Objective To develop and validate an automated organoid image segmentation approach based on deep learning for addressing the issues of high misidentification rate,blurred boundary and poor generalization in current organoid segmentation,thereby facilitating researchers to monitor and analyze organoid growth more efficiently.Methods The wavelet scattering coefficient matrix and capsule convolution module were integrated into the U-Net architecture to construct the organoid image segmentation model OrgCapsU-Net which was trained and evaluated on 3 organoid image datasets from different tissue sources.Results Compared with current mainstream segmentation algorithms,OrgCapsU-Net could better distinguish organoid and impurity,and lead to smoother segmentation boundaries,achieving superior performance across 4 evaluation metrics on 3 datasets.Conclusion OrgCapsU-Net delivers excellent segmentation performance and can be applied to organoids from various tissue sources,showing strong potential for applications in the in vitro model establishment,high-throughput drug screening,and personalized medicine.

Objective:To analyze the relationship between CT characteristics and related quantitative parameters of spectral CT in diagnosing the nature of thyroid nodules and lymph node metastasis in patients.Methods:This retrospective analysis included 198 patients with thyroid nodules who visited Shangqiu First People’s Hospital between Jun. 2019 and Dec. 2024. The patients included 53 males and 145 females, aged (50.96 ± 5.36) years. A total of 105 patients were classified as benign nodules and 93 patients as malignant nodules (45 with metastasis and 48 without metastasis). All patients underwent spectral CT scans to analyze the efficacy of spectral CT in diagnosing the nature of thyroid nodules and lymph node metastasis in malignant nodules. Continuous data were expressed as ±s, and intergroup comparisons were performed using independent sample t-tests. Enumeration data were expressed as [n (%) ] and tested using the chi-squared test. Receiver-operating characteristic (ROC) curves were constructed to determine the diagnostic efficacy of various CT features and related quantitative parameters in diagnosing thyroid nodules and cervical lymph node metastasis. Results:The AUCs of capsule, edge and shape for diagnosing malignant nodules were 0.706, 0.701 and 0.735, respectively. The AUCs of IC, NIC and slope of energy spectrum curve in arterial phase and IC, NIC and slope of energy spectrum curve in venous phase for diagnosing malignant thyroid nodules were 0.967, 0.992, 0.966, 0.819, 0.991 and 0.986, respectively. The AUCs of nodule number, capsule, edge, shape and long diameter of nodule for diagnosing cervical lymph node metastasis in patients with malignant thyroid nodules were 0.642, 0.617, 0.643, 0.619 and 0.651, respectively. The AUCs of IC, NIC and slope of energy spectrum curve in arterial phase and IC, NIC and slope of energy spectrum curve in venous phase were 0.941, 0.941, 0.955, 0.786, 0.881 and 0.824, respectively. Multivariate analysis showed that multiple nodules, absence of capsule, blurred margins, irregular shape, nodule long diameter >10 mm, IC, NIC in the arterial and venous phases, and increased slope of the energy spectrum curve were independent risk factors for cervical lymph node metastasis in patients with malignant thyroid nodules ( OR=2.631, 1.854, 2.694, 1.936, 2.657, 2.064, 2.314, 2.525, 2.342, 2.712, 2.986, P<0.05) . Conclusions:In spectral CT examinations of patients with thyroid nodules, malignant nodules often show characteristics such as no capsule and blurred edges, accompanied by changes in relevant quantitative parameters. These CT characteristics and quantitative parameters have good diagnostic efficacy for the nature of thyroid nodules and cervical lymph node metastasis in patients with malignant nodules, and have high clinical application value.

