BioMed Research International

Rapid prediction of the severity of acute coronary syndrome (ACS) is crucial for appropriate intervention in emergency department. Neutrophils (Neu), lymphocytes (Lym) and monocytes (Mon) and their ratios (Neu/Lym, NLR; Mon/Lym, MLR NeuxMon/Lym, SIRI) are acknowledged to be associated with the prediction of the severity and adverse outcome of ACS patients. Here, we analysed retrospectively eosinophils (Eos) and Eos-derived novel ratios (Neu/Eos, NER; Mon/Eos, MER; Neu x Mon/Eos, SIII; Neu/Eos x Lym, NEL; Mon/Eos x Lym, MEL; Neu x Mon/Eos x Lym, SV) of first admitted 1053 ACS patients within 24 hours of symptom onset to predict ST-segment elevation of myocardial infarction (STEMI), high Gensini score (H) and cardiac dysfunction (Killip Classification l to III grades). Results showed that Eos was significantly decreased in ST (n=227), Gensini (H) (n=311) and Killip I group (n=237) (P<0.05). All Eos-derived ratios (NER, MER, SIII, NEL, MEL, SV) were significantly higher with diagnostic severity (ST, Gensini (H), and Killip I group (P<0.05). ROC analysis revealed that SIII and SV predicted ST and Gensini (H) with high specificity and sensitivity, which were similar to that of NLR, MLR and SIRI. Conclusion: Eos and Eos-derived ratios, SIII and SV in particular, are strongly linked to the prediction of the severity of ACS, along with those of well-established leukocyte ratios. The new ratios of Eos hold significant importance in emergency department for quick evaluation of ACS patients.

IntroductionHeparin-binding protein is an inflammatory factor with predictive value and participates in the inflammatory response through antibacterial effects, chemotaxis, and increased vascular permeability. The role of heparin-binding protein in sepsis has been progressively demonstrated, but few studies have been conducted in the context of multiple trauma combined with bacterial infections. This study aims to investigate the predictive value of heparin-binding protein for bacterial infections in patients with severe multiple trauma. Materials and methodsPatients with multiple trauma in the emergency intensive care unit were selected for the study, and plasma heparin-binding protein concentrations and other laboratory parameters were measured within 48 hours of admission to the hospital. A two-sample comparison and univariate logistic regression analysis were used to investigate the relationship between heparin-binding protein and bacterial infection in multiple trauma patients. A multifactor logistic regression model was constructed, and the ROC curve was plotted. ResultsNinety-seven patients with multiple-trauma were included in the study, 43 with bacterial infection and 54 without infection. According to data analysis, heparin-binding protein was higher in the infected group than in the control group [(32.00{+/-}3.20) ng/mL vs. (18.52{+/-}1.33) ng/mL]. Univariate logistic regression analysis shows that heparin-binding protein is related to bacterial infection (OR=1.10, Z=3.91, 95%CI:1.05[~]1.15, P=0.001). Multivariate logistic regression equations showed that patients were 1.12 times more likely to have bacterial infections for each value of heparin-binding protein increase, holding neutrophils and PCT constant. ROC analysis shows that heparin-binding protein combined with neutrophils and PCT has better predictive value for bacterial infection [AUC=0.935, 95%CI:0.870[~]0.977]. ConclusionsHeparin-binding protein may predict bacterial infection in patients with severe multiple trauma. Combining heparin-binding protein, PCT, and neutrophils may improve bacterial infection prediction.

Sepsis is defined as the systemic response to an infectious disease, whether caused by bacteria, viruses, fungi or protozoa. Sepsis has several etiologies according to the worsening of the disease, those of bacterial origin with 70%, of which Gram-negative bacilli are the most frequent, especially in patients with the most severe disease. The most common community infections are respiratory infections, urinary tract infections and skin infections, with elderly individuals and children being more susceptible to complications of the immune system. The objective of this research is to analyze whether the time between hospitalization and the start of antibiotic treatment is directly related to the mortality rate and length of stay. This study was carried out in the form of documentary field research, where data collection was performed using data from the medical records of patients diagnosed with community infection or sepsis. Data collection was carried out from a form where patient identification, age, infectious focus, date and time of admission to the emergency room, date and time of the 1st dose of antibiotic, time interval between admission and antibiotic administration, ICU stay, days of mechanical ventilation and outcome. 34 patients were followed up in the emergency room and in the ICU, with an average age of these patients is 71.4 {+/-} 30 years. This research showed a high mortality rate of the included patients who were diagnosed with community infection.

