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  1. Article: Machine Learning Predictive Model for Septic Shock in Acute Pancreatitis with Sepsis.

    Xia, Yiqin / Long, Hongyu / Lai, Qiang / Zhou, Yiwu

    Journal of inflammation research

    2024  Volume 17, Page(s) 1443–1452

    Abstract: Objective: Acute pancreatitis (AP) progresses to septic shock can be fatal. Early identification of high-risk patients and timely intervention can prevent and interrupt septic shock. By analyzing the clinical characteristics of AP with sepsis, this ... ...

    Abstract Objective: Acute pancreatitis (AP) progresses to septic shock can be fatal. Early identification of high-risk patients and timely intervention can prevent and interrupt septic shock. By analyzing the clinical characteristics of AP with sepsis, this study uses machine learning (ML) to build a model for early prediction of septic shock within 28 days of admission, which guided emergency physicians in resource allocation and medical decision-making.
    Methods: This retrospective cohort study collected data from the emergency departments (EDs) of three tertiary care hospitals in China. The dataset was randomly divided into a training dataset (70%) and a testing dataset (30%). Ten ML classifiers were utilized to analyze characteristics of AP with sepsis in the training dataset upon admission. Results were evaluated through cross-validation analysis. The optimal model was then tested on the testing dataset without any parameter modifications. The ML model was evaluated using the receiver operating characteristic curve (ROC) and compared to scoring systems through the DeLong test.
    Results: A total of 604 AP patients with sepsis were included in this study. The auto-encoder (AE) model based on mean normalization, Pearson correlation coefficient (PCC), and recursive feature elimination (RFE) selection, achieved the highest Area Under the Curve (AUC) on the validation dataset (AUC 0.900, accuracy 0.868), with the AUC of 0.879 and accuracy of 0.790 on the testing dataset. Compared to the Sequential Organ Failure Assessment (AUC 0.741), quick Sequential Organ Failure Assessment (AUC 0.727), Acute Physiology and Chronic Health Evaluation II (AUC 0.778), and Bedside Index of Severity in Acute Pancreatitis (AUC 0.691), the AE model showed superior performance.
    Conclusion: The AE model outperforms traditional scoring systems in predicting septic shock in AP patients with sepsis within 28 days of admission. This assists emergency physicians in identifying high-risk patients early and making timely medical decisions.
    Language English
    Publishing date 2024-03-05
    Publishing country New Zealand
    Document type Journal Article
    ZDB-ID 2494878-0
    ISSN 1178-7031
    ISSN 1178-7031
    DOI 10.2147/JIR.S441591
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Development and Validation of a Rapid and Efficient Prognostic Scoring System for Sepsis Based on Oxygenation Index, Lactate and Glasgow Coma Scale.

    Lai, Qiang / Xia, Yiqin / Yang, Wentao / Zhou, Yiwu

    Journal of inflammation research

    2023  Volume 16, Page(s) 2955–2966

    Abstract: Objective: To develop a concise scoring system for efficient and rapid assessment of sepsis prognosis applicable to emergency departments.: Methods: This was a single-center retrospective cohort study of patients with sepsis. In this study, a new ... ...

    Abstract Objective: To develop a concise scoring system for efficient and rapid assessment of sepsis prognosis applicable to emergency departments.
    Methods: This was a single-center retrospective cohort study of patients with sepsis. In this study, a new scoring system (oxygenation index, lactate, and Glasgow coma scale: GOL) was developed through a derivation group, and then the GOL was validated using a validation group. Multivariate logistic regression analysis was performed to investigate the relationship between GOL and 28-day adverse outcomes. The GOL was compared with the previous scoring system using receiver operating characteristic curves (ROC) and decision analysis curves. The endpoints of this study were mortality, mechanical ventilation (MV), and admission to the intensive care unit (AICU).
    Results: 608 patients were included in the derivation group and 213 patients in the validation group, with 131 and 42 deaths, respectively. In the validation group, lactate (Lac), oxygenation index (PaO
    Conclusion: The GOL is a simple, rapid, and accurate method for early identification of patients at increased risk of in-hospital death from sepsis.
    Language English
    Publishing date 2023-07-18
    Publishing country New Zealand
    Document type Journal Article
    ZDB-ID 2494878-0
    ISSN 1178-7031
    ISSN 1178-7031
    DOI 10.2147/JIR.S418531
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: The effect of externally applied traditional Chinese medicine in diabetic foot: A systematic review and meta-analysis of 34 RCTs.

