Objective: To analyze the prevalence status and clustering patterns of risk factors for chronic diseases among adult residents in Rui' an City, Zhejiang Province, so as to provide a basis for formulating strategies for the prevention and control of chronic diseases and implementing risk factor interventions. Methods: A multi-stage random cluster sampling method was used to select residents aged ≥18 years in 5 townships (sub-districts) of Rui' an City as survey subjects from December 2023 to March 2024. Data on basic information, history of major chronic diseases, lifestyle behaviors, height, weight, and blood biochemical indicators were collected through questionnaire surveys, physical examinations, and laboratory tests. Descriptive analysis was used to analyze the prevalence status of 5 risk factors for chronic diseases. K-means clustering analysis was used to analyze clustering patterns. Results: A total of 3 060 people were surveyed, including 1 476 males, accounting for 48.24%, and 1 584 females, accounting for 51.76%. The median age was 49.00 (interquartile range, 25.00) years. There were 1 275 cases (41.67%) of hypertension, 462 cases (15.10%) of diabetes, and 1 460 cases (47.71%) of dyslipidemia. Insufficient fruit and vegetable intake, excessive salt intake, overweight and obesity, excessive red meat intake, and smoking involved 2 201, 1 878, 1 541, 1 337, and 571 people, with prevalences of 71.93%, 61.37%, 50.36%, 43.69%, and 18.66%, respectively. K-means clustering analysis identified 4 clustering patterns: smoking-insufficient fruit and vegetable intake type (249 people, accounting for 8.20%), low intake type (1 421 people, accounting for 46.75%). high red meat type (245 people, accounting for 8.07%), and high BMI-high salt type (1 118 people, accounting for 36.96%). The prevalences of hypertension and diabetes were higher in adult residents of the high BMI-high salt type, at 56.53% and 20.30%, respectively. The prevalence of dyslipidemia was higher in adult residents of the smoking-insufficient fruit and vegetable intake type, at 59.44%. Conclusions The prevalence of insufficient fruit and vegetable intake among adult residents in Rui' an City is relatively high. The clustering pattern of chronic disease risk factors is dominated by the low intake type. The prevalence of chronic diseases is higher in adult residents of the high BMI-high salt type and smoking-insufficient fruit and vegetable intake type. It is suggested to carry out health education and collaborative intervention of risk factors for different risk groups.

Objective To explore the CT and MRI characteristics of pancreatic mucinous cystic neoplasm with associated invasive carcinoma(MCN-AIC)and their clinical application.Methods A retrospective analysis was conducted on the CT and MRI manifes-tations,clinical presentations,and laboratory results of 10 patients with pathologically confirmed MCN-AIC.Results Four of 10 patients presented to the clinic with abdominal pain.Plain CT showed all 10 lesions with hypointensity,and enhanced CT showed 8 lesions with mild delayed enhancement.MRI showed 8 lesions with limited diffusion on diffusion weighted imaging(DWI).2 lesions had cal-cification and 8 lesions had no calcification.6 lesions were located at the pancreatic head,3 at the pancreatic tail,and remaining one at the pancreatic neck.In addition,main pancreatic duct dilatation in 6 leisons,no main pancreatic duct dilatation in 4 lesions,thickened cyst wall in 10 lesions,wall nodules in 4 lesions,no wall nodules in 6 lesions,and intratumoral segregations in 5 lesions,5 lesions without segregations.Conclusion The CT and MRI manifestations of MCN-AIC have certain characteristics and play an important role in imaging diagnosis,which can provide a reference basis for the treatment.

Objective To explore the CT and MRI characteristics of pancreatic mucinous cystic neoplasm with associated invasive carcinoma(MCN-AIC)and their clinical application.Methods A retrospective analysis was conducted on the CT and MRI manifes-tations,clinical presentations,and laboratory results of 10 patients with pathologically confirmed MCN-AIC.Results Four of 10 patients presented to the clinic with abdominal pain.Plain CT showed all 10 lesions with hypointensity,and enhanced CT showed 8 lesions with mild delayed enhancement.MRI showed 8 lesions with limited diffusion on diffusion weighted imaging(DWI).2 lesions had cal-cification and 8 lesions had no calcification.6 lesions were located at the pancreatic head,3 at the pancreatic tail,and remaining one at the pancreatic neck.In addition,main pancreatic duct dilatation in 6 leisons,no main pancreatic duct dilatation in 4 lesions,thickened cyst wall in 10 lesions,wall nodules in 4 lesions,no wall nodules in 6 lesions,and intratumoral segregations in 5 lesions,5 lesions without segregations.Conclusion The CT and MRI manifestations of MCN-AIC have certain characteristics and play an important role in imaging diagnosis,which can provide a reference basis for the treatment.

