A Stepwise Interventional Strategy for the Removal of Adherent Totally Implanted Central Venous Access Port Catheters.

BACKGROUND: To evaluate the safety and effectiveness of a stepwise interventional strategy for the removal of adherent totally implanted central venous access port catheters, consisting of a guidewire support, antegrade coaxial separation, and retrograde coaxial separation with increasing technical complexity. METHODS: This study has a retrospective design. Thirty-two patients who had failed routine removal of the port catheter and were then transferred to interventional radiology between November 2017 and December 2023 were reviewed. The technical success and complication rates were recorded. RESULTS: All adherent catheters were successfully removed without catheter fragmentation, using guidewire support (n = 21), antegrade coaxial separation (n = 5), and retrograde coaxial separation (n = 6). The technical success rate was 100%, and no complications occurred. CONCLUSIONS: The proposed stepwise interventional strategy successfully removed adherent port catheters, with good safety and high effectiveness. It appeared to reduce the incidence of catheter fracture during the removal of adherent totally implantable central venous access port catheters.

Interfacial Rheological and Emulsion Properties of Self-Assembled Cyclodextrin-Oil Inclusion Complexes.

To investigate the effect of the molecular size of alkanes and the cavity size of cyclodextrins (CDs) on the formation of interfacial host-guest inclusion complexes, the interfacial tension (IFT) of CD (α-CD, ß-CD, γ-CD) solutions against oils (hexadecane, dodecylbenzene) was determined by interfacial dilational rheology measurements. The results show that the "space compatibility" between CDs and oil molecules is crucial for the formation of interface host-guest inclusion complexes. Hexadecane with a smaller molecular size can form host-guest inclusion complexes with small cavities of α-CD and ß-CD, dodecylbenzene with a larger molecular size can form interfacial aggregates with the medium-sized cavity of ß-CD easily, and the polycyclic aromatic hydrocarbon molecules in kerosene can form inclusion complexes with the large cavity of γ-CD. The formation of interfacial inclusion complexes leads to lower IFT values, higher interfacial dilational modulus, nonlinear IFT responses to the interface area oscillating, and skin-like films at the oil-water interface. What's more, the phase behavior of Pickering emulsions formed by CDs with different oils is explored, and the phenomena in alkane-CD emulsions are in line with the results in dilatation rheology. The interfacial active host-guest structure in the kerosene-γ-CD system improves the stability of the Pickering emulsion, which results in smaller emulsion droplets. This unique space compatibility characteristic is of great significance for the application of CDs in selective host-guest recognition, sensors, enhanced oil recovery, food industries, and local drug delivery.

Fracture of inferior vena cava stent after endovascular treatment for Budd-Chiari syndrome: A case series and literature review.

Budd-Chiari syndrome (BCS) is a rare condition characterized by hepatic venous outflow obstruction. Balloon angioplasty, with or without stenting, is the recommended first-line treatment modality in Asian countries. As a supplement to balloon angioplasty, expandable metallic Z-stent deployment can effectively improve long-term inferior vena cava (IVC) patency. Although stent placement is a standard and frequently performed treatment, very few IVC stent-related complications, such as stent fractures, have been reported. Here we present a case series and a comprehensive review of IVC stent fractures in patients with BCS. The most common characteristic of IVC stent fractures is a protrusion of the proximal segment of the IVC stent into the right atrium and its systolic and diastolic movements along with heart rhythms. Accurate stent deployment, large-diameter balloon dilation, patient breath-holding training, preferential selection of a triple stent, and the use of an internal jugular vein approach to stent deployment may ensure precise stent localization and avoid postoperative complications.

Effect of Natural Aging on Cold Forming Performance of 2219 Aluminum Alloy.

To facilitate the manufacturing of the thin-walled components of 2219 aluminum alloy, the quenching-forming-aging (Q-F-A) process has been increasingly utilized. However, natural aging (NA) after quenching significantly affects the cold forming performance of this alloy. In this study, experiments are conducted to investigate the effect of NA time on the cold forming performance of 2219 aluminum alloy. The results indicate that NA can weaken the Portevin-Le Chatelier (PLC) effect, thereby reducing its influence on the cold forming performance of the alloy. The PLC effect becomes indistinct when the aging time reaches 2 years. The yield strength of 2219 aluminum alloy increases monotonically with aging time, while the elongation first increases rapidly and then decreases. After an aging time of 2 years, the yield strength increases by 28.6% from that of newly quenched alloys. The strain hardening index and hardening coefficient indicate that short-term NA (less than 4 days) increases the work hardening rate, while long-term NA reduces it. Microstructural analysis shows that the strengthening effect of NA on 2219 aluminum alloy is mainly due to the growth of G.P. zones and the precipitation of θ″ phases. The NA precipitation behavior can also cause the aggregation of solute atoms and weaken the PLC effect.

