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Development and validation of novel models for the prediction of intravenous corticosteroid resistance in acute severe ulcerative colitis using logistic regression and machine learning

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Gastroenterology Report 2022年第1期10卷 498-506页

作者： Si Yu Hui Li Yue Li Hui Xu Bei Tan Bo-Wen Tian yi-min dai Feng Tian Jia-ming Qian Department of Gastroenterology Peking Union Medical College HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijingP.R.China Department of Gastroenterology Shengjing Hospital of China Medical UniversityShenyangLiaoningP.R.China

Background The early prediction of intravenous corticosteroid(IVCS)resistance in acute severe ulcerative colitis(ASUC)patients remains an unresolved challenge.This study aims to construct and validate a model that accurately predicts IVCS resistance.Methods A retrospective cohort was established,with consecutive inclusion of patients who met the diagnosis criteria of ASUC and received IVCS during index hospitalization in Peking Union Medical College Hospital between March 2012 and January 2020.The primary outcome was IVCS resistance.Classification models,including logistic regression and machine learning-based models,were constructed.External validation was conducted in an independent cohort from Shengjing Hospital of China Medical University.Results A total of 129 patients were included in the derivation cohort.During index hospitalization,102(79.1%)patients responded to IVCS and 27(20.9%)failed;18(14.0%)patients underwent colectomy in 3 months;6 received cyclosporin as rescue therapy,and 2 eventually escalated to colectomy;5 succeeded with infliximab as rescue therapy.The Ulcerative Colitis Endoscopic Index of Severity(UCEIS)and C-reactive protein(CRP)level at Day 3 are independent predictors of IVCS resistance.The areas under the receiver-operating characteristic curves(AUROCs)of the logistic regression,decision tree,random forest,and extreme-gradient boosting models were 0.873(95%confidence interval[CI],0.704–1.000),0.648(95%CI,0.463–0.833),0.650(95%CI,0.441–0.859),and 0.604(95%CI,0.416–0.792),respectively.The logistic regression model achieved the highest AUROC value of 0.703(95%CI,0.473–0.934)in the external validation.Conclusions In patients with ASUC,UCEIS and CRP levels at Day 3 of IVCS treatment appeared to allow the prompt prediction of likely IVCS resistance.We found no evidence of better performance of machine learning-based models in IVCS resistance prediction in ASUC.A nomogrambased on the logistic regression model might aid in the management of ASUC patients.

关键词： acute severe ulcerative colitis steroid resistance colectomy machine learning

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Intravenous Administration of Carbetocin Versus Oxytocin for Preventing Postpartum Hemorrhage After Vaginal Delivery in High Risk Women:A Double-blind,Randomized Controlled Trial

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Maternal-Fetal Medicine 2020年第2期2卷 72-79页

作者： Hua Liu Xiu-Yun Xu Ning Gu Xiao-Dong Ye Zhi-Qun Wang Ya-Li Hu yi-min dai Department of Obstetrics and Gynecology Nanjing Drum Tower HospitalNanjing University Medical SchoolNanjing 210008China

Objective::To compare the effects between carbetocin and oxytocin on reducing postpartum hemorrhage(PPH)after vaginal delivery in high risk pregnant women.Methods::A prospective double-blinded randomized study was conducted in the Nanjing Drum Tower Hospital from March to May 2018.Women at or beyond 28 gestational weeks,cephalic presentation,18-45 years old,and with at least one risk factor for PPH,were enrolled.Using a computer-generated randomization sequence,women were randomized to carbetocin group or oxytocin group which receive 100μg intravenous infusion carbetocin or 10 IU intravenous infusion of oxytocin after anterior shoulder and before placental delivery.The primary outcome was the incidence of blood loss≥500 mL within 24 hours postpartum.The secondary outcomes were amount of total blood loss,blood loss within 2 hours after delivery,the rate of blood loss≥1000 mL postpartum,need for a second-line uterotonics and interventions,blood transfusion,difference between hemoglobin before and 48 hours after delivery,adverse maternal events attributed to the trial medication.Hemodynamic status(blood pressure and pulse)was measured at 0 minutes,30 minutes,60 minutes,and 120 minutes after delivery.Results::A total of 314 and 310 participants constituted the carbetocin and oxytocin groups,respectively.The baseline characteristics were comparable between the groups.The carbetocin group had similar rates of PPH(blood loss≥500 mL)and rates of≥1000 mL PPH,(29.6%vs.26.8%,P=0.48)and(3.2%vs.3.5%,P=0.83),to the oxytocin group.The average amount of bleeding was(422.9±241.4)mL in carbetocin group and(406.0±257.5)mL in oxytocin group,which was no statistically significant difference(P=0.40).Either the amount of blood loss within 2 hours((55.5±33.9)mL vs.(59.9±48.7)mL)was no statistically significant difference(P=0.19).The need for therapeutic uterotonics was 23.9%in carbetocin group and 23.5%in oxytocin group,which was also no statistically difference(P=0.93).The rate of blood transfusion(P=0.62)and hemoglobin change(P=0.07)w

