Abstract:Objective To investigate the value of high-frequency musculoskeletal ultrasound imaging in the diagnosis of lateral collateral ligament injuries of the ankle joint.Methods A total of 79 patients with lateral collateral ligament injuries of the ankle joint admitted to the General Hospital of Northern Theater Command of PLA from July 2020 to July 2024 were enrolled.Using MRI and surgical results as the gold standard,musculoskeletal ultrasound imaging was performed before surgery to evaluate the accuracy and compare the diagnostic efficacy.Results The accuracy rate of high-frequency musculoskeletal ultrasound imaging in diagnosing lateral collateral ligament injuries of the ankle joint was 97.47％.The sensitivity for type Ⅲ ligament injuries was 90.9％,which was higher than that for type Ⅰ and type Ⅱ injuries.The diagnostic rates of high-frequency musculoskeletal ultrasound imaging for injuries in different sites(calcaneofibular ligament,anterior talofibular ligament,and posterior talofibular ligament)were 90％,100％,and 100％,respectively,with no statistically significant differences among them(P＞0.05).There were no significant differences in accuracy,sensitivity,and missed diagnosis rate between high-frequency musculoskeletal ultrasound imaging and magnetic resonance examination or surgical exploration(P＞0.05).Conclusion High-frequency musculoskeletal ultrasound imaging can dynamically observe the lateral collateral ligament of the ankle joint,clearly display the type and degree of ligament injury,and reflect the differences in various diagnostic efficacy indicators among different ligament types.It provides an effective basis for early targeted clinical treatment and the prompt recovery of patients.

Abstract:Objective To analyze and compare the predictive performance of six machine learning models,namely logistic regression(LR),linear discriminant analysis(LDA),decision tree(DT),random forest(RF),CatBoost,and LightGBM,in predicting the risk of retinopathy in patients with type 2 diabetes.Methods Based on the early warning dataset of diabetic complications from the National Population Health Data Center,retinopathy risk prediction models for type 2 diabetic patients were constructed based on different algorithms.After data cleaning,the training dataset and test dataset were divided according to 7∶3,and the prediction performance(accuracy,recall,precision,F1-Score,and AUC)of the six models was compared using the ten-fold cross-validation method.Results In the test dataset,six models were used to predict the risk of retinopathy in patients with type 2 diabetes,and LightGBM exhibited the highest accuracy(0.773 8),recall(0.825 1),precision(0.762 0),F1-Score(0.792 3),and AUC(0.843 4).CatBoost followed with accuracy(0.744 1),recall(0.787 8),precision(0.729 1),F1-Score(0.757 3),and AUC(0.828 0).Conclusion For predicting the risk of retinopathy in patients with type 2 diabetes,LightGBM performs the best among the six models.Additionally,ensemble learning classifiers(LightGBM,CatBoost,and RF)outperform weak learning classifiers(DT,LR,and LDA)in terms of predictive performance,offering a convenient and reliable reference for clinical auxiliary diagnosis and risk prediction of retinal complications in patients with type 2 diabetes.

Abstract:Objective To investigate the dynamic regulation of DNA damage-inducible transcript 4(DDIT4)in the adaptation of hepatocellular carcinoma(HCC)cells to hypoxic microenvironments and its impact on malignant behavior.Methods A hypoxic model of HCC cells was established using CoCl2 to simulate hypoxic conditions,and the expression of DDIT4 was detected.A stable DDIT4 knockdown cell line was constructed using lentivirus-mediated RNA interference.Cell proliferation and autophagy were assessed using CCK-8 and Western blotting.Transcriptomic and metabolomic sequencing were employed to analyze changes in metabolic pathways.The phosphorylation level of key mTORC1 site(Ser2448)was detected to elucidate the molecular regulatory mechanisms.Results Hypoxic treatment induced dynamic changes in DDIT4 expression in HepG2 cells,with a peak at 24 h followed by a significant decline at 48 h(P＜0.01).DDIT4 knockdown significantly enhanced cell proliferation(P＜0.01)and inhibited autophagic flux(P＜0.05).Integrated transcriptomic and metabolomic analyses further revealed that DDIT4 deficiency led to abnormalities in glycolysis and purine metabolism,along with imbalances in redox homeostasis.Mechanistically,DDIT4 deficiency significantly increased the phosphorylation activity of mTORC1(Ser2448)(P＜0.05).Conclusion Through dynamical regulation of mTORC1 pathway,DDIT4 coordinates hypoxic adaptation of HCC and relieves stress damage through upregulation in the early phase,while its later depletion triggers excessive mTORC1 activation,driving metabolic reprogramming and malignant proliferation.Analyzing the dynamic regulation of DDIT4 in different stages of hypoxia may provide novel therapeutic strategies to overcome clinical challenges in HCC,including chemoresistance and postoperative recurrence.

