China's public hospitals have basically established a smart hospital construction framework of the"trinity"of smart medical care,smart service and smart management,and have achieved a series of results.However,in the process of construction,there are still obstacles such as"information islands",insufficient capital and technology investment,and difficulty in coordination between various systems.The construction of smart hospitals needs to build solutions from the three dimensions of system,resources and technology to promote the improvement of the refined and intelligent level of hospital management and promote the high-quality development of public hospitals.

Objective Pre-packaged space scallion pancakes are prone to quality deterioration during storage due to starch retrogradation and lipid oxidation,which affects their food safety and sensory characteristics.Therefore,investigating their quality changes during storage and predicting shelf life are of great significance for ensuring the quality of space food.Methods study conducted accelerated shelf-life tests at(37±1)℃ and(47±1)℃ under simulated spacecraft food storage conditions.Comprehensive analyses were performed,including physicochemical properties(acid value,peroxide value,carbonyl value),microbiological indicators(total bacterial count,coliforms),color parameters(L*,a*,b*,c*,h°),and texture characteristics(hardness,adhesiveness,etc.).XRD and FTIR were employed to verify starch retrogradation and lipid oxidation.Results Physicochemical properties:The acid value gradually decreased and stabilized with prolonged storage.The peroxide value increased rapidly at 37℃and 47℃,with samples stored at 47℃approaching the safety limit(0.25 g/100 g)within 40 days,while the carbonyl value exhibited a decreasing trend.Microbiological indicators:All samples met the requirements of GJB 4992A-2012.No microbial contamination was detected initially,with only minor bacterial growth observed in later stages,and no coliforms were detected throughout the storage period.Color changes:During storage at 20℃,the a*value increased by 91.67%,while b* and c* values showed significant increases.Meanwhile,L* and h° values decreased by 7.42%and 8.75%,respectively.Texture deterioration:Overall texture characteristics declined,and XRD and FTIR analyses confirmed aggravated starch retrogradation.Shelf-life prediction:Correlation analysis identified peroxide value as the key factor.The established prediction model had an error margin of less than 10%,with predicted shelf lives of 236,121,and 57 days at 20℃,37℃,and 47℃,respectively.Conclusion This study reveals the quality change patterns of space scallion pancakes during storage.The established shelf-life prediction model provides theoretical and methodological support for quality monitoring of pre-packaged space foods.

China's public hospitals have basically established a smart hospital construction framework of the"trinity"of smart medical care,smart service and smart management,and have achieved a series of results.However,in the process of construction,there are still obstacles such as"information islands",insufficient capital and technology investment,and difficulty in coordination between various systems.The construction of smart hospitals needs to build solutions from the three dimensions of system,resources and technology to promote the improvement of the refined and intelligent level of hospital management and promote the high-quality development of public hospitals.

Objective:To explore the feasibility of circulating tumor cell (CTC) dual-antibody enrichment and dual-antibody detection for epithelial-mesenchymal phenotypes in patients with hepatocellular carcinoma (HCC), and investigate the clinical diagnostic value of CTC typing in evaluating postoperative recurrence and prognosis of HCC.Methods:Of 89 HCC patients who underwent surgical treatment in Zhejiang Jinhua Guangfu Tumor Hospital from March 2020 to January 2024 were enrolled into this study, including 73 males and 16 females, aged (64.4±9.5) years old. The peripheral blood samples of patients were collected before operation. Epithelial CTC, mesenchymal CTC and hybrid epithelial-mesenchymal CTC in blood samples of patients with HCC were enriched and detected by EpCAM/CSV double capture antibodies and PanCK/CSV double detection antibodies. Kaplan-Meier analysis was employed to assess recurrence-free survival (RFS) and overall survival (OS) rates. Univariate and multivariate Cox regression were used to analyze the effects of different types of CTC on postoperative RFS and OS.Results:The detection rates of total CTC, epithelial CTC, mesenchymal CTC and hybrid epithelial-mesenchymal CTC were 92.1% (82/89), 64.0% (57/89), 62.9% (56/89) and 55.1% (49/89), respectively. Multivariate Cox regression analysis showed that HCC patients with more mesenchymal CTC ( HR=2.408, 95% CI: 1.580-3.668) and hybrid epithelial-mesenchymal CTC ( HR=1.840, 95% CI: 1.004-3.371) in peripheral blood had higher postoperative recurrence risk (both P<0.05). Univariate Cox regression showed patients with more total CTC ( HR=1.426, 95% CI: 1.040-1.954, P=0.028) was associated with survival. Conclusion:The technique of epithelial-mesenchymal phenotypes analysis of circulating tumor cells based on dual-antibody capture and dual-antibody detection is feasible. The number of mesenchymal CTC and hybrid epithelial-mesenchymal CTC before operation is the influencing factor of postoperative recurrence in patients with hepatocellular carcinoma.