关键词： Postpartum hemorrhage Carbetocin Manually remove of placenta Oxytocin Uterotonics agent Vaginal delivery

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Study on the optimal incident proton energy of ^(7)Li(p,n)^(7)Be neutron source for boron neutron capture therapy

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Nuclear Science and Techniques 2024年第3期35卷 170-180页

作者： yi-Nan Zhu Zuo-Kang Lin Hai-Yan Yu Ye dai Zhi-min dai Xiao-Han Yu Shanghai Institute of Applied Physics Chinese Academy of SciencesShanghai 201800China University of Chinese Academy of Science Beijing 100049China

Boron neutron capture therapy(BNCT)is recognized as a precise binary targeted radiotherapy technique that effectively eliminates tumors through the^(10)B(n,α)^(7)Li nuclear reaction.Among various neutron sources,accelerator-based sources have emerged as particularly promising for BNCT applications.The^(7)Li(p,n)^(7)Be reaction is highly regarded as a potential neutron source for BNCT,owing to its low threshold energy for the reaction,significant neutron yield,appropriate average neutron energy,and additional benefits.This study utilized Monte Carlo simulations to model the physical interactions within a lithium target subjected to proton bombardment,including neutron moderation by an MgF_(2)moderator and subsequent BNCT dose analysis using a Snyder head phantom.The study focused on calculating the yields of epithermal neutrons for various incident proton energies,finding an optimal energy at 2.7 MeV.Furthermore,the Snyder head phantom was employed in dose simulations to validate the effectiveness of this specific incident energy when utilizing a^(7)Li(p,n)^(7)Be neutron source for BNCT purposes.

关键词： Boron neutron capture therapy ^(7)Li(p,n)7Be neutron source Incident proton energy Monte Carlo simulation

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Experimental Study on Wind Load Characteristics Caused by Wind Damage in Vulnerable Areas of Low-rise Building Roofs

Experimental Study on Wind Load Characteristics Caused by Wi...

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作者： Shu JIANG yi-min dai Yang-jin YUAN Si-ji SONG Key Laboratory of Wind-resistance and Vibration Control（Hunan Provincial） College of Civil Engineering Hunan University of Science and Technology

Through the wind tunnel test on the opening of different locations and local areas in vulnerable areas of low-rise building roofs, the distribution characteristics of wind pressure inside and outside the roof caused by roof damage. The results show that the influence of the wind direction angle on the internal pressure caused by the wind is obvious, and the internal pressure caused by the opening on the leeward surface is small and the change law is obviously different from that on the windward surface. The correlation coefficient on the inner side of the roof opening is higher than that on the side of the unopened roof, and the correlation between wind pressure on the measurement points near the opening is larger than other regions.

关键词： Low-rise buildings Roof openings Wind tunnel tests Wind-induced internal pressure

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Metagenomics reveals the microbial community and functional metabolism variation in the partial nitritation-anammox process:From collapse to recovery

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Journal of Environmental Sciences 2024年第1期135卷 210-221页

作者： Hong Wang Hui Gong Xiaohu dai min Yang State Key Laboratory of Pollution Control and Resource Reuse College of Environmental Science and EngineeringTongji UniversityShanghai 200092China BIOMATH Department of Data Analysis and Mathematical ModellingGhent UniversityGhent 9000Belgium

Mainstream partial nitritation-anammox(PNA)process easily suffers from performance instability and even reactor collapse in application.Thus,it is of great significance to unveil the characteristic of performance recovery,understand the intrinsic mechanism and then propose operational strategy.In this study,we combined long-term reactor operation,batch tests,and metagenomics to reveal the succession of microbial community and functional metabolism variation from system collapse to recovery.Proper aeration control(0.10-0.25mg O_(2)/L)was critical for performance recovery.It was also found that Candidatus Brocadia became the dominant flora and its abundance increased from 3.5%to 11.0%.Significant enhancements in carbon metabolism and phospholipid biosynthesis were observed during system recovery,and the genes abundance related to signal transduction was dramatically increased.The up-regulation of sdh and suc genes showed the processes of succinate dehydrogenation and succinyl-CoA synthesis might stimulate the production of amino acids and the synthesis of proteins,thereby possibly improving the activity and abundance of AnAOB,which was conducive to the performance recovery.Moreover,the increase in abundance of hzs and hdh genes suggested the enhancement of the anammox process.Changes in the abundance of key genes involved in nitrogen metabolism indicated that nitrogen removal pathway was more diverse after system recovery.The achievement of performance recovery was driven by anammox,nitrification and denitrification coupled with dissimilatory nitrate reduction to ammonium.These results provide deeper insights into the recovery mechanism of PNA system and also provide a potential regulation strategy for the stable operation of the mainstream PNA process.