This study investigates the role of specific microRNAs (miRNAs) in autosomal dominant polycystic kidney disease (ADPKD). Network analysis using Cytoscape 3.10.1 revealed 28 miRNAs that target two or more PKD related genes, while 14 miRNAs interacted with three or more genes. Pathway analysis of these 14 miRNAs, conducted via the miRPath V4.0 tool, utilized various resources such as KEGG, GO terms, Pfam, and MSigDB, highlighting their functional roles in ADPKD. Among these 14 miRNAs, four were prioritized for further analysis based on the higher number of target genes and existing evidence of their expression in blood. These miRNAs were analyzed for fold change expression levels using qRT-PCR on blood-derived RNA samples from ADPKD patients (n=19) and healthy controls (n=5). These four miRNAs--hsa-miR20a-5p, hsa-miR27b-3p, hsa-miR3613-3p, and hsa-miR181a-5p-- showed significant upregulation with p-values of 0.0179, 0.0002, 0.0166, and 0.0402 respectively. The functional enrichment of miRNAs involved in PKD evidently suggests that these play diverse roles in regulating key processes such as cell cycle progression, mTOR signaling, autophagy, EMT, and cellular responses to hypoxia thus playing crucial role in the pathogenesis of ADPKD and could serve as potential biomarkers or therapeutic targets.

BackgroundKidney transplantation is the best option for the treatment of end-stage kidney disease (ESKD). Acute rejection (AR) episodes are a major determinant of renal allograft survival. Cellular senescence in the pathogenesis of allograft failure. Herein, we aimed to explore hub cellular senescence-related gene in AR after kidney transplantation. MethodsThe data used in this study was obtained from the Gene Expression Omnibus database. The hub cellular senescence-related gene was identified using WGCNA and three machine learning algorithms. The function information was analyzed using the GO and KEGG enrichment analysis. The correlation between hub gene and immune cells was calculated using ssGSEA algorithm and Pearsons correlation analysis. ResultsA total of 31 cellular senescence-related genes were differentially expressed in the AR and stable groups. Among which, 19 genes were correlated with onset of AR after kidney transplantation. After utilizing the three machine learning algorithms, IFNG was identified as the hub cellular senescence-related gene. IFNG was highly expressed in AR samples, and it could better distinguish between stable individuals and AR patients after kidney transplantation. Moreover, the expression of IFNG was closely correlated with immune cell infiltration and function. IFNG expression was associated with multiple drugs. Finally, we found that IFNG was high expressed in kidney tissues of AR in allogeneic kidney transplant mice ConclusionsOur study revealed that cellular senescence-related gene IFNG might be a potential biomarker AR after kidney transplantation.

Three anti-HIV drugs, ritonavir, lopinavir and darunavir, might have therapeutic effect on coronavirus disease 2019 (COVID-19). In this study, the structure models of two severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) proteases, coronavirus endopeptidase C30 (CEP_C30) and papain like viral protease (PLVP), were built by homology modeling. Ritonavir, lopinavir and darunavir were then docked to the models, respectively, followed by energy minimization of the protease-drug complexes. In the simulations, ritonavir can bind to CEP_C30 most suitably, and induce significant conformation changes of CEP_C30; lopinavir can also bind to CEP_C30 suitably, and induce significant conformation changes of CEP_C30; darunavir can bind to PLVP suitably with slight conformation changes of PLVP. It is suggested that the therapeutic effect of ritonavir and lopinavir on COVID-19 may be mainly due to their inhibitory effect on CEP_C30, while ritonavir may have stronger efficacy; the inhibitory effect of darunavir on SARS-CoV-2 and its potential therapeutic effect may be mainly due to its inhibitory effect on PLVP.

