Development and validation of a clinical prediction model for the risk of distal metastasis in intrahepatic cholangiocarcinoma: a real-world study.

BACKGROUND: Cholangiocarcinoma (CCA) is a highly malignant and easily metastatic bile duct tumor with poor prognosis. We aimed at studying the associated risk factors affecting distal metastasis of CCA and using nomogram to guide clinicians in predicting distal metastasis of CCA. METHODS: Based on inclusion and exclusion criteria, 345 patients with CCA were selected from the Fifth Medical Center of Chinese PLA General Hospital and were divided into distal metastases (N = 21) and non-distal metastases (N = 324). LASSO regression models were used to screen for relevant parameters and to compare basic clinical information between the two groups of patients. Risk factors for distal metastasis were identified based on the results of univariate and multivariate logistic regression analyses. The nomogram was established based on the results of multivariate logistic regression, and we drawn the corresponding correlation heat map. The predictive accuracy of the nomogram was evaluated by receiver operating characteristic (ROC) curves and calibration plots. The utility of the model in clinical applications was illustrated by applying decision curve analysis (DCA), and overall survival(OS) analysis was performed using the method of Kaplan-meier. RESULTS: This study identified 4 independent risk factors for distal metastasis of CCA, including CA199, cholesterol, hypertension and margin invasion, and developed the nomogram based on this. The result of validation showed that the model had significant accuracy for diagnosis with the area under ROC (AUC) of 0.882 (95% CI: 0.843-0.914). Calibration plots and DCA showed that the model had high clinical utility. CONCLUSIONS: This study established and validated a model of nomogram for predicting distal metastasis in patients with CCA. Based on this, it could guide clinicians to make better decisions and provide more accurate prognosis and treatment for patients with CCA.

Case report: Emerging species in post-traumatic endophthalmitis: Acinetobacter johnsonii.

Acinetobacter johnsonii is an uncommon cause of endophthalmitis. This case report describes a 40-year-old male admitted with pain, redness, and vision loss in his right eye after an open globe injury by a steel fragment. Clinical assessment confirmed post-traumatic endophthalmitis with an intraocular foreign body. The patient underwent a vitreous biopsy, lensectomy, vitrectomy, and intravitreal antibiotics, followed by laser photocoagulation and foreign body extraction via the pars plana. Acinetobacter johnsonii was isolated from the vitreous culture. A combination of vancomycin, levofloxacin and ceftazidime was administered, leading to reduced infection and inflammation. Postoperatively at one month, the patients' best-corrected visual acuity had improved to 20/63. The anterior segment exhibited no inflammation, the vitreous cavity was clear, and the retina with hemorrhage and laser treatment remained stable. The one-year follow-up confirmed the continued stability of the ocular condition. Acinetobacter johnsonii, a rare cause of endophthalmitis often linked to trauma or surgery, should be recognized as a possible pathogen in post-traumatic endophthalmitis cases, meriting clinical consideration.

Artificial intelligence-assisted metastasis and prognosis model for patients with nodular melanoma.

OBJECTIVE: The objective of this study was to identify the risk factors that influence metastasis and prognosis in patients with nodular melanoma (NM), as well as to develop and validate a prognostic model using artificial intelligence (AI) algorithms. METHODS: The Surveillance, Epidemiology, and End Results (SEER) database was queried for 4,727 patients with NM based on the inclusion/exclusion criteria. Their clinicopathological characteristics were retrospectively reviewed, and logistic regression analysis was utilized to identify risk factors for metastasis. This was followed by employing Multilayer Perceptron (MLP), Adaptive Boosting (AB), Bagging (BAG), logistic regression (LR), Gradient Boosting Machine (GBM), and eXtreme Gradient Boosting (XGB) algorithms to develop metastasis models. The performance of the six models was evaluated and compared, leading to the selection and visualization of the optimal model. Through integrating the prognostic factors of Cox regression analysis with the optimal models, the prognostic prediction model was constructed, validated, and assessed. RESULTS: Logistic regression analyses identified that marital status, gender, primary site, surgery, radiation, chemotherapy, system management, and N stage were all independent risk factors for NM metastasis. MLP emerged as the optimal model among the six models (AUC = 0.932, F1 = 0.855, Accuracy = 0.856, Sensitivity = 0.878), and the corresponding network calculator (https://shimunana-nm-distant-m-nm-m-distant-8z8k54.streamlit.app/) was developed. The following were examined as independent prognostic factors: MLP, age, marital status, sequence number, laterality, surgery, radiation, chemotherapy, system management, T stage, and N stage. System management and surgery emerged as protective factors (HR < 1). To predict 1-, 3-, and 5-year overall survival (OS), a nomogram was created. The validation results demonstrated that the model exhibited good discrimination and consistency, as well as high clinical usefulness. CONCLUSION: The developed prediction model more effectively reflects the prognosis of patients with NM and differentiates between the risk level of patients, serving as a useful supplement to the classical American Joint Committee on Cancer (AJCC) staging system and offering a reference for clinically stratified individualized treatment and prognosis prediction. Furthermore, the model enables clinicians to quantify the risk of metastasis in NM patients, assess patient survival, and administer precise treatments.

