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@#Objective To construct a radiomics model for identifying clinical high-risk carotid plaques. Methods A retrospective analysis was conducted on patients with carotid artery stenosis in China-Japan Friendship Hospital from December 2016 to June 2022. The patients were classified as a clinical high-risk carotid plaque group and a clinical low-risk carotid plaque group according to the occurrence of stroke, transient ischemic attack and other cerebrovascular clinical symptoms within six months. Six machine learning models including eXtreme Gradient Boosting, support vector machine, Gaussian Naive Bayesian, logical regression, K-nearest neighbors and artificial neural network were established. We also constructed a joint predictive model combined with logistic regression analysis of clinical risk factors. Results Finally 652 patients were collected, including 427 males and 225 females, with an average age of 68.2 years. The results showed that the prediction ability of eXtreme Gradient Boosting was the best among the six machine learning models, and the area under the curve (AUC) in validation dataset was 0.751. At the same time, the AUC of eXtreme Gradient Boosting joint prediction model established by clinical data and carotid artery imaging data validation dataset was 0.823. Conclusion Radiomics features combined with clinical feature model can effectively identify clinical high-risk carotid plaques.
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@#Objective To identify the preoperative risk factors for prolonged mechanical ventilation (PMV) after pulmonary thromboendarterectomy (PTE). Methods The clinical data of patients who underwent PTE from December 2016 to August 2021 in our hospital were retrospectively analyzed. The patients were divided into two groups according to the postoperative mechanical ventilation time, including a postoperative mechanical ventilation time≤48 h group (≤48 h group) and a postoperative mechanical ventilation time>48 h (PMV) group (>48 h group). Univariable and logistic regression analysis were used to identify the preoperative risk factors for postoperative PMV. Results Totally, 90 patients were enrolled in this study. There were 40 patients in the ≤48 h group, including 30 males and 10 females, with a mean age of 45.48±12.72 years, and there were 50 patients in the >48 h group, including 29 males and 21 females, with a mean age of 55.50±10.42 years. The results showed that in the ≤48 h group, the median postoperative ICU stay was 3.0 days, and the median postoperative hospital stay was 15.0 days; in the >48 h group, the median postoperative ICU stay was 7.0 days, and the median postoperative hospital stay was 20.0 days. The postoperative PMV was significantly correlated with tricuspid annular plane systolic excursion (TAPSE) [OR=0.839, 95%CI (0.716, 0.983), P=0.030], age [OR=1.082, 95%CI (1.034, 1.132), P=0.001] and pulmonary vascular resistance (PVR) [OR=1.001, 95%CI (1.000, 1.003), P=0.028]. Conclusion Age and PVR are the preoperative risk factors for PMV after PTE, and TAPSE is the preoperative protective factor for PMV after PTE.
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Objective To explore the effect of angiogenesis in carotid atherosclerotic plaque.Methods From Jan 2016 to Aug 2016,Carotid artery plaque was abtained in 52 cases after carotid endarterectomy at the Department of Cardiovascular Surgery of China-Japan Friendship Hospital.Patients were divided into symptomatic group and asymptomatic group.Specimens were stained with HE and Movat,and the density,size,distribution and morphology of neovascularization were counted.Results The density of neovascularization in the symptomatic group and the asymptomatic group were 5.27 ± 0.46 and 2.30 ±0.29,respectively (P ＜ 0.001),the average cross-sectional area of neovascularization in the symptomatic group was (2.26±0.21) mm2 and (1.00 ±0.48) mm2 in the asymptomatic group (P=0.02).In the distribution,the symptomatic group and the asymptomatic group were 3.37 ± 0.46/ mm2,1.32 ±0.16/mm2 in basal part,3.71 ±0.42/mm2,1.56 ±0.20/mm2 in the shoulder part,3.48 ±0.44/mm2,1.55 ± 0.21/ mm2 in the fibrous cap,respectively (P ＜ 0.001).Conclusion The density and cross-sectional area of neovascularization in the symptomatic group were larger than those in the asymptomatic group,irregular branching vessels were dominant.
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Objective To evaluate diagnostic method and treatment strategy for free floating thrombus in carotid artery.Methods From Ju12016 to Oct 2017,7 patients with free floating thrombus in carotid artery was diagnosed at our department.The medical history,symptoms,diagnosis,treatment strategy and prognosis of those patients were analyzed retrospectively.Results Among 7 patients,4 were symptomatic;4 patients were concomitant with severe carotid artery stenosis and 3 with mild to moderate stenosis.3 received carotid endarterectomy and patch angioplasty.4 received carotid artery stenting with distal cerebral protection divice.There was no perioperative and 30-day stroke,myocardial infarction,death or hyperperfusion syndrome occurred.The 12-month follow up showed no restenosis,no free floating thrombus recurrence and no ischemic cerebrovascular event.Conclusion Free floating filling defect in carotid artery is a typical sign for unstable plaque.Both carotid endarterectomy and carotid artery stenting can be used for the treatment of free floating thrombus.