Abstract:Robot-assisted laparoscopic technology has gradually developed since the end of the 20th century,with high-quality 3D surgical field imaging and sub-millimeter operational accuracy,promoting the innovation of precision and minimally invasive urological surgery.In radical prostatectomy,robot technology significantly improves postoperative urinary control and sexual function recovery through improved surgical techniques such as Retzius space preservation,Hood technique,and posterior approach,and has a lower positive margin and biochemical recurrence rate than open and laparoscopic surgery.Robot-assisted partial nephrectomy achieves the goal of"Trifecta" by shortening the warm ischemia time and reducing renal function damage,and its perioperative outcomes are superior to those of open and laparoscopic procedures.For radical nephrectomy combined with removal of inferior vena cava tumor thrombus,robot technology can reduce intraoperative bleeding and complications,but it requires multidisciplinary collaboration and optimization of preoperative neoadjuvant therapy.Robot-assisted radical cystectomy has shown outstanding performance in bleeding control and minimally invasive procedures,but complete internal urinary diversion still needs to be promoted.In addition,robot technology has demonstrated safety and minimally invasive advantages in areas such as adrenal tumor resection,ureteral reconstruction,and kidney transplantation,especially showing great potential in complex cases.Although robot technology has limitations such as lack of tactile feedback and high cost,the rapid development of domestic systems and the remote application of 5G provide new opportunities for its popularization.In the future,with the integration of AI technology,robotic surgery will further break through in the two aspects of"precision"and"remote",promoting the development of minimally invasive urology.

Abstract:Objective To explore the differences in postoperative renal function among robot-assisted,laparoscopic,and open partial nephrectomy(PN)for T1b renal tumors.Methods A retrospective analysis was conducted on clinical data from 246 patients with T1b renal tumors who underwent PN at Xijing Hospital,Air Force Medical University from March 2009 to April 2023.The patients were divided into three groups:open partial nephrectomy(OPN)group(n=98),laparoscopic partial nephrectomy(LPN)group(n=102),and robot-assisted partial nephrectomy(RAPN)group(n=46).The estimated glomerular filtration rate(eGFR)and eGFR decline were compared among the three groups at 3 months,6 months,1 year,2 years,3 years,4 years,and 5 years postoperatively.Results The median follow-up duration was 12(6,48)months.Preoperative eGFR was higher in the LPN group compared to the OPN group(P=0.002)and higher in the RAPN group compared to the OPN group(P＜0.001),with no significant difference between LPN group and RAPN group(P=0.211).During follow-up,statistically significant differences in eGFR were observed among the groups at 3 months and 6 months postoperatively(P＜0.05),but no significant differences were found at 1-5 years postoperatively(P＞0.05).Pairwise comparisons at 3 months postoperatively showed higher eGFR in the LPN group(P=0.002)and RAPN group(P＜0.001)compared to the OPN group,with no significant difference between LPN group and RAPN group(P=0.108).At 6 months postoperatively,eGFR remained higher in the LPN group(P=0.010)and RAPN group(P=0.033)compared to the OPN group,with no significant difference between LPN group and RAPN group(P=0.940).For eGFR decline,significant differences were observed among the groups at 3 months postoperatively(P=0.044),but no significant differences were found at 6 months and 1-5 years postoperatively(P＞0.05).Pairwise comparisons at 3 months postoperatively showed greater eGFR decline in the OPN group compared to the LPN group(P=0.016),but no significant differences were observed between OPN group and RAPN group(P=0.102)or between LPN group and RAPN group(P=0.609).Conclusion The OPN group has worse baseline eGFR and greater eGFR decline at 3 months postoperatively,suggesting that minimally invasive techniques offer better early renal function preservation compared to traditional OPN.The long-term eGFR at 1-5 years postoperatively is similar among the three surgical procedures.Taking into account the preoperative baseline differences,it suggests that OPN may have a stronger protective effect on long-term renal function after surgery for T1b renal tumors.