ObjectiveTo explore the value of bedside ultrasound in monitoring peak flow velocity of abdominal aorta and its branches in assessing the volume status of patients with septic shock. MethodsA total of 80 patients with septic shock admitted to the Foshan Rehabilitation Hospital(The Fifth Peoples Hospital of Foshan) and the Guangdong Provincial Peoples Hospital from June 2022 to June 2023 were selected as the research subjects. All patients were treated with mechanical ventilation,and deep venous catheters were placed in the internal jugular vein or subclavian vein to monitor central venous pressure (CVP).PiCCO catheters were placed in the femoral artery to monitor hemodynamic data.At the same time,the maximum internal diameter of the inferior vena cava (IVCmax),the respiratory variation of the inferior vena cava ({square}IVC),the peak flow velocity of the abdominal aorta (VpeakAA),the peak flow velocity of the celiac artery (VpeakCA),and the peak flow velocity of the superior mesenteric artery (VpeakSMA)were monitored under bedside ultrasound.The global end-diastolic volumn index(GEDI)was used as a grouping indicator,with GEDI[&le;]680ml/m2 as the low-volume group and GEDI[&ge;]800ml/m2 as the high-volume group.Compare the differences in peak flow velocity between the abdominal aorta,celiac artery,and superior mesenteric artery between the two groups,and analyze the correlation between peak flow velocity of the abdominal aorta,celiac artery,and superior mesenteric artery and IVCmax,{Delta}IVC,CVP,and stroke volume variability (SVV);draw a receiver operating characteristic (ROC) curve for the subjects,calculate the area under the curve,and find the diagnostic threshold. ResultsThere was no significant difference in general data between the two groups (P>0.05).The VpeakAA,VpeakCA,and VpeakSMA in the high-volume group were all higher than those in the low-volume group, and the differences were statistically significant (P<0.05). However,VpeakCA and VpeakSMA were significantly correlated with IVCmax, {bigtriangleup} IVC,CVP,and SVV (P<0.05).The ROC curve analysis showed that VpeakAA,VpeakCA,and VpeakSMA could effectively evaluate the volume status of patients with septic shock, and the area under the VpeakSMA curve was 0.846,with a 95% confidence interval of 0.693-0.999,and had high sensitivity and specificity. ConclusionBedside ultrasound can dynamically monitor VpeakAA,VpeakCA,and VpeakSMA,which has great value in the evaluation of volume status in patients with septic shock.

ObjectiveSelf-adhesive resin cements are easy to use and do not need further preparation but their bonding ability to dentin is somehow questionable.Ddentin preparation with acidic solutions and therefore removing smear layer can increase bond strength of self-adhesive resin cements to dentin. As a matter of fact it is assumed that deproteinization of dentin can increase contact between cement and dentin. In the present study the effect of deproteinization of dentin with different concentrations and times of sodium hypochlorite on the push out bond strength of resin cement to dentin is assessed. Materials and methods60 third molar teeth were selected and divided to 4 groups consisting of 5% and 20% concentrations and 2 and 10 minutes of using. Samples were randomly divided into six groups of ten. All samples used size 2 Whitepost FGM fiber posts (FGM, Joinville, SC, Brazil), with a diameter of 1.2 mm. Samples were cemented using dual-cure self-adhesive TheraCem (Bisco, USA), cured for 40 seconds with an LED Plus device from Woodpecker made in China All the specimens were then mounted in plastic cylinders. After 24 hours they were cut with 0.2 mm thickness diamond disc to two coronal and apical parts. Push out strength test was done with Instron 1122R (Universal Testing Machine). ResultsIncreasing the concentration and using time of sodium hypochlorite increased push out bond strength. DiscussionDeproteinization not only can increase push out bond strength but also increase time and concentration can elevate bond strength measures.

Fucosylation plays an important role in the development of carcinogenesis. miRNA-1290 emerged as crucial molecule to regulate cancer cell proliferation. This study evaluated the role of miRNA-1290 to development of gastric cancer by regulation of fucosyltransferase-IV, specific protein-1 (SP1) and 1,3-fucosylated glycans.We analyzed the role of H. pylori and miR-1290 in gastric cancer cells in induce fucosylation and cell proliferation, as well as SP1 and ubiquitin protein interaction. We found miR-1290 induced proliferation in H. pylori CagA treated gastric cancer cells by stimulating FUT4/LeY fucosylation, as evidence by high expression of miR-1290 and phosphorylation of EGFR and MAPKs pathway in dose-dependent manner. In addition, miR-1290 inhibited SP1 protein with the regulation of ubiquitin-proteasomal system and leads to stimulate FUT4 and 1,3-fucosylated glycans level. We report the role of miRNA-1290 to stimulate FUT4 fucosylation and LeY through EGFR/MAPKs pathway by targeting SP1 in the development of gastric cancer.

