Objective:Middle ear cholesteatoma is a common otolaryngological disease, and traditional diagnostic methods have certain limitations. This study aims to construct a computer-aided diagnosis model for middle ear cholesteatoma based on integrated convolutional neural networks (CNNs) to improve diagnostic accuracy and efficiency.Methods:Firstly, Data were collected from patients who visited the Department of Otorhinolaryngology Head and Neck Surgery at the First People′s Hospital of Yinchuan between January 2020 and December 2021. 8 000 temporal bone CT images were collected, including 5 000 images diagnosed pathologically as middle ear cholesteatoma and 3 000 normal images. A five-fold cross-validation method was used to divide the dataset into training and testing sets. Next, a transfer learning approach was used to initialize model parameters, and the AlexNet, GoogleNet, and ResNet networks were pre-trained to extract deep features from the images. Then, the Softmax classification algorithm was applied to classify the features, resulting in three independent classifiers. These classifiers were combined using an ensemble learning method with a weighted voting approach to obtain the final diagnostic results. Finally, the model was evaluated by comparing the ensemble classifier with individual classifiers to assess its accuracy, precision, sensitivity, specificity, and diagnostic time, and a comparison with low-mid-and high-experience physician groups was conducted to comprehensively evaluate the model′s diagnostic performance.Results:The experimental results showed that the model achieved an accuracy of 88.8%(178/200), precision of 92.9%,(112/120) sensitivity of 89.8%(108/120), and specificity of 88.1%(70/80). The average diagnostic time for individual patient temporal bone CT images was reduced to 2-3 seconds. Compared to the diagnostic results from low-mid-and high-experience physician groups, the model demonstrated significant advantages and effectively assisted clinicians in making rapid and accurate middle ear cholesteatoma diagnoses.Conclusion:The proposed middle ear cholesteatoma diagnostic model based on integrated convolutional neural networks exhibits high recognition accuracy and rapid diagnostic speed, significantly improving clinical diagnostic efficiency, especially in early screening and auxiliary diagnosis, making it of considerable value in clinical practice.

Objective:Middle ear cholesteatoma is a common otolaryngological disease, and traditional diagnostic methods have certain limitations. This study aims to construct a computer-aided diagnosis model for middle ear cholesteatoma based on integrated convolutional neural networks (CNNs) to improve diagnostic accuracy and efficiency.Methods:Firstly, Data were collected from patients who visited the Department of Otorhinolaryngology Head and Neck Surgery at the First People′s Hospital of Yinchuan between January 2020 and December 2021. 8 000 temporal bone CT images were collected, including 5 000 images diagnosed pathologically as middle ear cholesteatoma and 3 000 normal images. A five-fold cross-validation method was used to divide the dataset into training and testing sets. Next, a transfer learning approach was used to initialize model parameters, and the AlexNet, GoogleNet, and ResNet networks were pre-trained to extract deep features from the images. Then, the Softmax classification algorithm was applied to classify the features, resulting in three independent classifiers. These classifiers were combined using an ensemble learning method with a weighted voting approach to obtain the final diagnostic results. Finally, the model was evaluated by comparing the ensemble classifier with individual classifiers to assess its accuracy, precision, sensitivity, specificity, and diagnostic time, and a comparison with low-mid-and high-experience physician groups was conducted to comprehensively evaluate the model′s diagnostic performance.Results:The experimental results showed that the model achieved an accuracy of 88.8%(178/200), precision of 92.9%,(112/120) sensitivity of 89.8%(108/120), and specificity of 88.1%(70/80). The average diagnostic time for individual patient temporal bone CT images was reduced to 2-3 seconds. Compared to the diagnostic results from low-mid-and high-experience physician groups, the model demonstrated significant advantages and effectively assisted clinicians in making rapid and accurate middle ear cholesteatoma diagnoses.Conclusion:The proposed middle ear cholesteatoma diagnostic model based on integrated convolutional neural networks exhibits high recognition accuracy and rapid diagnostic speed, significantly improving clinical diagnostic efficiency, especially in early screening and auxiliary diagnosis, making it of considerable value in clinical practice.

