南方医科大学学报杂志最新文献

{"title":"[A Transformer-based multimodal model for predicting hospital-acquired infections using imaging and clinical laboratory data].","authors":"Mingxu Zhang, Diheng Wu, Jiaze Lin, Yijun Lü, Linghong Zhou, Xin Zhen, Hao Zhou, Genggeng Qin","doi":"10.12122/j.issn.1673-4254.2026.06.22","DOIUrl":"10.12122/j.issn.1673-4254.2026.06.22","url":null,"abstract":"<p><strong>Objectives: </strong>To construct a Transformer-based multimodal data encoding model for predicting hospital-acquired infections (HAI).</p><p><strong>Methods: </strong>Laboratory test data of 300 000 patients were extracted from the publicly available MIMIC-IV database. The laboratory data of 1172 patients and chest X-ray images from 274 of these patients were collected from Nanfang Hospital. A novel Transformer-based encoding model was developed to process the data, which was then connected to a machine learning classifier for predicting HAI. The radiomic and deep learning features were extracted from the chest X-ray images for predicting ventilator-associated pneumonia (VAP). These imaging features were subsequently integrated with the laboratory test data using a feature fusion algorithm. The model performance was evaluated by assessing the accuracy, the area under the ROC curve (AUC), sensitivity, and specificity. The proposed algorithm was quantitatively compared against traditional machine learning classifiers to validate its effectiveness and feasibility.</p><p><strong>Results: </strong>The results demonstrated that the model developed in this study achieved an AUC of 0.989 in the internal validation set. In the external validation set, the optimal model for predicting HAI attained an AUC of 0.98, and following the integration of imaging features, the optimal model reached an AUC of 0.93 in the VAP prediction task, demonstrating superior performance over the baseline models.</p><p><strong>Conclusions: </strong>The Transformer-based model for processing laboratory test data has excellent predictive capability and good clinical applicability for HAI prediction with also good performance for predicting VAP.</p>","PeriodicalId":18962,"journal":{"name":"南方医科大学学报杂志","volume":"46 6","pages":"1423-1433"},"PeriodicalIF":0.0,"publicationDate":"2026-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13294750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148318248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[MS-DTNet: an efficient model combining multi-scale convolution and dual-tower attention for detecting abnormal heart sounds].","authors":"Yaoqi Wen, Xueqi Lu, Qiucen Wu, Huayuan Chen, Chaomin Chen","doi":"10.12122/j.issn.1673-4254.2026.06.24","DOIUrl":"10.12122/j.issn.1673-4254.2026.06.24","url":null,"abstract":"<p><strong>Objectives: </strong>To develop an efficient model for detecting abnormal heart sounds and providing technical support for automated phonocardiogram (PCG) analysis.</p><p><strong>Methods: </strong>The proposed model, MS-DTNet, integrates multi-scale convolution and a dual-tower attention mechanism. The network employs depthwise separable convolution to achieve a lightweight architecture, applies multi-scale convolution to capture features across receptive fields in parallel, utilizes a dual-tower structure to extract both short- and long-term temporal information, and incorporates a flipped-attention mechanism to further enhance feature representation. Experiments were conducted on the public CinC2016 dataset using 5-fold cross-validation.</p><p><strong>Results: </strong>In the abnormal heart sound classification task, the proposed model achieved an average accuracy of 94.49%, a specificity of 93.44%, a sensitivity of 95.49%, a precision of 93.81%, F1-score of 94.64%, and ROC-AUC of 98.65%, outperforming all the comparison models.</p><p><strong>Conclusions: </strong>The proposed MS-DTNet model demonstrates excellent performance in PCG classification and provides technical assistance for multi-source heart sound analysis and clinical decision support.