Objective:To evaluate the safety and efficacy of digital technology-assisted debridement and bone and soft tissue reconstruction in the treatment of chronic osteomyelitis of the tibia.Methods:This retrospective study analyzed clinical data from 38 patients (26 males, 12 females; mean age 45.61±18.36 years, range 16-83 years) with chronic post-traumatic osteomyelitis complicated by soft tissue defects in the tibia, treated at the Department of Orthopaedics, Fourth Medical Center of PLA General Hospital between June 2021 and June 2023. There were 18 cases of traffic accidents, 6 cases of high-altitude falls, 6 cases of heavy objects and 6 cases of low-energy falls. Lesion sites: 12 cases in the upper segment of the tibia, 12 cases in the middle segment, and 14 cases in the lower segment. According to the Cierny-Mader classification, there were 24 cases of type III and 14 cases of type IV. Before the operation, the "3D point cloud technology" was used to plan the debridement range of bone and soft tissue. During the operation, the optical navigation system was used to monitor the debridement range in real time. The flap was designed by combining "Reading Tablet Treasure" with CT angiography, and the amount of bone graft was predicted by AI algorithm. The surgical method adopted is the Masquelet technique, namely thorough debridement, bone cement occupation and soft tissue repair in the first stage, and bone reconstruction in the second stage. Comparing the calculated bone defect amount and soft tissue defect area before the operation with the actual measured values after debridement. The cure rate of infection was evaluated by using the McKee bone infection treatment criteria after the operation. The visual analogue scale (VAS) for pain, lower extremity functional scale (LEFS), and self-rating anxiety scale (SAS) were used to evaluate the improvement of the quality of life of postoperative patients.Results:38 patients were followed up with a mean follow-up of 13.53±2.37 months. 37 patients' infections were effectively controlled, and 1 patient had a recurrence of infection, with an effectiveness rate of 97% for the treatment of McKee's infections. The preoperative calculated bone defect amount and soft tissue defect area were 51.05±26.31 cm 3 and 68.42±43.45 cm 2 respectively, and the actual measured values after debridement during the operation were 51.66±26.35 cm 3 and 68.82±43.76 cm 2 respectively. There was no statistically significant difference before and after the operation ( P>0.05). The interval between the first and second stage surgeries was 10.36±1.61 weeks, and all flaps survived after the first stage surgery. Two months after the operation, one case had recurrent osteomyelitis. After palliative treatment, sinus tracts were formed at the infection site. At the 12-month regular dressing change follow-up, there were still purulent secretions in the sinus tracts. There was no recurrence of infection after primary debridement in 37 cases, and the bone grafts healed. The bone healing time was 3.58±0.97 months. The postoperative VAS, LEFS, and SAS scores were 1.00±0.91, 66.68±7.91, and 34.30±4.29, respectively, which were significantly improved compared with the preoperative scores of 7.54±1.52, 21.22±4.29, and 52.70±6.74, respectively, and the difference was statistically significant ( P<0.05). Conclusions:The application of digital technology to precisely design the debridement range of bone and soft tissue, and the real-time holographic visualization monitoring of the debridement range during the operation can achieve precise debridement of bone and soft tissue and personalized and precise repair of soft tissue defects. It is a safe and effective technique for the treatment of chronic osteomyelitis of the tibia.

Objective:To develop an intelligent recognition and precise segmentation technique using ultrasonic images，and to enhance diagnostic efficiency and accuracy.Methods:A total of 1，430 patients diagnosed with uterine fibroids through transvaginal ultrasonography at the Maternal and Child Health Hospital of Guangming from November 2020 to October 2024 were retrospectively included. Ultrasonic images were manually annotated by two experienced physicians and reviewed by a senior expert. The Mask DINO deep learning model was used for lesion segmentation，and the segmentation results were optimized using ellipse fitting technology. Model performance was evaluated using the Dice coefficient，intraclass correlation coefficient（ICC），mean absolute error（MAE），and measurement accuracy.Results:In the test set of 286 cases，the average Dice coefficient of model prediction was 0.992，indicating extremely high segmentation accuracy. The average accuracy of lesion identification by the model was 0.909，with 241 correctly identified samples，19 basically correct samples，and 26 incorrect samples. In terms of long and short axis measurements，the ICC of the model's direct predictions were 0.871（short axis）and 0.784（long axis），with MAE of 0.436 cm（short axis）and 0.508 cm（long axis）. After optimization with ellipse fitting，the ICC increased to 0.893（short axis）and 0.866（long axis），and the MAE decreased to 0.191 cm（short axis）and 0.274 cm（long axis），the measurement accuracy improved significantly.Conclusions:The intelligent recognition and precise segmentation technique for uterine fibroids based on ultrasonic images constructed in this study performed excellently in lesion segmentation and measurement，it can significantly improve the efficiency and accuracy of diagnosis.