Objective:To investigate associations of serum β 2-microglobulin (β 2M) with baseline stroke severity and outcome at 3 months after onset in patients with acute ischemic stroke (AIS). Methods:Patients with first-ever AIS admitted to the Department of Neurology, the Affiliated Municipal Hospital of Xuzhou Medical University from January 2018 to May 2022 were included retrospectively. The severity of stroke was evaluated according to the National Institute of Health Stroke Scale score at admission. ≤8 was defined as mild stroke, and >8 was defined as moderate to severe stroke. At 3 months after onset, the modified Rankin Scale was used to evaluate the clinical outcome, ≤2 points was defined as good outcome and >2 points was defined as poor outcome. Multivariate logistic regression analysis was used to determine associations of β 2M with the severity and outcome of stroke. Results:A total of 463 patients with AIS were enrolled, including 263 males (56.68%), aged 62.89±11.77 years. There were 319 patients (68.89%) in the mild stroke group and 144 (31.10%) in the moderate to severe stroke group; 304 patients (65.66%) in the good outcome group and 159 (34.34%) in the poor outcome group. Univariate analysis showed that the β 2M in the moderate to severe stroke group and the poor outcome group were significantly higher than those in the mild stroke group and the good outcome group, respectively (all P<0.05). Multivariate logistic regression analysis showed that β 2M was an independent influencing factor for stroke severity (odds ratio 2.476, 95% confidence interval 1.621-3.783; P<0.001) and poor outcome (odds ratio 5.179, 95% confidence interval 2.941-11.121; P<0.001) in patients with AIS. Conclusion:There is a significant independent correlation between high serum β 2M and the severity and poor outcome of stroke in patients with AIS.

This article summarizes the current application of Traditional Chinese Medicine (TCM) nursing techniques in clinical nursing of obstetrics and gynecology, providing a reference for the clinical nursing and related research of obstetric and gynecological diseases in TCM, and promoting the widespread application of TCM nursing techniques in obstetrics and gynecology.

This paper summarizes the current situation and necessity of the training of traditional Chinese medicine (TCM) nursing specialists in China, as well as the existing achievements and existing problems, and puts forward the prospects and suggestions for the training of TCM nursing team, so as to strengthen the construction of TCM nursing culture, build a high-quality TCM nursing talent team, and promote the high-quality development of TCM nursing.

Objective : To study the effect of ubiquinol⁃cytochrome C reductase subunit 2 (QCR2) on cell cycle arrest of cervical cancer SiHa cell line , and to explore related mechanisms. Methods : The log⁃phase SiHa cells were taken , and QCR2 siRNA and control siRNA were transfected into SiHa cells by liposome transfection , which were set as QCR2 siRNA group and control siRNA group , and untreated cells were set as a blank group. qRT⁃PCR and Western blot were used to determine the relative expression of QCR2 , p53 mRNA and protein. Propidium iodide(PI) staining was used to determine cell cycle. The cells in the QCR2 siRNA group were taken , and were intervened with a final concentration of 50 nmol/L ubiquitin⁃proteasome inhibitor PS341 as the QCR2 siRNA + PS341 group. In addition , the cells in the QCR2 siRNA group were intervened with the same amount of normal saline (NS) and set as the QCR2 siRNA + NS group. Western blot was used to determine the relative expression of p53 protein. The immunoprecipitation test was used to determine the level of p53 ubiquitination. Results : Observed under a fluorescence microscope , the transfection efficiency of QCR2 siRNA group and control siRNA group were both > 80% . Compared with the blank group and control siRNA group , the relative expression of QCR2 mRNA and protein in the QCR2 siRNA group decreased (P < 0. 05) , the proportion of G0/G1 increased (P < 0. 05) , and the proportion of S , G2/M decreased (P < 0. 05) . There was no significant difference in the relative expression of p53 mRNA between the groups. Compared with the blank group and control siRNA group , the relative expression of p53 protein in the QCR2 siRNA group increased (P < 0. 05) . Compared with the blank group and QCR2 siRNA + PS341 group , the relative expression of p53 protein in the QCR2 siRNA group and QCR2 siRNA + NS group increased (P < 0. 05) . Compared with the blank group and control siRNA group , the degree of p53 ubiquitination in the QCR2 siRNA group was reduced ( P < 0. 05 ) . Conclusion Silencing QCR2 can block SiHa cells in G0/G1 phase. Its mechanism may be related to the inhibition of p53 ubiquitination and the increase of its protein expression.

