With the widespread adoption of low-dose CT screening and the extensive application of high-resolution CT, the detection rate of sub-centimeter lung nodules has significantly increased. How to scientifically manage these nodules while avoiding overtreatment and diagnostic delays has become an important clinical issue. Among them, lung nodules with a consolidation tumor ratio less than 0.25, dominated by ground-glass shadows, are particularly worthy of attention. The therapeutic challenge for this group is how to achieve precise and complete resection of nodules during surgery while maximizing the preservation of the patient's lung function. The "watershed topography map" is a new technology based on big data and artificial intelligence algorithms. This method uses Dicom data from conventional dose CT scans, combined with microscopic (22-24 levels) capillary network anatomical watershed features, to generate high-precision simulated natural segmentation planes of lung sub-segments through specific textures and forms. This technology forms fluorescent watershed boundaries on the lung surface, which highly fit the actual lung anatomical structure. By analyzing the adjacent relationship between the nodule and the watershed boundary, real-time, visually accurate positioning of the nodule can be achieved. This innovative technology provides a new solution for the intraoperative positioning and resection of lung nodules. This consensus was led by four major domestic societies, jointly with expert teams in related fields, oriented to clinical practical needs, referring to domestic and foreign guidelines and consensus, and finally formed after multiple rounds of consultation, discussion, and voting. The main content covers the theoretical basis of the "watershed topography map" technology, indications, operation procedures, surgical planning details, and postoperative evaluation standards, aiming to provide scientific guidance and exploration directions for clinical peers who are currently or plan to carry out lung nodule resection using the fluorescent microscope watershed analysis method.

Objective: To assess the nutritional supply status of school meals for primary and secondary school students in Henan Province, so as to provide a basis for scientific guidance of school meals. Methods: During 2021-2023, 115 lunch and dinner samples were collected from 25 primary and secondary schools in Zhoukou, Anyang and Luoyang of Henan Province by a direct selection method, and 13 nutrients were determined for each sample. The nutrient supply was evaluated based on Nutrition Guidelines of School Meals and Reference Intake of Dietary Nutrients for Chinese Residents (2023 Edition). Mann-Whitney U test was used to compare the differences of nutritional supply between urban and rural schools. Results: The median values for energy (709.77 kcal,1 kcal=4.18 kJ), fat energy supply ratio (0.27) and carbohydrate energy supply ratio (0.55) in the 66 lunches and dinners from primary school were within the recommended range. The supply of protein (28.39 g) and sodium (1 464.59 mg) was excessive. The median values of zinc (2.62 mg) and dietary fiber (5.19 g) were lower than the reference values. No statistically significant differences were observed in the supply of 13 nutrients between urban and rural primary schools( U = 427.00 -633.00, P > 0.05 ). Among 49 samples from secondary schools, the median value of energy supply (930.02 kcal), carbohydrate energy ratio ( 0.54 ) and fat energy supply ratio(0.25) were within the recommended range; and the median values of protein (38.82 g) and sodium (2 556.80 mg) were higher than the standard; and the median values of calcium (250.32 mg) and vitamin B1 (0.16 mg) were lower than the standard. Additionally, the differences in the level of vitamin B2 ( U =372.00) and zinc ( U =375.00) between the urban and rural secondary schools were statistically significant ( P <0.05). Conclusion Nutrient supply of primary and secondary school meals in three cities of Henan Province is inadequate and imbalanced, and the recipe need to be further optimized and improved.

Objective: : The objective of this study was to assess the relationship between spermine synthase (SMS) expression, tumor occurrence, and prognosis in lower-grade gliomas (LGGs). Methods: : A total of 523 LGG patients and 1152 normal brain tissues were included as controls. Mann-Whitney U test was performed to evaluate SMS expression in the LGG group. Functional annotation analysis was conducted to explore the biological processes associated with high SMS expression. Immune cell infiltration analysis was performed to examine the correlation between SMS expression and immune cell types. The association between SMS expression and clinical and pathological features was assessed using Spearman correlation analysis. In vitro experiments were conducted to investigate the effects of overexpressing or downregulating SMS on cell proliferation, apoptosis, migration, invasion, and key proteins in the protein kinase B (AKT)/epithelialmesenchymal transition signaling pathway. Results: : The study revealed a significant upregulation of SMS expression in LGGs compared to normal brain tissues. High SMS expression was associated with certain clinical and pathological features, including older age, astrocytoma, higher World Health Organization grade, poor disease-specific survival, disease progression, non-1p/19q codeletion, and wild-type isocitrate dehydrogenase. Cox regression analysis identified SMS as a risk factor for overall survival. Bioinformatics analysis showed enrichment of eosinophils, T cells, and macrophages in LGG samples, while proportions of dendritic (DC) cells, plasmacytoid DC (pDC) cells, and CD8+ T cells were decreased. Conclusion : High SMS expression in LGGs may promote tumor occurrence through cellular proliferation and modulation of immune cell infiltration. These findings suggest the prognostic value of SMS in predicting clinical outcomes for LGG patients.

