This paper proposes a two-stage method integrating visual foundation models （VFM） and diffusion models. The segment anything model （SAM） as VFM is combined with the SegRefiner diffusion model to construct the SAM-SegRefiner framework for automated segmentation of edema， inflammation， and thrombus regions in histopathological images of hemorrhoidal tissue， providing a reproducible technical tool for the objective quantification of pathological morphology and its application in traditional Chinese medicine （TCM） syndrome research. Trained and validated on multi-center retrospective data， the SAM-SegRefiner model achieved an average pixel accuracy of 95.32% and a mean intersection over union （mIoU） of 66.81% on an independent test set， significantly outperfor-ming comparative models such as U-Net， MixU-Net， and SAM-Med2D， and also demonstrating robust cross-center generalization capability. Furthermore， by correlating the quantitatively segmented results from the model with the patients' TCM syndrome types， the potential associations between pathomorphological features and TCM syndrome differentiation have been explored. The analysis revealed no statistically significant differences in the degree of inflammatory infiltration and thrombus formation among different syndrome types， suggesting a complex relationship between local pathological changes and systemic syndrome manifestations.

BACKGROUND:The elastic modulus of bone-cartilage integration scaffolds differs significantly from that of natural bone-cartilage tissue,which can lead to a stress shield effect.As a result,the implants become loose and deformed,affecting the repair of osteochondral tissue.Cell gradient scaffolds made by axial direction three-period minimal surface have the same porosity and elasticity modulus as the human body,which provides a new idea for bone-cartilage scaffold design.OBJECTIVE:To study the effect of cell type and pore size on the mechanical properties of cell gradient scaffolds.METHODS:Three basic cells of Gyroid(G)type,Diamond(D)type,and Primitive(P)type were used.Through mathematical modeling of three-period minimal surface,different sizes and types of cells were used in the gradient region.A total of six kinds of cell gradient scaffolds(G-2P-4D,P-2D-4G,D-2P-4D,G-2D-4P,P-2G-4D,and D-2G-4P)were constructed and mechanical experiments and simulation experiments were conducted to evaluate the mechanical properties of the scaffolds.Flow performance parameters of the fluids in the scaffolds were obtained through computational fluid dynamics simulation.RESULTS AND CONCLUSION:Finite element mechanical simulation and compression experiment showed that P-2G-4D and P-2D-4G with the highest elastic modulus(148.67 MPa and 152.1 MPa),bearing a higher body load,improved the stability of the scaffold.The stress distribution in D-2P-4G was even and effectively reduced stress concentration,so that the connection function area could effectively transfer stress and reduce stress shielding.Flow rate was changing the least in G-2D-4P(0.10-0.48 mm/s).Permeability was higher than other scaffolds so that body fluids were able to flow though the gradient scaffold after implantation.This design method provides a new idea for the design of osteochondral scaffolds,and the simulation analysis results also provide a reference for the prediction of bone integration after implantation of scaffolds.

BACKGROUND:As a temporary matrix for new bone growth,the porous scaffold plays a key role in the process of bone repair.The structural design of porous scaffolds is a research priority in the process of bone repair.OBJECTIVE:To summarize traditional bone scaffolds(regular,uniform scaffolds)and bionic scaffolds(irregular,inhomogeneous scaffolds)in the field of bone tissue engineering research.METHODS:A computerized search was performed in the databases of CNKI,VIP,WanFang,Web of Science,Science Direct,PubMed,and EI.Literature published from January 2008 to March 2024 was selected.The search terms in Chinese included"bone tissue engineering,bionic scaffolds,bone trabeculae,traditional scaffolds,bone repair,triple-period minimal surfaces."The search terms in English were"bone tissue engineering,bionic scaffolds,bone trabeculae,traditional scaffolds,bone repair,TPMS."Finally,81 articles were included for review.RESULTS AND CONCLUSION:The structural design of bone scaffolds is the key to achieve bone repair and bone regeneration,and scaffold technology in bone tissue engineering has made remarkable progress.Traditional regular porous scaffolds are widely used due to their simple manufacturing process and good mechanical properties.However,these scaffolds often lack biological activity and are difficult to mimic the complex microenvironment of natural bone tissue,limiting their ability to promote cell proliferation and bone regeneration.On the contrary,bionic scaffolds provide a more suitable physiological microenvironment by mimicking the structural features of natural bone tissues,which promotes the proliferation and differentiation of osteoblasts,as well as the formation of new bone,and provides a new way of thinking for the effective treatment of bone defects.Despite the great potential of bionic scaffolds in theory,they still face many challenges in practical applications.Factors such as the scaffold's biocompatibility,bioactivity,and its long-term stability still need to be further verified through clinical trials.