Objective:We conducted a quality analysis and a survey of current situation of portable blood glucose meters from hospitals and patient sources in Zhejiang Province..Methods:The study is a retrospective cross-sectional study that included 252 portable blood glucose meters, of which 35 portable blood glucose meters (4 in provincial hospitals, 29 in municipal hospitals, and 2 in county-level hospitals) selected for the "Zhejiang Province Portable Blood Glucose Meter Flight Quality Control Inspection" project in April 2023, 126 portable blood glucose meters collected for the "Zhejiang Hospital Portable Blood Glucose Meter Whole Hospital Comparison" project in January 2024, and 91 portable blood glucose meters collected from patients in the "Zhejiang Hospital Home Portable Blood Glucose Meter Convenience Service" project from 2021 to 2023. By comparing the blood glucose results with the reference analyzer, evaluate the qualification rate of portable blood glucose meters between hospitals and patients, imported and domestic brands, and analyze the distribution of blood glucose concentration intervals for unqualified portable blood glucose meters. Conduct a survey questionnaire on the use of portable blood glucose meters by patients to analyze their trust in the results, quality control execution rate, comparison awareness rate, and comparison execution rate.Results:The overall qualification rate of portable blood glucose meters in hospitals (95.7%) was higher than that of portable blood glucose meters use by patients (70.3%), and the difference was statistically significant ( χ 2=31.94 , P<0.001). Among the unqualified blood glucose meters, the unqualified blood glucose concentration is mainly concentrated in the high concentration range (65.9%). Among imported brands, the qualification rate of blood glucose meters from hospitals(99.3%) is higher than that from patients(74.0%), and the difference is statistically significant ( χ 2=36.97, P<0.001). Meanwhile, 75% of patients fully trust the detection results of the blood glucose meter, but its instrument qualification rate is 69%. The awareness rate of patients regarding the comparison of portable blood glucose meters is 73%, but the execution rate of quality control and standard comparison of portable blood glucose meters by patients is 0. Conclusion:The quality of portable blood glucose meters in Zhejiang Province is uneven, with the highest pass rate for portable blood glucose meters from hospitals. Patients have weak awareness of quality control and comparison of portable blood glucose meters.

[Purpose]To analyze the incidence and mortality of female breast cancer in Zhejiang cancer registration areas in 2021 and the trends from 2000 to 2021.[Methods]The data of cancer inci-dence,mortality and population data reported by cancer registration areas in Zhejiang Province from 2000 to 2021 were collected.The crude incidence/mortality rates,age-standardized rates ad-justed by Chinese standard population(ASIRC,ASMRC)and world standard population(ASIRW,ASMRW),cumulative rates(0～74 years old),truncated rates(35～64 years old),proportion of fe-male breast cancer and age-specific rate were calculated.The average annual percentage change(AAPC)of female breast cancer incidence and mortality rates in Zhejiang from 2000 to 2021 was calculated using Joinpoint software.[Results]In 2021,there were 7 262 new cases of female breast cancer in Zhejiang cancer registration areas,accounting for 12.70％of all new female can-cer cases.The crude incidence rate,ASIRC and ASIRW were 65.71/105,42.03/105 and 39.22/105,respectively.The cumulative incidence rate(0～74 years old)was 4.26％,and the truncated rate(35～64 years old)was 98.34/105.The ASIRC in urban and rural areas were 43.15/105 and 40.15/105,respectively.There were 992 deaths of female breast cancer,accounting for 6.97％of all female cancer deaths.The crude mortality rate,ASMRC and ASMRW were 8.98/105,4.62/105 and 4.47/105,respectively.The cumulative mortality rate(0～74 years old)was 0.48％,and the truncated rate(35～64 years old)was 8.89/105.The ASMRC in urban and rural areas were 4.79/105 and 4.34/105,respectively.The incidence rate of female breast cancer reached the peak at the age group of 60～64 years old,and the mortality rate reached the peak at the age group of 85 years old and above.From 2000 to 2021,the crude incidence rate,ASIRC and ASIRW of female breast cancer in Zhejiang cancer registration areas showed significant increasing trends(all P＜0.05).The crude mortality rate and ASMRW of female breast cancer also showed significant increasing trends(all P＜0.05).[Conclusion]The incidence rate of female breast cancer in Zhejiang Province was higher than the national average,while the mortality rate was lower than the national average in 2021.Both the incidence and mortality rates showed increasing trends from 2000 to 2021.Fur-thermore,distinct urban-rural disparities existed in both incidence and mortality characteristics.

