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Data driven analysis reveals prognostic genes and immunological targets in human sepsis-associated acute kidney injury

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World Journal of Emergency Medicine 2024年第2期15卷 91-97页

作者： Qing Zhao Jinfu Ma Jianguo Xiao Zhe Feng Hui Liu Department of Diagnosis and Treatment of Cadres the First Medical CenterChinese PLA General HospitalBeijing 100853China Intensive Care unit the 305th Hospital of Chinese PLABeijing 100032China Department of Critical Care Medicine the First Medical CenterChinese PLA General HospitalBeijing 100853China Nephrology Department the First Medical CenterChinese PLA General HospitalBeijing 100853China

BACKGROUND:The molecular mechanism of sepsis-associated acute kidney injury(SA-AKI)is unclear.We analyzed co-differentially expressed genes(co-DEGs)to elucidate the underlying mechanism and intervention targets of SA-AKI.METHODS:The microarray datasets GSE65682,GSE30718,and GSE174220 were downloaded from the Gene Expression Omnibus(GEO)database.We identified the co-DEGs and constructed a gene co-expression network to screen the hub genes.We analyzed immune correlations and disease correlations and performed functional annotation of the hub genes.We also performed single-cell and microenvironment analyses and investigated the enrichment pathways and the main transcription factors.Finally,we conducted a correlation analysis to evaluate the role of the hub genes.RESULTS:Interleukin 32(IL32)was identified as the hub gene in SA-AKI,and the main enriched signaling pathways were associated with hemopoiesis,cellular response to cytokine stimulus,inflammatory response,and regulation of kidney development.Additionally,IL32 was significantly associated with mortality in SA-AKI patients.Monocytes,macrophages,T cells,and NK cells were closely related to IL32 and were involved in the immune microenvironment in SA-AKI patients.IL32 expression increased significantly in the kidney of septic mouse.Toll-like receptor 2(TLR2)was significantly and negatively correlated with IL32.CONCLUSION:IL32 is the key gene involved in SA-AKI and is significantly associated with prognosis.TLR2 and relevant immune cells are closely related to key genes.

关键词： Sepsis Acute kidney injury Interleukin 32 Toll-like receptor 2 Bioinformatics analysis

Calcitonin gene-related peptide inhibits neuronal apoptosis in heatstroke rats via PKA/p-CREB pathway

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Chinese Journal of Traumatology 2024年第1期27卷 18-26页

作者： Jie Zhu Ya-Hong Chen Jing-Jing Ji Cheng-Xiang Lu Zhi-Feng Liu Department of Pediatric General Hospital of Southern Theater Command of PLAGuangzhou510010China Department of Medical Intensive Care unit General Hospital of Southern Theater Command of PLAGuangzhou510010China Department of Intensive Care unit Zhongshan Hospital Xiamen UniversityXiamenFujian province361004China

Purpose:The incidence of heatstroke(HS)is not particularly high;however,once it occurs,the consequences are serious.It is reported that calcitonin gene-related peptide(CGRP)is protective against brain injury in HS rats,but detailed molecular mechanisms need to be further investigated.In this study,we further explored whether CGRP inhibited neuronal apoptosis in HS rats via protein kinase A(PKA)/p-cAMP response element-binding protein(p-CREB)pathway.Methods:We established a HS rat model in a pre-warmed artificial climate chamber with a temperature of(35.5±0.5)℃and a relative humidity of 60%±5%.Heatstress was stopped once core body temperature reaches above 41℃.A total of 25 rats were randomly divided into 5 groups with 5 animals each:control group,HS group,HS+CGRP group,HS+CGRP antagonist(CGRP8-37)group,and HS+CGRP+PKA/p-CREB pathway blocker(H89)group.A bolus injection of CGRP was administered to each rat in HS+CGRP group,CGRP8-37(antagonist of CGRP)in HS+CGRP8-37 group,and CGRP with H89 in HS+CGRP+H89 group.Electroencephalograms were recorded and the serum concentration of S100B,neuron-specific enolase(NSE),neuron apoptosis,activated caspase-3 and CGRP expression,as well as pathological morphology of brain tissue were detected at 2 h,6 h,and 24 h after HSin vivo.The expression of PKA,p-CREB,and Bcl-2 in rat neurons were also detected at 2 h after HSin vitro.Exogenous CGRP,CGRP8-37,or H89 were used to determine whether CGRP plays a protective role in brain injury via PKA/p-CREB pathway.The unpairedt-test was used between the 2 samples,and the mean±SD was used for multiple samples.Double-tailedp<0.05 was considered statistically significant.Results:Electroencephalogram showed significant alteration ofθ(54.50±11.51vs.31.30±8.71,F=6.790,p=0.005)andαwave(16.60±3.21vs.35.40±11.28,F=4.549,p=0.020)in HS group compared to the control group 2 h after HS.The results of triphosphate gap terminal labeling(TUNEL)showed that the neuronal apoptosis of HS rats was increased in the cortex(9.67±3.16vs.1.80±1.10,F=11.002,p=0.001)and

