BACKGROUND:Cervical spondylosis is a chronic degenerative disease that has become one of the most common and frequent diseases threatening human health.At present,the initial diagnosis of the cervical spine and its surrounding structures mainly relies on the interpretation of medical images by radiologists,which not only requires a high level of technical requirements for operators,but also has the disadvantages of strong subjectivity,high labor intensity,and low efficiency.With the rapid development of artificial intelligence technology,its powerful data processing and image recognition capabilities have shown broad application prospects in the medical field.Deep learning has also made certain progress in the research of spinal diseases.OBJECTIVE:To summarize the current status and research progress in the application of artificial intelligence technology in cervical spine imaging images in recent years,evaluating the performance of artificial intelligence models as well as future trends and challenges to be overcome.METHODS:The first author searched the relevant articles in WanFang,CNKI,and PubMed in June 2024.The Chinese search terms were"artificial intelligence,deep learning,cervical spine."English serach terms were"artificial intelligence,Al,cervical vertebrae,cervical."Finally,101 articles were included and analyzed.RESULTS AND CONCLUSION:(1)Artificial intelligence technology can realize automatic segmentation of cervical vertebrae and measurement of curvature change by segmentation,classification,landmarks recognition of medical image parts,detect cervical vertebral fracture,nerve root,and spinal cord type cervical spondylosis,identify cervical spine ossification of posterior longitudinal ligament,and predict post-surgery related risk factors and cervical vertebra maturation classification.(2)Although artificial intelligence technology has shown great potential in the field of cervical spine research,it is still in the early stages of exploration and rapid development,with unlimited room for development and innovation.

Objective:To understand the current situation and the relevant factors of the intrinsic capacity of the elderly in nursing institutions.Methods:It was a cross-sectional study. From December 2023 to February 2024, a total of 10 elderly people living in 5 institutions in Huaihua City, Hunan Province, 3 institutions in Changsha City, and 2 institutions in Yinchuan City, Ningxia Hui Autonomous Region, were conveniently selected. Relevant clinical data of the participants were collected through questionnaires. The 5 dimensions of motor, psychological, cognitive, vitality, and perceptual were selected to evaluate the intrinsic capacity of the participants, and their total intrinsic capacity scores were calculated by using the Short Physical Performance Battery, Geriatric Depression Scale, Mini-mental State Examination, Short-Form Mini-Nutritionalas Assessment and the Complaints Sensory Functioning, respectively. Multiple linear stepwise regression models were used to analyze the correlates of intrinsic competence in older adults in nursing facilities.Results:Two hundred and seventy institutionalized older adults were included in the analysis, aged (80.9±8.5) years, 117(43.33%) were male, and the length of residence in an institution was 1.50(0.83, 3.00) years.The intrinsic capacity score of the 270 institutionalized older adults was 2.24±0.97, of which 265(98.15%) had declining intrinsic capacity and 5(1.85%) had good intrinsic capacity. The results of multiple linear stepwise regression analysis showed that literacy level, economic source, occupation, frequency of exercise, use of smartphones, use of elderly mobility aids, and whether or not the elderly living in the nursing home received financial support from the state were independently associated with the intrinsic ability of the elderly living in the nursing home (all P<0.05). Conclusions:The overall level of intrinsic capacity of the investigated elderly in nursing homes is low, and literacy level, economic source, occupation, use of smartphones, use of elderly mobility aids, and whether the nursing home receives state financial support are independent correlates of the intrinsic ability of the elderly in nursing homes.

