Comparison of LASSO and random forest models for predicting the risk of premature coronary artery disease.

PURPOSE: With the change of lifestyle, the occurrence of coronary artery disease presents a younger trend, increasing the medical and economic burden on the family and society. To reduce the burden caused by this disease, this study applied LASSO Logistic Regression and Random Forest to establish a risk prediction model for premature coronary artery disease(PCAD) separately and compared the predictive performance of the two models. METHODS: The data are obtained from 1004 patients with coronary artery disease admitted to a third-class hospital in Liaoning Province from September 2019 to December 2021. The data from 797 patients were ultimately evaluated. The dataset of 797 patients was randomly divided into the training set (569 persons) and the validation set (228 persons) scale by 7:3. The risk prediction model was established and compared by LASSO Logistic and Random Forest. RESULT: The two models in this study showed that hyperuricemia, chronic renal disease, carotid artery atherosclerosis were important predictors of premature coronary artery disease. A result of the AUC between the two models showed statistical difference (Z = 3.47, P < 0.05). CONCLUSIONS: Random Forest has better prediction performance for PCAD and is suitable for clinical practice. It can provide an objective reference for the early screening and diagnosis of premature coronary artery disease, guide clinical decision-making and promote disease prevention.

A Nickel Dissolution Process for Multilayer Electroforming to Achieve Ultrahigh Adhesion Strength.

Multilayer electroforming has a high potential to produce Ni/Ni layer structured metal walls with excellent material properties and a high thickness uniformity. However, Ni is easily oxidized in air, which fundamentally leads to a low adhesion strength between the Ni layers. Here, a novel in situ treatment is proposed for improving the adhesion performance between Ni layers. This treatment integrated the steps of electrochemical dissolution, surface protection, and electroforming. A study of the polarization behavior implied the electroformed Ni layer was dissolved efficiently in the NH2SO3H solution, beginning at a dissolution current density of 5 A·cm-2, which could remove the oxide film. A smooth substrate surface with a good surface hydrophilicity was obtained starting at 8 A·cm-2, helping to protect the activated substrate from being contaminated and oxidized. The experimental results showed that ultrahigh normal and shear adhesion strengths over 400 MPa between the Ni layers were achieved.

Study of Copper Electrodeposition at a Very Low Temperature near the Freezing Point of Electrolyte.

At or above room temperature, metal electrodeposits often feature coarse grains, uneven microstructure and high roughness with abnormal bulges. In this study, copper electrodeposits with abnormal properties were prepared in a sulfate bath at a low temperature near the freezing point of the electrolyte. The results showed that the average grain size of the copper featured an "increase-decrease" trend while decreasing the temperature form 5 °C to -5 °C, yielding a trend from 0.25 µm to 1 µm and then to 0.6 µm. In the early stage, the temperature does not change the three-dimensional continuous nucleation mode of deposited copper. When the nucleus density reaches saturation, the polarization caused by overpotential will act on the respective nucleation and crystal growth process twice, and finally exhibit a completely different trend than that at room temperature. This study may provide insights for breakthroughs in material properties from a temperature perspective.

Solitary plasmacytoma of the left rib misdiagnosed as angina pectoris: A case report.

BACKGROUND: Solitary plasmacytoma in the left rib is rare and can cause chest discomfort such as chest pain and tightness, and its clinical manifestations are not typical, so it is often misdiagnosed. We report a case of left costal plasmacytoma misdiagnosed as angina pectoris. We also review the literature and provide suggestions as to how to avoid misdiagnosis. CASE SUMMARY: A 77-year-old man with a history of intermittent chest tightness for 3 years presented with pain in the left chest for 1 wk and was admitted to hospital. The cardiologists initially diagnosed angina pectoris but the findings of coronary angiography were not consistent with the symptoms. Computed tomography showed that the left eighth rib mass was accompanied by bone destruction. The patient was transferred to our department for further treatment. Preoperative biopsy indicated that the lesion was possibly malignant, and elective surgery was performed to remove the lesion. The size of the tumor was about 4 cm. The tumor was spindle-shaped and protruded into the pleural cavity, without invading the lungs. Postoperative pathology confirmed that the left rib lesion was plasmacytoma. After 14 mo follow-up, the patient died of systemic metastasis. CONCLUSION: Left rib solitary plasmacytoma is a rare disease confined to a specific rib and can cause local pain. Attention should be paid to the differential diagnosis of angina pectoris to avoid misdiagnosis.

Ubiquitin specific peptidase 47 promotes proliferation of lung squamous cell carcinoma.