Abstract:In 1975,human parvovirus B19(B19V),which is only pathogenic to humans,was first discovered,but research has found that it existed for thousands of years.Due to the time limit of literature,B19V outbreak was recorded only in a unit or country.As for the harm of B19V to humans,it is generally believed that it is mostly mild,and typical manifestations and characteristic diseases are often introduced.However,their atypical manifestations,disability and mortality are not well understood.Since the beginning of 2024,sudden outbreaks of B19V infection have been reported in the United States and more than ten countries in Europe.The affected populations are mainly children and pregnant women,with child deaths and fetal loss posing significant risks.For atypical cases,diagnosis is often delayed due to difficulty in identifying B19V infection.This article briefly introduces the characteristics of B19V,the complexity and atypia of its manifestations,diagnostic criteria,the key problems of both outbreak period and long-term response strategies,providing suggestions for China to deal with the outbreak and final resolution of B19V infection.

Abstract:The characteristics of new aircraft,new combat requirements,and special flight environments pose higher demands on the physical and mental qualities of pilots,bringing new challenges to aviation medical support.Domestic teams have focused on the actual combat needs of aviation units,conducted research on key technologies for aviation medical support,created new simulation training technologies of vestibular function and vestibular illusion,developed high-altitude micro pressure training cabins and underwater escape training equipment,formulated comprehensive prevention and treatment plans for neck and waist injuries,and promoted solutions to key issues that restrict the operational efficiency of pilots.This paper summarizes the technological breakthroughs and theoretical innovations in the field of aviation medical support in China in recent years,as well as the positive role played by the application of these achievements in improving the operational efficiency of pilots,which has certain guiding significance for promoting the disciplinary development of aviation medicine.

Abstract:Objective To investigate the role of microRNA-210,a bioactive substance of exosomes(exos)derived from bone marrow mesenchymal stem cells(BMSCs),in mice after myocardial infarction(MI)to evaluate its potential clinical value in MI.Methods BMSCs-exos were extracted,identified and analyzed by electron microscopy and Western blotting.All mice were randomly divided into four groups:Sham group(only thoracotomy without ligation),MI group(thoracotomy and left anterior descending artery ligation),MI+BMSCs-exos group(left anterior descending artery ligation followed by injection of BMSCs-exos),MI+BMSCs-exos+microRNA-210 inhibitor group(left anterior descending artery ligation followed by injection of BMSCs-exos transfected with microRNA-210 inhibitor).After the mouse model of MI was established by left anterior descending coronary artery ligation,exos or exos transfected with microRNA-210 inhibitor were infused intramuscularly around the infarcted myocardium immediately.MicroRNA-210 was extracted from myocardial tissues of each group and its expression was detected by PCR.The cardiac function was tested by echocardiography.The MI area was measured after Evans blue staining of the heart.The apoptosis of cardiomyocytes in each group was detected by TUNEL.The expression of apoptosis-related proteins in cardiomyocytes was detected by Western blotting.Results Compared with Sham group,left ventricular ejection fraction(LVEF)and left ventricular fractional shortening(LVFS)in MI group were significantly decreased,the MI area was significantly increased,the apoptosis level of cardiomyocytes was significantly increased,the apoptosis-related protein Bcl-2 expression was significantly decreased,and Bax expression was significantly increased(P＜0.05).Compared with MI group,LVEF and LVFS in MI+BMSCs-exos group were significantly increased,MI area was significantly decreased,myocardial apoptosis level was significantly decreased,apoptosis-related protein Bcl-2 expression was significantly increased,and Bax expression was significantly decreased(P＜0.05).Compared with MI+BMSCs-exos group,LVEF and LVFS in MI+BMSCs-exos+microRNA-210 inhibitor group were significantly decreased,MI area was significantly increased,myocardial apoptosis level was significantly increased,apoptosis-related protein Bcl-2 expression was significantly decreased,and Bax expression was significantly increased(P＜0.05).Conclusion BMSCs-exos inhibit apoptosis via microRNA-210,thereby improving the cardiac function of mice after MI and reducing MI area of mice,and playing a certain protective role in MI.