Pd sub-nanolayer on Au core for enhanced catalytic hydrogenation reduction of oxyanions pollutants: Synergistic effect of Pd and Au.

Oxyanion pollutants in industrial wasterwater, such as (Cr(VI)), BrO3- (Br(V)) and SeO32- (Se(IV)) have detrimental or toxic effects on individual health when their concentrations accumulated to a certain level. The conversion of these oxyanions into harmless/industrial-valuable products or removal from wastewater is of significance. Herein, we designed Pd sub-nanolayer on Au core catalysts supported on Al2O3 (sub-Pd-Au/Al2O3) for highly effective catalytic hydrogenation reduction of oxyanions under ambient conditions. The sub-Pd(0.049)-Au(0.927)/Al2O3 catalyst exhibited the highest catalytic activity and TOF value for Cr(VI), Br(V) and Se(IV) reduction, respectively, by optimizing the Pd loading amount. The synergistic effect between Pd sub-nanolayer and Au core enhanced catalytic activity by regulating the Pd dispersion and site property, according to thorough characterizations that included high-angle annular dark-field transmission electron microscopy (HAADF-TEM) image, in-situ CO-IR adsorption, CO chemisorption, and X-ray photoelectron spectroscopy (XPS). This work might provide some new lights on design of highly efficient catalysts for the elimination of oxyanion pollutants.

Fasudil hydrochloride hydrate, a Rho-kinase inhibitor, ameliorates hepatic fibrosis in rats with type 2 diabetes.

BACKGROUND: Hyperglycemia may accelerate liver fibrosis. Currently, there is no effective treatment for liver fibrosis induced by type 2 diabetes. The study aim was to investigate whether RhoA/Rho kinase (ROCK) pathway is involved in liver fibrosis in the rats with type 2 diabetes and define the protective effects of fasudil on livers. METHODS: A rat model of type 2 diabetes was established by high fat diet combined with streptozotocin (30 mg/kg, intraperitoneal injection). Animals were randomly assigned to 3 groups: control rats, untreated diabetic rats that received vehicle and fasudil-treated diabetic rats that received ROCK inhibitor fasudil hydrochloride hydrate (10 mg/kg per day, intraperitoneal injection, for 14 weeks). The morphological features of liver were observed by HE staining. Accumulation of collagen in livers was determined by Masson staining and the measurement of hydroxyproline. The mRNA expression of transforming growth factor-ß1 (TGFß1), connective tissue growth factor (CTGF), type-I, and type-III procollagen was assessed with real-time polymerase chain reaction. The phosphorylation of myosin phosphatase target subunit-1 (MYPT1) and the protein levels of TGFß1 and α-smooth muscle actin (a-SMA) were evaluated by Western blotting. RESULTS: Compared with control rats, untreated diabetic rats showed higher values of collagen and hydroxyproline in livers (P < 0.01), the phosphorylation of MYPT1 and the protein levels of TGFß1 and α-SMA were increased (P < 0.01), and the mRNA expression of TGFß1, CTGF, type-I, and type-III procollagen was upregulated (P < 0.01); compared with untreated diabetic rats, treatment with fasudil signifcantly reduced values of collagen and hydroxyproline (P < 0.01), and decreased the phosphorylation of MYPT1 and the levels of TGFß1 and α-SMA (P < 0.01), concomitant with the downregulation of TGFß1/CTGF, type-I, and type-III procollagen mRNA expression (P < 0.01). CONCLUSIONS: Fasudil ameliorates liver fibrosis in rats with type 2 diabetes at least partly by inhibiting TGFß1/CTGF pathway and α-SMA expression. Inhibition of RhoA/ROCK may be a novel therapeutic target for liver fibrosis in diabetic non-alcoholic steatohepatitis.

Experimental co-digestion of corn stalk and vermicompost to improve biogas production.