</p>","PeriodicalId":18962,"journal":{"name":"南方医科大学学报杂志","volume":"46 6","pages":"1444-1454"},"PeriodicalIF":0.0,"publicationDate":"2026-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13294741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148318353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Image-guided application of plant pigment patch and laser microdot ablation for surface marking in radiotherapy for breast cancer: a randomized controlled trial].","authors":"Liangyi Fang, Dehuan Xie, Dianyi Huang, Qinwen DU, Shasha DU, Teng Zhu, Hengwen Sun","doi":"10.12122/j.issn.1673-4254.2026.06.21","DOIUrl":"10.12122/j.issn.1673-4254.2026.06.21","url":null,"abstract":"<p><strong>Objectives: </strong>To validate the non-inferiority of plant-based pigment patches as surface markers for postoperative radiotherapy localization in breast cancer, evaluate their accuracy, durability and safety, and identify the factors influencing pigment fading to determine the patients eligible for these patches.</p><p><strong>Methods: </strong>In this randomized controlled trial, 80 patients receiving their first course of postoperative radiotherapy for breast cancer were randomly assigned in a 1:1 ratio to plant-based pigment patch group (trial group) or conventional laser microdot tattoo group (control group). The primary outcome was 3-dimensional setup error (non-inferiority margin: 0.7 mm). The secondary outcomes included uniaxial errors, re-marking frequency, skin adverse events, patient comfort, and healthcare satisfaction. Linear mixed-effects models and Cox regression were used for data analyses.</p><p><strong>Results: </strong>The baseline characteristics of the patients were balanced between the two groups. The trial group demonstrated non-inferiority to the control group in setup accuracy (3-dimensional error: 3.12±1.14 mm <i>vs</i> 3.05±0.98 mm; mean difference: 0.07 mm; 95% <i>CI</i>: -0.31 to 0.45; upper limit <0.7 mm). No significant differences were observed in the uniaxial errors. Patient comfort scores were significantly higher in the trial group (4.23±0.65 <i>vs</i> 0.15±0.82, <i>P</i><0.001). The incidence of skin adverse events was zero in the trial group but 12.5% in the control group (<i>P</i><0.05). Multivariable Cox regression identified oily skin (HR=2.78, <i>P</i><0.001), frequent sweating (HR=3.02, <i>P</i><0.001), frequent washing (HR=1.42, <i>P</i><0.05), and a high BMI (HR=1.32, <i>P</i><0.05) as independent risk factors for faster pigment fading, while the use of a protective agent was a protective factor (HR=0.47, <i>P</i>=0.019).</p><p><strong>Conclusions: </strong>Plant-based pigment patches are non-inferior to conventional laser microdots and offer comparable positioning accuracy with superior comfort and safety.</p>","PeriodicalId":18962,"journal":{"name":"南方医科大学学报杂志","volume":"46 6","pages":"1416-1422"},"PeriodicalIF":0.0,"publicationDate":"2026-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13294736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148318230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Elevation of red blood cell distribution width to hematocrit ratio is associated with increased 28-day all-cause mortality in septic patients].","authors":"Ziyu Wang, Jingwen Wu, Hanbing Wang, Yan Xu, Chunling Jiang, Li Zhou","doi":"10.12122/j.issn.1673-4254.2026.06.06","DOIUrl":"10.12122/j.issn.1673-4254.2026.06.06","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the association between the red blood cell distribution width to hematocrit (RDW/HCT) ratio and 28-day all-cause mortality in patients with sepsis.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using the MIMIC-IV database (27 335 adult patients), and the eICU-CRD database was used for external validation (17 406 adult patients). The patients were grouped by RDW/HCT ratio quartiles. The primary outcome was 28-day all-cause mortality. Kaplan-Meier survival curves were used to assess the survival rates. Multivariable Cox regression and restricted cubic spline (RCS) analyses were performed to examine the association between RDW/HCT ratio and patient mortality. Subgroup analyses were conducted to assess the robustness of the findings.