Naringin attenuates Actinobacillus pleuropneumoniae-induced acute lung injury via MAPK/NF-κB and Keap1/Nrf2/HO-1 pathway.

Actinobacillus pleuropneumoniae (APP) causes porcine pleuropneumonia (PCP), which is clinically characterized by acute hemorrhagic, necrotizing pneumonia, and chronic fibrinous pneumonia. Although many measures have been taken to prevent the disease, prevention and control of the disease are becoming increasingly difficult due to the abundance of APP sera, weak vaccine cross-protection, and increasing antibiotic resistance in APP. Therefore, there is an urgent need to develop novel drugs against APP infection to prevent the spread of APP. Naringin (NAR) has been reported to have an excellent therapeutic effect on pulmonary diseases, but its therapeutic effect on lung injury caused by APP is not apparent. Our research has shown that NAR was able to alleviate APP-induced weight loss and quantity of food taken and reduce the number of WBCs and NEs in peripheral blood in mice; pathological tissue sections showed that NAR was able to prevent and control APP-induced pathological lung injury effectively; based on the establishment of an in vivo/in vitro model of APP inflammation, it was found that NAR was able to play an anti-inflammatory role through inhibiting the MAPK/NF-κB signaling pathway and exerting anti-inflammatory effects; additionally, NAR activating the Nrf2 signalling pathway, increasing the secretion of antioxidant enzymes Nqo1, CAT, and SOD1, inhibiting the secretion of oxidative damage factors NOS2 and COX2, and enhancing the antioxidant stress ability, thus playing an antioxidant role. In summary, NAR can relieve severe lung injury caused by APP by reducing excessive inflammatory response and improving antioxidant capacity.

[Circular RNA-Encoded Proteins in Gastrointestinal Cancer:A Review].

Circular RNAs(CircRNAs)are a class of non-coding RNAs with a covalently closed-loop structure,high stability,and tissue specificity,with the production mechanisms different from linear RNAs.Recent studies have discovered that some CircRNAs can encode proteins via cap-independent translation mechanisms such as internal ribosome entry site,N6-methyladenosine,and rolling loop translation.The encoded proteins regulate homologous linear proteins or downstream signaling pathways via protein bait or other mechanisms,thereby exerting biological functions.Studies have shown that CircRNAs play a role in various diseases,especially in tumor progression,proliferation,invasion,and metastasis and immune regulation.Therefore,by elucidating the expression and roles of proteins encoded by CircRNAs in tumorigenesis and development,this paper is expected to provide new tumor markers and potential targets for tumor diagnosis and treatment.

[Application of a low copper diet guidance based on food exchange portions in children with hepatolenticular degeneration]. / åŸºäºŽé£Ÿç‰©äº¤æ¢ä»½æ³•çš„ä½Žé“œé¥®é£ŸæŒ‡å¯¼åœ¨è‚è±†çŠ¶æ ¸å˜æ€§æ‚£å„¿ä¸­çš„åº”ç”¨æ•ˆæžœ.

OBJECTIVES: To study the efficacy of a low-copper diet guidance based on food exchange portions in children with hepatolenticular degeneration. METHODS: A self-controlled study was conducted from July 2021 to June 2022, including 30 children under the age of 18 who were diagnosed with hepatolenticular degeneration and poorly controlled with a low-copper diet. During the medical visit, personalized low-copper diet guidance was provided to the children and their parents using a copper-containing food exchange table and a copper food exchange chart. During home care, compliance with the low-copper diet of the children was improved by recording dietary diaries and conducting regular follow-ups. The changes in 24-hour urine copper level, liver function indicators, and the low-copper diet knowledge of the children's parents were observed before and after the intervention, with no change in the original drug treatment. RESULTS: After 8, 16, and 24 weeks of intervention, the 24-hour urine copper level decreased significantly compared to before intervention (P<0.05). When compared to 8-week intervention, the urine copper level decreased significantly after 16 and 24 weeks of intervention. The 24-hour urine copper level after 24 weeks of intervention decreased significantly compared to 16 weeks of intervention (P<0.05).After 24 weeks of intervention, the alanine aminotransferase and aspartate aminotransferase levels decreased significantly compared to before intervention (P<0.05). Additionally, in 16 of the cases (53%), alanine aminotransferase and aspartate aminotransferase returned to normal levels. Following 8 weeks of intervention, the low-copper diet knowledge of the children's parents increased significantly (P<0.05). CONCLUSIONS: A low-copper diet guidance based on food exchange portions can effectively decrease the urine copper level and improve liver function in children with hepatolenticular degeneration. Furthermore, it can increase the low-copper diet knowledge of the children's parents.

