Yttrium-90 selective internal radiation therapy (⁹⁰Y-SIRT) is a treatment technique that delivers radioactive microspheres precisely to the arterial vascular bed of neoplasms, utilizing beta radiation to administer a high local dose of radiation to the neoplasm tissues. This technology has demonstrated significant efficacy in patients with unresectable pirmary liver cancers and liver metastases. This article systematically reviews the development history and clinical application status of ⁹⁰Y-SIRT in the treatment of liver cancer, and looks forward to future development directions.

Background Hypertension is one of the chronic diseases with the highest prevalence in China, and a history of hypertension may potentially exacerbate hearing loss. Investigating the association between long-term blood pressure trends and hearing thresholds could contribute to hearing protection efforts for occupationally noise-exposed populations. Objective By investigating hearing thresholds and blood pressure levels among occupationally noise-exposed workers in an urban rail transit enterprise, and conducting a comprehensive analysis of the association between long-term blood pressure changes and hearing thresholds, to provide data references for health management strategies targeting occupationally noise-exposed workers. Methods Workers exposed to occupational noise at a rail transit enterprise were enrolled as study subjects and underwent pure-tone audiometry. Group-based trajectory modeling was employed to identify blood pressure trajectories. Categorical data were compared using chi-square tests, while normally distributed continuous variables were analyzed via t-tests and analysis of variance (ANOVA). Generalized linear mixed models (GLMMs) were subsequently applied toexamine associations between these trajectory groups and high-frequency hearing thresholds. Results Among 2 002 occupationally noise-exposed workers, the median (P₂₅, P₇₅) age was 32 (28, 35) years, with a median (P₂₅, P₇₅) working tenure of 7 (3, 10) years. In 2019, the positive hypertension rate was 9.04%, with a mean systolic blood pressure (SBP) of (122.97±11.60) mmHg and a mean diastolic blood pressure (DBP) of (76.37±9.02) mmHg. The hearing loss prevalence was 10.1%, showing bilateral high-frequency average hearing thresholds of (17.18±8.71) dB and speech-frequency average thresholds of (13.79±3.46) dB. Three distinct trajectory groups were identified for both SBP and DBP. Compared with other trajectory groups, the high-stable DBP group exhibited significantly higher hearing loss prevalence (χ²=6.34, P=0.042) and elevated high-frequency hearing thresholds (all Ps<0.05). Specifically, within the 30-39 age subgroup, the moderate-stable DBP group demonstrated 1.96 dB lower high-frequency thresholds than the high-stable group [β(95%CI): −1.96 (−3.61, −0.32), P=0.020]. Conclusion Among occupationally noise-exposed workers in a municipal rail transit enterprise, DBP trajectories demonstrated a positive association with high-frequency hearing thresholds. Notably, in young and middle-aged occupationally noise-exposed populations, DBP may exert a more critical influence than SBP on the progression of hearing loss.

The China Anti-Cancer Association (CACA) Guidelines are the first set of guidelines developed for the holistic integrative management of cancers in China. An "on-campus CACA Guidelines" event was initiated by the China Anti-Cancer Association and numerous experts in medical education in February 2023. This event was aimed to integrate the key points and practical application of the guidelines into medical education and to foster high-caliber talents through revised educational materials, innovative teaching approaches, and enhanced hands-on training. The "on-campus CACA Guidelines" event took place in 222 medical schools nationwide and received positive responses from all participating schools. The CACA guidelines were incorporated into teaching by updating the curriculum, improving teacher training, and establishing facilities for practical training. The incorporation of the CACA guidelines has effectively improved teacher capabilities, streamlined academic evaluation, promoted a positive academic environment, and strengthened students' practical skills. These guidelines provide key insights and directions for medical education reform in China.

