BackgroundLow medication compliance among patients with severe mental disorders increases the disease burden on both the patients' families and the society. Medication adherence is influenced by numerous factors. Traditional methods such as Logistic regression struggle to quantify the importance of these factors. By introducing Extreme Gradient Boosting （XGBoost） combined with Shapley Additive Explanations （SHAP）， enables the quantification of the relative contribution weights of each factor， providing support for identifying the core influencing factors. ObjectiveTo explore the influencing factors of medication adherence among patients with severe mental disorders in Zhuhai， aiming to provide references for optimizing patient management strategies. MethodsExtract the data of patients with severe mental disorders who were registered on the mental health system platform in Zhuhai City from January 1， 2023 to March 31， 2025. A total of 9 329 patients were finally included for analysis. Influencing factors were screened using univariate analysis and multivariate logistic regression analysis， and an XGBoost model combined with the SHAP algorithm was constructed to quantify the importance of each influencing factor. ResultsAmong 9 329 patients， 8 446 demonstrated medication adherence， yielding an adherence rate of 90.53%. Multivariable analysis identified several risk factors significantly associated with medication non-adherence， being unmarried （OR=1.237， 95% CI： 1.019–1.502） or divorced （OR=1.389， 95% CI： 1.038–1.832）， a diagnosis of mental retardation with psychiatric disorders （OR=3.025， 95% CI： 2.402–3.796） or paranoid psychosis （OR=5.117， 95% CI： 3.086–8.299）， a disease duration of 2–4 years （OR=1.355， 95% CI： 1.085–1.696）， 4–6 years （OR=2.143， 95% CI： 1.671–2.747）， or >6 years （OR=1.681， 95% CI： 1.365–2.079）， lack of guardian subsidies （OR=1.412， 95% CI： 1.099–1.801）， absence of a disability certificate （OR=1.900， 95% CI： 1.588–2.282）， not being enrolled in care and support groups （OR=1.384， 95% CI： 1.183–1.617） or community services （OR=1.313， 95% CI： 1.042–1.645）， and not cohabiting with a guardian （OR=1.257， 95% CI： 1.048–1.501）. Conversely， the enrollment in special outpatient disease programs （OR=0.716， 95% CI： 0.609–0.842） and a family history of mental illness （OR=0.713， 95% CI： 0.503–0.982） were identified as protective factors. The XGBoost model exhibited robust predictive performance， with a sensitivity of 0.433， specificity of 0.944， accuracy of 0.891， Area Under the Curve （AUC） of 0.837， and F1 value of 0.449. Feature importance ranking indicated that the top three factors were disease duration， diagnosis， and the acquisition of disability certificates. ConclusionPolicy-based support （acquisition of disability certificates， special outpatient disease enrollment） and clinical disease characteristics （disease duration， diagnosis type） are key factors affecting medication adherence among patients with severe mental disorders in Zhuhai City. ［Funded by Zhuhai Medical Research Project （number， 2220009000281）］

Objective By population survey,to explore the epidemiological characteristics of gastric precancerous lesions in Lishui District of Nanjing and provide objective basis for the prevention and treatment of early gastric cancer.Methods From July 2021 to December 2022,21 977 patients who received endoscopy and/or 13C-UBT in Lishui District People's Hospital and 6 medical community units in Nanjing City were retrospectively analyzed for demography characteristics,detection rate of gastric precancerous lesions,and H.Pylori infection rate.Results(1)590 cases of gastric precancerous lesions were detected(detection rate 2.68%);(2)The total detection rate of precancerous lesions and three pathological types in males were all higher than those in females(all P<0.001);(3)The minimum age for the total detection rate of precancerous lesions in males and the mini-mum age for each pathological type were lower than in females(P<0.001,0.009,0.005,0.002);(4)The popu-lation total H.pylori infection rate was 23.10%,the H.pylori infection rate in patients with precancerous lesions was higher than that in non-precancerous lesions(P<0.001),both H.pylori infection rate of male and female in precancerous lesions were all higher than those of non-precancerous lesions of the same sex(all P<0.001),in addition,the H.pylori infection rate of male whether in precancerous or non-precancerous lesions was higher than that of female(all P<0.001);(5)The precancerous lesions detection rate in male,female,and the overall age range of 20～29 to 70～79 years is positively correlated with age growth(P<0.001),and rapidly decreases after the age of 79,the of H.pylori infection rate was also positively correlated with age growth(P<0.001),and the trend of age change(P<0.001)was parallel to the precancerous lesions detection rate.Conclusions The detec-tion rate of gastric precancerous lesions in this region is above the average level in China;the total H.pylori infec-tion rate is at a relatively low level in China;the H.pylori infection rate is parallel to the age trend of the detection rate of gastric precancerous lesions,and increases with age.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