ObjectiveChronic periodontitis has been proposed to be linked to coronavirus disease (COVID-19) on the basis of its inflammation mechanism. We aimed to evaluate this association by investigating the expression of Angiotensin Converting Enzyme-2 (ACE2) in periodontal compartments, which contain dysbiosis-associated pathogenic bacteria, and how it can be directly or indirectly involved in exacerbating inflammation in periodontal tissue. Material and MethodsThis observational clinical study included 23 adult hospitalized patients admitted to Universitas Indonesia Hospital with PCR-confirmed COVID-19, while 6 non-COVID-19 participants come to periodontal clinic were included as control. Using real time-PCR (qPCR) and gingival crevicular fluids (GCF) samples from COVID-19 patients with and without diabetes and periodontitis, we assessed the mRNA expression of angiotensin-converting enzyme 2 (ACE2), IL-6, IL-8, complement C3, and LL-37 as well as the relative proportion of Porphyromonas gingivalis, Fusobacterium nucleatum, and Veillonella parvula to represent the dysbiosis condition in periodontal microenvironment. All analyses were performed to determine their relationship. ResultsACE2 mRNA expression was detected in the GCF of periodontitis-COVID-19 patients with and without diabetes. However, only periodontitis-COVID-19 patients with diabetes showed a positive relationship between ACE2 expression and inflammatory conditions in the periodontal microenvironment. In addition, the interplay between pro-inflammatory cytokine (IL-6) and complement C3 could be used as a predictor of the severity of periodontal inflammation in COVID-19 patients with diabetes. ConclusionThe study data show that the SARS-CoV-2 entry gene is expressed in the GCF of patients with COVID-19, and its expression correlates with inflammatory markers.

PurposeOur aim in this study is to determine the benefits of serum lactate, albumin and base excess values in predicting prognosis and mortality in patients with sepsis or septic shock when evaluated together. MethodsWe performed a retrospective observational study. Included 217 patients admitted to Hacettepe University Hospital Adult Emergency Department, that were 18-year-old and more, and had 2 or more SOFA scores. We evaluated admission hour, 24. hour and 48. Hour lactate, albumin and base excess. We searched changes of the lactate, albumin and base excess values and calculate the hospital mortality and 90-days-mortality. ResultsDecrease in 0-24-48th hour albumin values increases the mortality of sepsis patients in our study. While 0-48th hour lactate values do not affect the hospital mortality, the increase in the 24th hour lactate value increases the hospital mortality. The increase in 0-48th hour lactate values increases the 90-day mortality. Changes of base excess values had no effect on hospital mortality and 90-day mortality. There was no effect of lactate, albumin and base excess values on mortality in patients with septic shock. When the mortality rates are analyzed according to the lactate clearance of patients with sepsis, hospital mortality increases only as 24-hours lactate clearance decreases. Alactic base excess has no effect on the mortality. While no significant AUC value was found for base excess in ROC analyzes; the AUC values of lactate and albumin are significant, but their sensivity is low since the AUC values found for lactate and albumin are below 0.70. In ROC analyzes for lactate clearance, the AUC value for 24-hour lactate clearance is significant, but the sensivity of the AUC value is low. The areas under the curve (AUC) were not statistically significant in the ROC analyzes for the alactic base excess. ConclusionsContrary to the literature, lactate, albumin and base excess were found to have low sensitivity in determining prognosis and mortality in our study. When factors that may affect serum lactate, albumin and base excesss (such as chronic liver diseases, chronic kidney diseases, metformin use) are excluded, the values of these biomarkers in determining mortality in sepsis and septic shock decrease.

