MRI-based Machine Learning Radiomics Can Predict CSF1R Expression Level and Prognosis in High-grade Gliomas.

The purpose of this study is to predict the mRNA expression of CSF1R in HGG non-invasively using MRI (magnetic resonance imaging) omics technology and to evaluate the correlation between the established radiomics model and prognosis. We investigated the predictive value of CSF1R in the Cancer Genome Atlas (TCGA) and The Cancer Imaging Archive (TCIA) database. The Support vector machine (SVM) and the Logistic regression (LR) algorithms were used to create a radiomics_score (Rad_score), respectively. The effectiveness and performance of the radiomics model was assessed in the training (n = 89) and tenfold cross-validation sets. We further analyzed the correlation between Rad_score and macrophage-related genes using Spearman correlation analysis. A radiomics nomogram combining the clinical factors and Rad_score was constructed to validate the radiomic signatures for individualized survival estimation and risk stratification. The results showed that CSF1R expression was markedly elevated in HGG tissues, which was related to worse prognosis. CSF1R expression was closely related to the abundance of infiltrating immune cells, such as macrophages. We identified nine features for establishing a radiomics model. The radiomics model predicting CSF1R achieved high AUC in training (0.768 in SVM and 0.792 in LR) and tenfold cross-validation sets (0.706 in SVM and 0.717 in LR). Rad_score was highly associated with tumor-related macrophage genes. A radiomics nomogram combining the Rad_score and clinical factors was constructed and revealed satisfactory performance. MRI-based Rad_score is a novel way to predict CSF1R expression and prognosis in high-grade glioma patients. The radiomics nomogram could optimize individualized survival estimation for HGG patients.

Efficacy of epidural esketamine on postoperative sleep quality after laparoscopic and robotic lower abdominal surgeries: a study protocol for randomised, double-blind, controlled trial.

INTRODUCTION: Postoperative sleep disturbances significantly impair postoperative recovery. The administration of intravenous esketamine has been shown to potentially improve postoperative sleep quality. However, the effectiveness of epidural esketamine in improving postoperative sleep quality remains to be elucidated. This study aims to explore the impact of both intraoperative and postoperative use of epidural esketamine on the postoperative sleep quality of patients undergoing minimally invasive lower abdominal surgeries. METHODS AND ANALYSIS: This randomised, double-blind, parallel-group, placebo-controlled trial will be conducted at the Fudan University Shanghai Cancer Centre. A total of 128 adults undergoing minimally invasive lower abdominal surgeries will be randomly allocated in a 1:1 ratio to either the esketamine group or the placebo group. In the esketamine group, epidural esketamine will be administered intraoperatively (0.2 mg/kg) and postoperatively (25 mg). Postoperatively, all patients will receive epidural analgesia. The primary outcome of the study is the incidence of poor sleep quality on the third day after surgery. The sleep quality assessment will be conducted using the Pittsburgh Sleep Quality Index and a Numeric Rating Scale of sleep. The main secondary outcomes include postoperative pain and anxiety and depression scores. The postoperative pain, both rest pain and movement pain, will be assessed using a Numerical Rating Scale within 5 days after surgery. Anxiety and depression scores will be evaluated using the Hospital Anxiety and Depression Scale both before and after the surgery. Safety outcomes will include delirium, fidgeting, hallucinations, dizziness and nightmares. The analyses will be performed in accordance with intention-to-treat principle ETHICS AND DISSEMINATION: Ethics approval has been obtained from the Ethics Committee of the Shanghai Cancer Centre (2309281-9). Prior to participation, all patients will provide written informed consent. The results of the trial are intended to be published in a peer-reviewed journal. TRIAL REGISTRATION NUMBER: ChiCTR2300076862.

Core muscle strength training of young soccer players / Treino de força muscular no core de jovens jogadores de futebol / Entrenamiento de la fuerza muscular en el core de jóvenes jugadores de fútbol

ABSTRACT Introduction Core strength training is a modern method of approach that matches the current demand for a more resilient physique on young players. Although it was initially conceived as complementary training to contribute to strength and agility, other benefits have been observed for soccer athletes nowadays. Among the under-explored benefits is the effect on the athletes' stability. Objective This article explores core training results on stability in young soccer players. Methods The theoretical applicability of basic stability training for young soccer players with core muscle strength training is discussed using mathematical statistics. The theoretical result is confronted with the practice of the controlled experiment on 18 young soccer players in 32 weeks with stabilization protocols. Results The fitness and soccer skills of the young men improved significantly (P<0.05). Conclusion Core strength training can promote the overall fitness of young soccer players. This training protocol for core strengthening achieves the primary goal of improving athletes' competitive ability and fitness. Evidence Level II; Therapeutic Studies - Investigating the results.