关键词： Heatstroke Calcitonin gene-related peptide Brain injury Apoptosis

A GMDA clustering algorithm based on evidential reasoning architecture

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Chinese Journal of Aeronautics 2024年第1期37卷 300-311页

作者： Haibin WANG Xin GUAN Xiao YI Shuangming LI Guidong SUN Naval Aviation University Yantai 264001China unit 92941 of pla Huludao 125001China Institute of Systems Engineering Beijing 100082China

The traditional clustering algorithm is difficult to deal with the identification and division of uncertain objects distributed in the overlapping region,and aimed at solving this problem,the Evidential Clustering based on General Mixture Decomposition Algorithm(GMDA-EC)is proposed.First,the belief classification of target cluster is carried out,and the sample category of target distribution overlapping region is extended.Then,on the basis of General Mixture Decomposition Algorithm(GMDA)clustering,the fusion model of evidence credibility and evidence relative entropy is constructed to generate the basic probability assignment of the target and achieve the belief division of the target.Finally,the performance of the algorithm is verified by the synthetic dataset and the measured dataset.The experimental results show that the algorithm can reflect the uncertainty of target clustering results more comprehensively than the traditional probabilistic partition clustering algorithm.

关键词： Evidential clustering Credal partition Evidential reasoning Mixed decomposition Gaussian mixture model

Magnetic resonance-guided focused ultrasound for essential tremor:a prospective,single center,single-arm study

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Neural Regeneration Research 2024年第9期19卷 2075-2080页

作者： Rui Zong Xuemei Li Chunyu Yin Jianfeng He Dekang Zhang Xiangbing Bian Lichao Huang Jiayou Zhou Zhipei Ling Lin Ma Xin Lou Longsheng Pan Xinguang Yu Seniro Department of Neurosurgery The First Medical Center of the PLA General HospitalBeijingChina Clinics of Cadre Department of OutpatientThe First Medical Center of the PLA General HospitalBeijingChina Department of Radiology The First Medical Center of the PLA General HospitalBeijingChina

The safety and effectiveness of magnetic resonance-guided focused ultrasound thalamotomy has been broadly established and validated for the treatment of essential tremor.In 2018,the first magnetic resonance-guided focused ultrasound system in Chinese mainland was installed at the First Medical Center of the pla General Hospital.This prospective,single center,open-label,single-arm study was part of a worldwide prospective multicenter clinical trial(ClinicalTrials.gov Identifier:NCT03253991)conducted to confirm the safety and efficacy of magnetic resonance-guided focused ultrasound for treating essential tremor in the local population.From 2019 to 2020,10 patients with medication refractory essential tremor were recruited into this open-label,single arm study.The treatment efficacy was determined using the Clinical Rating Scale for Tremor.Safety was evaluated according to the incidence and severity of adverse events.All of the subjects underwent a unilateral thalamotomy targeting the ventral intermediate nucleus.At the baseline assessment,the estimated marginal mean of the Clinical Rating Scale for Tremor total score was 58.3±3.6,and this improved after treatment to 23.1±6.4 at a 12-month follow-up assessment.A total of 50 adverse events were recorded,and 2 were defined as serious.The most common intraoperative adverse events were nausea and headache.The most frequent postoperative adverse events were paresthesia and equilibrium disorder.Most of the adverse events were mild and usually disappeared within a few days.Our findings suggest that magnetic resonance-guided focused ultrasound for the treatment of essential tremor is effective,with a good safety profile,for patients in Chinese mainland.