BACKGROUND: Ubiquitin specific peptidase 47 (USP47) is a kind of deubiquitinase, which has been reported to play oncogenic roles in several malignancies including colorectal cancer and breast cancer. OBJECTIVE: Here we aimed to investigate the clinical significance of USP47 in lung squamous cell carcinoma (LUSC). METHODS: We retrospectively enrolled a cohort of LUSC patients who underwent surgical resection in our hospital (n = 280) and conducted immunohistochemistry staining for their tumor tissues targeting USP47. The correlations between USP47 expression and clinicopathological characteristics were evaluated by Chi-square test. Univariate and multivariate analyses were conducted to assess the prognostic predictive role of USP47 in LUSC. Cell lines and mice models were utilized to explore the tumor-related functions of USP47 in vitro and in vivo, respectively. RESULTS: Among the 280 cases, there were 127 cases classified as high-USP47 expression and 153 cases with low-USP47 expression. Statistical analyses revealed that higher USP47 expression was independently correlated with larger tumor size, advanced T stage, and unfavorable prognosis. Knockdown of USP47 by shRNA resulted in impaired proliferation of LUSC cell lines and reduced nucleus beta-catenin level. Furthermore, xenograft assays demonstrated that silencing USP47 can inhibit LUSC tumor growth in vivo. CONCLUSION: Our research established a novel tumor-promoting effect and prognostic predictive role of USP47 in LUSC, thereby providing evidence for further therapeutic development.

Electrochemical 3D printing of Ni-Mn and Ni-Co alloy with FluidFM.

Additive manufacturing can realize almost any designed geometry, enabling the fabrication of innovative products for advanced applications. Local electrochemical plating is a powerful approach for additive manufacturing of metal microstructures; however, previously reported data have been mostly obtained with copper, and only a few cases have been reported with other elements. In this study, we assessed the ability of fluidic force microscopy to produce Ni-Mn and Ni-Co alloy structures. Once the optimal deposition potential window was determined, pillars with relatively smooth surfaces were obtained. The printing process was characterized by printing rates in the range of 50-60 nm s-1. Cross-sections exposed by focused ion beam showed highly dense microstructures, while the corresponding face scan with energy-dispersive x-ray spectroscopy spectra revealed a uniform distribution of alloy components.

Staging Surgery for The Treatment of Aortic Arch Aneurysm Combined with Aberrant Bilateral Subclavian Artery, Persistent Left Superior Vena Cava and Airway Compression: A Case Report.

BACKGROUND: To describe staging surgery for the treatment of a patient with aortic arch aneurysm combined with aberrant bilateral subclavian artery, persistent left superior vena cava (PLSVC), and airway compression. CASE REPORT: A 42-year-old female was hospitalized for aortic arch aneurysm involving aberrant bilateral subclavian artery, PLSVC, and airway compression. The patient's aneurysm was successfully treated by stage I surgery, including total aortic arch replacement and stented elephant trunk procedure and stage II surgery, including tracheal stenting and tracheotomy. Aortic CTA examination showed an unobstructed lumen and a good stent position without tracheal stent migration. Regular postoperative follow-up showed no complications, such as dyspnea, cough, and sputum, or other discomfort symptoms. CONCLUSIONS: Total aortic arch replacement, elephant trunk surgery, and second-stage tracheal stent surgery are effective and safe for the treatment of aortic arch aneurysm combined with aberrant bilateral subclavian artery, PLSVC, and airway compression.

Clinical analysis of cardiac myxoma leading to embolic events / 中国胸心血管外科临床杂志

@#Objective    To investigate the clinical manifestations of patients with cardiac myxoma and the factors affecting the occurrence of embolic events. Methods     A retrospective study of 38 patients with cardiac myxoma diagnosed and surgically removed from January 2010 to December 2017 was performed. There were 11 males and 27 females at age of 32-75 (50.00±16.12) years. The patients were divided into a non-embolized group and an embolized group. The clinical manifestations of the patients were summarized and the factors leading to embolism were analyzed. Rseults    Of the 26 patients in the non-embolized group, 22 patients (84.62%) had dyspnea, 14 patients (53.85%) had palpitations, 4 patients (15.38%) had angina pectoris, and 1 patient (3.85%) had heart failure. Of the 12 patients in the embolized group, 4 patients (33.33%) had dyspnea, 3 patients (25%) had palpitations, and 1 patient (8.33%) had angina pectoris. The mean diameter of the non-embolized group was 5.71±1.63 cm, and the maximum diameter of the tumor in the embolized group was 4.52±1.88 cm. There was no significant difference between the maximum diameter of the tumor in the embolized group and the maximum diameter of the non-embolized group (P>0.05). Atrial fibrillation occurred in 2 patients in the non-embolized group before operation. Atrial fibrillation occurred in 5 patients in the embolized group. Atrial fibrillation was more likely to occur in the embolized group (P<0.05). Conclusion     Atrial fibrillation in the patients with cardiac myxoma is closely related to embolic events. The size of myxoma is not related to the occurrence of embolic events.

Association between alcohol consumption and colorectal cancer risk: a case-control study in the Han Chinese population.

