randomly divided into a study group(43 cases)and a control group(43 cases).After 6 months of intervention,neurological function,motor and limb function,psychological state,and quality of life scores were compared between the two groups to assess the effects of the intervention.Results:After the intervention,neurological function indexes in the study group,including S100B protein,myelin basic protein and National Institutes of Health Stroke Scale score,were significantly lower than those in the control group(all P<0.05).In contrast,brain-derived neurotrophic factor and Mini-Mental State Examination scores were significantly higher in the study group(all P<0.05).Additionally,motor function,Barthel score,Fugl-Meyer score,and muscle strength(grades V and IV)were significantly higher in the study group compared to the control group(all P<0.05).Psychological resilience,including scores for toughness,optimism,and strength,as well as the total resilience score,were significantly higher in the study group(all P<0.05).Moreover,the Generic Quality of Life Inventory score was also significantly higher in the study group(P<0.05).Conclusion:Cognitive intervention combined with aerobic limb rehabilitation exercises can alleviate neurological damage in hemiplegic patients with hypertensive intracerebral hemorrhage,enhance muscle strength,promote limb and motor function recovery,and improve psychological state and quality of life.
基金supported by the National Natural Science Foundation of China(31901300).
文摘Pinus koraiensis is the dominant and constructive species of the zonal vegetation in Northeast China,known as the mixed broadleaf-Korean pine forest.Although carbohydrate metabolism pathways in the seed embryo are known to play crucial roles during seed dormancy and germination in P.koraiensis,it remains unclear whether these metabolic pathways function differentially across tissues.P.koraiensis seeds that had undergone different durations of moist chilling in their natural environment,yielding seeds with relatively deeper primary physiological dormancy(DDS)and seeds with released primary physiological dormancy(RDS).A non-targeted metabolomic analysis was conducted on the radicle and hypocotyl-cotyledon portions of both DDS and RDS,before and after a two-week incubation under favorable conditions.Under germination conditions,RDS and DDS showed divergent metabolic profiles,especially regarding carbohydrate metabolism.Specifically,RDS seeds showed significantly reduced substrates of respiratory metabolic pathways in both radicles and hypocotyl-cotyledons.Conversely,the intermediates of the carbohydrate metabolism pathway(particularly the tricarboxylic acid cycle)accumulating in radicles of DDS seeds under germination conditions.Moreover,in RDS,the carbohydrate metabolic pathways were more prevalent in the hypocotyl-cotyledon,while lysine degradation and ascorbate and aldarate metabolism were the dominant metabolic pathways in radicles.In contrast,the tricarboxylic acid cycle showed higher activity in DDS radicles compared to hypocotyl-cotyledons.We further demonstrated that carbohydratemetabolic pathways continue to play a dominant role in both dormancy maintenance and germination processes of P.koraiensis seeds.Notably,the carbohydratemetabolism in radicles likely exerts more critical regulatory functions in these two physiological processes compared to that in cotyledon and hypocotyl tissues.
基金Supported by the Program of General Hospital of Western Theater,No.2021-XZYG-C33.
文摘Splenic histiocytic sarcoma(SHS)is a rare,aggressive hematological malignancy with unclear progression and management.Our case illustrates the progression and pathophysiological processes of SHS and provides key data for the diagnosis,treatment and management of SHS.A 60-year-old female with incidentally detected splenic mass(6.0 cm×5.7 cm)underwent splenectomy,confirmed as SHS in 2020.Post-op imatinib therapy was given.In 2022,hepatic metastases(2.4 cm×2.9 cm)with pancytopenia led to supportive care.Lesions enlarged to 4.3 cm×2.7 cm,leading to multi-organ failure and death at 33 months.The case was categorized into three distinct stages based on the pathophysiology of SHS:Early-stage splenic tumor growth,mid-stage liver metastasis with hematological abnormalities,and late-stage tumor infiltration leading to multiorgan failure.For SHS,this case highlights the pivotal role of early intervention and the value of personalized treatment strategies.
