Objective:To investigate the value of radiomics signatures based on 18F-FDG PET/CT for predicting molecular classification and Ki-67 expression of breast cancer. Methods:A total of 134 female patients ((55.4±13.3) years) who underwent 18F-FDG PET/CT examination and were diagnosed with breast cancer by pathology in the First Affiliated Hospital of Soochow University from April 2016 to May 2023 were retrospectively enrolled. LIFEx software was used to extract radiomics features and the least absolute shrinkage and selection operator (LASSO) algorithm and independent-sample t test were used to screen potentially meaningful features and calculate the radiomics score, which were considered as radiomics models. Clinical characteristics were selected by supervised logistic regression and clinical models were established. Radiomics features and clinical characteristics were incorporated to logistic regression analysis to establish combined models. ROC curves were drawn and the differences among AUCs were analyzed by Delong test. Results:Among 134 patients, 22 were with triple negative breast cancer (TNBC), 47 were human epidermal growth factor receptor 2 (HER2) over-expression type, 37 were Luminal A type and the rest 28 were Luminal B type. The expression of Ki-67 was high in 85 patients, and was low in the rest 49 patients. The AUCs (95% CI) of the combined models for predicting TNBC, HER2 overexpression type, Luminal A type and Ki-67 expression were 0.843(0.770-0.900), 0.808(0.723-0.876), 0.825(0.711-0.908) and 0.836(0.762-0.894), respectively, which were higher than those of clinical models ( z values: 1.97-3.06, all P<0.05). Conclusion:The predictive model combining radiomics signatures based on 18F-FDG PET/CT and clinical characteristics can well predict the molecular classification and Ki-67 expression level of breast cancer.

Objective To describe the current status of the caregiver preparedness in mothers of fetus with treatable congenital malformation,and to explore its influencing factor.Methods 210 pregnant women with fetuses diagnosed with treatable congenital malformations in the obstetrics department of a tertiary specialized hospital in Dalian were selected as the study subjects by convenient sampling method from November 2022 to August 2023.The survey was conducted using the General Situation Questionnaire,Caregiver Preparedness Scale,Simplified Coping Style Questionnaire,shortened Chinese version of the Family Resilience Assessment Scale and Social Support Rating Scale.The factors influencing the caregiver preparedness in mothers of fetus with treatable congenital malformation were analyzed using univariate analysis and multiple linear regression.Results Finally,201 mothers of fetuses with treatable congenital malformations were included in the study.The total score of caregiver preparedness was(20.47±6.29),among which the emergency response,management dimension and care stress dimension scored lower.It is concluded that education level,age,subjective support,use of social and economic resources and negative coping are the factors that affect the caregiver preparedness in mothers of fetus with treatable congenital malformation.Conclusion The caregiver preparedness in mothers of fetus with treatable congenital malformation needs to be improved.Medical staff should design a personalized and comprehensive nursing plan to intervene according to the factors,so as to improve the recovery and quality of life of children.

Breast cancer has now become the most common malignancy in women globally. Chemotherapy-induced peripheral neuropathy (CIPN) is one of the common adverse reactions in chemotherapy for breast cancer, and when severe, it can significantly impact the treatment outcomes and quality of life of patients. This article provides an overview of the incidence, influencing factors, assessment tools, and intervention strategies for CIPN in breast cancer patients, with the aim of offering a reference for healthcare professionals to enhance symptom management in breast cancer patients.

Self-management helps patients alleviate the impact of disease on their social functions, emotions, and interpersonal relationships. This article provides an overview of the origin, key components, and current application of Individual and Family Self-Management Theory in clinical nursing. Based on this overview, the article presents future directions to enhance the understanding of this theory among Chinese nursing personnel and to further promote its application in nursing practice in China.