RESUMO Introdução O treino de força do core é um método moderno de abordagem que condiz com a atual exigência por um físico mais resistente sobre os jovens jogadores. Embora seja inicialmente concebido como um treino complementar para contribuir com a força e agilidade, atualmente tem se observado outros benefícios para os atletas de futebol. Dentre os benefícios pouco explorados está o efeito na estabilidade dos atletas. Objetivo Este artigo explora os resultados do treino básico do core na estabilidade sobre jovens jogadores de futebol. Métodos Discute-se por meio de estatísticas matemáticas a aplicabilidade teórica do treino básico de estabilidade aos jovens jogadores de futebol com o treino de força muscular do core. O resultado teórico é confrontado com a prática do experimento controlado em 18 jovens jogadores de futebol no período de 32 semanas com protocolos de estabilização. Resultados O preparo físico e as habilidades futebolísticas dos jovens melhoraram significativamente (P<0,05). Conclusão O treino de força central pode promover a aptidão geral dos jovens jogadores de futebol. Este protocolo de treino para fortalecimento do core atinge a meta principal de melhorar a capacidade competitiva e a aptidão física dos atletas. Nível de evidência II; Estudos Terapêuticos - Investigação de Resultados.

RESUMEN Introducción El entrenamiento de la fuerza del core es un método de enfoque moderno que se ajusta a la demanda actual de un físico más resistente en los jóvenes jugadores. Aunque inicialmente se concibió como un entrenamiento complementario para contribuir con la fuerza y la agilidad, hoy en día se han observado otros beneficios para los atletas de fútbol. Entre los beneficios poco explorados está el efecto sobre la estabilidad de los atletas. Objetivo Este artículo explora los resultados del entrenamiento del core en la estabilidad de los jóvenes futbolistas. Métodos Se discute la aplicabilidad teórica del entrenamiento de la estabilidad básica para jóvenes futbolistas con el entrenamiento de la fuerza de los músculos centrales por medio de la estadística matemática. El resultado teórico se confronta con la práctica del experimento controlado en 18 jóvenes futbolistas en el período de 32 semanas con protocolos de estabilización. Resultados La forma física y las habilidades futbolísticas de los jóvenes mejoraron significativamente (P<0,05). Conclusión El entrenamiento de la fuerza del núcleo puede promover el estado físico general de los jóvenes futbolistas. Este protocolo de entrenamiento para el fortalecimiento del núcleo logra el objetivo principal de mejorar la capacidad competitiva y la forma física de los atletas. Nivel de evidencia II; Estudios terapéuticos - Investigación de resultados.

Effects of bilateral early breast sucking and unilateral early breast sucking within 2 h after delivery on lactation, breast distending pain and postpartum lochia.

OBJECTIVE: To investigate the effects of bilateral early breast sucking and unilateral early breast sucking within 2 h after delivery on lactation, breast distending pain and postpartum lochia. METHODS: The clinical data of 128 parturients were analyzed retrospectively. According to the different ways of early breast suction, the parturients were divided into control group (n=64) and observation group (n=64). Among them, unilateral early sucking was performed within 2 h after delivery in the control group, while bilateral early sucking was carried out in the observation group. We compared the lactation, breast distending pain, postpartum lochia, nutritional status, coagulation index, complications and breast feeding success rate. RESULTS: The lactation amount of the observation group was higher than that of the control group on the 3rd, 5th and 7th day after delivery; the VAS scores showed opposite trends; the amount of lochia in the observation group was less than that in the control group; the ALb, PA and Hb levels in the observation group were higher on the 7th day after delivery. Compared with the control group, the FIB, PT and APTT time was shorter and the D-D level was higher; the incidence of postpartum hemorrhage, galactostasis and postpartum depression in the observation group was lower, and the success rate of feeding on the 1st, 3rd and 7th day after delivery was higher in the observation group seven days after intervention. CONCLUSION: Bilateral early breast sucking within 2 h after delivery is helpful to increase lactation and reduce breast distending pain and postpartum lochia. It also promotes maternal nutritional status and coagulation function, reduces the incidence of postpartum complications, and improves the breastfeeding rate.

A comparative study of bilateral and unilateral early sucking within 2 hours of delivery on lactation.