Objective:To observe the effect of cognitive-motor dual-task training on patients with subacute stroke and to analyze the mechanism of improvement in brain functional connectivity by functional near-infrared spectroscopy(fNIRS).Method:Forty patients with subacute stroke were randomly divided into a control group(n=20)and an obser-vation group(n=20).All patients were given conventional comprehensive rehabilitation treatment.The control group was given walking and cognitive function training separately,while the observation group was given cog-nitive-motor dual-task training.The cognition,motor function and activities of daily living were evaluated by mini-mental state examination(MMSE),functional ambulation category scale(FAC)and modified Barthel in-dex(MBI)before and after 6 weeks of treatment.fNIRS was used to compare the functional activity of the primary motor cortex(M1),supplementary motor area(SMA),prefrontal cortex(PFC)and the functional connectivity of each brain region under task states.Result:A total of 37 patients were included in the final statistics,and there was no difference in baseline lev-el between the two groups before treatment(P>0.05).After intervention,the MMSE,FAC and MBI of the two groups were better than those before treatment,and the observation group was better than the control group.The differences were statistically significant(P<0.05).At the same time,fNIRS observation showed that after treatment,except the right M1 and right PFC,the functional intensity of M1,SMA and PFC in the two groups were higher than those before treatment.The functional intensity of SMA in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).Af-ter treatment,the functional connection intensity of brain regions on the injured side in the two groups were higher than those before treatment,and the functional connection intensity between bilateral SMA,M1 and PFC,SMA and PFC in the observation group were higher than those in the control group,and the differenc-es were statistically significant(P<0.05).Conclusion:Compared with conventional motor and cognitive function training,cognitive-motor dual-task training can more significantly improve cognitive,motor function and independence in patients with subacute stroke.The mechanism may be related to the fact that dual-task training can effectively improve the brain func-tional intensity of the SMA area,the functional connection intensity between M1 and PFC as well as SMA and PFC.

Objective:To explore the effect of different swallowing tasks on cortex activation and functional connectivity in stroke survivors with dysphagia using functional near-infrared spectroscopy (fNIRS).Methods:Thirty stroke survivors with dysphagia performed three different swallowing tasks: swallowing action observation (SO), swallowing action execution (SE), and swallowing action imagination (SI). During each task, fNIRS was used to document the brain concentrations of oxyhemoglobin and deoxyhemoglobin. Cortex activation (β value) and brain functional connectivity were assessed.Results:Compared with the resting state, the areas activated during the SO task included the left primary sensory cortex and the right prefrontal cortex. During the SE and SI tasks the left prefrontal cortex and the left motor cortex were activated as well. Compared with hemorrhagic stroke survivors, ischemic stroke survivors showed significantly greater activation of the right primary sensory cortex, the right motor cortex, and the left primary sensory cortex during the SE task. Functional connectivity during the SO, SE and SI tasks was significantly greater than in the resting state, with the average connectivity values during the SE task significantly higher than during the SI task.Conclusions:Stroke survivors with dysphagia exhibit increased activation in the prefrontal cortex and primary sensory cortex during different swallowing tasks. Such tasks can improve their brain functional connectivity.

