The diagnosis,treatment,and prognosis evaluation of cervical spondylosis are challenging in clinic.Machine learning(ML)models can improve the accuracy and efficiency of cervical spondylosis diagnosis by processing complex clinical data,assist in selecting more precise treatment plans,and evaluate prognosis.Through the domestic and foreign literature review on the application of ML models in cervical spondylosis in recent years,the study classifies and summarizes the relevant models applied in the diagnosis,treatment,and prognosis evaluation of cervical spondylosis,introduces classic algorithms such as random forest,as well as new algorithms such as convolutional neural networks,deep neural networks and long short-term memory networks,aiming to provide reference ML solutions for various stages of cervical spondylosis diagnosis and treatment.

Objective:To explore the chain mediating role of general self-efficacy and humanistic care competence between oncology nurses' empathy and medical narrative competence, with a view to informing the development of targeted medical narrative competence enhancement strategies.Methods:Convenience sampling was used to select 1 104 oncology nurses from 17 ClassⅢ Grade A hospitals in Yunnan Province from May to August 2023 for the study. The General Information Questionnaire, Narrative Competence Scale, Chinese version of the Jefferson Scale of Empathy, Caring Ability Inventory, and General Self-Efficacy Scale were used to survey oncology nurses. Pearson correlation was used to analyze the correlation among oncology nurses' general self-efficacy, empathy, humanistic care competence, and medical narrative competence. Mediating effects were analyzed using Model 6 in the SPSS macro program PROCESS 4.0 plug-in. Bootstrap method was used to repeat the sampling 5 000 times for the chained mediating effect test.Results:A total of 1 104 questionnaires were distributed and the number of valid questionnaires recovered was 931, with a valid recovery rate of 84.33% (931/1 104). Among 931 oncology nurses, the scores of Narrative Competence Scale, Caring Ability Inventory, Chinese version of Jefferson Scale of Empathy, and General Self-Efficacy Scale were (151.52±17.61), (191.68±18.80), (95.31±13.96), and (27.59±6.02), respectively. There was a positive two-by-two correlation among oncology nurses' medical narrative competence, empathy, humanistic care competence, and general self-efficacy ( P<0.01). General self-efficacy and humanistic care competence acted as chain mediators between oncology nurses' empathy and medical narrative competence, with the mediating effect accounting for 43.13% of the total effect. Conclusions:General self-efficacy and humanistic care are mediating variables between oncology nurses' empathy and medical narrative competence. Nursing managers should focus on the cultivation of nurses' empathy, stimulate nurses' self-efficacy, and promote the practice of nursing humanistic care, which in turn improves oncology nurses' medical narrative competence and the quality of nursing services.

The diagnosis,treatment,and prognosis evaluation of cervical spondylosis are challenging in clinic.Machine learning(ML)models can improve the accuracy and efficiency of cervical spondylosis diagnosis by processing complex clinical data,assist in selecting more precise treatment plans,and evaluate prognosis.Through the domestic and foreign literature review on the application of ML models in cervical spondylosis in recent years,the study classifies and summarizes the relevant models applied in the diagnosis,treatment,and prognosis evaluation of cervical spondylosis,introduces classic algorithms such as random forest,as well as new algorithms such as convolutional neural networks,deep neural networks and long short-term memory networks,aiming to provide reference ML solutions for various stages of cervical spondylosis diagnosis and treatment.

Objective:To explore the chain mediating role of general self-efficacy and humanistic care competence between oncology nurses' empathy and medical narrative competence, with a view to informing the development of targeted medical narrative competence enhancement strategies.Methods:Convenience sampling was used to select 1 104 oncology nurses from 17 ClassⅢ Grade A hospitals in Yunnan Province from May to August 2023 for the study. The General Information Questionnaire, Narrative Competence Scale, Chinese version of the Jefferson Scale of Empathy, Caring Ability Inventory, and General Self-Efficacy Scale were used to survey oncology nurses. Pearson correlation was used to analyze the correlation among oncology nurses' general self-efficacy, empathy, humanistic care competence, and medical narrative competence. Mediating effects were analyzed using Model 6 in the SPSS macro program PROCESS 4.0 plug-in. Bootstrap method was used to repeat the sampling 5 000 times for the chained mediating effect test.Results:A total of 1 104 questionnaires were distributed and the number of valid questionnaires recovered was 931, with a valid recovery rate of 84.33% (931/1 104). Among 931 oncology nurses, the scores of Narrative Competence Scale, Caring Ability Inventory, Chinese version of Jefferson Scale of Empathy, and General Self-Efficacy Scale were (151.52±17.61), (191.68±18.80), (95.31±13.96), and (27.59±6.02), respectively. There was a positive two-by-two correlation among oncology nurses' medical narrative competence, empathy, humanistic care competence, and general self-efficacy ( P<0.01). General self-efficacy and humanistic care competence acted as chain mediators between oncology nurses' empathy and medical narrative competence, with the mediating effect accounting for 43.13% of the total effect. Conclusions:General self-efficacy and humanistic care are mediating variables between oncology nurses' empathy and medical narrative competence. Nursing managers should focus on the cultivation of nurses' empathy, stimulate nurses' self-efficacy, and promote the practice of nursing humanistic care, which in turn improves oncology nurses' medical narrative competence and the quality of nursing services.