Abstract:Objective To compare and analyze the safety and effectiveness of carotid endarterectomy(CEA)and carotid artery stenting(CAS)in the treatment of carotid artery stenosis,and explore the differences in clinical efficacy between the two surgical methods.Methods A prospective analysis was conducted on the clinical data of 161 patients with carotid artery stenosis who received CEA or CAS treatment from September 2018 to September 2021.Results After 1 year of follow-up,both groups of patients underwent B-ultrasound at 6 months and 1 year of follow-up.The plaque detection rate and restenosis rate in CEA group were significantly lower than those in CAS group(P＜0.01).The improvement of postoperative National Institutes of Health Stroke Scale(NIHSS)and Mini-Mental State Examination(MMSE)in CEA group was better than that in CAS group(P＜0.01).For patients with mild infarction before surgery,the improvement of modified Rankin Scale(mRS)in CEA group was better than that in CAS group(P＜0.01),and the difference was statistically significant.Conclusion The plaque detection rate of B-ultrasound follow-up at 6 months and 1 year after surgery in CEA group is significantly lower than that in CAS group,and the restenosis rate in CEA group is lower than that in CAS group.After treatment,both groups are able to improve the neurological and cognitive function of patients.The CEA group shows better improvement in postoperative NIHSS and MMSE.For patients with preoperative infarction,CEA shows more significant improvement in mRS.

Abstract:Objective To investigate whether carotid artery shunting can reduce cerebral ischemia-reperfusion injury(IRI)after carotid endarterectomy(CEA).Methods This study was an observational case-control study.Patients who underwent CEA in the Department of Neurosurgery from January 2019 to December 2022 were collected in the Stroke Construction Center database of Tangdu Hospital,Air Force Medical University.A total of 340 patients were divided into two groups.The shunting group included 142 patients who underwent carotid artery shunting,while the control group included 198 patients who did not undergo carotid artery shunting.The indications for carotid artery shunting were severe bilateral internal carotid artery(ICA)stenosis(＞70％),severe ICA stenosis(＞70％)with contralateral ICA occlusion,and ICA subocclusion.The incidence of in-hospital and early postoperative stroke,postoperative IRI,and neurological system were compared between the two groups.Results Cranial nerve injury occurred significantly more frequently in patients in the shunt group compared with the control group(6.3％vs 2.8％).The incidence of postoperative IRI after CEA in the shunt group was significantly lower than that in the control group(P=0.02).During the postoperative follow-up,there were no significant differences in stroke,mortality,and vascular restenosis between the two groups.Conclusion Our findings suggest that carotid artery shunting significantly reduces the incidence of cerebral IRI after CEA in high-risk patients compared with the control group.

Abstract:Objective To investigate the relationship between pancreatic stiffness and pancreatic islet function in patients with type 2 diabetes mellitus(T2DM)by using virtual touch tissue quantification(VTQ)technique.Methods A total of 120 hospitalized T2DM patients(89 males and 31 females),with a mean age of(52.38±12.81)years and diabetes duration of(7.82±6.28)years,were collected in Department of Endocrinology,Tangdu Hospital,Air Force Medical University from June 2020 to January 2021.All subjects underwent anthropometric measurements and fasting blood glucose,fasting C-peptide,glycosylated hemoglobin and other biochemical indicators.VTQ technique was used to measure the pancreatic stiffness.Patients were divided into groups according to the tertiles of pancreatic stiffness,and the C-peptide levels of different pancreatic stiffness groups were compared by one-way ANOVA.Pearson correlation analysis and multiple stepwise linear regression analysis were used for statistical correlation analysis.Results The C-peptide levels decreased gradually with the increase of pancreatic stiffness(F=8.241,P＜0.05).Pearson correlation analysis showed that pancreatic stiffness was positively correlated with diabetes duration(r=0.339,P＜0.01),and negatively correlated with C-peptide levels(r=-0.308,P＜0.01).Multiple linear regression analysis showed that pancreatic stiffness and diabetes duration were independent influencing factors of C-peptide levels(standardized regression coefficients β=-0.228,-0.051,P＜0.05).Conclusion Increased pancreatic stiffness is associated with decreased C-peptide levels.VTQ technique can be used to evaluate pancreatic stiffness,and pancreatic stiffness can be used as an indicator to measure pancreatic islet beta cell function in clinical practice.

