Objective:To construct classification models of traumatic brain injury (TBI) based on the injury data collected at the scene of the accidents and validate its efficacy.Methods:A retrospective cohort study was conducted to analyze the pre-hospital treatment data of 368 TBI patients admitted to the Second Affiliated Hospital of Army Military Medical University from January 2019 to December 2023, including 243 males and 125 females, aged 18-82 years [(48.1±20.8)years]. The patients′ Glasgow coma scale (GCS) scores were 3-15 points [11.0(3.0, 15.0)points] at emergency medical service arrival. The patients were randomly assigned to the training set ( n=257) and test set ( n=111) at a ratio of 7∶3. According to the admission diagnosis, the patients fell into the mild TBI group ( n=62), medium TBI group ( n=137), severe TBI group ( n=120), and extremely severe TBI group ( n=49). In the training set, 44 patients fell into mild TBI group, 98 into medium TBI group, 82 into severe TBI group and 33 into extremely severe TBI group, while in the test set, 18 patients fell into mild TBI group, 39 into medium TBI group, 38 into severe TBI group and 16 into extremely severe TBI group. The following 12 kinds of injury data, including MARCH [massive hemorrhage (M), airway obstruction (A), respiratory failure (R), circulatory failure (C) and hypothermia (H)], GCS, pre-hospital index (PHI), shock index (SI), reverse SI multiplied by GCS (rSIG), optic nerve sheath diameter (ONSD) measured by ultrasound, scalp and skull injuries were collected at the scene of the accidents. Three machine algorithm including random forest (RF), support vector machine (SVM) and logistic regression (LR) were used to construct scene data-based TBI classification models. The accuracy rate, precision rate, recall rate, F1 value and area under receiver operating characteristic (ROC) curve (AUC) of the 3 models were used to verify the efficiency of the models for TBI classification. Shapley additive explanations (SHAP) method was used to interpret the results of the optimal model. The 12 kinds of injury data in the models were sorted according to their contribution to the TBI classification and the injury data with greater contribution were selected. Results:In the test set, the accuracy rate of the RF, SVM and LR models was 0.93, 0.92 and 0.87, respectively; the precision rate was 0.93, 0.92 and 0.89, respectively; the recall rate was 0.93, 0.92 and 0.87, respectively; the F1 value was 0.93, 0.92 and 0.87, respectively. In the mild, medium, severe and extremely severe TBI groups in the test set, the AUC of the RF model was 0.96 (95% CI 0.92, 0.98), 0.98 (95% CI 0.94, 0.99), 0.97 (95% CI 0.95, 0.98), and 0.97 (95% CI 0.96, 0.98), respectively; the AUC of the SVM model was 0.90 (95% CI 0.88, 0.94), 0.95 (95% CI 0.92, 0.97), 0.96 (95% CI 0.94, 0.98), and 0.95 (95% CI 0.92, 0.99), respectively; the AUC of the LR model was 0.90 (95% CI 0.83, 0.96), 0.90 (95% CI 0.84, 0.95), 0.96 (95% CI 0.95, 0.98), and 0.95 (95% CI 0.94, 0.97), respectively. The RF model demonstrated optimal discriminative performance for TBI classification. As the SHAP′s interpretation of the RF model indicated, among the 12 kinds of injury data, those with greater contributions to the TBI classification were GCS, rSIG, SI, PHI, respiratory failure, ONSD, and circulatory failure in sequence. Conclusions:Of the scene data-based TBI classification models, the RF model achieves good predictive performance for TBI classification when compared with the SVM model and LR model. Besides, GCS, rSIG, SI, PHI, respiratory failure, ONSD and circulatory failure contribute significantly to the classification of TBI in the RF model, which may assist emergency medical personnel in field triage and management of TBI at accident scenes.

