Accurate segmentation of oral surgery-related tissues from cone beam computed tomography(CBCT)images can significantly accelerate treatment planning and improve surgical accuracy.In this paper,we propose a fully automated tissue segmentation system for dental implant surgery.Specifically,we propose an image preprocessing method based on data distribution histograms,which can adaptively process CBCT images with different parameters.Based on this,we use the bone segmentation network to obtain the segmentation results of alveolar bone,teeth,and maxillary sinus.We use the tooth and mandibular regions as the ROI regions of tooth segmentation and mandibular nerve tube segmentation to achieve the corresponding tasks.The tooth segmentation results can obtain the order information of the dentition.The corresponding experimental results show that our method can achieve higher segmentation accuracy and efficiency compared to existing methods.Its average Dice scores on the tooth,alveolar bone,maxillary sinus,and mandibular canal segmentation tasks were 96.5%,95.4%,93.6%,and 94.8%,respectively.These results demonstrate that it can accelerate the development of digital dentistry.

Drugs under special management include narcotic drugs,psychotropic drugs,toxic drugs for medical use,radiopharmaceuticals,and pharmaceutical precursor chemicals.Supervising and guiding the clinical use of drugs under special management is one of the important responsibilities of the Pharmaceutical Management and Drug Therapy Committee(Group)of medical institutions.The standard for drugs under special management is led by the Pharmaceutical Professional Committee of the China Hospital Association,which standardizes 16 key elements of organizational management,process management,and quality control management drugs under special management in medical institutions.It can guide the standardized implementation of Pharmaceuticals under special control work in various levels and types of medical institutions.This article elaborates on the methods and contents of formulating standards for Pharmaceuticals under special management,to provide reference and inspiration for medical institutions to carry out special drug drug management and daily related work.

Objective:To evaluate the clinical efficacy of Fried Licorice Decoction Plus-minus in combination with PD-1 therapy for patients with advanced non-small cell lung cancer(NSCLC)with Qi-Yin deficiency.Methods:From December 2020 to December 2022,72 patients diagnosed with advanced NSCLC with Qi-Yin deficiency were enrolled in this study.The patients were recruited from Jilin Provincial Cancer Hospital and the Affiliated Hospital of Changchun University of Chinese Medicine.The patients were randomly assigned into two groups,with 36 patients in each group.The control group received PD-1 treatment alone,and the treatment group received PD-1 combined with Fried Licorice Decoction Plus-minus.The measures of primary outcomes included immune function(CD3+,CD3+/CD4+,and CD3+/CD8+)and quality of life score(Kamofsky,KPS).The measures of secondary outcomes included the objective response rate(ORR);traditional Chinese medicine(TCM)symptom score;serum tumor marker carcinoembryonic antigen(CEA);neuron-specific enolase(NSE);cytokeratin fragment(CYFRA211);and incidence of immune-related adverse events such as gastrointestinal toxicity,pulmonary toxicity,hepatotoxicity,and thyroid toxicity.Results:Regarding immune function regulation,a significant improvement was observed in CD3+,CD3+/CD4+,and CD3+/CD8+.Furthermore,at T3 and T4 time points,an improvement was observed in patient quality of life indicators such as the tumor markers CEA and CY211.In addition,symptoms related to TCM syndrome,including coughing,fatigue,palpitations,and diarrhea were significantly reduced compared to the baseline levels.Moreover,the treatment group exhibited superior outcomes compared to those of the control group in terms of reducing immune-associated pneumonia and diarrhea(P<0.05).The ORR for both groups was similar;36%for those receiving com-bination therapy vs.25%for those receiving PD-1 monotherapy.Therefore,no significant differences between these two groups were ob-served(P>0.05).Conclusions:The combination of Fried Licorice Decoction Plus-minus and PD-1 in the treatment of patients with advanced NSCLC showed a significant enhancement in immune function,improvement in clinical efficacy,reduction in immune-related adverse reac-tions,and had an excellent safety profile.

