To explore the effect and mechanism of alcohol withdrawal (AW) on the pain and inflammatory response of septic mice.

A total of 30 mice were randomly divided into a control group, a sepsis group [lipopolysaccharide (LPS) group], and an AW + sepsis group (AW + LPS group), with 10 mice in each group. Mice in the control group were fed normally for 14 days and injected with 0.1 mL isotonic NaCl solution via the tail vein on the 15th day. Mice in the LPS group received routine feeding for 14 days, followed by tail vein injection of 0.1 mL LPS solution on the 15th day. Mice in the AW + LPS group were given gradient alcohol feeding for 14 days, and injected with 0.1 mL LPS solution via the tail vein on the 15th day. Daily observations were made on the changes of mice' weight, water intake, food intake and behavior, and the pain assessments were conducted. Mice were euthanized to collect lung tissue for detecting the wet-to-dry weight ratio (W/D), measuring the protein and messenger RNA (mRNA) expression of inducible nitric oxide synthase (iNOS), and observing pathological slices via hematoxylin-eosin (HE) staining. Bronchoalveolar lavage fluid (BALF) was collected to detect the expression levels of tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6).

Compared with the control group, mice in the LPS group and AW + LPS group presented decreased body weight and markedly reduced water and food intake, with moderate pain. HE staining revealed obvious pulmonary edema, congestion, and increased infiltration of inflammatory cells in the lungs of mice in both the LPS group and the AW + LPS group. There were statistically significant differences in the lung W/D ratio, iNOS mRNA and protein expression, and BALF TNF-α and IL-6 levels among the three groups (F = 215.400, 20.270, 26.900, 2 318.000, 985.500; all P < 0.001). Compared with the control group, all the above indexes were significantly increased in the LPS group and AW + LPS group, with highest levels in the AW + LPS group (all P < 0.05).

AW aggravates sepsis-induced pain, pulmonary injury and systemic inflammatory response, which may be mediated by the regulation of iNOS protein.

To explore the relationship between the peripheral blood phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin (PI3K/Akt/mTOR) signaling pathway and the pulmonary function and prognosis in patients with idiopathic pulmonary fibrosis (IPF).

A total of 180 patients with IPF were selected as the study group, and another 100 healthy volunteers who underwent physical examinations were taken as the control group. The expression levels of peripheral blood PI3K, Akt and mTOR messenger RNA (mRNA) and the pulmonary function indicators [forced vital capacity (FVC), forced expiratory volume in one second (FEV₁) and FEV₁/FVC] of the two groups were detected and compared. Correlation between the PI3K/Akt/mTOR signaling pathway in peripheral blood and the lung function parameters of IPF patients was analyzed by Pearson correlation analysis. After one-year follow-up, the patients with IPF were divided into a good prognosis group (n = 94) and a poor prognosis group (n = 86) based on their prognosis. Multivariate logistic regression was used to analyze the influencing factors for their prognosis.

The expression levels of PI3K, Akt and mTOR mRNA in peripheral blood of the study group were higher than those of the control group, while the FVC, FEV₁ and FEV₁/FVC in the study group were lower than those in the control group (t = 15.263, 48.390, 45.704, 25.249, 37.731, 43.181; all P < 0.001). The expression of PI3K, Akt and mTOR mRNA in peripheral blood was negatively correlated with FVC, FEV₁ and FEV₁/FVC (all P < 0.05). Compared with the good prognosis group, patients in the poor prognosis group had higher PI3K, Akt and mTOR mRNA expression in peripheral blood and lower FVC, FEV₁ and FEV₁/FVC ratios, with older age (all P < 0.001). Advanced age, elevated PI3K, Akt and mTOR mRNA expression in peripheral blood, and decreased FVC, FEV₁ and FEV₁/FVC were risk factors for poor prognosis in IPF patients (all P < 0.05).

The upregulation of PI3K, Akt and mTOR mRNA expression in peripheral blood of IPF patients is closely associated with impaired lung function and poor prognosis.

To investigate the predictive efficacy of the comprehensive inflammatory prognostic index (CIPI) for 90-day clinical prognosis in patients with acute ischemic stroke (AIS) undergoing reperfusion therapy, and to provide medical evidence for optimizing the prognostic assessment system in this patient population.

A total of 1 327 AIS patients who underwent reperfusion therapy at the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital) from January 2022 to December 2024 were retrospectively enrolled. Baseline clinical data and routine blood test parameters obtained within 24 hours of symptom onset and before reperfusion therapy were collected to calculate the CIPI value. The modified Rankin scale (mRS) score at 90 days after symptom onset was set as the outcome measure, and patients were divided into a favorable prognosis group (mRS score 0-2) and an unfavorable prognosis group (mRS score 3-6). The baseline data between the two groups were compared. Univariate and multiple-model stepwise-adjusted logistic regression analyses were performed to analyze the association between CIPI and 90-day unfavorable prognosis. A restricted cubic spline (RCS) model was applied to explore the dose-response relationship between CIPI and the risk of unfavorable prognosis.

