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Abstract Due to the resistance of carbapenem-resistant Klebsiella pneumoniae (CRKP) to most antibiotics, CRKP treatment is challenging, which results a high mortality rate. CRKP infection poses a significant challenge for infection management and treatment, especially among neonates and premature infants. Therefore, it is important to understand the clinical characteristics of CRKP bloodstream infection (BSI) in premature infants and identify the related risk factors for death. This study aims to explore and analyze the clinical characteristics and risk factors affecting mortality of BSI caused by CRKP in premature infants. A retrospective study was conducted in a Children’s Hospital in Henan to analyze clinical data of premature infants with CRKP BSI admitted from January 2015 to December 2022. Univariate and multivariate logistic regression models were utilized to investigate risk factors affecting mortality. Receiver operating characteristic curves were employed to evaluate the predictive value of different indicators on mortality, and differences in area under the curve (AUC) were compared using Stata 17 SE. A total of 96 premature infants with CRKP BSI were enrolled, including 70 patients in the survival group and 26 in the death group. At the onset of infection, 69 (71.9%) patients exhibited persistent tachycardia (heart rate > 180 beats/min), 61 (63.5%) had fever, and 59 (61.4%) experienced apnea episodes. Concurrent meningitis (OR 9.588, 95% CI 1.401–57.613, P = 0.021), concurrent necrotizing enterocolitis (NEC) (OR 7.881, 95% CI 1.672–73.842, P = 0.032), and the maximum vasoactive-inotropic score (VIS) value within 48 h of onset (OR 1.467, 95% CI 1.021–1.782, P = 0.001) were identified as independent risk factors for mortality. The univariate analysis showed that ceftazidime-avibactam (CAZ/AVI) treatment and appropriate early antimicrobial treatment were significantly associated with survival (P

Abstract Accurate prediction of oocyte maturation is a critical determinant of success in in vitro fertilization-embryo transfer (IVF-ET) procedures. This review provides a comprehensive analysis of the various predictive approaches employed to assess oocyte maturity, including single indicators, combined indicators, and predictive models. Factors such as ovarian reserve, patient characteristics, and controlled ovarian hyperstimulation (COH) strategies can significantly influence oocyte maturation rates. Single indicators, including hormone levels, ultrasound parameters, and clinical parameters, have been extensively studied. However, their predictive power may be limited when used in isolation. Combined indicators, integrating multiple parameters, have demonstrated improved predictive performance compared to single indicators. Additionally, predictive models and algorithms, such as machine learning and deep learning models, have emerged as promising tools for assessing oocyte maturity. These models leverage advanced statistical and computational methods to analyze complex datasets and identify patterns that can predict oocyte maturation rates with potentially higher accuracy. Despite these advancements, several gaps and limitations persist, including limited generalizability, lack of standardization, insufficient external validation, and the need to incorporate patient-specific factors and emerging technologies. The review highlights potential areas for further research, such as multicenter collaborative studies, integration of advanced omics technologies, development of personalized prediction models, and investigation of trigger time optimization strategies. Recommendations for clinical practice include utilizing a combination of indicators, adopting validated predictive models, tailoring approaches based on individual patient characteristics, continuous monitoring and adjustment, and fostering multidisciplinary collaboration. Accurate prediction of oocyte maturation holds profound implications for improving the success rates of IVF-ET and enhancing the chances of achieving a healthy pregnancy. Continued research, innovative approaches, and the implementation of evidence-based practices are essential to optimize assisted reproductive outcomes.

