Abstract:Objective To investigate the mechanism of action of the plant sterol β-sitosterol on prostate cancer and its selectivity for cells with different androgen receptor(AR)statuses,providing new evidence for the treatment of prostate cancer and the transformation and application of plant sterols.Methods PC-3 cells with AR-negative and 22RV1 cells with AR-positive were used as models.Cell counting kit-8(CCK-8)and colony formation assays were conducted to detect the inhibitory effect on proliferation.Apoptosis detection and cell cycle analysis were performed to reveal the cell cycle arrest and pro-apoptotic mechanisms.Immunofluorescence,enzyme-Linked immunosorbent assay(ELISA)and real-time quantitative reverse transcription polymerase Chain reaction(RT-qPCR)were used to comprehensively analyze the regulation of Ki67 expression.Zebrafish experiments were further conducted to verify its in vivo anti-tumor activity and safety.Results β-sitosterol inhibited the proliferation of PC-3 and 22RV1 cells in a dose-dependent manner,with PC-3 cells being more sensitive.It promoted early and late apoptosis in both cell types,arrested the cell cycle at the G0/G1 phase,and inhibited the expression of Ki67 protein.In zebrafish,it could suppress the growth of xenograft tumors.Conclusion β-sitosterol inhibits the malignant behavior of prostate cancer cells through multiple pathways,with good safety in both in vitro and in vivo settings,providing a basis for its development as a natural anti-cancer drug.

Abstract:Objective To explore the potential active components and action targets of Qingyi Tongfu Decoction in the treatment of hyperlipidemic acute pancreatitis(HLAP)by using network pharmacology and molecular docking technology,and to investigate its possible mechanism of action.The binding ability of key active components and core targets was verified by molecular docking.Methods The active components and their action targets of Qingyi Tongfu Decoction were screened through TCMSP and BATMAN-TCM databases.The related targets of HLAP were obtained from Drugbank,GeneCards,OMIM and other databases.The intersection targets of drugs and diseases were taken as the potential action targets of Qingyi Tongfu Decoction in the treatment of HLAP.The protein-protein interaction(PPI)network of potential targets was constructed by STRING database and imported into Cytoscape software.The core targets were screened by CytoHubba plugin.Meanwhile,a"Chinese medicine-active component-intersection target"network diagram was constructed to visualize the multi-component-multi-target relationship.The intersection targets were analyzed for gene ontology(GO)functional enrichment and Kyoto encyclopedia of genes and genomes(KEGG)pathway enrichment by DAVID database,and bubble charts were drawn using R language.Finally,the key active components and core targets in the network were selected and molecular docking was performed using AutoDockTools,PyMOL and other software.Results There were 49 potential action targets of Qingyi Tongfu Decoction in the treatment of HLAP.KEGG pathway enrichment analysis showed that these targets were significantly enriched in key pathways such as the AGE-RAGE signaling pathway of diabetic complications,lipid and atherosclerosis pathways,and PI3K/AKT signaling pathways.Molecular docking results showed that the key active components and core targets all exhibited strong binding activity.Conclusion Qingyi Tongfu Decoction treats HLAP through multi-component and multi-target effects,providing an effective theoretical basis for the treatment of HLAP with Qingyi Tongfu Decoction.

Abstract:Objective To analyze the differences in risk factors between small artery occlusion stroke(SAO)and large artery atherosclerosis stroke(LAA),and to provide a basis for precise prevention and treatment of the two subtypes of stroke.Methods Retrospective analysis of clinical data of Yiyang Third People's Hospital and Shenzhen Second People's Hospital from January 2022 to December 2024.Among them,there were 204 SAO patients,97 LAA patients,and 78 patients with vasovagal syncope(VVS)were selected as the control group.The age,gender,and whether they had hypertension,diabetes,hyperlipidemia,and hyperhomocysteinemia(HHcy)were collected from the three groups of patients and compared between groups.Results The age of the SAO group was greater than that of the VVS group,and the proportions of male patients,those with hypertension,diabetes,and HHcy were all higher in the SAO group than those in the VVS group,while the proportion of patients under 60 years old was lower in the SAO group than that in the VVS group,with statistically significant differences(P<0.05).The age of the LAA group was greater than that of the VVS group,and the proportions of male patients,those with hypertension,and diabetes were all higher in the LAA group than those in the VVS group,while the proportion of patients under 60 years old was lower in the LAA group than that in the VVS group,with statistically significant differences(P<0.05).The age of the SAO group was greater than that of the LAA group,and the proportions of patients under 60 years old and those with hyperlipidemia were both lower in the SAO group than those in the LAA group,with statistically significant differences(P<0.05).Conclusion Age≥60 years,male gender,hypertension,and diabetes are common risk factors for both SAO and LAA.Age and HHcy play a more significant role in the onset of SAO,while hyperlipidemia may play a more crucial role in the onset of LAA.Clinical individualized prevention and control strategies should be formulated based on the differences in risk factors between the two subtypes of stroke.

