Objective:To construct a competency-oriented psychosomatic medical cognitive ability model for medical students, and provide theoretical basis for practical research on improving their psychosomatic medical cognitive abilities.Methods:Based on a literature review and behavioral event interviews with 20 medical students, a 23-item questionnaire was developed to assess the cognitive abilities of medical students in psychosomatic medicine. In October 2023, a stratified random sampling method was used to select third- and fourth-year undergraduates from the affiliated clinical college of a medical university for a questionnaire survey on the Questionnaire Star platform. SPSS 22.0 software was used for item analysis, internal consistency analysis, and exploratory factor analysis. AMOS 21.0 software was employed for confirmatory factor analysis.Results:Based on the reliability and validity analysis of the questionnaire, two items were removed, and a competency-oriented psychosomatic medical cognitive ability model for medical students was constructed. The model consisted of 21 items in the three dimensions of knowledge, skill, and attitude.Conclusions:The competency-oriented psychosomatic medical cognitive ability model for medical students shows high reliability and validity in statistical analysis, thereby contributing to the cultivation of their psychosomatic medical cognitive abilities.

Medical visual question answering (MVQA) plays a crucial role in the fields of computer-aided diagnosis and telemedicine. Due to the limited size and uneven annotation quality of the MVQA datasets, most existing methods rely on additional datasets for pre-training and use discriminant formulas to predict answers from a predefined set of labels. This approach makes the model prone to overfitting in low resource domains. To cope with the above problems, we propose an image-aware generative MVQA method based on image caption prompts. Firstly, we combine a dual visual feature extractor with a progressive bilinear attention interaction module to extract multi-level image features. Secondly, we propose an image caption prompt method to guide the model to better understand the image information. Finally, the image-aware generative model is used to generate answers. Experimental results show that our proposed method outperforms existing models on the MVQA task, realizing efficient visual feature extraction, as well as flexible and accurate answer outputs with small computational costs in low-resource domains. It is of great significance for achieving personalized precision medicine, reducing medical burden, and improving medical diagnosis efficiency.
Humans ; Image Processing, Computer-Assisted/methods* ; Diagnosis, Computer-Assisted/methods* ; Algorithms ; Telemedicine

OBJECTIVE To screen characteristic peaks of hypervirulent Klebsiella pneumoniae(hvKP)using ma-trix-assisted laser desorption ionization time-of-flight mass spectrometry(MALDI-TOF MS)combined with EX-Smartspec software and establish a rapid detection model for hvKP.METHODS Based on identification criteria of any positive peg-344,iroB,iucA,rmpA,prmpA2 genes or siderophore production＞30 μg/ml,89 hvKP and 72 classical Klebsiella pneumoniae(cKP)strains were initially collected and validated for virulence via Galleria mellonella assays.A diagnostic model distinguishing hvKP from cKP was constructed using EX-Smartspec soft-ware and a convolutional neural network algorithm,integrating characteristic peaks and cluster analysis to provide a rapid and accurate clinical diagnostic tool.RESULTS MALDI-TOF MS analysis identified a characteristic hvKP peak at(3 835±100)ppm.Receiver operating characteristic(ROC)curve analysis revealed optimal performance in distinguishing hvKP with an area under the curve(AUC)=0.741.When AUC ≥0.089,the model demonstra-ted high sensitivity(86.41％),specificity(69.90％),accuracy(78.16％),positive predictive value(74.17％),and negative predictive value(83.72％)in differentiating hvKP from cKP.Cluster analysis further validated the model's classification accuracy.Additionally,the typing classification model exhibited high accuracy(approxi-mately 0.95 and 0.90 in training and validation phases,respectively)and low loss values(-0.18 and 0.30).Val-idation of 6 randomly selected hvKP and 5 cKP strains showed a 100.00％pass rate.CONCLUSION The estab-lished diagnostic model for hvKP and cKP provides a rapid and accurate clinical tool for timely treatment of hvKP-related infections.