Hua-Jing Yuan,1 Hua-Chen Jiao,2 Xiu-Juan Liu,2 Hao Hao,2 Yang Liu,2 Yi-Tao Xue,2 Yan Li2 1Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, 250014, People’s Republic of China; 2Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, 250014, People’s Republic of ChinaCorrespondence: Yi-Tao Xue; Yan Li, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Shanshi East Road, Lixia District, Jinan City, Shandong Province, People’s Republic of China, Tel +86-531-82602943 ; +86-531-68611662, Email xytsdzydfy@126.com; liyan88130@163.comPurpose: The association between serum uric acid (SUA) and atrial fibrillation (AF) has been widely focused on and studied in recent years. However, the exact association between SUA and AF is unclear, and the effect of gender on the association between SUA levels and AF has been controversial. This study aimed to investigate the association between SUA levels and non-valvular AF (NVAF) and the potential effect of gender on it.Patients and Methods: A total of 866 NVAF patients (463 males, age 69.44 ± 8.07 years) and 646 sex-matched control patients in sinus rhythm, with no history of arrhythmia were included in this study. t-test, ANOVA, and chi-square test were used for baseline data analysis. The receiver operating characteristic curve, logistic regression and Pearson correlation analysis were used for correlation analysis.Results: Compared to controls, NVAF patients exhibited higher SUA (P< 0.001). After adjusting for confounders of NVAF, SUA remained significantly associated with NVAF, regardless of gender (OR= 1.31, 95% CI 1.18– 1.43, P< 0.001). SUA demonstrated higher predictability and sensitivity in predicting the occurrence of female NVAF compared to male (area under the curve was 0.68 (95% CI 0.64– 0.72, P< 0.001), sensitivity 87.3%), with the optimal cut-off point identified as 5.72 mg/dL. Furthermore, SUA levels correlated with APOA1, Scr and NT-proBNP in NVAF patients. SUA levels varied significantly among NVAF subtypes.Conclusion: High SUA levels were independently associated with NVAF, regardless of gender. SUA exhibited higher predictability and sensitivity in predicting the occurrence of NVAF in females compared to males. High SUA levels may affect other NVAF-related factors and participate in the pathophysiological process of NVAF.Keywords: serum uric acid, non-valvular atrial fibrillation, gender difference, retrospective study, predictive indicators

Background: One of the main risk factors for the occurrence of oral cancer is oral precancerous lesions (OPLs). Early management and preventive efforts depend on knowing the transformation rate and detecting predictive signs of malignancy. Methods: For 6 months, a group of 200 individuals with clinically diagnosed OPLs was followed up on in this longitudinal research. To examine biomarker expression levels and describe the lesions, examinations using immunohistochemistry, histopathology, and clinical methods were carried out. Findings: Over the course of 2 years, 200 patients with OPLs were monitored in this study. Most lesions had mild dysplasia, according to histopathological examination. The expression of many biomarkers that were correlated with the dysplasia grade were p53 (60.0%), Ki-67 (40.0%), CDKN2A (30.0%), and epidermal growth factor receptor (EGFR) (25.0%). Conclusion: In summary, this study emphasizes how crucial it is to provide patients with OPLs with individualized care plans and routine surveillance. Certain biomarkers, such EGFR, Ki-67, and p53, can be useful prognostic markers for identifying malignant transformation. To confirm these results and create tailored therapies for high-risk patients, more study is necessary.

ObjectiveThis study aimed to assess the clinical importance of various biomarkers, including NLR, CEA, CA199, CA125, CA153, and HE4, through dynamic testing to evaluate the effectiveness of neoadjuvant chemotherapy (NACT) for individuals facing advanced ovarian cancer. This provides valuable information for tailoring treatment plans to individual patients, thereby leading to a more personalized and effective management of individuals facing ovarian cancer.MethodsThe levels of NLR, CA125, CA199, CEA, CA153, and HE4 were detected before chemotherapy and after 3 courses of chemotherapy. Patients were categorized into ineffective and effective groups according to the effectiveness of NACT. To evaluate the factors influencing NACT’s effectiveness in individuals facing advanced ovarian cancer, receiver operating characteristic (ROC) curves, predictive modeling, and multifactorial regression analysis were employed.ResultsIn the effective group, the patients’ age, maximum tumor diameter, and CEA and HE4 levels of the patients were significantly higher compared to those in the ineffective group (P