Abstract:Objective To explore the psychological status and influencing factors of 1 242 epilepsy patients in rural areas of Shaanxi Province.Methods A cross-sectional study was conducted on patients with convulsive epilepsy who were enrolled in the Shaanxi Province Rural Epilepsy Prevention and Management Project from February 2012 to September 2020.The sociodemographic data and seizure symptomatology information of epilepsy patients were collected through questionnaire survey,and the epilepsy-related psychological burden score was assessed.K-means clustering algorithm in the field of machine learning was used to divide the epilepsy patients into low psychological burden and high psychological burden groups based on the scores of epilepsy-related psychological burden.Multivariate logistic regression analysis was used to analyze the influencing factors of epilepsy-related psychological burden.Results A total of 1 242 patients participated in this study,and 1 109(89.3％)patients showed varying degrees of epilepsy-related psychological burden,with the most common concern being epilepsy recurrence,accounting for 77.4％.There were 454(36.6％)patients in the high psychological burden group,with the most concerning issue being accidental injury,accounting for 96.9％.Multivariate logistic regression analysis showed that unmarried/divorced status,seizure frequency≥24 times/year before treatment,annual family income＜36 000 yuan,and uncontrolled seizures in the past year were risk factors for higher psychological burden in epilepsy patients in rural areas(P＜0.05).Conclusion Nearly 90％of the patients show varying degrees of epilepsy-related psychological burden.Marital status,annual family income,and the condition of seizures are significantly correlated with epilepsy-related psychological burden in rural patients.It is necessary to strengthen epilepsy knowledge education and provide social support and psychological intervention for rural patients to improve their quality of life.

Abstract:Objective To explore the effects of perceived stress on emotional eating among military academy cadets and the chain mediating effects of anxiety and sleep quality,providing a basis for the training of healthy eating behaviors and psychological interventions among military academy cadets.Methods Using the Perceived Stress Scale,Adult Eating Behavior Scale,Self-Rating Anxiety Scale,and Pittsburgh Sleep Quality Index,a questionnaire survey was conducted among undergraduate students at a military academy in Xi'an,and a total of 777 valid questionnaires were collected.SPSS software was employed to conduct correlation analysis,regression analysis,and chain mediating effect analysis to test the mediating effects of anxiety and sleep quality between perceived stress and emotional eating.Results There were significant positive correlations between perceived stress and anxiety(r=0.612,P＜0.01),sleep quality(r=0.492,P＜0.05),and emotional eating(r=0.327,P＜0.05).Anxiety and sleep quality had partial mediating effects between perceived stress and emotional eating,and there was also a chain mediating effect between them,with the mediating effect accounting for 49.32％of the total effect.Conclusion The perceived stress of military academy cadets can indirectly affect emotional eating behaviors through anxiety and sleep quality.It is recommended to help cadets cope with stress and reduce emotional eating behaviors through psychological counseling and improving the sleep environment.

Abstract:Objective To analyze the mechanism of Xiaochaihu decoction in preventing and treating Mycoplasma pneumoniae pneumonia(MPP)in children by using network pharmacology and molecular docking.Methods The effective active ingredients of Xiaochaihu decoction were retrieved through the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform,and the prescription-related targets were obtained through UniProt.The related targets of MPP in children were collected from GeneCards,DrugBank and CTD databases.Jvenn software was used to obtain the intersection targets of drugs and diseases,and STRING database was used to obtain the relevant information of the protein-protein interaction(PPI)of the intersection targets.Cytoscape 3.10.2 software was used to draw the"drug-component-target"network diagram and PPI network diagram.GO functional enrichment and KEGG pathway enrichment analyses were performed for intersection targets.AutoDockTools 1.5.7 software was used to predict the binding energy of small molecule ligands and biological macromolecular receptors,and PyMOL software was used to map and display the molecular docking results.Results A total of 159 active ingredients and 286 targets of Xiaochaihu decoction were screened,and a total of 88 intersection targets of drugs and disease targets were found.GO functional enrichment analysis showed that it involved 947 biological processes,and KEGG pathway enrichment analysis showed that it mainly involved 187 signaling pathways.Its related signaling pathways mainly included AKT1,IL6,TNF,JUN,PTGS2,TP53,etc.Molecular docking suggested that the active ingredients of the prescription had good binding power with the core targets.Conclusion Xiaochaihu decoction may act on multiple targets such as AKT1,JUN,and PTGS2 through quercetin,kaempferol,and β-sitosterol to inhibit inflammatory reactions and regulate immune function,thereby preventing MPP in children.