BACKGROUND:Cervical spondylosis is a chronic degenerative disease that has become one of the most common and frequent diseases threatening human health.At present,the initial diagnosis of the cervical spine and its surrounding structures mainly relies on the interpretation of medical images by radiologists,which not only requires a high level of technical requirements for operators,but also has the disadvantages of strong subjectivity,high labor intensity,and low efficiency.With the rapid development of artificial intelligence technology,its powerful data processing and image recognition capabilities have shown broad application prospects in the medical field.Deep learning has also made certain progress in the research of spinal diseases.OBJECTIVE:To summarize the current status and research progress in the application of artificial intelligence technology in cervical spine imaging images in recent years,evaluating the performance of artificial intelligence models as well as future trends and challenges to be overcome.METHODS:The first author searched the relevant articles in WanFang,CNKI,and PubMed in June 2024.The Chinese search terms were"artificial intelligence,deep learning,cervical spine."English serach terms were"artificial intelligence,Al,cervical vertebrae,cervical."Finally,101 articles were included and analyzed.RESULTS AND CONCLUSION:(1)Artificial intelligence technology can realize automatic segmentation of cervical vertebrae and measurement of curvature change by segmentation,classification,landmarks recognition of medical image parts,detect cervical vertebral fracture,nerve root,and spinal cord type cervical spondylosis,identify cervical spine ossification of posterior longitudinal ligament,and predict post-surgery related risk factors and cervical vertebra maturation classification.(2)Although artificial intelligence technology has shown great potential in the field of cervical spine research,it is still in the early stages of exploration and rapid development,with unlimited room for development and innovation.

Objective:To understand the current situation and the relevant factors of the intrinsic capacity of the elderly in nursing institutions.Methods:It was a cross-sectional study. From December 2023 to February 2024, a total of 10 elderly people living in 5 institutions in Huaihua City, Hunan Province, 3 institutions in Changsha City, and 2 institutions in Yinchuan City, Ningxia Hui Autonomous Region, were conveniently selected. Relevant clinical data of the participants were collected through questionnaires. The 5 dimensions of motor, psychological, cognitive, vitality, and perceptual were selected to evaluate the intrinsic capacity of the participants, and their total intrinsic capacity scores were calculated by using the Short Physical Performance Battery, Geriatric Depression Scale, Mini-mental State Examination, Short-Form Mini-Nutritionalas Assessment and the Complaints Sensory Functioning, respectively. Multiple linear stepwise regression models were used to analyze the correlates of intrinsic competence in older adults in nursing facilities.Results:Two hundred and seventy institutionalized older adults were included in the analysis, aged (80.9±8.5) years, 117(43.33%) were male, and the length of residence in an institution was 1.50(0.83, 3.00) years.The intrinsic capacity score of the 270 institutionalized older adults was 2.24±0.97, of which 265(98.15%) had declining intrinsic capacity and 5(1.85%) had good intrinsic capacity. The results of multiple linear stepwise regression analysis showed that literacy level, economic source, occupation, frequency of exercise, use of smartphones, use of elderly mobility aids, and whether or not the elderly living in the nursing home received financial support from the state were independently associated with the intrinsic ability of the elderly living in the nursing home (all P<0.05). Conclusions:The overall level of intrinsic capacity of the investigated elderly in nursing homes is low, and literacy level, economic source, occupation, use of smartphones, use of elderly mobility aids, and whether the nursing home receives state financial support are independent correlates of the intrinsic ability of the elderly in nursing homes.

BACKGROUND:As a unique structure of the cervical spine,the occurrence,development and progression of the uncovertebral joint directly affect the stability and range of motion of the cervical spine,and are also closely related to the pathogenesis of cervical spondylosis.A thorough understanding of the developmental characteristics of the uncovertebral joint is of great significance for the pathogenesis,diagnosis,and treatment of cervical spondylosis. OBJECTIVE:By using imaging and three-dimensional reconstruction technology to measure and observe the cervical uncinate process-related angle in a large sample of different age groups,the aim is to reveal the characteristics of its changes with age and vertebral growth,as well as its relationship with cervical spine stability. METHODS:Using a retrospective research design,we collected 1 447 cases of raw CT imaging data that meet the study requirements for complete cervical spine segments.The raw data were imported into Mimics 21.0 software in DICOM format for post-processing and measurement of angle of uncinate process and sagittal angle of uncinate process.The data were grouped based on gender,age,and side. RESULTS AND CONCLUSION:(1)With the increase of vertebral sequence,the angle of uncinate process increased in a V-shaped shape,and the lowest peak was at C5.The overall population showed a sharp peak with the increase of age,and the peak value mostly occurred in the age range of 30-39 years.(2)The sagittal angle of the uncinate process increased like a fishhook with the increase of the vertebral sequence,and the overall angle of the uncinate process increased with age,and the peak value mostly occurred in the age range of 20-29 years.The uncinate process angle and sagittal angle showed only partial significant differences between sides and genders(P<0.05).(3)It is concluded that the angle of the uncinate process increased with the increase of vertebral sequence in a V-shaped manner.The sagittal angle of the uncinate process increases like a fish hook with increasing vertebral order,while the two angles generally peak with increasing age.The angle of the uncinate process is about 131°,which may be closely related to the stability of the cervical spine,while the sagittal angle of the uncinate process is about 14°,and its function may play a certain role in limiting the excessive rotation of the cervical spine.