Objective:To explore the complex network correlation between interoceptive sensitivity and sleep quality in colorectal cancer patients with colostomy, clarify core symptoms and bridging symptoms, so as to provide theoretical support for developing targeted intervention measures.Methods:Convenience sampling method was used to select 287 colorectal cancer patients with colostomy at Shanxi Province Fenyang Hospital and Lyuliang First People's Hospital between October 2023 and November 2024 as study subjects. Patients were assessed using the General Information Questionnaire, Multidimensional Assessment of Interoceptive Awareness Version 2-Chinese, and Pittsburgh Sleep Quality Index. Network analysis was employed to investigate the network correlation between interoceptive sensitivity and sleep quality, as well as the characteristics of core nodes. A total of 287 questionnaires were distributed, and 281 effective questionnaires were collected, with an effective response rate of 97.91% (281/287) .Results:Network analysis revealed that the strongest connection weights linking interoceptive sensitivity to sleep quality were observed between trust and daytime dysfunction (connection weight: -0.20), followed by trust and sleep duration (connection weight: -0.10). The strength, betweenness, and closeness of trust centrality indicators were 1.24, 2.34, and 1.73, respectively. Trust emerged as the core node within the interoceptive sensitivity cluster. The strength, betweenness, and closeness of daytime dysfunction indicators were 1.15, 1.92 and 1.67. Daytime dysfunction emerged as the core node within the sleep quality cluster. Trust served as a bridging role in the complex network correlation between interoceptive sensitivity and sleep quality.Conclusions:There is a strong correlation between trust and daytime dysfunction and sleep duration among colorectal cancer patients with colostomy. Trust is a key factor in the network correlation between interoceptive sensitivity and sleep quality. Clinical healthcare providers can develop targeted interventions based on trust to improve the interoceptive sensitivity and sleep quality of colorectal cancer patients with colostomy.

Objective: To evaluate the immunogenicity and safety of co-administration with bivalent human papillomavirus (HPV) vaccine and hepatitis E virus (HEV) vaccine, so as to provide reference for optimizing the vaccination schedule. Methods: Females aged 18 to 25 years were recruited from September to October 2021 in Hengdian College of Film & Television in Zhejiang Province and randomly divided into the HPV+HEV group, the HPV group, and the HEV group. The vaccination procedures were one dose each at 0, 1, and 6 months. Immunogenicity was evaluated by detecting the geometric mean titers (GMT) of HPV16 IgG, HPV18 IgG, and/or HEV IgG antibodies before the first vaccination and one month after the full course of immunization, and comparing the difference in seroconversion, and the GMT ratio. The non-inferiority margin was set at a seroconversion difference of ≤5%, and the lower limit of the 95%CI of the GMT ratio was >0.5. Safety was evaluated by collecting conjunctive local reactions/events and systemic reactions/events within 7 days after each dose, non-conjunctive adverse events within 30 days after each dose, and serious adverse events throughout the observation period (0 to 7 months). Results: A total of 240 females were included, among whom 236 completed the full vaccination program, including 79 in the HPV+HEV group, 77 in the HPV group, and 80 in the HEV group. One month after the full course of immunization, the seroconversion rates of HPV16 IgG and HPV18 IgG antibodies in both the HPV+HEV group and the HPV group were 100%, and the differences in seroconversion rates were 0 (95%CI: -3.39%-+∞). The seroconversion rates of HEV IgG antibodies in both the HPV+HEV group and the HEV group were 100%, and the difference in seroconversion rates was 0 (95%CI: -3.27%-+∞). The GMT of HPV16 IgG and HPV18 IgG antibodies in the HPV+HEV group was 393.88 and 284.86 IU/mL respectively, which was not inferior to 489.39 and 341.24 IU/mL in the HPV group, and the GMT ratios were 0.80 (95%CI: 0.66-+∞) and 0.83 (95%CI: 0.68-+∞), respectively. The GMT of HEV IgG in the HPV+HEV group was 13.55 U/mL, which was not inferior to 12.72 U/mL in the HEV group, and the GMT ratio was 1.07 (95%CI: 0.92-+∞). The incidences of pain, pruritus, and induration in the HPV+HEV group were 54.43%, 21.52% and 40.51% respectively, which were significantly higher than 10.39%, 0, and 0 in the HPV group (all P<0.05). The incidences of redness/swelling, muscle pain/general weakness in the HPV+HEV group were 2.53% and 0, respectively, which were significantly lower than 12.50% and 16.25% in the HEV group (both P<0.05). Conclusion The co-administration of the bivalent HPV vaccine and HEV vaccine is not inferior to individual vaccination in terms of immunogenicity and safety, and the vaccination plan can be optimized through co-administration.