The goal of the research was to evaluate the application of self-developed virtual simulation software of fiber post all-ce-ramic crown restoration in the teaching of dental undergraduates.Fifty-five undergraduates majoring in stomatology were enrolled,including 26 sophomores and 29 senior students.Theoretical lecture and virtual simulation software of fiber post all-ceramic crown restoration were used for teaching.After class,questionnaires were completed by the students.The results of the questionnaire showed that more than half of the students were very interested in the virtual simulation software of this course(56.36％),and try-ing other forms of virtual simulation courses(52.73％).The simulation stimulated their interest in in-depth learning of prosthodon-tics(52.73％)and their expectation for the future working environment(54.55％).They were very satisfied with the virtual simula-tion effect(52.73％).Compared with two different grades,there are significant differences in the statistical data of three survey questions,including whether they are interested in in-depth study of prosthodontics,whether they have expectations for the future working environment,and whether they can clearly understand basic anatomical structure of teeth and basic concepts such as post,core and root canal.There was no significant difference in other questionnaire between grades.The virtual simulation software of fi-ber post all-ceramic crown restoration has a good effect on the teaching of dental undergraduates,which worth carrying out and pro-moting in the future teaching work.

Prolonged disorders of consciousness(pDoC)are complex and prolonged conditions that severely impact patient prognosis and remain a clinical treatment challenge.In recent years,neural regulation-based awakening therapies have been widely applied in the assessment and treatment of pDoC patients.Repetitive transcranial magnetic stimulation(rTMS)technology can regulate neural activity and improve patients'consciousness states,demonstrating positive awakening effects for pDoC patients.However,the optimal stimulation parameters and awakening mechanisms of rTMS remain unclear.This article reviews the pathological mechanisms of pDoC,clinical applications of rTMS at different targeting sites and stimulation frequencies,and focuses on exploring how rTMS promotes consciousness recovery through neural mechanisms such as altering neural pathways,reshaping brain networks,promoting synaptic plasticity and neurotransmitter release,regulating neurotrophic factor expression,and modulating cerebral hemodynamics.Based on artificial intelligence,the article also prospects the future clinical research applications of rTMS.

Objective:To investigate the clinical efficacy of strengthening the spleen to nourish the lung in treating stable chronic obstructive pulmonary disease (COPD) with lung and spleen qi deficiency complicated by sarcopenia. Methods:This study was designed as a prospective study. A total of 65 patients with stable COPD and sarcopenia who received treatment at Kunshan Hospital of Chinese Medicine from January 2021 to December 2021 were included in the study. They were randomly divided into a control group and an observation group using the random number table method. The control group ( n = 34) was treated with conventional therapy, while the observation group ( n = 31) was treated with Shenling Baizhu Powder, a traditional Chinese medication based on the principle of strengthening the spleen to nourish the lung, in addition to the conventional therapy given to the control group. Both groups were treated for 1 month. Traditional Chinese medicine syndrome score, pulmonary function, grip strength, walking speed, albumin and prealbumin levels were compared between the two groups. Results:After treatment, the scores of all traditional Chinese medicine syndromes in the observation group were significantly lower than those in the control group (all P < 0.05). Compared with the control group, the levels of forced expiratory volume in the first second (FEV 1)[(1.51 ± 0.27) L vs. (1.32 ± 0.20) L, t = 3.11, P < 0.001 ] and FEV 1/forced vital capacity (FVC) [(57.20 ± 8.41)% vs. (52.89 ± 5.66)%, t = 2.30, P = 0.025] were significantly higher in the observation group. Compared with before treatment, gait speed [(1.07 ± 0.27) m/s vs. (0.90 ± 0.30) m/s, t = 7.66, P < 0.001], grip strength [(20.62 ± 5.07) kg vs. (19.42 ± 5.78) kg, t = 3.55, P < 0.001], albumin [(231.38 ± 49.40) g/L vs. (200.26 ± 65.87) g/L, t = 3.70, P < 0.001] and prealbumin [(39.53 ± 3.45) g/L vs. (35.81 ± 4.46) g/L, t = 4.08, P < 0.001] levels in the observation group were significantly increased after treatment. There were no significant differences in gait speed, grip strength, albumin, and prealbumin levels in the control group before and after treatment (all P > 0.05). Conclusions:The method of strengthening the spleen to nourish the lung shows good clinical efficacy in treating stable COPD with lung and spleen deficiency complicated by sarcopenia, and it has great potential for broader application.