关键词： efficacy essential tremor magnetic resonance-guided focused ultrasound(MRgFUS) movement disorder safety stereotactic therapy thalamotomy ventral intermediate nucleus

Robotic versus laparoscopic surgery for sporadic benign insulinoma:Short-and long-term outcomes

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Hepatobiliary & Pancreatic Diseases International 2024年第4期23卷 399-405页

作者： Zhu-Zeng Yin Yuan-Xing Gao Zhi-Ming Zhao Ming-Gen Hu Wen-Bo Tang Rong Liu Faculty of Hepato-Pancreato-Biliary Surgery The First Medical CenterChinese PLA General HospitalBeijing 100853China Institute of Hepatobiliary Surgery of Chinese pla Beijing 100853China Key Laboratory of Digital Hepatobiliary Surgery of Chinese pla Beijing 100853China

Background:Minimally invasive surgery is the optimal treatment for insulinoma.The present study aimed to compare short-and long-term outcomes of laparoscopic and robotic surgery for sporadic benign insulinoma.Methods:A retrospective analysis of patients who underwent laparoscopic or robotic surgery for insulinoma at our center between September 2007 and December 2019 was conducted.The demographic,perioperative and postoperative follow-up results were compared between the laparoscopic and robotic groups.Results:A total of 85 patients were enrolled,including 36 with laparoscopic approach and 49 with robotic approach.Enucleation was the preferred surgical procedure.Fifty-nine patients(69.4%)underwent enucleation;among them,26 and 33 patients underwent laparoscopic and robotic surgery,respectively.Robotic enucleation had a lower conversion rate to laparotomy(0 vs.19.2%,P=0.013),shorter operative time(102.0 vs.145.5 min,P=0.008)and shorter postoperative hospital stay(6.0 vs.8.5 d,P=0.002)than laparoscopic enucleation.There were no differences between the groups in terms of intraoperative blood loss,the rates of postoperative pancreatic fistula and complications.After a median follow-up of 65 months,two patients in the laparoscopic group developed a functional recurrence and none of the patients in the robotic group had a recurrence.Conclusions:Robotic enucleation can reduce the conversion rate to laparotomy and shorten operative time,which might lead to a reduction in postoperative hospital stay.

关键词： Robotic surgical procedures Laparoscopy Insulinoma Enucleation Pancreatectomy

Transcriptome analysis suggests broad jejunal alterations in Linghu’s obesity-diarrhea syndrome:A pilot study

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World Journal of Gastroenterology 2024年第21期30卷 2777-2792页

作者： Xiao-Tong Niu Xiang-Yao Wang Yan Wang Ke Han Nan Ru Jing-Yuan Xiang En-Qiang Linghu Medical School of Chinese pla Chinese PLA General HospitalBeijing 100853China Department of Gastroenterology The First Medical Center of Chinese PLA General HospitalBeijing 100853China School of Medicine Nankai UniversityTianjin 300071China