    Yang, Yan-Wu / Zhou, Yi-Wu / Ge, Mei-Ling

    Foot (Edinburgh, Scotland)

    2023  Volume 56, Page(s) 102045

    Abstract: Aim: This study aimed to investigate the clinical efficacy of externally applied Traditional Chinese Medicine (TCM) on diabetic foot.: Methods: We searched the China Knowledge Network (CNKI), Wanfang Database, PubMed and Web of Science from inception ...

    Abstract Aim: This study aimed to investigate the clinical efficacy of externally applied Traditional Chinese Medicine (TCM) on diabetic foot.
    Methods: We searched the China Knowledge Network (CNKI), Wanfang Database, PubMed and Web of Science from inception to July 31, 2022, to find all randomized control trials (RCTs) related to externally applied TCMs in diabetic foot treatment. Information about the total effective rate, healing rate, and healing time were extracted. In addition, the relative risk (RR)/odds ratio (OR) or standardized mean difference (SMD) and 95 % confidence interval (CI) were calculated.
    Results: Finally, a total of 34 RCTs including 3758 patients were included in this meta-analysis. There were 5 articles that reported hydropathic compress with astrogalin, 14 articles that reported MEBO burn cream, 9 articles that reported compound cortex phellodendri liquid and 6 articles that reported Shengji Yuhong ointment. Compared with the basic treatment, the externally applied TCM (astrogalin, MEBO burn cream, compound cortex phellodendri liquid and Shengji Yuhong ointment) combined with basic treatment improved the total effective rate (RR = 1.31 [1.20, 1.42], P < 0.0001) and healing rate (RR = 1.84 [1.56, 2.17], P < 0.0001) and shortened the healing time (SMD = - 2.51 [- 3.39, - 1.63], P < 0.0001).
    Conclusion: Our systematic review and meta-analysis revealed that common TCM applied externally could significantly improve the clinical efficacy comparing to the basic treatment.
    Language English
    Publishing date 2023-07-23
    Publishing country Scotland
    Document type Journal Article ; Review
    ZDB-ID 1070358-5
    ISSN 1532-2963 ; 0958-2592
    ISSN (online) 1532-2963
    ISSN 0958-2592
    DOI 10.1016/j.foot.2023.102045
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Early prediction models for extended-spectrum β-lactamase-producing Escherichia coli infection in emergency department: A protocol for systematic review and meta analysis.

    Zhou, Yiwu / Zhang, Shu

    Medicine

    2021  Volume 100, Issue 15, Page(s) e25504

    Abstract: Background: Resistance in gram-negative bacteria has gained great importance in recent decades and one reason is the rapid increase of extended spectrum β-lactamase (ESBL)-producing bacteria as a growing problem worldwide. The increasing proportion of ... ...

    Abstract Background: Resistance in gram-negative bacteria has gained great importance in recent decades and one reason is the rapid increase of extended spectrum β-lactamase (ESBL)-producing bacteria as a growing problem worldwide. The increasing proportion of ESBL-producing Enterobacteriaceae (ESBL-E) infections acquired in the emergency community is a new feature of ESBLs epidemiology. Early recognition of patients with extended-spectrum β-lactamase-producing Escherichia coli infection is important in the emergency department. To mitigate the burden on the healthcare system, while also providing the best possible care for patients, early recognition of the infection is needed.
    Methods: For the acquisition of required data of eligible prospective/retrospective cohort study or randomized controlled trials (RCTs), we will search for publications from PubMed, Web of science, EMBASE, Cochrane Library, Google scholar. Two independent reviewers will read the full English text of the articles, screened and selected carefully, removing duplication. Then we evaluate the quality and analyses data by Review Manager (V.5.4). Results data will be pooled and meta-analysis will be conducted if there's 2 eligible studies considered.
    Results: This systematic review and meta-analysis will evaluate the value of the early prediction models for Extended-spectrum β-lactamase-producing E coli infection in emergency department.
    Conclusions: This systematic review and meta-analysis will provide clinical evidence for predicting Extended-spectrum β-lactamase-producing E coli infection in emergency department, inform our understanding of the value of the predictive model in predicting Extended-spectrum β-lactamase-producing E coli infection in emergency department in the early stage. The conclusions drawn from this study may be beneficial to patients, clinicians, and health-related policy makers.
    Study registration number: INPLASY202130049.
    MeSH term(s) Adult ; Clinical Decision Rules ; Cross-Sectional Studies ; Early Diagnosis ; Emergency Service, Hospital ; Escherichia coli/enzymology ; Escherichia coli Infections/diagnosis ; Female ; Humans ; Male ; Meta-Analysis as Topic ; Prospective Studies ; Randomized Controlled Trials as Topic ; Research Design ; Retrospective Studies ; Systematic Reviews as Topic ; beta-Lactam Resistance ; beta-Lactamases/analysis
    Chemical Substances beta-Lactamases (EC 3.5.2.6)
    Language English
    Publishing date 2021-04-13
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80184-7
    ISSN 1536-5964 ; 0025-7974
    ISSN (online) 1536-5964
    ISSN 0025-7974
    DOI 10.1097/MD.0000000000025504
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Potential biomarkers in hypoglycemic brain injury.

