Objective:To evaluate spinal-pelvic mobility and sagittal spinal-pelvic alignment characteristics in patients with developmental dysplasia of the hip (DDH), and to investigate differences in sagittal spinal-pelvic parameters between patients with DDH and those with osteonecrosis of the femoral head (ONFH).Methods:A total of 55 patients with DDH who underwent primary total hip arthroplasty (THA) at the Affiliated Hospital of Xuzhou Medical University between April 2021 and March 2024 were retrospectively analyzed. The cohort included 8 males and 47 females, with a mean age of 56.16±10.82 years (range: 26-76 years). Among them, 18 patients had bilateral DDH and 37 had unilateral DDH. Fifty-five age- and sex-matched patients with ONFH were selected as the control group. Unilateral DDH cases were classified according to the Hartofilakidis classification: 18 cases of type A, 13 cases of type B, and 6 cases of type C. Lateral spinal-pelvic radiographs were used to measure pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), and lumbar lordosis (LL) in both standing and sitting positions. Changes in sagittal spinal-pelvic parameters between standing and sitting positions were analyzed to assess spinal-pelvic mobility. Spinal-pelvic mobility was considered abnormal if △SS was outside the range of 10°-30°. Abnormal mobility was further categorized as stiffness (△SS<10°) or hypermobility (△SS>30°).Results:The PI (52.37°±12.43°), standing PT (12.13°±9.50°), and sitting PT (36.49°±13.43°) of DDH patients were significantly higher than those of ONFH patients (44.88°±11.38°, 7.80°±11.36°, and 28.91°±11.38°, respectively), with statistically significant differences ( P<0.05). Abnormal spinal-pelvic mobility, including both stiffness and hypermobility, was observed in 53% of DDH patients, with stiffness accounting for 20%. These proportions were significantly higher than those in ONFH patients, which were 24% and 6%, respectively ( P<0.05). The prevalence of abnormal spinal-pelvic mobility in Hartofilakidis type C DDH patients was 83%, significantly higher than the 30.8% observed in type B patients (χ 2=4.550, P=0.033). The standing LL (54.37°±11.59°) and sitting LL (28.56°±15.51°) in unilateral DDH patients were significantly greater than those in bilateral DDH patients (46.88°±15.30° and 20.42°±9.77°, respectively), with statistically significant differences ( P< 0.05). Conclusions:Compared with patients with ONFH, those with DDH demonstrate a higher prevalence of abnormal spinal-pelvic mobility, particularly a greater incidence of spinal stiffness. Among DDH subtypes, Hartofilakidis type C patients exhibit a higher proportion of abnormal mobility compared to types A and B. Additionally, patients with unilateral DDH present with greater lumbar lordosis than those with bilateral involvement.

Background/Aims: The World Health Organization set the goal of eliminating hepatitis C virus (HCV) by 2030, with 80% and 65% reductions in HCV incidence and mortality rates, respectively. We aimed to evaluate the health benefits, cost-effectiveness and return on investment (ROI) of HCV elimination. Methods: Using an HCV transmission compartmental model, we evaluated the benefits and costs of different strategies combining screening and treatment for Chinese populations. We identified strategies to achieve HCV elimination and calculated the incremental cost-effectiveness ratios (ICERs) per disability-adjusted life year (DALY) averted for 2022–2030 to identify the optimal elimination strategy. Furthermore, we estimated the ROI by 2050 by comparing the required investment with the economic productivity gains from reduced HCV incidence and deaths. Results: The strategy that results in the most significant health benefits involves conducting annual primary screening at a rate of 14%, re-screening people who inject drugs annually and the general population every five years, and treating 95% of those diagnosed (P14-R4-T95), preventing approximately 5.75 and 0.44 million HCV infections and deaths, respectively, during 2022–2030. At a willingness-to-pay threshold of $12,615, the P14-R4-T95 strategy is the most cost-effective, with an ICER of $5,449/DALY. By 2050, this strategy would have a net benefit of $120,997 million (ROI=0.868). Conclusions Achieving HCV elimination in China by 2030 will require significant investment in large-scale universal screening and treatment, but it will yield substantial health and economic benefits and is cost-effective.

