Nomogram for assistant diagnosing acute suppurative cholangitis: a case-control study.

BACKGROUND: Acute suppurative cholangitis (ASC) lacks sensitive and specific preoperative diagnostic criteria. Some researchers suggest treating ASC as severe cholangitis. This study aimed to explore the relationship between the Tokyo Guidelines 2018 (TG18) grading system for acute cholangitis (AC) and the diagnosis of acute suppurative cholangitis (ASC), searching for independent risk factors of ASC and develop a nomogram to discriminate ASC from acute nonsuppurative cholangitis (ANSC) accurately. METHODS: After applying the inclusion and exclusion criteria, 401 patients with acute cholangitis (AC) were retrospectively analyzed at Nanjing First Hospital between January 2015 and June 2023. SPSS version 27.0 and R studio software were used to analyze data obtained from medical records. The results were validated in a prospective cohort of 82 AC patients diagnosed at Nanjing First Hospital between July 2023 and February 2024. RESULTS: Among the 401 patients, 102 had suppurative bile (the ASC group; AC grade I: 40 [39.2%], AC grade II: 27 [26.5%], AC grade III: 35 [34.3%]), whereas 299 did not have (the ANSC group; AC grade I: 157 [52.5%], AC grade II: 92 [30.8%], AC grade III: 50 [16.7%]). The specificity of ASC for diagnosing moderate-to-severe cholangitis is 79.7%. Multivariate logistic regression analysis identified concurrent cholecystitis, CRP, PCT, TBA, and bile duct diameter as independent risk factors for suppurative bile, and all of these factors were included in the nomogram. The calibration curve exhibited consistency between the nomogram and the actual observation, and the area under the curve was 0.875 (95% confidence interval: 0.835-0.915), sensitivity was 86.6%, and specificity was 75.5%. CONCLUSION: Suppurative bile is a specific indicator for diagnosing moderate-to-severe cholangitis. However, diagnosing ASC with AC grade II and AC grade III has the risk of missed diagnosis as the sensitivity is only 60.8%. To improve the diagnostic rate of ASC, this study identified concurrent cholecystitis, CRP, PCT, TBA, and preoperative bile duct diameter as independent risk factors for ASC, and a nomogram was developed to help physicians recognize patients with ASC.

The application of autofluorescence system contributes to the preservation of parathyroid function during thyroid surgery.

PURPOSE: The purpose of this study was to investigate the impact of autofluorescence technology on postoperative parathyroid function and short-term outcomes in patients undergoing thyroid surgery. METHODS: A total of 546 patients were included in the study, with 287 in the conventional treatment group and 259 in the autofluorescence group. Both groups underwent central lymph node dissection, which is known to affect parathyroid function. Short-term outcomes, including rates of postoperative hypocalcemia and parathyroid dysfunction, serum calcium and PTH levels on the first postoperative day, as well as the need for calcium supplementation, were analyzed. A multivariable analysis was also conducted to assess the impact of autofluorescence on postoperative parathyroid dysfunction, considering factors such as age, BMI, and preoperative calcium levels. RESULTS: The autofluorescence group demonstrated significantly lower rates of postoperative hypocalcemia and parathyroid dysfunction compared to the conventional treatment group. The autofluorescence group also had better serum calcium and PTH levels on the first postoperative day, and a reduced need for calcium supplementation. Surprisingly, the use of autofluorescence technology did not prolong surgical time; instead, it led to a shorter hospitalization duration. The multivariable analysis showed that autofluorescence significantly reduced the risk of postoperative parathyroid dysfunction, while factors such as age, BMI, and preoperative calcium levels did not show a significant correlation. CONCLUSION: This study provides evidence that autofluorescence technology can improve the preservation of parathyroid function during thyroid surgery, leading to better short-term outcomes and reduced postoperative complications. The findings highlight the potential of autofluorescence as a valuable tool in the management of parathyroid hypofunction. Further research and validation are needed to establish the routine use of autofluorescence technology in the thyroid.