基金supported by a grant from the Zhejiang Province Traditional Chinese Medicine Science and Technology Plan Project(2019ZB101)。
文摘Hepatitis E virus(HEV)is the primary cause of acute viral hepatitis globally and is prevalent in many developing countries.Serological epidemiology studies[1,2]suggest that approximately onethird of the global population has been infected with HEV.There are an estimated 20 million new cases of HEV infection worldwide annually.World Health Organization(WHO)reported that HEV caused approximately 44000 deaths in 2015,which accounted for3.3%of deaths from viral hepatitis[3,4].Clinically,most cases of acute hepatitis E have a self-limiting course.However,co-infection with other viruses can increase the risk of acute or subacute liver failure.Hepatitis B virus(HBV)and HEV are highly prevalent in many regions worldwide,and these areas have high rates of coinfection with both viruses.The rate of co-infection with HEV among patients with chronic hepatitis B(CHB)is high,resulting in more severe health outcomes and a significantly elevated risk of liver failure and death.
基金supported by National Natural Science Foundation of China(81272737).
文摘Acute pancreatitis(AP)is a prevalent gastrointestinal disease necessitating hospitalization globally,with an annual incidence ranging from 13 to 45 per 100,000 individuals[1]and a mortality rate of 5%-10%.[2]While most cases follow a self-limiting course,approximately 20%-30%of cases progress to severe acute pancreatitis(SAP),characterized by pancreatic necrosis and multiorgan failure,with the mortality rate increasing to 36%-50%.
文摘BACKGROUND Hepatocellular carcinoma(HCC)is the most common pathological type of liver cancer and was the third leading cause of cancer-related deaths worldwide in 2020.AIM To evaluate the diagnostic potential of key tumor markers in serum,bile,and fecal samples for detecting HCC.METHODS Blood,bile,and fecal samples were collected from patients(n=265)with HCC and cholecystitis from Guangxi Medical University’s First Affiliated Hospital.Immunohistochemistry was performed on 69 HCC samples,and 16S ribosomal RNA sequencing was conducted on 166 fecal samples.Tumor marker cut-off values in bile and feces were determined using the Youden index,while serum biomarkers followed hospital standards.Diagnostic performance was evaluated using receiver operating characteristic analysis.RESULTS The areas under the curve(AUCs)for distinguishing HCC were 0.898,0.904,and 0.859 for serum alpha-fetoprotein(AFP),prothrombin induced by vitamin K absence-II(PIVKA-II),and bile AFP,respectively.Serum AFP had the highest diagnostic value(80%)for early-stage HCC.Combination analysis found that bile AFP and serum PIVKAII achieved the highest AUC of 0.965(P<0.001),suggesting that bile AFP may serve as a valuable complementary biomarker,particularly in cases where serum AFP is not significantly elevated.Additionally,bile AFP was positively correlated with Actinomyces,which plays a significant role in promoting tumorigenesis;and was negatively correlated with Faecalibacterium,which was associated with robust anticancer immune responses(P<0.05).These findings suggest the potential role of gut microbiota in modulating AFP levels and HCC progression.CONCLUSION Bile AFP improved the sensitivity of HCC detection,with the combination of bile AFP and PIVKA-II demonstrating the highest AUC for HCC diagnosis.AFP is associated with poorer clinical outcomes.
基金Shandong-Chongqing Science and Technology Cooperation Project(2024LYXZ021)Natural Science Foundation of Shandong Province(ZR2023QG014)。
文摘Breast cancer is the most common malignant tumor among women worldwide,with its incidence and mortality ranking first among all cancers.Early diagnosis and treatment significantly improve prognosis and reduce disease-related mortality.Chest computed tomography(CT),a routine examination for physical assessments and hospitalized patients,can screen for the presence of breast nodules and provide an initial assessment of malignancy risk.In recent years,artificial intelligence(AI)has advanced rapidly in the medical field.Studies have demonstrated that the sensitivity and accuracy of chest CT in diagnosing breast cancer are enhanced through the application of AI methods.This article explores the research progress in breast cancer diagnosis utilizing artificial intelligence based on chest CT examinations.
基金Supported by the Shanghai Municipal Health Commission Project,No.20214Y0284.
