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At present, percutaneous nephrolithotomy has become an option for hospitals increasingly to treat calculus. However, due to the certain risk of percutaneous nephrolithotomy, it may lead to postoperative complications. Analyzing the preoperative factors of septic shock after percutaneous nephrolithotomy can provide guidance for reducing the incidence of septic shock after PCNL. This article establishes a logistic regression model based on preoperative factors, uses statistical methods, and uses the professional statistical software SPSS to create a database and analyze the data. The method of classification data analysis was used to determine various influencing factors including patient factors, stone factor, and preoperative factors and combined B-ultrasound guidance and percutaneous nephrolithotomy to reduce the risk of surgery. The experimental results found that the percutaneous nephroscope laser lithotripsy guided by the smart Internet of Things can effectively perform lithotripsy; in this paper, the preoperative data of different complications are obtained, and the risk of surgery is closely related to the operation time. The operation time exceeds 90 minutes and causes the risk of severe bleeding after PCNL. It is twice the operation time of less than 90 minutes and 5 times the operation time of less than 60 minutes. [ABSTRACT FROM AUTHOR]

Triple-negative breast cancer (TNBC) is a widely prevalent breast cancer, with a mortality rate of up to 25%. TNBC has a lower survival rate, and the significance of N7-methylguanosine (m7G) modification in TNBC remains unclear. Thus, this study is aimed at investigating m7G-related miRNAs in TNBC patients through in silico analysis. In our research, RNA sequencing and clinical data were obtained from The Cancer Genome Atlas (TCGA) database. The miRNAs targeting typical m7G modification regulators Methyltransferase-like 1 (METTL1) and WD repeat domain 4 (WDR4) were predicted on the TargetScan website. A miRNA risk model was built, and its prognostic value was evaluated by R soft packages. Single-sample gene set enrichment analysis was used to assess immune infiltration, and further expression of immune checkpoints was investigated. As a result, miR-421, miR-5001-3p, miR-4326, miR-1915-3p, miR-3177-5p, and miR-4505 were identified to create the risk model. A nomogram consisting of the stage N and risk model predicted overall survival effectively among TNBC patients. Treg and TIL were shown to be strongly linked to the risk model, and the high-risk group had higher levels of four immune checkpoints expression (CD28, CTLA-4, ICOS, and TNFRSF9). A risk model consisting of m7G-related miRNAs was constructed. The findings of the current study could be used as a prognostic biomarker and can provide a novel immunotherapy insight for TNBC patients. [ABSTRACT FROM AUTHOR]

Background: Currently, there are few studies on the effect of prophylactic anti-hepatitis B virus (HBV) therapy (AVT) for mother-to-child transmission during pregnancy on postpartum hepatitis flare (PHF) and the risk factors for postpartum hepatitis flare in women with chronic hepatitis B infection. Aim: To analyze the effect of AVT on the postpartum hepatitis flare and risk factors related to postpartum hepatitis flare. Methods: This study retrospectively enrolled hepatitis B surface antigen (HBsAg)-positive and hepatitis B e antigen (HBeAg)-positive women with HBV DNA ≥ 10 6 IU/mL. Six hundred fourteen pregnant women were included: 444 in the anti-HBV therapy group (T-G) and 170 in the control group (C-G). To analyze the risk factors, women with alanine aminotransferase (ALT) flare (ALT > 40 U / L) were assigned to the PHF group (PHF-G, n = 355), and all the others were assigned to a non-PHF group (NPHF-G, n = 259). Results: At 6 weeks postpartum, ALT and AST levels were higher, and ALB levels were lower in the C-G than those in T-G (P < 0.05). Also, ALT (at baseline, pregnancy 32nd and 36th, intrapartum), AST (at pregnancy 32nd and 36th week, and intrapartum), HBcAb (at baseline, intrapartum), and HBV DNA (at intrapartum) of PHF-G were significantly higher than those of NPHF-G (P < 0.05). Multivariate analysis showed that ALT (OR = 1.067 , P < 0.001) and HBcAb (OR = 1.213 , P ≤ 0.001) in pregnant women were risk factors for PHF. The prophylactic anti-HBV for the prevention of perinatal HBV transmission (OR = 0.357 , P < 0.001) was the protective factor for PHF. Conclusion: Pregnant women with prophylactic anti-HBV during the third trimester of pregnancy had a lower incidence of postpartum hepatitis flare, especially a lower risk of serious hepatitis flare. ALT and HBcAb in pregnant women were risk factors for PHF. Women infected with HBV should be closely monitored ALT during pregnancy and postpartum. [ABSTRACT FROM AUTHOR]