Objective:To analyze the epidemiological characteristics of mumps in China under the immunization strategies of different doses of mumps-containing vaccines(MuCV) by analyzing the national mumps surveillance data from 2020 to 2023.Methods:Based on the national mumps surveillance data from 2020 to 2023, a comparative analysis was conducted on the mumps incidence and the distribution characteristics of mumps cases in time, region and population in the three different periods of 2004-2007 (without MuCV implementation), 2008-2019 (one-dose MuCV implementation) and 2020-2023 (two-dose MuCV implementation) in China.Results:From 2020 to 2023, the annual incidence rate of mumps was 6.48-9.20/100 000, and the annual number of reported cases was 91 303-129 120 cases. After the implementation of the 2-dose MuCV immunization strategy, the epidemiological characteristics of mumps in China have changed to some extent. Compared with the period of 2004-2007 and 2008-2019, the traditional seasonal epidemic pattern of mumps disappeared from 2020 to 2023, with no obvious epidemic peak throughout the year. There was no significant regional difference in the incidence of mumps. Children and adolescents under 15 years of age were the main population of mumps (accounting for 85.46%), of which children aged 5-9 years accounted for 45.07%. Compared with the period of 2004-2007 and 2008-2019, the proportion of mumps cases in the 0-4 years old group showed an increasing trend, the proportion of mumps cases in the 10-14 years old group showed a decreasing trend, and the proportion of adult cases over 40 years old also increased from 2020 to 2023. The age group with the highest incidence of mumps was found to have shifted from 7 years old to 4 years old.Conclusions:The 2-dose MuCV immunization strategy has effectively reduced the incidence of mumps in China. It is necessary to strengthen the surveillance of mumps in kindergartens and primary school children.