Objective: : The objective of this study was to assess the relationship between spermine synthase (SMS) expression, tumor occurrence, and prognosis in lower-grade gliomas (LGGs). Methods: : A total of 523 LGG patients and 1152 normal brain tissues were included as controls. Mann-Whitney U test was performed to evaluate SMS expression in the LGG group. Functional annotation analysis was conducted to explore the biological processes associated with high SMS expression. Immune cell infiltration analysis was performed to examine the correlation between SMS expression and immune cell types. The association between SMS expression and clinical and pathological features was assessed using Spearman correlation analysis. In vitro experiments were conducted to investigate the effects of overexpressing or downregulating SMS on cell proliferation, apoptosis, migration, invasion, and key proteins in the protein kinase B (AKT)/epithelialmesenchymal transition signaling pathway. Results: : The study revealed a significant upregulation of SMS expression in LGGs compared to normal brain tissues. High SMS expression was associated with certain clinical and pathological features, including older age, astrocytoma, higher World Health Organization grade, poor disease-specific survival, disease progression, non-1p/19q codeletion, and wild-type isocitrate dehydrogenase. Cox regression analysis identified SMS as a risk factor for overall survival. Bioinformatics analysis showed enrichment of eosinophils, T cells, and macrophages in LGG samples, while proportions of dendritic (DC) cells, plasmacytoid DC (pDC) cells, and CD8+ T cells were decreased. Conclusion : High SMS expression in LGGs may promote tumor occurrence through cellular proliferation and modulation of immune cell infiltration. These findings suggest the prognostic value of SMS in predicting clinical outcomes for LGG patients.

Objective: : The objective of this study was to assess the relationship between spermine synthase (SMS) expression, tumor occurrence, and prognosis in lower-grade gliomas (LGGs). Methods: : A total of 523 LGG patients and 1152 normal brain tissues were included as controls. Mann-Whitney U test was performed to evaluate SMS expression in the LGG group. Functional annotation analysis was conducted to explore the biological processes associated with high SMS expression. Immune cell infiltration analysis was performed to examine the correlation between SMS expression and immune cell types. The association between SMS expression and clinical and pathological features was assessed using Spearman correlation analysis. In vitro experiments were conducted to investigate the effects of overexpressing or downregulating SMS on cell proliferation, apoptosis, migration, invasion, and key proteins in the protein kinase B (AKT)/epithelialmesenchymal transition signaling pathway. Results: : The study revealed a significant upregulation of SMS expression in LGGs compared to normal brain tissues. High SMS expression was associated with certain clinical and pathological features, including older age, astrocytoma, higher World Health Organization grade, poor disease-specific survival, disease progression, non-1p/19q codeletion, and wild-type isocitrate dehydrogenase. Cox regression analysis identified SMS as a risk factor for overall survival. Bioinformatics analysis showed enrichment of eosinophils, T cells, and macrophages in LGG samples, while proportions of dendritic (DC) cells, plasmacytoid DC (pDC) cells, and CD8+ T cells were decreased. Conclusion : High SMS expression in LGGs may promote tumor occurrence through cellular proliferation and modulation of immune cell infiltration. These findings suggest the prognostic value of SMS in predicting clinical outcomes for LGG patients.

Objective To investigate the current status and experience of scientific research,attitude and demand for research training,and other research situations in military doctors with standardized training,to construct a targeted training system for research capacity of military general practitioners,and to explore the effect of the training system on the comprehensive research ability of military doctors.Methods Eighty-one military general practitioners who participated in the standardized training at The First Affiliated Hospital of Naval Medical University in 2022 were selected as research objects.A questionnaire-based survey was conducted among these doctors.SPSS 25.0 software was used to analyze the data obtained.The cultivation of research capacity included the training of basic research skills,advancement of reseach capacity,and the improvement of the assessment and incentive mechanism.Before and one year after the training,the research status,research attitude and demand,comprehensive research capacity,and mentor's evaluation for the research capacity were investigated.Results After one year of training,basic research skills and comprehensive research capacity of military general practitioners were significantly improved,mentor's evaluation was gradually improved,research achievements were significantly increased,training attitudes became more positive,and training needs changed.Conclusion The research capacity of military general practitioners has been significantly improved through the construction of training system of research capacity and continuous practice.

Objective To investigate the expression of kinesin family member 23(KIF23)in rectal cancer and its association with prognosis.Methods This study included 90 patients with rectal cancer who underwent surgical treatment at the First Central Hospital of Baoding from May 2017 to October 2019.Immunohistochemical staining was used to detect KIF23 expression,and the results were analyzed in combination with clinical and pathological data.Survival analysis was conducted using Kaplan-Meier methods and Cox proportional hazards models to assess the association between KIF23 expression and patient prognosis.Results Compared with adjacent non-tumor tis-sues,the expression level of KIF23 protein was significantly higher in rectal cancer tissues.Positive expression of KIF23 was significantly correlated with TNM stage,lymph node metastasis and distant metastasis in rectal cancer patients(P＜0.05).Kaplan-Meier analysis revealed that individuals expressing high levels of KIF23 experienced notably diminished disease-free survival(DFS)and overall survival(OS)relative to those with low KIF23 expression(P＜0.05).Cox regression analysis revealed that advanced TNM stage,lymph node metastasis,distant metastasis,and elevated KIF23 expression served as an independent predictor of adverse outcomes in pa-tients with rectal cancer(P＜0.05).Conclusions The expression level of KIF23 is closely related to the prognosis of rectal cancer.