OBJECTIVE To provide reference for medication therapy management （MTM） of diabetic patients complicated with cardiovascular disease. METHODS A 63-year-old male diabetic patient who suffered from temporary headache every morning after percutaneous coronary intervention （PCI） visited the neurology department of our hospital， and then was recommended to the pharmaceutical outpatient department. The pharmacists thought that the patient’s symptoms of headache， severe constipation and hyperuricemia were more likely induced by the medication used. The pharmacists further found that his atherosclerotic cardiovascular disease （ASCVD） influencing factors such as blood pressure， heart rate， blood glucose and blood lipids did not reach standard. The pharmacists provided MTM services for the patient through pharmacy inquiry and adverse drug reactions judgement， medication evaluation， medication reconciliation， medication education and pharmacy follow-up. RESULTS Through fifteen MTM services for thirteen weeks， the pharmacists reconciliated and optimized the medication therapy plan， discontinued the use of Isosorbide mononitrate sustained-release tablets， Nifedipine controlled-release tablets， and Indapamide tablets， which caused adverse drug reactions； the number of drugs was adjusted from fifteen to seven， and the symptom of headache disappeared； severe constipation had also been significantly improved， and hyperuricemia dropped to normal range. The ASCVD influencing factors of blood pressure， heart rate， fasting plasma glucose， glycosylated hemoglobin， low-density lipoprotein cholesterol and uric acid were reduced from ＞140/90 mmHg（1 mmHg＝0.133 kPa）， 70-80 beats per minute， 7.71 mmol/L， 7.2%， 2.13 mmol/L and 494 μmol/L before MTM services to ＜130/80 mmHg， 55-60 beats per minute， 6.22 mmol/L， 6.3%， 1.55 mmol/L and 348 μmol/L after MTM services. CONCLUSIONS The pharmacists providing MTM services to the patients can improve their quality of life and therapeutic efficacy， reduce medication risks， and enhance the level of rational drug use in hospitals and pharmaceutical service capabilities.

An airway segmentation method based on coordinate information and multi-scale parallel network is proposed to solve the problem of insufficient accuracy of airway model in surgical navigation.Airway features at different scales are learned separately by a parallel network to address the feature conflict arising from airways of different sizes.Then,a coordinate guided up-sampling module is designed to utilize coordinate information from shallow features for guiding reconstruction of deeper features,thus restricting the spatial location of the target and improving the model accuracy.Finally,a channel guided multi-scale feature aggregation module is constructed to capture semantic details across multiple scales and investigate channel relationships between features at different scales.The proposed method and other models are trained and tested on two public datasets,namely LIDC-IDRI and EXACT'09.Experimental results show that the proposed method achieves an average Dice coefficient of 93.20%which is 2.61%higher than 3D U-Net,a false positive rate of only 0.012%,a tree length detection rate of 88.59%,and a branch detection rate of 97.42%,demonstrating that the method can be applied to lung disease diagnosis or navigation bronchoscopy.

Objective:To explore the effect of chronic incomplete sleep deprivation (SD) on ovarian reserve function in mice and its potential mechanisms.Methods:Sixteen 7-8 week old female C57BL/6 SPF mice were randomly divided into control and SD groups ( n=8 per group) after one week of acclimatization. The mice in the SD group were treated with SD from 7:00 to 10:00 using a deprivation rod for a total of 40 d. Before the first day and the last day of the experiment, vaginal smears were collected daily for 9 d to record and evaluate the estrous cycle. On the last day of the experiment, serum levels of estradiol, progesterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and melatonin (MT) were measured by enzyme-linked immunosorbent assay (ELISA). The ovaries were dissected to calculate the ovarian index and count the number of primordial follicles by hematoxylin-eosin (HE) staining. Cardiac perfusion was performed to get the brains and the expression of c-Fos protein was observed in the suprachiasmatic nucleus (SCN) by immunohistochemistry. Results:Compared with control group, SD group had a tendency of estrous cycle disorders. Hormone levels of estradiol [(20.19±3.67) ng/L], progesterone [(2.88±0.53) μg/L], and FSH [(13.42±2.36) U/L] in the SD group were significantly lower than those in control group [(24.66±2.15) ng/L, P=0.010; (3.43±0.49) μg/L, P=0.049; (17.01±1.49) U/L, P=0.003]. Hormone levels of LH and MT in the SD group were lower than those in control group, but without statistical significances (all P>0.05). There was no significant change in the number of primordial follicles between the two groups ( P>0.05). However, the oocyte morphology was poor, the granulosa cells were disorderedly arranged, the number of atretic follicles was decreased, and ovarian fibrosis was obvious in the SD group. Immunohistochemical staining showed an upregulation of c-Fos protein expression in the SCN of the SD group. Conclusion:Continuous 3 h SD for 40 d impairs ovarian reserve function in mice, possibly related to excessive activation of the SCN.

