Development and validation of a risk prediction model and prediction tools for post-thrombotic syndrome in patients with lower limb deep vein thrombosis.

PURPOSE: Our research aims to compare the predictive performance of decision tree algorithms (DT) and logistic regression analysis (LR) in constructing models, and develop a Post-Thrombotic Syndrome (PTS) risk stratification tool. METHODS: We retrospectively collected and analyzed relevant case information of 618 patients diagnosed with DVT from January 2012 to December 2021 in three different tertiary hospitals in Jiangxi Province as the modeling group. Additionally, we used the case information of 212 patients diagnosed with DVT from January 2022 to January 2023 in two tertiary hospitals in Hubei Province and Guangdong Province as the validation group. We extracted electronic medical record information including general patient data, medical history, laboratory test indicators, and treatment data for analysis. We established DT and LR models and compared their predictive performance using receiver operating characteristic (ROC) curves and confusion matrices. Internal and external validations were conducted. Additionally, we utilized LR to generate nomogram charts, calibration curves, and decision curves analysis (DCA) to assess its predictive accuracy. RESULTS: Both DT and LR models indicate that Year, Residence, Cancer, Varicose Vein Operation History, DM, and Chronic VTE are risk factors for PTS occurrence. In internal validation, DT outperforms LR (0.962 vs 0.925, z = 3.379, P < 0.001). However, in external validation, there is no significant difference in the area under the ROC curve between the two models (0.963 vs 0.949, z = 0.412, P = 0.680). The validation results of calibration curves and DCA demonstrate that LR exhibits good predictive accuracy and clinical effectiveness. A web-based calculator software of nomogram (https://sunxiaoxuan.shinyapps.io/dynnomapp/) was utilized to visualize the logistic regression model. CONCLUSIONS: The combination of decision tree and logistic regression models, along with the web-based calculator software of nomogram, can assist healthcare professionals in accurately assessing the risk of PTS occurrence in individual patients with lower limb DVT.

[The influence of oil heat treatment on wood decay resistance by Fourier infrared spectrum analysis].

Wood preservative treatment can improve defects of plantation wood such as easy to corrupt and moth eaten. Among them heat-treatment is not only environmental and no pollution, also can improve the corrosion resistance and dimension stability of wood. In this test Poplar and Mongolian Seoteh Pine was treated by soybean oil as heat-conducting medium, and the heat treatment wood was studied for indoor decay resistance; wood chemical components before and after treatment, the effect of heat treatment on wood decay resistance performance and main mechanism of action were analysed by Fourier infrared spectrometric. Results showed that the mass loss rate of poplar fell from 19.37% to 5% and Mongolian Seoteh Pine's fell from 8.23% to 3.15%, so oil heat treatment can effectively improve the decay resistance. Infrared spectrum analysis shows that the heat treatment made wood's hydrophilic groups such as hydroxyl groups in largely reduced, absorbing capacity decreased and the moisture of wood rotting fungi necessary was reduced; during the heat treatment wood chemical components such as cellulose, hemicellu lose were degraded, and the nutrient source of wood rotting fungi growth necessary was reduced. Wood decay fungi can grow in the wood to discredit wood is because of that wood can provide better living conditions for wood decay fungi, such as nutrients, water, oxygen, and so on. The cellulose and hemicellulose in wood is the main nutrition source of wood decay fungi. So the oil heat-treatment can reduce the cellulose, hemicellulose nutrition source of wood decay fungi so as to improve the decay resistance of wood.

Adhesion molecule CD146 and its soluble form correlate well with carotid atherosclerosis and plaque instability.

AIMS: Intraplaque neovascularization and foam cell infiltration contribute to the development of unstable plaque, leading to thromboembolism and stroke. Cell adhesion molecules (CAMs) have been reported to be involved in the progression of atherosclerosis and plaque vulnerability. The aim of this study was to assess the association of adhesion molecule CD146 with carotid plaque instability. METHODS: We collected forty atherosclerotic plaques from 40 patients undergoing carotid endarterectomy. The clinical information of each patient was obtained, and the plaque morphology and characteristics were examined by the ultrasound. The CD146 expressions of the plaques were graded by using semiquantitative scales. The serum level of soluble form of CD146 was detected by enzyme-linked immunosorbent assay (ELISA). RESULTS: CD146 expression was mainly on the intraplaque blood vessels and infiltrated macrophages. The CD146 expression was strongly correlated with the matrix metalloproteinase-9(MMP-9)expressions (P < 0.001) in the plaques. Soluble CD146 (sCD146) was also elevated in patients with atherosclerotic plaques. There was significant correlation between the increased CD146 expression and sCD146 level (P = 0.0057). sCD146 correlated well with serum MMP-9 (P < 0.0044), IL-6 (P = 0.0044) and high sensitivity C-reactive protein (hsCRP) (P = 0.005). CONCLUSIONS: Adhesion molecules CD146 and its soluble form strongly correlated with the development of inflammation of atherosclerosis and plaque instability. CD146 may be a promising biomarker for monitoring the development and instability of atherosclerotic plaque in patients with carotid diseases.