文摘BACKGROUND Preoperative risk assessments are vital for identifying patients at high risk of postoperative mortality.However,traditional scoring systems can be time consuming.We hypothesized that the use of machine learning models would enable rapid and accurate risk assessments to be performed.AIM To assess the potential of machine learning algorithms to develop predictive models of mortality risk after abdominal surgery.METHODS This retrospective study included 230 individuals who underwent abdominal surgery at the Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine between January 2023 and December 2023.Demographic and surgery-related data were collected and used to develop nomogram,decision-tree,random-forest,gradient-boosting,support vector machine,and naïve Bayesian models to predict 30-day mortality risk after abdominal surgery.Models were assessed using receiver operating characteristic curves and compared using the DeLong test.RESULTS Of the 230 included patients,52 died and 178 survived.Models were developed using the training cohort(n=161)and assessed using the validation cohort(n=68).The areas under the receiver operating characteristic curves for the nomogram,decision-tree,random-forest,gradient-boosting tree,support vector machine,and naïve Bayesian models were 0.908[95%confidence interval(CI):0.824-0.992],0.874(95%CI:0.785-0.963),0.928(95%CI:0.869-0.987),0.907(95%CI:0.837-0.976),0.983(95%CI:0.959-1.000),and 0.807(95%CI:0.702-0.911),respectively.CONCLUSION Nomogram,random-forest,gradient-boosting tree,and support vector machine models all demonstrate strong performances for the prediction of postoperative mortality and can be selected based on the clinical circumstances.
基金supported by the National Natural Science Foundation of China(82003451 and 82003455)Yunnan Fundamental Research Projects(202101AT070033)the Start-Up Fund for Introduction of High-level Talents to Dali University(YBS2021015).
文摘Hyperlipidemia is a risk factor for clinically significant thrombotic events in cardiovascular diseases.Platelet reactivity in hyperlipidemic conditions is enhanced when platelet scavenger receptor CD36 recognizes oxidized lipids in oxidized low-density lipoprotein(ox-LDL)particles,a process that induces atherothrombosis.Sulforaphane(SFN)is a dietary isothiocyanate enriched in cruciferous vegetables and exerts multiple biological activities.The current study sought to investigate the efficacy of SFN on platelet hyperreactivity under hyperlipidemic conditions in vitro and in vivo.Using a series of platelet functional assays in human platelets in vitro,we demonstrated that SFN attenuated ox-LDL-increased platelet aggregation and activation(surface CD62P expression).Mechanistically,studies using pharmacological inhibitors clarified that these inhibitory effects of SFN were mainly modulated by down-regulating CD36-mediated activation of Src kinases,leading to enhanced activation of cyclic adenosine monophosphate/protein kinase A(cAMP/PKA)signaling,and resultant inhibition of NADPH oxidase 2(NOX2)-dependent generation of reactive oxygen species(ROS).Moreover,12-week supplementation of SFN-enriched broccoli sprout extract(BSE,0.06%diet)in hyperlipidemic C57BL/6J mice also decreased platelet hyperreactivity.Studies using pharmacological inhibitors of CD36,protein kinase A(PKA)and NOX2 showed that the efficacy of BSE supplementation was mainly through modulating CD36-mediated the cAMP/PKA/NOX2 signaling.Thus,through modulating the cAMP/PKA/NOX2 pathway and attenuating CD36-mediated platelet hyperreactivity,SFN may play important protective roles in atherothrombosis under hyperlipidemic conditions.
基金supported by the Seventh Batch of National Academic Experience Inheritance Project for Senior TCM Experts from the National Administration of Traditional Chinese Medicine(No.GZYRJS[2022]76)the Sixth Batch of Beijing Municipal Academic Experience Inheritance Project for TCM Experts from Beijing Administration of Traditional Chinese Medicine(No.JZYKZ[2019]139).
文摘Granulomatosis with polyangiitis(GPA)poses significant therapeutic challenges due to its susceptibility to concurrent infections and frequent relapses.Professor SHI Zaixiang proposed the therapeutic theory of lifting depression and removing blood stasis,resolving phlegm and dispelling nodulation for GPA management.He identified the core pathogenesis as“Qi collapse with collateral obstruction and phlegm-stasis intermingling”,establishing the treatment principle of comprehensive intervention through ascending ancestral Qi,activating blood circulation,and resolving phlegm-stasis nodules.In clinical practice,Professor SHI emphasizes maintaining immune homeostasis with herbal medicine to enhance efficiency,while dynamically balancing Qi,blood,Yin,and Yang.Notably,he highlights the critical role of emotional factors in autoimmune disease progression.A representative case was provided to elucidate his clinical reasoning in GPA treatment.