Objective:To explore the effect of chronic incomplete sleep deprivation (SD) on ovarian reserve function in mice and its potential mechanisms.Methods:Sixteen 7-8 week old female C57BL/6 SPF mice were randomly divided into control and SD groups ( n=8 per group) after one week of acclimatization. The mice in the SD group were treated with SD from 7:00 to 10:00 using a deprivation rod for a total of 40 d. Before the first day and the last day of the experiment, vaginal smears were collected daily for 9 d to record and evaluate the estrous cycle. On the last day of the experiment, serum levels of estradiol, progesterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and melatonin (MT) were measured by enzyme-linked immunosorbent assay (ELISA). The ovaries were dissected to calculate the ovarian index and count the number of primordial follicles by hematoxylin-eosin (HE) staining. Cardiac perfusion was performed to get the brains and the expression of c-Fos protein was observed in the suprachiasmatic nucleus (SCN) by immunohistochemistry. Results:Compared with control group, SD group had a tendency of estrous cycle disorders. Hormone levels of estradiol [(20.19±3.67) ng/L], progesterone [(2.88±0.53) μg/L], and FSH [(13.42±2.36) U/L] in the SD group were significantly lower than those in control group [(24.66±2.15) ng/L, P=0.010; (3.43±0.49) μg/L, P=0.049; (17.01±1.49) U/L, P=0.003]. Hormone levels of LH and MT in the SD group were lower than those in control group, but without statistical significances (all P>0.05). There was no significant change in the number of primordial follicles between the two groups ( P>0.05). However, the oocyte morphology was poor, the granulosa cells were disorderedly arranged, the number of atretic follicles was decreased, and ovarian fibrosis was obvious in the SD group. Immunohistochemical staining showed an upregulation of c-Fos protein expression in the SCN of the SD group. Conclusion:Continuous 3 h SD for 40 d impairs ovarian reserve function in mice, possibly related to excessive activation of the SCN.

