Objective To investigate the association between air pollutant exposure and outpatient visit risk for community-acquired pneumonia (CAP) among children and adolescents, and to further evaluate its lagged effects and seasonal characteristics.Methods Clinical data from children and adolescents diagnosed with CAP at the First People's Hospital of Tianmen between 2021 and 2024 were collected, along with concurrent air pollutant and meteorological data. Descriptive statistics and Spearman correlation analysis were employed to evaluate the relationships among environmental variables and their associations with daily hospital visits. Generalized additive models were constructed to estimate the lagged effects of both single- and multi-pollutant models at optimal lag days. Distributed lag non-linear models (DLNM) were utilized to explore the lag-exposure-response relationship of pollutant.Results A total of 7,939 patients were included. The monthly average number of visits showed obvious seasonal variation, with high incidence in winter and spring, mainly in children aged ≤ 2 years and male patients. Spearman correlation analysis showed that temperature (r=0.291), humidity (r=0.149), and CO (r=0.106) were weakly positively correlated with daily CAP visits (P < 0.001), whereas O3 showed a weak negative correlation (r=-0.058, P=0.032). Single-pollutant models showed that CO [RR=26.508,95%CI (5.096,137.897)], SO2 [RR=1.361, 95%CI (1.125, 1.648)] and PM10 [RR=1.016, 95%CI(1.008, 1.023)] were significantly associated with increased CAP outpatient risk. In multi-pollutant models, PM10 maintained a relatively stable positive association with CAP visits, whereas the association for CO was less robust. DLNM analysis revealed that the association between PM10 exposure and CAP visits increased at lag 2-5 days, with stronger associations during the mid-to-late lag period, while CO showed a relatively weak lagged effect.Conclusion Exposure to ambient air pollutants was associated with an increased risk of CAP-related outpatient visits among children and adolescents. Among the pollutants examined, PM10 demonstrated a relatively stable lagged effect, suggesting that air pollution may contribute to the development and progression of pediatric respiratory diseases.
Disabled elderly and people with disabilities are particularly vulnerable to falls and related injuries during toileting, which has become a major public health concern. Currently, systematic and practical consensus guidelines for comprehensive prevention of toileting-related falls remain lacking in China. Based on international and domestic evidence on fall prevention, lower urinary tract symptom management, geriatric rehabilitation, psychological interventions and environmental modifications, as well as China's actual healthcare and long-term care conditions, this consensus formulates 16 recommendations covering risk factors, assessment protocols, interventions and post-fall rehabilitation management for toileting-related falls. It is intended to provide a reference for toileting-related falls prevention and intervention for disabled elderly and people with disabilities in medical institutions, elderly care institutions, communities and home settings.
Objective To construct chimeric antigen receptor T (CAR-T) cells targeting multiple myeloma-specific antigen-1 (MMSA-1) and evaluate their antitumor activity and preliminary safety in multiple myeloma (MM).Methods Flow cytometry was used to detect MMSA-1/ZDHHC9 expression in K562 cells, MM cell lines (MM.1S, U266, and RPMI-8226), and primary MM cells. MMSA-1-specific single-chain variable fragments were screened and used to construct second-generation CAR-T cells. CAR expression, cell expansion, cytotoxic activity against RPMI-8226 cells, and effector molecule release after target-cell stimulation were evaluated in vitro. The in vivo efficacy of CAR-T cells was assessed in an RPMI-8226 xenograft mouse model. Preliminary safety was evaluated using public database analysis, hematological and biochemical parameters, and H&E staining.Results MMSA-1/ZDHHC9 expression was detectable in MM.1S, U266, RPMI-8226, and primary MM cells, whereas K562 cells showed only low-level background signals. The CAR-positive rate of MMSA-1 CAR-T cells was approximately 52.2%, and MMSA-1 CAR-T cells showed favorable expansion in vitro. At effector-to-target ratios of 5:1, 3:1, and 1:1, MMSA-1 CAR-T cells significantly reduced the proportions of residual RPMI-8226 cells compared with conventional T cells group. In vivo experiments showed that MMSA-1 CAR-T cells reduced tumor burden and prolonged survival in mice, preliminary safety observations revealed no obvious sustained body weight loss, hematological abnormalities, liver or kidney dysfunction, or pathological changes in major organs.Conclusion MMSA-1 CAR-T cells exhibit preliminary anti-MM activity, suggesting that MMSA-1 may serve as a candidate complementary target for CAR-T therapy in MM. However, the applicable patient population and tissue safety still require further validation.