Abstract:Objective To explore the effect of Qingke Pingchuan granules combined with salmeterol/fluticasone propionate on clinical symptoms and blood gas analysis indicators in elderly patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 102 elderly patients with AECOPD admitted to Xiangcheng First People's Hospital from January 2022 to December 2024 were selected as the research subjects and divided into an observation group and a control group according to different treatment plans,with 51 cases in each group.Patients in the control group were treated with salmeterol/fluticasone propionate,while patients in the observation group were treated with Qingke Pingchuan granules in addition to the treatment of the control group.The Traditional Chinese Medicine(TCM)syndrome score,blood gas analysis indicators,lung function,exercise tolerance,and serum inflammatory factor levels of the two groups were compared before and after treatment.Results After treatment,the TCM syndrome score of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05);after treatment,the arterial partial pressure of carbon dioxide(PaCO2)of the observation group was lower than that of the control group,and the arterial partial pressure of oxygen(PaO2)and arterial oxygen saturation(SaO2)were higher than those of the control group,and the differences were statistically significant(P<0.05);after treatment,the peak expiratory flow(PEF),forced expiratory volume in the first second(FEV1),and FEV1/forced vital capacity(FVC)of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05);after treatment,the 6-minute walk test(6MWT)distance of the observation group was longer than that of the control group,and the modified Medical Research Council dyspnea questionnaire(mMRC)score was lower than that of the control group,and the difference was statistically significant(P<0.05);after treatment,the levels of serum interleukin-6(IL-6)and procalcitonin(PCT)of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).Conclusion Qingke Pingchuan granules combined with salmeterol/fluticasone propionate can relieve the clinical symptoms of elderly patients with AECOPD,enhance lung function,improve blood gas analysis indicators,increase exercise tolerance,and inhibit inflammatory responses.

Abstract:Objective To explore the risk factors for radiation gastritis in elderly patients with esophageal cancer after intensity-modulated radiotherapy.Methods A retrospective study was conducted on 110 elderly patients with esophageal cancer who underwent radical surgery at Anyang Tumor Hospital from March 2022 to January 2025.All patients received intensity-modulated radiotherapy after surgery and were divided into a radiation gastritis group(20 cases)and a non-radiation gastritis group(90 cases)based on whether they developed radiation gastritis after intensity-modulated radiotherapy.General and clinical data,as well as intensity-modulated radiotherapy-related indicators of the two groups were compared.Multivariate(unconditional)Logistic stepwise regression analysis was used to identify the risk factors for radiation gastritis in elderly patients with esophageal cancer after intensity-modulated radiotherapy.Results There were no statistically significant differences in gender,age,lesion location,lesion length,anastomosis location,postoperative chemotherapy,location of the thoracic stomach,mean dose(Dmean)to the thoracic stomach,maximum dose(Dmax)to the thoracic stomach,the percentage of gastric volume V5-V45,and irradiation length L10-L40 between the two groups(P>0.05).The proportion of patients with V50≥50.48%and L5≥16.70 cm in the radiation gastritis group was higher than that in the non-radiation gastritis group,and the difference was statistically significant(P<0.05).Logistic regression analysis showed that V50≥50.48%and L5≥16.70 cm were risk factors for radiation gastritis in elderly patients with esophageal cancer after intensity-modulated radiotherapy(all P<0.05).Conclusion V50≥50.48%and L5≥16.70 cm are risk factors for radiation gastritis in elderly patients with esophageal cancer after intensity-modulated radiotherapy,and clinical attention should be paid.