</p><p><strong>Results: </strong>The 28-day mortality rates were 19.3% in the MIMIC-IV cohort and 16.0% in the eICU-CRD cohort. In the MIMIC-IV cohort, Kaplan-Meier analysis showed that a higher RDW/HCT ratio was associated with an increased risk of 28-day mortality in septic patients (log-rank <i>P</i><0.0001). Multivariable Cox regression analysis suggested that an elevated RDW/HCT ratio was an independent risk factor for 28-day mortality in septic patients (HR=1.89, 95% <i>CI</i>: 1.52-2.36, <i>P</i><0.001). RCS analysis showed a non-linear, U-shaped relationship between the RDW/HCT ratio and 28-day mortality of septic patients. No significant interactions were observed in subgroup analyses. The trends in the eICU-CRD validation cohort were consistent with those observed in the MIMIC-IV cohort. <b>Conclusio</b>n Elevation of the RDW/HCT ratio is associated with an increased 28-day all-cause mortality rate in patients with sepsis.</p>","PeriodicalId":18962,"journal":{"name":"南方医科大学学报杂志","volume":"46 6","pages":"1256-1266"},"PeriodicalIF":0.0,"publicationDate":"2026-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13294752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148318216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Impact of HIV-1 genotypes and population mobility on HIV-1 transmission in Guangzhou: a molecular transmission network analysis].","authors":"Weiping Huang, Huanchang Yan, Shunming Li, Hao Wu, Yanshan Cai, Zhigang Han, Shixing Tang","doi":"10.12122/j.issn.1673-4254.2026.06.19","DOIUrl":"10.12122/j.issn.1673-4254.2026.06.19","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the impact of HIV-1 genotypes and population mobility on HIV-1 transmission in Guangzhou to obtain evidence for devising precision prevention and control strategies.</p><p><strong>Methods: </strong>Demographic data and HIV-1 pol sequences were obtained from 6783 newly diagnosed people living with HIV (PLWH) in 2008-2020 in Guangzhou, including 24.0% local Guangzhou residents, 0.9% mobile Guangzhou residents, 56.4% local non-Guangzhou residents, and 18.6% mobile non-Guangzhou residents. HIV-1 genotypes were determined and molecular transmission networks were constructed using HIV-TRACE. Degree centrality and multinomial logistic regression were used to identify the key characteristics of the PLWH and risk factors of HIV-1 transmission.</p><p><strong>Results: </strong>Among the PLWH, the dominated HIV-1 genotypes were CRF07_BC (39.6%), CRF01_AE (33.0%), and CRF55_01B (11.9%), and 43.3% of the PLWH formed 596 transmission clusters. Compared with subtype B, CRF01_AE (aOR=1.384, 95% <i>CI</i>: 1.072-1.798), CRF07_BC (aOR=2.462, 95% <i>CI</i>: 1.911-3.192), CRF55_01B (aOR=3.209, 95% <i>CI</i>: 2.424-4.271), and CRF59_01B (aOR=2.149, 95% <i>CI</i>: 1.437-3.219) were more likely to cluster. Population mobility was not associated with overall HIV-1 transmission, and local Guangzhou residents were more likely to be involved in CRF08_BC transmission (aOR=4.241, 95% <i>CI</i>: 1.494-12.790), whereas migrants had lower odds of transmitting CRF01_AE (aOR=0.740, 95% <i>CI</i>: 0.576-0.946) and subtype B (aOR=0.429, 95% <i>CI</i>: 0.182-0.922). The characteristics of high-risk individuals for HIV-1 transmission included local Guangzhou residents (aOR=1.390, 95% <i>CI:</i> 1.141-1.695), men (aOR=4.449, 95% <i>CI</i>: 2.402-8.242), MSM (aOR=1.783, 95% <i>CI</i>: 1.414-2.248), and infection with CRF07_BC (aOR=3.062, 95% <i>CI</i>: 1.963-4.777) or CRF55_01B (aOR=5.031, 95% <i>CI</i>: 3.159-8.014).</p><p><strong>Conclusions: </strong>Local Guangzhou residents, though accounting for only 24.9% in the PLWH, have a high risk of HIV-1 transmission, to which HIV-1 genotypes and MSM are also important contributors. Molecular network analysis provide important assistance for precision prevention and control of HIV-1 transmission.</p>","PeriodicalId":18962,"journal":{"name":"南方医科大学学报杂志","volume":"46 6","pages":"1395-1406"},"PeriodicalIF":0.0,"publicationDate":"2026-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13294727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148318202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Targeted inhibition of miR-503 upregulates Apelin expression to alleviate myocardial infarction in mice].","authors":"Jin Li, Yijie He, Fangfang Bi, Junxin Chen, Zhenyan Fan, Yu Zhang, Enyu Chen, Hongwen Xiao, Yun Wu, Hua Tian, Yuhong Zhou","doi":"10.12122/j.issn.1673-4254.2026.06.04","DOIUrl":"10.12122/j.issn.1673-4254.2026.06.04","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the effect of inhibiting miR-503 on myocardial infarction (MI) and clarify its upstream regulatory factors and downstream effector pathways to identify potential therapeutic targets for MI.