Objective To develop an AI agent-based training system for nursing assistants and evaluate its effectiveness in clinical practice.Methods A standardized knowledge base and AI assistant were established by integrating professional knowledge graphs and industry consensus to develop an intelligent nursing training system. Multiple evaluation indicators were compared before and after system implementation to comprehensively assess nursing assistants' learning performance and clinical practical competencies.Results A total of 50 medical nursing assistants were included. After system implementation, nursing assistants' core competencies improved significantly. Scores for theoretical knowledge (67.42 ± 7.77 vs. 63.98 ± 7.29), practical skills (76.98 ± 8.21 vs. 67.68 ± 7.48), and professional literacy (66.32 ± 6.56 vs. 59.48 ± 7.15) were all significantly higher than before implementation (P < 0.05). The total score for self-directed learning increased from (30.94 ± 2.94) to (47.18 ± 6.48) (P < 0.001). Compliance with basic life care specifications increased from 80.0% to 96.0%, and the implementation rate of nursing risk prevention measures increased from 72.0% to 94.0% (P < 0.05). In addition, the satisfaction levels of medical staff and patients were significantly improved (P < 0.001).Conclusion The AI agent-based training system significantly enhances the training quality and clinical care safety of nursing assistants, and improve multi-party satisfaction of doctors and patients. It is an effective strategy for optimizing geriatric health care services.
Objective To construct a curriculum system of general education and doctor-patient communication for oral emergency care and explore its clinical application effects.Methods The resident physicians rotating in the Oral Emergency Department, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, from June 2024 to August 2025 were retrospectively selected as the research subjects. Participants were assigned to an observation group (curriculum integrating general education with doctor-patient communication) or a control group (conventional communication curriculum) based on teaching modality. The SEGUE Framework (system for evaluating physician-grounded communication) scores and comprehensive practical competencies were assessed. Questionnaires were used to evaluate trainee satisfaction and teaching effectiveness.Results A total of 138 participants were enrolled, with 69 in each of the two groups. Upon course completion, scores of all dimensions of the SEGUE scale were higher in the observation group than in the control group (P< 0.05). The work-process mastery rate (92.75% vs. 79.71%), dispute-handling proficiency rate (66.67% vs. 49.28%), and excellent-and-good rate for interdisciplinary communication and collaboration (92.75% vs. 76.81%) were also higher in the observation group (P< 0.05). The overall teaching satisfaction rate was 98.55% in the observation group, with 95.65% of trainees willing to take part in relevant further learning. In the control group, the overall satisfaction rate was 88.41%, and 78.26% of trainees reported willingness for further relevant learning. The observation group demonstrated significantly higher overall teaching satisfaction and willingness for further learning (P< 0.05). Trainees in the observation group also gave better ratings for improvement of doctor-patient communication skills (92.75% vs. 73.91%), promotion of professional learning (88.41% vs. 72.46%), and richness of teaching content (95.65% vs. 75.36%) (P< 0.05).Conclusion Integrating general education into oral-emergency-oriented doctor-patient communication courses can effectively enhance residents' doctor-patient communication competence and comprehensive practical ability, and yield high trainee satisfaction. It provides a feasible reference for incorporating general education into the residency training system.
Ferroptosis and cuproptosis are two novel metal-dependent regulated cell death modalities, which have recently become research hotspots in colorectal cancer (CRC). Ferroptosis is driven by iron-dependent lipid peroxidation and regulates the progression of CRC via multiple signaling pathways including the System Xc--GSH-GPX4 axis, iron metabolism, and the p53 pathway, thereby inhibiting the proliferation and metastasis of CRC. In contrast, cuproptosis is triggered by abnormal intracellular copper accumulation, which disturbs the function of lipoylated proteins involved in the tricarboxylic acid cycle, induces mitochondrial proteotoxic stress, and ultimately suppresses the malignant growth of CRC cells. Ferroptosis and cuproptosis share core regulatory pathways in the occurrence and development of CRC, including glutathione metabolism, mitochondrial function modulation, and the p53 signaling network. This provides novel insights into overcoming therapeutic resistance and developing precise combination therapeutic strategies for CRC. This paper systematically reviews the mechanisms and interactions of ferroptosis and cuproptosis in CRC, and discusses their prospects for clinical translational application, aiming to provide a theoretical reference for further basic research and clinical practice of CRC.