Objective:To explore the clinical efficacy and safety of endoscopic multi-band ligation (EMBL) in the management of refractory gastroesophageal reflux disease (RGERD) combined with esophageal hiatal hernia (HH).Methods:This study was a prospective, multicenter, small-sample cohort study. Patients who were diagnosed as having RGERD combined with HH at Inner Mongolia Medical University Cancer Hospital and Inner Mongolia Medical University Hospital from January 2020 to June 2022 were selected to undergo EMBL. The 24-hour esophageal pH monitoring and high-resolution manometry (HRM) related indicators, gastroesophageal reflux index (GERI), gastroesophageal reflux disease questionnaire (GERD-Q) scores, and gastroesophageal reflux disease health-related quality of life (GERD-HRQL) scores were compared before and after the operation. The patient satisfaction and complications were also investigated.Results:A total of 25 patients were included, all of whom were successfully treated with EMBL. Reflux symptoms were relieved to varied degrees in all patients. There were no serious complications during or after the operation, such as perforation, bleeding, and dysphagia. Postoperative follow-up at 6 and 12 months showed a significant decrease in DeMeester scores [18.00 (5.83, 54.75) points, 16.30 (4.38, 60.00) points] compared to preoperative baseline [105.00 (60.80, 147.70) points, Z=-3.72, P<0.001; Z=-3.82, P<0.001]. The percentage of time of pH<4 [8.80 (6.10, 11.80)%, 8.95 (5.15, 10.90)%] significantly decreased compared to the baseline [31.15 (16.75, 54.75)%, Z=-3.72, P<0.001; Z=-3.72, P<0.001], the number of long refluxes [7.90 (4.93, 11.75) times, 6.90 (4.00, 10.75) times] significantly decreased compared to the baseline [33.00 (13.00, 43.00) times, Z=-3.82, P<0.001; Z=-3.58, P<0.001], and the number of acid refluxes (14.86±8.71 times, 12.93±5.51 times) significantly decreased compared to before (30.42±17.99 times, t=5.88, P<0.001; t=4.79, P<0.001). Lower esophageal sphincter resting pressure [9.70 (5.80, 19.58) mmHg, 11.70 (5.40, 19.78) mmHg] was significantly higher compared to before [4.70 (3.25, 7.00) mmHg, Z=-2.84, P<0.001; Z=-3.10, P<0.001]. GERD-Q scores (10.00±2.01 points, 9.43±1.74 points) were significantly higher compared to before (15.34±1.51 points, t=8.90, P<0.001; t=9.87, P<0.001), GERD-HRQL scores [7.00 (5.00, 7.75) points, 6.00 (5.75, 8.25) points] significantly decreased compared to preoperative baseline [13.50 (11.00, 21.25), Z=-3.73, P<0.001; Z=-3.72, P<0.001], and GERI (2.26%±1.58%, 2.07%±1.17%) significantly decreased compared to before (5.72%±2.27%, t=8.92, P<0.001; t=9.86, P<0.001). At 6 and 12 months postoperative follow-up, patient satisfaction [68.00% (15/25), 84.00% (21/25)] significantly increased compared to before [0.00% (0/25), Z=-4.63, P<0.001; Z=-6.48, P<0.001]. Conclusion:Preliminary small-sample study has shown that EMBL is safe, reliable and effective for the treatment of RGERD with HH.

Objective:To investigate the effect of low frequency repetitive transcranial magnetic stimulation(rTMS)com-bined with rehabilitation robot on balance function and motor ability of stroke patients.Method:Sixty stroke patients with hemiplegia who met the inclusion criteria were randomly divided into the rT-MS group(group A),the lower limb robot group(group B)and the rTMS combined with lower limb robot group(group C),with 20 subjects in each group.All the three groups also received conventional rehabilita-tion treatment for 4 weeks.The Berg balance scale(BBS)and Pro-kin balance test were used to evaluate the balance function of the three groups before and after treatment.The Fugl-Meyer assessment of lower extremity motor function(FMA-L)and functional ambulation category(FAC)scale were used to evaluate the patients'lower extremity function and walking ability.Result:Before treatment,there was no significant difference in BBS,balance test,FMA-L and FAC among the three groups(P＞0.05).After treatment,the BBS,balance test,FMA-L and FAC of the three groups were significantly improved compared with those before treatment(P＜0.05).The improvement of the BBS,bal-ance test,FMA-L and FAC in group C was significantly higher than that in group A and group B(P＜0.05).Conclusion:Low frequency rTMS combined with lower limb rehabilitation robot has a significant effect on bal-ance function and motor ability in stroke patients.