Objective To compare the therapeutic effect of intravascular ultrasound-guided(IVUS-guided)shockwave balloon and cutting balloon in the treatment of severe coronary artery lesions.Methods The clinical data of 180 patients with coronary artery calcified lesions,who were admitted to the Affiliated Zhengzhou Municipal Seventh People's Hospital of Southern Medical University and the Affiliated Henan Provincial Chest Hospital of Zhengzhou University of China from January 2021 to December 2022,were retrospectively analyzed.Using the random number table method,the patients were divided into study group(n=90,receiving IVUS-guided shockwave balloon technology)and control group(n=90,receiving IVUS-guided cutting balloon technology).The surgical outcomes and 24-month follow-up prognosis were compared between the two groups.Results The mean medical cost in the study group was higher than that in the control group(P＜0.05).After pretreatment,the plaque load in the study group was lower than that in the control group,while the minimum lumen diameter,minimum lumen area inside the stent,and stent expansion rate in the study group were all greater than those in the control group(all P＜0.05).One month after treatment,the patients of both groups showed a significant increase in left ventricular ejection fraction(LVEF)and a significant decrease in left ventricular end diastolic diameter(LVEDd)(both P＜0.05),but there were no statistically significant differences in the above two indicators between the two groups(both P＞0.05).The median survival time without adverse cardiovascular events(MACE)in the study group was longer than that in the control group(P＜0.05).Conclusion For the treatment of coronary artery calcified lesions,the IVUS-guided shockwave balloon technique has a certain and reliable therapeutic effect,the postoperative lumen area of the target vessel is larger,and the long-term prognosis is better,when compared with the IVUS-guided cutting balloon technique.

Abstract Kidney stones are common and frequently occurring diseases in urology. In recent years, the incidence of urinary stones has increased year by year, affecting people′s quality of life and aggravating the social and economic burden. The occurrence and development of kidney stones are closely related to metabolic factors. This review mainly conducts a systematic overview of the research on the relationship between electrolyte metabolism abnormalities, dyslipidemias and other metabolic disorder diseases and kidney stones in recent years.By exploring the relationship between various metabolic disorder diseases and kidney stones, this review provides reference for exploring the occurrence and development of kidney stones from the perspective of metabolism.

Objective To construct a preoperative prediction model for proliferative hepatocellular carcinoma(HCC)based on enhanced CT image features,and to analyze the prognosis of the disease.Methods A retrospective case-control study was conducted on 603 patients with pathologically confirmed HCC.Among them,519 cases from the First Affiliated Hospital of Army Medical University were randomly divided into a training group(n=363)and an internal verification group(n=156)in a ratio of 7:3.Another 84 patients from the Second Affiliated Hospital of Chongqing Medical University served as an external validation group.All patients underwent abdominal CT scan with contrast before surgery.The clinical data and CT imaging characteristics of proliferative and non-proliferative HCC patients were observed.Binary logistic regression analysis was used to identify the independent risk factors of proliferative HCC,and a nomogram prediction model was constructed.Receiver operating characteristic(ROC)curve was plotted to evaluate its diagnostic performance,and calibration curve and decision curve analysis(DCA)were applied to evaluate its calibration performance and clinical application value.The model was validated in both the internal and external validation groups.Kaplan-Meier survival curves were employed to compare the prognosis between proliferative and non-proliferative HCC.Results Multivariate analysis showed that negative result of HBV-DNA quantification,incomplete tumor capsule,intratumoral necrosis or ischemia(≥20%),and annular hyperenhancement in arterial phase were independent predictors in predicting proliferative HCC(P<0.05).Our nomogram model for predicting proliferative HCC based on the above clinical imaging features had an AUC value of 0.805(95%CI:0.756～0.854),a sensitivity of 83.19%and a specificity of 64.80%in the training group.For the internal validation group,the AUC value was 0.793(95%CI:0.721～0.854),the sensitivity was 67.86%,and the specificity was 75.00%.In the external validation group,the AUC value was 0.842(95%CI:0.746～0.912),the sensitivity was 72.41%,and the specificity was 90.91%.Calibration curve and DCA showed that the model had good calibration performance and clinical applicability.The disease free survival(DFS)of the patients with proliferative HCC diagnosed by pathologically confirmed/predictive models was significantly shorter than that of non-proliferative HCC patients(training group:P=0.005,P<0.001;internal validation group:P=0.006,P=0.006;external validation group:P=0.002,P=0.015).Conclusion Our prediction model based on clinical and imaging features can accurately diagnose proliferative HCC before surgery,and the prognosis of proliferative HCC is generally poor.