Among the 1 327 enrolled patients, 773 (58.25%) were assigned to the favorable prognosis group and 554 (41.75%) to the unfavorable prognosis group. The CIPI level in the unfavorable prognosis group was significantly higher than that in the favorable prognosis group [-0.302 (-2.147, 2.720) vs. -1.944 (-2.759, -0.061), Z = 9.078, P < 0.001]. Univariate logistic regression analysis showed that CIPI was a risk factor for 90-day unfavorable prognosis in AIS patients [odds ratio (OR) = 1.102, 95% confidence interval (CI) (1.071, 1.135), P < 0.001]. After stepwise adjustment for demographic characteristics, underlying medical history, and baseline National Institutes of Health Stroke Scale (NIHSS) score, CIPI remained an independent predictor of unfavorable prognosis [OR = 1.047, 95%CI (1.014, 1.082), P = 0.005]. The RCS model revealed a significant nonlinear association between CIPI and the risk of unfavorable prognosis (overall association P < 0.001, nonlinear association P < 0.001), with an accelerated upward trend in the risk of unfavorable prognosis as CIPI increased when CIPI ≥ -0.162.

CIPI is closely correlated with the 90-day prognosis of AIS patients undergoing reperfusion therapy. It is an independent predictor of unfavorable prognosis in this patient population, and can serve as a convenient assessment tool for early risk stratification of AIS after reperfusion therapy.

To identify risk factors for 3-year major adverse cardiovascular events (MACE) in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) using machine learning algorithms, least absolute shrinkage and selection operator (LASSO) regression, and differential analysis, and to develop a corresponding predictive model.

A total of 400 AMI patients who underwent PCI at Xiang'an Hospital of Xiamen University between January 2020 and December 2021 were retrospectively enrolled. Patients were divided into a MACE group (n = 102) and a good prognosis group (n = 298) according to the occurrence of adverse cardiovascular events within 3 years after PCI, and were further divided into a training set (n = 280) and a validation set (n = 120) in a 7 ∶ 3 ratio. Chi-square test, independent samples t-test, and Mann-Whitney U test were used for preliminary screening of potential risk factors. Random forest and LASSO regression were further applied to identify important clinical features associated with poor prognosis. A Venn diagram was used to obtain the intersection variables from the three methods. The "rms" package was used to construct a nomogram based on the selected variables. The predictive performance of the model was evaluated using receiver operating characteristic (ROC) curve analysis and decision curve analysis with the "pROC" and "rmda" packages.

The differential analysis and LASSO regression respectively identified 11 risk factors. Among the 15 features selected by the random forest model, five overlapping variables were identified, including heart rate, age, serum creatinine, hemoglobin, and left ventricular end-diastolic diameter. The nomogram constructed based on these five variables demonstrated good predictive performance, with an accuracy of 0.643 in the training set and 0.683 in the validation set. The area under the ROC curve was 0.649 [95% confidence interval (CI) (0.571, 0.726), P < 0.001] in the training set and 0.796 [95%CI (0.699, 0.892), P < 0.001] in the validation set.

Through machine learning, LASSO regression, and differential analysis, key factors influencing adverse events within 3 years after PCI in AMI patients are identified. The constructed predictive model has high value in forecasting such events.

To investigate the effect of early ambulation on postoperative rehabilitation in ICU patients undergoing liver transplantation.

Based on the intervention timing under the early progressive activity regimen, liver transplant patients between December 2022 and June 2024 were divided into an observation group and a control group, with 28 patients in each group. The observation group initiated a progressive activity regimen on the first post-transplantation day, while the control group began the same regimen on the seventh postoperative day. The clinical indicators (endotracheal tube retention time, gastric tube retention time, liver transplant ICU hospitalization time, and total hospitalization duration), recovery indicators [Rivermead mobility index (RMT) and manual muscle test (MMT)], and liver and kidney function indicators [alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin, urea, and creatinine] on the day before the operation (T0) and on the 2nd, 4th, 6th, 8th, 10th, 12th, and 14th days after the operation (T1 to T7) were compared between the two groups.

The endotracheal tube retention time (Z = 3.543, P < 0.001), gastric tube retention time (Z = 3.260, P = 0.001), liver transplant ICU hospitalization time (Z = 3.271, P = 0.001), and total hospitalization time (Z = 2.943, P = 0.003) of the observation group were all significantly shorter than those of the control group. Two weeks after the operation, the MMT (Z = 3.533, P < 0.001) and RMI (Z = 3.159, P = 0.002) of patients in the observation group were significantly higher than those in the control group. There were significant differences in the levels of ALT (χ² = 295.510, P < 0.001), AST (χ² = 311.721, P < 0.001), and total bilirubin (χ² = 145.279, P < 0.001) between the two groups at all time points before and after the operation. Moreover, the levels of ALT and AST in the observation group were much lower than those in the control group at the T2 time point (both P < 0.05), and the total bilirubin level in the observation group was much lower than that in the control group during the T5 to T7 period (all P < 0.05). There were no statistically significant differences in the levels of urea (F = 3.433, P = 0.069) and creatinine (F = 0.063, P = 0.803) at all time points before and after the operation between the two groups.

Early ambulation after liver transplantation is beneficial for postoperative recovery.