Objective:To compare the clinical efficacy of radiofrequency ablation and liver resection in the treatment of gastrointestinal stromal tumor liver metastasis.Methods:A retrospective cohort study was conducted, collecting medical records of 46 patients with gastrointestinal stromal tumor liver metastasis treated at the First Medical Center of the Chinese People′s Liberation Army General Hospital from January 2018 to December 2022. Patients were divided into radiofrequency ablation group ( n=20) and liver resection group ( n=26) based on the treatment method. Short-term efficacy and long-term prognosis between the two groups were compared. Short-term efficacy was evaluated based on intraoperative bleeding volume, operative time, hospital stay, hospitalization costs, while long-term efficacy was assessed by progression-free survival and overall survival. Normally distributed measurement data were expressed as mean±standard deviation ( ± s) and compared using the t-test. Non-normally distributed measurement data were expressed as M( Q1, Q3) and compared using the Wilcoxon rank-sum test. Count data were expressed as frequency (%) and compared using the chi-square test. The long-term prognosis of patients in both groups was compared using the Kaplan-Meier curve. Results:The intraoperative blood loss, operative time, postoperative hospital stay, and hospitalization costs for the radiofrequency ablation group were 5 (3, 5) mL, 60 (55, 60) min, 4.0 (3.0, 4.0) d, and 4.6 (3.8, 5.3) ten thousand yuan, respectively; for the liver resection group, these were 100 (50, 275) mL, 180 (155, 215) min, 7.0 (4.5, 9.5) d, and 8.6 (6.1, 10.8) ten thousand yuan, respectively, with statistically significant differences between the two groups( P<0.05). The median progression-free survival for the liver resection group was 37 months, with 1 and 3-year progression-free survival rates of 96% and 50%, respectively. For the radiofrequency ablation group, the median progression-free survival was 20.5 months, with 1 and 3-year progression-free survival rates of 65% and 20%, respectively, showing statistically significant differences between the two groups ( P<0.05). The 1, 3, and 5-year overall survival rates for the liver resection group were 100%, 100%, and 78.3%, respectively, while for the radiofrequency ablation group, they were 100%, 100%, and 82.2%, respectively, with no statistically significant difference ( P>0.05). Conclusions:Both liver resection and radiofrequency ablation can be considered as treatment options for gastrointestinal stromal tumor liver metastasis, with comparable long-term efficacy. Liver resection has a clear advantage in terms of local tumor control compared to radiofrequency ablation, which has the advantages of fewer complications, faster recovery, and shorter hospital stay.

To investigate the therapeutic effect of pectoralis major muscle flap transplantation in thoracotomy patients with sternal infection. Methods From January 2014 to December 2017, the treatment group of 39 patients with thoracic bone infection after cardiac surgery was used pectoralis major muscle flap to close the wound, while 26 patients were treated by debridement and vacuum sealing drainagea at the same time as the control group. The hospitalization time, hospital costs, number of operations, satisfaction survey, and relapse rate were compared between the those. Results Compared with the control group, the treatment group has the benefit of shorter hospitalization time [(18. 1 ± 3. 8)days vs. (36. 7 ± 11. 4) days], less hospital costs [(19429 ±4088)yuan vs. (33495 ±10712)yuan], less number of operations [(1. 1 ±0. 3)times vs. (2. 4 ±0. 8)times], higher level of satisfaction(56. 4％ vs. 30. 8％), lower relapse rate(5. 1％ vs. 26. 9％), the differences are statistically significant(all P <0. 05). Conclusion Thoracic reconstruction with pectoralis major muscle flap is an effective treatment for sternal infection in postcardiac surgery.

Objective To evaluate the possible protective effect of isoflurane and propofol on myocardium during off pump coronary artery bypass grafting (CABG) surgery. Methods Twenty-six patients undergoing elective CABG without cardiopulmonary bypass were allocated into propofol group (n=13) and isoflurane group (n=13). Anesthesia was performed in propofol group with propofol plus fentanyl, while isoflurane and fentanyl were used in isoflurane group. Artery blood samples were collected before induction of anesthesia, and during and after the surgery. Plasma troponin I (cTnI), creatine kinase-MB (CK-MB), interleukin-6 (IL-6), and lactate concentrations were determined respectively. Results At the 4 hours after operation, plasma level of cTnI was significantly increased in both groups, and no significant differences were found between them. Compared with baseline values, IL-6 in propofol group showed no significant changes at each endpoint. However, IL-6 values in isoflurane group were significantly higher than those in propofol group during and after surgery (P

Objective To explore the correlation between cytomegalovirus pneumonia (CMV-IP) and viral load in renal transplant recipients and to find out the threshold value of viral load for predicting CMV-IP. Methods The blood samples of 56 renal transplant recipients were taken weekly for the first 2 months and every 2 weeks for 2-6 months after transplantation.Real-time PCR were used to quantify the plasma CMV DNA.The mean viral loads of CMV-IP group and non-CMV-IP group in each time were compared using Wilcoxon test.Different cut-off values were tested to find the suitable values to predict the CMV-IP. Results Of the 56 recipients,8 (14.3%) developed CMV-IP.The viral loads were near zero in the first 4 weeks in both groups;from week 5 the viral load of CMV-IP group increased gradually and reached the climax at week 8 and then declined,but the load of non-CMV-IP group fluctuated at a low level.During weeks 5-11,the viral loads of CMV-IP group were higher than those of non-VMV-IP group.At 5,7 and 9 weeks,the differences of the viral loads between the 2 groups were significant (P