Comparative study of oncologic efficacy of cephalomedial to lateral dissection versus medial to lateral dissection in laparoscopic total mesorectal excision for rectal cancer: An RCT study.

BACKGROUND AND OBJECTIVES: We compared the 3-year overall survival between cephalomedial-to-lateral approach proctectomy (CEMP) and medial-to-lateral approach proctectomy (MAP) in patients undergoing laparoscopic total mesorectal excision for rectal cancer. The advantages of CEMP and the clinical value of No. 253 lymph nodes resection have not been objectively analyzed in literature. METHODS: This was a prospective, two-arm, multicenter, single-blinded, randomized trial. The primary endpoint was 3-year overall survival, and secondary endpoints included safety, feasibility, oncological radicality (including number of No. 253 lymph nodes harvested), short-term outcome, 3-year disease-free survival, rate of postoperative complications, mortality, and rate of recurrence. RESULTS: From May 2016 to July 2020, 506 patients were enrolled-256 in the CEMP group and 250 in the MAP group. Comparison of overall survival and disease-free survival showed that there was treatment benefit in the CEMP group (28.22 ± 12.12 vs. 27.44 ± 13.06, p = 0.485; 27.24 ± 12.01 vs. 26.42 ± 12.81; p = 0.457). More No. 253 lymph nodes were harvested in the CEMP group, and cases with positive No. 253 lymph nodes had worse prognosis in stage III. Surgical safety was equal for both approaches. CONCLUSIONS: Dissection of No. 253 lymph nodes may be important to improve clinical prognosis, but further studies with larger samples are needed to confirm this finding.

Bacterial succession in epiphytic biofilms and deciduous layer sediments during Hydrilla verticillata decay: A field investigation.

Submersed macrophytes decay is an important natural process and has important role in mass and energy flow in aquatic ecosystems. However, little is known about the dynamical changes in nutrients release and bacterial community during submersed macrophyte decay in natural environment. In this study, a field observation was conducted in a wetland dominated with Hydrilla verticillata for 36 days. Increase of H2O2 and malondialdehyde (MDA) content and decrease of soluble proteins concentration were detected in leaves during H. verticillata decay. Meanwhile, ammonium-N, soluble microbial products (SMP) and TOC concentration increased in overlying water. According to bacterial 16S rRNA Illumina sequencing analysis, the Shannon values were lower in epiphytic biofilms than deciduous layer sediments. The relative abundances of Proteobacteria, Cyanobacteria and Actinobacteria were higher in epiphytic biofilms than in deciduous layer sediments (P < 0.05). Co-occurrence network analyses showed that a total of 578 and 845 pairs of correlations (|r| > 0.6) were identified from 122 and 112 genera in epiphytic biofilms and deciduous layer sediments, respectively. According to co-occurrence patterns, eight hubs were mainly from phyla Proteobacteria, Acidobacteria and Parcubacteria in epiphytic biofilms; while 37 hubs from the 14 phyla (Proteobacteria, Bacteroidetes, Acidobacteria, Chloroflexi, et al.) were detected in deciduous layer sediments. Our results indicate that bacterial community in deciduous layer sediments was more susceptible than in epiphytic biofilms during decay process. These data highlight the role of microbial community in deciduous layer sediments on nutrients removal during H. verticillata decay and will provide useful information for wetland management.

Chlorogenic acid attenuates virulence factors and pathogenicity of Pseudomonas aeruginosa by regulating quorum sensing.