Ursolic Acid Ameliorates Myocardial Ischaemia/Reperfusion Injury by Improving Mitochondrial Function via Immunoproteasome-PP2A-AMPK Signalling.

Cardiac ischaemia/reperfusion (I/R) injury causes cardiomyocyte apoptosis and mitochondrial dysfunction. Ursolic acid (UA), as a pentacyclic triterpenoid carboxylic acid, exerts several bioactivities in animal models of different diseases, but the preventive role of UA in I/R-induced myocardial dysfunction remains largely unknown. Male wild-type mice were pre-administered with UA at a dosage of 80 mg/kg i.p. and then subjected to cardiac I/R injury for 24 h. Cardiac function and pathological changes were examined by echocardiography and histological staining. The protein and mRNA levels of the genes were determined using qPCR and immunoblotting analysis. Our results revealed that UA administration in mice significantly attenuated the I/R-induced decline in cardiac function, infarct size, myocyte apoptosis, and oxidative stress. Mechanistically, UA increased three immunoproteasome catalytic subunit expressions and activities, which promoted ubiquitinated PP2A degradation and activated AMPK-PGC1α signalling, leading to improved mitochondrial biosynthesis and dynamic balance. In vitro experiments confirmed that UA treatment prevented hypoxia/reperfusion (H/R)-induced cardiomyocyte apoptosis and mitochondrial dysfunction through activation of AMPK signalling. In summary, our findings identify UA as a new activator of the immunoproteasome that exerts a protective role in I/R-induced myocardial dysfunction and suggest that UA supplementation could be beneficial for the prevention of cardiac ischaemic disease.

Degradation of sulfamethoxazole by chlorination in water distribution systems: Kinetics, toxicity, and antibiotic resistance genes.

Sulfamethoxazole (SMX) is one of veterinary drugs and food additives, which has been frequently detected in surface waters in recent years and will cause damage to organisms. Therefore, SMX was selected as a target to be investigated, including the degradation kinetics, evolution of toxicity, and antibiotic resistance genes (ARGs) of SMX during chlorination in batch reactors and water distribution systems (WDS), to determine the optimal factors for removing SMX. In the range of investigated pH (6.3-9.0), the SMX degradation had the fastest rate at close to neutral pH. The chlorination of SMX was affected by the initial total free chlorine concentration, and the degradation of SMX was consistent with second-order kinetics. The rate constants in batch reactors are (2.23 ± 0.07) × 102 M-1  s-1 and (5.04 ± 0.30) × 10 M-1  s-1 for HClO and ClO-1 , respectively. Moreover, the rate constants in WDS are (1.76 ± 0.07) × 102 M-1  s-1 and (4.06 ± 0.62) × 10 M-1  s-1 , respectively. The degradation rate of SMX was also affected by pipe material, and the rate followed the following order: stainless-steel pipe (SS) > ductile iron pipe (DI) > polyethylene pipe (PE). The degradation rate of SMX in the DI increased with increasing flow rate, but the increase was limited. In addition, SMX could increase the toxicity of water initially, yet the toxicity reduced to the level of tap water after 2-h chlorination. And the relative abundance of ARGs (sul1 and sul2) of tap water samples was significantly increased under different chlorination conditions. PRACTITIONER POINTS: The degradation rate of SMX in batch reactor and WDS is different, and they could be described by first- or second-order kinetics. The degradation of SMX had the fastest rate at neutral pH. The degradation rate of SMX was also affected by pipe material and flow velocity. SMX increased the toxicity of water initially, yet the toxicity reduced after a 2-h chlorination. SMX increased the relative abundance of antibiotic resistance genes sul1 and sul2.

Relation Extraction in Biomedical Texts Based on Multi-Head Attention Model With Syntactic Dependency Feature: Modeling Study.