Abstract:Objective To investigate the influencing factors of adverse pregnancy outcomes in patients with endometriosis(EM)and infertility treated with mifepristone.Methods A total of 65 patients with EM and infertility admitted to Yucheng County People's Hospital from March 2021 to September 2024 were selected as the research subjects.They were divided into an adverse pregnancy outcome group and a non-adverse pregnancy outcome group based on whether they experienced adverse pregnancy outcomes after mifepristone treatment.The baseline and clinical data of the two groups were compared,and the items with significant differences were entered into the Logistic regression equation for statistical analysis to explore the influencing factors of adverse pregnancy outcomes in patients with EM and infertility after mifepristone treatment.Results Among the 65 patients with EM and infertility,21 patients experienced adverse pregnancy outcomes after mifepristone treatment and were included in the adverse pregnancy outcome group;44 patients did not experience adverse pregnancy outcomes and were included in the non-adverse pregnancy outcome group.The FMS-IW-control type fertility motivation score and the frequency of uterine cavity operations in the adverse pregnancy outcome group were higher than those in the non-adverse pregnancy outcome group,while the number of retrieved oocytes was lower,and the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that the FMS-IW-control type fertility motivation score and the frequency of uterine cavity operations were risk factors for adverse pregnancy outcomes in patients with EM and infertility after mifepristone treatment(OR>1,P<0.05),while the number of retrieved oocytes was a protective factor(OR<1,P<0.05).Conclusion The influencing factors of adverse pregnancy outcomes in patients with EM and infertility treated with mifepristone include the FMS-IW-control type fertility motivation score,the frequency of uterine cavity operations,and the number of retrieved oocytes.Clinically,these factors can be used to screen high-risk groups for adverse pregnancy outcomes and provide reference value for the formulation of prevention and treatment plans for adverse pregnancy outcomes.

Abstract:Objective To understand the prevalence of anxiety and depression among operating room nurses in Guangdong Province and the influencing factors,and to construct prediction models using machine learning.Methods Twelve medical institutions were randomly selected,and cluster sampling was used to conduct a survey of all operating room nurses through WeChat questionnaire star.The 7-item generalized anxiety disorder scale(GAD-7)and the patient health questionnaire-9(PHQ-9)were used to evaluate anxiety and depression,respectively.Chi-square test and Logistic regression were used for group comparison and multivariate analysis.The recursive feature elimination with cross-validation(RFECV)method was used to select the optimal predictive variables.Five methods,including logistic regression(LR),decision tree(DT),support vector machine(SVM),random forest(RF),and extreme gradient boosting(XGBoost),were used for model training,and the optimal model was selected.The Shapley additive explanations(SHAP)method was used for visualization interpretation.Results A total of 389 surveys were completed,with a prevalence rate of 57.3%for anxiety symptoms and 72.5%for depression symptoms.The XGBoost and LR models performed best in predicting anxiety and depression,respectively.Income,years of service,and daily working hours were important indicators for predicting anxiety,while occupational exposure,daily sleep time,and years of service were important indicators for predicting depression.Conclusion The prevalence of anxiety and depression among operating room nurses is relatively high and is influenced by multiple factors such as years of service,sleep,income,and occupational exposure.

Abstract:Objective To analyze the risk factors affecting the compliance of functional exercises after lumbar fusion surgery in patients with lumbar disc herniation.Methods A retrospective analysis was conducted on the clinical data of 100 patients with lumbar disc herniation who underwent lumbar fusion surgery at Pingdingshan First People's Hospital from October 2022 to October 2024.The patients were divided into a good compliance group(64 cases)and a poor compliance group(36 cases)based on their compliance with treatment three months after surgery.General data and various scores of the two groups were compared,and single-factor analysis was performed on the items with significant differences.Then,a multivariate Logistic regression analysis was conducted to identify the risk factors affecting the compliance of functional exercises after lumbar fusion surgery in patients with lumbar disc herniation.Results The proportion of patients with an educational level of junior high school or below,Oswestry Disability Index(ODI),Japanese Orthopaedic Association scores(JOA)for Low Back Pain,and Tampa Scale for Kinesiophobia(TSK)scores in the poor compliance group were all higher than those in the good compliance group,and the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that educational level of junior high school or below,ODI,JOA,and TSK scores all affected the compliance of functional exercises after lumbar fusion surgery in patients with lumbar disc herniation(all P<0.05).Receiver operating characteristic(ROC)curve analysis confirmed that ODI,JOA,and TSK scores could predict the compliance of functional exercises after lumbar fusion surgery in patients with lumbar disc herniation,with areas under the curve(AUC)of 0.933,0.920,and 0.877,respectively(all P<0.05).Conclusion Educational level,ODI score,JOA score,and TSK score all affect the compliance of functional exercises after lumbar fusion surgery in patients with lumbar disc herniation.Targeted postoperative functional exercise plans can be developed based on these factors to improve compliance.