Objective. Preeclampsia (PE) is a severe complication in pregnancy and a leading cause of maternal and infant mortality. However, the exact underlying etiology of PE remains unknown. Emerging evidence indicates that the cause of PE is associated with genetic factors. Therefore, the aim of this study is to identify susceptibility genes to PE. Materials and Methods. Human Exome BeadChip assays were conducted using 370 cases and 482 controls and 21 loci were discovered. A further independent set of 958 cases and 1007 controls were recruited for genotyping to determine whether the genes of interest ROS1 and PTPRK are associated with PE. Immunohistochemistry was used for localization. Both qPCR and Western blotting were utilized to investigate the levels of PTPRK in placentas of 20 PE and 20 normal pregnancies. Results. The allele frequency of PTPRK rs3190930 differed significantly between PE and controls and was particularly significant in severe PE subgroup and early-onset PE subgroup. PTPRK is primarily localized in placental trophoblast cells. The mRNA and protein levels of PTPRK in PE were significantly higher than those in controls. Conclusion. These results suggest that PTPRK appears to be a previously unrecognized susceptibility gene for PE in Han Chinese women, and its expression is also associated with PE, while ROS1 rs9489124 has no apparent correlation with PE risk. [ABSTRACT FROM AUTHOR]

Metro tunnel sections in China can generally be divided into two types, those in granite formations (D = 6.0 m) and those in soft soils (D = 6.2 m), to which the same shield tunnel machine cannot be applied. The consequent low rate of machine utilization needs to be addressed. One solution is to modify shield machines which tend to tunnel granite strata with varying degrees of weathering (D = 6.0 m) into those applicable in soft soils (D = 6.2 m). Shield tunneling is a complex operation accompanied by potential risks, and accordingly it is demanded in risk evaluation and management. Hence, according to the construction features of modified shield machines in soft soil areas, this paper identifies relevant risks before establishing a specific model of risk evaluation by virtue of a fuzzy comprehensive evaluation method. This model weighs risk factors by triangular fuzzy numbers, and the membership function included is of L-R type that is frequently used in engineering. This risk evaluation model is applied to one section tunnel (Binhai New Town-Lianhua) of Metro Line 6 in Fuzhou City. Tunneling tests in the field uncover problems of the modified shield machine, including inappropriate tunneling parameters, segment dislocation, segment damage, and inadequate grouting. The result conforms to that produced by the risk evaluation model, which in turn proves the reliability of this model. Field data are also analyzed to address existing problems and to determine the appropriate tunneling parameters. The validity of these tunneling parameters is verified when surface settlement is measured. [ABSTRACT FROM AUTHOR]

Purpose. To investigate the predictive value of changes in LAA size and function for cardiogenic stroke (CS) in patients with NVAF by coronary CTA examination. Materials and Method. 179 patients with NVAF were selected and grouped according to the outbreak of acute ischemic stroke and TIA within 2 years after coronary CTA examination. Those who met the criteria for CS were selected as cases (87 patients), and those neither stroke nor TIA as controls (92 patients). LAA size of selected patients was measured and data postprocessing was performed. The differences of baseline data and LAA parameters between groups were analyzed. The impacts of BMI, hyperlipidemia, the duration of AF, the LAAOA Index, and the LAAEF on CS were assessed by binary logistic regression. The predictive abilities of LAAOA Index, LAAEF, and the combined predictor were assessed by ROC curves. Results. Proportions of BMI ≥ 25 , prevalence of hyperlipidemia, duration of AF, and LAAODmax, LAAODmin, LAAOA, LAAVmax, and LAAVmin with their correction index were greater in cases than controls. The LAAEF was lower in cases than that in controls. The binary logistic regression model showed an increase in LAAOA Index (P = 0.005) and a decrease in LAAEF (P < 0.001) were independent risk factors for CS. ROC curve analysis showed that the optimal cutoff values of LAAOA Index and LAAEF to predict CS were 3.16 cm2/m2 and 38.71%, with AUC value of 0.712 and 0.734, respectively. The LAAOA Index-LAAEF combined predictor (AUC value = 0.786) was likely superior to either LAAOA Index or LAAEF. Conclusions. Coronary CTA can provide additional valuable parameters, as a by-product of coronary artery assessment without additional radiation dose, for the risk assessment of CS in patients with NVAF. Coronary CTA may make up for the limitation of single indicator of CHA2DS2-VASc in guiding anticoagulation program, to reduce the incidence of embolism and bleeding events. [ABSTRACT FROM AUTHOR]