Histone deacetylase 6 (HDAC6) have been demonstrated to play critical roles in the progression of tumor migration and invasion in recent years.However, little research has been done on hepatocellular carcinoma (HCC). This study investigated the role of HDAC6 in the migration and invasion of HCCLM3 cells and its potential mechanism. Western blot and immunohistochemistry were used to detect the expression of HDAC6 in normal hepatic cell line LO2 and HCC cell line HCCLM3. Transforming growth factor 1 (TGF-{beta}1) was proved as a direct target of HDAC6 by Western blot and qRT-PCR.The changes of migration and invasion ability of HCCLM3 cells were confirmed by wound healing and Transwell assays.Morphological changes of HCCLM3 cells were observed by microscope.Our study proved that drownregulated HDAC6 supress HCCLM3 cells metastasis and invasion. Meanwhile, our study verified that HDAC6 regulate EMT by targeting TGF-{beta}1.In conclusion, HDAC6 inhibits the EMT of HCCLM3 cells and further inhibits the migration and invasion of HCCLM3 cells by downregulating the expression of TGF-{beta}1.

BK polyomavirus-associated nephropathy (BKPyVAN) is a serious complication of kidney transplantation. Numerous kidney diseases such as BKPyVAN have been shown to cause mitochondrial dysfunction. This study aims to identify key mitochondria-related genes in BKPyVAN. We merged two datasets, GSE72925 and GSE47199, to form a training set after batch-effect removal. Hub mitochondria-related genes in BKPyVAN were identified using bioinformatics tools. The functional information of the hub genes was analyzed using gene set enrichment analysis (GSEA). A mouse model of polyomavirus (MPyV) infection was established to verify the expression levels of B-cell lymphoma 2-related protein A1 (BCL2A1), Caspase-3 (CASP3), and threonine synthase like 1 (THNSL1) in BKPyVAN. We identified nine mitochondria-related genes that were differentially expressed between BKPyVAN and stable graft samples and correlated with BKPyVAN onset. Among these, three genes (THNSL1, BCL2A1, and CASP3) were identified as robust mitochondria-related genes in BKPyVAN. THNSL1 and BCL2A1 were upregulated and CASP3 was downregulated in BKPyVAN samples. Moreover, THNSL1 and BCL2A1 were upregulated and CASP3 was downregulated in MPyV kidney tissue samples. These genes showed a significant diagnostic value for BKPyVAN. GSEA revealed the potential involvement of these genes in the immune pathways. Additionally, we found correlations between these genes and immune cell infiltration in BKPyVAN patients. Our study identified three robust biomarkers (THNSL1, BCL2A1 and CASP3) for BKPyVAN that might be potential targets for diagnosis and treatment. These biomarkers may be involved in immune pathways and show a significant correlation with immune cell infiltration, suggesting their critical role in BKPyVAN pathogenesis.

IgA nephropathy (IgAN) is the most common primary glomerulonephritis worldwide. Aging is a major risk factor for progression of IgAN to end stage renal disease. The purpose of this study was to identify and verify aging-related genes associated with IgAN through bioinformatics analysis. Microarray datasets of GSE93798 and GSE37460 were downloaded from the Gene Expression Omnibus (GEO) database. The aging-related DEGs (AR-DEGs) associated IgAN was analyzed by R programming software, and then genome ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis were performed. The PPI network of AR-DEGs was then contructed, and hub genes were ranked using five methods of the cytoHubba plugin in Cytoscape software. CIBERSORT algorithm was used to evaluate the infiltrating immune cells and their relationship with hub genes. Next, Nephroseq V5 online platform was used to verify and analyze the mRNA expression patterns of hub genes in IgAN patients and normal controls.A total of 372 DEGs were identified, of which the expression of 158 were upregulated and 214 were downregulated. GO and KEGG enrichment pathway analysis mainly focused on regulation of macrophage derived foam cell differentiation, PI3K-Akt signaling pathway. Based on the results of PPI network analysis, the eight hub genes were identified, including AGT, ALB, CD36, EGF, KDR, LPL, MYC, PPARGC1A. Immunoinfiltration analysis indicated that CD36 were closely related to immune cell infiltration. Furthermore, the expression levels of these hub genes were validated using the Nephroseq V5 online platform. Further clinical sample studies confirmed that CD36 was highly expressed in renal tissues of IgAN patients. These findings provide new insights into potential aging-related genes associated with IgAN, which may better contribute to understanding the pathogenesis of IgAN. CD36 may have diagnostic value for aging-related IgAN.