关键词： Partial nitritation-anammox Metagenomics Microbial community Functional metabolism Recovery

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Prenatal amoxicillin exposure induces developmental toxicity in fetal mice and its characteristics

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Journal of Environmental Sciences 2024年第3期137卷 287-301页

作者： Yongguo dai Yu Peng Wen Hu yi Liu Hui Wang Department of Pharmacology Wuhan University School of Basic Medical SciencesWuhan 430071China Department of Pharmacy Zhongnan Hospital of Wuhan UniversityWuhan 430071China Hubei Provincial Key Laboratory of Developmentally Originated Disease Wuhan 430071China

Amoxicillin,a widely used antibiotic in human and veterinary pharmaceuticals,is now considered as an“emerging contaminant”because it exists widespreadly in the environment and brings a series of adverse outcomes.Currently,systematic studies about the developmental toxicity of amoxicillin are still lacking.We explored the potential effects of amoxicillin exposure on pregnancy outcomes,maternal/fetal serum phenotypes,and fetal multiple organ development in mice,at different doses(75,150,300 mg/(kg·day))during late-pregnancy,or at a dose of 300 mg/(kg·day)during different stages(mid-/latepregnancy)and courses(single-/multi-course).Results showed that prenatal amoxicillin exposure(PAmE)had no significant infuence on the body weights of dams,but it could inhibit the physical development and reduce the survival rate of fetuses,especially during the midpregnancy.Meanwhile,PAmE altered multiple maternal/fetal serum phenotypes,especially in fetuses.Fetal multi-organ function results showed that PAmE inhibited testicular/adrenal steroid synthesis,long bone/cartilage and hippocampal development,and enhanced ovarian steroid synthesis and hepatic glycogenesis/lipogenesis,and the order of severity might be gonad(testis,ovary)>liver>others.Further analysis found that PAmE-induced multiorgan developmental and functional alterations had differences in stages,courses and fetal gender,and the most obvious changes might be in high-dose,late-pregnancy and multicourse,but there was no typical rule of a dose-response relationship.In conclusion,this study confirmed that PAmE could cause abnormal development and multi-organ function alterations,which deepens our understanding of the risk of PAmE and provides an experimental basis for further exploration of the long-term harm.

关键词： Amoxicillin Prenatal exposure Fetal development Organ function Developmental toxicity

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Exercise-induced adaptation of neurons in the vertebrate locomotor system

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Journal of Sport and Health Science 2024年第2期13卷 160-171页

作者： Yue dai yi Cheng Renkai Ge Ke Chen Liming Yang Key Lab of Adolescent Health Assessment and Exercise Intervention of ministry of Education College of Physical Education and Health CareEast China Normal UniversityShanghai 200241China Shanghai Key Laboratory of Multidimensional Information Processing School of Communication and Electronic EngineeringEast China Normal UniversityShanghai 200241China School of Physical Education and Health Care East China Jiaotong UniversityNanchang 330013China Key Laboratory of High Confidence Software Technologies of ministry of Education School of Computer SciencePeking UniversityBeijing 100871China

Vertebrate neurons are highly dynamic cells that undergo several alterations in their functioning and physiologies in adaptation to various external stimuli.In particular,how these neurons respond to physical exercise has long been an area of active research.Studies of the vertebrate locomotor system’s adaptability suggest multiple mechanisms are involved in the regulation of neuronal activity and properties during exercise.In this brief review,we highlight recent results and insights from the field with a focus on the following mechanisms:(a)alterations in neuronal excitability during acute exercise;(b)alterations in neuronal excitability after chronic exercise;(c)exercise-induced changes in neuronal membrane properties via modulation of ion channel activity;(d)exercise-enhanced dendritic plasticity;and(e)exercise-induced alterations in neuronal gene expression and protein synthesis.Our hope is to update the community with a cellular and molecular understanding of the recent mechanisms underlying the adaptability of the vertebrate locomotor system in response to both acute and chronic physical exercise.