OBJECTIVE: This study explored and analyzed the effects of bilateral and unilateral early sucking within 2 h after delivery on lactation. METHODS: From August 2019 to August 2020, 392 primiparas with full-term, singleton, natural delivery, and normal breast conditions were submitted to the Obstetrics Department of our hospital and were enrolled as the research subjects. The subjects were randomly divided into an experimental group and a control group, with 196 in each group. Both groups implemented early sucking with the assistance of a midwife within 2 h after delivery. The experimental group conducted bilateral breast sucking and the control group received unilateral sucking. The onset time of colostrum, the lactation volume, and the prolactin levels at 6 h, 24 h, 48 h, and 72 h after delivery, including neonatal urination and incidence of complications were compared between the two groups. RESULTS: The onset time of colostrum in the experimental group was much earlier than that in the control group with a statistically significant difference (P<0.05). The postpartum filling time of the experimental group was shorter than that of the control group, with a statistically significant difference (P<0.05). There was a statistically insignificant difference in the distribution of lactation yield between the two groups at 6 h of postpartum (P>0.05). The lactation yield distribution in the experimental group at 24 h, 48 h, and 72 h was critically superior to that in control group, with statistically significant difference (P<0.05). The degree of prolactin in the experimental group was higher than that in the control group (P<0.05). There was no significant difference in urination frequency and the incidence of complications between the two groups of neonates at 24 h, 48 h, and 72 h (P>0.05). CONCLUSION: The effect of bilateral early lactation within 2 h after delivery is superior to that of unilateral early lactation, which is worthy of clinical application.

Comparison of clinical efficacy of metoprolol combined with irbesartan and hydrochlorothiazide and non-invasive ventilator in the emergency treatment of patients with severe heart failure.

Clinical efficacy of metoprolol combined with irbesartan and hydrochlorothiazide and non-invasive ventilator in the emergency treatment of patients with severe heart failure (HF) was investigated. A retrospective analysis of the medical records of 124 patients with severe HF admitted to Binzhou Medical University Hospital from May 2012 to August 2016 was performed. Among them, 78 patients who were treated with metoprolol combined with irbesartan and hydrochlorothiazide and non-invasive ventilator for emergency treatment were enrolled into the Research Group, while the Control Group consisted of 46 patients treated with routine medical treatment. Echocardiographic parameters, 6-minute walking test results, the efficacy of the emergency treatment, cardiac function grading, left ventricular ejection fraction (LVEF) and brain natriuretic peptide (BNP) levels were compared between the two groups. After the emergency treatment, the echocardiographic indexes of both groups increased to different extents (P<0.05). Compared with the results before, patients of both groups walked longer within six minutes after the emergency treatment (P<0.05). After the emergency treatment, the BNP expression levels in the two groups decreased to different degrees (P<0.05). After a 7-day emergency treatment, the efficiency rate of treatment of the Research Group was higher than that of the Control Group (P<0.05). The method is helpful for the recovery of respiratory function, for relieving symptoms in short time, improving cardiac function and promising high safety, using metoprolol and irbesartan and hydrochlorothiazide combined with non-invasive ventilator had satisfactory clinical efficacy in the emergency treatment of patients with severe heart failure and is thus worthy of clinical promotion.

Impaired spatial learning and memory after sevoflurane-nitrous oxide anesthesia in aged rats is associated with down-regulated cAMP/CREB signaling.

Neurocognitive deficits arising from anesthetic exposure have recently been debated, while studies have shown that the phosphorylation of cyclic AMP response element-binding protein (CREB) in the hippocampus is critical for long-term memory. To better understand the neural effects of inhalational anesthetics, we studied the behavioral and biochemical changes in aged rats that were exposed to sevoflurane (Sev) and nitrous oxide (N2O) for 4 h. Eighteen-month-old rats were randomly assigned to receive 1.3% sevoflurane and 50% nitrous oxide/50% oxygen or 50% oxygen for 4 h. Spatial learning and memory were tested with the Morris water maze 48 h after exposure, and the results showed that sevoflurane-nitrous oxide exposure induced a significant deficit in spatial learning acquisition and memory retention. Experiments revealed that the cAMP and pCREB levels in the dorsal hippocampus were decreased in rats with anesthetic exposure in comparison with control rats 48 h after anesthesia as well as 15 min after the probe trial, but there were no significant differences in CREB expression. Besides these, the current study also found the DG neurogenesis significantly decreased as well as neuronal loss and neuronal apoptosis increased in the hippocampus of rats exposed to Sev+N2O. The current study demonstrated that down-regulation of cAMP/CREB signaling, decrease of CREB-dependent neurogenesis and neuronal survival in the hippocampus contributed to the neurotoxicity and cognitive dysfunction induced by general anesthesia with sevoflurane-nitrous oxide.

Retrospective analysis of acute fatty liver of pregnancy: twenty-eight cases and discussion of anesthesia.