An improved typhoon simulation method based on Latin hypercube sampling method.

In order to further improve the prediction accuracy of typhoon simulation method for extreme wind speed in typhoon prone areas, an improved typhoon simulation method is proposed by introducing the Latin hypercube sampling method into the traditional typhoon simulation method. In this paper, the improved typhoon simulation method is first given a detailed introduction. Then, this method is applied to the prediction of extreme wind speeds under various return periods in Hong Kong. To validate this method, two aspects of analysis is carried out, including correlation analysis among typhoon key parameters and prediction of extreme wind speeds under various return periods. The results show that the correlation coefficients among typhoon key parameters can be maintained satisfactorily with this improved typhoon simulation method. The results show that the improved typhoon simulation method can generate the correlations among all typhoon key parameters satisfactorily. Compared with the traditional typhoon simulation method, the improved typhoon simulation method has higher accuracy in predicting the typhoon extreme wind speed in Hong Kong, increasing by about 8% and 11% respectively at 200 m height and gradient height.

Impact of PaGLK transgenic poplar on microbial community and soil enzyme activity in rhizosphere soil.

Rhizosphere microorganisms are essential parts in maintaining soil ecological functions. Reforestation using genetically modified trees might have great potential to enhance tree production in biotic and abiotic stress, however, their long-term impact on rhizosphere microorganisms is scant. In this study, we studied soil enzyme activities and composition of rhizosphere microorganisms in 2-year-old transgenic PaGLK overexpression (OE), repressed expression (RE) and wild-type (WT) poplar (P. alba × P.berlinensis). The root exudates of PaGLK transgenic poplar (P.alba × P. berlinensis) were analyzed by liquid chromatography-mass spectrometry (LC-MS). The results showed that there were significant difference for soil sucrase, urease, catalase, neutral protease and cellulase between the transgenic and WT lines at different growth periods. Alpha diversity analysis showed that bacterial community abundance and diversity for RE lines were significantly lower than WT (p < 0.05), while RE lines for fungi were significantly higher than WT lines. At the genus level, Burkholderia was the dominant group of rhizosphere bacterial community, and the relative abundance for RE was significantly higher than WT. Tomentella was the dominant group for fungi community. Serendipita for RE was significantly higher than WT and OE. Main metabolite contents of (S)-ACPA, geniposidic acid, agnuside, hydroquinone and pyranocoumarins were significantly different among transgenic lines. These results suggest that transgenic activities have effects on root exudates, rhizosphere soil enzyme activities and soil microbial community composition, but long term effects need to be further investigated.

Rapid and high throughput detection of HBV YMDD mutants with fluorescence polarization.

AIM: To develop a simple and rapid detection of HBV gene variants and prediction of lamivudine-resistance in patients. METHODS: Initially, plasmids harboring the wild-type or mutant HBV DNA fragments were used in a model system. The technique was then applied to clinical samples for an analysis of YMDD mutations. The sera were extracted from chronic hepatitis patients who had received lamivudine treatment for more than one year. P region gene of HBV was amplified by polymerase chain reaction. The excess primers and dNTPs in PCR products were removed by cleaning-up reagents. Template-directed dye-terminator incorporation reaction was performed and R110 or TAMRA labeled acyclo-terminator was added on the 3' end of TDI-primer specifically. Fluorescence polarization value was measured with Victor 2 multilabel counter and the genotypes of HBV were analyzed. RESULTS: The YMDD genotypes in recombined positive plasmid and 56 serum samples of HBV infected patients were analyzed by using our TDI-FP method and the specificity and sensitivity were confirmed by DNA sequencing. Five of 56 serum samples showed YVDD phenotype (9%), including 1 YMDD and YVDD mixed infection. Four of 56 showed YIDD phenotype (7.1%). CONCLUSION: This is a simple, rapid, low cost and high throughput assay to detect HBV polymerase gene variants and suitable for large-scale screening and prediction of the lamivudine-resistance in clinical samples.