The goal of the research was to evaluate the application of self-developed virtual simulation software of fiber post all-ce-ramic crown restoration in the teaching of dental undergraduates.Fifty-five undergraduates majoring in stomatology were enrolled,including 26 sophomores and 29 senior students.Theoretical lecture and virtual simulation software of fiber post all-ceramic crown restoration were used for teaching.After class,questionnaires were completed by the students.The results of the questionnaire showed that more than half of the students were very interested in the virtual simulation software of this course(56.36％),and try-ing other forms of virtual simulation courses(52.73％).The simulation stimulated their interest in in-depth learning of prosthodon-tics(52.73％)and their expectation for the future working environment(54.55％).They were very satisfied with the virtual simula-tion effect(52.73％).Compared with two different grades,there are significant differences in the statistical data of three survey questions,including whether they are interested in in-depth study of prosthodontics,whether they have expectations for the future working environment,and whether they can clearly understand basic anatomical structure of teeth and basic concepts such as post,core and root canal.There was no significant difference in other questionnaire between grades.The virtual simulation software of fi-ber post all-ceramic crown restoration has a good effect on the teaching of dental undergraduates,which worth carrying out and pro-moting in the future teaching work.

Objective:To construct classification models of traumatic brain injury (TBI) based on the injury data collected at the scene of the accidents and validate its efficacy.Methods:A retrospective cohort study was conducted to analyze the pre-hospital treatment data of 368 TBI patients admitted to the Second Affiliated Hospital of Army Military Medical University from January 2019 to December 2023, including 243 males and 125 females, aged 18-82 years [(48.1±20.8)years]. The patients′ Glasgow coma scale (GCS) scores were 3-15 points [11.0(3.0, 15.0)points] at emergency medical service arrival. The patients were randomly assigned to the training set ( n=257) and test set ( n=111) at a ratio of 7∶3. According to the admission diagnosis, the patients fell into the mild TBI group ( n=62), medium TBI group ( n=137), severe TBI group ( n=120), and extremely severe TBI group ( n=49). In the training set, 44 patients fell into mild TBI group, 98 into medium TBI group, 82 into severe TBI group and 33 into extremely severe TBI group, while in the test set, 18 patients fell into mild TBI group, 39 into medium TBI group, 38 into severe TBI group and 16 into extremely severe TBI group. The following 12 kinds of injury data, including MARCH [massive hemorrhage (M), airway obstruction (A), respiratory failure (R), circulatory failure (C) and hypothermia (H)], GCS, pre-hospital index (PHI), shock index (SI), reverse SI multiplied by GCS (rSIG), optic nerve sheath diameter (ONSD) measured by ultrasound, scalp and skull injuries were collected at the scene of the accidents. Three machine algorithm including random forest (RF), support vector machine (SVM) and logistic regression (LR) were used to construct scene data-based TBI classification models. The accuracy rate, precision rate, recall rate, F1 value and area under receiver operating characteristic (ROC) curve (AUC) of the 3 models were used to verify the efficiency of the models for TBI classification. Shapley additive explanations (SHAP) method was used to interpret the results of the optimal model. The 12 kinds of injury data in the models were sorted according to their contribution to the TBI classification and the injury data with greater contribution were selected. Results:In the test set, the accuracy rate of the RF, SVM and LR models was 0.93, 0.92 and 0.87, respectively; the precision rate was 0.93, 0.92 and 0.89, respectively; the recall rate was 0.93, 0.92 and 0.87, respectively; the F1 value was 0.93, 0.92 and 0.87, respectively. In the mild, medium, severe and extremely severe TBI groups in the test set, the AUC of the RF model was 0.96 (95% CI 0.92, 0.98), 0.98 (95% CI 0.94, 0.99), 0.97 (95% CI 0.95, 0.98), and 0.97 (95% CI 0.96, 0.98), respectively; the AUC of the SVM model was 0.90 (95% CI 0.88, 0.94), 0.95 (95% CI 0.92, 0.97), 0.96 (95% CI 0.94, 0.98), and 0.95 (95% CI 0.92, 0.99), respectively; the AUC of the LR model was 0.90 (95% CI 0.83, 0.96), 0.90 (95% CI 0.84, 0.95), 0.96 (95% CI 0.95, 0.98), and 0.95 (95% CI 0.94, 0.97), respectively. The RF model demonstrated optimal discriminative performance for TBI classification. As the SHAP′s interpretation of the RF model indicated, among the 12 kinds of injury data, those with greater contributions to the TBI classification were GCS, rSIG, SI, PHI, respiratory failure, ONSD, and circulatory failure in sequence. Conclusions:Of the scene data-based TBI classification models, the RF model achieves good predictive performance for TBI classification when compared with the SVM model and LR model. Besides, GCS, rSIG, SI, PHI, respiratory failure, ONSD and circulatory failure contribute significantly to the classification of TBI in the RF model, which may assist emergency medical personnel in field triage and management of TBI at accident scenes.