Objective To explore the effect of physical exercise on semen quality in order to provide basic data and theoretical basis for the improvement of male reproductive health.Methods A cross-sectional study was conducted on 1 059 males who visited the Reproductive Medicine Center of Shandong Maternal and Child Health Hospital for medical treatment and physical examination during July 2022 and April 2023.Their demographic data and physical exercise data were surveyed with questionnaires.Total sperm count,sperm concentration,total sperm motility,forward movement and normal sperm morphology were analyzed with computer aided analysis.Logistic regression model and multiple linear regression model were applied to analyze the effects of physical exercise on semen quality.Results After adjustment for confounding factors such as age,body mass index,alcohol consumption and smoking,logistic regression analysis showed that the risk of abnormal semen quality was increased in patients with moderate and heavy exercise intensity(OR=2.103,OR=2.229).Compared with the participants with physical exercise ≤10 min per session,those with＞20 min per session had a lower risk of abnormal semen quality(OR=0.357,0.256,0.289 for exercise time for＞20～30,＞30～60,＞60 min,respectively).There was no statistical significance between physical exercise frequency and semen quality(P＞0.05).The participants having exercise well were at a lower risk for abnormal semen quality(OR=0.711).Multiple linear regression analysis revealed that the frequency of physical exercise was an influencing factor of sperm concentration(β=7.474,95％CI:4.800～10.149,P＜0.05);the time of physical exercise per session was an influencing factor for total sperm count(β=20.632,95％CI:7.634～33.629);the intensity of physical exercise(β=-1.461,95％CI:-2.392～-0.530)and time of physical exercise per session(β=2.608,95％CI:1.404～3.812,P＜0.05)were influencing factors for percentage of forward motility sperm(P＜0.05);and physical exercise intensity(β=-1.934,95％CI:-3.238～-0.630),time of physical exercise per session(β=4.211,95％CI:2.525～5.897)and frequency of physical exercise(β=-2.008,95％CI:-3.480～-0.536)were influencing factors of total sperm motility(P＜0.05).Conclusion Physical exercise may affect semen quality,greater intensity of physical exercise may be a risk factor for abnormal semen quality,and longer physical exercise time may be related to improving semen quality.Therefore,proper physical exercise can help improve semen quality.

