This paper uses the binomial logistic regression model and the 2011 China Health and Retirement Longitudinal Study ( CHALRS) to analyze the influencing factors on the choice of public or private hospitals by mid-dle-aged and elderly patients. The study finds that rural residents are significantly influenced by the self-evaluation of health, on-demand clinic consultation, and the use of basic medical insurance systems. There is a higher probability that patients that are not as healthy and that require clinical consultation or the use of the basic medical insurance sys-tem will choose public hospitals. The study concludes that elderly patients have greater trust in public hospitals when they seek treatment for disease risks. Moreover, the fixed points of medical insurance are concentrated in public hos-pitals, thereby prompting patients to choose public hospitals. It is suggested that the prevention and control of senile diseases be strengthened, the level of hospital consulting services be improved, and the access mechanisms of medi-cal insurance fixed point hospitals be adjusted.

Objective:To design automatic reverse osmosis water system with new design idea of reverse osmosis water system, to make sure of the procedure. Methods:During the design, using microcomputer technology to control water preparation and disinfection. Results:Using MCU to control preparation of water and disinfection, in order to monitor water quality. If water quality exceeds the standard, the system will alarm and generate records. Conclusion: Using microcomputer technology to design Reverse osmosis water system, not only reducing artificial, but also to improve the safety and controllability, even the quality control of reverse osmosis water system.

Objective:To evaluate the relationship between preoperative widespread pain and chronic post-surgical pain (CPSP) following total knee arthroplasty (TKA) in the patients with knee osteoarthritis.Methods:Two hundred American Society of Anesthesiologists physical status Ⅰ-Ⅲ patients with knee osteoarthritis, aged 40-70 yr, undergoing elective the first unilateral primary TKA under general anesthesia, were enrolled.The widespread pain index, visual analogue scale score, Hospital Anxiety and Depression Scale and Central Sensitization Inventory scores were recorded at 1 day before surgery.The patients were divided into CPSP-positive group and CPSP-negative group according to visual analogue scale score at 6 months after surgery.Risk factors for CPSP were analyzed by logistic regression.Results:The results of logistic regression analysis showed that increased preoperative widespread pain index score, Central Sensitization Inventory score and Hospital Anxiety and Depression Scale score and female were risk factors for CPSP after TKA.Conclusions:Preoperative widespread pain is a risk factor for CPSP following TKA in the patients with knee osteoarthritis.

Objective To observe the value of combined synthetic MRI and multiplexed sensitivity encoding diffusion weighted imaging(MUSE-DWI)for differentiating benign and malignant endometrial lesions.Methods Data of 112 patients with benign or malignant endometrial lesion confirmed by pathology were retrospectively analyzed.According to pathologic diagnosis,the patients were divided into malignant group(n=72)and benign group(n=40).Synthetic MRI and MUSE-DWI quantitative parameters,including T1,T2,proton density(PD)and apparent diffusion coefficient(ADC)of all lesions were acquired.The clinical data as well as ADC,T1,T2 and PD values of lesions were compared between groups,and those being significantly different between groups were included in univariate and multivariate logistic regression.Then the univariate and combined models were established for differentiating benign and malignant endometrial lesions.The receiver operating characteristic curves were drawn,and areas under the curves(AUC)were calculated to evaluated the diagnostic efficacy of the models,which were compared with DeLong test.Results Patients'age in malignant group were higher than that in benign group(P＜0.05).The length of the maximum diameter was larger,ADC,T2 and PD values were lower in malignant lesions than those in benign ones(all P＜0.05),while no significant difference of T1 value was found between groups(P=0.074).The AUC of ADC univariate model was 0.966,and there was no significant difference in AUC(0.970)between the combined ADC+T2+PD model(adjusted P＞0.05),but both higher than AUC of T2 univariate model(0.618),PD univariate model(0.664)and the combined T2+PD model(0.668)(all adjusted P＜0.05).Conclusion ADC univariate model and combined model with other parameters of combined synthetic MRI and MUSE-DWI could be used to effectively differentiate benign and malignant endometrial lesions.

ObjectiveTo study the effect of upper limb robot-assisted therapy on upper limb function and cerebral cortex activation in stroke patients using functional near-infrared spectroscopy (fNIRS). MethodsFrom January, 2022 to January, 2023, 32 stroke patients in Zhejiang Rehabilitation Medical Center were randomly divided into control group (n = 16) and experimental group (n = 16). Both groups received routine neurological medication and routine rehabilitation. The control group received routine upper limb exercises, the experimental group received upper limb robot-assisted therapy. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and fNIRS (oxyhemoglobin, deoxyhemoglobin, and total hemoglobin) before and four weeks after treatment. NIRS_SPM was used for activation analysis, Homer2 was used for blood oxygen concentration analysis. ResultsAfter treatment, the score of FMA-UE increased in both groups (|t| > 5.910, P < 0.001), and was higher in the experimental group than in the control group (t = -2.348, P < 0.05). fNIRS activation results showed that, the activation increased in the experimental group after treatment in channel 17 (F = 9.354, P < 0.01), and it was more than that in the control group (F = 5.217, P < 0.05). fNIRS blood oxygen concentration results showed that, the blood oxygen concentration increased in the experimental group after treatment in channel 17 (F = 12.179, P < 0.01), and it was more than that in the control group (F = 4.883, P < 0.05). ConclusionThe upper limb robot-assisted therapy can improve the upper limb motor function and cerebral cortex activation of stroke patients.

¹⁷⁷Lu- prostate specific membrane antigen (PSMA) radio-ligand therapy has been approved abroad for advanced prostate cancer and has been in several clinical trials in China. Based on domestic clinical practice and experimental data and referred to international experience and viewpoints, the expert group forms a consensus on the clinical application of ¹⁷⁷Lu-PSMA radio-ligand therapy in prostate cancer to guide clinical practice.