OBJECTIVE To investigate the mechanism by which Qiaobai cold compress solution （QBCS） improves acne vulgaris （AV） based on transcriptomics and animal experiments. METHODS Rats were randomly divided into a blank control group （ n ＝6） and a modeling group （ n ＝30）. AV models were established in the modeling group by topical application of oleic acid to the inner surface of both ears， combined with subcutaneous injection of Cutibacterium acnes suspension into the auricle. Successfully modeled rats were further divided into the model group， positive control group （Tretinoin cream， 0.045 g/kg）， and QBCS low-， medium-， high-dose groups [3.55， 7.11， 14.22 g/kg （calculated by the amount of crude drug） ] ， with 6 rats in each group. Rats in each d rug group were treated with the corresponding drugs once daily for 14 consecutive days. After the final administration， changes in the appearance of the ears and histopathological changes in the ear tissues were observed， and serum levels of inflammatory factors， including tumor necrosis factor-α （TNF-α）， interleukin-6 （IL-6） and IL-1β， were measured. Auricular tissues from the blank control group， model group and QBCS medium-dose group were collected for transcriptome sequencing. Differential expressed genes （DEGs） were screened and subjected to Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis， followed by validation using real-time quantitative polymerase chain reaction and Western blot assay. RESULTS Compared with the model group， rats in all QBCS groups showed alleviated auricular acne symptoms， with reduced epidermal thickening， sebaceous gland hyperplasia， and inflammatory cell infiltration. Serum levels of TNF-α （except for the QBCS low-dose group）， IL-6 （except for the QBCS low-dose group） and IL-1β were significantly decreased （ P ＜0.05）. A total of 590 DEGs were identified （blank control group vs. model group）， and 596 DEGs were identified （model group vs. QBCS medium-dose group）. Above DEGs （blank control group vs. model group） were mainly enriched in Toll-like receptor （TLR） and nuclear factor-kappa B （NF-κB） signaling pathways， etc. Validation experiments showed that， compared with model group， low-， medium- and high-dose of QBCS reduced， to varying degrees， the mRNA expression of TNF-α， TLR2， interferon-γ and CXC chemokine ligand 8 in the auricular tissues of AV rats， increased the mRNA expression of peroxisome-proliferator-activated receptor gamma and tumor protein 53， and inhibited the phosphorylation of NF-κB p65 protein as well as the expressions of TLR2 and myeloid differentiation primary response protein 88（MyD88） （ P ＜0.05）. CONCLUSIONS QBCS can alleviate auricular inflammation and skin lesions in AV rats. This effect may be related to inhibition of the TLR/MyD88/NF-κB signaling pathway， thereby suppressing the expression of downstream inflammatory factors such as TNF-α.

Objective To compare imaging quality and detection capability of bone metastases between Insight NM/CT Pro SPECT/CT(Insight SPECT/CT)and Siemens Symbia T16 SPECT/CT(Symbia T16 SPECT/CT)scanners.Methods Totally 40 patients with diagnosed or suspected bone metastases were prospectively enrolled.Whole-body bone imaging and local tomographic fusion imaging were performed using Symbia T16 and Insight SPECT/CT scanners with same method and parameters,and imaging quality and detection capability were compared between 2 devices.Results Among whole-body bone imaging acquired with Symbia T 16 SPECT/CT,the imaging quality score was 5 in 35 cases and 4 in 5 cases,and detected 118 positive bone lesions,including 36 lesions involved chest,28 involved spinal cord,30 involved pelvic bones,20 involved limbs and 4 involved cranial bones.The imaging quality score of local tomographic fusion imaging obtained with Symbia T16 SPECT/CT was 5 in all 40 cases,and 59 positive lesions involved bone regions were detected,including 14 lesions presented as bone destruction,11 presented as increased bone density and 34 showed uneven bone density on CT.Meanwhile,the whole-body bone imaging quality score acquired with Insight SPECT/CT was 5 in 35 cases,4 in 4 cases and 3 in 1 case,and both the detected positive lesions and the involved bone regions were consistent with those of Symbia T 16 SPECT/CT.Furthermore,the imaging quality,detected positive lesions and their involved regions,as well as CT manifestations on local tomographic fusion imaging obtained with Insight SPECT/CT scanner were all consistent with those of Symbia T 16 scanner.Conclusion The imaging quality of whole-body bone imaging and local tomographic fusion imaging of bone metastases of domestic Insight SPECT/CT were comparable to those of Siemens Symbia T16 SPECT/CT.