In this paper, we propose a multi-scale mel domain feature map extraction algorithm to solve the problem that the speech recognition rate of dysarthria is difficult to improve. We used the empirical mode decomposition method to decompose speech signals and extracted Fbank features and their first-order differences for each of the three effective components to construct a new feature map, which could capture details in the frequency domain. Secondly, due to the problems of effective feature loss and high computational complexity in the training process of single channel neural network, we proposed a speech recognition network model in this paper. Finally, training and decoding were performed on the public UA-Speech dataset. The experimental results showed that the accuracy of the speech recognition model of this method reached 92.77%. Therefore, the algorithm proposed in this paper can effectively improve the speech recognition rate of dysarthria.
Humans ; Dysarthria/diagnosis* ; Speech ; Speech Perception ; Algorithms ; Neural Networks, Computer

Objective In this research,we constructed a skin care program for radiodermatitis in breast cancer patients and explore its clinical application effect.Methods The skin care program for radiodermatitis of breast cancer patients was constructed by the evidence summary and expert meeting.By the convenient sampling method,the patients admitted from July 2022 to September 2022 were selected as the control group for routine nursing,and the patients admitted from October 2022 to December 2022 were selected as the intervention group.The severity of radiodermatitis and quality of life of patients were compared between the 2 groups.Results The Radiation-Induced Skin Reaction Assesment Scale score of the intervention group was(4.63±2.12)after intervention,which was lower than(9.88±2.35)of the control group.After intervention,our results determined by RTOG showed that 16 patients in the control group had grade Ⅰ dermatitis(66.7%);8 patients had grade Ⅱ dermatitis(33.3%);22 patients in the intervention group had grade Ⅰ dermatitis(91.7%),and 2 patients in the intervention group had grade Ⅱdermatitis(8.33%).The score of quality of life after intervention was(102.04±18.20)in the intervention group and(78.29±13.18)in the control group.The differences were statistically significant(P＜0.001).Conclusion The skin care program for radiodermatitis can effectively reduce the severity of radiodermatitis of breast cancer patients,and the quality of life of breast cancer patients during radiotherapy can be effectively improved.

Hypertension has a high global prevalence rate,which is the main preventable risk factor for cardiovascular disease.Home blood pressure monitoring plays an important role in diagnosis,adjustment of treatment strategies and long-term follow-up of hypertension.However,there are still enormous challenges for the popularization and standardized application of home blood pressure monitoring.Therefore,this review article describes indication,standardized implementation protocol,current status and influencing factors of implementation and management forms of home blood pressure monitoring.It can provide a reference for promoting the implementation of practical guidelines for home blood pressure monitoring and optimizing the application of home blood pressure monitoring.

Objective:To explore the status of sense of research gain in nursing postgraduates, and to explore the correlation of sense of research gain, learning engagement, and mentors' guidance behavior.Methods:From April to May 2022, a total of 238 nursing postgraduates in China were selected as the research objects by convenience sampling method, and were investigated using Sense of Research Gain, Utrech Work Engagement Scale-Student and Mentors' Guidance Behavior Scale. Pearson correlation analysis was used to explore the correlation of learning engagement, mentors' guidance behavior and sense of research gain in nursing postgraduates. Hierarchical linear regression analysis was used to explore the influencing factors of sense of research gain. A total of 238 questionnaires were distributed in this study, and 231 valid questionnaires were received, with an effective recovery rate of 97.06%.Results:The score of Utrech Work Engagement Scale-Student in nursing postgraduates was (31.47±6.01) , the score of Sense of Research Gain was (63.47±17.07) , and the score of Mentors' Guidance Behavior Scale was (50.90±11.10) . Pearson correlation analysis results showed that the total score and each dimension score of Sense of Research Gain and Mentors' Guidance Behavior Scale were positively correlated with the total score and each dimension score of Utrech Work Engagement Scale-Student ( r value were 0.351-0.662, P all <0.01) . Hierarchical linear regression analysis results showed that mentor's title, learning engagement and mentor's guidance behavior were the influencing factors of sense of research gain in nursing postgraduates ( P<0.05) , which could explain 55.60% of the variation of the sense of research gain. Conclusions:The sense of research gain of nursing postgraduates still needs to be improved. Mentor's title as professor, learning engagement and mentor's guidance behavior were the influencing factors of sense of research gain in nursing postgraduates. School should strengthen the level of learning engagement of nursing postgraduates, standardize mentor's guidance behavior, so as to improve sense of research gain.