Xiaojing Li,1 Liwei Bai,2 Ziru Niu,3 Qiang Lu3 1Department of Obstetrics, First Hospital of Qinhuangdao, Qinhuangdao, Hebei, 066000, People’s Republic of China; 2Department of Obstetrics, Qinhuangdao Hospital for Maternal and Child Health, Qinhuangdao, Hebei, 066000, People’s Republic of China; 3Department of Endocrinology, First Hospital of Qinhuangdao, Qinhuangdao, Hebei, 066000, People’s Republic of ChinaCorrespondence: Qiang Lu, Department of Endocrinology, First Hospital of Qinhuangdao, Qinhuangdao, Hebei, 066000, People’s Republic of China, Tel +86-13933909066, Email 13933909066@126.comPurpose: The objective of this study was to explore whether neck circumference can serve as an early predictor of the risk of Gestational Diabetes (GDM).Patients and Methods: A total of 318 singleton pregnant women who underwent routine prenatal examinations at Qinhuangdao Maternal and Child Health Hospital from September 2017 to September 2020 were selected and categorized into the GDM group and the normal glucose tolerance group (NGT) based on the results of the oral glucose tolerance test (OGTT) conducted during the second trimester. The general information and laboratory test results were compared and analyzed. Inter-group comparison was conducted using the t-test, and multivariate logistic regression analysis was employed to analyze the independent risk factors of GDM. The predictive threshold of various indicators for GDM occurrence during pregnancy was determined using the subject’s work curve.Results: The GDM group exhibited significantly higher levels of pre-pregnancy weight, pre-pregnancy BMI, neck circumference, waist circumference, hip circumference, triglycerides (TG), uric acid (UA), TG/HDL-C ratio, and waist-hip ratio compared to the NGT group. Additionally, HDL cholesterol (HDL-C) levels were significantly lower in the GDM group, and blood glucose levels at each point of the OGTT were markedly higher compared to the NGT group (P< 0.05). Multivariate logistic regression analysis revealed that neck circumference (OR=1.239, P< 0.001) and early pregnancy TG (OR=1.842, P< 0.001) were independent risk factors for GDM. The receiver operating characteristic analysis demonstrated that the optimal critical value of neck circumference for predicting GDM was 32.6 cm, with a sensitivity of 50% and specificity of 74.3%.Conclusion: The neck circumference during early pregnancy was found to be related to GDM, and the predictive cutoff point of 32.6 cm for neck circumference could be employed as a simple index to predict GDM in early pregnancy.Keywords: neck circumference, gestational diabetes, obesity, predictive indicators

China’s economy is in a state of rapid development in today’s digital era, and big data technology has become a key force in promoting industrial upgrading and economic operation. The article first constructs 14 economic operation indexes in 7 aspects to establish the regional economic index system according to each type of regional economy. After researching BP neural networks, a TMBA-BP neural network prediction model based on adaptive t-distribution has been proposed. The prediction model is used to predict the economic development of Liaoning City, and the results show that the TMBABP prediction model is accurate. Finally, the Gini coefficient is combined with the TMBA-BP model to explore the causes of regional economic differentiation in China. In terms of the contribution rate of regional differences, the inter-regional contribution rate is higher than the intra-regional contribution rate. It indicates that in the big data environment, the main reasons for the obvious regional economic differentiation in China are inter-regional differences, followed by intra-regional differences.

Objectives: Portal venous gas (PVG) was an important clinical sign in stage II or III necrotizing enterocolitis (NEC) in preterm neonates. Not a proper predictive indicator was found to predict the diseases (NEC with the presence of PVG) up to now. There is a need to put forward predictive indicators and compare the predictive effects among them.Methods: We conducted a retrospective study of preterm neonates with NEC-PVG (n = 61) or NEC-non PVG (n = 62) from 2014 to 2021. Predictive indicators were put forward and determined by receiver operating characteristic curve analysis. An analysis of the surgical interventions and their outcomes was performed.Results: The incidence rate of NEC among preterm neonates was 4.99%; surgical and conservative interventions accounted for 20.47 and 75.07%, and the mortality rate was 0.03%. The composition ratio of shock in the NEC-PVG group increased 13.2% (P = 0.029). C-reactive protein, fibrinogen degradation product, and blood glucose had better predictive effects in the predictive indicators (P < 0.05). Intestinal necrosis and subependymal hemorrhage in the outcomes of surgical interventions had a strong relationship with the presence of PVG in NEC II/III (P < 0.05).Conclusion: Early and reasonable use of antibiotics, improvement of coagulation function, rectification of acidosis, and decreased blood glucose could cut down the occurrence of the disease (NEC with the presence of PVG). Except for subependymal hemorrhage and intestinal necrosis, NEC with the presence of PVG did not increase the occurrence of other outcomes after surgery.