Objective:To understand the contract renewal willingness and its influencing factors among rural order-oriented medical students in Shaanxi Province. M ethods This study employed an explanatory sequential mixed methods design to examine contract renewal patterns among rural order-oriented medical graduates. From February to July 2024, a questionnaire survey was conducted among rural order-oriented medical students who graduated from 2015 to 2023 in Shaanxi Province. The participants were first stratified into three strata based on their year of graduation and stage of service, and one-third of each stratum was randomly selected as the research subjects. Univariate and multivariate analysis methods were used to explore the influencing factors of their willingness to renew their service in rural areas. Secondly, qualitative research methods were employed to conduct thematic interviews with 36 targeted medical students on the influencing factors of their willingness to renew their service. Results:A total of 513 valid questionnaires were collected during the quantitative research phase, including 224 males and 289 females. Of these, 14 were from the 2015-2017 cohort, 247 from the 2018-2020 cohort, and 252 from the 2021-2023 cohort. The results showed that only 30.4%(156/513) of the orientation medical students were willing to practice in primary care after the period of service. Univariate analysis showed that there were six factors related to the willingness to renew the contract, the consistency of the source and implementation of the contract, the completion of the standardized training of residents, the satisfaction with primary work, professional identity, the ability of primary diagnosis and treatment, and the training system and the suitability of primary work. Multivariate analysis showed that the willingness to renew the contract was significantly higher in the students who had the same place of origin and the place of performance( OR=1.7, 95% CI: 1.1-2.6, P=0.022). The willingness to renew the contract was significantly higher among students who participated in the standardized residency training than those who completed the training( OR=2.0, 95% CI: 1.3-3.0, P=0.003), and students with a better fit between the training system and working in primary care were more likely to renew their contract( OR=4.1, 95% CI: 2.8-6.0, P<0.001). Four themes were extracted from the interview: subjective factors, objective environment, policy factors and other factors. Conclusions:The study shows that improving the consistency of the source of students and the implementation of the contract, strengthening the standardized training of residents, and optimizing the adaptation of the training system to the primary work are the key measures to improve the willingness of directional medical students to renew their contract at the primary level.

Objective To study the development of conus medullaris by quantitative three-dimensional ultrasound in the second and third trimesters of pregnancy,and to analyze the value of terminal caudal vertebral ossification center count in diagnosis of closed spina bifida.Methods A total of 108 normal fetuses in the second and third trimesters of pregnancy who were admitted to Baoding No.1 Central Hospital from January 2019 to March 2024 were selected and assigned to the normal group.The distance between the fetal conus medullaris and the first sacral vertebra,the distance between the end of the conus medullaris and the end of sacrum,and the number of corresponding vertebrae were measured by three-dimensional ultrasound at different gestational weeks.Meanwhile,54 fetuses who were confirmed to have closed spina bifida after delivery were enrolled into the abnormal group.The number of ossification centers on the median sagittal section of the caudal spine was counted and compared between the two groups.The receiver operating characteristic(ROC)curve was drawn to analyze the value of ossification center count of distal caudal vertebrae in diagnosis of closed spina bifida.Results With the increase of gestational weeks,the distance between the fetal conus medullaris and the first sacral vertebra and the distance between the end of the conus medullaris and the end of the sacral bone were gradually increased.The conus medullaris of normal fetuses was mainly located in L1.5,L2 and L2.5,accounting for 85.19%(92/108).The ossification center count of distal caudal vertebra was slightly increased with the increase of gestational weeks in the normal group.At 17-20 gestational weeks,85.71%(12/14)of the ossification center count of distal caudal vertebra was 5 to 7.At 21-28 gestational weeks,100.00%(45/45)of the ossification center count was 6 and more.At week 29 and above,100.00%(45/45)of the ossification center count was more than 7.In the abnormal group,96.30%(52/54)of the fetuses had the ossification center less than 6,and 85.71%(42/49)of the ossification center count was≤5 at 21-32 gestational weeks.There were significant differences in the ossification center count between the two groups at 17-20,21-24,25-28,29-32,and 33-36 gestational weeks(P<0.05).ROC curve showed that,at 17-20,21-24,25-28,29-32,and 33-36 gestational weeks,the area under the curve(AUC)in prediction of closed spina bifida was 0.804,0.744,0.776,0.819,and 0.722 when the ossification center count of distal caudal vertebra was 5.31,4.59,4.81,4.67,and 5.49 as the cut-off value,respectively.Conclusion The conus medullaris moves upward with the increase of gestational weeks in the second and third trimesters of pregnancy.The ossification center count of the distal caudal vertebra is less than 6 in most fetuses with closed spina bifida,which is conducive to screening for closed spina bifida.