Objective To comprehend the present condition of sustaining within familial pulmonary rehabilitation for COPD patients,alongside exploring the factors that impact this continuity.Methods A convenience sampling method was used to select 392 COPD patients from outpatient clinics of 2 tertiary-level A hospitals and 1 community health service center in Huaihua in Hunan Province from December 2023 to February 2024 as survey respondents.Patients were surveyed using the general information questionnaire,the COPD Assessment Test,the Modified Medical Research Council Dyspnea Scale,the Exercise Benefits/Barriers Scale,and the Brief 2-Way Social Support Scale.Results We sent out 392 questionnaires and collected 362 valid ones,with an effective response rate of 92.47％.The percentage of COPD patients who never performed home pulmonary rehabilitation was 56.08％,and the maintenance time of health behaviors in home pulmonary rehabilitation was 17.40％for 1-3 months,7.18％for 4-6 months,4.70％for 7-12 months,and 14.64％for more than 1 year.The results of multiple linear regression analysis showed that exercise place,pulmonary rehabilitation health education,exercise habits before having COPD,perceived level of exercise behavior,and two-way social support were influential factors affecting the maintenance of health behaviors in pulmonary rehabilitation in the families of COPD patients,which explained 38.5％of the variability.Conclusion Patients with COPD have a low level of maintenance of health behaviors in home pulmonary rehabilitation,and health education on exercise rehabilitation for COPD patients and caregivers should be strengthened to enhance patients'level of exercise perception and ability to utilize social support.

Objective:To explore the clinical effect and cost-effectiveness of a delayed start protocol with gonadotropin-releasing hormone (GnRH) antagonist in patients with diminished ovarian reserve (DOR).Methods:A retrospective study was performed in 376 cycles of DOR patients undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) from July 2017 to December 2019 in Reproductive Center of Yichun Maternal and Child Health Hospital who had GnRH antagonist protocol to ovarian stimulation. According to the start time, those patients were divided into two groups, the delayed start group including 43 cycles (the start time at day 7-10 of menstruation), the conventional start group including 333 cycles (start normally at day 2-4 of menstruation). The ovulation induction results, clinical outcomes and cost-effectiveness ratio of the two groups with controlled ovarian sitmulation (COS) were compared. Propensity score matching (PSM) was performed on age, duration of infertility, body mass index, follicle-stimulating hormone (FSH) level on the first day of gonadotropin (Gn) used, the dosage of Gn used on the first day, antral follicle count (AFC), anti-Müllerian hormone (AMH) were analyzed again after PSM to reduce the influence of unequal characters between the two groups. Results:Before matching, the conventional start protocol patients' FSH level of the first day of Gn used was lower than that of the delayed start protocol, the results of ovarian stimulation such as the total duration of Gn used [(8.0±2.0) d], the total dosage of Gn used [(1 740.1±561.2) IU], estradiol level on human chorionic hormone (hCG) injection day [(1 371.2±1 203.3) ng/L], total number of oocytes retrieved (5.1±5.1), number of M II oocytes retrieved (4.4±4.3) were lower [(9.0±2.0) d, P<0.001; (2 055.1±634.7) IU, P<0.001; (1 853.5±1 351.5) ng/L, P=0.03; 7.0±5.5, P=0.03; 6.1±4.8, P=0.03], but the two pronuclei fertilization rate (71.7%±32.1%) was higher than that in the conventional start protocol patients (58.9%±31.2%, P=0.01). We also found the total costs of per cycle [(14 179.9±2 909.4) yuan] was less than that of the conventional protocol [(16 003.6±2 543.1) yuan, P<0.001]. After matching, the two groups had the same estradiol level on hCG injection day, total number of oocytes retrieved, number of M II oocytes retrieved ( P>0.05), but the total duration of Gn used [(7.9±2.0) d], the total dosage of Gn used [(1 729.8±563.8) IU], the total cost per cycle [(14 232.5±2 923.9) yuan] of delayed protocol remain lower and the two pronuclei fertilization rate (71.0%±32.2%) was also higher than those of the conventional protocol [(8.8±1.5) d, P=0.03; (2 021.5±726.1) IU, P=0.04; (15 590.2±3 116.9) yuan, P=0.04; 55.4%±37.5%, P=0.04]. There was no difference in the fresh embryo transfer rate, the cycle cancellation rate and the clinical pregnancy rate between the two groups neither before nor after PSM. Conclusion:The delayed start antagonist protocol maybe improve the normal fertilization rate and reduce the total days of Gn used, the total dosage of Gn used so as to have less total cost of each cycle in patients with DOR.