Background. Evidence regarding the relationship between body mass index (BMI) and 1-year unplanned readmission was limited. Therefore, the objective of this research is to investigate whether BMI was independently related to 1-year unplanned readmission in Chinese patients with acute myocardial infarction (AMI) after percutaneous transluminal coronary intervention (PCI) after adjusting for other covariates. Methods. The present study was a cohort study. A total of 214 participants with AMI after PCI were involved in a hospital in China from 1st January 2017 to 1st January 2018. The target independent variable and the dependent variable were BMI measured at baseline and 1-year unplanned readmission, respectively. Covariates involved in this study included age, gender, TC, triglyceride, HDL-C, LDL-C, PT, APTT, INR, creatinine, HGB, LVEF, discharge medication, marital status, educational level, COPD, diabetes mellitus, heart failure, history of ischemic stroke, history of hemorrhagic stroke, arrhythmia, and hypertension. Results. The average age of 172 selected participants was 60.2 ± 10.8 years old, and about 68.6% of them was male. The rate of readmission in patients with AMI was 26.14%. The result of fully adjusted binary logistic regression showed BMI was negatively associated with risk of readmission after adjusting confounders (hazard ratio (HR) = 1.1, 95% CI 0.93–1.29). Nonlinear relationship was detected between BMI and 1-year unplanned readmission, whose point was 29.3. The effect sizes and the confidence intervals of the left and right sides of inflection point were 0.9 (0.7–1.2, P for nonlinearity = 0.530) and 2.8 (1.3–5.8, P for nonlinearity = 0.008), respectively. Conclusion. BMI has a nonlinear relationship with 1-year unplanned readmission in patients with myocardial infarction. The 1-year unplanned readmission rate of overweight patients (BMI > 29.3 kg/m2) has increased significantly. Obesity paradox does not exist in terms of readmission of Chinese patients with myocardial infarction after PCI. [ABSTRACT FROM AUTHOR]

Objective. Whether optimal cardiovascular health metrics may reduce the risk of cardiovascular events in secondary prevention is uncertain. The study was conducted to evaluate the influence of lifestyle changes on clinical outcomes among the subjects underwent percutaneous coronary intervention (PCI). Methods. The study group consists of 17,099 consecutive PCI patients. We recorded data on subject lifestyle behavior changes after their procedure. Patients were categorized as ideal, intermediate, or poor CV health according to a modified Life's Simple 7 score (on body mass, smoking, physical activity, diet, cholesterol, blood pressure, and glucose). Multivariable COX regression was used to evaluate the association between CV health and revascularization event. We also tested the impact of cumulative cardiovascular health score on reoccurrence of cardiovascular event. Results. During a 3-year median follow-up, 1,583 revascularization events were identified. The observed revascularization rate was 8.0%, 9.3%, and 10.6% in the group of patients with optimal (a modified Life's Simple 7 score of 11–14), average (score = 9 or 10), or inadequate (less or equal than 8) CV health, respectively. After multivariable analysis, the adjusted hazard ratios were 0.83 (95% CI: 0.73–0.94) and 0.89 (95% CI: 0.79–0.99) for patients with optimal and average lifestyle changes comparing with the inadequate tertile (P for trend = 0.003). In addition, each unit increase in above metrics was associated with a decrease risk of revascularization (HR, 0.96; 95% confidence interval, 0.93–0.98; P < 0.001). Conclusion. Ideal CV health related to lower incidence of cardiovascular events, even after the percutaneous coronary intervention. Revascularization can be reduced by lifestyle changes. The cardiovascular health metrics could be extrapolated to secondary prevention and need for further validation. [ABSTRACT FROM AUTHOR]

Ovarian serous cystadenocarcinoma is a common malignant tumor of female genital organs. Treatment is generally less effective as patients are usually diagnosed in the late stage. Therefore, a well-designed prognostic marker provides valuable data for optimizing therapy. In this study, we analyzed 303 samples of ovarian serous cystadenocarcinoma and the corresponding RNA-seq data. We observed the correlation between gene expression and patients’ survival and eventually established a risk assessment model of five factors using Cox proportional hazards regression analysis. We found that the survival time in high-risk patients was significantly shorter than in low-risk patients in both training and testing sets after Kaplan-Meier analysis. The AUROC value was 0.67 when predicting the survival time in testing set, which indicates a relatively high specificity and sensitivity. The results suggest diagnostic and therapeutic applications of our five-gene model for ovarian serous cystadenocarcinoma. [ABSTRACT FROM AUTHOR]