Objective:To explore the application and teaching effect of artificial intelligence (AI) image recognition education system in standardized training on ultrasound-guided nerve block technique for novice anesthesiology residents.Methods:Forty residents trained in the Department of Anesthesiology of Cancer Hospital of Chinese Academy of Medical Sciences and the Department of Anesthesiology of the Affiliated Hospital of Qingdao University from January 2023 to December 2023 were selected as study subjects, and randomly divided into experimental group (teaching with the AI image recognition education system) and control group (traditional teaching) to undergo training and assessments on the nerve block technique, with 20 residents in each group. The training quality for the two groups was assessed by comparing the clinical practice score, teaching effect evaluation, and teaching quality evaluation. SPSS 23.0 software was used for the t-test and chi-square test on data. Results:Compared with the control group, residents in the experimental group had higher clinical practice scores [(4.65±0.49) vs. (3.60±0.75), P<0.001] and better method mastery [(17.45±1.23) vs. (13.85±1.27), P<0.001], satisfaction with clinical operation [(16.70±1.34) vs. (13.95±1.00), P<0.001], and learning enthusiasm [(17.35±1.50) vs. (13.55±0.94), P<0.001] for the ultrasound-guided nerve block technique. The teaching quality score of the experimental group was higher than that of the control group [(17.30±1.59) vs. (14.25±1.68), P<0.001]. Therefore, the training quality of residents in the experimental group was better than that of the control group. Conclusions:The application of AI image recognition education system in standardized training on the ultrasound-guided nerve block technique improves the teaching quality of teachers, enhances the learning effect of novice anesthesiology residents, and mobilizes learning enthusiasm, which is worthy of further promotion and application.

Objective:To explore the application and teaching effect of artificial intelligence (AI) image recognition education system in standardized training on ultrasound-guided nerve block technique for novice anesthesiology residents.Methods:Forty residents trained in the Department of Anesthesiology of Cancer Hospital of Chinese Academy of Medical Sciences and the Department of Anesthesiology of the Affiliated Hospital of Qingdao University from January 2023 to December 2023 were selected as study subjects, and randomly divided into experimental group (teaching with the AI image recognition education system) and control group (traditional teaching) to undergo training and assessments on the nerve block technique, with 20 residents in each group. The training quality for the two groups was assessed by comparing the clinical practice score, teaching effect evaluation, and teaching quality evaluation. SPSS 23.0 software was used for the t-test and chi-square test on data. Results:Compared with the control group, residents in the experimental group had higher clinical practice scores [(4.65±0.49) vs. (3.60±0.75), P<0.001] and better method mastery [(17.45±1.23) vs. (13.85±1.27), P<0.001], satisfaction with clinical operation [(16.70±1.34) vs. (13.95±1.00), P<0.001], and learning enthusiasm [(17.35±1.50) vs. (13.55±0.94), P<0.001] for the ultrasound-guided nerve block technique. The teaching quality score of the experimental group was higher than that of the control group [(17.30±1.59) vs. (14.25±1.68), P<0.001]. Therefore, the training quality of residents in the experimental group was better than that of the control group. Conclusions:The application of AI image recognition education system in standardized training on the ultrasound-guided nerve block technique improves the teaching quality of teachers, enhances the learning effect of novice anesthesiology residents, and mobilizes learning enthusiasm, which is worthy of further promotion and application.

In order to reduce bone resorption after tooth extraction and achieve the necessary soft and hard tissue augmentation, it is very important to adequately manage the tooth extraction site. Alveolar ridge preservation (ARP) before implantation helps to obtain predictable and satisfactory bone augmentation results. In this paper, the characteristics, histological studies, clinical applications and therapeutic effects of osteoconductive alternative materials in ARP are introduced, and related references are provided for their application in ARP.

Objective:To collect data on urinary flow rate in the elderly female population across the country and to analyze the range of reference values.Methods:This study enrolled 333 subjects from July 2020 to June 2022.The study implementation process was divided into two steps.In the first step, subjects completed an electronic questionnaire, which included basic information about the subject, a short form for urinary incontinence, and a scoring form for the symptoms of overactive bladder syndrome.In the second step, the staff introduced the use of a mobile uroflowmetric device and distributed the instrument and materials.Uroflow rate data were automatically uploaded to a cloud database via the mobile phone.Subsequently, two or more physicians specializing in urinary control performed Uroflow rate-qualifying screenings and conducted statistical analyses.Results:A total of 333 subjects were enrolled in the study, and the researchers collected 1375 qualified urine flow rate records using a mobile urine flow rate instrument.The age of the subjects ranged from 60 to 84 years, with a mean age of 69 years.The reference ranges for urinary flow rate were found to be 24.8-26.2 s, with a mean urinary flow rate of 12.2-12.9 ml/s, a maximum urinary flow rate of 22.2-23.4 ml/s, and a time to peak of 8.5-9.7 s. The study observed a tendency for both maximal and mean urinary flow rates to decrease in older women as their age increased(Pearson correlation coefficient: -0.1, P<0.001). Conclusions:The uroflow rate of older women decreases with aging.Specifically, the average uroflow rate of women over 80 years old is lower than that of other age groups.This study aims to establish normal uroflow parameters for uroflowmetry in healthy older women in China.