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Objective To investigate the characteristics and significance of inflammatory factors and insulin resistance index in patients with type 2 diabetes mellitus complicated with depression.MethodsThe patients with type 2 diabetes mellitus complicated with depression were treated with IL-2, TNF-α and HOMA-IR in control group.The patients in type 2 diabetes mellitus had no complication and depression., Record the above indicators of test results.ResultsIL-2, TNF-α and HOMA-IR were the highest in the study group (P<0.05).The levels of IL-2, TNF-α and HOMA-IR in control group 1 and control group 2 were significantly higher than those in control group (P<0.05).There was no significant difference between the two groups.ConclusionThere is a high level of insulin resistance index and inflammatory factor in patients with type 2 diabetes mellitus complicated with depression.Therefore, it is suggested that the treatment of type 2 diabetes mellitus can be treated with anti-inflammatory and insulin resistance.The.
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Objective To study less weak blood trace elements and semen quality in patients with azoospermia relevance to guide the clinical treatment.MethodsMarch 2015 to October 2016 and less refined asthenospermia diagnosis and treatment of 78 cases of patients admitted to hospital as the observation group, while admission examination to select healthy men the same period 42 cases as the control group.Two men underwent routine semen analysis and content detection of trace elements in the blood.ResultsThe difference between serum calcium and copper content in the control group was not significant;and serum zinc content of the observation group (7.23±2.70)μmol/L, lead content was (29.33±15.97)μg/L, the control group respectively (13.37±2.34)μmol/L, lead content was (7.09±5.74)μg/L;the difference was significant (P<0.05).Observed a negative correlation of serum zinc content and sperm motility (r=-0.162, P<0.05), the lead content and sperm density, normal sperm morphology rate, sperm motility rate negative correlation (r=-0.112,-0.067,-0.142, P<0.05), the copper content and sperm density positively correlated with the forward movement of sperm rate negatively correlated (r=0.058,-0.137, P<0.05).ConclusionWeak content less closely related to the quality of semen azoospermia patient's blood zinc, lead, copper, and close monitoring to guide clinical treatment.
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Objective To compare the differences of liver function indexes in patients with acute left heart failure and congestive heart failure , and to provide the basis for the diagnosis of heart failure .Methods 142 cases of heart failure from March 2014 to December 2015 in our hospital were selected and divided into 68 cases of acute left heart failure group and 74 cases of congestive heart failure group.The differences in liver function tests were compared between the two groups by comparing the differences in the indexes of heart failure, liver blood biochemistry, general biochemical indexes and late follow-up data.Results Compared with the indexes of heart failure, there were no significant differences in ejection fraction, NT-proBNP, history of heart failure>one years, and the number of patients with right heart failure, the difference was statistically significant (P<0.05).Comparison of liver blood biochemistry: patients with acute left heart failure were alanine aminotransferase, aspartate amino transferase, albumin increased, the difference was statistically significant (P<0.05), and glutamyl aminotransferase, total bilirubin, direct bilirubin, indirect bilirubin decreased, the difference was statistically significant (P<0.05).There was no significant difference between the two groups of patients with alkaline phosphatase and total protein.Compared with the general biochemical indexes, increased triglyceride levels in patients with congestive heart failure group, the difference was statistically significant (P<0.05), there was no significant difference in other indexes.Conclusion AHF patients with ALT, AST increased, CHF with GGT, TBIL, DBIL, IBIL increased, ALB decreased mainly.