Objective To build an automatic segmentation model of temporomandibular joint(TMJ)based on magnetic resonance im-aging(MRI)using deep learning method.Methods The MRI data of TMJ of 104 subjects were collected,with the articular disc,con-dyle and glenoid fossa marked.The adaptive U-Net framework(nnU-Net)was used to construct a segmentation model,which was sub-jected to both quantitative and qualitative assessments.Results The segmentation model demonstrated excellent accuracy in segmenta-tion.In the segmentation of different joint structures,the model achieved Dice of 0.77 for the articular disc,0.85 for the condyle,and 0.66 for the glenoid fossa.The model showed similar segmentation performance when processing MRI images in both open-mouth and closed-mouth states.Conclusion This study developed an automatic segmentation model for TMJ MRI based on deep learning,which can assist clinicians in diagnosing anterior displacement of the TMJ disc.

Objective:To explore the mediating role of activity of daily living between social support and cognitive function of rural elderly.Methods:A face-to-face questionnaire survey was conducted from July to August 2019 among 1 626 rural elderly people selected by multi-stage cluster random method in Guiyang City and Qiannan Prefecture, Guizhou Province.The contents include general situation, social support rate scale (SSRS), activity of daily living scale (ADL) and mini-mental state examination (MMSE). Partial correlation analysis and multiple linear regression analysis were used to analyze the relationship among social support, activity of daily living and cognitive function in the elderly by SPSS 23.0 software. AMOS 28.0 software was used to construct structural equation models, and Bootstrap method was used to test the mediating role of activity of daily living.Results:The scores of cognitive function, social support and activity of daily living of the rural elderly were (20.83±5.47), (34.96±6.42) and (16.51±3.29), respectively.There were statistically significant differences in the cognitive function scores among rural elderly with different levels of social support and activity of daily living( F=33.418, t=25.533, P<0.01). The partial correlation analysis showed that the social support score was positively correlated with the cognitive function score ( r=0.161, P<0.01), and the activity of daily living score was negatively correlated with scores of social support and cognitive function ( r=-0.083, -0.453, both P<0.01). Multiple linear stepwise regression analysis showed that social support, objective support dimensions, activity of daily living and instrumental activity of daily living were influencing factors of cognitive function of rural elderly( P<0.001).The results of structural equation model showed that the activity of daily living played a partial mediating role between social support and cognitive function in rural elderly, with the mediating effect of 0.046 (95% CI=0.025-0.075), accounting for 13.18% of total effect (effect value=0.349, 95% CI=0.277-0.415). Conclusion:The activity of daily living of rural elderly plays a partial mediating effect between social support and cognitive functioning.

Objective To investigate the initial temperature sensation and pressure pain sensation in patients receiving invisible or-thodontic treatment.Methods Twenty-two patients receiving clear aligner treatment(experimental group)and 22 volunteers(control group)participated.Perceptual changes were assessed using the visual analogue scale(VAS)and quantitative sensory testing(QST).The QST employed in this study included warm detection threshold/heat pain threshold(WDT/HPT),cold detection threshold/cold pain threshold(CDT/CPT),and pressure pain threshold(PPT).Tests were conducted on teeth 21 and 31,their gums,the left hand,and the left masseter muscle.Assessments occurred at baseline,2 hours,24 hours,7 days,and 28 days after aligner placement.Re-sults In the experimental group,VAS scores peaked at 24 hours and then significantly decreased(P＜0.01).For teeth 21 and 31,the WDT and HPT of the labial attached gingiva,along with the PPT of these teeth,showed significant decreases at 24 hours and 7 days compared to baseline and the control group(P＜0.01).At 24 hours and 7 days,VAS scores were negatively correlated with the WDT and HPT of the labial attached gingiva of teeth 21 and 31(P＜0.05).Conclusion At 24 hours and 7 days post-clear aligner treatment,thermal sensitivity and pain,as well as pressure pain sensitivity,increased for the gingiva of teeth 21 and 31.Thermal sensitivity was also correlated with pain intensity.