Quorum sensing (QS) is a cell-to-cell communication that is used by bacteria to regulate collective behaviors. Quorum sensing controls virulence factor production in many bacterial species and it is regarded as an attractive target to combat bacterial pathogenicity, especially against antibiotic-resistant bacteria. Chlorogenic acid (CA), abundant in fruits, vegetables, and Chinese herbs, processes multiple activities. In this research, we explored its quorum sensing quenching activity. In Pseudomonas aeruginosa, CA significantly inhibited the formation of biofilm, the ability of swarming, and virulence factors including protease and elastase activities and rhamnolipid and pyocyanin production. CA showed similar inhibitory effects in Chromobacterium violaceum on its biofilm formation, swarming motility, chitinolytic activity and violacein production. We examined the expression of QS-related genes in P.aeruginosa  and found these genes were all downregulated by CA treatment. Computational modeling revealed that CA can form hydrogen bonds with all three QS receptors. Caenorhabditis elegans and mouse infection models were employed to explore the anti-virulence ability of CA and its effect on pathogenesis process in vivo. CA extended the survival period and reduced the quantity of P. aeruginosa in nematode gut, showing a moderate protective effect on C. elegans. In mice wound model, CA-treated groups showed an accelerating healing rate and the bacteria number in wound area was also decreased by CA treatment. It is suggested by our research that CA has potential to be used as an anti-virulence factor in P. aeruginosa infection.

Comparison of immune responses induced by porcine parvovirus virus-like particles and inactivated vaccine.

Laboratory-prepared inactivated porcine parvovirus (PPV) vaccines and VP2 virus-like particles (VLPs) were utilized to immunize gilts. PPV BQ strain and SP2/0 cells were used. Hemagglutination-inhibiting (HI) antibody titers were measured in the immunized gilts and the differences in cytokine production of interferon gamma (IFN-γ, IL-2 and IL-4) were compared. CD4+ and CD8+ T cells proliferation were compared by flow cytometry. The variation between the immune response level induced by inactivated PPV vaccine and VP2 VLPs were determined. The results showed that all vaccinated gilts had HI antibody titers reaching 1:256 for at least one month post immunization and the peak level of antibody could be sustained for one month; further, PPV antibodies could be detected in the second week post immunization with VP2 VLPs. We also found that the level of cytokines (IFN-γ, IL-2 and IL-4) were all increased post immunization and continued to rise after the booster immunization; the level of increase in IFN-γ and IL-2 were significantly higher than IL-4. The flow cytometry results showed that the numbers of the CD4+ and CD8+ T cells subsets were significantly higher in the groups immunized with inactivated PPV vaccine or VP2 VLPs than those of negative control group (p<0.01); additionally, the number of CD4+ cells in the gilts that received VP2 VLP immunization was significantly higher than the inactivated vaccine group (p<0.01). In summary, the inactivated PPV vaccine and PPV VP2 VLPs were both able to induce humoral and cellular immunity, but the VP2 VLPs lead to better cellular immune responses in gilts compared to those of the inactivated vaccine..

A fusion antitumor peptide regulates proliferation and apoptosis of endothelial cells.

The present research has been carried out to elicit the mechanism of antiangiogenic activity of a fusion peptide P2. Peptide P2 was designed by the connection of a heptapeptide MMP inhibitor to ES-2, a fragment of Endostatin. In a previous study, P2 demonstrated strong antiangiogenic and antitumor effect, and the current work explains the antiangiogenic mechanism of P2 through endothelial cell proliferation and apoptosis. In our study, it was shown that P2 inhibited HUVECs proliferation at a low serum concentration and this effect might be achieved through arresting cell cycle by decreasing the expression level of Cyclin D1. In addition, P2 was found to induce apoptosis of HUVECs. Using Western blot, it was indicated that P2 induced the cleavage of Caspase-3, the hallmark protease of apoptosis. The activation and expression of the upstream regulator Caspase-9 can also be affected by P2 treatment. Furthermore, P2 reduced the protein level of antiangiogenic factors Bcl-xL and Bcl-2. These results revealed that P2 regulates endothelial cell apoptosis through intrinsic apoptotic pathway.

Identification of Varieties of Dried Red Jujubes with Near-Infrared Hyperspectral Imaging.