Abstract:Objective To explore the molecular mechanisms of Cordycepin and cordycepic acid from Cordyceps militaris against cervical cancer(CC)from the perspective of systems biology,focusing on the multiple signal integration mechanisms.Methods Cordycepin and cordycepic acid were selected as the research objects.Based on the network pharmacology approach,the protein-protein interaction networks of their anti-CC effects were constructed.Using the CC Hela cell line,after determining the appropriate drug treatment concentrations,the inhibitory effects on cell proliferation and the induction of apoptosis were evaluated.The expression levels of key signaling pathway nodes in the network were analyzed.Results A total of 80 common targets between Cordycepin and CC and 131 common targets between cordycepic acid and CC were collected.After constructing the corresponding interaction networks,pathway enrichment analysis showed that Cordycepin-related targets were mapped to 73 pathways,and cordycepic acid-related targets were mapped to 166 signaling pathways.Cell experiments indicated that both could inhibit CC cell proliferation and promote apoptosis in a concentration-dependent manner,with cordycepic acid showing a stronger inhibitory effect on proliferation than that of Cordycepin.Further analysis of the gene expression of 9 key node proteins suggested that there were differences in the regulatory mechanisms between cordycepic acid and Cordycepin.Conclusion Cordycepin and cordycepic acid from Cordyceps militaris can play significant roles in the anti-CC mechanism by interfering with multiple signal transduction pathways and regulating the expression of multiple key target proteins.This study provides theoretical support and experimental evidence for systematically explaining the molecular mechanism of Cordyceps militaris against CC.

Abstract:Objective To study the influencing factors of bladder paralysis in patients with cervical cancer(CC)after laparoscopic radical surgery and formulate relevant intervention and treatment measures to provide reference and basis for the prevention and treatment of bladder paralysis in these patients.Methods The clinical data of 136 CC patients admitted to Anyang Tumor Hospital from November 2021 to September 2024 were retrospectively collected.All patients underwent laparoscopic radical surgery and were followed up for 3 months after the operation.They were divided into a paralysis group(46 cases)and a non-paralysis group(90 cases)based on whether bladder paralysis occurred after the operation.Univariate and multivariate analyses were conducted to identify the influencing factors of bladder paralysis in CC patients after laparoscopic radical surgery.Prediction model:Logit(P)=-8.917+number of lymph nodes removed×0.637+extent of surgery×0.498+width of parametrial tissue resection×0.557+length of vaginal stump×0.719+duration of catheter indwelling×0.496+urinary tract inflammation×0.539+whether standardized rehabilitation exercises were performed after surgery×0.622,likelihood ratio χ2=134.73,DF=6,P<0.001.Results The number of lymph nodes removed,width of parametrial tissue resection,extent of surgery,whether standardized rehabilitation exercises were performed after surgery,length of vaginal stump,urinary tract inflammation,and duration of catheter indwelling were all influencing factors of bladder paralysis in CC patients after laparoscopic radical surgery(OR=1.891,1.645,1.745,1.863,2.052,1.714,1.642,P<0.05).The receiver operating characteristic(ROC)curve analysis results showed that when Logit(P)>12.27,the area under the curve(AUC)was 0.824,the sensitivity was 86.96%,and the specificity was 71.11%.Conclusion There are many influencing factors for bladder paralysis in CC patients after laparoscopic radical surgery,and targeted interventions can be made based on these factors to reduce the incidence of bladder paralysis.

Abstract:Objective To explore the influence mechanism and optimization path of orthopedic material management under the background of the superposition of artificial joint centralized procurement policy and diagnosis-related group(DRG)/disease diagnosis-related group(DIP)medical insurance payment reform.Methods Based on the data of 732 orthopedic surgery cases in a tertiary general hospital in Shenzhen from January 2022 to September 2024,variance analysis was used to compare six indicators including average cost per case and material cost ratio for the two main diagnoses of"femoral neck fracture"and"avascular necrosis of the femoral head"under DRG/DIP payment methods.Results The average cost per case decreased by 30.93%(P<0.001)due to artificial joint centralized procurement,but it rebounded by 6.54%(P<0.001)after DIP payment,and the material cost ratio rebounded from 51.69%to 55.39%.The pre-set surplus amount changed from a surplus of 30,400 yuan during the DRG payment period to a loss of 600 yuan during the DIP payment period.The material cost ratio decreased after the implementation of centralized procurement for both diagnoses,but the material cost ratio for"femoral neck fracture"rebounded by 30.61%(P<0.05)after DIP payment.The laboratory test cost ratio for"femoral neck fracture"showed significant differences under the influence of artificial joint centralized procurement and medical insurance payment policy adjustments(P<0.05).The examination cost ratio and laboratory test cost ratio for"avascular necrosis of the femoral head"showed significant changes due to the centralized procurement policy(P<0.05).The material cost ratio and pre-set surplus amount for both"femoral neck fracture"and"avascular necrosis of the femoral head"were strongly positively correlated(r=0.62 and 0.68,respectively),while the drug cost ratio was strongly negatively correlated with the pre-set surplus amount(r=-0.55 and-0.72,respectively).Conclusion DIP weakens the cost control effect of centralized procurement of orthopedic materials through the redistribution of disease scores.It is suggested to establish a three-dimensional evaluation model of disease type-orthopedic materials-therapeutic effect,implement hierarchical authorization management of orthopedic materials,and construct a dual assessment system including economic and quality indicators to improve the efficiency of medical insurance fund utilization through a"evaluation-assessment-optimization"closed loop.