Objective To analyze the current status, hot spots, and trends of artificial intelligence (AI) in clinical nutrition in the past decade using bibliometric methods.Methods A systematic search was conducted in the Web of Science Core Collection to identify English-language literature on the application of AI in clinical nutrition. The search period was set from January 1, 2015 to December 31, 2024. CiteSpace 6.4.R1 software was used to conduct visual data analysis of the included literature, covering annual publication volume, authors, countries (regions), keywords, and citation information.Results A total of 355 articles were included (279 original researchs and 76 reviews). The overall number of publications showed an upward trend, with a particularly sharp increase in 2024. The United States and China were the top two countries in terms of publication volume. The two authors with the highest number of publications (five articles) are both researchers at the University of Valencia in Spain. After excluding the search terms, the top 5 effective high-frequency keywords were health, risk, impact, precision nutrition, and obesity. The results of keyword clustering indicated that dietary assessment, disease nutrition management, and personalized nutrition guidance were the research hotspots in this field.Conclusion The research on the application of AI in clinical nutrition has been increasing year by year. AI has been widely applied in screening, assessment, diagnosis, and patient education in clinical nutrition, with remarkable effects. In the future, it is necessary to further strengthen the optimization and customized management of AI models to better promote the precise application of AI in clinical nutrition.
Objective To compare the efficacy and safety of pyrotinib single- and dual-targeted therapy in HER2-positive stage Ⅳ breast cancer.Methods Clinical data from HER2-positive stage Ⅳ breast cancer patients treated with pyrotinib at the Guangxi Medical University Cancer Hospital between October 2018 and January 2025 were retrospectively collected. Based on the treatment regimen, patients were divided into the single-target group (pyrotinib alone as the targeted drug) and the double-targeted group (pyrotinib-based dual-targeted therapy). The efficacy and safety between the groups were compared, and the effects of different factors on efficacy were analyzed. Median progression-free survival (mPFS) was calculated using the Kaplan-Meier method, and prognostic factors were analyzed using Cox regression analysis.Results A total of 59 patients were enrolled, including 27 in the single-target group and 32 in the dual-target group. The mPFS of patients in the double-target group was longer than that of the single-target group (17.1 months vs. 10.0 months), but the difference was not statistically significant (P=0.214). Multivariate Cox regression analysis showed that Eastern Cooperative Oncology Group (ECOG) score of 2 was an independent risk factor for mPFS [HR=2.892, 95%CI (1.135, 7.366), P=0.026], while no prior treatment with lapatinib was an independent protective factor for mPFS [HR=0.138, 95%CI (0.036, 0.535), P=0.004]. In terms of safety, there was no statistically significant difference in the incidence of various adverse reactions between the two groups (P > 0.05).Conclusion Compared with the pyrotinib single-targeted therapy regimen, the pyrotinib dual-targeted therapy regimen has a longer mPFS in the treatment of HER2-positive stage Ⅳ breast cancer patients, but the difference is not statistically significant. This conclusion needs further verification through large-sample studies. ECOG score ≤1 and no prior treatment with lapatinib were independent predictors of favorable prognosis.
Objective To systematically evaluate the effects of different rehabilitation nursing models on chronic pain, quality of life, and functional status in patients after lumbar spine surgery.Methods PubMed, Web of Science, Embase, The Cochrane Library, CNKI, VIP, WanFang Data databases were electronically searched for randomized controlled trials (RCTs) investigating different rehabilitation nursing models in patients after lumbar spine surgery from inception to December 31, 2025. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was conducted using RevMan 5.4 and R 4.4.5 software.Results A total of 21 RCTs involving 1,804 patients after lumbar spine surgery were included. The Meta-analysis showed that, in terms of pain intensity, postoperative Visual Analogue Scale (VAS) scores were significantly lower in the rehabilitation nursing intervention group than in the conventional nursing group [MD=-0.67, 95%CI (-1.27, -0.07),P=0.036]. Regarding quality of life, no statistically significant difference was observed between the two groups in the bodily pain domain score of the 36-Item Short Form Health Survey (SF-36) [MD=6.83, 95%CI (-5.89, 19.55),P=0.226]. In terms of functional impairment, rehabilitation nursing interventions significantly reduced the Oswestry Disability Index (ODI) score [MD=-5.65, 95%CI (-8.34, -2.95),P < 0.001]. Subgroup analysis revealed that comprehensive interventions significantly improved ODI scores, but current evidence is insufficient to demonstrate superiority over other rehabilitation nursing models.Conclusion Current evidence suggests that rehabilitation nursing interventions may provide certain benefits in reducing pain intensity and functional impairment in patients after lumbar spine surgery; however, clear evidence supporting an improvement in quality of life remains insufficient.
