Objective:To explore the elements of the diversified caring bank based on long-term care insurance system to provide a basis for the construction of diversified caring bank framework system.Methods:The phenomenological research method was adopted to conduct semi-structured interviews with 15 nursing management personnel in pension institutions in Suzhou and Suzhou long-term care insurance policy implementation management personnel in March to May 2021. NVivo 11 was used to manage interview data, and applied Colaizzi 7-step analysis to conduct inductive analysis and extract the themes.Results:The elements of the diversified caring bank based on long-term care insurance system were divided into three main modules: diversified caring personnel, diversified caring content and diversified incentive measures. The diversified caring personnel module included full-time and part-time caring personnel. Diversified caring content included six elements: daily life assistance, professional life caring, professional medical caring, communication and emotional support, emergency caring and special disease caring. Diversified incentive measures module included two elements: labor currency and "benefit" care currency.Conclusions:The diversified caring personnel provides continuous power for disabled caring; diversified caring content provides ways to meet the various needs of the disabled elderly; diverse incentives are effective ways to attract and stabilize the caring workforce.

Objective To investigate the predictive value of systemic immune inflammation index(SII)scores in long-term survival of patients with stage Ⅲ squamous lung cancer treated with radical radiotherapy.Methods Clinical data of stage Ⅲ squamous lung cancer patients who underwent radical radiotherapy at the Radiotherapy Department of the Fourth Hospital of Hebei Medical University from January 2010 to December 2018 were retrospectively analyzed.The peripheral hematological indexes one week before radiotherapy were collected and recorded.X-Tile software was applied to determine the best cut-off values for continuous variables.Kaplan-Meier method was used to analyze overall survival(OS)and progression-free survival(PFS).Results A total of 453 patients were included in this study.There were 336 patients in the low SII group(＜1 277.3),and other 117 patients were in the high SII group(≥1 277.3).The median OS and median PFS in the high SII group were shorter than those in the low SII group(OS:20.8 months vs.31.0 months,Log-rank χ2=18.015,P＜0.01;PFS:13.0 months vs.21.0 months,Log-rank χ2=15.062,P＜0.01).Multivariate Cox regression analysis showed that high SII was associated with OS(HR=1.628,95%CI:1.294-2.047,P<0.001)and PFS(HR=1.559,95%CI:1.240-1.961,P<0.001).Other influencing factors included late TNM stage,poor radiotherapy efficacy and decreased HALP score.Conclusion SII can be used to evaluate the long-term survival of patients with stage Ⅲ lung squamous cell carcinoma receiving radical radiotherapy,and the increase of SII indicates a poor prognosis.

Objective:To investigate the computed tomography (CT)-based integrated deep learning model for qualitative and quantitative classification of hepatic portal vein.Methods:The retrospective study was conducted. The CT imaging data of 291 patients undergoing upper-abdomen enhanced CT examination in the Beijing Tsinghua Changgung Hospital of Tsinghua University from October 2017 to January 2019 were collected. There were 195 males and 96 females, aged (51±12)years. The hepatic portal vein was reconstructed using the three-dimensional reconstruction system. Three-dimensional point cloud was input to the encoder model to obtain the three-dimen-sional reconstructed vectorized representation, which was used for qualitative classification and quantitative representation classification. Measurement data with normal distribution were repre-sented as Mean± SD, and comparison between groups was conducted using the paired t test. Count data were repre-sented as percentages or absolute numbers, and comparison between groups was analyzed using the paired chi-square test. Results:(1) Three-dimensional reconstruction of portal vein and anatomical classification. Three-dimensional structure was reconstructed in the 291 patients. Classification of main hepatic portal vein showed 211 cases of Akgul type A, 29 cases of Akgul type B, 16 cases of Akgul type C, 10 cases of Akgul type D, and 25 cases of unclassifiable. (2) Prediction of qualitative classification of main hepatic portal vein. Of the 291 patient samples, 25 unclassifiable or poor quality samples were excluded, 266 samples were used for automated qualitative classification of the main portal vein by machine model. There were 211 cases of Akgul type A, 29 cases of Akgul type B, 26 cases of Akgul type C&D. The Macro-F1 of 266 patients was 61.93%±40.50% and the accuracy was 84.99%, versus 32.38%±19.81% and 61.65% of Random classifier, showing significant differ-ences between them ( t=7.85, χ2=62.89, P<0.05). (3) Quantitative representation of portal vein classification. The probabilities of quantitative classification for Akgul qualitative classification of similar samples included P@1 as 73%±45%, P@3 as 70%±37%, P@5 as 69%±35%, P@10 as 67%± 32%, mean reciprocal rank(MRR) as 80%±34%, versus 57%±50%, 58%±35%, 58%±32%, 58%± 30%, 70%±37% of the baseline model, showing significant differences between the two analytical methods ( t=5.22, 5.11, 5.00, 4.99, 3.47, P<0.05). Conclusion:The automated classification model for the hepatic portal vein structure was constructed using CT-based three-dimensional reconstruc-tion and deep learning technology, which can achieve automatic qualitative classification and quanti-tatively describe the hepatic portal vein structure.

The aim of this experiment is to investigate the mechanism of liver cell damage induced by nonylphenol(NP).After establishing an in vitro model of NP induced BRL-3A liver cell injury,changes of oxidative damage markers were evaluated,Fe2+content was determined,the ultrastruc-ture of BRL-3A was observed,and the expression level of iron death marker proteins were deter-mined.The results showed that NP could significantly increase ROS and MDA in BRL-3A cells(P＜0.05);the GSH content,GSH Px activity,and SOD activity were significantly reduced(P＜0.05);the Fe2+content significantly increased(P＜0.05)and showed a dose-dependent effect;the mitochondrial volume of BRL-3A cells significantly decreases,the mitochondrial cristae break or e-ven disappear,and some mitochondria show vacuolization;the expression levels of iron homeostasis related proteins TFR1 and FTH1 were significantly reduced(P＜0.05).The results indicate that ferroptosis is involved in the mechanism of NP induced liver cell damage,which bene-fits for further exploration of NP pathogenesis.