OBJECTIVE To screen characteristic peaks of hypervirulent Klebsiella pneumoniae(hvKP)using ma-trix-assisted laser desorption ionization time-of-flight mass spectrometry(MALDI-TOF MS)combined with EX-Smartspec software and establish a rapid detection model for hvKP.METHODS Based on identification criteria of any positive peg-344,iroB,iucA,rmpA,prmpA2 genes or siderophore production＞30 μg/ml,89 hvKP and 72 classical Klebsiella pneumoniae(cKP)strains were initially collected and validated for virulence via Galleria mellonella assays.A diagnostic model distinguishing hvKP from cKP was constructed using EX-Smartspec soft-ware and a convolutional neural network algorithm,integrating characteristic peaks and cluster analysis to provide a rapid and accurate clinical diagnostic tool.RESULTS MALDI-TOF MS analysis identified a characteristic hvKP peak at(3 835±100)ppm.Receiver operating characteristic(ROC)curve analysis revealed optimal performance in distinguishing hvKP with an area under the curve(AUC)=0.741.When AUC ≥0.089,the model demonstra-ted high sensitivity(86.41％),specificity(69.90％),accuracy(78.16％),positive predictive value(74.17％),and negative predictive value(83.72％)in differentiating hvKP from cKP.Cluster analysis further validated the model's classification accuracy.Additionally,the typing classification model exhibited high accuracy(approxi-mately 0.95 and 0.90 in training and validation phases,respectively)and low loss values(-0.18 and 0.30).Val-idation of 6 randomly selected hvKP and 5 cKP strains showed a 100.00％pass rate.CONCLUSION The estab-lished diagnostic model for hvKP and cKP provides a rapid and accurate clinical tool for timely treatment of hvKP-related infections.

Objective:To construct a competency-oriented psychosomatic medical cognitive ability model for medical students, and provide theoretical basis for practical research on improving their psychosomatic medical cognitive abilities.Methods:Based on a literature review and behavioral event interviews with 20 medical students, a 23-item questionnaire was developed to assess the cognitive abilities of medical students in psychosomatic medicine. In October 2023, a stratified random sampling method was used to select third- and fourth-year undergraduates from the affiliated clinical college of a medical university for a questionnaire survey on the Questionnaire Star platform. SPSS 22.0 software was used for item analysis, internal consistency analysis, and exploratory factor analysis. AMOS 21.0 software was employed for confirmatory factor analysis.Results:Based on the reliability and validity analysis of the questionnaire, two items were removed, and a competency-oriented psychosomatic medical cognitive ability model for medical students was constructed. The model consisted of 21 items in the three dimensions of knowledge, skill, and attitude.Conclusions:The competency-oriented psychosomatic medical cognitive ability model for medical students shows high reliability and validity in statistical analysis, thereby contributing to the cultivation of their psychosomatic medical cognitive abilities.

AIM:To establish a nomogram model to predict the effect of serum ferritin on diabetic retinopathy and evaluate the model.METHODS:A total of 21 variables, including ferritin, were screened by univariate and multivariate regression analysis to determine the risk factors of diabetic retinopathy. A nomogram prediction model was established for evaluation and calibration.RESULTS:Ferritin, duration of diabetes, hemoglobin, urine microalbumin, regularity of medication and body mass index were included in the nomogram model. The consistency index of the prediction model with serum ferritin was 0.813(95%CI: 0.748-0.879). The calibration curves of internal and external verification showed good performance, and the probability of the threshold suggested by the decision curve was in the range 10% to 90%. The model had a high net profit value.CONCLUSIONS:Serum ferritin is an important risk factor for diabetic retinopathy. A new nomogram model, which includes body mass index, duration of diabetes, ferritin, hemoglobin, urine microalbumin and regularity of medication, has a high predictive accuracy and could provide early prediction for clinicians.