BACKGROUND: With the rapid expansion of biomedical literature, biomedical information extraction has attracted increasing attention from researchers. In particular, relation extraction between 2 entities is a long-term research topic. OBJECTIVE: This study aimed to perform 2 multiclass relation extraction tasks of Biomedical Natural Language Processing Workshop 2019 Open Shared Tasks: relation extraction of Bacteria-Biotope (BB-rel) task and binary relation extraction of plant seed development (SeeDev-binary) task. In essence, these 2 tasks are aimed at extracting the relation between annotated entity pairs from biomedical texts, which is a challenging problem. METHODS: Traditional research methods adopted feature- or kernel-based methods and achieved good performance. For these tasks, we propose a deep learning model based on a combination of several distributed features, such as domain-specific word embedding, part-of-speech embedding, entity-type embedding, distance embedding, and position embedding. The multi-head attention mechanism is used to extract the global semantic features of an entire sentence. Meanwhile, we introduced a dependency-type feature and the shortest dependency path connecting 2 candidate entities in the syntactic dependency graph to enrich the feature representation. RESULTS: Experiments show that our proposed model has excellent performance in biomedical relation extraction, achieving F1 scores of 65.56% and 38.04% on the test sets of the BB-rel and SeeDev-binary tasks. Especially in the SeeDev-binary task, the F1 score of our model is superior to that of other existing models and achieves state-of-the-art performance. CONCLUSIONS: We demonstrated that the multi-head attention mechanism can learn relevant syntactic and semantic features in different representation subspaces and different positions to extract comprehensive feature representation. Moreover, syntactic dependency features can improve the performance of the model by learning dependency relation between the entities in biomedical texts.

[Effectiveness of induction therapy with exclusive enteral nutrition in pediatric Crohn's disease]. / å ¨è‚ å† è¥å »å¯¹å„¿ç«¥å ‹ç½—æ©ç— è¯±å¯¼ç¼“è§£ç–—æ•ˆç ”ç©¶.

OBJECTIVES: To evaluate the effectiveness of induction therapy with exclusive enteral nutrition (EEN) in pediatric Crohn's disease (CD). METHODS: A retrospective analysis was performed on the medical data of 62 children with CD who received EEN in Children's Hospital, Zhejiang University School of Medicine, from March 2013 to August 2021. The medical data included general information and height, weight, Pediatric Crohn's Disease Activity Index (PCDAI), Crohn's Disease Endoscopic Index of Severity, C-reactive protein, erythrocyte sedimentation rate, and serum albumin level before treatment and after 8 weeks of treatment. The changes in the above indicators were compared before and after treatment. RESULTS: Among the 62 children with CD, there were 39 boys (63%) and 23 girls (37%), with a mean age of (11.9±3.0) years at diagnosis. Among the 55 children who completed EEN treatment for at least 8 weeks, 48 (87%) achieved clinical remission at week 8. PCDAI at week 8 was significantly lower than that before treatment (P<0.001). Except for 17 children with involvement of the small intestine alone and 3 children with involvement of the colon who did not receive colonoscopy reexamination, the remaining 35 children with involvement of the colon received colonoscopy reexamination after the 8-week EEN treatment. Of the 35 children, 29 (83%) achieved mucosal healing. As for the 48 children who achieved clinical remission at week 8, there were significant improvements in height-for-age Z-score and body mass index-for-age Z-score at week 8 (P<0.01). As for the 7 children who did not achieve clinical remission at week 8, there were no significant changes in height-for-age Z-score and body mass index-for-age Z-score at week 8 (P>0.05). CONCLUSIONS: The 8-week EEN treatment has a good effect on clinical remission and mucosal healing in children with CD. For the children with CD achieving clinical remission, EEN can improve their height and body mass index.

Solitary renal duplication with misaligned malrotation of upper and lower moieties complicated by complete staghorn stones in the lower moiety: a case report / 中华泌尿外科杂志

Solitary kidney, renal duplication and malrotation are rare congenital renal malformations in urology department, and probably contributed to some complications such as obstruction, hydronephrosis, infection, stones. In this case report, we firstly presented a male patient with rarely multiple renal malformations, including solitary kidney, renal duplication, misaligned malrotation of upper and lower moieties, and accompanied by complete staghorn stones and hydronephrosis, who was treated with open pyelolithotomy under general anesthesia. After the operation, obstruction, hydronephrosis, and infection were relieved.