Abstract:Objective To monitor the adverse reactions of β-lactam antibiotics in the pediatrics department of Xinyang Municipal Hospital of Traditional Chinese Medicine and provide guidance for pharmaceutical service intervention.Methods A retrospective analysis was conducted on the medical records of 116 children treated with β-lactam antibiotics in the pediatrics department of Xinyang Municipal Hospital of Traditional Chinese Medicine from May 2023 to May 2025.The occurrence of adverse reactions,involved drugs,affected systems-organs,and clinical manifestations were statistically analyzed.The children were divided into an occurrence group and a non-occurrence group based on whether adverse reactions occurred.Univariate and multivariate Logistic regression analyses were used to identify the independent risk factors for adverse reactions after treatment with β-lactam antibiotics in children.Results Among the 116 children treated with β-lactam antibiotics,22 cases had adverse reactions,with an incidence rate of 18.97%(22/116).Among them,a highest incidence of adverse reactions was observed with amoxicillin-clavulanate,piperacillin-tazobactam,and ceftriaxone,accounting for 22.73%,18.18%,and 13.64%,respectively.Adverse reactions mainly affected the skin and appendages system,hematological system,and digestive system,with less impact on other systems.Univariate analysis showed that the proportion of children in the occurrence group who received intravenous injection and high-dose administration were higher than those in the non-occurrence group,and the duration of medication was longer,with statistically significant differences(P<0.05).Multivariate Logistic regression analysis showed that intravenous injection,high-dose administration,and long duration of medication were independent risk factors for adverse reactions after treatment with β-lactam antibiotics in children(OR>1,P<0.05).Conclusion The incidence of adverse reactions to β-lactam antibiotics in the pediatrics department of Xinyang Municipal Hospital of Traditional Chinese Medicine is relatively high.Intravenous injection,high-dose administration,and long duration of medication are independent risk factors for adverse reactions.It is recommended to formulate pharmaceutical service intervention measures based on these factors to reduce the risk of adverse reactions to β-lactam antibiotics.

Abstract:Objective To analyze the composition characteristics and risk factors of kidney stones in Qingyuan area,China,and provide suggestions for the prevention and treatment of kidney stones.Methods The clinical data of patients who visited Qingyuan People's Hospital from January 2020 to December 2022 were retrospectively collected.A total of 1500 patients with kidney stones were included in an observation group,and 1495 healthy individuals undergoing physical examinations were included in a control group.All kidney stone components were analyzed by infrared spectroscopy,and the risk factors for the formation of kidney stones were analyzed by Logistic regression.Results A total of 262 patients(17.47%)had single-component kidney stones,among them,there are 85 cases of calcium oxalate monohydrate stones(accounting for 32.44%),which have the highest proportion.A total of 1238 patients(82.53%)had mixed-component kidney stones,and most of them contained calcium oxalate stones.Logistic regression analysis showed that daily water intake<1.2 L,tea drinking,alcohol drinking,high-salt diet,high-protein diet,low vegetable intake,and a family history of stones were independent risk factors for kidney stones(P<0.05).Conclusion Calcium oxalate stones are the most common type of kidney stones in Qingyuan area.Daily water intake<1.2 L,tea drinking,alcohol drinking,high-salt diet,high-protein diet,low vegetable intake,and a family history of stones affect the formation of kidney stones.

Abstract:Objective To analyze the independent influencing factors of clinical pregnancy in patients undergoing fresh cleavage-stage embryo transfer and construct a nomogram prediction model to optimize individualized treatment strategies.Methods This study retrospectively analyzed the clinical data of 1708 patients who underwent in vitro fertilization/intracytoplasmic sperm injection combined with embryo transfer(IVF/ICSI-ET)and fresh cleavage-stage embryo transfer at the Reproductive Medicine Center of Changde Hospital Affiliated to Xiangya School of Medicine,Central South University from January 2019 to March 2023.The patients were randomly divided into a modeling group(1196 cases)and a validation group(512 cases)at a ratio of 7:3.The data of the modeling group were analyzed.With clinical pregnancy as the outcome variable,univariate Logistic regression analysis was first conducted,followed by variable selection using Lasso regression to establish a multivariate Logistic prediction model and draw a nomogram.The discrimination and calibration of the nomogram were evaluated using the area under the receiver operating characteristic(ROC)curve(AUC),calibration curves,and decision curve analysis(DCA).Results Multivariate Logistic regression analysis showed that age,antral follicle count,high-quality embryo rate,endometrial thickness on the day of human chorionic gonadotropin(HCG),and the number of transferred embryos were independent influencing factors of clinical pregnancy.The nomogram model constructed based on these factors demonstrated good performance in both the modeling and validation groups:in terms of discrimination,the AUC of the ROC was 0.767(95%CI:0.740～0.794)and 0.740(95%CI:0.697～0.783),respectively;in terms of calibration,the Hosmer-Lemeshow test results showed no significant difference(P=0.676 in the modeling group and P=0.629 in the validation group);DCA further confirmed that the model had positive clinical net benefit and could effectively assist clinical decision-making.Conclusion Age,antral follicle count,high-quality embryo rate,endometrial thickness on the day of HCG,and the number of transferred embryos are independent influencing factors of clinical pregnancy.The nomogram constructed based on these factors is helpful in predicting the pregnancy success rate of patients undergoing fresh cleavage-stage embryo transfer.