Objective To investigate the outcomes of the ESAT6-CFP10 skin test (EC-ST) among close contacts of pulmonary tuberculosis (PTB) patients in school settings and to identify factors associated with positive EC-ST results, and to provide a theoretical basis for PTB prevention and control strategies in schools.Methods From January 2024 to March 2025, EC-ST screening and a questionnaire survey were conducted among close contacts of school-diagnosed PTB patients in Jiangning District, Nanjing City. Univariate and multivariate generalized estimating equations (GEE) models were employed to explore potential factors associated with positive EC-ST results among school-based close contacts.Results Based on 40 confirmed PTB cases, a total of 1,860 close contacts within schools who had been exposed to these cases were screened. EC-ST results identified 55 individuals with positive reactions, resulting in a positivity rate of 2.96%. The positivity rates varied significantly among different age groups, occupations, and screening frequencies (P < 0.05). Multivariate GEE analysis revealed that obesity was a protective factor for positive EC-ST result among close contacts in school settings [OR=0.74, 95%CI (0.56, 0.98),P=0.037], absence of Bacillus Calmette-Guérin (BCG) vaccination scar [OR=1.29, 95%CI (1.12, 1.49),P< 0.001], and no previous history of tuberculosis/latent tuberculosis infection [OR=1.48, 95%CI (1.09, 2.01),P=0.012] were risk factors for positive EC-ST result among close contacts in school settings.Conclusion Schools should enhance the monitoring and management of PTB infection by implementing timely screening measures for close contacts of confirmed cases. Particular attention should be given to high-risk groups, including individuals with underweight and absence of BCG vaccination scar. Early detection ofMycobacterium tuberculosis infections and active PTB cases is essential for effective prevention of transmission within schools.
Objective To systematically review the effect of the abdominal drawing-in maneuver (ADIM) on chronic nonspecific low back pain (CNLBP).Methods PubMed, Web of Science, Embase, The Cochrane Library, CNKI, VIP, WanFang Data and SinoMed databases were electronically searched to collect randomized controlled trials (RCTs) on the treatment of CNLBP with ADIM from inception to January 31, 2026. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was performed using RevMan 5.4 software.Results A total of 13 RCTs involving 402 patients were included. The results of Meta-analysis showed that the ADIM group was superior to the control group (blank control or conventional treatment) in alleviating pain in patients with CNLBP [MD=-2.08, 95%CI (-2.60, -1.56), P < 0.001]; in terms of improving functional disability, the ADIM group showed significantly better outcomes than the control group in both the Oswestry Disability Index score [MD=-1.21, 95%CI (-2.05, -0.37),P = 0.005] and Roland Morris Disability Questionnaire score [MD =-3.12, 95%CI (-4.66, -1.58),P < 0.001], with statistically significant differences. The subgroup analysis results showed that ADIM protocols with ≥ 8 weeks of intervention, > 3 weekly sessions, and ≤ 30 minutes per session may best improve CNLBP.Conclusion Current evidence shows that ADIM can reduce pain and improve functional disability in CNLBP patient.