Objective To evaluate the performance of the artificial intelligence (AI)-enabled snail identification system for recognition of Oncomelania hupensis robertsoni and Tricula in schistosomiasis-endemic areas of Yunnan Province. Methods Fifty O. hupensis robertsoni and 50 Tricula samples were collected from Yongbei Township, Yongsheng County, Lijiang City, a schistosomiasis-endemic area in Yunnan Province in May 2024. A total of 100 snail sample images were captured with smartphones, including front-view images of 25 O. hupensis robertsoni and 25 Tricula samples (upward shell opening) and back-view images of 25 O. hupensis robertsoni and 25 Tricula samples (downward shell opening). Snail samples were identified as O. hupensis robertsoni or Tricula by schistosomiasis control experts with a deputy senior professional title and above according to image quality and morphological characteristics. A standard dataset for snail image classification was created, and served as a gold standard for recognition of snail samples. A total of 100 snail sample images were recognized with the AI-enabled intelligent snail identification system based on a WeChat mini program in smartphones. Schistosomiasis control professionals were randomly sampled from stations of schistosomisis prevention and control and centers for disease control and prevention in 18 schistosomiasis-endemic counties (districts, cities) of Yunnan Province, for artificial identification of 100 snail sample images. All professionals are assigned to two groups according the median years of snail survey experiences, and the effect of years of snail survey experiences on O. hupensis robertsoni sample image recognition was evaluated. A receiver operating characteristic (ROC) curve was plotted, and the sensitivity, specificity, accuracy, Youden’s index and the area under the curve (AUC) of the AI-enabled intelligent snail identification system and artificial identification were calculated for recognition of snail sample images. The snail sample image recognition results of AI-enabled intelligent snail identification system and artificial identification were compared with the gold standard, and the internal consistency of artificial identification results was evaluated with the Cronbach’s coefficient alpha. Results A total of 54 schistosomiasis control professionals were sampled for artificial identification of snail sample image recognition, with a response rate of 100% (54/54), and the accuracy, sensitivity, specificity, Youden’s index, and AUC of artificial identification were 90%, 86%, 94%, 0.80 and 0.90 for recognition of snail sample images, respectively. The overall Cronbach’s coefficient alpha of artificial identification was 0.768 for recognition of snail sample images, and the Cronbach’s coefficient alpha was 0.916 for recognition of O. hupensis robertsoni snail sample images and 0.925 for recognition of Tricula snail sample images. The overall accuracy of artificial identification was 90% for recognition of snail sample images, and there was no significant difference in the accuracy of artificial identification for recognition of O. hupensis robertsoni (86%) and Tricula snail sample images (94%) (χ² = 1.778, P > 0.05). There was no significant difference in the accuracy of artificial identification for recognition of snail sample images with upward (88%) and downward shell openings (92%) (χ² = 0.444, P > 0.05), and there was a significant difference in the accuracy of artificial identification for recognition of snail sample images between schistosomiasis control professionals with snail survey experiences of 6 years and less (75%) and more than 6 years (90%) (χ² = 7.792, P < 0.05). The accuracy, sensitivity, specificity and AUC of the AI-enabled intelligent snail identification system were 88%, 100%, 76% and 0.88 for recognition of O. hupensis robertsoni snail sample images, and there was no significant difference in the accuracy of recognition of O. hupensis robertsoni snail sample images between the AI-enabled intelligent snail identification system and artificial identification (χ² = 0.204, P > 0.05). In addition, there was no significant difference in the accuracy of artificial identification for recognition of snail sample images with upward (90%) and downward shell openings (86%) (χ² = 0.379, P > 0.05), and there was a significant difference in the accuracy of artificial identification for recognition of snail sample images between schistosomiasis control professionals with snail survey experiences of 6 years and less and more than 6 years (χ² = 5.604, P_adjusted < 0.025). Conclusions The accuracy of recognition of snail sample images is comparable between the AI-enabled intelligent snail identification system and artificial identification by schistosomiasis control professionals, and the AI-enabled intelligent snail identification system is feasible for recognition of O. hupensis robertsoni and Tricula in Yunnan Province.