BACKGROUND Obesity is associated with a significantly increased risk for chronic diarrhea,which has been proposed as Linghu’s obesity-diarrhea syndrome(ODS);however,its molecular mechanisms are largely unknown.AIM To reveal the transcriptomic changes in the jejunum involved in ODS.METHODS In a cohort of 6 ODS patients(JOD group),6 obese people without diarrhea(JO group),and 6 healthy controls(JC group),high-throughput sequencing and bioinformatics analyses were performed to identify jejunal mucosal mRNA expression alterations and dysfunctional biological processes.In another cohort of 16 ODS patients(SOD group),16 obese people without diarrhea(SO group),and 16 healthy controls(SC group),serum diamine oxidase(DAO)and D-lactate(DLA)concentrations were detected to assess changes in intestinal barrier function.RESULTS The gene expression profiles of jejunal mucosa in the JO and JC groups were similar,with only 1 differentially expressed gene(DEG).The gene expression profile of the JOD group was significantly changed,with 411 DEGs compared with the JO group and 211 DEGs compared with the JC group,129 of which overlapped.The enrichment analysis of these DEGs showed that the biological processes such as digestion,absorption,and transport of nutrients(especially lipids)tended to be up-regulated in the JOD group,while the biological processes such as rRNA processing,mitochondrial translation,antimicrobial humoral response,DNA replication,and DNA repair tended to be down-regulated in the JOD group.Eight DEGs(CDT1,NHP2,EXOSC5,EPN3,NME1,REG3A,pla2G2A,and PRSS2)may play a key regulatory role in the pathological process of ODS,and their expression levels were significantly decreased in ODS patients(P<0.001).In the second cohort,compared with healthy controls,the levels of serum intestinal barrier function markers(DAO and D-LA)were significantly increased in all obese individuals(P<0.01),but were higher in the SOD group than in the SO group(P<0.001).CONCLUSION Compared with healthy controls and obese individuals without diarrhe

关键词： Obesity Chronic diarrhea Jejunum Transcriptome Intestinal barrier

Development and validation of a nomogram model for predicting the risk of gallstone recurrence after gallbladder-preserving surgery

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Hepatobiliary & Pancreatic Diseases International 2024年第3期23卷 288-292页

作者： Peng Liu Yong-Wei Chen Che Liu Yin-Tao Wu Wen-Chao Zhao Jian-Yong Zhu Yang An Nian-Xin Xia Faculty of Hepato-Pancreato-Biliary Surgery the First Medical CenterChinese PLA General HospitalBeijing 100853China Institute of Hepatobiliary Surgery of Chinese pla Beijing 100853China Key Laboratory of Digital Hepetobiliary Surgery of Chinese pla Beijing 100853China

Background:The high incidence of gallstone recurrence was a major concern for laparoscopic gallbladderpreserving surgery.This study aimed to investigate the risk factors for gallstone recurrence after gallbladder-preserving surgery and to establish an individualized nomogram model to predict the risk of gallstone recurrence.Methods:The clinicopathological and follow-up data of 183 patients who were initially diagnosed with gallstones and treated with gallbladder-preserving surgery at our hospital from January 2012 to January 2019 were retrospectively collected.The independent predictive factors for gallstone recurrence following gallbladder-preserving surgery were identified by multivariate logistic regression analysis.A nomogram model for the prediction of gallstone recurrence was constructed based on the selected variables.The C-index,receiver operating characteristic(ROC)curve and calibration curve were used to evaluate the predictive power of the nomogram model for gallstone recurrence.Results:During the follow-up period,a total of 65 patients experienced gallstone recurrence,and the recurrence rate was 35.5%.Multivariate logistic regression analysis revealed that the course of gallstones>2 years[odds ratio(OR)=2.567,95%confidence interval(CI):1.270-5.187,P=0.009],symptomatic gallstones(OR=2.589,95%CI:1.059-6.329,P=0.037),multiple gallstones(OR=2.436,95%CI:1.133-5.237,P=0.023),history of acute cholecystitis(OR=2.778,95%CI:1.178-6.549,P=0.020)and a greasy diet(OR=2.319,95%CI:1.186-4.535,P=0.014)were independent risk factors for gallstone recurrence after gallbladder-preserving surgery.A nomogram model for predicting the recurrence of gallstones was established based on the above five variables.The results showed that the C-index of the nomogram model was 0.692,suggesting it was valuable to predict gallstone recurrence.Moreover,the calibration curve showed good consistency between the predicted probability and actual probability.Conclusions:The nomogram model for the prediction of gallstone recurrence might hel

关键词： Gallstone Gallbladder-preserving surgery Recurrence Risk factors Nomogram

Predictive performance of the variation rate of the driving pressure on the outcome of invasive mechanical ventilation in patients with acute respiratory distress syndrome

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Chinese Journal of Traumatology 2024年第2期27卷 107-113页