Objective To investigate the actual clinical demands and differentiated needs for undergraduate stomatology courses among eight-year program clinical medicine graduates with clinical work experience, and to provide a basis for curriculum optimization and teaching reform.Methods A questionnaire survey was conducted among the graduates of the eight-year program from 2015 to 2025 in Peking Union Medical College. Stratified surveys were carried out according to department type, clinical seniority and experience in participating in stomatological consultations to collect the respondents' multi-dimensional evaluations of the current curriculum, demands for teaching content and suggestions for improvement.Results A total of 111 respondents with 1 year or more of clinical work experience were included. 75.68% of respondents were satisfied with the current undergraduate curriculum, and 33.33% considered the importance of stomatology teaching in undergraduate clinical medicine education to be moderate or unimportant. The most desired content among all respondents was the diagnosis and treatment of common oral diseases (98.20%), among which the diagnosis and treatment of common periodontal diseases (83.78%), common oral surgical procedures and perioperative patient management (74.77%), and the identification and treatment of oral emergencies (72.07%) were the most urgent needs. Stratified analysis showed that the demand rate for oral emergency management was 79.17% in the group with stomatological consultation experience, which was significantly higher than 58.97% in the group without such experience.Conclusions The demands for stomatology courses among eight-year program clinical medicine graduates are distinctly clinically oriented and present differentiated characteristics based on consultation experience. Based on the actual clinical demands, it is necessary to optimize the stomatology curriculum teaching system and construct a system more in line with real clinical needs by building a modular curriculum system, implementing hierarchical teaching, strengthening scenario-based practice, and innovating teaching and assessment forms.
Ferroptosis is an iron-dependent form of programmed cell death characterized by excessive accumulation of lipid peroxides. It is extensively involved in various physiological processes and pathological injuries in the body, and is morphologically and biochemically distinct from other cell death modes such as apoptosis, necrosis, and autophagic cell death. The activation and progression of ferroptosis are precisely and synergistically regulated by intracellular iron metabolism, lipid metabolism, antioxidant systems, and multiple signaling pathways. Hypoxia is a typical common feature of the pathological microenvironments in various diseases, including solid tumors, ischemia-reperfusion injury, and neurodegenerative diseases, which remodel cellular metabolic patterns and mediate cellular stress responses by activating the hypoxia-inducible factor (HIF) signaling pathway. Existing studies have confirmed that hypoxia regulates the progression of ferroptosis via the HIF pathway, presenting complex and bidirectional regulatory characteristics. This review systematically summarizes the core regulatory network of ferroptosis, elaborates the molecular mechanisms underlying the crosstalk between hypoxia signaling and ferroptosis pathways, and focuses on analyzing the bidirectional regulatory effects of hypoxia on ferroptosis. It aims to provide a novel theoretical basis and potential therapeutic targets for the mechanistic research and clinical prevention and treatment of related diseases.
Objective To analyze the disease burden and changing trends of human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) in China from 1990 to 2023, and to predict future trends.Methods Based on the Global Burden of Disease 2023 database, incidence, prevalence, mortality, disability-adjusted life years (DALY) and their age-standardized rates(ASRs) were used to analyze the disease burden of HIV/AIDS in China from 1990 to 2023. Trends were evaluated using Joinpoint regression, and disease burden from 2024 to 2035 was projected using a Bayesian age-period-cohort (BAPC) model.Results From 1990 to 2023, the overall burden of HIV/AIDS in China increased markedly. Incidence rose from 0.90 per 100,000 to 2.70 per 100,000, prevalence from 5.37 per 100,000 to 45.74 per 100,000, mortality from 0.17 per 100,000 to 2.51 per 100,000, and DALY from 8.36 per 100,000 person-years to 109.30 per 100,000 person-years. Across all years, ASRs were consistently higher in males than in females. Incidence increased with age, prevalence peaked among older adults, and DALY rates were highest in middle-aged populations. Joinpoint regression indicated overall increasing trends in age-standardized incidence rates (ASIR) [average annual percentage change (AAPC)=3.64%, 95%CI (3.42%, 3.82%)], age-standardized prevalence rates (ASPR) [AAPC=6.28%, 95%CI (6.22%, 6.34%)], age-standardized mortality rates (ASMR) [AAPC=7.90%, 95%CI (7.71%, 8.14%)], and age-standardized DALY rates (ASDR) [AAPC=7.90%, 95%CI (7.73%, 8.11%)] from 1990 to 2023 (P < 0.05). BAPC projections suggest that from 2024 to 2035, ASIR in the overall population will continue to increase, while ASPR, ASMR, and ASDR will decline.Conclusion The HIV/AIDS burden in China increased substantially from 1990 to 2023, with pronounced sex- and age-related disparities. The ASIR of HIV/AIDS in China is predicted to continue rising in the future. Therefore, further strengthened prevention and control of HIV/AIDS transmission is warranted, with targeted strategies tailored to the characteristics of different sex and age groups.
