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ObjectiveTo explore the risk factors of unplanned hospital visiting in patients received video-assisted thoracic surgery （VAST） for pulmonary nodule resections based on enhanced recovery after surgery （ERAS）. MethodsA retrospective study was performed to analyze the clinical date of 767 patients received VAST for pulmonary resections based on ERAS in Day Care Unit of Nanjing Drum Tower Hospital from January 2021 to December 2022. Patients were divided into unplanned revisiting group and conventional visiting group according to whether they had unplanned hospital visiting. The risk factors of unplanned hospital visiting were analyzed and prediction model was developed. The receiver operating characteristic （ROC） was used to analyze the predictive factors. ResultsThere were 51 patients （6.65%） with unplanned hospital visiting after discharge. Compared with the conventional visiting group, the ASA grade was significantly higher, the proportion of smoking and air leak≥2 grade were increased, the thoracic drainage time and the level of C-reactive protein(CRP) at first day after operation were increased in unplanned revisiting group （P＜0.05）. The logistic regression analysis showed air leak≥2 grade （OR=6.184, 95%CI: 2.048-18.674） and the level of CRP at first day after operation （OR=1.013, 95%CI: 1.000-1.025） were the independent risk factor of unscheduled hospital visiting in patients received VAST for pulmonary resections. The area under the ROC(AUC) curve of postoperative CRP was 0.618 （95%CI: 0.583-0.653, P=0.009）, with a cutoff value of 22.80mg/L; The AUC of the prediction model was 0.691 （95%CI: 0.657-0.724, P＜0.01）, with a cutoff value of 0.058. Conclusion Air leak≥2 grade and the level of CRP at first day after operation are independent risk factors of unplanned hospital visiting in patients undergoing VAST for pulmonary resections based on ERAS.

Background and Purpose: Delirium is a common mental disorder after adult cardiovascular surgery. Fifteen to 23% of patients undergoing cardiovascular surgery and cardiomyopathy experience delirium, and the efficacy of treatment interventions for delirium has been consistently unsatisfactory. Methods: A total of 729 patients who underwent cardiovascular surgery were randomly allocated into a training set and a validation set. A nomogram was developed using a logistic regression model to predict the incidence of delirium following cardiovascular surgery. The validity of the model was assessed by determining the receiver operating characteristic (ROC) curve, calculating the area under the ROC curve (AUROC), performing a calibration plot, and executing a decision curve analysis. This model was internally validated using the bootstrap method. Results: Postoperative delirium (POD) occurred in 165 cases (22.6%) among the 729 patients. Predictors included age, transient ischemic attack, length of preoperative stay, preoperative left ventricular injection fraction and N‐terminal pro‐B‐type natriuretic peptide level, and intraoperative infusion of dexmedetomidine and human fibrinogen. The nomogram showed sufficient differentiation and calibration (AUROC = 0.754, 95% confidence interval = 0.703–0.804). The calibration graphs showed that the predictive values of the nomogram were in agreement with the actual values. The analysis of the training and validation sets suggested that the model possessed specific clinical significance. Conclusions: In summary, the predictive model consists of seven factors that can roughly predict the occurrence of POD in patients who undergo cardiovascular surgery. [ABSTRACT FROM AUTHOR]

Background: Icariin (ICA) inhibits inflammatory response in various diseases, but the mechanism underlying ICA treating airway inflammation in asthma needs further understood. We aimed to predict and validate the potential targets of ICA against asthma‐associated airway inflammation using network pharmacology and experiments. Methods: The ovalbumin‐induced asthma‐associated airway inflammation mice model was established. The effects of ICA were evaluated by behavioral, airway hyperresponsiveness, lung pathological changes, inflammatory cell and cytokines counts. Next, the corresponding targets of ICA were mined via the SEA, CTD, HERB, PharmMapper, Symmap database and the literature. Pubmed‐Gene and GeneCards databases were used to screen asthma and airway inflammation‐related targets. The overlapping targets were used to build an interaction network, analyze gene ontology and enrich pathways. Subsequently, flow cytometry, quantitative real‐time PCR and western blotting were employed for validation. Results: ICA alleviated the airway inflammation of asthma; 402 targets of ICA, 5136 targets of asthma and 4531 targets of airway inflammation were screened; 216 overlapping targets were matched and predicted ICA possesses the potential to modulate asthmatic airway inflammation by macrophage activation/polarization. Additionally, ICA decreased M1 but elevated M2. Potential targets that were disrupted by asthma inflammation were restored by ICA treatment. Conclusions: ICA alleviates airway inflammation in asthma by inhibiting the M1 polarization of alveolar macrophages, which is related to metabolic reprogramming. Jun, Jak2, Syk, Tnf, Aldh2, Aldh9a1, Nos1, Nos2 and Nos3 represent potential targets of therapeutic intervention. The present study enhances understanding of the anti‐airway inflammation effects of ICA, especially in asthma. [ABSTRACT FROM AUTHOR]

Non‐small cell lung cancer (NSCLC) is increasing dramatically. It is believed that energy metabolism‐related genes could play an important role in etiology of NSCLC. In this study, we sought to assess the correlation between three LEPR single nucleotide polymorphisms (rs1137101, rs1137100 and rs6588147) with NSCLS susceptibility. In total, 1193 NSCLC cases and 1056 controls were included. SNPscan™ genotyping method was used to analyze the genotypes of LEPR polymorphisms. Compared to rs6588147 GG in LEPR gene, this study identified a protective role of LEPR rs6588147 GA and GA/AA for the occurrence of NSCLC (GA vs. GG [p = 0.021] and GA/AA vs. GG [p = 0.030]). As well, we found that a protective role of LEPR rs6588147 for the occurrence of non‐SCC subgroup (p < 0.05). By logistic regression analysis, we found that the rs6588147 A allele related genotypes might play a protective role for the occurrence of NSCLC in drinking, BMI ≥24 kg/m2, smoking and male subgroups. We also found that the rs1137101 A allele related genotypes played a protective role for the occurrence of NSCLC in male, younger participants (under 59 years) and overweight/obesity (BMI ≥24 kg/m2) subgroups. We found that LEPR Ars1037100Ars1037101Ars6588147 haplotype might play a protective role for the occurrence of NSCLC (p = 0.013). In addition, our findings indicated that LEPR rs1137100 G>A SNP might increase the risk of lymph node metastases (p = 0.038). This study highlights that LEPR rs6588147, rs1137101 genotypes and LEPR Ars1037100Ars1037101Ars6588147 haplotype are correlated with the occurrence of NSCLC. LEPR rs1137100 G>A SNP increases the risk of lymph node metastases. [ABSTRACT FROM AUTHOR]