Objective To make sciatic nerve traction injury models of rabbit , in order to prospectively evaluate possibility and accuracy of diffusion tensor tracking (DTT) in sciatic nerve injures. Methods The right sciatic nerves of 32 New Zealand white rabbits were selected for traction injury , and the left sciatic nerves were the sham operation side. DTI scan was performed before and after the operation on 1st day , 3rd day, and 1 week, 2, 3, 4, 6 and 8th week respectively, and DTT was reconstructed. Then the length of reconstructed fiber tracts and fiber density index were calculated. After the MRI scan , the sciatic nerve was removed to perform pathologic examination at different time points. Results The difference of the length of reconstructed fiber tracts between nerve traction injury and sham operation side was significant at 1 day~2weeks after operation (P<0.05), while the difference was not significant at 3~8 weeks.The fiber density index of nerve traction injury and sham operation side was significantly different at 1 day~8 weeks(P<0.05). 1day after operation, myelin sheath of traction portion was obviously twisting. 3 days after operation , a large amount of myelin sheath broke down. 2 weeks after operation , axon, myelin sheath degeneration and regeneration coexisted at the same time. 8 weeks after operation , nerve fibers regenerated and restored to normal structure. Conclusion The length time curve and density index-time curve of nerve traction injury are consistent with the changes of pathology , which can be used as a supplementary method to evaluate the degeneration and regeneration in nerve injury.

Objective To investigate the correlation between eigenvalues(λ∥ andλ⊥)of sciatic nerve and limb function in a rabbit model of acute nerve traction inj ury for finding the role ofλ∥ andλ⊥ on diagnosis of nerve inj uries.Methods The right sciatic nerves of 32 Newland rabbits were selected to be performed as traction injury,and then left sciatic nerves were treated as control for the sham operation side.MRI DTI scan was performed before and after the operation on 1 day ,3 day,and 1 week,2,3,4,6 and 8 weeks respectively.Theλ∥ andλ⊥ of inj ured sciatic nerves and sham operated nerves were measured,meanwhile functional exami-nations were evaluated,and then analyzing the correlation betweenλ⊥ of inj ured sciatic nerves and the score of inj ured limb function in the periods of 3 days to 8 weeks;finally different portions of sciatic nerve were removed for histological examinations.Results Theλ⊥ of inj ured sciatic nerves in the proximal portion was slightly increased at 3 days and recovered to the normal at 2 weeks.Theλ⊥ of inj ured sciatic nerves in the traction portion and distal portion were slightly raised at 1 day,reached to its maximum value at 3 days,and then decreased gradually after 1 week and dropped to the pre-operation level after 4 weeks.Theλ⊥ of inj ured sciatic nerves in the proximal portions was significantly higher than that of the sham-operated nerves from 1 day to 1 week(F=7.275,P=0.000). Theλ⊥ of inj ured sciatic nerves in the traction portion and distal portion were significantly higher than that of the sham-operated nerves from 1 day to 3 weeks(F=5.851,F=3.794,P=0.001,P=0.000).However,there was no significantly difference between theλ∥ of inj ured nerves in each portion and sham-operated nerves .The negative correlation between theλ⊥ of inj ured sciatic nerves in the distal portion and the score of the nerve function in the injured limb was found (r=-0.938,r=-0.897,P<0.01).Conclu-sion Theλ⊥ of inj ured nerves in the traction portion and distal portion could monitor the process of degeneration and regeneration of sciatic nerve in traction inj ury,while theλ∥ plays no obvious role in diagnosis of nerve inj uries.