</p><p><strong>Methods: </strong>Mouse models of MI established by ligation of the left anterior descending coronary artery were treated with intravenous injections of normal saline, antagomir-503 or antagomiR-NC (<i>n</i>=5). Cardiac function and infarct size of the mice were evaluated by echocardiography and TTC staining, respectively. Primary neonatal rat cardiomyocytes with hypoxic exposure were treated with AMO-503 or its negative control, and the changes in miR-503 expression was detected by qRT-PCR. Cell viability, injury, apoptosis, mitochondrial membrane potential, and ultrastructure were assessed using MTT assay, LDH release assay, TUNEL staining, JC-1 staining, and transmission electron microscopy, respectively. Western blotting was performed to detect the changes in apoptosis-related proteins and the key targets.</p><p><strong>Results: </strong>MiR-503 expression was significantly upregulated in both MI mouse hearts and hypoxic cardiomyocytes. In MI mouse models, antagomir-503 significantly improved cardiac function, reduced infarct size, downregulated Bax and cleaved caspase-3 expressions, and upregulated Apelin expression. In hypoxic neonatal rat cardiomyocytes, treatment with AMO-503 significantly enhanced cell viability, decreased cell apoptosis rate, and restored mitochondrial membrane potential. Mechanistically, the long non-coding RNA AK134630 could bind to and negatively regulate miR-503, and inhibition of miR-503 effectively relieved the inhibitory effect of RNA AK134630 on the downstream target gene Apelin.</p><p><strong>Conclusions: </strong>Inhibition of miR-503 alleviates MI injury in mice by upregulating Apelin expression to inhibit cardiomyocyte apoptosis and protect mitochondrial function, and AK134630 participates in this regulatory mechanism as an upstream ceRNA of miR-503.</p>","PeriodicalId":18962,"journal":{"name":"南方医科大学学报杂志","volume":"46 6","pages":"1235-1243"},"PeriodicalIF":0.0,"publicationDate":"2026-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13294734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148318041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[<i>Trillium tschonoskii</i> Maxim saponin protects neurological function in rats with post-stroke cognitive impairment by promoting ER-phagy].","authors":"Dan Yang, Fangyu Zhao, Yiduo He, Hong Zhu, Xin Liu, Xianbing Chen","doi":"10.12122/j.issn.1673-4254.2026.06.016","DOIUrl":"10.12122/j.issn.1673-4254.2026.06.016","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the mechanism that mediates the neuroprotective effects of <i>Trillium tschonoskii</i> Maxim (TTM) against post-stroke cognitive impairment (PSCI) in rats.</p><p><strong>Methods: </strong>Adult SD rats were randomized into Sham operation, PSCI model, TTM, rapamycin (an autophagy inducer), 3-methyladenine (an autophagy inhibitor), and TTM+3-MA groups, and rat models of cognitive impairment were established using a modified thread occlusion method. Cognitive function of the rats was assessed using Morris water maze test. Histopathological changes, neuronal apoptosis, dendritic spines, and protein expressions of FAM134B, LC3, ATG5, P62, GRP78, Bax, Bcl-2, IL-10, IL-1β, and TNF-α were evaluated using HE, Nissl, TUNEL, Golgi staining, immunohistochemistry, immunofluorescence staining, and Western blotting.</p><p><strong>Results: </strong>Compared with the sham-operated rats, the rat models of PSCI showed significantly prolonged escape latency, reduced target quadrant time and platform crossings, severe hippocampal damage, increased ATG5 and GRP78 expression, elevated apoptosis, increased IL-1β, TNF-α, Bax, GRP78, and P62 expressions, and decreased IL-10, Bcl-2, and LC3 expressions, with slightly increased FAM134B-LC3 and calnexin-LC3 co-localization. Compared with those in the model group, the rats receiving TTM treatment showed significantly shortened escape latency, increased target quadrant time and platform crossings, increased ATG5 and dendritic spines, decreased GRP78 expression, enhanced FAM134B-LC3 and calnexin-LC3 co-localization, reduced IL-1β, TNF-α, Bax, GRP78, and P62 expressions, and increased FAM134B, ATG5, LC3, IL-10, and Bcl-2 expressions; the rats treated with 3-MA showed the opposite changes.</p><p><strong>Conclusions: </strong>Excessive ER stress is activated early after stroke, shifting from adaptive to pro-apoptotic signaling, with insufficient ER-phagy flux. TTM modulates ER-phagy, alleviates ERS, reduces neuroinflammation and apoptosis, protects dendritic spines, and improves cognitive function in rats with PSCI.