Preliminary study of machine learning in the screening of proteinuria in rural areas of Shanxi province / 中华肾脏病杂志

Objective:To screen the incidence of proteinuria in rural areas of Shanxi province and construct a risk prediction model of proteinuria based on machine learning algorithm.Methods:It was a cross-sectional investigation study. The residents ≥30 years old in rural areas of Shanxi province from April to November 2019 were screened by multi-stage stratified sampling method, and data from questionnaire surveys, physical examinations, and laboratory examinations were collected. Urine albumin/creatinine ratio ≥30 mg/g was defined as proteinuria, and the incidence of proteinuria was calculated. Subjects were divided into proteinuria group and non-proteinuria group. The machine learning binary classification model of proteinuria and non-proteinuria was constructed based on the stackable integrated logistic regression algorithm (SE-LR), logistic regression, support vector machine, decision tree, random forest and extreme gradient lift algorithms, respectively. The area under the receiver operating characteristic curve, accuracy, recall, and F1 weights were used to evaluate the predictive efficiency of the comparison models. Finally, the importance of the predictive features of the model with the best overall performance was ranked.Results:There were 8 869 rural residents included in the study, aged (58.59±9.49) years old, with 3 872 males (43.66%) and 4 997 females (56.34%). The prevalence of proteinuria in rural areas of Shanxi province was 13.49% (1 196/8 869). Blood pressure, pulse, body mass index, waist circumference, proportion of obesity or overweight, proportion of hypertension, proportion of moderate to severe salt intake, glycosylated hemoglobin, uric pH value, urinary specific gravity, proportion of positive urinary occult blood, proportion of positive urinary glucose, proportion of positive urinary ketone body, proportion of urinary red blood cell count ≥5/μl, proportion of urinary white blood cell count ≥10/μl and urinary α1 microglobulin in the proteinuria group were all higher than those in the non-proteinuria group (all P<0.05). The proportions of lack of exercise and drinking history in the proteinuria group were lower than those in non-proteinuria group (both P<0.05). The overall performance of SE-LR model was the best, with the area under the curve (0.736, 95% CI 0.719-0.746) slightly lower than that of the logistic regression model (0.745, 95% CI 0.680-0.762), and the highest accuracy (0.844), recall rate (0.621) and F1 weighting value (0.801). In the SE-LR model, the orders of importance of the top 10 features were urinary α1- microglobulin, urinary occult blood, urinary sugar, uric acid basicity, smoking history,overweight or obesity, body mass index, total cholesterol, glycosylated hemoglobin and hypertension. Conclusions:The prevalence of proteinuria is high in rural areas of Shanxi province. The risk prediction model of proteinuria established by machine learning algorithm can predict the risk of proteinuria and identify its risk factors, which can provide a scientific basis for disease prevention, intervention, and treatment in the community and clinic to a certain extent.

Effect of Modified Taohe Chengqitang on NLRP3 Inflammasomes in Rats with Diabetic Cardiomyopathy / 中国实验方剂学杂志