In order to realize rapid identification of dried red jujubes, this paper proposes a method based on near-infrared hyperspectral imaging technology. The near-infrared hyperspectral images (1 000～1 600 nm) of 240 samples in total from 4 cultivars of dried red jujubes will be acquired. The samples are to be divided into the calibration set and the prediction set in the ratio of 2∶1. 7, 8, 10 effective wavelengths are to be selected by principal component analysis(PCA), x-loading weight(x-LW)and successive projection algorithm(SPA) respectively. The dimensionality of original hyperspectral images will be reduced with PCA, and texture features of the first principal component image are to be extracted with gray-level co-occurrence matrix(GLCM).The partial least squares-discriminant analysis(PLS-DA), back propagation neural network(BPNN)and least square support vector machine(LS-SVM) are to be applied to build identification models with the selected effective wavelengths, texture features and fusion of the former two features. The identification rates of the models based on fusion features will be higher than those of models based on the spectral features or texture features respectively. The BPNN models based on the fusion features will obtain the best results, whose identification rates of prediction set are to be 100%. The results in this paper indicate that the near-infrared hyperspectral imaging technology has great potential to identify the dried red jujubes rapidly.

[Study on Visual Identification of Corn Seeds Based on Hyperspectral Imaging Technology].

The seed purity is an important indicator of seed quality. The paper proposes a visual identification method of corn seed based on the near-infrared (874~1,734 nm) hyperspectral image technology. Hyperspectral image data of 4 cultivars of a total of 384 corn seed samples will be acquired. Then 288 of samples are to be selected randomly as the calibration set, and the remaining 96 samples will be used for the prediction set. After inspection of the near-infrared spectral curves, 7 effective wavelengths (EWs) are to be selected by successive projection algorithm (SPA). And then 7 EWs of the calibration set will be used as input to build a partial least squares (PLS) model. Good results are to be obtained with Rc = 0.917 7, RMSECV = 0.444 2; Rcv = 0.911 5, RMSECV = 0.459 9. And the total identification rate of the developed PLS model will be 78.5% for the calibration set and 70.8% for the prediction set. Finally, average spectral data of each corn seed in a hyperspectral image will be extracted by image process technology, and used as input of the developed SPA-PLS model. In the produced identification map, different colors are to be used to represent different predicted cultivars. 3 mixture samples of corn seeds will be identified, and help to achieve satisfied visual effects. The result indicates that, by means of the visual identification technology we could intuitively observe the distribution of corn seeds of different cultivars in mixture samples. The research provides help for the identification and screening of seeds in agricultural production.

[Study on Non-Detective Determination of ß-Carotene Content in Loquats with Raman Spectroscopy].

In china, researches on Raman spectroscopy in terms of foodstuff mainly focus on carbohydrates, fatty acids, proteins and vitamins. Conventional methods for determining the carotenoids content require the extraction of the samples as well as other cleanup steps. In this work, Raman spectroscopy is applied to get the measured value form loquats with different mature stage which are compared with the reference value get from High Performance Liquid Chromatography (HPLC)，in order to find new, fast, and nondestructive calibration methods for quantification of ß-carotene content in loquat fruits. Least Squares Support Vector Machine and Partial least squares data processing methods are used to analyze the Raman spectra while PLS model has a prediction quality with the correlation coefficient of 0.845; the root-mean-square error of 0.022 µg·g(-1) and LS-SVM model has a better prediction quality with the correlation coefficient of 0.910 with the root-mean-square error of 0.058 µg·g(-1).

[Study on the Visualization of the Biomass of Chlorella sp., Isochrysis galbana, and Spirulina sp. Based on Hyperspectral Imaging Technique].