Objective To evaluate multi-slice CT (MSCT) features and pathological basis of lung cancer containing thin-walled airspace. Methods Thirty?five cases of pathologically confirmed lung cancer containing thin-walled airspace were retrospectively analysed with regard to clinical data, pathological types and MSCT features between 2012 and 2015.There were 35 cases(25 adenocarcinoma, 9 squamous carcinoma, 1 spindle cell tumor) in total. MSCT features were compared between the lesions with or without solid component .Fisher exact test was used for the statistical analysis. For dynamic follow-up CT scans, the lesion dynamic change was evaluated .Correlations between the pathological section and CT images of the 11 cases were analysed. Results These features accounted for more than 60% of all MSCT signs in 35 cases, including round shape in 28 cases(80.0%),lobulation in 32 cases(91.4%),multiple cysts in 27 cases(77.1%), irregular inner wall in 33 cases(94.3%)and septum in airspace in 31 cases(88.6%). Shape, spiculation, bronchus cut-off, blood vessel and bronchus passing through the airspace, and ground-glass opacity were significantly different between the lesions with or without solid component(P<0.05).The frequency of spiculation(11 cases) and bronchus cut-off(12 cases) in mixed solid lesions was higher than that in lesions without solid component(1 case, respectively).The frequency of irregular shape(6 cases),blood vessel passing through the airspace(12 cases),ground-glass opacity(13 cases)and bronchus passing through the airspace(7 cases) in lesions without solid were higher than that in solid mixed lesions(1, 1, 5, 3 cases respectively).The pathological basis of the formation of thin-walled airspace was obvious central necrosis in solid lesions and emphysematous change due to the tumor cells diffused along the inner airspace wall and the alveolar wall destruction.Five lesions were with progressive wall thickening and increased size of the airspace,and two lesions were with decreased size of the airspace and enlarged nodules in followed CT.One case of lung cancer with thin-walled airspace evolved from ground glass nodule. Conclusions The CT manifestation of lung cancer containing thin-walled airspace was characteristic.The pathological basis of the thin-walled airspace was various.

Objective To explore the value of a radiomics model based on contrast-enhanced CT at the arterial and venous phases in predicting the regional lymph node metastasis in rectal cancer.Methods The data of 303 patients with pathologically proven rectal cancer were analyzed retrospectively,and 1 648 CT radiomics features of the primary tumors were extracted from the arterial and venous phases,respectively.Four machine learning models were used including radiomics score(Rad-score),K-nearest neighbor(KNN),multi-layer perceptron(MLP)and support vector machine(SVM),and the model with the best diagnostic performance was selected.Taking the predicted probability of the best machine model in the arterial and venous phases as the input value,logistic regression algorithm was used to further construct a combined nomogram.Results The SVM model had been proved to be the most efficient among the four machine learning models,whether in arterial or venous phases.The combined nomogram based on ASVM and VSVM prediction probability further improved the ability to predict regional lymph node metastasis.The area under the curve(AUC)of the train group was 0.860,and that of the validation group was 0.801,which were higher than those of ASVM model(train group,AUC=0.822;validation group,AUC=0.777)and VSVM model(train group,AUC=0.832;validation group,AUC=0.786).Conclusion The arterial-venous phases radiomics combined nomogram model based on enhanced CT images performs well in predicting rectal cancer patients'pre-treatment lymph node metastasis.

Objective To investigate the effects of socioeconomic factors on the prognosis of multiple myeloma (MM) patients and construct a prediction model for evaluating myeloma-specific survival (MSS) rates. Methods A total of 32625 patients diagnosed with MM between January 2007 and December 2016 were included through the SEER database. Cox regression model was used to analyze the predictive indicators of MSS. The results of the multivariate subgroup analysis were presented as forest plots. The significant factors identified in the multivariate Cox analysis were used to construct a nomogram. The predictive performance of the nomogram was assessed using the AUC and calibration plots. A nomogram score-based risk stratification system was constructed using a restricted cubic spline. Results Patients were divided into five groups according to their socioeconomic status (SES). Groups with higher SES had relatively higher proportions of those part of the White, insured, married, and urban populations. Age, gender, race, marital status, insurance status, and SES were independent prognostic factors of MSS (all P < 0.001). The linear trend of increased MSS risk with decreasing SES was most pronounced among the White, married, insured, and urban patients (all P < 0.001). The nomogram exhibited good discrimination and accuracy in both training and validation sets, showing AUC values of 0.701, 0.709, and 0.722 for predicting 3-, 5-, and 8-year MSS, respectively. A risk stratification model was established based on the nomogram total points and the HR, which then divided patients into three different risk levels with substantial survival disparities (all P < 0.001). Conclusion Socioeconomic factors, such as marital status, insurance status, and SES, have a significant impact on the survival outcomes of MM patients. The nomogram and the risk stratification model based on these factors can accurately and reliably predict MSS.