Objective To conduct a systematic review and Meta-analysis of predictive models for moderate-to-severe pain after interventional therapy for hepatocellular carcinoma (HCC) in China.Methods CNKI, WangFang, VIP, SinoMed, PubMed, Embase, Web of Science, The Cochrane Library were electronically searched to collect literature relevant to the research objectives from inception to July 15, 2026. Two researchers extracted data, assessed the model and conducted the Meta-analysis by using the CHecklist for Critical Appraisal and Data Extration for Systematic Reviews of Prediction Modelling Studies (CHARMS), the Prediction Model Risk of Bias Assessment Tool-Artificial Intelligence (PROBAST+AI), and R software version 4.5.0.Results A total of 16 studies involving 23 predictive models and 6,609 patients were included. The included studies showed good applicability but a high risk of bias. Meta-analysis results showed that the incidence of moderate-to-severe pain after liver cancer intervention was 34% [95%CI(26%, 43%)]. The overall model's predictive performance metric AUC was 0.80 [95%CI(0.77, 0.84)]. Gender was a factor influencing model performance. The primary predictors of moderate-to-severe pain after HCC interventional therapy were tumor number, tumor size, transarterial chemoembolization (TACE) procedure type, history of abdominal pain after TACE, vascular invasion, age, distance from the tumor to the liver capsule, use of ethanol embolization, iodized oil volume >10 mL, preoperative pain, and drug-eluting bead transarterial chemoembolization (DEB-TACE) (P< 0.05).Conclusion Research on predictive models for moderate-to-severe pain after interventional therapy for HCC in China remains underdeveloped. Future studies should focus on patient gender distribution and integrate multiple machine learning modeling with multimodal data fusion pain assessment approaches to further optimize and externally validate existing models, thereby facilitating the translation of predictive tools into clinical precision pain management.
Chronic non-healing wounds,such as diabetic foot ulcers,venous ulcers,and burn wounds,represent a persistent clinical challenge due to delayed repair and high risk of complications.Studies have shown the role of macrophages in regulating lymphatic vessel formation and function through phenotypic transitions,forming what is referred to as the"macrophage-lymphatic axis".This axis relies on IL-4/STAT6-VEGF-C/VEGFR-3-PI3K/Akt signaling,and coordinates lymphatic endothelial cell proliferation,migration,and lumen formation via paracrine signals,exosomes,and direct cell interactions.Despite differences in etiology,these chronic wounds share common features,including insufficient macrophage reparative polarization,impaired lymphangiogenesis,and compromised lymphatic drainage.Targeted Western medicine therapies,bioactive components of traditional Chinese medicine(TCM),and integrated TCM-Western medicine interventions can break the cycle of persistent inflammation and stalled repair by modulating multiple steps in these processes.This review summarizes current understanding of the macrophage-lymphatic axis in chronic wound repair,its dysregulation,and potential interventions.
ObjectiveThis study aimed to evaluate the predictive value of the triglyceride-glucose (TyG) index for coronary in-stent restenosis (ISR) and develop a machine learning model integrating TyG with multidimensional clinical features. MethodsTwo hundred and seventy patients who underwent coronary stent implantation in Department of Cardiovascular Medicine, Longyan First Affiliated Hospital of Fujian Medical University from January 2021 to December 2024 were enrolled. They were categorized into the ISR (n = 62) and non-ISR (n = 208) groups based on follow-up angiography. The TyG index was calculated. Risk factors for ISR were identified using univariate and multivariate Logistic regression, and the predictive performance of TyG was assessed using ROC curves. Five machine learning algorithms [Logistic regression(LR), random Forest(RF）,extreme gradient boosting(XGBoost）,light gradient boosting machine(LightGBM), support vector machine(SVM）]were trained and validated using 5-fold cross-validation. Model interpretability was achieved via SHAP analysis. ResultsThe ISR incidence was 23.0% (62/270). Patients with ISR exhibited a significantly higher TyG index compared to controls (9.17±0.42 vs. 8.82±0.45, P ＜ 0.001). Multivariable analysis identified the TyG index as an independent predictor of ISR (OR = 5.641, 95% CI: 2.428 ～ 13.108, P ＜ 0.001). The TyG index yielded an AUC of 0.708 (cutoff: 9.111; sensitivity: 62.9%; specificity: 73.1%). Among the machine learning models, LR demonstrated superior performance (AUC = 0.841±0.041), with SHAP analysis highlighting the TyG index as a critical predictive variable. ConclusionsThe TyG index serves as an independent risk factor and predictor for ISR following coronary stenting. Integrating TyG into machine learning models based on multidimensional clinical data significantly improves ISR prediction accuracy.