Objective:To explore the current situation of nurses' turnover intention and its influencing factors based on the intergenerational differences, analyze the similarities and differences.Methods:From January to March 2018, 12 291 nurses from 23 general hospitals were selected by stratified cluster sampling. The nurses were investigated with the Turnover Intention Questionnaire, Work-Family Conflict Scale and Perceived Person-Environment Fit Scale. Pearson correlation analysis was used to explore the correlation between nurses' work-family conflict, person-environment fit and turnover intention. Multiple linear regression analysis was used to explore the influencing factors of nurses' turnover intention among different generations. A total of 12 291 questionnaires were distributed and 12 291 were retrieved. After eliminating the questionnaires with obvious logical errors, 11 753 valid questionnaires were finally recovered, with an effective recovery rate of 95.62% (11 753/12 291) .Results:The turnover intention of post-70s nurses was lower than that of post-80s and post-90s nurses. Work-family conflict, person-environment fit and whether the nurses have experienced negative events in the past year were the common influencing factors of nurses' turnover intention among different generations ( P<0.01) . The professional title, the number of night shifts and the fertility were the specific influencing factors of the post-90s nurses' turnover intention ( P<0.05) . The employment form was the specific influencing factor of post-80s nurses' turnover intention ( P<0.05) . Conclusions:The turnover intention of post-80s and post-90s nurses were higher than that of the post-70s nurses. There are differences in the current situation and influencing factors of nurses' turnover intention in different birth years. It is suggested that intervention strategies should be formulated according to the intergenerational characteristics of nurses to effectively reduce nurses' turnover intention.

Objective:To explore the application of English for medical purpose (EMP) in integrated medical education for medical undergraduates.Methods:A total of 120 undergraduates who participated in the integrated medical education in Chongqing Medical University were divided into EMP group and traditional medical English teaching group. There was no difference in the syllabus knowledge between the two groups. The teaching method of EMP group combined with integrated medical education and gave medical English teaching according to the organ system. The traditional group conducted the teaching according to the traditional medical English teaching method based on word formation and sentence understanding. SPSS 24.0 was used for t-test. Results:The scores of medical vocabulary test in the EMP teaching group were higher than those in the traditional teaching group [(85.00±3.52) vs. (65.67±3.33)]. The number of Review papers published in EMP group was 14, while 6 in traditional teaching group. The teachers used a randomized double-blind method to score the students' review papers (total score was 100 points). The results showed that the score of properly using medical vocabulary of students in the EMP teaching group were higher than those in the traditional teaching group [(84.52±2.34) vs. (70.98±1.45)]. The scientific evaluation score on review content in EMP group was higher than that in traditional teaching group [(88.87± 4.68) vs. (71.87±2.41)]. The grammar score of EMP group was higher than that of traditional teaching group [(90.01±7.24) vs. (76.00±3.76)].Conclusion:Medical English EMP course can better cooperate with the integrated education for medical undergraduates, improve students' ability of using medical English to retrieve literature and understand medical English according to organ system.

Objective:To explore the research status and trends of sarcopenic obesity at home and abroad, so as to provide a reference for the nursing staff to carry out related clinical work or research.Methods:The articles on sarcopenic obesity included from January 1, 2000 to December 31, 2021 were retrieved in the Web of Science core database. Bibliometric analysis was performed using CiteSpace software.Results:From 2000 to 2021, there were 1 252 articles related to sarcopenic obesity, and the number of articles published showed an upward trend year by year. Totals of 83 countries or regions participated in the research, and the country with the largest number of publications was the United States (286) . The most published journal was Clinical Nutrition (44) . The author with the most papers was Wolfgang Kemmler (14) , and the institution with the most papers was Korea University (57) . Research hotspots mainly focused on immune resistance, disease risk and nutritional intervention.Conclusions:Bibliometric analysis reveals research patterns and trends in sarcopenic obesity. Foreign countries started early in this research field, and my country is still in its infancy. There is also an urgent need to cultivate research leaders in the field of sarcopenic obesity, form an inter-institutional cooperation mechanism, and carry out multidisciplinary teamwork to promote the health of the elderly.

Objective:To explore the research status and trends of sarcopenic obesity at home and abroad, so as to provide a reference for the nursing staff to carry out related clinical work or research.Methods:The articles on sarcopenic obesity included from January 1, 2000 to December 31, 2021 were retrieved in the Web of Science core database. Bibliometric analysis was performed using CiteSpace software.Results:From 2000 to 2021, there were 1 252 articles related to sarcopenic obesity, and the number of articles published showed an upward trend year by year. Totals of 83 countries or regions participated in the research, and the country with the largest number of publications was the United States (286) . The most published journal was Clinical Nutrition (44) . The author with the most papers was Wolfgang Kemmler (14) , and the institution with the most papers was Korea University (57) . Research hotspots mainly focused on immune resistance, disease risk and nutritional intervention.Conclusions:Bibliometric analysis reveals research patterns and trends in sarcopenic obesity. Foreign countries started early in this research field, and my country is still in its infancy. There is also an urgent need to cultivate research leaders in the field of sarcopenic obesity, form an inter-institutional cooperation mechanism, and carry out multidisciplinary teamwork to promote the health of the elderly.