An important issue facing university education is the adaptation and transformation of freshmen.In order to guide students to adapt to the needs of research-based learning,Jilin University has opened a freshman seminar for all first-year undergraduate students,emphasizing the cultivation of students'thinking patterns and learning abilities.For medical students,it is necessary to ap-ply the learned medical knowledge to clinical problem analysis.Therefore,it is particularly important to cultivate students'integrated thinking from basic to clinical at the beginning of enrollment.In recent years,organ system integration has gradually been carried out in medical schools both domestically and internationally.In the course of integrating the immune system and diseases,the morphology of the immune system is relatively abstract and difficult to observe.In the early stages of enrollment,students still lack the thinking of organ system integration,and the initial stage of immune system integration courses is difficult to carry out.Therefore,we aimed to guide students towards adaptability and academic transformation through freshman seminars,explored the integration of the immune system's organ system as a pathway,and used the BOPPPS teaching model as a means for preliminary exploration.In the freshman seminar,the main focus is on the"morphology and structure-mechanism and function-disease-diagnosis-treatment"of the immune sys-tem,helping students establish a learning mindset that integrates disease diagnosis and treatment based on basic medical courses such as immunology and anatomy.Using BOPPPS to reform the"teaching"of teachers,establishing a student-centered teaching model from six aspects:bridge,objective,pre-assessment,participatory learning,post-assessment and summary,can better guide students to actively think and participate in the entire learning process,focus on the construction of students'fragmented knowledge thinking mode,internalize medical humanities literacy,and improve the quality of medical talent cultivation in colleges and universities.

Objective:To investigate the risk factors for lung metastasis from differentiated thyroid cancer (DTC), predict the occurrence of lung metastasis, and diagnose lung metastasis early.Methods:From April 2013 to May 2023, 442 DTC patients (145 males, 297 females; age (41.6±13.1) years) who received 131I treatment in the First Affiliated Hospital of the Air Force Medical University were retrospectively analyzed. All patients were divided into lung metastasis group ( n=124) and non-lung metastasis group ( n=318) according to pathology or clinical, imaging and laboratory test results. Patients were randomly divided into training set ( n=309) and validation set ( n=133) at the ratio of 7∶3. The differences of clinical data between the two groups were compared by χ2 test and Mann-Whitney U test. Factors affecting lung metastasis were analyzed by multivariate logistic regression analysis. ROC curve analysis was used to evaluate the predictive ability of the model. Results:The differences of sex, primary tumor type, multifocal, extra thyroid tissue invasion, number of operations, thyroglobulin (Tg) level before 131I treatment, maximum diameter of primary lesion, lymphocyte absolute value, neutrophil absolute value and B-Raf proto-oncogene, serine/threonine kinase (BRAF) V600E mutation between the two groups were statistically significant ( χ2 values: 7.72-107.77, z values: from -6.50 to -2.44, all P<0.05). Multivariate logistic regression analysis showed that multifocal (odds ratio ( OR)=5.646, 95% CI: 1.763-18.089, P=0.004), BRAF V600E mutation ( OR=0.184, 95% CI: 0.062-0.543, P=0.002), Tg level before 131I treatment ( OR=1.015, 95% CI: 1.004-1.025, P=0.005), lymphocyte absolute value ( OR=0.395, 95% CI: 0.166-0.940, P=0.036) and maximum diameter of primary lesion ( OR=1.932, 95% CI: 1.207-3.093, P=0.006) were independent factors affecting lung metastasis. The AUCs of the training set and validation set obtained by the nomogram prognostic model were 0.899 and 0.889, respectively. Conclusion:Large primary tumor, multiple focus, non-mutated BRAF V600E gene, high Tg level before 131I treatment and low lymphocyte absolute value may be considered as risk factors for lung metastasis of DTC.

Anti-glomerular basement membrane (GBM) nephritis and anti-neutrophil cytoplasmic antibody (ANCA) -associated vasculitis are both autoimmune diseases that can involve multiple systems throughout the body, and both can cause crescent glomerulonephritis. At present, cases of such "double-positive" antibodies have been reported at home and abroad , but the cases of acute progressive glomerulonephritis (RPGN) with IgA nephropathy that are both positive for GBM and ANCA are relatively rare. This case was a middle-aged female patient, whose clinical manifestations were consistent with rapidly progressive glomerulonephritis, positive for anti-GBM antibodies and anti-myeloperoxidase. After renal puncture biopsy, she was diagnosed as anti-GBM nephritis complicated with ANCA associated vasculitis and IgA nephropathy.After treatment with plasma exchange, hemodialysis, glucocorticoids, cyclophosphamide, etc., the condition improved and the patient was discharged. But the patient did not follow the doctor's instructions to take medication and continue hemodialysis treatment after discharge, and the condition worsened, ultimately leading to death.