OBJECTIVE To analyze the relationship between the postoperative intervertebral space infection and the expressions of β-catenin and glycogen synthase kinase-3β(GSK-3β)in the patients with lumbar disc herniation(LDH).METHODS A total of 201 patients with LDH who received surgical procedures in Harbin Orthopedics and Traumatology Hospital from Jan.2022 to May 2024 were enrolled in the study and were divided into the infection group and the no infection group according to the status of postoperative intervertebral space infection.The distri-bution and drug resistance of pathogens isolated from the patients of the infection group were detected.The rela-tive expression levels of peripheral blood Wnt,β-catenin and GSK-3β proteins were compared between the two groups.RESULTS Among the 201 patients who received surgical procedures,21 had postoperative intervertebral space infections,with the infection rate 10.45％.Totally 26 strains of pathogens were isolated from the 21 patients in the infection group,11(42.31％)of which were gram-negative bacteria,and 15(57.69％)were gram-positive bacteria.The operation duration of the infection group was(3.46±0.89)hour,longer than(3.09±0.73)hour of the no infection group(t=2.146,P=0.033).There were significant differences in the expressions of peripheral blood β-catenin and GSK-3β proteins between the infection group and the no infection group(P＜0.05).Receiver operating characteristic(ROC)curve analysis showed that the areas under the curves(AUCs)of the relative ex-pression levels of β-catenin and GSK-3β were 0.836 and 0.800,respectively;the sensitivities were 52.40％and 66.70％,respectively;the specificities were 90.56％and 93.89％,respectively;the cut-off point were 5.65 and 2.15,respectively.CONCLUSIONS The LDH patients are at high risk of postoperative intervertebral space infec-tion,the patients with the infection show the activation of Wnt/β-catenin signaling pathways and the rise of ex-pression levels of β-catenin and GSK-3β proteins.The levels of the indexes may facilitate the prediction of postop-erative intervertebral space infection in the LDH patients.

Objective To investigate pharmacologically active components of Yiqi Zishen Formula(YZF)and their mechanisms for alleviating airway inflammation in mice with chronic obstructive pulmonary disease(COPD).Methods Ultra-high-performance liquid chromatography coupled with quadrupole-orbitrap mass spectrometry was employed to characterize the chemical components in YZF and YZF-medicated rat serum.A compound-disease target network was constructed based on serum components of YZF to screen the key pathways and targets using enrichment analysis.A mouse model of cigarette smoke-induced COPD was used to evaluate the anti-inflammatory effect of YZF and validate the expression of key proteins in network pharmacology-enriched pathways.Fifty male C57BL/6J mice were randomized equally into control group,COPD model group,high-and low-dose YZF treatment groups,and N-acetylcysteine treatment group.Pulmonary function of the mice was assessed using whole-body plethysmography,and lung histopathology,alveolar structure,and airway remodeling were analyzed using HE staining.The levels of IL-1β,IL-6,and TNF-α in bronchoalveolar lavage fluid(BALF)were determined with ELISA,and pulmonary expressions of PI3K,Akt,phosphorylated Akt(p-Akt),p65,and phosphorylated p65(p-p65)were detected using immunohistochemistry.Results We identified a total of 156 chemical components(including 26 flavonoids or flavonoid glycosides,27 alkaloids,and 11 saponins)in YZF and 43 prototype components in medicated rat serum.Network pharmacology revealed 704 YZF-related targets and 1199 COPD-associated targets.Integrated analysis suggested that the anti-COPD effects of YZF were associated with the PI3K-Akt signaling pathway.In mouse models of COPD,YZF treatment significantly increased mean alveolar number and peak expiratory flow(P<0.05),reduced mean linear intercept,bronchial wall thickness,lung coefficient,and BALF cytokine levels,and suppressed the expressions of PI3K,Akt,p-Akt,p65,and p-p65 in the lung tissues.Conclusion YZF alleviates COPD symptoms and airway inflammation in mice possibly by inhibiting the PI3K/Akt/NF-κB pathway through its multiple components that interact with multiple targets.