[Association between both triglyceride level, newly identified carotid plaque and middle-aged and elderly population, Beijing].

OBJECTIVE: To evaluate the association between triglyceride (TG) level and newly identified 5-year carotid plaque and to explore the prediction value of TG level on the newly-identified carotid plaque with risk factors of traditional atherosclerosis. METHODS: A cohort study was adopted. The baseline survey including CVD risk factors and B-mode ultrasound of carotid artery was performed in 2002, and the second follow-up examination was performed in 2007. We evaluated 1949 participants with lipid measurements and B-mode ultrasound of carotid arteries in the two surveys (with mean age as 57.9±8.1 years and 39.2% were men). The baseline TG levels were divided into four groups: group 1 (TG<1.13 mmol/L), group 2 (TG=1.13-1.69 mmol/L), group 3 (TG=1.70-2.25 mmol/L) and group 4 (TG≥2.26 mmol/L). Newly identified carotid plaque was regarded as the indicator of progression of carotid atherosclerosis. New relationship between fasting TG levels and newly identified carotid plaque was analysed. RESULTS: Compared to newly identified carotid plaque which including different TG level groups, the incidence of newly artery plaque had significantly increased along with the increase of baseline triglyceride level (30.8%, 38.8%, 41.9% and 44.2% respectively, with χ2=21.22, P<0.01). Compared to individuals (TG<1.13 mmol/L), TG seemed a risk factor of plaque progression (P<0.01). After adjusted for age, sex, dyslipidemia and other risk factors, high TG group (TG≥2.26 mmol/L) appeared a significant independent predictor of newly identified carotid plaque (OR=1.37, 95%CI: 1.00-1.86). When further stratifying the traditional atherosclerosis risk factors, we found that high TG group with smoking or hypertension was an independent factor of atherosclerosis progression. CONCLUSION: With the increase of triglyceride levels, the rate of newly identified carotid plaque also increased. After adjusting age, sex, dyslipidemia and other risk factors, serum fasting TG≥2.26 mmol/L appeared to be an independent predictor of newly developed carotid plaque.

Characteristics and risk factors of cerebrovascular accidents after percutaneous coronary interventions in patients with history of stroke.

BACKGROUND: Percutaneous coronary intervention (PCI) is a well-established method for managing coronary diseases. However, the increasing use of PCI has led to an increased incidence of acute cerebrovascular accidents (CVA) related to PCI. In this study, we investigated the characteristics and risk factors of CVA after PCI in patients with known stroke history. METHODS: Between January 1, 2005 and March 1, 2009, 621 patients with a history of stroke underwent a total of 665 PCI procedures and were included in this retrospective study. Demographic and clinical characteristics, previous medications, procedures, neurologic deficits, location of lesion and in-hospital clinical outcomes of patients who developed a CVA after the cardiac catheterization laboratory visit and before discharge were reviewed. RESULTS: Acute CVA was diagnosed in 53 (8.5%) patients during the operation or the perioperative period. Seventeen patients suffered from transient ischemic attack, thirty-four patients suffered from cerebral infarction and two patients suffered from cerebral hemorrhage. The risk factors for CVA after PCI in stroke patients were: admission with an acute coronary syndrome, use of an intra-aortic balloon pump, urgent or emergency procedures, diabetes mellitus, and poor left ventricular systolic function, arterial fibrillation, previous myocardial infarction, dyslipidemia, tobacco use, and no/irregular use of anti-platelet medications. CONCLUSIONS: The incidence of CVA during and after PCI in patients with history of stroke is much higher than that in patients without history of stroke. Patients with atrial fibrillation, previous myocardial infarction, diabetes mellitus, dyslipidemia, tobacco use, and no or irregular use of anti-platelet medications were at higher risk for recurrent stroke. This study showed a strong association between acute coronary syndromes and in-hospital stroke after PCI.