摘要
Objective To develop a predictive model for postoperative acute kidney injury(AKI)in elderly patients using machine learning methods.Methods The preoperative information and postopera-tive follow-up information of elderly patients who underwent surgery from June 2019 to July 2020 were col-lected,and the laboratory examination results were extracted.A total of 115 preoperative variables were in-cluded.A model of postoperative AKI was constructed using five methods:extreme gradient boosting(XGB),gradient boosting machine(GBM),random forest(RF),support vector machine(SVM),and elastic net logistic regression(ELA).The performance of the model was evaluated using area under the re-ceiver operating characteristic curve(AUROC),area under the precision recall curve(AUPRC),and Brier score.To simplify the model for clinical application,the original model was obtained and some varia-bles with low correlation were removed,and the model was evaluated again using the above method.Results This study ultimately included 5 929 elderly patients,3 359 males(56.7%)and 2 570 females(43.3%),aged 65-99 years.Among them,154 patients(2.6%)experienced postoperative AKI.Among the prediction models constructed using five machine learning methods,XGB has the highest AUROC and AU-PRC,with values of 0.798(95%CI 0.705-0.888)and 0.230(95%CI 0.079-0.374),respectively.Its Brier score is the lowest among all models,the score is 0.023(95%CI 0.014-0.029).After simplifying the XGB model,72 variables were retained.The AUROC of the simplified model was 0.790(95%CI 0.711-0.861),slightly lower than that of the original model.The AUPRC was 0.176(95%CI 0.070-0.313),and the Brier score was 0.024(95%CI 0.017-0.033),and there was no significant statistical difference,indicating that there was no significant difference in the predictive ability of the simplified model compared to the original model.Conclusion Among the five machine learning methods used to construct postoperative AKI prediction models,XGB has the best predictive performance.The simplified XGB predic-tion model still retains high predictive performance and is easier to be promoted in clinical practice.
摘要
Saliva, like blood, urine, and other body fluids, contains extremely rich substances, among which salivary uric acid has a good correlation with serum uric acid, and could replace serum uric acid to a certain extent. In recent years, it has been found that salivary uric acid has a unique clinical value that serum uric acid does not have, and it is related to the occurrence and development of adolescent hypertension, adolescent body fat accumulation and preeclampsia, etc., so it is speculated that salivary uric acid has a certain application prospect. The aim of this review is to provide an update on the research of salivary uric acid and its future prospect.
摘要
Objective:To investigate the application value of artificial neural network in laparoscopic surgery training.Methods:The prospective cohort study was conducted. A total of 158 trainees from the First Hospital Affiliated to Army Medical University between Semptember and November, 2019 who had no experience in laparoscopic technology were selected for laparoscopic surgery training, including 52 graduate students of surgery from grade 2019, 2018 and 2017, 58 surgeons receiving standardized residency training, 12 interns and 36 refresher physicians. The 158 trainees were divided into two groups using the random number table. Trainees trained by artificial neural network laparoscopic simulator were allocated into artificial neural network group, and trainees trained by box laparoscopic simulator were allocated into general laparoscopic simulator group. Trainees in both groups were trained using the laparoscopic simulator for 10 hours (5-day continuous training, 2 hours per day) on fundamentals of laparoscopic surgery. Observation indicators: (1) comparison of operation grades on laparoscopic simulator before and after training in the two groups; (2) comparison of improvement of the operation grades on laparoscopic simulator after training between the two groups. Measurement data with normal distribution were represented as Mean± SD, comparison within groups was analyzed using the paired t test and comparison between groups was analyzed using the independent sample t test. Measurement data with skewed distribution were represented as M (range). Results:A total of 158 trainees were selected for eligibility, including 140 males and 18 females, aged from 23 to 34 years, with a median age of 27 years. Of the 158 trainees, 79 were in the artificial neural network group and 79 were in the general laparoscopic simulator group. (1) Comparison of operation grades on laparoscopic simulator before and after training in the two groups: operation grades of the nails transferring, pattern cutting, ligation, sewing knots in vivo and sewing knots in vitro for the artificial neural network group before training were 51.2±4.9, 45.6±3.7, 43.0±3.6, 42.1±3.1, and 39.6±3.1, respectively. The above indicators for the artificial neural network group after training were 78.6±3.0, 76.4±3.9, 79.9±2.5, 78.3±3.5, and 84.1±3.8, respectively. There were significant differences in the above indicators for the artificial neural network group before and after training ( t=-42.490, -56.256, -80.373, -70.802, -79.742, P<0.05). The above indicators for the general laparoscopic simulator group before training were 50.1±2.9, 45.4±3.9, 42.7±3.0, 42.3±3.4, and 39.2±4.7, respectively. The above indicators for the general laparoscopic simulator group after training were 70.4±5.0, 69.8±4.0, 72.3±3.3, 72.3±3.5, and 72.8±3.2, respectively. There were significant differences in the above indicators for the general laparoscopic simulator group before and after training ( t=-28.942, -42.436, -58.357, -52.322, -53.098, P<0.05). (2) Comparison of improvement of the operation grades on laparoscopic simulator after training between the two groups: improvement of the operation grades in the nails transferring, pattern cutting, ligation, sewing knots in vivo and sewing knots in vitro for the artificial neural network group after training were 27.4±5.7, 30.8±5.0, 36.9±4.1, 36.2±4.5 and 39.5±5.4, respectively. The above indicators for the general laparoscopic simulator group after training were 20.3±6.2, 24.4±5.1, 29.6±4.5, 29.9±5.1 and 33.5±5.6, respectively. There were significant differences in the above indicators between the two groups ( t=7.597, 7.946, 10.638, 8.200, 6.969, P<0.05). Conclusion:The introduction of artificial neural network in laparoscopic surgery training can improve the training effects.