Objective:To explore the diagnostic value of serum soluble semaphorin 4D (sSema4D) and soluble CD40 ligand (sCD40L) in left ventricular hypertrophy (LVH) in patients with primary hypertension (EH).Methods:Eighty-four patients with EH combined with LVH admitted to Qingdao Hospital of Shandong First Medical University from December 2022 to December 2023 were prospectively selected as the study group, and 84 patients with EH and without LVH admitted to Qingdao Hospital of Shandong First Medical University during the same period were regarded as the control group. Enzyme linked immunosorbent assay was applied to detect the levels of sSema4D and sCD40L. Employing Pearson correlation coefficient, the study assessed the association between concentrations of sSema4D and sCD40L in serum and various echocardiographic measurements. A multivariate Logistic regression model was engaged to probe into the contributing factors for the development of LVH. ROC curve was plotted to analyze the diagnostic value of serum sSema4D and sCD40L for EH combined with LVH.Results:Serum sSema4D and sCD40L levels were significantly higher in the study group than in the control group: (8.56 ± 2.19) μg/L vs. (5.12 ± 1.43) μg/L, (4.02 ± 1.03) μg/L vs. (3.22 ± 0.98) μg/L, and the differences were statistically significant ( P<0.05). The duration of hypertension, LVEDD, IVSTD, LVPWT, and LVMI were significantly higher in the study group than in the control group: (7.33 ± 1.53) years vs. (4.26 ± 1.35) years, (50.28 ± 3.33) mm vs. (44.45 ± 3.76) mm, (11.64 ± 3.21) mm vs. (9.53 ± 2.89) mm, (12.45 ± 1.52) mm vs. (9.13 ± 0.98) mm, (126.11 ± 15.28) g/m 2 vs. (81.15 ± 11.31) g/m 2, and the differences were statistically significant ( P<0.05). According to Pearson correlation analysis, it was known that both serum sSema4D and sCD40L were positively correlated with LVEDD, IVSTD, LVPWT and LVMI ( r = 0.425 and 0.533, 0.612 and 0.436, 0.513 and 0.628, 0.589 and 0.618; P<0.05). Multivariate Logistic regression analysis showed that hypertension duration, LVEDD, IVSTD, LVPWT, LVMI, sSema4D, sCD40L were risk factors for LVH in EH patients ( P<0.05). According to the ROC curve, the AUC for diagnosing EH combined with LVH with serum sSema4D was 0.848, the AUC for diagnosing EH combined with LVH with serum sCD40L was 0.725, and the AUC for diagnosing EH combined with LVH with serum sCD40L was 0.888, the combination of sCD40L and sCD40L was superior to their respective individual diagnoses ( Z = 2.651 and 2.526, P<0.05). Conclusions:The serum levels of sSema4D and sCD40L in patients with EH combined with LVH are obviously elevated, which are influencing factors for the occurrence of EH combined with LVH. Combined testing of the two has high diagnostic value for EH combined with LVH.

BACKGROUND:The elastic modulus of bone-cartilage integration scaffolds differs significantly from that of natural bone-cartilage tissue,which can lead to a stress shield effect.As a result,the implants become loose and deformed,affecting the repair of osteochondral tissue.Cell gradient scaffolds made by axial direction three-period minimal surface have the same porosity and elasticity modulus as the human body,which provides a new idea for bone-cartilage scaffold design.OBJECTIVE:To study the effect of cell type and pore size on the mechanical properties of cell gradient scaffolds.METHODS:Three basic cells of Gyroid(G)type,Diamond(D)type,and Primitive(P)type were used.Through mathematical modeling of three-period minimal surface,different sizes and types of cells were used in the gradient region.A total of six kinds of cell gradient scaffolds(G-2P-4D,P-2D-4G,D-2P-4D,G-2D-4P,P-2G-4D,and D-2G-4P)were constructed and mechanical experiments and simulation experiments were conducted to evaluate the mechanical properties of the scaffolds.Flow performance parameters of the fluids in the scaffolds were obtained through computational fluid dynamics simulation.RESULTS AND CONCLUSION:Finite element mechanical simulation and compression experiment showed that P-2G-4D and P-2D-4G with the highest elastic modulus(148.67 MPa and 152.1 MPa),bearing a higher body load,improved the stability of the scaffold.The stress distribution in D-2P-4G was even and effectively reduced stress concentration,so that the connection function area could effectively transfer stress and reduce stress shielding.Flow rate was changing the least in G-2D-4P(0.10-0.48 mm/s).Permeability was higher than other scaffolds so that body fluids were able to flow though the gradient scaffold after implantation.This design method provides a new idea for the design of osteochondral scaffolds,and the simulation analysis results also provide a reference for the prediction of bone integration after implantation of scaffolds.