Objective:To evaluate spinal-pelvic mobility and sagittal spinal-pelvic alignment characteristics in patients with developmental dysplasia of the hip (DDH), and to investigate differences in sagittal spinal-pelvic parameters between patients with DDH and those with osteonecrosis of the femoral head (ONFH).Methods:A total of 55 patients with DDH who underwent primary total hip arthroplasty (THA) at the Affiliated Hospital of Xuzhou Medical University between April 2021 and March 2024 were retrospectively analyzed. The cohort included 8 males and 47 females, with a mean age of 56.16±10.82 years (range: 26-76 years). Among them, 18 patients had bilateral DDH and 37 had unilateral DDH. Fifty-five age- and sex-matched patients with ONFH were selected as the control group. Unilateral DDH cases were classified according to the Hartofilakidis classification: 18 cases of type A, 13 cases of type B, and 6 cases of type C. Lateral spinal-pelvic radiographs were used to measure pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), and lumbar lordosis (LL) in both standing and sitting positions. Changes in sagittal spinal-pelvic parameters between standing and sitting positions were analyzed to assess spinal-pelvic mobility. Spinal-pelvic mobility was considered abnormal if △SS was outside the range of 10°-30°. Abnormal mobility was further categorized as stiffness (△SS<10°) or hypermobility (△SS>30°).Results:The PI (52.37°±12.43°), standing PT (12.13°±9.50°), and sitting PT (36.49°±13.43°) of DDH patients were significantly higher than those of ONFH patients (44.88°±11.38°, 7.80°±11.36°, and 28.91°±11.38°, respectively), with statistically significant differences ( P<0.05). Abnormal spinal-pelvic mobility, including both stiffness and hypermobility, was observed in 53% of DDH patients, with stiffness accounting for 20%. These proportions were significantly higher than those in ONFH patients, which were 24% and 6%, respectively ( P<0.05). The prevalence of abnormal spinal-pelvic mobility in Hartofilakidis type C DDH patients was 83%, significantly higher than the 30.8% observed in type B patients (χ 2=4.550, P=0.033). The standing LL (54.37°±11.59°) and sitting LL (28.56°±15.51°) in unilateral DDH patients were significantly greater than those in bilateral DDH patients (46.88°±15.30° and 20.42°±9.77°, respectively), with statistically significant differences ( P< 0.05). Conclusions:Compared with patients with ONFH, those with DDH demonstrate a higher prevalence of abnormal spinal-pelvic mobility, particularly a greater incidence of spinal stiffness. Among DDH subtypes, Hartofilakidis type C patients exhibit a higher proportion of abnormal mobility compared to types A and B. Additionally, patients with unilateral DDH present with greater lumbar lordosis than those with bilateral involvement.

Background/Aims: The World Health Organization set the goal of eliminating hepatitis C virus (HCV) by 2030, with 80% and 65% reductions in HCV incidence and mortality rates, respectively. We aimed to evaluate the health benefits, cost-effectiveness and return on investment (ROI) of HCV elimination. Methods: Using an HCV transmission compartmental model, we evaluated the benefits and costs of different strategies combining screening and treatment for Chinese populations. We identified strategies to achieve HCV elimination and calculated the incremental cost-effectiveness ratios (ICERs) per disability-adjusted life year (DALY) averted for 2022–2030 to identify the optimal elimination strategy. Furthermore, we estimated the ROI by 2050 by comparing the required investment with the economic productivity gains from reduced HCV incidence and deaths. Results: The strategy that results in the most significant health benefits involves conducting annual primary screening at a rate of 14%, re-screening people who inject drugs annually and the general population every five years, and treating 95% of those diagnosed (P14-R4-T95), preventing approximately 5.75 and 0.44 million HCV infections and deaths, respectively, during 2022–2030. At a willingness-to-pay threshold of $12,615, the P14-R4-T95 strategy is the most cost-effective, with an ICER of $5,449/DALY. By 2050, this strategy would have a net benefit of $120,997 million (ROI=0.868). Conclusions Achieving HCV elimination in China by 2030 will require significant investment in large-scale universal screening and treatment, but it will yield substantial health and economic benefits and is cost-effective.