Abstract:Objective To explore the impact of elderly role experience teaching training on medical students'care and empathy abilities.Methods A total of 74 medical students who were on clinical rotation in the Geriatrics Department of the First Affiliated Hospital,Sun Yat-sen University from December 2024 to March 2025 were selected as the research subjects and received elderly role experience teaching courses.Before and after the training,questionnaires were conducted using the care ability inventory(CAI)and the Jefferson scale of empathy for health professionals(JSE-HPS).After the training,the students'satisfaction with the teaching was also surveyed.Results After the experience,the total score of the medical students'care ability was(185.53±9.60)points,which was higher than the score before the experience(178.84±13.43)points.The score of the courage dimension significantly increased compared to before the experience,with a statistically significant difference(P<0.05).After the experience,the total score of the medical students'empathy ability was lower than before,but the difference was not statistically significant(P>0.05).However,the score of the emotional care dimension significantly decreased compared to before,with a statistically significant difference(P<0.05).After the experience,72 students(97.30%)expressed satisfaction with the role experience,and 2 students(2.70%)chose the"general"option.Regarding the teaching design,70 students(94.59%)were satisfied,and 4 students(5.41%)chose the"general"option.Conclusion Medical students have a high satisfaction with the elderly role experience teaching.This teaching training can effectively enhance medical students'care abilities and help provide more humanized medical services for elderly patients in clinical practice.However,the training has a negative impact on medical students'empathy abilities,suggesting that the teaching methods for medical students'experiential learning need to be further optimized.

Abstract:Objective To investigate the compliance of home-based rehabilitation exercises among patients with non-small cell lung cancer(NSCLC)after thoracoscopic radical surgery,analyze the related influencing factors,and propose targeted intervention strategies.Methods A total of 100 NSCLC patients who underwent thoracoscopic radical surgery at Kaifeng Central Hospital from January 2023 to October 2024 were included in the study.General information questionnaires,rehabilitation exercise compliance scales,social support assessment scales,disease perception scales,and self-efficacy scales were used to evaluate the patients'compliance with home-based rehabilitation exercises,social support levels,disease perception,and self-efficacy.Univariate analysis and multiple linear regression analysis were used to analyze the related influencing factors.Results The total score of postoperative rehabilitation exercise compliance was(41.47±5.47)points,the total score of social support was(37.23±3.07)points;the total score of disease perception was(42.47±4.56)points,and the total score of self-efficacy was(79.24±5.10)points.There was a statistically significant difference in the postoperative rehabilitation exercise compliance scores among NSCLC patients of different ages,educational levels,occupations,places of residence,average monthly family incomes,clinical stages,and whether they had other chronic diseases(P<0.05);Pearson correlation analysis showed that the postoperative rehabilitation exercise compliance of NSCLC patients was positively correlated with social support,disease perception,and self-efficacy(r=0.427,0.512,0.634,P<0.05);multiple linear regression analysis showed that age,presence of other chronic diseases,total score of social support,total score of disease perception,and total score of self-efficacy were the main influencing factors of postoperative rehabilitation exercise compliance in NSCLC patients(P<0.05),among which age,presence of other chronic diseases,and total score of disease perception were negatively correlated with postoperative rehabilitation exercise compliance;total score of social support and total score of self-efficacy were positively correlated with postoperative rehabilitation exercise compliance.Conclusion The compliance of home-based rehabilitation exercises after thoracoscopic radical surgery for NSCLC is influenced by multiple factors,among which self-efficacy is the most important influencing factor.Clinically,comprehensive intervention strategies should be focused on elderly patients and those with chronic diseases,including enhancing self-efficacy,strengthening social support,and improving disease perception,to effectively improve the compliance of rehabilitation exercises.