Many epidemiologic studies have reported that alcohol is a risk factor for colorectal cancer. To further evaluate the association, we carried out a case-control study in the Han Chinese population. From February 2008 to February 2013, we carried out a hospital-based case-control study on colorectal cancer. Information was collected using a questionnaire. Cases were 310 patients with colorectal cancer; 620 healthy matched controls were also recruited. Multiple logistic regression was used to estimate the odds ratios (OR) and the corresponding 95% confidence intervals. Alcohol consumption was associated with increased colorectal cancer risk, but OR was significant only among heavy drinkers (OR=2.18, for ≥21 drinks/week). Colorectal cancer risk was 4.01-fold higher in heavy smokers (≥20 cigarettes/day) and heavy drinkers (≥21 drinks/week) in comparison with never smokers who consumed less than 7 drinks/week. The relationship was strengthened by stratified studies of sex. Among former drinkers, the excess of risk disappeared in those who had quit for at least 10 years (OR=0.86). Our study confirmed that heavy alcohol consumption was associated with an increasing risk of colorectal cancer; smoking modified this relationship, especially heavy smokers. Further data from large cohorts are desirable for conclusive confirmation.

Efficacy of amiodarone in the prevention of atrial fibrillation after coronary artery bypass grafting: A systematic review and meta-analysis / 中国胸心血管外科临床杂志

@#Objective     To evaluate efficacy of amiodarone in the prevention of atrial fibrillation after coronary artery bypass grafting. Methods     CBM (from January 1978 to August 2017), CNKI (from January 1987 to August 2017), VIP (from January 1989 to August 2017), Wanfang (from January 1998 to August 2017) and PubMed (from January 1989 to August 2017) databases were searched. The articles were selected based on the inclusion and exclusion criteria. Quality of articles was assessed by improved Jadad scale. Statistical analysis was performed using RevMan 5.3. Results     There were 19 articles meeting inclusion criteria including 2 817 patients and all were randomized controlled trial (RCT). There were 16 articles with high quality and 3 articles with low quality by improved Jadad scale. Compared with the placebo, amiodarone had a significant effect on reducing the incidence of atrial fibrillation after coronary artery bypass grafting (RR=0.37, 95% CI 0.28 to 0.50, P<0.000 01) and different administration models and time of amiodarone had effect on the atrial fibrillation after aterial bypass grafting (P<0.05). Conclusion    Compared with the placebo, amiodarone is effective in reducing the incidence of atrial fibrillation after coronary artery bypass grafting.

Morphine and pregabalin in the treatment of neuropathic pain.

The drugs that are currently available to treat neuropathic pain exhibit inadequate efficacy and numerous adverse effects. The present study compared the efficacy of combination therapy with pregabalin and morphine with that of each as a single agent in patients with neuropathic pain. The primary measurement was mean daily pain intensity. Secondary measurements included a pain questionnaire, adverse effects, mood and quality of life. Combination therapy of morphine plus pregabalin and morphine monotherapy were both more effective at reducing neuropathic pain than pregabalin monotherapy. Furthermore, patients in the combination group noted that their quality of life markedly improved from the baseline, as compared with the patients in the other two groups. These findings indicate that combination therapy with morphine and pregabalin may be used as a valuable therapy for neuropathic pain.

Long-term outcome after surgical resection for cholangiocarcinoma and prognostic index value.

OBJECTIVE: To investigate the prognostic factors of patients with cholangiocarcinoma and establish a prognostic model to evaluate the prognosis. METHODS: 169 cases of cholangiocarcinoma were analyzed retrospectively. Clinicopathological factors were evaluated using univariate and multivariate analysis. Prognostic index (PI) was calculated based on the results of multivariate analysis. Patients with different PI were divided into 3 groups in order to compare the survival rate of each group and draw the survival curves. Individual expected survival rate was calculated based on the prognostic Cox model and PI. The PI equation was built that included all significant variables and coefficients as follow formula: PI = (ß1 × lymph node metastasis) + (ß2 × CEA level) - (ß3 × surgical margin). RESULTS: Univariate analysis showed that CEA, lymph node metastasis, surgical margin, AJCC staging, tumor differentiation and adjuvant chemotherapy were prognostic impacts. The difference was statistically significant (p < 0.05). Cox multivariate analysis showed that CEA, lymph node metastasis and surgical margin are three separate prognostic factors. According to different PI, patients were divided into high-risk group, middle-risk group and low-risk group and three groups were statistically significant difference in survival rate (P < 0.05). CONCLUSION: Racical resection is the key to improve the long-term survival rate of cholangiocarcinoma. By using prognostic Cox model and the PI, the prognosis of patients could be estimated and individualized clinical treatment could be conducted.

Cholangiocarcinoma: prognostic factors after surgical resection in China.