</p>","PeriodicalId":18962,"journal":{"name":"南方医科大学学报杂志","volume":"46 6","pages":"1365-1373"},"PeriodicalIF":0.0,"publicationDate":"2026-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13294743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148318240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Tongmai Yangxin</i> pills alleviate myocardial ischemia-reperfusion injury by enhancing mitochondrial function <i>via</i> activating the ERK signaling pathway.","authors":"Yanyan Wang, Zhihui Song, Liuli Guo, Yang Xiao, Rui Chen, Yi Wang","doi":"10.12122/j.issn.1673-4254.2026.06.01","DOIUrl":"10.12122/j.issn.1673-4254.2026.06.01","url":null,"abstract":"<p><p><b>BACKGROUND</b>: To explore the mechanism of <i>Tongmai yangxin</i> pills (TMYX) for improving myocardial ischemia-reperfusion injury (MIRI) in rats. <b>METHODS</b>: In a SD rat model of MIRI, the therapeutic effects of TMYX were evaluated by cardiac echography, measurement of myocardial infarction area, and examination of myocardial pathology, myocardial enzymes, and serum levels of inflammatory cytokines. In cultured H9c2 cells, the protective effects of aqueous extract of TMYX in the presence or absence of an ERK inhibitor against hypoxia/reoxygenation (H/R) injury and on mitochondrial function were evaluated by assessing cell viability, apoptosis, reactive oxygen species (ROS) levels, cytoplasmic and mitochondrial Ca²⁺ concentrations, mitochondrial membrane potential, mitochondrial permeability transition pore (mPTP) opening, and mitochondrial respiration. The mitochondria-related indicators were measured to validate the role of the ERK signaling pathway in mediating the alleviating effect of TMYX on mitochondrial function in H9c2 cells with H/R injury. <b>RESULTS</b>: In rat models of MIRI, TMYX significantly improved cardiac function, alleviated myocardial injury, and reduced inflammatory factor levels, oxidative stress, and myocardial infarction area. In H9c2 cells with H/R injury, TMYX treatment obviously enhanced H9c2 cell viability, increased cellular ATP and ATPase levels and mitochondrial membrane potential, and reduced cell apoptosis rate, ROS level, and mPTP opening. The application of the ERK inhibitor significantly attenuated the protective effect of TMYX on mitochondrial function of H9c2 cells with H/R injury. <b>CONCLUSION</b>: TMYX alleviate MIRI in rats by promoting mitochondrial function <i>via</i> activating the ERK signaling pathway.</p>","PeriodicalId":18962,"journal":{"name":"南方医科大学学报杂志","volume":"46 6","pages":"1203-1215"},"PeriodicalIF":0.0,"publicationDate":"2026-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13294737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148318080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Effect of intraoperative dexmedetomidine on postoperative sleep disturbance in elderly surgical patients: a prospective multicenter cohort study].","authors":"Bingbing Meng, Chang Liu, Guosong Liao, Kai Zhang, Muze Yang, Juanjuan Gu, Jingsheng Lou, Yanhong Liu, Qiang Fu, Jiangbei Cao, Weidong Mi, Hao Li","doi":"10.12122/j.issn.1673-4254.2026.06.03","DOIUrl":"10.12122/j.issn.1673-4254.2026.06.03","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the association between intraoperative dexmedetomidine administration and postoperative sleep disturbance in elderly patients undergoing noncardiac surgeries.</p><p><strong>Methods: </strong>This prospective observational study included patients aged ≥65 years undergoing noncardiac surgeries between April, 2020 and April, 2022 in multiple hospitals. The primary outcome was the incidence of postoperative sleep disturbance within 3 days after surgery, assessed using the Sleep Quality-Numeric Rating Scale. The secondary outcomes included the incidences of sleep disturbance on the night of surgery and two subsequent nights, postoperative severe pain, postoperative delirium, acute kidney injury, stroke and pulmonary infection. Univariate and multivariate logistic regression analyses were conducted to explore the relationship between dexmedetomidine and postoperative sleep disturbance. Propensity score matching was used to balance the baseline characteristics, and subgroup analyses were performed to explore the association between dexmedetomidine and postoperative sleep disturbance.