ObjectiveTo investigate the effect of modified Taohe Chengqitang on NOD-like receptor protein 3 （NLRP3） inflammasome activation in rats with diabetic cardiomyopathy. MethodSPF male SD rats aged 3-4 weeks were randomly divided into a normal group and an experimental group. The rats in the experimental group were fed on a high-fat diet for 4 weeks and then received intraperitoneal injection of streptozotocin （STZ） at 35 mg·kg-1 to induce the diabetes model. The rats in the experimental group were randomly divided into model group， low- and high-dose modified Taohe Chengqitang groups （11.7 g·kg-1 and 23.4 g·kg-1）， and metformin hydrochloride group （67.5 mg·kg-1） according to the fast blood glucose （FBG）. The cardiac function and structure of rats were detected by ultrasonic imaging after 8 weeks of continuous intragastric administration. Blood samples from the femoral artery were collected to detect FBG， triglyceride （TC）， and total cholesterol （TG） of rats. Hematoxylin-eosin （HE） staining was used to observe the pathological changes in rat myocardium. Serum levels of interleukin-1β （IL-1β） and interleukin-18 （IL-18） were determined by enzyme-linked immunosorbent assay （ELISA）. The protein expression of NLRP3， apoptosis-associated speck-like protein containing a CARD （ASC）， cysteinyl aspartate-specific protease 1 （Caspase-1）， and phosphorylated nuclear factor kappa-B p65 （p-NF-κB p65） in the myocardium was detected by Western blot. ResultCompared with the normal group， the model group showed increased levels of FBG， TC， and TG （P<0.01）， decreased left ventricular ejection fraction （EF） and left ventricular fractional shortening （FS） （P<0.05）， myocardial hypertrophy and myocardial fibrosis as revealed by HE staining， increased serum levels of 1L-1β and 1L-18 and protein expression of NLRP3， ASC， Caspase-1， and p-NF-κB p65 in myocardial tissues （P<0.01）. Compared with the model group， the modified Taohe Chengqitang groups and the metformin group showed reduced levels of FBG， TC， and TG （P<0.05）， restored EF and FS （P<0.05）， improved pathological changes in myocardial tissues， and decreased serum levels of IL-1β and IL-18 and protein expression of NLRP3， ASC， Caspase-1， and p-NF-κB p65 in myocardial tissues （P<0.05）. The improvement was more significant in the high-dose modified Taohe Chengqitang group （P<0.05）. ConclusionModified Taohe Chengqitang can protect the myocardium by inhibiting the activation of NLRP3 inflammasomes.

Implementation and Management of Socialized Outsourcing of the Electromechanical and Property Maintenance Services in General Hospitals / 现代医院

The steps and process of the socialization of outsourcing the electromechanical and property maintenance in a provincial general hospital in South China were introduced to discuss about socialized management modes and provide references for promotion and management of outsourcing such services.

An Investigation on Oral Health Status of 480 Lahu People in Lincang, Yunnan / 昆明医科大学学报

Objective To provide guidance for oral health prevention by investigating oral health status of 480 Lahu people.Methods Oral health status of 480 Lahu people were investigated by trained dental therapists using standard diagnostic criteria and record.Participants were divided into 4 groups according to their age.Results The Lahu People in Linxiang county suffered from severe dental caries and periodontal disease.The caries prevalence rate among children of 5 years old was 78.3％.The rate of calculus among the children of 12 years old was 75％.The prevalence rates of caries and periodontal pockets were 91.7％ and 43.3％ among the adults between 35 and 44 years old.The above data were significantly higher than the results of the Third National Oral Health Survey.The rates of gingival bleeding and periodontal pocket were 51.7％ and 49.2％ among the aged from 65 to 74 years old,which were lower than that of the Third National Oral Health Survey.Among the participants,76％ never brushed teeth and 85％ brushed teeth only once a day in people who brushed teeth regularly.Conclusion Poor status and maintenance of oral health in the Lahu People suggest that education and resources for oral health should be invested.

Orthokeratology for treating myopia:a report of clinical application / 眼科新进展

Objective　To make a preliminary analysis of orthokeratology(OK) for treating myopia.Methods　OK lenses were chosen to treat myopia with or without astigmatism according to the myopia characterizations, then changes of their visions, refractions, corneal curvature and eccedtricities after being treated for ld, 1、2、3、4 weeks were observed once every 4weeks and were followed up for 18 months.Results　Significant changes were observed after being treated. Slight myopia: the diopters decreased-2.75D±0.50D,the horizontal meridians flattened 1.64±0.21, the vertical 0.92±0.27 and the eccedtricities declined 0.47±0.11; Middle myopia: the diopters decreased -5.50D±0.75D,the horizontal meridians flattened 2.16±0.45, the vertical 1.61±0.67, and the eccedtricities declined 0.38±0.07; High myopia:the diopters did -6.75D±0.50D,the horizontal did 3.86±0.56, the vertical 2.97±0.67 and the eccedtricities did 0.32±0.10. The predicabilities of slight and middle myopia were superior to high myopia's.Conclusion　Orthokeratology is a non-traumatic therapy and the clinical application should be careful and scientific.