BACKGROUND: Tendon injury and dysfunction often occurs in military training, but the exactly epidemiological, pathological, physiological, healing and remodeling mechanisms of tendonopathy is still unclear, even the pain due to chronic tendon dysfunction should be further studied.OBJECTIVE: To evaluate the effect of forced training on the muscular strength of ankle joint and the cross-sectional area (CSA) of achilles tendon of infantry soldiers, and look for effective training methods.DESIGN: One-sample contrasting study.SETTING: Fourth Military Medical University of Chinese PLA; InStitute of Military Training-related Medical Sciences, the 150 Hospital of Chinese PLA.PARTICIPANTS: The study was carried out in the Institute of Military Training-related Medical Sciences, the 150 Hospital of Chinese PLA from March to June 2004. Thirty male light infantry recruits and thirty one-year-trained male soldiers were regarded as recruit group and one-year soldier group. The enlisted age ranged from 17 to 18 years. Recruits did not have the history of special training and injury of ankle joints. All of them were able to undertake routinely physical training.METHODS: The recruits participated in routinely physical trainings, such as grenade throwing and 5 km cross-country race, and forced trainings, such as dorsiflexors and plantarflexors on ankle joint, twice a day for each training item for 8 successive weeks. The forced training included calf raise for 50 times and sit-ups for 50 times on 45° arched board.Moreover, one-year soldiers were undertaken routinely physical trainings. Eight weeks later, the isokinetic testing of ankle joint and CSA of achilles tendon were measured before and after trainings.MAIN OUTCOME MEASURES: Comparisons of CSA of achilles tendon and changes of muscular strength of ankle joint between recruits before routine training and after 8-week forced training and one-year soldiers after routine training.RESULTS: All 60 soldiers were involved in the final analysis. Partial correlation was showed between CSA and body weight (r =0.446, P=0.015), and there was no difference in CSA before and after training. The relative peak torque, endurance and torque acceleration energy of plantarflexors, dorsiflexors and evertors were distinctively higher in recruit group and one-year soldier group after training than those in recruit group before training (P ＜ 0.05); however, there was no difference between recruit group and one-year soldier group after training.CONCLUSION: Forced training method can improve physical readiness in a short time. No changes of CSA of achilles tendon after training show that the improvement of ankle muscular strength may be through the rebuilding of its inner-structure rather than through the hypertrophy of the tendon.

Objective:To eliminate the bacteriostatic action ofA,wei Capsule in microbial limit examination so as to establishing the method ofmicrobial limit for A,wei Capsule.Methods:The plating and culture medium diluted methods were used to determine the antimicrobial effect ofA,wei Capsule by recovery rates with 5 control trains.Results:According to the results, the recovery rates were higher than 70% by culture medium diluted method, which indicated no antimicrobial effect with them.Conclusion:According to the results, the culture medium diluted method can eliminate the bacteriostatic action ofA,wei Capsule preferably with accurate result and reaching the objective.

Han Jiangbo. Department of Theoretical Mechanics, Luoyang Industry College. Luoyang Since January 1982 we have relocated the insertion of a part of pectoralis major or deltoid muscle in the treatment of 5 cases of habitual dislocation of shoulder. After over a year of follow-up no recurrence of dislocation has been found in all the cases. The shoulder joint seemed to be stable, the range of movements increased, and disturbance in supination was corrected. The operative procedure was studied in fresh cadavers and human skeleton. Studies on mechanical model of shoulder joint, with theoretical calculation of changes in pronation after muscle displacement, showed that movements of pronation were remarkably increased after displacement of partial pectoralis major and deltoideus. It could also compensate the weatened subscapularis.