</p><p><strong>Results: </strong>Among the 5245 patients, 1352 (25.78%) developed postoperative sleep disturbance within 3 days after surgery. The incidence of postoperative sleep disturbance was significantly lower in dexmedetomidine group than in the non-dexmedetomidine group (unadjusted: 21.0% <i>vs</i> 27.9%, <i>P</i><0.001; PSM: 20.7% <i>vs</i> 25.4%, <i>P</i><0.001). Dexmedetomidine was significantly associated with a reduced risk of postoperative sleep disturbance (unadjusted: OR=0.69, 95% <i>CI</i>: 0.60-0.79, <i>P</i><0.001; Model I: OR=0.76, 95% <i>CI</i>: 0.66-0.87, <i>P</i><0.001; Model II: OR=0.75, 95% <i>CI</i>: 0.65-0.87, <i>P</i><0.001; PSM: OR=0.77, 95% <i>CI</i>: 0.65-0.91, <i>P</i><0.001), and the association remained significant in subgroup analyses for gender, ASA classification, surgery duration, and surgical types). The incidences of severe postoperative pain, postoperative delirium and pulmonary infection were all significantly lower in dexmedetomidine group.</p><p><strong>Conclusions: </strong>Intraoperative dexmedetomidine administration is associated with reduced postoperative sleep disturbance in elderly patients undergoing noncardiac surgery and lowers the incidences of severe postoperative pain, postoperative delirium and pulmonary infections.</p>","PeriodicalId":18962,"journal":{"name":"南方医科大学学报杂志","volume":"46 6","pages":"1228-1234"},"PeriodicalIF":0.0,"publicationDate":"2026-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13294735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148318228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Development and validation of an interpretable machine learning model for predicting reguirement of early invasive mechanical ventilation in patients with acute pancreatitis].","authors":"Xixuan Wu, Tong Sha, Hongbin Hu, Maomao Sun, Jie Wu, Zhongqing Chen","doi":"10.12122/j.issn.1673-4254.2026.06.14","DOIUrl":"10.12122/j.issn.1673-4254.2026.06.14","url":null,"abstract":"<p><strong>Objectives: </strong>To explore the risk factors for early respiratory failure in patients with acute pancreatitis (AP) and develop an interpretable machine learning model to predict the need for invasive mechanical ventilation (MV) within 72 h of ICU admission.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted using data of adult patients with acute pancreatitis from the MIMIC-IV database, excluding those receiving invasive MV at ICU admission. The primary outcome was initiation of invasive MV within 72 h after ICU admission. Multiple machine learning models were developed and internally validated, and the best-performing model was externally validated using the eICU-CRD database. Model interpretability was assessed using SHapley Additive exPlanations (SHAP).</p><p><strong>Results: </strong>A total of 517 patients with acute pancreatitis from the MIMIC-IV database were included, with 361 assigned to the training cohort and 156 to the internal testing cohort; 269 patients from the eICU-CRD database were included as the external validation cohort. The patients who developed early respiratory failure exhibited more severe organ dysfunction at ICU admission. The random forest model achieved an AUC of 0.908 in the training cohort, 0.733 in the internal testing cohort, and 0.681 in the external validation cohort. SHAP analysis identified sequential organ failure assessment (SOFA) score, use of vasoactive agents, and acute kidney injury (AKI) as the most important predictive factors.</p><p><strong>Conclusions: </strong>The interpretable machine learning model demonstrates moderate predictive performance in both the internal and external validation cohorts and can be used for early risk assessment of invasive MV in patients with acute pancreatitis. The key predictive variables primarily reflect multi-organ dysfunction consistent with the underlying pathophysiological mechanisms of acute pancreatitis.</p>","PeriodicalId":18962,"journal":{"name":"南方医科大学学报杂志","volume":"46 6","pages":"1339-1348"},"PeriodicalIF":0.0,"publicationDate":"2026-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13294751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148318204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}