Objective:To analyze the clinical characteristics and prognosis of pregnant women with hemorrhagic fever with renal syndrome (HFRS).Methods:A total of 11 pregnant women with HFRS admitted to The Second Affiliated Hospital of Xi′an Jiaotong University (four cases), The Second Affiliated Hospital of Air Force Medical University (four cases), The First Affiliated Hospital of Xi′an Jiaotong University (one case) and Central Hospital of Xianyang City (two cases) between November 2009 and February 2019 were included as the study group, and 24 age-matched non-pregnant women with HFRS were selected as the control group. The age, complications, clinical classification and laboratory indexes of the two groups were analyzed retrospectively, and the clinical outcomes of pregnant women and their fetuses in the study group were followed up. The data between two groups were compared using Mann-Whitney U test or chi-square test. Results:Patients in the study and control groups were 29 (22, 33) and 32 (24, 37) years old, respectively. Seven of 11 patients in study group were severe and critical cases, which was significantly higher than that in the control group (16.7%(4/24), χ2=7.722, P=0.015). In the study group, 10 patients had hypervolemic syndrome, 10 patients had pulmonary edema and six patients had overlapping hypotension shock phase and oliguria phase, which were all higher than those in the control group ((2/24, 8.3%), (2/24, 8.3%) and (2/24, 8.3%), respectively; χ2=22.828, 22.828 and 9.135, respectively, all P<0.01). Compared with the control group, the pregnant patients in study group had a higher urea nitrogen maximum and serum creatinine maximum, and the differences were both statistically significant ( Z=-2.453 and -2.336, respectively, both P<0.05), while they had a lower serum albumin minimum, hemoglobin maximum and hemoglobin minimum, and the differences were all statistically significant ( Z=-3.742, -3.350 and -4.034, respectively, all P<0.01). All pregnant women with HFRS recovered. Nine pregnant women gave birth to nine healthy infants. All of them received breastfeeding and the feeding duration were more than six months. No abnormal growth and development were found during an average follow-up of three years. Conclusions:Pregnancy can aggravate the severity of HFRS, and pregnant women have higher risk of the multiple stages overlap and the complications such as hypervolemic syndrome and acute pulmonary edema. After recovery from HFRS, mother may carry to full-term pregnancy.

Follicular lymphoma (FL) is usually occult, with a wide range of disease manifestations and prognosis. In recent years, with the combination of anti-CD20 monoclonal antibody and standard chemotherapy methods, as well as the use of immunomodulators and hematopoietic stem cell transplantation, the survival rate of FL patients has been greatly improved, but it is still considered to be an incurable disease. Recent studies have shown that the chimeric antigen receptor T-cell (CAR-T) therapy can improve the survival rate and the prognosis of FL patients. The article will elaborate on the mechanism, clinical research progress, adverse reactions and limitations of CAR-T in the treatment of FL.

Objective To explore a new method for synthesizing arginine modified chitosan ( AC ) with mono-arginine substitution and high degree of substitution, and to evaluate the biological effect of AC as gene carriers. Methods The single arginine modified chitosan (sAC) was synthesized by means of protecting and de-protecting the arginine amino group before and after chitosan modified arginine reaction. Liu's arginine-modified chitosan ( LAC ) was prepared according to the methods reported in the literature . The conjunction of arginine to chitosan was detected by infrared spectroscopy and nuclear magnetic resonance spectroscopy. Three kinds of chitosan gene nanoparticles were respectively prepared by complex coacervation and characterized, including sAC gene nanoparticles (sACGNs), the LAC gene nanoparticles (LACGNs) and the chitosan gene nanoparticles (CGNs). A10 rat vascular smooth cells transfected with sACGNs were used to estimate the in vitro cellular uptake, internalization mechanisms and transfection efficiency. Thiazolyl blue tetrazolium blue (MTT) assay was used to measure the cytotoxicity. Results The infrared spectrum analysis confirmed that sAC was obtained via the conjunction of arginine to chitosan. Nuclear magnetic resonance spectrum analysis showed that the degree of substitution of arginine in sAC and LAC was 21.3％and 6.4％, respectively. When the ratio of nitrogen to phosphorus (N/P ratio) was 2:1, the particle sizes of CGN, LACGN, and sACGN were (94.81±2.93) nm, (124.53±2.55) nm, and (128.53±2.04) nm, respectively, and the Zeta potentials were (3.50±1.61) mV, (5.74±0.41) mV, and (6.04±1.39) mV, respectively. For the cellular uptake, CGNs were mainly through the clathrin-mediated endocytic pathway, and LACGNs and sACGN were mainly through the caveolin-mediated endocytic pathway. Compared with CGNs, LACGNs and sACGNs showed higher cellular uptake and transfection efficiency , and the differences were statistically significant ( all P<0 . 05 ) . sACGNs achieved the highest transfection efficiency in the near-neutral pH environment. MTT results showed that when the mass concentration of sACGNs reached 100μg/ml, the survival rate of A10 cells was still higher than 90％, indicating the non-cytotoxicity of sACGNs. Conclusion The new method successfully synthesized single arginine-modified chitosan. As a gene carrier, sACGNs show higher gene transfection efficiency and lower cytotoxicity than CGNs and LACGNs in near neutral pH environment.

Primary myelofibrosis (PMF) is a type of myeloproliferative neoplasms (MPN) with the worst prognosis in MPN. Immunomodulators, erythropoiesis-stimulating agents, cytoreductive drugs, splenectomy, etc. can significantly reduce the symptoms of patients, but can not improve the prognosis of patients. Allogeneic hematopoietic stem cell transplantation remains the only method that may cure PMF. The marketed JAK kinase inhibitor ruxolitinib and the hypomethylating agents, anti-fibrosis agents and telomerase inhibitorprovide new ideas for the treatment of PMF, made it possible to reverse the natural course of myelofibrosis. This paper reviews the progress of PMF therapy.