BackgroundCalcium-modulated inhibitors are commonly used after allogeneic haematopoietic stem cell transplantation (allo-HSCT), and the risk factors for the development of acute graft-versus-host disease (aGVHD) may differ among immunosuppressive regimens, presenting a challenge for clinical prediction. Cyclosporine (CsA) is a frequently used immunosuppressant in the postoperative period. By investigating the clinical characteristics and risk factors of aGVHD in allo-HSCT treated with the CsA regimen, we aspire to furnish evidence-based proof for patients applying CsA after allo-HSCT. MethodsThis retrospective study based on the clinical data of patients who received allo-HSCT and used CsA in the First Affiliated Hospital of Guangxi Medical University from June 2020 to July 2023, calculated the incidence rate of aGVHD, and analyzed the risk factors of poor prognosis through logical regression. Simultaneously perform ROC curve analysis. ResultsA total of 129 subjects were enrolled in this study, among whom 19 patients developed aGVHD. The sites of aGVHD involvement were skin in 11 cases (57.9%) and intestine in 8 cases (42.1%). Univariate analysis results showed that CsA concentration on days 15 ~ 21 after transplantation, bacterial infection before transplantation, fungal infection before transplantation, and pretreatment programme were the associated factors with aGVHD. Multifactorial analysis revealed that CsA concentration on days 15~21 after transplantation (OR=0.987, 95% CI=0.978~0.997, P=0.011), CsA dose-normalized concentration on days 15 ~ 21 after transplantation (OR=1.015, 95% CI=1.001 ~ 1.029, P=0.035), bacterial infection before transplantation (OR=0.255, 95%CI=0.079 ~ 0.823, P=0.022), and pretreatment programme (OR=0.488, 95% CI=0.252 ~ 0.944, P=0.033) were independent risk factors for aGVHD. After transplantation, the ideal threshold of CsA concentration is 136.45 ng/ml. ConclusionThis study highlights the necessity for patients undergoing allo-HSCT and receiving CsA regimens to be particularly vigilant about the pretreatment programme, the monitoring of CsA or CsA dose-normalized concentration on days 15 ~ 21 after transplantation, and to avoid bacterial infections before surgery.

MicroRNAs (miRNAs) are important regulators of gene expression at the post-transcriptional level. The present study aims to investigate the role of miR-384 in Reelin by regulating ADAMTS4 in neuronal cell lines. Brain tissues from A{beta}1-42 induced mouse model of Alzheimers disease and the control group were collected. RT-PCR, Western blotting and immunohistochemistry were performed to detect the levels of ADAMTS4 and miR-384 in tissues. Luciferase reporter assay, Western blotting and in vitro assay were used to validate that ADAMTS4 was the target gene of miR-384. Neuronal cell line, Neuro-2a, was selected for transfection assay. ADAMTS4 was significantly down-regulated in hippocampi of Alzheimers disease mouse model, and negatively correlated with miR-384. Then, ADAMTS4 was identified as a direct target of miR-384. Over-expressing of miR-384 in Neuro-2a showed that ADAMTS4 and the cleaved Reelin fragments were down regulated, and proliferation of neuronal cell lines (Neuro-2a and SH-SY5Y) were inhibited through DAB-1 pathway. In conclusion, these results revealed that miR-384 may play a regulatory role in Reelin via inhibiting ADAMTS4 in neuronal cell lines.

IntroductionThe fructosamine is originated of the glycation of plasmatic proteins, especially albumin, in addition to immunoglobulins and proteins diverse. It constitutes an alternative biomarker of glycemic control when glycated hemoglobin is not indicated for this purpose. ObjectiveTo define the mathematical relationship between fructosamine and average glucose values. MethodThe study comprised the laboratorial data collected of 1227 diabetic subjects (type 1 and type 2). Fructosamine levels obtained at the end of three weeks and measured were compared with the average glucose levels of the three previous weeks. The average glucose levels were determined by the weighted mean of the daily fasting capillary glucose results performed during the study period, and the plasma glucose taken at the time of the fructosamine. ResultsA total of 9,450 glucoses were performed. Linear regression analysis between the fructosamine and average glucose levels showed that each increase of 1.0 {micro}mol/L in fructosamine increase 0.5mg/dL in the average glucose levels as evidenced in the equation forward: Average glucose levels = 0.5157 x Fructosamine - 20. According to the coefficient of determination (r2 = 0.353492, P < 0.006881), making it possible to calculate the estimated average glucose according to the frutosamine values. ConclusionFructosamine levels can be expressed as average glucose levels for assessing the metabolic control of diabetic patients.