Effective cultivation of the microalgae is the key issue for microalgal bio-energy utilization. In nutrient rich culture conditions, the microalge have a fast growth rate, but they are more susceptible to environmental pollution and influence. So to monitor the the growth process of microalgae is significant during cultivating. Hyperspectral imaging has the advantages of both spectra and image analysis. The spectra contain abundant material quality signal and the image contains abundant spatial information of the material about the chemical distribution. It can achieve the rapid information acquisition and access a large amount of data. In this paper, the authors collected the hyperspectral images of forty-five samples of Chlorella sp., Isochrysis galbana, and Spirulina sp., respectively. The average spectra of the region of interest (ROI) were extracted. After applying successive projection algorithm (SPA), the authors established the multiple linear regression (MLR) model with the spectra and corresponding biomass of 30 samples, 15 samples were used as the prediction set. For Chlorella sp., Isochrysis galbana, and Spirulina sp., the correlation coefficient of prediction (r(pre)) are 0.950, 0.969 and 0.961, the root mean square error of prediction (RMSEP) for 0.010 2, 0.010 7 and 0.007 1, respectively. Finally, the authors used the MLR model to predict biomass for each pixel in the images of prediction set; images displayed in different colors for visualization based on pseudo-color images with the help of a Matlab program. The results show that using hyperspectral imaging technique to predict the biomass of Chlorella sp. and Spirulina sp. were better, but for the Isochrysis galbana visualization needs to be further improved. This research set the basis for rapidly detecting the growth of microalgae and using the microalgae as the bio-energy.

[Study on the Nondestructive Detection Methods for Dynamica Change of Lipid Content in Chlorella sp.].

Microalgae based biodiesel production requires a large amount of lipid accumulation in the cells, and the accumulation is greatly influenced by the environment. Therefore, it is necessary to find fast and non-destructive methods for lipid change detection. In this paper, Chlorella sp. was adopted as the objective, which was cultured under different light condition consisted of red and blue lights with different proportion. We applied the visible near-infrared spectroscopy (Vis/NIRs) technique to detect the dynamic change of lipid during the microalgae growth processes and utilized hyperspectral imaging technology for visualization of lipid distribution in the suspension. The transmittance and reflectance spectra of microalgae were acquired with Vis/NIRs and hyper-spectroscopy, respectively. In the comparison of the transmittance and reflectance spectra, they showed some different characteristics. Meanwhile it also varied in terms of the number and the area of feature wavelengths obtained by successive projections algorithm (SPA) based on the different spectra. But the established multiple linear regression (MLR) model for lipid content prediction had similar results with rpre of 0.940, RMSEP of 0.003 56 and rpre of 0.932, RMSEP of 0.004 23, respectively. Based on the predictive model, we obtained the spectra and analyzed the lipid dynamic change in microalgae in one life cycle. In the life cycle, the lipid content in Chlorella sp. was relatively stable from the beginning of inoculation to exponential phase, the increase and accumulation of lipid phenomenon occurred in the late exponential phase. Combined with the MLR model and the hypersepctral images, we studied the visualization result of microalgae suspension in the steady phase. The stimulated images showed that the microalgae with higher lipid content appeared gathering. This study compared the difference and the feasibility of the Vis/NIRs and hyperspectral imaging technique in lipid content detection applied in microalgae growing microalgae. The results are meaningful for the fast and non-destructive detection of the growth information of microalgae. It has boththeoretical and practical significance for developing microalgal culture and harvest strategy in practice.

Preoperative diabetes as a protective factor for pancreatic fistula after pancreaticoduodenectomy: a meta-analysis.

BACKGROUND: The role of diabetes mellitus (DM) in pancreatic fistula (PF) or clinical relevant PF (CR-PF) after pancreaticoduodenectomy (PD) or pylorus-preserving pancreaticoduodenectomy (PPPD) is unclear. We conducted a meta-analysis to investigate the relationship between DM and PF or CR-PF. DATA SOURCES: Embase, MEDLINE and Cochrane databases were searched systematically for relevant articles from January 2005 to June 2013. The selected studies that examined clinical risk factors of PF or CR-PF were included. We created pooled estimates for our outcomes using the random-effects model. RESULTS: Sixteen observational clinical studies were included. Pooling of PF rates from ten studies revealed that DM was associated with a decreased risk of PF (P=0.01). CR-PF rates from 8 studies showed no significant difference between DM and control group (P=0.14). CONCLUSIONS: DM is not a risk factor for PF in patients undergoing PD or PPPD. On the contrary, patients without DM are at a higher risk of PF because the pancreases in these patients have more fatty tissue and the pancreas is soft.