Congenital renal arteriovenous fistula associated multiple renal arteries and thoracic scoliosis: a case report / 中华泌尿外科杂志

A recurrent misdiagnosed case of congenital left renal arteriovenous fistula (RAVF) with multiple left renal arteries and scoliosis was reported. The patient was admitted to hospital on 29 August 2020 due to repeated hematuria for one year. No abnormality was found in two flexible ureteroscope examinations, imaging and laboratory examinations after admission. It was found that the structure of blood vessels in the inferior pole of renal sinus was disordered, and the blood vessels were tortuous and clustered through careful reading of CT enhancement films. The dilated tortuous blood vessels were also seen around the renal pelvis, and hematuria was considered to be caused by renal vascular malformation. In order to confirm the etiology, digital subtraction angiography (DSA) of renal artery was performed. DSA showed a congenital left renal RAVF with three renal arteries, and the arteriovenous fistula of renal arteries was embolized. For patients presenting with severe gross hematuria, if tumor, stone, tuberculosis, or coagulation abnormalities were excluded by conventional imaging and/or laboratory examination the possibility of congenital renal vascular malformation should be suspected, and DSA examination should be performed. Endovascular embolization is an effective treatment for congenital RAVF.

Nursing of a case of goal-directed pulmonary rehabilitation after spinal cord surgery for type Ⅱ spinal muscular atrophy / 中国实用护理杂志

Objective:To summarize the nursing care measures of a patient after spinal orthopedic surgery for spinal muscular atrophy type Ⅱ.Methods:The patient was provided with a goal-directed pulmonary rehabilitation nursing program during ICU resuscitation by exercise pulmonary function, monitor difficult airway extubation and alleviating anxiety.Results:The patient postoperative pulmonary function recovered well, the difficult airway was extubated smoothly and the anxiety was relieved. The patient was discharged from the hospital on the 17th day after the operation.Conclusions:Goal-directed pulmonary care can help promote pulmonary rehabilitation and improve the quality of patient survival after orthopedic surgery for spinal muscular atrophy typeⅡ.

Reduced Plasma Estradiol Levels are Associated with Sleep Apnea in Depressed Peri- and Post-Menopausal Women.

OBJECTIVE: This study aimed at investigating the correlation between estradiol and sleep apnea among women with major depressive disorders during the perimenopausal and postmenopausal periods. METHODS: A total of 84 perimenopausal and postmenopausal women diagnosed with depression, and who had been subjected to whole-night polysomnography (PSG) were retrospectively studied. They were assigned into two groups based on the presence of OSA (apnea-hypopnea index (AHI)≥5) (OSA vs non-OSA). The correlation between estradiol levels and apnea-hypopnea index were assessed by logistic regression models after adjusting for age, body mass index (BMI), Hamilton Depression Rating Scale (HAMD), Pittsburgh Sleep Quality Index (PSQI), apnea frequency and progesterone. RESULTS: Among the 84 patients, 45.23% had OSA. Estradiol levels were significantly elevated in non-OSA than in OSA patients (p<0.05). Univariate analysis revealed that elevated estradiol levels are associated with reduced odds of OSA (odds ratio [OR] 0.92, 95% confidence interval [CI] 0.875-0.966, p = 0.001). Multivariate analyses showed that low estradiol levels (OR = 0.859, 95% CI 0.826-0.991, p = 0.031), higher HAMD scores (OR = 1.212, 95% CI 1.012-1.453, p = 0.037), higher apnea frequency (OR = 2.493, 95% CI 1.389-4.473, p = 0.002) and higher BMI (OR=1.635, 95% CI 1.136-2.353, p = 0.008) are correlated with OSA. CONCLUSION: The ratio of depressed perimenopausal to postmenopausal women comorbid OSA was high. Higher BMI, low estradiol levels, high apnea frequency and high HAMD scores were correlated with OSA diagnosis and could be potential diagnostic markers for OSA in depressed perimenopausal and postmenopausal women. Reduced estradiol levels were correlated with an increased risk of OSA among depressed perimenopausal and postmenopausal women.

Prolonged parent-child separation and pain in adolescence: The role of HPA-axis genetic variations.