AIMS: To summarize the clinical features, perioperative management and maternal and neonatal outcomes of patients with acute fatty liver of pregnancy (AFLP) and to discuss the management of anesthesia in these patients. METHODS: This study was a retrospective review over a period of 5 years and 9 months; 28 cases from the Shanghai Public Health Clinical Center were included. Records were reviewed for symptoms, signs, laboratory findings, clinical courses, perioperative management and maternal and neonatal outcomes. RESULTS: Of the AFLP cases analyzed in the present study, 75.0% occurred in primipara and 63.3% occurred with male fetuses. Prodromic symptoms included the sudden onset of fatigue, nausea, vomiting, anorexia and jaundice. Laboratory results indicated liver function abnormalities, coagulopathy, hypoglycemia, leukocytosis and negative urine bilirubin. There were 2 maternal deaths (7.1%) without fetal deaths. Cesarean sections were performed in 16 cases under neuraxial anesthesia and in 12 cases under general anesthesia with rapid-sequence induction. CONCLUSION: Early diagnosis, prompt delivery and intensive supportive treatment are critical for improving the prognosis of AFLP. Anesthesia selection should be individualized and general anesthesia with rapid-sequence induction may be the best choice for patients with severe coagulopathy.

Retrieval of Consolidated Spatial Memory in the Water Maze Is Correlated with Expression of pCREB and Egr1 in the Hippocampus of Aged Mice.

OBJECTIVE: To study the relationship of the expression of phosphorylated cyclic AMP response element-binding protein (pCREB) and early growth response protein 1 (Egr1) in the hippocampus of aged mice with retrieval of consolidated spatial memory in a water maze. METHODS: Twenty-four aged mice were allocated into no training or probe test (naïve), no training but exposed to the same probe test (NTPRT), received training and probe test (PRT), and received training but no probe test (NPRT) groups. Twelve mice were trained in a water maze over 14 days. After the final probe trial on day 15, all mice were anesthetized and the brains were removed. pCREB immunoreactivity (pCREB-ir) and Egr1 immunoreactivity (Egr1-ir) in the hippocampal CA1 and CA3 areas were examined. RESULTS: pCREB-ir and Egr1-ir in the CA1 and CA3 areas of the NPRT and PRT groups were significantly higher than those of the naïve and NTPRT groups, and those in the PRT group were significantly higher than in the NPRT group. In all groups, pCREB-ir was significantly higher in the CA3 area compared to the CA1 area, while Egr1-ir was significantly higher in the CA1 area compared to the CA3 area. CONCLUSION: Retrieval, as well as formation, of consolidated spatial memory in the water maze is correlated with expression of pCREB and Egr1 in the hippocampus of aged mice.

[Evaluation of a portable device based on peripheral arterial tone in the detection of obstructive sleep apnea].

OBJECTIVE: To assess the accuracy of a wrist-worn device (Watch-PAT 200) in the diagnosis of obstructive sleep apnea syndrome (OSAHS). METHODS: Forty-three adult subjects with suspected OSAHS simultaneously had a standard in-laboratory polysomnogram (PSG) and wore the Watch-PAT 200 during a full-night recording. PSG sleep and respiratory events were scored according to standard criteria. The PSG recordings were blindly manually analyzed, while Watch-PAT data were scored automatically based on the algorithm developed previously. RESULTS: The mean age of the subjects was (42.2 ± 12.2) years (x(-) ± s), and mean body mass index was (28.0 ± 3.9) kg/m(2). Mean PSG apnea hypopnea index (AHI) was (34.9 ± 29.9) events per hour, and mean PAT-AHI was (36.0 ± 29.2) events per hour. There was a significant correlation between PAT AHI and AHI by PSG (r = 0.931, P < 0.01). A Bland-Altman plot of PAT AHI and PSG AHI was also used to assess the accuracy of Watch-PAT 200. At lower levels of AHI, PAT tended to overestimate disease severity, while at higher levels of AHI, Watch-PAT underestimated severity. To assess sensitivity and specificity of Watch-PAT, constructed receiver operator characteristic curves using a variety of AHI threshold values (5, 15 and 30 events per hour). For AHI ≥ 5 events per hour as threshold value, the Watch-PAT diagnosing rate was 93%, and sensitivity as well as specificity were 94.7% and 80.0%. The misdiagnosis rate and missed diagnosis rate were 20.0% and 5.3%. Optimal combinations of sensitivity and specificity for the AHI threshold values (15 and 30 events per hour) were 82.6% and 100.0%, 95.0% and 95.7% respectively. CONCLUSION: The Watch-PAT 200 may offer an accurate, robust, and reliable ambulatory method for the detection of OSAHS, with minimal patient discomfort.