Objective: To observe the effects of electroacupuncture (EA) pretreatment on M1 polarization of alveolar macrophages (AMs) in rats with acute lung injury (ALI) induced by lipopolysaccharide (LPS), and to explore the potential protective mechanism of EA.Methods: Forty Sprague-Dawley rats were randomly divided into a normal group, a model group, and three groups of EA pretreatment [including a Chize (LU5) group, a Zusanli (ST36) group and a Chize (LU5) plus Zusanli (ST36) group], with eight rats in each group. The model rats of ALI were established by instilling LPS [2 mg/(kg·bw)] into the trachea of rats for 3 h. The rats in each EA pretreatment group were pretreated with EA for 30 min per day at the corresponding bilateral acupoints 6 d before instilling LPS. Three hours after modeling, the pulmonary function of the rats was tested, and the lung tissue was taken to calculate the ratio of lung wet weight to dry weight (W/D). The pathological lung changes and the injury score were observed by hematoxylin-eosin staining. The contents of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, and myeloperoxidase (MPO) in rat's bronchoalveolar lavage fluid (BALF) were detected by enzyme-linked immunosorbent assay. The mRNA and protein expression levels of M1 macrophage markers clusters of differentiation 86 (CD86), inducible nitric oxide synthase (iNOS), and its signaling pathway factor Toll-like receptor (TLR) 4, and nuclear factor-κB (NF-κB) p65 in the alveoli were detected by fluorescence quantitative polymerase chain reaction and Western blot, respectively. Results: After being induced by LPS, the pulmonary function of the model rats showed that the forced expiratory volume in 0.1 s (FEV0.1), forced expiratory volume in 0.3 s (FEV0.3), and their respective ratios of FEV to forced vital capacity (FVC) (including FEV0.1/FVC and FEV0.3/FVC) were significantly decreased (P<0.01), while the W/D of lung tissue was increased (P<0.01). The score of lung injury was significantly higher (P<0.01). The contents of TNF-α, IL-1β, and MPO in the BALF and the mRNA and protein expression levels of CD86, iNOS, TLR4, and NF-κB p65 in the lung tissue were significantly increased (P<0.01). After EA pretreatment, the FEV0.1, FEV0.3, FEV0.1/FVC, and FEV0.3/FVC were significantly increased, the lung injury score decreased significantly, and the contents of TNF-α, IL-1β, and MPO in the BALF and the expression levels of CD86, iNOS, TLR4, and NF-κB p65 mRNAs and proteins in the alveoli decreased significantly (P<0.05 or P<0.01). Compared with the other two single acupoint groups, the contents of TNF-α, IL-1β, and MPO in the BALF and the expression levels of CD86, iNOS, TLR4, and NF-κB p65 mRNAs in the alveoli in the Chize (LU5) plus Zusanli (ST36) group were significantly lower (P<0.01). Conclusion: EA pretreatment at Chize (LU5) and Zusanli (ST36) can inhibit inflammation and reduce pulmonary injury in ALI rats induced by LPS. The effect of the combination of Chize (LU5) and Zusanli (ST36) is better than that of using these two acupoints separately, and its mechanism may be related to the inhibition of AMs' M1 polarization by down-regulation TLR4/NF-κB signaling pathway.