Abstract:Objective To explore the changes of serum lactic acid(LAC)level before and after hyperbaric oxygen(HBO)treatment in high-altitude pulmonary edema(HAPE)and its correlation with prognosis.Methods In this study,165 HAPE patients who received HBO treatment in Wenzhou People's Hospital from June 2020 to June 2023 were selected,and general data,blood routine parameters,blood biochemical tests,liver and kidney function,coagulation function indexes,inflammatory factor levels and other related clinical data of the subjects were statistically analyzed.According to the evaluation criteria of efficacy,patients with curative effect were divided into good prognosis group(n=118),and patients with effective and ineffective efficacy were divided into poor prognosis group(n=47).Logistic regression was used to analyze the relationship between LAC and prognosis of HBO treatment in HAPE patients.Subgroup analysis was performed to analyze the correlation between LAC and the risk of poor prognosis after HBO treatment in HAPE patients.Locally weighted scatterplot smoothing(LOWESS)was used to analyze the two-dimensional curve relationship of continuous variables.The interaction between blood flow in cerebral microcirculation and vascular growth factor was analyzed.The dose-response relationship between blood flow in cerebral microcirculation and poor prognosis was analyzed by restricted cubic splines.Finally,decision curve analysis(DCA)of blood flow in cerebral microcirculation was performed.Results Compared with before HBO treatment,there were statistically significant differences in heart rate,respiratory frequency,arterial oxygen saturation,arterial partial pressure of carbon dioxide,arterial partial pressure of oxygen,albumin(Alb),globulin(Glb),red blood cell count,LAC,lactate dehydrogenase(LDH),blood uric acid,urine uric acid,serum aspartate aminotransferase(AST),α-hydroxybutyrate dehydrogenase(α-HBDH),and creatine kinase(CK)in HAPE patients after treatment(P＜0.05).Among the HAPE patients treated with HBO,the indexes of Alb,Glb,LAC,LDH,AST,α-HBDH and CK in the poor prognosis group were significantly higher than those in the good prognosis group(P＜0.05).Multivariate logistic regression analysis showed that LAC,LDH,Alb,α-HBDH and CK were independent influencing factors of poor prognosis in HAPE patients(P＜0.05).In the Alb,LDH,α-HBDH and CK subgroups,there was a stable correlation between LAC and the risk of poor prognosis after HBO treatment in HAPE patients,and there was no interaction between subgroups(Pinteraction＞0.05).LOWESS analysis showed that Alb,LDH,α-HBDH,CK and LAC all had a certain nonlinear relationship,and LAC was positively correlated with Alb,LDH,α-HBDH and CK(P＜0.05).Restricted cubic spline analysis showed that the continuous change of LAC was correlated with poor prognosis in a nonlinear dose-response manner,and LAC was positively correlated with poor prognosis(P＜0.05).When LAC was greater than the cutoff value of 1.56 mmol/L,the risk of poor prognosis increased significantly with the increase of LAC level.DCA showed that LAC had important clinical value in predicting the prognosis of patients.Conclusion High-level LAC is an independent factor affecting the poor prognosis of HAPE patients,and it is positively correlated with poor prognosis.This index may be helpful to evaluate the prognosis of HAPE patients.

Abstract:The incidence of post-traumatic stress disorder(PTSD)is increasing year by year,but the traumatic events leading to PTSD and their consequences are often ignored by patients.Recent evidence suggests that the formation of fear memories and the occurrence of stress-related diseases are accompanied by morphological and functional remodeling of astrocytes.In this paper,we review the existing studies on the role of astrocytes in the pathogenesis of PTSD.Astrocytes synthesize and secrete neurotrophic,pro-and anti-inflammatory factors and regulate the microenvironment of central nervous system through metabolic pathways,ion homeostasis control,and clearance of neurotransmitters.Stress or trauma can cause damage to these important functions of astrocytes,which leads to the pathophysiological evolution of PTSD.Because of the above important role of astrocytes,they may become an effective potential target for PTSD treatment.

Abstract:Objective To train the sample features by using support vector machine(SVM)algorithm,and to use machine learning for mental health status,so as to realize automatic classification and recognition.Methods Firstly,undersampling method was used to solve the problem of sample imbalance,then normalization method was used to control the scores of all indicators in an interval,and samples were trained by selecting different kernel functions of SVM.Finally,hyperparameters were tuned by grid search to obtain the best parameter combination,and the samples were tested again to obtain the evaluation report of the model.Results The results showed that the accuracy,recall and F1-Score of the algorithm based on Sigmoid and RBF kernel functions were improved after grid search parameter tuning.Conclusion This paper provides an idea for the intelligent assessment of psychological risk,which can be applied to other scenarios with a little modification.