Objective To investigate the clinical value of an 18F-FDG PET/CT radiomics model in differentiating benign from malignant solitary pulmonary nodules with negative tumor markers and positive FDG uptake. MethodsThe data of 130 patients with such pulmonary nodules admitted to Baoding No. 1 Central Hospital from January 2019 to December 2024 were collected. The patients were randomly divided into a training set (n = 91) and an internal test set (n = 39) at a ratio of 7:3. Eligible independent cases were additionally collected from the Cancer Imaging Archive (TCIA) public database as an external validation set (n = 45). PET and CT radiomics features were extracted using LIFEx software. Core features were selected through intraclass correlation coefficient (ICC) stability assessment, Spearman correlation analysis, and least absolute shrinkage and selection operator (LASSO) regression. Logistic regression (LR), random forest (RF), and support vector machine (SVM) models were constructed separately. Receiver operating characteristic (ROC) curves and decision curve analysis (DCA) were used to evaluate and compare the performance of the models. ResultsA total of 8 key radiomics features were ultimately selected, including 4 PET features and 4 CT features. In the internal test set, the LR model showed the best performance, with an area under the curve (AUC) of 0.819 (95% CI: 0.738-0.892), a sensitivity of 0.792, and a specificity of 0.800. In the external validation set, the LR model also maintained the best discriminative performance, with an AUC of 0.801 (95% CI: 0.713-0.905), which was significantly higher than those of the RF model (AUC = 0.721, P = 0.041) and the SVM model (AUC = 0.717, P = 0.028). DCA demonstrated that the LR model yielded greater clinical net benefit in both the internal test set and the external validation set. ConclusionsFor difficult-to-differentiate solitary pulmonary nodules with negative tumor markers and high FDG uptake, PET/CT radiomics models, particularly the LR model, have good discriminative performance and generalizability and can provide an objective quantitative reference for preoperative decision-making.
Compared with conventional clinical testing techniques,electrochemical detection of tumor markers offers distinct advantages in accuracy,rapid response,and real-time monitoring,providing early warning for related diseases.The performance of electrochemical immunosensors is governed by multiple factors,among which the selection of nanomaterials is particularly critical.This review focuses on carcinoembryonic antigen(CEA)as the target analyte and addresses the general principles of electrochemical immunosensor design and fabrication.Based on a bibliometric visualization analysis,research hotspots and evolutionary trends are revealed,and electrochemical detection principles of linear sweep voltammetry,cyclic voltammetry,and square wave voltammetry are described.Three representative nanomaterials—noble metals,transition metal compounds,and carbon-based materials—are systematically analyzed in terms of their structure-activity relationships and applications in immunosensor design.The results indicate that multi-component composites,leveraging synergistic effects among constituents,can effectively integrate conductivity and catalytic activity,representing a key route to overcome the sensitivity bottleneck.Furthermore,the combination of screen-printed electrodes with microfluidic technology facilitates the gradual standardization of sensor fabrication,serving as a pivotal approach to bridge the gap between laboratory research and clinical translation.This technical pathway,characterized by batch electrode fabrication and automated micro-sample processing,can reduce detection costs and operational errors,and is expected to provide useful insights for developing highly sensitive and low-cost point-of-care CEA detection devices.
Female reproductive system-related diseases, such as intrauterine adhesions, thin endometrium, and premature ovarian insufficiency, have emerged as major clinical problems affecting women’s reproductive health. However, conventional treatments are limited by suboptimal efficacy and pronounced adverse effects. Advances in regenerative medicine have introduced novel therapeutic strategies for these conditions. Platelet-rich plasma (PRP), as an autologous biological agent, has demonstrated promising prospects in the treatment of reproductive disorders due to its favorable tissue-repair potential and bio-safety. Recent studies indicate that exosomes are key active components mediating the biological effects of PRP, and they have attracted increasing attention because of their high stability, strong targeting capacity, and low immunogenicity. This review summarizes the biological characteristics of PRP and platelet-derived exosomes, as well as their clinical applications in female reproductive system disorders, with the aim of providing a reference for both clinical practice and scientific research.