作者： Hui-Dan Jing Jun-Ying Tian Wei Li Bing-Ling He Hong-Chao Li Fu-Xia Jian Cui Shang Feng Shen Department of Intensive Care unit The Affiliated Hospital of Guizhou Medical UniversityGuiyang 550004China Department of Intensive Care unit Army Medical Center of PLAChongqing400042China College of Foreign Languges Chongqing Medical UniversityChongqing400016China

Purpose:To assess the value of the driving pressure variation rate(ΔP%)in predicting the outcome of weaning from invasive mechanical ventilation in patients with acute respiratory distress syndrome.Methods:In this case-control study,a total of 35 patients with moderate-severe acute respiratory distress syndrome were admitted to the intensive care unit between January 2022 and December 2022 and received invasive mechanical ventilation for at least 48 h were enrolled.Patients were divided into successful weaning group and failed weaning group depending on whether they could be removed from ventilator support within 14 days.Outcome measures including driving pressure,PaO2:FiO2,and positive end-expiratory pressure,etc.were assessed every 24 h from day 0 to day 14 until successful weaning was achieved.The measurement data of non-normal distribution were presented as median(Q1,Q3),and the differences between groups were compared by Wilcoxon rank sum test.And categorical data use the Chi-square test or Fisher's exact test to compare.The predictive value ofΔP%in predicting the outcome of weaning from the ventilator was analyzed using receiver operating characteristic curves.Results:Of the total 35 patients included in the study,17 were successful vs.18 failed in weaning from a ventilator after 14 days of mechanical ventilation.The cut-off values of the medianΔP%measured by Operator 1 vs.Operator 2 in the first 4 days were≥4.17%and 4.55%,respectively(p<0.001),with the area under curve of 0.804(sensitivity of 88.2%,specificity of 64.7%)and 0.770(sensitivity of 88.2%,specificity of 64.7%),respectively.There was a significant difference in mechanical ventilation duration between the successful weaning group and the failure weaning group(8(6,13)vs.12(7.5,17.3),p=0.043).The incidence of ventilator-associated pneumonia in the successful weaning group was significantly lower than in the failed weaning group(0.2‰vs.2.3‰,p=0.001).There was a significant difference noted between these 2 groups in the 28-day mortality(11.8%vs.66.7%,

关键词： Driving pressure Driving pressure variation rate Acute respiratory distress syndrome Mechanical ventilation

MTTSNet:Military time-sensitive targets stealth network via real-time mask generation

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Defence Technology（防务技术） 2024年第3期33卷 601-612页

作者： Siyu Wang Xiaogang Yang Ruitao Lu Zhengjie Zhu Fangjia Lian Qing-ge Li Jiwei Fan pla Rocket Force University of Engineering Xi'an 710025China

The automatic stealth task of military time-sensitive targets plays a crucial role in maintaining national military security and mastering battlefield dynamics in military applications.We propose a novel Military Time-sensitive Targets Stealth Network via Real-time Mask Generation(MTTSNet).According to our knowledge,this is the first technology to automatically remove military targets in real-time from videos.The critical steps of MTTSNet are as follows:First,we designed a real-time mask generation network based on the encoder-decoder framework,combined with the domain expansion structure,to effectively extract mask images.Specifically,the ASPP structure in the encoder could achieve advanced semantic feature fusion.The decoder stacked high-dimensional information with low-dimensional information to obtain an effective mask layer.Subsequently,the domain expansion module guided the adaptive expansion of mask images.Second,a context adversarial generation network based on gated convolution was constructed to achieve background restoration of mask positions in the original image.In addition,our method worked in an end-to-end manner.A particular semantic segmentation dataset for military time-sensitive targets has been constructed,called the Military Time-sensitive Target Masking Dataset(MTMD).The MTMD dataset experiment successfully demonstrated that this method could create a mask that completely occludes the target and that the target could be hidden in real time using this mask.We demonstrated the concealment performance of our proposed method by comparing it to a number of well-known and highly optimized baselines.

关键词： Deep learning Military application Targets stealth network Mask generation Generative adversarial network