Objective To analyze the ecological suitability of Codonopsis pilosula;To provide theoretical reference for expanding the planting scale of Codonopsis pilosula in Shanxi Province.Methods Information on the distribution of Codonopsis pilosula samples through the fourth survey of TCM resources in Shanxi Province and literature review;the MaxEnt model and ArcGIS 10.8 geographic information system software were used to analyze the ecological factors affecting the distribution of Codonopsis Radix in Shanxi Province,and the suitable distribution areas of Codonopsis pilosula in Shanxi Province were predicted.Results The predicted distribution areas of Codonopsis pilosula in Shanxi Province by the model were highly consistent with the actual distribution area;the AUC of the training set was 0.945,indicating good prediction results.The predominant ecological factors(contributing)impacting the distribution of Codonopsis pilosula included vegetation type(31.1%),the standard deviation of seasonal temperature fluctuations(25.0%),slope(8.3%),mean January precipitation(5.3%),mean May precipitation(5.0%),and elevation(4.9%)etc.The optimal vegetation types conducive to the proliferation of Codonopsis pilosula were identified as temperate deciduous shrubs,temperate grasslands,temperate coniferous forests,and temperate deciduous broad-leaved forests.The standard deviation of seasonal temperature change was within the range of 92 to 108,the slope gradient was from 14° to 30°,mean January precipitation was of 4 to 6.8 mm,mean May precipitation was of 33.5 to 58 mm,and elevation ranged from 1 100 to 2 800 meters.Codonopsis pilosula was mainly distributed in Lucheng,Qinxian and Qinyuan counties in the eastern part of Taiyue Mountain in Changzhi City;Pu County,Fenxi County,Fenyang City of Lyuliang City in the Lyuliang Mountain Range and Yushe County of Jinzhong City in the northern part of Taiyue Mountain.The most suitable area in Shanxi Province was 14 109.67 km2,the suitable area encompassed 22 837.62 km2,the relatively suitable area covered 41 982.96 km2,while the unsuitable area extended over 77 769.75 km2.Conclusion The geographical distribution data of Codonopsis pilosula resources in Shanxi Province may serve as a basis for further examination of regional zoning,with the establishment of wild cultivation bases for Codonopsis pilosula in proximity to various mountain ranges,such as the Taihang Mountains.Moreover,the artificial cultivation conditions can be modified in accordance with the optimal growth environment of Codonopsis pilosula,thereby optimizing the management of Codonopsis resources.

Objective:In order to advance the upgrade of the Traditional Chinese Medicine(TCM)"preventive healthcare"project and develop high-quality TCM preventive healthcare services.Methods:Utilizing stakeholder theory to identify the stakeholders of current TCM health preservation services,and analyze the core stakeholders'interest relationships,influence,connection strength,policy impact,and the recognition degree for TCM"preventive healthcare".Results:It describes the economic connotations and current development status of TCM"preventive healthcare"services,where the core stakeholders include government and functional departments,medical insurance departments,medical institutions,medical and health technicians,and patient groups.By comparing the interest descriptions of core stakeholders,the existing problems are analyzed.Conclusion:The government should improve policy management and promote departmental collaboration.Medical insurance departments need to strengthen policy coordination and product development.Medical institutions should establish a multi-level service system,optimize the service model,improve the incentive mechanism for medical and health technicians,and enhance service capabilities.The patient group should enhance health awareness and optimize the service experience.Through the management strategy driven by interests,it can promote the high-quality development of TCM preventive treatment services and meet the health needs of the residents.