Background/Aims: The World Health Organization set the goal of eliminating hepatitis C virus (HCV) by 2030, with 80% and 65% reductions in HCV incidence and mortality rates, respectively. We aimed to evaluate the health benefits, cost-effectiveness and return on investment (ROI) of HCV elimination. Methods: Using an HCV transmission compartmental model, we evaluated the benefits and costs of different strategies combining screening and treatment for Chinese populations. We identified strategies to achieve HCV elimination and calculated the incremental cost-effectiveness ratios (ICERs) per disability-adjusted life year (DALY) averted for 2022–2030 to identify the optimal elimination strategy. Furthermore, we estimated the ROI by 2050 by comparing the required investment with the economic productivity gains from reduced HCV incidence and deaths. Results: The strategy that results in the most significant health benefits involves conducting annual primary screening at a rate of 14%, re-screening people who inject drugs annually and the general population every five years, and treating 95% of those diagnosed (P14-R4-T95), preventing approximately 5.75 and 0.44 million HCV infections and deaths, respectively, during 2022–2030. At a willingness-to-pay threshold of $12,615, the P14-R4-T95 strategy is the most cost-effective, with an ICER of $5,449/DALY. By 2050, this strategy would have a net benefit of $120,997 million (ROI=0.868). Conclusions Achieving HCV elimination in China by 2030 will require significant investment in large-scale universal screening and treatment, but it will yield substantial health and economic benefits and is cost-effective.

Objective To investigate the prediction model of hypotension in patients with hepato-cellular carcinoma resection using controlled low central venous pressure technique(CLCVP).Methods A total of 144 patients with liver cancer admitted from January 2020 to June 2023 were retrospectively ana-lyzed,including 81 males and 63 females,aged 45-64 years,BMI 22-26 kg/m2,ASA physical status Ⅰ or Ⅱ.144 patients were randomly divided into trial set(n=96)and verification set(n=48)according to 2:1.The trial set and verification set were divided into hypotensive group and non-hypotensive group ac-cording to whether hypotension occurred after operation.Preoperative albumin,preoperative hemoglobin,op-eration method,operation time,tumor site,tumor size,hilar block time,number of hilar block times,hilar block interval time,blood loss,mean intraoperative CVP,intraoperative fluid volume,and intraoperative u-rine volume were collected.Univariate and multivariate Logistic analysis were used to analyze the risk factors of hypotension in the experimental group,and a risk prediction model was established.The risk prediction model was verified in the validation group.Results There were 29 patients(30.2％)of postoperative hy-potension in the test group and 15 patients(31.3％)of postoperative hypotension in the validation group.Compared with the non-hypotensive group,the preoperative albumin in the hypotensive group was signifi-cantly decreased(P<0.05),the operation time was significantly prolonged,the ratio of tumor diameter≥5 cm,and the amount of blood loss were significantly increased(P<0.05).Multivariate analysis showed that preoperative albumin elevation(OR=0.216,95％CI 0.164-0.665,P<0.05)was an independent protective factor for postoperative hypotension.Prolonged operative time(OR=2.649,95％CI 1.802-7.553,P<0.05),tumor diameter≥5 cm(OR=3.789,95％CI 2.011-12.458,P<0.05),in-creased blood loss(OR=8.873,95％CI 2.750-17.553,P<0.05)was an independent risk factor for postoperative hypotension.According to the results of multi-factor analysis,the risk factors of postoperative hypotension in patients with controlled low central venous pressure hepatocellular carcinoma resection were established:F=-408.64-(1.534×preoperative albumin)+(0.974×operation time)+(1.332×tumor diameter≥5 cm)+(2.183×blood loss).The risk model was validated in the validation set,and the area under the ROC curve(AUC)was0.821(0.695-0.943),the sensitivity was71.7％,and the speci-ficity was 86.5％.The Hosmer-Lemeshow goodness of fit test showed that χ2=10.654,P=0.222.Conclusion Prolonged operative time,tumor diameter≥5 cm and increased blood loss are risk factors for hypotension after hepatocellular carcinoma resection using CLCVP technique,and higher preoperative albumin is protective factor.The establishment of risk prediction model through multi-factor analysis has good forecasting value.