Abstract:Objective To analyze the application effect of neoadjuvant chemotherapy in patients with locally advanced breast cancer(LABC)and the risk factors for recurrence.Methods Sixty-two patients with LABC who were diagnosed and received neoadjuvant chemotherapy at the 989th Hospital of the Joint Logistic Support Force of the Chinese People's Liberation Army from August 2021 to August 2024 were selected as the research subjects.They were followed up after treatment to observe the recurrence situation.Univariate and Logistic multivariate analyses were used to analyze the risk factors for recurrence in LABC patients after neoadjuvant chemotherapy.Results Among the 62 patients who received neoadjuvant chemotherapy,24 cases recurred after a follow-up period of 2 to 30 months,with a recurrence rate of 38.71%.Univariate analysis showed that there were statistically significant difference in maximum tumor diameter before treatment,postoperative lymph node stage,human epidermal growth factor receptor 2(HER2),breast cancer metastasis suppressor gene 1(BRMS1),inhibitor of growth factor 4(ING4),cell proliferation nuclear antigen(Ki-67),and estrogen receptor(ER)/progesterone receptor(PR)between the two groups(P<0.05);while there was no statistically significant difference in age,body mass index,family history,pathological type,clinical stage,neoadjuvant chemotherapy regimen,and androgen receptor(AR)status(P>0.05).Logistic multivariate analysis results indicated that maximum tumor diameter>5 cm before treatment,postoperative lymph node stage N3,HER2 status,and high expression of Ki-67 were independent risk factors for recurrence in LABC patients after neoadjuvant chemotherapy(P<0.05).Conclusion After receiving different regimens of neoadjuvant chemotherapy,maximum tumor diameter>5 cm,postoperative lymph node stage N3,HER2 positive,and high expression of Ki-67 are independent risk factors for recurrence in LABC patients.

Abstract:Objective To explore the differences in olfactory function,eye movement characteristics,and magnetic resonance imaging(MRI)brain structure indicators between patients with Alzheimer's disease(AD)and mild cognitive impairment(MCI),and to analyze the value of combined application of multimodal biomarkers in the early diagnosis of AD.Methods Thirty patients with AD andforty patients with MCI admitted to the Second People's Hospital of Futian District Shenzhen,Shenzhen Luohu People's Hospital,and Shenzhen Second People's Hospital from July 2021 to August 2024 were selected as the AD group and MCI group.Forty healthy individuals who underwent physical examinations at shenzhen Second People's Hospital from January 2022 to August 2024 were recruited as the normal control(NC)group.Olfactory function was evaluated using the Chinese smell identification test(CSIT),eye movement parameters were recorded using artificial intelligence-based eye tracking technology,and brain region volumes were measured using 3.0 T MRI.Group differences,indicator correlations,and diagnostic efficacy were evaluated using analysis of variance,Spearman correlation analysis,and Logistic regression models.Results The volumes of the left and right hippocampus,left and right amygdala,left and right precentral gyrus,left and right prefrontal and left and right cuneus in the AD and MCI group were smaller than those in the NC group,and the volumes of the left hippocampus,left and right amygdala,left and right precentral gyrus,left and right prefrontal lobe,and left and right cuneus in the AD group were smaller than those in the MCI group.The mini-mental state examination(MMSE)and Montreal cognitive assessment(MoCA)scores in the AD and MCI groups were lower than those in the NC group,and the scores in the AD group were lower than those in the MCI group.The CSIT scores,error eye movement correction frequency,and new photo dwell time in the AD group were lower or shorter than those in the NC group,but the indexes of the MCI group were higher or longer than those of the AD group,with statistically significant differences(P<0.05).There were significant positive correlations between MMSE scores,MoCA scores,left hippocampal volume,right hippocampal volume,left amygdala volume,right amygdala volume,left precentral gyrus volume,left cuneus volume,error eye movement correction frequency,and CSIT scores(P<0.05),among which the left hippocampal volume had a strong positive correlation with the CSIT score(r=0.622,P<0.05).In terms of MRI brain structure indicators,the left hippocampal volume was significantly positively correlated with the error eye movement correction frequency(r=0.537,P<0.05),and also had a certain correlation with the new photo dwell time(r=0.320,P<0.05).The right amygdala volume was significantly positively correlated with the new photo dwell time(r=0.397,P<0.05).The left prefrontal lobe volume was significantly positively correlated with the error eye movement correction frequency(r=0.441,P<0.05).The receiver operating characteristic(ROC)curve analysis showed that the area under the curve(AUC)for diagnosing AD by CSIT,MMSE score,left hippocampal volume,and error eye movement correction frequency were 0.799,0.789,0.628,and 0.687,respectively.The AUC value of the logistic regression prediction model constructed with CSIT score,error eye movement correction frequency,left hippocampal volume,and MMSE score as variables reached 0.903,which was significantly higher than that of each individual indicator(P<0.05).Conclusion Multimodal biological markers of olfaction,eye movement,and MRI brain structure show differences among AD,MCI,and NC groups.The diagnostic model constructed by combining olfaction,eye movement,and MRI brain structure can further improve the diagnostic efficacy of early AD,providing a new strategy for early screening of AD.