BACKGROUND:As a temporary matrix for new bone growth,the porous scaffold plays a key role in the process of bone repair.The structural design of porous scaffolds is a research priority in the process of bone repair.OBJECTIVE:To summarize traditional bone scaffolds(regular,uniform scaffolds)and bionic scaffolds(irregular,inhomogeneous scaffolds)in the field of bone tissue engineering research.METHODS:A computerized search was performed in the databases of CNKI,VIP,WanFang,Web of Science,Science Direct,PubMed,and EI.Literature published from January 2008 to March 2024 was selected.The search terms in Chinese included"bone tissue engineering,bionic scaffolds,bone trabeculae,traditional scaffolds,bone repair,triple-period minimal surfaces."The search terms in English were"bone tissue engineering,bionic scaffolds,bone trabeculae,traditional scaffolds,bone repair,TPMS."Finally,81 articles were included for review.RESULTS AND CONCLUSION:The structural design of bone scaffolds is the key to achieve bone repair and bone regeneration,and scaffold technology in bone tissue engineering has made remarkable progress.Traditional regular porous scaffolds are widely used due to their simple manufacturing process and good mechanical properties.However,these scaffolds often lack biological activity and are difficult to mimic the complex microenvironment of natural bone tissue,limiting their ability to promote cell proliferation and bone regeneration.On the contrary,bionic scaffolds provide a more suitable physiological microenvironment by mimicking the structural features of natural bone tissues,which promotes the proliferation and differentiation of osteoblasts,as well as the formation of new bone,and provides a new way of thinking for the effective treatment of bone defects.Despite the great potential of bionic scaffolds in theory,they still face many challenges in practical applications.Factors such as the scaffold's biocompatibility,bioactivity,and its long-term stability still need to be further verified through clinical trials.

Objective:To explore the diagnostic value of serum soluble semaphorin 4D (sSema4D) and soluble CD40 ligand (sCD40L) in left ventricular hypertrophy (LVH) in patients with primary hypertension (EH).Methods:Eighty-four patients with EH combined with LVH admitted to Qingdao Hospital of Shandong First Medical University from December 2022 to December 2023 were prospectively selected as the study group, and 84 patients with EH and without LVH admitted to Qingdao Hospital of Shandong First Medical University during the same period were regarded as the control group. Enzyme linked immunosorbent assay was applied to detect the levels of sSema4D and sCD40L. Employing Pearson correlation coefficient, the study assessed the association between concentrations of sSema4D and sCD40L in serum and various echocardiographic measurements. A multivariate Logistic regression model was engaged to probe into the contributing factors for the development of LVH. ROC curve was plotted to analyze the diagnostic value of serum sSema4D and sCD40L for EH combined with LVH.Results:Serum sSema4D and sCD40L levels were significantly higher in the study group than in the control group: (8.56 ± 2.19) μg/L vs. (5.12 ± 1.43) μg/L, (4.02 ± 1.03) μg/L vs. (3.22 ± 0.98) μg/L, and the differences were statistically significant ( P<0.05). The duration of hypertension, LVEDD, IVSTD, LVPWT, and LVMI were significantly higher in the study group than in the control group: (7.33 ± 1.53) years vs. (4.26 ± 1.35) years, (50.28 ± 3.33) mm vs. (44.45 ± 3.76) mm, (11.64 ± 3.21) mm vs. (9.53 ± 2.89) mm, (12.45 ± 1.52) mm vs. (9.13 ± 0.98) mm, (126.11 ± 15.28) g/m 2 vs. (81.15 ± 11.31) g/m 2, and the differences were statistically significant ( P<0.05). According to Pearson correlation analysis, it was known that both serum sSema4D and sCD40L were positively correlated with LVEDD, IVSTD, LVPWT and LVMI ( r = 0.425 and 0.533, 0.612 and 0.436, 0.513 and 0.628, 0.589 and 0.618; P<0.05). Multivariate Logistic regression analysis showed that hypertension duration, LVEDD, IVSTD, LVPWT, LVMI, sSema4D, sCD40L were risk factors for LVH in EH patients ( P<0.05). According to the ROC curve, the AUC for diagnosing EH combined with LVH with serum sSema4D was 0.848, the AUC for diagnosing EH combined with LVH with serum sCD40L was 0.725, and the AUC for diagnosing EH combined with LVH with serum sCD40L was 0.888, the combination of sCD40L and sCD40L was superior to their respective individual diagnoses ( Z = 2.651 and 2.526, P<0.05). Conclusions:The serum levels of sSema4D and sCD40L in patients with EH combined with LVH are obviously elevated, which are influencing factors for the occurrence of EH combined with LVH. Combined testing of the two has high diagnostic value for EH combined with LVH.