BACKGROUND: Increasing evidence has demonstrated that childhood adversity was a predictor of pain and hypothalamic-pituitary-adrenal (HPA) axis genetic variation is associated with pain risk. This study aims to explore possible effects of prolonged childhood separation from parents and HPA polygenic risk score (PRS) on pain among adolescents in rural China. METHOD: We used data from 219 adolescents in rural area of Fuyang city, Anhui province, China. Parent-child separation was collected through interview and pain intensity was reported using the 11-point Numerical Rating Scale. SNP genotyping was performed using an improved multiplex ligation detection reaction (iMLDR) technique. The PRS was computed based on 3 single nucleotide polymorphisms (SNPs) in 2 genes (FKBP5 and NR3C1) related to HPA-axis stress reactivity. RESULTS: Pain among adolescents separated from both parents scored higher compared to those without parent-child separation, however, this association was only observed in adolescents with moderate to high tertiles of PRS groups (parent-child separation in moderate group vs. no parent-child separation in moderate group: 3.07 vs. 1.57, P < 0.001; parent-child separation in highest group vs. no parent-child separation in highest group: 3.02 vs. 1.26, P < 0.001; parent-child separation in lowest group vs. no parent-child separation in lowest group: 2.34 vs. 1.25, P = 0.225). After controlled for demographic characteristics, psychopathological symptoms, adverse childhood experiences, parental warmth, prolonged childhood parent-child separation increased pain scores by 1.52 points (95% CI:0.72, 2.33) and 1.72 points (95% CI:1.13, 2.31) in moderate and high PRS groups, respectively. CONCLUSION: Our findings suggest that adolescents separated from both parents while carrying more risk alleles related to HPA-axis stress reactivity are at heightened risk of pain.

7,8-Dihydroxyflavone Enhanced Colonic Cholinergic Contraction and Relieved Loperamide-Induced Constipation in Rats.

BACKGROUND: Whether 7,8-dihydroxyflavone (7,8-DHF), a tyrosine kinase receptor B (TrkB) agonist, modulates colonic smooth muscle motility and/or alleviates constipation has not yet been studied. AIMS: Here, we aimed to determine how 7,8-DHF influences carbachol (CCh)-stimulated contraction of colonic strips and the in vivo effect of 7,8-DHF on constipation. METHODS: Muscle strips were isolated from rat colons for recording contractile tension and performing western blotting. Constipation was induced in rats with loperamide. RESULTS: Although it specifically activated TrkB, 7,8-DHF applied alone neither activated PLCγ1 in the colonic strips nor induced colonic strip contraction. However, 7,8-DHF enhanced CCh-stimulated PLCγ1 activation and strip contraction. The PLCγ1 antagonist U73122 suppressed both CCh-stimulated and 7,8-DHF-enhanced/CCh-stimulated contraction. While clarifying the underlying mechanism, we revealed that 7,8-DHF augmented muscarinic M3 receptor expression in the colonic strips. The M3-selective antagonist tarafenacin specifically inhibited the 7,8-DHF-enhanced/CCh-stimulated contraction of the colonic strips. Since 7,8-DHF increased Akt phosphorylation, and LY294002 (an antagonist of PI3K upstream of Akt) dramatically inhibited both 7,8-DHF-augmented M3 expression and 7,8-DHF-enhanced/CCh-stimulated contractions, we assumed that 7,8-DHF/TrkB/Akt was associated with the modulation of M3 expression in the colonic strips. ANA-12, a specific TrkB antagonist, not only inhibited TrkB activation by 7,8-DHF but also suppressed 7,8-DHF-enhanced cholinergic contraction, 7,8-DHF/CCh-mediated activation of PLCγ1/Akt, and M3 overexpression in colonic strips. In vivo 7,8-DHF, also by promoting intestinal motility and M3 expression, significantly alleviated loperamide-induced functional constipation in rats. CONCLUSIONS: Our results suggest that 7,8-DHF regulates colonic motility possibly via a TrkB/Akt/M3 pathway and may be applicable for alleviating constipation.

The defluorination of perfluorooctanoic acid by different vacuum ultraviolet systems in the solution.