摘要
Objective To explore the role of Th17 cells in the pathogenesis of asthma .Methods Peripheral blood was obtained from 10 patients with asthma(asthma group) and 10 healthy volunteers(control group) .RORγt mRNA expression of lymphocytes was measured by RT-PCR ,percentage of Th17 cell was detected by FCM ,IL-17 in plasma was examined by ELISA .Results RORγt mRNA level in asthma group(0 .46 ± 0 .07) was significantly higher than that in control group (0 .15 ± 0 .02) ,proportion of Th17 cell in asthma group(28 .53 ± 7 .20)% was significantly higher than that in control group(14 .72 ± 2 .33)% ,P<0 .01 .Com-pared with IL-17 level in control group(59 .68 ± 8 .85)pg/mL ,there was significant increase in asthma group(102 .31 ± 11 .45)pg/mL(P<0 .01) .Conclusion Th17 cell is associated with asthma ,and probably aggravating asthma condition through increasing in-flammation secreting IL-17 .
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Accessed to literatures at home and abroad, we introduced the process of indigo naturalis transforming from dyestuff industry into pharmaceutical industry. It is affirmed that the precursors of indigo and indirubin are isatan A, isatan B, isatan C and indicant. Meanwhile, author clarified the mechanism of transformation for these precursors transforming into indigo and indirubin. And we summarized methods of determination for these precursors. In summary, these references provide us accordance of study on processing principle of Indigo naturalis, and lay the foundation for technics of making indigo and indirubin entering into modern industry.
Subject(s)
Indigo Carmine , Indoles , Chemistry , Metabolism , Oxidation-Reduction , Pigmentation , Plants , Metabolism , Temperature摘要
<p><b>OBJECTIVE</b>To screen the factors that affect indirubin-generated significantly in the process of preparing indigo naturalis, optimize level combination and determine the optimum technology for indirubin-generated.</p><p><b>METHOD</b>Using concentration of indirubin (mg x g(-1)) that generated by fresh leaf as an index, Plackett-Burman design, Box-Behnken design response surface analysis as the statistical method, we screened the significantly influencing factors and the optimal level combination.</p><p><b>RESULT</b>The soaking and making indirubin process in preparing indigo naturalis was identified as the wax is not removed before immersion with immersion pH 7, solvent volume-leaf weight (mL: g)15, soaked not avoided light, soaking 48 h, temperature 60 degrees C, ventilation time of 180 min, and added ammonia water to adjust pH to 10.5.</p><p><b>CONCLUSION</b>The soaking and making indirubin process in preparing indigo naturalis is optimized systematically. It clarify the various factors on the impact of the active ingredient indirubin which controlled by industrialized production become reality in the process of preparing indigo naturalis, at the same time, it lay the foundation for processing principle of indigo naturalis.</p>
Subject(s)
Control Groups , Dose-Response Relationship, Drug , Hydrogen-Ion Concentration , Indigo Carmine , Indigofera , Chemistry , Indoles , Chemistry , Metabolism , Myanmar , Plant Leaves , Chemistry摘要
Objective To construct the eukaryotic expression plasmid for the expression of human Connexin26 in COS-7 cells.Methods Total RNA was isolated from human peripheral blood lymphocytes and used as template for the PCR cloning of the human Connexin26 gene.The human Cx26 cDNA containing the 678 bp whole coding region of the human Connexin26 gene was amplified by PCR using specific primers and cloned into the pCI-neo vector to construct the recombinant eukaryotic expression plasmid,pCI-Cx26.The recombinant plasmid was identified by restriction endonuclease digestion,and transfected into COS-7 cells by liposome.The expression of Cx26 mRNA and the protein were analyzed by RT-PCR and SDS-PAGE,respectively.Results Restriction endonuclease digestion analysis verified successful construction of the recombinant plasmid,pCI-Cx26.The expression of Cx26 mRNA and protein in the transfected COS-7 cells were detected by RT-PCR and SDS-PAGE,respectively.Conclusion The eukaryotic expression plasmid for human Cx26 has been constructed successfully with the capability of expression in COS-7 cells.
摘要
Chinese materia medica(CMM) industry is one of the most national identity in China′s industries.According to the development situation in recent years,putting forward some reasonable ideas will promote better and faster development of the CMM industry.In this paper,through the literature review combined with CMM industry development status,the current structure of CMM industry was analyzed.And based on the concept of the industrial chain,the CMM industry chain structure was analyzed and described.The proposal of building a harmonious CMM industry chain was put forward clearly,which will conform to the requirements of the CMM industry development.Above all,this article has provided some constructive ideas for future development of CMM industry.