Objective To investigate the sleep quality ,emotional state and their relationship for flying personnel so as to provide reference for the targeted aeromedical support. Methods Two hundred and forty-nine flying personnel participated in the anonymous questionnaire surveys ,including Pittsburgh sleep quality index (PSQI) ,self-evaluation of anxiety scale (SAS) ,self-rating depression scale (SDS ) , and profile of mood state (POMS ).Comparisons of sleep quality among flying personnel ,norm and ordinary soldiers were conducted.The correlation between sleep quality and emotional state was analyzed then. Results There were 238 questionnaires returned and the effective rate was 95.6%.The prevalence of sleeping disorders in 238 flying personnel was 36.6%.Their total score of PSQI was (6.79 ± 3.06) ,which was significantly higher than that of norm and ordinary soldiers (t＝ 14.706 ,5.967 , P＜0.01) and their scores of anxiety and depression were higher than those of the domestic norm (t＝4.867 ,3.147 , P＜0.01).In addition ,with the total score of PSQI increased the scores on SAS , SDS , tension-anxiety , depression-dejection , anger-hostility , fatigue-inertia and confusion-bewiderment showed upward trend.But the score on vigor-activity was decreased.Correlation analysis showed that the total score of PSQI was positively correlated with the scores on SAS , SDS , tension-anxiety , depression-dejection , anger-hostility , fatigue-inertia and confusion-bewiderment (r＝0.549-0.665 ,P＜0.01) ,and was negatively correlated with vigor-activity (r＝ －0.417 , P＜ 0.01 ). Conclusions Sleep quality is an important indicator of emotional state. Sleep quality of flying personnel is lower than that of norm and ordinary soldiers and this means the flying personnel are in obviously higher tension and stress state.

Objective To investigate the sleep quality ,emotional state and their relationship for flying personnel so as to provide reference for the targeted aeromedical support. Methods Two hundred and forty-nine flying personnel participated in the anonymous questionnaire surveys ,including Pittsburgh sleep quality index (PSQI) ,self-evaluation of anxiety scale (SAS) ,self-rating depression scale (SDS ) , and profile of mood state (POMS ).Comparisons of sleep quality among flying personnel ,norm and ordinary soldiers were conducted.The correlation between sleep quality and emotional state was analyzed then. Results There were 238 questionnaires returned and the effective rate was 95.6%.The prevalence of sleeping disorders in 238 flying personnel was 36.6%.Their total score of PSQI was (6.79 ± 3.06) ,which was significantly higher than that of norm and ordinary soldiers (t＝ 14.706 ,5.967 , P＜0.01) and their scores of anxiety and depression were higher than those of the domestic norm (t＝4.867 ,3.147 , P＜0.01).In addition ,with the total score of PSQI increased the scores on SAS , SDS , tension-anxiety , depression-dejection , anger-hostility , fatigue-inertia and confusion-bewiderment showed upward trend.But the score on vigor-activity was decreased.Correlation analysis showed that the total score of PSQI was positively correlated with the scores on SAS , SDS , tension-anxiety , depression-dejection , anger-hostility , fatigue-inertia and confusion-bewiderment (r＝0.549-0.665 ,P＜0.01) ,and was negatively correlated with vigor-activity (r＝ －0.417 , P＜ 0.01 ). Conclusions Sleep quality is an important indicator of emotional state. Sleep quality of flying personnel is lower than that of norm and ordinary soldiers and this means the flying personnel are in obviously higher tension and stress state.

Objective To study the effect of rhodiola crenulata compound on serum corticosterone and myocardial glucocorticoid receptor ( GR) in rats exposed high sustained +Gz.Methods Seventy-two healthy SD rats were randomly divided into six groups: blank control group, stress control group, +10 Gz stress group and low, medium, high dose drug group, with twelve rats in each.20 mL/kg menstruum was fed to each rat once per day for 14 days.Low, medium and high dose drug group were fed with rhodiola crenulata compound at doses of 0.75 g/kg, 1.5 g/kg and 3.0 g/kg respectively, the other three groups were fed with equal volume saline.Rats were exposed to high +Gz in 15th day.The concentration of corticosterone in the serum of each group rats was detected with ELISA. Western blot was used to detect the expressions of GR in the myocardium of each group rats .Results The content of corticosterone was significantly elevated in +10Gz stress group, while the expression of GR in the myocardium was markedly declined (P <0.01,P <0.05).However, compound preconditioning could decrease concentration of corticosterone in the serum and enhance the expression of GR in the myocardium from rats after +10 Gz exposure. The corticosterone concentration of medium and high dose drug groups was significantly lower and the level of GR expression in the myocardium was significantly higher than that of +10 Gz stress group ( P <0.05 , P <0.01 ) . Conclusion Rhodiola crenulata compound preconditioning could regulate the concentration of corticosterone in the serum and the level of GR expression in the myocardium of the rats exposed +10 Gz, which may be related with its protective effect on high sustained +Gz-induced injury of myocardium.