Perfluorooctanoic acid (PFOA) is one kind of persistent organic pollutants that is often detected in water. In recent years, the effective degradation technologies of PFOA have attracted widespread attentions. Thus, in this study, the defluorination efficiency of PFOA in different systems (i.e., ultraviolet (UV), vacuum ultraviolet (VUV), vacuum ultraviolet/persulfate (VUV/PS) and vacuum ultraviolet/residual chlorine (VUV/RC)) was evaluated. Moreover, the different impact factors (i.e., the initial concentrations of persulfate and PFOA, temperature, anions, and initial pH values) on PFOA degradation by VUV/PS system were investigated. The results showed that VUV system was more effective than UV system for PFOA defluorination. VUV system combined with persulfate would further enhance the defluorination efficiency while residual chlorine would decrease it. In VUV/PS system, the defluorination efficiency of PFOA was the best as the molar ratio of PFOA and persulfate at 1:60. Moreover, higher temperature, lower initial PFOA concentration, and acid condition were favorable for the defluorination of PFOA. Under the different influence factors, the defluorination efficiency of PFOA fitted well to the first-order reaction kinetic model. When the temperature was range from 20°C to 40°C, the value of activation energy was 8.73 kJ/mol. Besides, the inhibition effect of three kinds of anions on PFOA defluorination followed the order: NO 3 -  > Cl-  >  CO 3 2 - . PRACTITIONER POINTS: The defluorination efficiency of perfluorooctanoic acid (PFOA) in water by different VUV systems was compared. VUV system is more effective than UV system for PFOA defluorination. Persulfate will enhance the defluorination efficiency by VUV system. Hypochlorite will decrease the defluorination efficiency by VUV system.

Association between obesity and the risk of uterine fibroids: a systematic review and meta-analysis.

BACKGROUND: Uterine fibroids (UFs) are the most common form of sex steroid hormone-dependent benign tumours that grow in the walls of the uterus. Several observational studies have examined the association between obesity and the risk of UFs, but findings are inconsistent. The objective of this systematic review and meta-analysis is to further examine the association of obesity with the risk/prevalence of UFs. METHODS: A literature search was performed in three databases (PubMed, EMBASE and Web of Science) from 1 January 1992 to 30 May 2020. We used random-effect models to calculate the pooled ORs with corresponding 95% CIs. Additionally, we performed a dose-response meta-analysis to analyse the effect of body mass index (BMI), weight change since age 18, waist-to-hip ratio and waist circumference on the risk/prevalence of UFs. RESULTS: A total of 22 articles, covering 24 studies including 325 899 participants and 19 593 cases, were selected based on our inclusion criteria. We found a positive association between obesity and the risk/prevalence of UFs (OR, 1.19; 95% CI, 1.09 to 1.29). Among participants with the highest BMI, the pooled OR was 1.19 (1.09 to 1.31) when compared to participants with normal BMI. For weight change since age 18, the pooled OR (95% CI) of UFs was 1.26 (1.12 to 1.42) among the highest change group when compared with no change. Additionally, our meta-analysis indicated the relationship of BMI with risk of UFs to be an inverse J-shaped pattern. CONCLUSIONS: The results of this meta-analysis suggest that obesity may increase the risk/prevalence of UFs, and the association is non-linear.

Distribution and drug resistance of wound pathogenic microorganisms in outpatients of wound healing center / 中华创伤杂志

Objective:To analyze the distribution and drug resistance of wound pathogenic microorganisms in outpatients of wound healing center so as to provide a basis for the standardized construction of wound healing centers.Methods:A retrospective case series study was used to analyzed the data of 365 outpatients treated at Ruijin Hospital, Shanghai Jiaotong University School of Medicine from December 2017 to October 2019. There were 220 males and 145 females, aged (58.8±18.9)years (range, 18-98 years). The patients included 92 first-visit patients and 273 re-visit patients. The culture results (positive rate of pathogenic microorganisms, bacterial species, bacterial distribution) and drug sensitivity results of the wound secretions were compared and analyzed.Results:(1) Among 365 samples of wound secretions, 198 patients were positive for pathogenic microorganisms with a positive rate of 54.3%. A total of 107 strains (51.0%) of Gram-positive bacteria were detected, mainly Staphylococcus aureus (70 strains, 33.3%); 95 strains (45.2%) of Gram-negative bacteria were detected, mainly Escherichia coli (20 strains, 9.5%), followed by Pseudomonas aeruginosa (17 strains, 8.1%); 8 strains (3.8%) of fungi were detected. (2) A total of 26 (28.3%) first-visit patients were positive for pathogenic microorganisms, and 172 (63.0%) re-visit patients were positive for pathogenic microorganisms. The rate of positive microorganism detection had significant differences between first-visit and re-visit patients ( P<0.05). (3) A total of 29 strains were detected in first-visit patients, including 16 strains (55.2%) of Gram-positive bacteria, 11 strains (37.9%) of Gram-negative bacteria and 2 strains (6.9%) of fungi. A total of 181 strains were detected in re-visit patients, including 91 strains (50.3%) of Gram-positive bacteria, 84 strains (46.4%) of Gram-negative bacteria and 6 strains (3.3%) of fungi. The microbial distribution was significantly different between first-visit and re-visit patients ( P<0.05). (4) Compared with first-visit patients, the resistance of Staphylococcus aureus isolated from the re-visit patients to spenicillin, oxacillin, ciprofloxacin, tetracycline, clindamycin, moxifloxacin, erythromycin, and levofloxacin were increased variably. No vancomycin-resistant Staphylococcus aureus was detected, indicating that the staphylococcus aureus presented in the wound was highly sensitive to vancomycin. Conclusions:Staphylococcus aureus is the most common microorganism in wound secretions in outpatients of wound healing center. The rate of positive pathogenic microorganisms in wound secretions of re-visit patients is significantly higher than that of first-visit patients, and the distribution of pathogenic microorganisms of first-visited and revisited patients differs significantly. The Staphylococcus aureus detected in re-visit patients has a higher resistance to common antibiotics compared with first-visit patients. It is suggested that timely detection of pathogenic microorganisms in outpatients and effective control and supervision of outpatient infections are important contents that cannot be ignored in the construction of wound healing center.