AIM: To observe the clinical efficacy of 8-0 polypropylene scleral-sutured fixed intraocular lens(IOL)suspension implantation with the double knots technique in aphakic eyes.METHODS: Retrospective case series study. The data of 30 aphakic cases(31 eyes, 22 males)that underwent IOL suspension in our hospital from January 2021 to November 2022 were collected. The suspension of IOL(AcrySof IQ or Tecnis ZCB00)was performed by 8-0 polypropylene scleral-sutured with the double knots technique. The visual acuity, intraocular pressure(IOP), IOL position and complications with at least 6 mo of follow-up were observed.RESULTS: The mean preoperative uncorrected visual acuity(UCVA, LogMAR)and best-corrected visual acuity(BCVA, LogMAR)were 2.53±0.78 and 0.35±0.26, respectively, which were 0.58±0.26 and 0.36±0.27 at 6 mo postoperatively, respectively. And the differences in UCVA were statistically significant(t=15.408, P<0.01), whereas the difference in BCVA was not(t=-1.677, P=0.104). There were no intraoperative complications, with IOL position all centered, but 3 eyes had IOL tilt, 2 eyes had intraocular hypertension, 5 eyes had corneal edema, and 1 eye had suture exposure postoperatively. There were no complications such as hyphema, vitreous hemorrhage, macular edema, corneal endothelial decompensation, hypotony, choroidal detachment, retinal detachment, fulminant superior choroidal hemorrhage, endophthalmitis, or others.CONCLUSION: The 8-0 polypropylene scleral-sutured fixed intraocular lens suspension implantation with the double knots technique can improve the postoperative visual acuity of aphakic patients, and fewer complications, which is an option for the treatment of aphakia, dislocation of the lens and ligament abnormalities.

Objective:To describe the detail sampling design,weighting,instruments,filed procedures and quality control methods of the epidemiological survey on dementia among community residents in Tongliao City.Methods:A three-stage disproportionate probability sampling design was used to investigate the inhabitants aged 65 years and over in Tongliao City,Inner Mongolia Autonomous Region.The 10/66 Dementia Research Group(10/66 DRG)assessment instruments were used to diagnose dementia,using computer-assisted personal interview mode in the selected older people.Comprehensive quality control methods were implemented throughout the field-work.Results:A total of 166 villages or communities were sampled from nine counties or districts in Tongliao Cit-y.Totally 4 345 older people were interviewed with 96.2％response rate.By calculating sampling design weights,non-response adjustment weights and post-stratification adjustment weights,these weights were multiplied and per-formed trimming adjustment and standardization adjustment to generate final weights.The 171 interviewers were well-trained and qualified to carry out filed interview.Quality control methods included computer data check,audio record check,and telephone check in order to ensure the quality of the survey.Conclusion:This survey is imple-mented using a rigorous sampling design and timely quality control methods,and uses the 10/66 DRG assessment instruments with satisfactory international validity and reliability as survey instruments,which has international cross-cultural comparability.It provides a valid and feasible methodology of epidemiological survey on dementia for further studies in different regions in China.

Objective:To analyze the general chapter for lotions 0127 of the Chinese Pharmacopoeia 2020 Vol-ume Ⅳ,and discuss how to improve the general technical requirements of lotions 0127 in the Chinese Pharma-copoeia.Methods:By comparing the general chapter for lotions in domestic and international pharmacopoe-ias,the definition,classification,process,storage and corresponding inspection requirements were analyzed.Results and Conclusions:The general chapter for lotions 0127 of the Chinese Pharmacopoeia should be revised,including improvement of the definition,increasement of forms of preparations,and expansion of included varieties,so as to promote scientific regulation for drugs and exhibit a guiding role of the Chinese pharmacopoeia in drug control.

Because the classification system of radical surgery for rectal cancer has not been established, it is impossible to select the appropriate surgical method according to the clinical stage of the tumor. In this paper, we explained the theory of " four fasciae and three spaces " of pelvic membrane anatomy and then combined this theory with the membrane anatomical basis of Querleu-Morrow classification for radical cervical cancer resection. Based on this theory and the membrane anatomy of Querleu-Morrow classification of radical cervical cancer resection, we proposed a new classification system of radical rectal cancer surgery based on membrane anatomy according to the lateral lymph node dissection range of the rectum. This system classifies the surgery into four types (ABCD) and defines corresponding subtypes based on whether the autonomic nerve was preserved. Among them, type A surgery is total mesorectal excision (TME) with urogenital fascia preservation, type B surgery is classical TME, type C surgery is extended TME, and type D surgery is lateral extended resection. This classification system unifies the anatomical terminology of the pelvic membrane, validates the feasibility of using the " four fasciae and three fascial spaces " theory to classify rectal cancer surgery, and lays the theoretical foundation for the future development of a unified and standardized classification of radical pelvic tumor surgery.
Female ; Humans ; Uterine Cervical Neoplasms ; Rectal Neoplasms/pathology* ; Rectum/anatomy & histology* ; Pelvis/innervation* ; Proctectomy