Objective:To prospectively guide the change of chemotherapy regimen in mouse 5-fluorouracil (5-FU) resistance subcutaneous xenograft tumor model derived from gastric cancer patients by the early changes of MRI apparent diffusion coefficient (ADC), and to compare the difference of tumor load between ADC guided dressing change group and volume guided dressing change group.Methods:From January to June 2020, thirty patient-derived xenografts mouse models were established using 5-FU resistant gastric cancer cells coming from patients, and were randomly divided into experimental group and control group by AdaBoost algorithm, with 15 mice in each group. On the 26th day after transplantation, all mice began chemotherapy with 5-FU as the first-line chemotherapy drug, and underwent MR examination once every two days, including T 2WI and diffusion weighted imaging (DWI). Volumes of tumors were measured using an open-source software ITK-SNAP and values of ADC were measured on ADC maps. According to the change rate of tumor ADC value in the experimental group and the tumor volume growth rate in the control group, the replacement time of chemotherapy drugs was determined, and 5-FU was replaced by paclitaxel. The end point of the experiment was the day that the mice entered the cachexia state. Independent-sample t test was used to compare the difference of tumor load between the two groups. Results:After 5-FU treatment, the ADC value of the two groups both increased. The ADC value began to decline on the 4th day after chemotherapy, and the experimental group continued chemotherapy with paclitaxel instead of 5-FU at this time point. The tumor volume growth rate of the control group increased significantly on the 6th day after chemotherapy (from 8.6% to 16.1%), and the control group used paclitaxel instead of 5-FU chemotherapy at this time point. The observed end point was on the 18th day after chemotherapy. The tumor load of the experimental group [(1.82±0.09) cm 3] was lower than that of the control group [(2.01±0.09) cm 3], and the difference was statistically significant ( t=2.25, P=0.033). On the 16th day after chemotherapy in the experimental group and the 18th day after chemotherapy in the control group, the time of paclitaxel administration in both groups was 12 days. The tumor load in the experimental group [(1.61±0.12) cm 3] was also lower than that in the control group [(2.01±0.09) cm 3], and the difference was statistically significant ( t=2.03, P=0.040). Conclusions:For the subcutaneous transplantation model of 5-FU resistant gastric cancer mice, according to the early changes of tumor ADC value after chemotherapy, the replacement of chemotherapy drugs can obtain a lower tumor load, suggesting that it is a feasible method to optimize the chemotherapy regimen.

Objective Aiming at the clinical problem of the low matching degree with the patient’s anatomical morphology for traditional cervical fusion cage, a cervical fusion cage with the function of adjustable height and the shape matched with the vertebral body was established, and its biomechanical properties were evaluated. Methods A cervical C4-5 segment fusion model was established according to anterior cervical discectomy and fusion (ACDF), so as to simulate different motion conditions, i.e. anterior flexion, posterior extension, left/right lateral flexion, left/right rotation, and stress of the fusion cage and vertebral endplate was calculated. After three-dimensional (3D) printing of the fusion cage, an in vitro mechanical experiment was conducted to explore safety and stability of the fusion cage. ResultsThe fusion cage could keep the range of motion (ROM) of cervical vertebrae at the fusion segment with 1°-2.8° and reduce the ROM to 40%-80% of the natural segment. In the in vitro compression test, the yield load of the fusion cage was (2 721.67±209) N, which met the maximum demand of the physiological load in service state. Conclusions The designed fusion device with adjustable height shows better biomechanical properties and can reduce the selection step in operation.