Chinese Clinical Named Entity Recognition in Electronic Medical Records: Development of a Lattice Long Short-Term Memory Model With Contextualized Character Representations.

BACKGROUND: Clinical named entity recognition (CNER), whose goal is to automatically identify clinical entities in electronic medical records (EMRs), is an important research direction of clinical text data mining and information extraction. The promotion of CNER can provide support for clinical decision making and medical knowledge base construction, which could then improve overall medical quality. Compared with English CNER, and due to the complexity of Chinese word segmentation and grammar, Chinese CNER was implemented later and is more challenging. OBJECTIVE: With the development of distributed representation and deep learning, a series of models have been applied in Chinese CNER. Different from the English version, Chinese CNER is mainly divided into character-based and word-based methods that cannot make comprehensive use of EMR information and cannot solve the problem of ambiguity in word representation. METHODS: In this paper, we propose a lattice long short-term memory (LSTM) model combined with a variant contextualized character representation and a conditional random field (CRF) layer for Chinese CNER: the Embeddings from Language Models (ELMo)-lattice-LSTM-CRF model. The lattice LSTM model can effectively utilize the information from characters and words in Chinese EMRs; in addition, the variant ELMo model uses Chinese characters as input instead of the character-encoding layer of the ELMo model, so as to learn domain-specific contextualized character embeddings. RESULTS: We evaluated our method using two Chinese CNER datasets from the China Conference on Knowledge Graph and Semantic Computing (CCKS): the CCKS-2017 CNER dataset and the CCKS-2019 CNER dataset. We obtained F1 scores of 90.13% and 85.02% on the test sets of these two datasets, respectively. CONCLUSIONS: Our results show that our proposed method is effective in Chinese CNER. In addition, the results of our experiments show that variant contextualized character representations can significantly improve the performance of the model.

Urethral meatus stricture BOO stimulates bladder smooth muscle cell proliferation and pyroptosis via IL­1ß and the SGK1­NFAT2 signaling pathway.

Bladder outlet obstruction (BOO), which is primarily caused by benign prostatic hyperplasia, is a common chronic disease. However, previous studies have most commonly investigated BOO using the acute obstruction model. In the present study, a chronic obstruction model was established to investigate the different pathological alterations in the bladder between acute and chronic obstruction. Compared with chronic obstruction, acute obstruction led to increased expression of proliferating cell nuclear antigen and interleukin­1ß, which are markers of proliferation and inflammation, respectively. Furthermore, increased fibrosis in the bladder at week 2 was observed. Low pressure promoted mice bladder smooth muscle cell (MBSMC) proliferation, and pressure overload inhibited cell proliferation and increased the proportion of dead MBSMCs. Further investigation using serum/glucocorticoid regulated kinase 1 (SGK1) small interfering RNAs indicated that low pressure may promote MBSMC proliferation by upregulating SGK1 and nuclear factor of activated T­cell expression levels. Therefore, the present study suggested that acute obstruction led to faster decompensation of bladder function and chronic bladder obstruction displayed an enhanced ability to progress to BOO.