关键词： Dendritic plasticity Excitability Exercise Ion channel modulation Neuron adaptation

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Extracorporeal membrane oxygenation as a bridging therapy for patients with thiamine deficiency-induced pulmonary arterial hypertension

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World Journal of Emergency Medicine 2024年第2期15卷 147-149页

作者： Fangfang Qiu Weixing dai Tengyue Huang min Li Department of Intensive Care Unit the Fourth Affiliated Hospital of Zhejiang University School of MedicineYiwu 322000China Department of Intensive Care Unit the Second Affiliated Hospital of Zhejiang University School of MedicineHangzhou 310009China

Thiamine deficiency is characterized by a deficiency of thiamine(vitamin B1),lactic acidosis,pulmonary arterial hypertension(PAH),right-sided heart failure,and peripheral nerve damage.Thiamine deficiency is easily misdiagnosed and missed during clinical practice and is associated with death in severe cases.[1,2]Here we reported a patient who was admitted to the hospital with severe metabolic acidosis and pulmonary hypertension and finally diagnosed with thiamine deficiency by detecting plasma vitamin B1 levels.Since clinically obvious thiamine deficiency is rare,and cases of thiamine deficiency requiring extracorporeal membrane oxygenation(ECMO)treatment are rarer,we believe that our case will be helpful for emergency clinicians.

关键词： vitamin hypertension arterial

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Gallbladder carcinosarcoma with a poor prognosis: A case report

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World Journal of Clinical Cases 2024年第10期12卷 1817-1823页

作者： yi dai min Meng Qi-Zhi Luo Yuan-Jun Liu Fan Xiao Chun-Hua Wang Department of Hepatobiliary Surgery Suining Central HospitalSuining 629000Sichuan ProvinceChina The Cancer Center Suining Central HospitalSuining 629000Sichuan ProvinceChina Department of Pathology Suining Central HospitalSuining 629000Sichuan ProvinceChina Department of Liver Surgery&Liver Transplantation West China Hospital of Sichuan UniversityChengdu 610041Sichuan ProvinceChina

BACKGROUND Carcinosarcoma of the gallbladder is a rare malignant tumor with a very poor prognosis.To date,only approximately 100 patients have been reported in the English literature.The prognosis of this tumor type is poor,the preoperative diagnosis is difficult,and there is a possibility of a misdiagnosis.We present an unsuccessful case of carcinosarcoma of the gallbladder with a preoperative misdiagnosis and rapid early postoperative recurrence.Therefore,we have a deeper understanding of the poor prognosis of gallbladder carcinosarcoma(GBC)patients.CASE SUMMARY The patient is a 65-year-old male.He was admitted to the hospital because of right upper abdomen distending pain and discomfort for half a month.Abdominal magnetic resonance imaging revealed a polycystic mass in the right lobe of the liver and the fossa of the gallbladder.After admission,the patient was diagnosed with a liver abscess,which was treated by abscess puncture drainage.Obviously,this treatment was unsuccessful.Hepatectomy and cholecystectomy were performed one month after the puncture.Postoperative pathologic examination revealed carcinosarcoma of the gallbladder,and the resected specimen contained two tumor components.One month after surgery,the patient's tumor recurred in situ and started to compress the duodenum,resulting in duodenal obstruction and bleeding.The treatment was not effective.The patient died of gastrointestinal hemorrhage and hypovolemic shock.CONCLUSION Carcinosarcoma of the gallbladder is a rare malignant tumor that is easily misdiagnosed preoperatively and has a poor prognosis.

关键词： Gallbladder disease Carcinosarcoma Misdiagnosis Poor prognosis Pathological diagnosis Recurrence Case report

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Fecal microbiota transplantation for irritable bowel syndrome:Current evidence and perspectives

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World Journal of Gastroenterology 2024年第16期30卷 2179-2183页

作者： Cong dai Yu-Hong Huang min Jiang Department of Gastroenterology First Hospital of China Medical UniversityShenyang 110001Liaoning ProvinceChina

In this editorial we comment on the article published in the recent issue of the World journal of Gastroenterology.We focus specifically on the mechanisms underlying the effects of fecal microbiota transplantation(FMT)for irritable bowel syndrome(IBS),the factors which affect the outcomes of FMT in IBS patients,and challenges.FMT has emerged as a efficacious intervention for clostridium difficile infection and holds promise as a therapeutic modality for IBS.The utilization of FMT in the treatment of IBS has undergone scrutiny in numerous randomized controlled trials,yielding divergent outcomes.The current frontier in this field seeks to elucidate these variations,underscore the existing knowledge gaps that necessitate exploration,and provide a guideline for successful FMT implementation in IBS patients.At the same time,the application of FMT as a treatment for IBS confronts several challenges.

关键词： Fecal microbiota transplantation Irritable bowel syndrome Microbiota Randomized controlled trial Meta-analysis

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