Objective:To analyze the effect of comprehensive rehabilitation intervention on the physical functioning of frail elderly persons.Methods:A total of 318 frail elderly persons were randomly divided into a control group ( n=164) and an observation group ( n=154) to test different interventions. Propensity score matching was used to balance the baseline information between the two groups 1∶1. A total of 200 cases were successfully matched, with 100 cases in each group. Both groups received drug treatment and routine nursing, while the observation group was additionally provided with comprehensive rehabilitation. Before and after 4 weeks of the treatment, both groups were evaluated using visual analogue scale (VAS) scoring for their perception of pain intensity, hand grip strength, gait speed, 6-minute walking distance (6MWD), 5 sit-up time, and the timed up and go test (TUGT). Results:There were no significant differences between the groups in any of the measurements before the experiment. Afterward, all of the outcome measures except gait speed were significantly better among the experimental group than among the controls, on average.Conclusions:Comprehensive rehabilitation can relieve pain, improve the walking, handgrip strength and exercise endurance of the frail elderly.

The treatment of inner ear disease is developing towards local drug delivery to avoid drawbacks of systemic approach.The cochlear implants with drug delivery functions,a newly developed method of drug delivery into inner ear for treatment,has become the focus of research in recent years.In this review,we will describe recent advances in characteristics,product developments and applications of different types of drug loaded cochlear implants for local therapy.

Traditional Chinese medicine has been paid more and more attention in the development of modern healthcare,and its clinical diagnosis and treatment have broad prospects and enormous potential.However,the current traditional Chinese medicine diagnosis and treatment model have serious shortcomings in service capacity and,diagnosis,and treatment effect.The rapid development of big data and artificial intelli-gence technology provides an opportunity for the iterative upgrade of traditional Chinese medicine diagnosis and treatment models.This article reviewed the current situation of artificial intelligence empowering tradi-tional Chinese medicine clinical diagnosis and treatment,clarified the problems and challenges faced by artifi-cial intelligence technology in data integration,data quality,and data analysis in traditional Chinese medicine clinical diagnosis and treatment,and proposed to empower from the aspects of disciplinary integration,data quality optimization,data privacy protection,and promotion and application,so as to provide reference for im-proving the effectiveness of traditional Chinese medicine clinical diagnosis and treatment.

ObjectiveTo investigate the current status of health literacy among type 2 diabetes mellitus patients in Shanghai communities, to analyze its correlation with glycemic and lipid metabolic indicators and quality of life (QoL), and to provide an evidence for the development of effective intervention measures. MethodsA follow⁃up survey was conducted among diabetic patients diagnosed at hospitals above the secondary level from March to June, 2023, who were part of a diabetes cohort study jointly established by Songnan Community in Baoshan District and the Shanghai Institute of Endocrinology. Patients were assessed using a simplified evaluation form for diabetes-related health literacy and a QoL scale, and metabolic indicators such as blood glucose and blood lipids were measured. Pearson correlation coefficients were employed to assess the relationship between health literacy levels and metabolic indicators as well as QoL. Logistic regression models were used to estimate the odds ratios (OR) and 95% confidence intervals (CI) for the associations between patients’ health literacy levels, metabolic status, and QoL. ResultsAmong the 932 diabetic patients surveyed, the health literacy level was low, with an average score of (65.2±13.4) points of which (62.6±13.8) points for males and (67.9±12.5) points for females. The average QoL score was (44.1±9.2) points of which (44.0±9.5) points for males and (44.2±8.9) points for females. The achievement rates of HbA1c, total cholesterol (TC), and triglycerides (TG) were 51.6%, 30.3%, and 64.8%, respectively. The TC achievement rate among male patients (37.6%) was significantly higher than that among females (22.8%). Significant differences in HbA1c achievement rates were observed across age groups, education levels, disease durations, and BMI levels (P<0.05). Similarly, significant differences were found in FPG achievement rates across different age groups, annual household incomes, disease durations, and family histories (P<0.05). No statistically significant differences were noted in TG and HDL-C achievement rates across all variables (P>0.05). However, LDL-C achievement rates were significantly higher in patients without complications compared to those with complications (P<0.05). Health literacy showed a significant negative correlation with psychological dimension, treatment dimension, and QoL scores (r=-0.14, P<0.05). After adjusting for potential confounding factors, a significant association was found between patients’ health literacy levels and QoL, but not with metabolic indicators. ConclusionThere is a significant correlation between health literacy levels and QoL among diabetic patients in community settings. Further exploration is needed to identify factors influencing patients’ QoL and glycemic and lipid metabolic indicators.