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The relative long-term efficacy and safety of sirolimus-eluting stents [SES] compared with paclitaxel-eluting stents [PES] in multiple comparative studies remains controversial. This report evaluates 29 randomized trials with 18,379 patients in whom long-term [more than 1 year] outcomes were evaluated. The primary outcomes were target lesion revascularization [TLR] and the secondary end points were death, cardiac death, myocardial infarction [MI], major adverse cardiac events [MACEs], target vessel revascularization [TVR] and stent thrombosis [ST]. In comparison with PES, SES significantly reduced the long-term risk of TLR [RR=0.68; 95% CI=0.57 to 0.80, p<0.001], TVR [RR=0.69; 95% CI= 0.60 to 0.79, p<0.001] and MACE [RR=0.82; 95% CI= 0.77 to 0.88, p<0.001], while there were no significant difference with respect to death, cardiac death, MI and ST between the two groups. SES performance was significantly better for reducing the former three outcomes and comparable for the majority of the secondary end points when compared against PES
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Objective To investigate the effect of ischemic preconditioning (IPC) on the expression of a disintegrin and metalloprotease with thrombospondin type 1 motifs (ADAMTS-1), and to study whether the application of small interfering (si)RNA specifically targeting ADAMTS-1 would help to recover IPC protection in the aged heart. Methods The 32 young (4 months) and 32 aged(24 months) male Sprague-Dawley (SD) rats were assigned randomly to IPC group (n=20) and sham operated group (n= 12) respectively. Myocardial samples from the ischemic-reperfused region were harvested for detecting the ADAMTS-1 expression. In addition, the 110 aged SD rats were assignedrandomly to ADAMTS-1 siRNA group and control group (n=55, each). The effects of ADAMTS-1siRNA transfcction on the expression of ADAMTS-1 protein, myocardial infarction survival rate,heart function and myocardial infarction size after IPC were observed.Results Twenty-four hours after IPC, the ADAMTS-1 protein expression increased significantly in iscbemic-reperfused region both in young and aged rats (P＜0. 05), and the protein expression was higher in aged rats than in young rats (P＜0.05). In young-IPC group, the absorbency showed ADAMTS-1 protein expression at 0 hrs and 24 hrs after IPC were 0. 05±0.01 and 0.12±0.03 by immunohistochemical staining, and were 0.68±0. 16 and 1. 17±0.21 by Western blots respectively. In aged-IPC group, the absorbency showed ADAMTS-1 protein expression at 0 hrs and 24 hrs after IPC were 0.07±0. 03 and 0.21 ±0.04 by immunohistochemical staining, and were 0. 76±0. 21 and 1. 48±0. 17 by Western blots. In the aged rats, ADAMTS-1 siRNA transfection inhibited ADAMTS-1 protein expression (0. 66±0. 19and 0.78±0.21, by Western blots at 0 hrs and 24 hrs after IPC, P＞0.05), but didn't improve myocardial infarction survival rates [ADAMTS-1 siRNA group and sham operated group: 14.3% (5/35) vs. 17.1 %(6/35), P＞0.05], left ventricular fractional shortening [(14.0±3.2)% vs. (13.0±2.9)%, P＞0.05] and myocardial infarction size[(39.0±4.1)% vs. (38.0±5.3)%, P＞0.05].Conclusions ADAMTS-1 expression induced by IPC increases significantly in aged versus in young rats. ADAMTS-1 knockdown by siRNA inhibits ADAMTS-1 protein expression but cannot recover the age-associated loss of IPC protection.
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OBJECTIVE To investigate the flora distribution,character in producing enzyme and drug resistance to eleven antiobics of Flavobacterium in our hospital,and analyse its MDR character in order to direct the clinical medication. METHODS 219 clinical isolates of Flavobacterium were detected out ESBLs and AmpC ?-lactamases by three-dimensional test,MBL by the double-disk synergy test,at the same time,drug resistance to eleven antiobics were also detected by K-B method. RESULTS Hospital infection caused by Flavobacterium mostly are Chrvseobacterium meningosepticum,secondly are Chryseobacterium indologenes.Respiratory tract was prone to be infected than other fite,futhermore,ICU patient was more easier to catch infection than other wards(P
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OBJECTIVE To understand the pathogen distribution and drug resistance of pelvic inflammatory disease in women,then help the clinic to use drug rationally. METHODS Totally 342 bacteria were isolated from the cervical or pelvic secretion and given in vitro drug sensitivity test with Kirby-Bauer method. ESBLs detected by ESBLs affirm test and AmpC detected by cefoxitin three dimensional test in G-bacteria. RESULTS From the 342 strains isolated from this group,there were 215 G-(62.9%),the primary pathogenic bacteria were Escherichia coli,Klebsiella pneumoniae and Serratia marcescens,at the same time,there were 127 G+ (37.1%),the most common pathogens were coagulase-negative staphylococci (CNS) and Staphylococcus aureus. The detectable rate of ESBLs and AmpC together were 38.1% and 34.9% in G-,that of only ESBLs occupied 13.0%,that of only AmpC was 9.8%,that of ESBLs combined with high yield AmpC occupied 13.9%,and that of ESBLs combined with induced AmpC occupied 11.2%. Otherwise,the resistance rate to antibiotics was all higher than 48% except VAN,TEC,QDA and rifampin in G+. The rate of resistance to IPM,MEM and FEP were 5.58%,3.72%,and 26.0% respectively in G-,and the drug resistance rate of enzyme-prodncing G-were much more than that without enzyme-producing (P