    Zhao, Shuquan / Liu, Zihao / Ma, Longda / Yin, Min / Zhou, Yiwu

    Forensic science, medicine, and pathology

    2023  

    Abstract: Oxidative stress is a major underlying mechanism in hypoglycemic brain injury. Several oxidative stress-related proteins were identified through previous proteomics and literature review. The aim of the present study was to evaluate the potential of ... ...

    Abstract Oxidative stress is a major underlying mechanism in hypoglycemic brain injury. Several oxidative stress-related proteins were identified through previous proteomics and literature review. The aim of the present study was to evaluate the potential of these proteins as biomarkers in hypoglycemic brain injury. Forty male Sprague Dawley rats were randomly and equally divided into four groups: control, acute hypoglycemia, hypoglycemia resuscitation 24 h, and hypoglycemia resuscitation 7 days. The hypoglycemic brain injury rat model was successfully constructed according to the Auer model. Real-time fluorescent quantitative polymerase chain reaction, western blot analysis, and immunohistochemical staining were used to quantify the expression of oxidative stress-related proteins. We also verified the expression level of selected protein in the brain samples of fatal insulin overdose cases. The expression of oxidative stress-related proteins PEX1/5/12 was down-regulated in hypoglycemic brain injury (P < 0.05), while the expressions of DJ-1 and NDRG1 were up-regulated (P < 0.05). Compared with the control group, the serum oxidative stress indexes SOD and MDA in the acute hypoglycemia group were significantly different (P < 0.01). The expressions of DJ-1 and NDRG1 in the hippocampus, cortex, and hypothalamus of rats were increased (P < 0.05). The expressions of DJ-1 and NDRG1 proteins in the cortex of the autopsy samples of insulin overdose were increased (P < 0.05). Oxidative stress-related proteins showed potential value as specific molecular markers in hypoglycemic brain injury, but further confirmatory studies are needed.
    Language English
    Publishing date 2023-07-19
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2195904-3
    ISSN 1556-2891 ; 1547-769X
    ISSN (online) 1556-2891
    ISSN 1547-769X
    DOI 10.1007/s12024-023-00681-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Hydrogen sulfide poisoning in forensic pathology and toxicology: mechanism and metabolites quantification analysis.

    Zhang, Jiaxin / Ma, Longda / Liu, Yu / Tong, Xin / Zhou, Yiwu

    Critical reviews in toxicology

    2023  Volume 52, Issue 9, Page(s) 742–756

    Abstract: Historically, hydrogen sulfide ( ... ...

    Abstract Historically, hydrogen sulfide (H
    MeSH term(s) Hydrogen Sulfide ; Forensic Pathology ; Thiosulfates ; Forensic Toxicology
    Chemical Substances Hydrogen Sulfide (YY9FVM7NSN) ; Thiosulfates
    Language English
    Publishing date 2023-02-21
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1097071-x
    ISSN 1547-6898 ; 1040-8444
    ISSN (online) 1547-6898
    ISSN 1040-8444
    DOI 10.1080/10408444.2023.2168177
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Early prediction models for prognosis of diabetic ketoacidosis in the emergency department: A protocol for systematic review and meta-analysis.