Objective:To evaluate the safety and efficacy of digital technology-assisted debridement and bone and soft tissue reconstruction in the treatment of chronic osteomyelitis of the tibia.Methods:This retrospective study analyzed clinical data from 38 patients (26 males, 12 females; mean age 45.61±18.36 years, range 16-83 years) with chronic post-traumatic osteomyelitis complicated by soft tissue defects in the tibia, treated at the Department of Orthopaedics, Fourth Medical Center of PLA General Hospital between June 2021 and June 2023. There were 18 cases of traffic accidents, 6 cases of high-altitude falls, 6 cases of heavy objects and 6 cases of low-energy falls. Lesion sites: 12 cases in the upper segment of the tibia, 12 cases in the middle segment, and 14 cases in the lower segment. According to the Cierny-Mader classification, there were 24 cases of type III and 14 cases of type IV. Before the operation, the "3D point cloud technology" was used to plan the debridement range of bone and soft tissue. During the operation, the optical navigation system was used to monitor the debridement range in real time. The flap was designed by combining "Reading Tablet Treasure" with CT angiography, and the amount of bone graft was predicted by AI algorithm. The surgical method adopted is the Masquelet technique, namely thorough debridement, bone cement occupation and soft tissue repair in the first stage, and bone reconstruction in the second stage. Comparing the calculated bone defect amount and soft tissue defect area before the operation with the actual measured values after debridement. The cure rate of infection was evaluated by using the McKee bone infection treatment criteria after the operation. The visual analogue scale (VAS) for pain, lower extremity functional scale (LEFS), and self-rating anxiety scale (SAS) were used to evaluate the improvement of the quality of life of postoperative patients.Results:38 patients were followed up with a mean follow-up of 13.53±2.37 months. 37 patients' infections were effectively controlled, and 1 patient had a recurrence of infection, with an effectiveness rate of 97% for the treatment of McKee's infections. The preoperative calculated bone defect amount and soft tissue defect area were 51.05±26.31 cm 3 and 68.42±43.45 cm 2 respectively, and the actual measured values after debridement during the operation were 51.66±26.35 cm 3 and 68.82±43.76 cm 2 respectively. There was no statistically significant difference before and after the operation ( P>0.05). The interval between the first and second stage surgeries was 10.36±1.61 weeks, and all flaps survived after the first stage surgery. Two months after the operation, one case had recurrent osteomyelitis. After palliative treatment, sinus tracts were formed at the infection site. At the 12-month regular dressing change follow-up, there were still purulent secretions in the sinus tracts. There was no recurrence of infection after primary debridement in 37 cases, and the bone grafts healed. The bone healing time was 3.58±0.97 months. The postoperative VAS, LEFS, and SAS scores were 1.00±0.91, 66.68±7.91, and 34.30±4.29, respectively, which were significantly improved compared with the preoperative scores of 7.54±1.52, 21.22±4.29, and 52.70±6.74, respectively, and the difference was statistically significant ( P<0.05). Conclusions:The application of digital technology to precisely design the debridement range of bone and soft tissue, and the real-time holographic visualization monitoring of the debridement range during the operation can achieve precise debridement of bone and soft tissue and personalized and precise repair of soft tissue defects. It is a safe and effective technique for the treatment of chronic osteomyelitis of the tibia.

Objective:In order to advance the upgrade of the Traditional Chinese Medicine(TCM)"preventive healthcare"project and develop high-quality TCM preventive healthcare services.Methods:Utilizing stakeholder theory to identify the stakeholders of current TCM health preservation services,and analyze the core stakeholders'interest relationships,influence,connection strength,policy impact,and the recognition degree for TCM"preventive healthcare".Results:It describes the economic connotations and current development status of TCM"preventive healthcare"services,where the core stakeholders include government and functional departments,medical insurance departments,medical institutions,medical and health technicians,and patient groups.By comparing the interest descriptions of core stakeholders,the existing problems are analyzed.Conclusion:The government should improve policy management and promote departmental collaboration.Medical insurance departments need to strengthen policy coordination and product development.Medical institutions should establish a multi-level service system,optimize the service model,improve the incentive mechanism for medical and health technicians,and enhance service capabilities.The patient group should enhance health awareness and optimize the service experience.Through the management strategy driven by interests,it can promote the high-quality development of TCM preventive treatment services and meet the health needs of the residents.

Objective:To explore the effect of combining transcranial magnetic stimulation (rTMS) with acupuncture in the treatment of patients with vascular cognitive impairment (VCI).Methods:A total of 40 VCI patients were randomly assigned to either the control group or the experimental group ( n=20 per group) using a random number table. Both groups received routine treatment and rTMS, while the experimental group was additionally provided with acupuncture for four weeks. The rTMS was at 10Hz at 90% of the motor threshold. Before and after the treatment, both groups′ cognition was evaluated using the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE). Ability in the activities of daily living (ADL) was quantified using the modified Barthel Index (MBI). Serum levels of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) were measured using enzyme-linked immunosorbent assays. Results:Significant improvement was observed in both groups′ average MoCA, MMSE, and MBI scores, along with reductions in peripheral serum IL-6 and TNF-α levels. The experimental group exhibited significantly higher MoCA subdomain scores in the visuospatial and executive function, attention, and delayed recall subdomains, as well as a higher total MoCA score compared to the control group. The average MMSE and MBI scores were significantly higher in the experimental group than the control group, and that group′s serum IL-6 and TNF-α levels were significantly lower, on average. Pearson correlation analysis demonstrated a positive correlation between the improvements in MoCA and MMSE scores and the reductions in IL-6 and TNF-α levels in both groups.Conclusions:rTMS combined with acupuncture effectively improves cognition and ADL ability among VCI patients. The underlying mechanism may be associated with the reduction of neuroinflammatory factors IL-6 and TNF-α.