Abstract:Objective To explore the influence of the ratio of low-density lipoprotein cholesterol(LDL-C)to high-density lipoprotein cholesterol(HDL-C)on the severity and prognosis of patients with acute ischemic stroke(AIS).Methods A total of 90 AIS patients admitted to Nanyang Central Hospital from September 2021 to September 2024 were selected as the observation subjects.The 90 patients were divided into a mild-to-moderate injury group(36 cases)and a severe injury group(54 cases)based on the degree of neurological deficits.After discharge,the patients were followed up for 3 months.According to the modified Rankin scale(mRS),the 90 subjects were divided into a good prognosis group(63 cases)and a poor prognosis group(27 cases).The levels of serum LDL-C,HDL-C,and the LDL-C/HDL-C ratio were compared among the subgroups.Pearson correlation analysis was used for correlation analysis,and multivariate analysis was conducted using the Logistic regression model.The predictive value of serum LDL-C/HDL-C ratio for the prognosis of AIS was evaluated by the receiver operating characteristic(ROC)curve.Results The level of serum LDL-C and LDL-C/HDL-C ratio in the severe injury group were significantly higher than those in the mild to moderate injury group,while the level of HDL-C was significantly lower than that in the mild to moderate injury group,and the difference was statistically significant(P<0.001).The level of serum LDL-C and LDL-C/HDL-C ratio in the poor prognosis group were significantly higher than those in the good prognosis group,while the level of HDL-C was significantly lower than that in the good prognosis group(P<0.001).Correlation analysis showed that the level of serum LDL-C and LDL-C/HDL-C ratio were positively correlated with the severity of AIS(r=0.442,0.467,both P<0.05),while the level of HDL-C was negatively correlated with the severity of AIS(r=-0.453,P<0.001).The differences in age,the proportion of males,the proportions of history of stroke,diabetes,hyperlipidemia and smoking,the levels of serum LDL-C and HDL-C,and the LDL-C HDL-C ratio between the patients in the poor prognosis group and the good prognosis group were statistically significant(P<0.05).There was no statistically significant difference in the proportions of patients with a history of hypertension,coronary heart disease and alcohol consumption between the two groups(P>0.05).Multivariate Logistic regression analysis showed that age,male gender,history of stroke,history of diabetes,hyperlipidemia,smoking history,LDL-C,and LDL-C/HDL-C were risk factors for poor prognosis in AIS patients(P<0.05),while HDL-C was a protective factor for poor prognosis in AIS patients(P<0.001).The ROC curve results showed that the area under the curve(AUC)of LDL-C,HDL-C,and LDL-C/HDL-C were 0.724,0.768,and 0.839,respectively,with sensitivities of 0.692,0.889,and 0.778,and specificities of 0.861,0.711,and 0.806,respectively.Conclusion The LDL-C HDL-C ratio is closely related to the severity and prognosis of AIS patients,suggesting that monitoring and regulating lipid levels may help improve the condition and prognosis of AIS patients.

Abstract:Objective To explore the therapeutic effect of balance psychotherapy guided by virtual reality technology combined with escitalopram on depression.Methods A total of 80 patients with depression from Fuzhou Mental Health Sanatorium and Fuzhou Second General Hospital from October 2022 to October 2024 were selected as the research subjects and divided into a control group and an observation group,with 40 cases in each group.Patients in the control group received escitalopram treatment,while those in the observation group received balance psychotherapy guided by virtual reality technology in addition to the treatment of the control group.The adaptation load index,mindfulness level,and disease severity of the two groups were compared before and after treatment.Results After treatment,the adaptation load index of both groups was lower than that before treatment,and the index in the observation group was lower than that in the control group,with statistically significant difference(P<0.05);after treatment,the five factors scores and total scores of mindfulness level of both groups were higher than those before treatment,and the scores in the observation group were higher than those in the control group,with statistically significant differences(P<0.05);after treatment,the Montgomery-Asberg Depression Rating Scale scores and 17-item Hamilton Depression Scale scores of both groups were lower than those before treatment,and the scores in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).Conclusion The treatment plan of balance psychotherapy guided by virtual reality technology combined with escitalopram for patients with depression can reduce the severity of the disease on the basis of regulating the adaptation load index and mindfulness level.