Abstract:Objective To compare the clinical efficacy of vaginal natural orifice transluminal endoscopic surgery(vNOTES)and traditional laparoscopic surgery(LAP)for total hysterectomy in large uteri,and to explore the clinical application value of vNOTES.Methods A retrospective analysis was conducted on patients who underwent total hysterectomy for benign lesions with a uterine mass ≥ 500 g at the Department of Gynecology,Wenzhou People's Hospital from January 2021 to January 2023.Patients were divided into vNOTES group(n=56)and LAP group(n=58).The general data,operative time,intraoperative blood loss,postoperative pain scores,hospital stay,postoperative complications,and related functional recovery were compared between the two groups.Results No significant differences were observed in baseline characteristics between the two groups.The vNOTES group demonstrated significantly shorter operative time[(157.31±31.73)min vs(178.37±47.68)min,P=0.007],reduced time to first postoperative flatus[(22.15±5.84)h vs(30.00±8.75)h,P=0.001],shorter hospital stay[(3.05±0.49)d vs(4.33±1.27)d,P=0.001],and lower postoperative pain scores[(1.33±1.36) vs(3.96±1.18),P=0.001)compared to the LAP group.No significant differences were found in intraoperative blood loss,postoperative complication rates,and functional recovery between the two groups.Conclusion vNOTES significantly shortens operative time and hospital stay while reducing postoperative pain scores in total hysterectomy for large uteri,aligning with the concept of enhanced recovery after surgery.It is a promising technique worthy of clinical promotion.

Abstract:Objective To investigate the factors influencing the willingness of medical freshmen to engage in learning behavior and to propose corresponding teaching strategies based on the extended theory of planned behavior.Methods Firstly,the theoretical hypothesis model of learning behavior willingness was constructed based on the extended theory of planned behavior.Then,a random sample of freshmen from a certain medical college was surveyed using questionnaires to investigate their willingness to engage in learning behavior and the influencing factors.Descriptive statistics were used to analyze the characteristics of the respondents and the current status of their learning behavior willingness.Structural equation modeling was used to verify the influencing factors of learning behavior willingness.Finally,according to the survey results,teaching strategies were proposed.Results A total of 433 effective questionnaires were collected in this survey.The average scores of the three items in the learning behavior willingness scale were approximately 4.220±1.079,4.240±1.065,and 4.230±1.077,respectively.The fitting values of the constructed structural equation modeling were all within the acceptable range.The ranking of the variables influencing learning behavior willingness was as follows:striving for success attribution(0.360)＞perceived usefulness(0.302)＞learning self-efficacy(0.163)＞avoiding failure attribution(0.066),among which avoiding failure attribution was a negative influencing factor,and the rest were positive influencing factors.Based on the above results,the following teaching strategies were proposed:①Cultivate freshmen's cognition of the importance of learning;②Strengthen freshmen's confidence in university learning;③Guide freshmen to make correct attributions about learning.Conclusion The learning behavior willingness of medical college freshmen are influenced by multiple factors,and targeted teaching strategies need to be adjusted to stimulate their learning enthusiasm and improve teaching effectiveness.

Abstract:Macrophages,as essential components of the innate immune system,play a pivotal role in the anti-tumor immune response by directly phagocytosing tumor cells or through the secretion of cytokines and antigen presentation,which activates T cells after phagocytic activation.Nonetheless,tumor cells often elude macrophage attacks by overexpressing phagocytic checkpoint molecules such as CD47,PD-L1,or CD24.These molecules act on macrophages,transmitting inhibitory signals that suppress their phagocytic activity and facilitating immune evasion.Blocking the phagocytic checkpoint signals in macrophages to restore their capacity to eliminate tumor cells has emerged as a key strategy to enhance the effectiveness of tumor immunotherapy,as evidenced by clinical trials.This review primarily outlines the identified macrophage phagocytic checkpoint molecules and their blockade application in anti-tumor immune therapy,while also envisioning the future development of macrophage phagocytosis checkpoint blockade in anti-tumor immunotherapy.