Chronic kidney disease (CKD) is a global public health problem characterized by persistent kidney damage or loss of kidney function. Previously, the diagnosis of CKD has mainly relied on serum creatinine and estimation of the glomerular filtration rate. However, with the development and progress of artificial intelligence (AI), AI has played different roles in various fields, such as early diagnosis, progression prediction, prediction of associated risk factors, and drug safety and efficacy evaluation. Therefore, research related to the application of AI in the field of CKD has become a hot topic at present. Therefore, this study adopts a bibliometric approach to study and analyze the development and evolution patterns and research hotspots of AI-CKD. English publications related to the field between January 1, 2004, and June 27, 2024, were extracted from the Web of Science Core Collection database. The research hotspots and trends of AI-CKD were analyzed at multiple levels, including publication trends, authors, institutions, countries, references and keywords, using VOSviewer and CiteSpace. The results showed that a total of 203 publications on AI-CKD were included in the study, of which Barbieri Carlo from the University of Milan, Italy, had the highest number of publications (NP=5) and had a high academic impact (H-Index=5), while the USA and its institution, the Mayo Clinic, were the publications. The USA and its Mayo Clinic are the countries and institutions with the highest number of publications, and China is the country with the second highest number of publications, with three institutions attributed to China among the top five institutions. Germanys institution, Fresenius Medical Care, has the highest academic impact (H-index=6). Keyword analysis yielded artificial intelligence, chronic kidney disease, machine learning, prediction model, risk, deep learning, and other keywords with high frequency, and cluster analysis based on the timeline yielded a total of 8 machine learning, deep learning, retinal microvascular abnormality, renal failure, Bayesian network, anemia, bone disease, and allograft nephropathology clusters. This study provides a comprehensive overview of the current state of research and global frontiers of AI-CKD through bibliometric analysis. These findings can provide a valuable reference and guidance for researchers.

ObjectiveThe purpose of this study is to compare the outcomes of using auto-transplanted tooth and flap for repairing sinus perforation after tooth extraction. The aim is to provide a new reference for selecting appropriate repair methods for maxillary sinus perforation. Methods and materialsThis study involved 19 patients with sinus perforation who underwent treatment at the Department of Oral Surgery, Hospital of Stomatology Wuhan University, from March 2021 to September 2022. The study included two groups: a test group with 11 cases where perforation of the maxillary sinus mucosa greater than 5 mm was found during autologous tooth transplantation, and a control group with 8 cases where maxillary sinus mucosa perforation greater than 5 mm was found during tooth extraction. Clinical examination and radiographic examination were taken at 2 weeks, 1, 3, 6, and 12 months post-surgery of two groups. The two-year survival probability of the AT group was assessed using Kaplan-Meier survival analysis. ResultsThe success rate of the auto-transplantation (AT) group was 72.7% (8/11), while the success rate of the flap transfer (FT) group was 100%. Upon analysis, it was found that the survival probability of AT group was significantly lower when the gingival index(GI) score was 2 (51.8%), in comparison to when it was 0 or 1 (100%). ConclusionThe study findings demonstrated that the utilization of auto-transplanted teeth yielded a favorable outcome in restoring maxillary sinus perforation, suggesting its viability as a potential option.

Abbreviated Injury Score (AIS) and Injury Severity Score (ISS) scores are used to measure the severity of trauma patients in the emergency department, but they have several problems such as a calculation complexity. In this study, we developed a mortality prediction model of trauma patients using the data from electronic medical records and compared it with a model using AIS/ISS scores. This is a prognostic study using the data of patients who were admitted to Hitachi General Hospital Emergency and Critical Care Center from April 2018 to March 2019. The features were age, sex, vital signs, and clinical diagnoses, and the outcome was in-hospital death. Of 337 eligible patients, 11 died during the hospitalization. The predictive performance of our model was comparable to that of the AIS/ISS scores model (AUC 0.912 vs 0.961). Clinical diagnoses were important in predicting the mortality rate. Our study suggests that a trauma severity index calculated by the predicting model using information from electronic medical records might replace AIS/ISS score.