[摘 要] 目的：探讨miR-125a-5p通过调控Bcl-2相关永生基因4（Bcl-2-associated athanogene 4，BAG4）的表达抑制胃癌细胞迁移和侵袭的分子机制。方法：选用2014年1月至2015年12月兰州大学第一医院手术切除的82例胃癌组织标本及配对的癌旁组织以及人胃癌细胞系MGC803、BGC823、SGC7901、HGC27及人胃黏膜上皮细胞（GES-1），qPCR法检测胃癌组织、癌旁组织及胃癌细胞系中miR-125a-5p的表达水平。分别将miR-125a-5p mimic、miR-125a-5p inhibitor、（si-BAG4）siRNA-BAG4及阴性对照质粒转染至胃癌细胞，划痕愈合实验和Transwell侵袭实验分别检测miR-125a-5p/BAG4信号轴对胃癌细胞迁移和侵袭能力的影响。WB检测胃癌细胞中BAG4蛋白的表达。荧光素酶报告基因实验验证miR-125a-5p和BAG4之间的靶向调控关系。结果：miR-125a-5p在胃癌组织和细胞系中均低表达（均P<0.01）。miR-125a-5p的表达与患者的性别（P=0.953）、年龄（P=0.772）、肿瘤部位(P=0.867)、组织学分级（P=0.745）和肿瘤大小（P=0.088）无相关性，与胃癌患者的T分期（P=0.003）、N分期（P=0.001）、M分期（P=0.027）和TNM分期（P=0.035）显著相关，差异有统计学意义。miR-125a-5p低表达是胃癌患者总生存时间的独立危险因素。过表达miR-125a-5p显著抑制胃癌细胞的迁移和侵袭能力（均P<0.01）。敲降BAG4可逆转miR-125a-5p inhibitor对胃癌细胞迁移和侵袭能力的抑制作用。荧光素酶报告基因实验证实miR-125a-5p可与BAG4 3'非翻译区（untranslated regions，UTR）结合抑制其表达。结论：miR-125a-5p通过靶向下调BAG4的表达水平进而抑制胃癌细胞的迁移和侵袭。

Objective:To summarize the midterm to long-term outcomes and experiences of endovascular treatment (ET) of spontaneous isolated superior mesenteric artery dissection (SISMAD).Methods:The clinical data of 31 SISMAD patients from Jan 2011 to Dec 2019 treated with ET was retrospectively analyzed.Results:Successful ET was achieved in 29 patients with a technical success rate of 93.5%. A total of 36 self-expandable bare stents were planted in 28 patients and plain old balloon angioplastry (POBA) was performed in 1 patient. Abdominal pain disappeared within 24 hours in 89.3% of the patients after stenting. The rate of perioperative complication was 3.2%. There was no SMA dissection rupture bleeding, nor perioperative death occurred. The mean follow-up time was 53.5 (range, 6 to 110) months. There was no dissecting aneurysm formation, no SMA rupture and bleeding, and no stent rupture during the follow-up. The post ET 1-year, 3-year, and 5-year free from reintervention rate were 100%, 100%, and 91.7%, respectively.Conclusions:ET for SISMAD is safe and effective with satisfactory perioperative and midterm to long-term outcomes.

Objective:To construct a clinical training target system for masters of nursing specialist (MNS) , so as to provides references for clinical training of masters of nursing specialist in China.Methods:The index system was preliminarily constructed by literature review, semi-structured interview and preliminary investigation. The convenient sampling method was used to select 20 experts from Beijing, Shanghai, Jiangsu and other regions from August to October 2020 to conduct two rounds of expert letter consultation, revise and improve the indicators and establish the clinical training target system for masters of nursing specialist.Results:The valid recovery rates of the two rounds of expert letter consultation questionnaire were both 100.00% (20/20) , and the expert authority coefficient was 0.93. The Kendall's coordination coefficient of total index of the first and second rounds of expert letter consultation questionnaire was 0.461 and 0.317, respectively ( P<0.01) . Finally, the clinical training objective system for masters of nursing specialist included 3 first-level indicators (quality objectives, knowledge objectives and skills objectives) , 6 second-level indicators and 27 third-level indicators. Conclusions:The clinical training target system for master of nursing specialist established in this study is scientific, credible, comprehensive and practical, which can provide a reference for the clinical training of masters of nursing specialist in China.