[SLC2A2 gene analysis in three Chinese children with Fanconi-Bickel syndrome].

Fanconi-Bickel syndrome (FBS, OMIM 227810), a rare autosomal recessive disorder of carbohydrate metabolism, is caused by SLC2A2 (GLUT2) mutations. The study reported 3 cases of FBS who were confirmly diagnosed by SLC2A2 gene analysis. The three patients showed typical features like glycogen storage disease and proximal renal tubular nephropathy. Homozygous splice-site mutation IVS8+5G>C (c.1068+5 G>C) was found in patient A and homozygous nonsense mutation c.1194T>A (p.Tyr398X) in patient B. Patient C harboured a missense mutation c.380C>A (p.Ala127Asp) and a de novo insertion c.970dupT (p.324TyrfsX392) which was not inherited from her parents. Four mutations were identified in the 3 Chinese FBS patients. Except IVS8+5G>C mutation, the other 3 mutations were novel in Chinese population. To the best of our knowledge, patient C may be the first FBS case worldwide with de novo mutation.

Application of international videoconferences for continuing medical education programs related to laparoscopic surgery.

BACKGROUND: Continuing medical education (CME) is an effective way for practicing physicians to acquire up-to-date clinical information. MATERIALS AND METHODS: We conducted four CME seminars in 2007-2010 endorsed by the Chinese Medical Association Council on Medical Education. Overseas telelectures and live case demonstrations were introduced in each seminar via telemedicine based on a digital video transport system. Network stability and packet loss were recorded. An anonymous mini-questionnaire was conducted to evaluate the satisfaction of attendees regarding the image and sound quality, content selection, and overall evaluation. RESULTS: Four telelectures and five live case demonstrations were successfully conducted. Stability of the network was maintained during each videoconference. High-quality videos of 720 × 480 pixels at the rate of 30 frames per second were shown to the entire group of attendees. The time delay between Shanghai and Fukuoka, Japan, was only 0.3 s, and the packet loss was 0%. We obtained 129 valid responses to the mini-questionnaire from a total of 146 attendees. The majority of the attendees were satisfied with the quality of transmitted images and voices and with the selected contents. The overall evaluation was ranked as excellent or good. CONCLUSIONS: Videoconferences are excellent channels for CME programs associated with laparoscopic training.

[A splicing mutation of EXT1 in a Chinese pedigree with hereditary multiple exostoses].

OBJECTIVE: Hereditary multiple exostoses (HME) is an autosomal dominant monogenic disorder of paraplasia ossium. Mutations in EXT1 and EXT2 have been suggested to be responsible for over 70% of HME cases. This study aimed to analyze the clinical features and pathogenic mutations in a Chinese family with HME (6 patients in 24 members of 3 generations) and to review the relative literature regarding mutations in EXT1 and EXT2 in the Chinese population. METHODS: Clinical pedigree dada from a Chinese family of HME were collected and analysed. EXT gene mutations in this pedigree assessed by PCR and sequencing. Pubmed and Wanfang (a Chinese database) were searched for the literature related to gene mutations in Chinese HME patients. RESULTS: In the pedigree analyzed, the age of onset of HME was becoming younger, the disease was becoming more severe, and the number of osteochondromas was increasing, in successive generations. A splicing mutation IVS5+1G>A, first identified in Chinese population, was found in all diseased members of this pedigree. According the currently available literature, EXT1 and EXT2 mutations have been detected in 29% (26/90) and 43% (39/90) Chinese families with HME. CONCLUSIONS: HME starts earlier and becomes more severe and extensive with each successive generation in members of the pedigree analyzed. A splicing mutation, IVS5+1G>A, of EXT1, first identified in Chinese population, may be responsible for HME in the studied pedigree. EXT1 and EXT2 mutation rates may be different between the Chinese and Western populations.

[Three PHEX gene mutations in Chinese subjects with hypophosphatemic rickets and literature review].