OBJECTIVE: The management of cholangiocarcinoma remains a challenge due to poor prognosis. The aim of this study was to identify the influencing factors related to outcome of patients with cholangiocarcinoma. METHODS: From January 1999 to January 2009, 169 cases of cholangiocarcinoma undergoing surgery were analyzed retrospectively. Relationships between survival and clinicopathological factors including patient demographics and tumor characteristics were evaluated using univariate and multivariate analysis. RESULTS: The 1-, 3- and 5-year survival rates of patients after resection were 52.6%, 32.4%, 11.7%, respectively. Univariate analysis showed that CEA, lymph node metastasis, surgical margin, AJCC staging, tumor differentiation and adjuvant chemotherapy were prognostic impacts. The difference was statistically significant (P<0.05). Cox multivariate analysis showed that CEA, lymph node metastasis and surgical margin are three independent prognostic factors. CONCLUSION: Radical resection is the key to improve the long-term survival rate of cholangiocarcinoma. Important predictive factors related to poor survival are CEA, lymph node metastasis and surgical margin.

Surgical procedure and long-term survival of hilar cholangiocarcinoma.

OBJECTIVE: The aim of this study was to identify the influencing factors related to outcome of patients with hilar cholangiocarcinoma. METHODS: From January 1999 to January 2009, 204 cases of hilar cholangiocarcinoma undergoing surgery were analyzed retrospectively. Bismuth-Corlette classification showed type I in 18 patients, type II in 40, type IIIa in 65, type IIIb in 54, type IV in 27. Survival analysis was performed by the Kaplan-Meier method and the relationship between each of the clinicopathologic variables and survival was assessed by the log-rank test. Multivatiate results were confirmed using Cox regression. RESULTS: Radical resection was accomplished in 161 of 204 patients (78.9%). Radical resection offered the best chance of long-term survival, with the 1-, 3-, and 5-year survival rate were 62.6%, 42.4%, 23.7%, respectively. Univariate analysis showed that lymph node metastasis, surgical margin, operative procedure and tumor differentiation were prognostic impacts. The difference was statistically significant (P < 0.05). Cox multivariate analysis showed that lymph node metastasis and surgical margin are two separate prognostic factors. CONCLUSION: Racical resection is the key to improve the long-term survival rate of hilar cholangiocarcinoma and a favorable outcome after resection is mainly determined by curative resection and the absence of lymph node metastasis.

Treatment and multivariate analysis of colorectal cancer with liver metastasis.

BACKGROUND/AIMS: The aim of this study was to identify the influencing factors related to outcome of patients of colorectal cancer with liver metastasis. METHODOLOGY: From January 1999 to January 2009, 293 cases of colorectal cancer with liver metastasis undergoing surgery were analysised retrospectively. Relationships between survival and clinicopathological factors including patient demographics and tumor characteristics were evaluated using univariate and multivariate analysis. Results: The 1-, 3- and 5-year survival rates of patients after resection were 58.3%, 26.4%, and 11.3%, respectively. Univariate analysis showed that preoperative CEA level, degree of primary tumor differentiation, resection margin, number of liver metastases, resection of liver metastases were prognostic impacts. The difference was statistically significant (p<0.05). Cox multivariate analysis showed that preoperative CEA level, number of liver metastases, and resection of liver metastases are three separate prognostic factors. CONCLUSIONS: Racical resection is the key to improve the long-term survival rate of colorectal cancer with liver metastasis. Important predictive factors related to poor survival are preoperative CEA level and number of liver metastases.

Change in the perioperative blood glucose and blood lactate levels of non-diabetic patients undergoing coronary bypass surgery.

In the present study, a retrospective analysis of the trends and factors affecting blood glucose and blood lactate levels was carried out for non-diabetic adult patients who had undergone coronary artery bypass graft (CABG) surgery. Between October 2009 and October 2011, 200 non-diabetic adult patients undergoing CABG surgery were examined. Glucose and lactic acid levels were observed successively during surgery [following the induction of anesthesia, cardio-pulmonary bypass (CPB), aortic cross-clamping and aortic stop flow infusion], at the end of surgery and after surgery [1, 6, 12, 24 and 48 h after admission to the intensive care unit (ICU)]. The results of blood gas analyses and other related indicators for trend analysis were investigated. The peak blood glucose and blood lactate levels during CPB, as well as other CPB factors, were also analyzed. Following aortic cross-clamping, intraoperative blood glucose and blood lactate levels increased gradually with increasing operative time. Postoperatively, blood glucose and blood lactate levels continued to rise. Blood glucose and blood lactic acid levels during CPB were positively correlated. The blood glucose and blood lactate levels of non-diabetic adult patients undergoing CABG increased gradually with operative time following aortic cross-clamping. Moreover, blood glucose and blood lactate levels were positively correlated with the duration of CPB and duration of aortic cross-clamping.