    Li, Qin / Lv, Lin / Chen, Yao / Zhou, Yiwu

    Medicine

    2021  Volume 100, Issue 21, Page(s) e26113

    Abstract: Background: Diabetic ketoacidosis (DKA) is one of the most serious complications after diabetes poor control, which seriously threatens human life, health, and safety. DKA can rapidly develop within hours or days leading to death. Early evaluation of ... ...

    Abstract Background: Diabetic ketoacidosis (DKA) is one of the most serious complications after diabetes poor control, which seriously threatens human life, health, and safety. DKA can rapidly develop within hours or days leading to death. Early evaluation of the prognosis of DKA patients and timely and effective intervention are very important to improve the prognosis of patients. The combination of several variables or characteristics is used to predict the poor prognosis of DKA, which can allocate resources reasonably, which is beneficial to the early classification intervention and clinical treatment of the patients.
    Methods: For the acquisition of required data of eligible prospective/retrospective cohort study or randomized controlled trials (RCTs), we will search for publications from PubMed, Web of science, EMBASE, Cochrane Library, Google scholar, China national knowledge infrastructure (CNKI), Wanfang and China Science and Technology Journal Database (VIP). Two independent reviewers will read the full English text of the articles, screened and selected carefully, removing duplication. Then we evaluate the quality and analyses data by Review Manager (V.5.4). Results data will be pooled and meta-analysis will be conducted if there's 2 eligible studies considered.
    Results: This systematic review and meta-analysis will evaluate the value of the prediction models for the prognosis of DKA in the emergency department.
    Conclusions: This systematic review and meta-analysis will provide clinical basis for predicting the prognosis of DKA. It helps us to understand the value of predictive models in evaluating the early prognosis of DKA. The conclusions drawn from this study may be beneficial to patients, clinicians, and health-related policy makers.
    Study registration number: INPLASY202150023.
    MeSH term(s) Diabetic Ketoacidosis/diagnosis ; Early Diagnosis ; Emergency Service, Hospital ; Humans ; Meta-Analysis as Topic ; Models, Statistical ; Prognosis ; Systematic Reviews as Topic
    Language English
    Publishing date 2021-05-31
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80184-7
    ISSN 1536-5964 ; 0025-7974
    ISSN (online) 1536-5964
    ISSN 0025-7974
    DOI 10.1097/MD.0000000000026113
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Identification of a murder caused by brodifacoum poisoning based on clinical examinations and LC-MS/MS results.

    Yu, Zhonghao / Zhao, Erjuan / Shi, Qing / Yuan, Yuhao / Ma, Jinghong / Zhou, Luwang / Duan, Yijie / Zhou, Yiwu

    International journal of legal medicine

    2024  

    Abstract: Brodifacoum exerts its antagonistic effect against the metabolism of vitamin K, an essential component in the synthesis of blood coagulation factors. This effect ultimately hinders the blood's capacity to clot effectively, rendering it a commonly ... ...

    Abstract Brodifacoum exerts its antagonistic effect against the metabolism of vitamin K, an essential component in the synthesis of blood coagulation factors. This effect ultimately hinders the blood's capacity to clot effectively, rendering it a commonly employed rodenticide. Instances of lethal poisonings are exceedingly rare owing to expeditious medical intervention and treatment. Within this report, we present a case of brodifacoum-induced homicide, wherein the patient exhibited distinct clinical examinations and symptoms. Moreover, the patient's blood sample exhibited a noteworthy brodifacoum concentration of 0.681 µg/mL even after a period of 43 days following the incident of poisoning. Although an autopsy was not conducted due to religious restrictions, we endeavor to reasonably deduce the cause of death and furnish corroborative evidence for clinical diagnosis, treatment, and forensic examination in instances involving brodifacoum poisoning.
    Language English
    Publishing date 2024-03-05
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1055109-8
    ISSN 1437-1596 ; 0937-9827
    ISSN (online) 1437-1596
    ISSN 0937-9827
    DOI 10.1007/s00414-024-03198-z
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: A rare case of respiratory failure associated with spinal cord injury caused by stabbing with scissors and a knife.