The clinical data of three Chinese children who had been definitely diagnosed with X-link dominate hypophosphatemic rickets (XLH) by gene mutation analysis of phosphate-regulating gene with homologies to endopeptidases on the X chromosome (PHEX) were retrospectively studied and the relevant literature was reviewed. PHEX gene mutations were detected in all 3 XLH children; a nonsense mutation (c.58C>T) in one case and splicing mutations (c.1645+1G>A, c.436+1G>A) in the other two cases. Among these mutations, c.436+1G>A was novel. As of January 2014, a total of 329 PHEX gene mutations were reported, primarily within three mutation hot spots, throughout the world. Missense mutations accounted for the highest proportion (24%) among all mutations. There is literature showing geographic differences in the total number of XLH subjects and PHEX mutation types across the world. In the current literature, 89 cases of XLH with 28 types of PHEX mutations have been reported in the population of mainland China. Exon 22 is the most frequent mutation site (18%) and missense mutations are the most common type of mutations (61%). It is concluded that exon 22 is the mutation hot spot and missense mutation is the most common type of mutation in the PHEX gene in Chinese XLH patients and that c.436+1G>A detected in this study is a novel PHEX gene mutation in Chinese with XLH.

Development and validation of an interpretable machine learning for mortality prediction in patients with sepsis.

Introduction: Sepsis is a leading cause of death. However, there is a lack of useful model to predict outcome in sepsis. Herein, the aim of this study was to develop an explainable machine learning (ML) model for predicting 28-day mortality in patients with sepsis based on Sepsis 3.0 criteria. Methods: We obtained the data from the Medical Information Mart for Intensive Care (MIMIC)-III database (version 1.4). The overall data was randomly assigned to the training and testing sets at a ratio of 3:1. Following the application of LASSO regression analysis to identify the modeling variables, we proceeded to develop models using Extreme Gradient Boost (XGBoost), Logistic Regression (LR), Support Vector Machine (SVM), and Random Forest (RF) techniques with 5-fold cross-validation. The optimal model was selected based on its area under the curve (AUC). Finally, the Shapley additive explanations (SHAP) method was used to interpret the optimal model. Results: A total of 5,834 septic adults were enrolled, the median age was 66 years (IQR, 54-78 years) and 2,342 (40.1%) were women. After feature selection, 14 variables were included for developing model in the training set. The XGBoost model (AUC: 0.806) showed superior performance with AUC, compared with RF (AUC: 0.794), LR (AUC: 0.782) and SVM model (AUC: 0.687). SHAP summary analysis for XGBoost model showed that urine output on day 1, age, blood urea nitrogen and body mass index were the top four contributors. SHAP dependence analysis demonstrated insightful nonlinear interactive associations between factors and outcome. SHAP force analysis provided three samples for model prediction. Conclusion: In conclusion, our study successfully demonstrated the efficacy of ML models in predicting 28-day mortality in sepsis patients, while highlighting the potential of the SHAP method to enhance model transparency and aid in clinical decision-making.

Recent advances in potential therapeutic targets of ferroptosis­associated pathways for the treatment of stroke (Review).

Stroke is a severe neurological disease that is associated with high rates of morbidity and mortality, and the underlying pathological processes are complex. Ferroptosis fulfills a significant role in the progression and treatment of stroke. It is well established that ferroptosis is a type of programmed cell death that is distinct from other forms or types of cell death. The process of ferroptosis involves multiple signaling pathways and regulatory mechanisms that interact with mechanisms inherent to stroke development. Inducers and inhibitors of ferroptosis have been shown to exert a role in the onset of this cell death process. Furthermore, it has been shown that interfering with ferroptosis affects the occurrence of stroke, indicating that targeting ferroptosis may offer a promising therapeutic approach for treating patients of stroke. Hence, the present review aimed to summarize the latest progress that has been made in terms of using therapeutic interventions for ferroptosis as treatment targets in cases of stroke. It provides an overview of the relevant pathways and molecular mechanisms that have been investigated in recent years, highlighting the roles of inducers and inhibitors of ferroptosis in stroke. Additionally, the intervention potential of various types of Traditional Chinese Medicine is also summarized. In conclusion, the present review provides a comprehensive overview of the potential therapeutic targets afforded by ferroptosis­associated pathways in stroke, offering new insights into how ferroptosis may be exploited in the treatment of stroke.