Anaerobic co-digestion of corn stalk and vermicompost (VC) as well as mono-digestion of corn stalk were investigated. Batch mono-digestion experiments were performed at 35+/-1 degrees C and initial total solid loading (TSL) ranged from 1.2% to 6.0%. Batch co-digestion experiments were performed at 35+/-1 degrees C and initial TSL of 6% with VC proportions ranged from 20% to 80% of total solid (TS). For mono-digestion of corn stalk, a maximum methane yield of 217.60+/-13.87 mL/g TS(added) was obtained at initial TSL of 4.8%, and acidification was found at initial TSL of 6.0% with the lowest pH value of 5.10 on day 4. Co-digestion improved the methane yields by 4.42-58.61% via enhancing volatile fatty acids (VFAs) concentration and pH value compared with mono-digestion of corn stalk. The maximum biogas yield of 410.30+/-11.01 mL/g TS(added) and methane yield of 259.35+/-13.85 mL/g TS(added) were obtained for 40% VC addition. Structure analysis by X-ray diffractometry (XRD) showed that the lowest crystallinity of 35.04 of digested corn stalk was obtained from co-digestion with 40% VC, which decreased 29.4% compared to 49.6 obtained from un-treated corn stalk. It is concluded that co-digestion with VC is beneficial for improving biodigestibility and methane yield from corn stalk.

[Nitrogen removal in earthworm ecofilter treating domestic wastewater].

The removal efficiency of different forms of nitrogen was studied in earthworm ecofilter treating domestic wastewater, and the mechanisms were discussed. Results indicated that, the major form of total nitrogen (TN) in influent water and effluent water were existed as ammonia-nitrogen (NH4+ -N) and nitrate-nitrogen (NO3- -N), respectively. NH4+ -N /TN in influent water and NO3- -N /TN in effluent water were 83.88% and 76.46%, respectively, NH4+ -N decreased and NO3- -N increased during the process. The average removal efficiency of TN and NH4+ -N were 28.08% and 90.44%, respectively, nitrate-nitrogen accumulated massively and nitrite-nitrogen (NO2- -N) accumulated a little. It was also observed that nitrification in earthworm ecofilter was strong and the denitrification was inhibited, TN removal was not as obvious as the NH4+ -N removal due to the poor denitrification environment. The overall removal of TN can be improved by increasing wet/dry ratio, modifying the structure of filter, multistage filter series, following by constructed wetland, and increasing C/N ratio of the influent water.

[Anaerobic co-digestion of corn stalk and vermicompost].

The characteristics of corn stalk digested alone at different total solid (TS) loading rates and co-digestion of various proportions of corn stalk and vermicompost were investigated by batch model at 35 degrees C +/- 1 degrees C. The organic loading rates (OLRs) studied were in the range of 1.2%-6.0% TS and increasing proportions of vermicompost from 20% to 80% TS. A maximum methane yield of corn stalk digested alone was 217.60 mL/g obtained at the TS loading rate of 4.8%. However, when the TS loading rate was 6.0%, the anaerobic system was acidified and the lowest pH value was 5.10 obtained on day 4 and the biogas productivity decreased. Furthermore, co-digestion of vermicompost and corn stalk in varying proportions were investigated at constant of 6.0% TS. Co-digestion with vermicompost improved the biodegradability of corn stalk and the methane yield was improved by 4.42%-58.61%, and led to higher pH values, higher volatile fatty acids (VFAs) concentration and lower alkalinity content compared with corn stalk digested alone. The maximum biogas yield and methane yield of 410.30 mL/g and 259. 35 mL/g were obtained for 40% vermicompost and 60% corn stalk respectively. Compared with corn stalk digested alone, co-digested with vermicompost didn' t affect methane content and the fermentation type, but promoted the destruction of crystalline of cellulose and the highest destruction rate was 29.36% for 40% vermicompost and 60% corn stalk. Therefore, adding vermicompost was beneficial for the decomposition and increasing the biotransformation rate of corn stalk.

[Preparation of a novel graphite electrode and its effect on phenol degradation].

In order to find an effective, stable, environmentally compatible electrode for the elimination of organic pollutants, preparation of a novel graphite electrode (NGE) was explored using graphite, epoxy resin, curing agent and acetone as materials. Water, ethanol aqueous solution, acetone, ultrasound-acetone and electrochemical method were used to pretreat the electrode. The first three methods obtained poor effect. Ultrasound-acetone could improve the pretreatment, but satisfied results were difficult to achieve. Electrochemical method could work effectively. Electrochemical oxidation of phenol was carried out on NGE and commercial graphite electrode (CGE), respectively. UV spectroscopy was used to study evolution of phenol oxidation. The results showed that CGE resulted in accumulation of bensoquine in the electrolyte, though it was more effective than NGE on phenol oxidation. While much less benzoquinone was found in the electrolyte for NGE. TOC removal rate were 40% and 31% for NGE and CGE, respectively. SEM study showed that CGE was severely corroded after phenol degradation, while NGE was undamaged, showing good stability.