    Yuan, Yuhao / Yin, Min / Zhao, Shuquan / Shi, Qing / Yu, Zhonghao / Zhou, Yiwu

    Forensic science, medicine, and pathology

    2023  

    Abstract: In forensic practice, spinal cord injury (SCI) resulting in death has rarely been reported. Here, we present the case of a 65-year-old woman who on admission was conscious without dyspnea or dysphagia. Physical examination revealed two sharp objects ... ...

    Abstract In forensic practice, spinal cord injury (SCI) resulting in death has rarely been reported. Here, we present the case of a 65-year-old woman who on admission was conscious without dyspnea or dysphagia. Physical examination revealed two sharp objects penetrating the neck: a pair of scissors lodged in the neck on the right side of the thyroid cartilage and a knife embedded in the nuchal region accompanied by minor seepage of bloody exudate. Radiography showed that the scissors and knife were retained in the cervical spine. Despite a series of medical interventions, the patient died 26 days later.
    Method: A systematic forensic autopsy was performed.
    Results: The cause of death was confirmed to be respiratory failure associated with SCI, which was caused by the combination of scissors and a knife.
    Conclusion: Based on this case, we believe that when there are multiple causes of death, forensic pathologists should determine the primary, immediate, contributory, and other causes of death to ascertain criminal responsibility.
    Language English
    Publishing date 2023-11-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2195904-3
    ISSN 1556-2891 ; 1547-769X
    ISSN (online) 1556-2891
    ISSN 1547-769X
    DOI 10.1007/s12024-023-00738-8
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  10. Article ; Online: Prognostic value of sarcopenia in older adults with transcatheter aortic valve implantation: A systematic review and meta-analysis.

    Yang, Yan-Wu / Pan, Pan / Xia, Xin / Zhou, Yi-Wu / Ge, Mei-Ling

    Archives of gerontology and geriatrics

    2023  Volume 115, Page(s) 105125

    Abstract: Objective: We conducted this systematic review and meta-analysis to summarize the prevalence of sarcopenia and its impact on mortality in patients undergoing TAVI.: Method: Medline, EMBASE, and PubMed were searched from inception to October 14, 2022 ... ...

    Abstract Objective: We conducted this systematic review and meta-analysis to summarize the prevalence of sarcopenia and its impact on mortality in patients undergoing TAVI.
    Method: Medline, EMBASE, and PubMed were searched from inception to October 14, 2022 to retrieve eligible studies that assessed sarcopenia in patients undergoing TAVI. Pooled sarcopenia prevalence was calculated with 95% confidence interval (CI), and heterogeneity was estimated using the I
    Results: 13 studies involving 5248 patients (mean age from 78.1 to 84.9 years) undergoing TAVI were included. There were eleven studies defined sarcopenia based on loss of skeletal muscle mass index (SMI), while only two studies used low muscle mass plus low muscle strength and/or low physical performance. Overall, the pooled prevalence of sarcopenia in patients undergoing TAVI was 49% (95% CI 41%-58%). Sarcopenia was associated with an increased risk of long-term (≥1 year) mortality in patients after TAVI (HR 1.57, 95% CI 1.33-1.85, P < 0.001), with similar findings in the subgroups stratified by follow-up time, definition of sarcopenia, study location, and study design. Furthermore, the 1-, 2-, and 3-year cumulative probabilities of survival in patients with sarcopenia were significantly lower than non-sarcopenia (74.0% vs 91.0%, 68.3% vs 78.0%, and 72.6% vs 79.8%, all P < 0.05).
    Conclusions: Although there are substantial differences in diagnostic criteria, sarcopenia is highly prevalent in patients undergoing TAVI and its linked to increased long-term mortality after TAVI.
    MeSH term(s) Aged ; Aged, 80 and over ; Humans ; Aortic Valve Stenosis/complications ; Aortic Valve Stenosis/surgery ; Prognosis ; Risk Factors ; Sarcopenia/etiology ; Sarcopenia/complications ; Transcatheter Aortic Valve Replacement/mortality ; Treatment Outcome
    Language English
    Publishing date 2023-07-11
    Publishing country Netherlands
    Document type Journal Article ; Meta-Analysis ; Research Support, Non-U.S. Gov't ; Systematic Review
    ZDB-ID 603162-6
    ISSN 1872-6976 ; 0167-4943
    ISSN (online) 1872-6976
    ISSN 0167-4943
    DOI 10.1016/j.archger.2023.105125
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