Objective:To investigate the safety of minimally invasive liver resection for resectable hepatocellular carcinoma (HCC) complicated with portal hypertension.Methods:The propensity score matching and retrospective cohort study was conducted. The clinicopathological data of 807 patients with resectable HCC who underwent minimally invasive liver resection in 8 medical centers, including Sir Run Run Shaw Hospital, Affiliated with the Zhejiang University School of Medicine et al, from June 2011 to November 2022 were collected. There were 670 males and 137 females, aged 58(50,66)years. Of the 807 patients, 173 cases with portal hypertension were divided into the portal hypertension group, and 634 cases without portal hypertension were divided into the non-portal hypertension group. Observation indicators: (1) propensity score matching and comparison of general data of patients between the two groups after matching; (2) intraoperative and post-operative situations; (3) subgroup analysis. Propensity score matching was done by the 1:1 nearest neighbor matching method, with the caliper setting as 0.001. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the rank sum test. Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Comparison of ordinal data was constructed using the non-parameter rank sun test. Results:(1) Propensity score matching and comparison of general data of patients between the two groups after matching. Of the 807 patients, 268 cases were successfully matched, including 134 cases in the portal hypertension group and 134 cases in the non-portal hypertension group. The elimination of the tumor diameter and robot-assisted surgery confounding bias ensured comparability between the two groups after propensity score matching. (2) Intraoperative and postoperative situations. The occlusion time of porta hepatis, cases with intraoperative blood transfusion, cases with postoperative complication, cases with complication >Ⅱ grade of Clavien-Dindo classification, cases of Clavien-Dindo classification as Ⅰ grade, Ⅱ grade, Ⅲ grade, Ⅳ grade, cases with liver related complication were 27.0(15.0,43.0)minutes, 33, 55, 15, 13, 29, 14, 1, 37 in the portal hypertension group, versus 35.0(22.0,60.0)minutes, 17, 25, 5, 14, 9, 4, 1, 13 in the non-portal hypertension group, showing significant differences in the above indicators between the two groups ( Z=-2.15, χ2=6.30, 16.39, 4.38, 20.72, 14.16, P<0.05). (3) Subgroup analysis. Results of subgroups analysis showed that in cases with major live resection, the operation time, volume of intraoperative blood loss, duration of postoperative hospital stay were 243.5(174.6,296.3)minutes, 200.0(150.0,600.0)mL, 7.5(6.0,13.0)days in the portal hypertension group, versus 270.0(180.0,314.5)minutes, 200.0 (75.0,450.0)mL, 7.0(5.5,10.0)days in the non-portal hypertension group, showing no significant difference in the above indicators between the two groups ( Z=-0.54, -1.73, -0.92, P>0.05). In cases with non-major live resection, the operation time, volume of intraoperative blood loss, duration of postoperative hospital stay were 170.0(120.0,227.5)minutes, 100.0(50.0,200.0)mL, 8.0(5.0,10.0)days in the portal hypertension group, versus 170.0(120.0,227.5)minutes, 100.0(50.0,200.0)mL, 7.0(5.5,9.0)days in the non-portal hypertension group, showing no significant difference in the above indicators between the two groups ( Z=-1.39, -0.10, 1.05, P>0.05). In cases with anatomical liver resection, the operation time, volume of intraoperative blood loss, duration of postoperative hospital stay were 210.0(150.0,285.0)minutes, 150.0(50.0,200.0)mL, 8.0(6.0,9.3)days in the portal hypertension group, versus 225.5(146.3,306.8)minutes, 100.0(50.0,250.0)mL, 7.0(6.0,9.0)days in the non-portal hypertension group, showing no significant difference in the above indica-tors between the two groups ( Z=-0.75, -0.26, -0.91, P>0.05). In cases with non-anatomical liver resection, the operation time, volume of intraoperative blood loss, duration of postoperative hospital stay were 173.5(120.0,231.5)minutes, 175.0(50.0,300.0)mL, 7.0(5.0,11.0)days in the portal hyper-tension group, versus 186.0(123.0,262.5)minutes, 100.0(50.0,200.0)mL, 7.0(5.0,9.5)days in the non-portal hypertension group, showing no significant difference in the above indicators between the two groups ( Z=-0.97, -1.12, -0.98, P>0.05). Conclusion:Minimally invasive liver resection or even major liver resection is safe and feasible for screened HCC patients complicated with portal hyper-tension, but attention should be paid to the prevention and treatment of postoperative complications.

The establishment of the endometrial receptive state,the implantation of activated blastocysts,and the decidualization of the uterine stroma are essential conditions for successful implantation in mammals and play decisive roles for subsequent pregnancy outcomes.The Wnt signaling pathway is associated with a variety of key functions such as proliferation,differentiation,apoptosis,and regeneration.During the embryo implantation,the Wnt signaling pathway plays an indispensable role.Studies have shown that the abnormal expression of Wnt signaling pathway can lead to endometriosis,endometrial cancer,and other reproductive diseases that seriously affect human health and quality of life.In this article we summarize the roles of Wnt signaling pathway in the establishment of uterine receptivity,blastocyst activation,embryo implantation,and decidualization and its regulatory mechanisms.

Objective To investigate the effect of melatonin on osteoblast proliferation and osteogenic poten-tial in vitro cultured.Methods In vitro cultured human osteoblasts by different concentrations of melatonin (0, 1.0E -7,1.0E -6,1.0E -5,1.0E -4,1.0E -3mol/L)intervention 24 h,48 h,72 h,96 h.MTT assay was meas-ured by changes in cell proliferation,intervention in 96 hours,melatonin was measured by RT -PCR in cells OPG, RANK,RANKL influence,PTHLH mRNA expression.Results Compared with other groups,OD490 of the control group had statistical significance(all P <0.05).Compared with the control group,there were statistically significant differences in the ratio of OPG/RANKL of the dosing groups(all P <0.05).Conclusion Melatonin can promote the growth of bone into the cells and inhibit the action of bone cells into bone.