Objective: To develop the Family-School-Community Cooperation Dilemma Scale for Nutritional Education in Primary Schools Students, and to determine its reliability and validity, in order to provide a basis for developing targeted strategies to promote family-school-community cooperation in the area of nutritional education. Methods: Based on overlapping spheres of influence theory, the initial scale was developed through a qualitative and literature review, discussion with Delphi experts and a pilot survey from July 2022 to July 2023. From July to September 2023, a total of 125 primary school parents, 118 primary school teachers and 113 community personnel were selected from six cities in Jiangsu Province by convenient sampling methods, who were investigated to test the reliability and validity of the scale and to develop a formal scale. Results: The final Family-School-Community Cooperation Dilemma Scale for Nutritional Education in Primary School students consisted of 3 dimensions and 19 items. The exploratory analysis extracted three metric factors, with a contribution ratio of 69.07% to the accumulated variance. The mean scale component effectiveness was 0.94, and the coefficient of association between the respective dimensions and the scale ranged from 0.80 to 0.91.The overall Cronbach α coefficient for the scale was 0.95, the folded half reliability was 0.87, and the retest reliability was 0.98. Conclusion The Family-School-Community Cooperation Dilemma Scale for Nutritional Education in Primary School Students has good reliability and validity, and can be used to measure the degree of the family-school-community cooperation dilemma regarding nutritional education in primary school students.

Objective To observe the changes in intradiscal internal internal pressure before and after percutaneous nucleoplasty (PN) in the patients with discogenic low back pain (DLBP),and to explore the mechanism of PN for alleviating DLBP.Methods Thirty patients definitely diagnosed as DLBP undergoing PN in the orthopedic department of this hospital from June 2023 to October 2023 were selected.The internal pressure of the lumbar disc was measured before and after the surgery.The visual analog scale (VAS),Japa-nese orthopedic association score (JOA) and Oswestry disability index (ODI) were used to assess the pain level of the patients before operation and at postoperative 1 d,1 month,3 months.The surgical efficacy was e-valuated by using the modified MacNab criteria.The linear correlation analysis was used to observe the relation-ship between the internal pressure of lumbar disc and changes in each pain score,and the factors possibly affecting postoperative effect was analyzed by using the multivariate logistic regression analysis.Results Compared with be-fore the surgery,the immediate postoperative internal pressure of lumbar disc in the patients was significantly decreased.The JOA scores at postoperative 1 d,1 month and 3 months were significantly increased,while the VAS and ODI scores were significantly decreased,and the differences were statistically significant (P<0.05). The excellent rates of surgical efficacy at postoperative 1 d,1 month and 3 months were 66.7％,73.3％ and 63.3％,respectively.The internal pressure of lumbar disc difference value between before operation and on postoperative 1 d and internal pressure of lumbar disc decrease rate had no significant correlation with the change value of each pain score (P>0.05).The multivariate logistic regression analysis showed that the dis-ease duration and the decrease rate of internal pressure of lumbar disc were the influencing factors of clinical efficacy in PN (P<0.05).Conclusion The occurrence of DLBP may be related with the increase of internal pressure of lumbar disc.PN could effectively reduce internal pressure of lumbar disc and achieve the goal of pain relief.