Objective To build an automatic segmentation model of temporomandibular joint(TMJ)based on magnetic resonance im-aging(MRI)using deep learning method.Methods The MRI data of TMJ of 104 subjects were collected,with the articular disc,con-dyle and glenoid fossa marked.The adaptive U-Net framework(nnU-Net)was used to construct a segmentation model,which was sub-jected to both quantitative and qualitative assessments.Results The segmentation model demonstrated excellent accuracy in segmenta-tion.In the segmentation of different joint structures,the model achieved Dice of 0.77 for the articular disc,0.85 for the condyle,and 0.66 for the glenoid fossa.The model showed similar segmentation performance when processing MRI images in both open-mouth and closed-mouth states.Conclusion This study developed an automatic segmentation model for TMJ MRI based on deep learning,which can assist clinicians in diagnosing anterior displacement of the TMJ disc.

Objective:To explore the mediating role of activity of daily living between social support and cognitive function of rural elderly.Methods:A face-to-face questionnaire survey was conducted from July to August 2019 among 1 626 rural elderly people selected by multi-stage cluster random method in Guiyang City and Qiannan Prefecture, Guizhou Province.The contents include general situation, social support rate scale (SSRS), activity of daily living scale (ADL) and mini-mental state examination (MMSE). Partial correlation analysis and multiple linear regression analysis were used to analyze the relationship among social support, activity of daily living and cognitive function in the elderly by SPSS 23.0 software. AMOS 28.0 software was used to construct structural equation models, and Bootstrap method was used to test the mediating role of activity of daily living.Results:The scores of cognitive function, social support and activity of daily living of the rural elderly were (20.83±5.47), (34.96±6.42) and (16.51±3.29), respectively.There were statistically significant differences in the cognitive function scores among rural elderly with different levels of social support and activity of daily living( F=33.418, t=25.533, P<0.01). The partial correlation analysis showed that the social support score was positively correlated with the cognitive function score ( r=0.161, P<0.01), and the activity of daily living score was negatively correlated with scores of social support and cognitive function ( r=-0.083, -0.453, both P<0.01). Multiple linear stepwise regression analysis showed that social support, objective support dimensions, activity of daily living and instrumental activity of daily living were influencing factors of cognitive function of rural elderly( P<0.001).The results of structural equation model showed that the activity of daily living played a partial mediating role between social support and cognitive function in rural elderly, with the mediating effect of 0.046 (95% CI=0.025-0.075), accounting for 13.18% of total effect (effect value=0.349, 95% CI=0.277-0.415). Conclusion:The activity of daily living of rural elderly plays a partial mediating effect between social support and cognitive functioning.

Objective To compare imaging quality and detection capability of bone metastases between Insight NM/CT Pro SPECT/CT(Insight SPECT/CT)and Siemens Symbia T16 SPECT/CT(Symbia T16 SPECT/CT)scanners.Methods Totally 40 patients with diagnosed or suspected bone metastases were prospectively enrolled.Whole-body bone imaging and local tomographic fusion imaging were performed using Symbia T16 and Insight SPECT/CT scanners with same method and parameters,and imaging quality and detection capability were compared between 2 devices.Results Among whole-body bone imaging acquired with Symbia T 16 SPECT/CT,the imaging quality score was 5 in 35 cases and 4 in 5 cases,and detected 118 positive bone lesions,including 36 lesions involved chest,28 involved spinal cord,30 involved pelvic bones,20 involved limbs and 4 involved cranial bones.The imaging quality score of local tomographic fusion imaging obtained with Symbia T16 SPECT/CT was 5 in all 40 cases,and 59 positive lesions involved bone regions were detected,including 14 lesions presented as bone destruction,11 presented as increased bone density and 34 showed uneven bone density on CT.Meanwhile,the whole-body bone imaging quality score acquired with Insight SPECT/CT was 5 in 35 cases,4 in 4 cases and 3 in 1 case,and both the detected positive lesions and the involved bone regions were consistent with those of Symbia T 16 SPECT/CT.Furthermore,the imaging quality,detected positive lesions and their involved regions,as well as CT manifestations on local tomographic fusion imaging obtained with Insight SPECT/CT scanner were all consistent with those of Symbia T 16 scanner.Conclusion The imaging quality of whole-body bone imaging and local tomographic fusion imaging of bone metastases of domestic Insight SPECT/CT were comparable to those of Siemens Symbia T16 SPECT/CT.