Objective:To explore the clinical effect and cost-effectiveness of a delayed start protocol with gonadotropin-releasing hormone (GnRH) antagonist in patients with diminished ovarian reserve (DOR).Methods:A retrospective study was performed in 376 cycles of DOR patients undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) from July 2017 to December 2019 in Reproductive Center of Yichun Maternal and Child Health Hospital who had GnRH antagonist protocol to ovarian stimulation. According to the start time, those patients were divided into two groups, the delayed start group including 43 cycles (the start time at day 7-10 of menstruation), the conventional start group including 333 cycles (start normally at day 2-4 of menstruation). The ovulation induction results, clinical outcomes and cost-effectiveness ratio of the two groups with controlled ovarian sitmulation (COS) were compared. Propensity score matching (PSM) was performed on age, duration of infertility, body mass index, follicle-stimulating hormone (FSH) level on the first day of gonadotropin (Gn) used, the dosage of Gn used on the first day, antral follicle count (AFC), anti-Müllerian hormone (AMH) were analyzed again after PSM to reduce the influence of unequal characters between the two groups. Results:Before matching, the conventional start protocol patients' FSH level of the first day of Gn used was lower than that of the delayed start protocol, the results of ovarian stimulation such as the total duration of Gn used [(8.0±2.0) d], the total dosage of Gn used [(1 740.1±561.2) IU], estradiol level on human chorionic hormone (hCG) injection day [(1 371.2±1 203.3) ng/L], total number of oocytes retrieved (5.1±5.1), number of M II oocytes retrieved (4.4±4.3) were lower [(9.0±2.0) d, P<0.001; (2 055.1±634.7) IU, P<0.001; (1 853.5±1 351.5) ng/L, P=0.03; 7.0±5.5, P=0.03; 6.1±4.8, P=0.03], but the two pronuclei fertilization rate (71.7%±32.1%) was higher than that in the conventional start protocol patients (58.9%±31.2%, P=0.01). We also found the total costs of per cycle [(14 179.9±2 909.4) yuan] was less than that of the conventional protocol [(16 003.6±2 543.1) yuan, P<0.001]. After matching, the two groups had the same estradiol level on hCG injection day, total number of oocytes retrieved, number of M II oocytes retrieved ( P>0.05), but the total duration of Gn used [(7.9±2.0) d], the total dosage of Gn used [(1 729.8±563.8) IU], the total cost per cycle [(14 232.5±2 923.9) yuan] of delayed protocol remain lower and the two pronuclei fertilization rate (71.0%±32.2%) was also higher than those of the conventional protocol [(8.8±1.5) d, P=0.03; (2 021.5±726.1) IU, P=0.04; (15 590.2±3 116.9) yuan, P=0.04; 55.4%±37.5%, P=0.04]. There was no difference in the fresh embryo transfer rate, the cycle cancellation rate and the clinical pregnancy rate between the two groups neither before nor after PSM. Conclusion:The delayed start antagonist protocol maybe improve the normal fertilization rate and reduce the total days of Gn used, the total dosage of Gn used so as to have less total cost of each cycle in patients with DOR.