Objective: To explore the association between negative life events and smartphone addiction among middle school students, so as to provide theoretical support and practical guidance for prevention and intervention of smartphone addiction among middle school students. Methods: Using cluster sampling, 8 890 students were selected to survey from 27 junior high schools and 3 senior high schools in a district of Shenzhen in 2022 (baseline) and 2023 (followup). Data were collected through selfresigned questionnaires on basic information, the Smartphone Addiction Scale-Short Version, and the Adolescent Selfrating Life Events Checklist. Mixedeffects models were employed to analyze the association. Results: Compared to 2022, the punishment scores of middle school students in 2023 [1.00 (0.00, 6.00) and 1.00 (0.00, 6.00)] decreased (Z=4.27), while the scores of interpersonal stress, learning stress and adaptation [4.00(0.00, 8.00), 4.00(0.00, 8.00); 4.00(1.00, 8.00), 5.00(2.00, 9.00); 2.00 (0.00, 6.00), 3.00 (0.00, 7.00)] increased (Z=-3.04, -8.36, -6.80) (P<0.01). Mixedeffects models revealed a positive doseresponse relationship between negative life events and smartphone addiction (OR=1.08-1.17, P<0.01). Stepwise regression showed independent positive effects of interpersonal stress (OR=1.05), academic stress (OR=1.03), and adaptation stress (OR=1.11) on smartphone addiction (P<0.01). Subgroup analysis of nonaddicted students in 2022 confirmed persistent associations for academic stress (OR=1.03) and adaptation (OR=1.07) (P<0.01). Conclusion Negative life events exhibit a positive doseresponse relationship with smartphone addiction, particularly interpersonal stress, academic stress, and adaptationrelated events.

Objective: To explore the longitudinal association between only-child status and smartphone addiction among middle school students, so as to provide a basis for establishing family intervention measures for smartphone addiction in middle school students. Methods: In October 2022 and October 2023, a preliminary survey and follow-up were conducted among 8 759 middle and high school students from 30 schools in a district of Shenzhen. A self-designed questionnaire was used to determine whether the students were the only-child, and the Chinese Version of the Smartphone Addiction Scale-Short Version (C-SAS-SV) was utilized to assess the students smartphone addiction status. A multilevel mixed-effects model and subgroup analysis were applied to examine the association between only-child status and smartphone addiction among middle school students. Results: During 2022 to 2023, the prevalence of smartphone addiction in the cohort of middle school students increased from 24.1% to 25.2%. Compared with only-child, non-only child were more likely to be addicted to smartphones (adjusted model: OR =1.2, 95% CI =1.1-1.4) and also scored higher on smartphone addiction (adjusted model: β =0.9, 95% CI =0.2-1.5)( P <0.05). Subgroup analysis further revealed that compared to baseline, non-only child demonstrated an increased prevalence of smartphone addiction (adjusted model: OR = 1.2 , 95% CI =1.0-1.5) and higher addiction scores (adjusted model: β =0.8, 95% CI =0.2-1.5) after one year( P <0.05). Conclusions Non-only child face higher risk of smartphone addiction. Under the current population policy, it is crucial to address smartphone addiction among middle school students who is not only child.

Objective: To explore the potential causal association between adolescent compulsive behaviour and smartphone addiction based on longitudinal data, so as to provide reference for the establishment of adolescent smartphone addiction interventions. Methods: A preliminary survey and follow-up were conducted on 8 907 middle and high school students in a district of Shenzhen in 2022 and 2023, respectively. Compulsive behaviours were measured by using the Mental Health Inventory for Middle School Students-60 Items (MMHI-60), smartphone addiction was assessed by using the Smartphone Addiction Scale-Short Version ( SAS- SV), and the associations between compulsive behaviours and smartphone addiction were analysed by using multilevel mixed-effects models and subgroup analyses. Results: Smartphone addiction detection rates among middle school students were significantly associated with genders, father s education level, mother s education level, study load subgroups, and whether or not they were single-parent families, and there were statistical differences ( χ 2=17.21-175.34, P <0.05). Students with compulsive behaviours were 2.98 times more likely to develop smartphone addiction than those without compulsive behaviours ( OR=2.98, 95%CI=2.77-3.22, P <0.05). Subgroup analysis of middle school students without smartphone addiction in the first year found that compulsive behaviours significantly predicted smartphone addiction ( OR= 1.76 , 95%CI=1.54-2.01, P <0.05). Conclusion There is a potential causal association between obsessive-compulsive behaviours and smartphone addiction in middle school students, and obsessive-compulsive behaviours in middle school students could significantly predicted the occurrence of smartphone addiction.