Objective:To investigate the clinical efficacy of strengthening the spleen to nourish the lung in treating stable chronic obstructive pulmonary disease (COPD) with lung and spleen qi deficiency complicated by sarcopenia. Methods:This study was designed as a prospective study. A total of 65 patients with stable COPD and sarcopenia who received treatment at Kunshan Hospital of Chinese Medicine from January 2021 to December 2021 were included in the study. They were randomly divided into a control group and an observation group using the random number table method. The control group ( n = 34) was treated with conventional therapy, while the observation group ( n = 31) was treated with Shenling Baizhu Powder, a traditional Chinese medication based on the principle of strengthening the spleen to nourish the lung, in addition to the conventional therapy given to the control group. Both groups were treated for 1 month. Traditional Chinese medicine syndrome score, pulmonary function, grip strength, walking speed, albumin and prealbumin levels were compared between the two groups. Results:After treatment, the scores of all traditional Chinese medicine syndromes in the observation group were significantly lower than those in the control group (all P < 0.05). Compared with the control group, the levels of forced expiratory volume in the first second (FEV 1)[(1.51 ± 0.27) L vs. (1.32 ± 0.20) L, t = 3.11, P < 0.001 ] and FEV 1/forced vital capacity (FVC) [(57.20 ± 8.41)% vs. (52.89 ± 5.66)%, t = 2.30, P = 0.025] were significantly higher in the observation group. Compared with before treatment, gait speed [(1.07 ± 0.27) m/s vs. (0.90 ± 0.30) m/s, t = 7.66, P < 0.001], grip strength [(20.62 ± 5.07) kg vs. (19.42 ± 5.78) kg, t = 3.55, P < 0.001], albumin [(231.38 ± 49.40) g/L vs. (200.26 ± 65.87) g/L, t = 3.70, P < 0.001] and prealbumin [(39.53 ± 3.45) g/L vs. (35.81 ± 4.46) g/L, t = 4.08, P < 0.001] levels in the observation group were significantly increased after treatment. There were no significant differences in gait speed, grip strength, albumin, and prealbumin levels in the control group before and after treatment (all P > 0.05). Conclusions:The method of strengthening the spleen to nourish the lung shows good clinical efficacy in treating stable COPD with lung and spleen deficiency complicated by sarcopenia, and it has great potential for broader application.

Objective To explore the effects of the long non-coding RNA(lncRNA)NK2 homeobox 1-antisense RNA 1(NK2-1-AS1),which mediates the microRNA(miR)-96-5p/PR domain-containing protein 16(PRDM16)axis,on anaplastic thyroid cancer(ATC)cell proliferation,migration,and invasion in vitro and transplanted tumor growth in vivo.Methods The differentially expressed lncRNA NKX2-1-AS1 in ATC tissues and cells,its target miRNA miR-96-5p,and its downstream target gene PRDM16 were screened using a bioinformatics analysis.The dual-luciferase reporter assay validated the relationship between NKX2-1-AS1 and miR-96-5p as well as the connection between miR-96-5p and PRDM16.Western blotting was performed to detect the effect of miR-96-5p overexpression on PRDM16 in CAL-62 cells overexpressed with NKX2-1-AS1.Plate clone formation,scratch,and Transwell assays were used to detect the effects of PRDM16knockdown on the proliferation,migration,and invasion of CAL-62 cells overexpressing NKX2-1-AS1.CAL-62 cells were injected subcutaneously into nude mice and the effect was observed of PRDM16knockdown on the growth of transplanted tumors of CAL-62 cells overexpressing NKX2-1-AS1.Results The bioinformatics analysis revealed that the NK2-1-AS1/miR-96-5p/PRDM16 axis was involved in regulating ATC development.The dual-luciferase reporter assay demonstrated that NKX2-1-AS1 bound to miR-96-5p and miR-96-5p bound to PRDM16.NKX2-1-AS1 overexpression upregulated PRDM16 protein expression in CAL-62 cells,while miR-96-5p overexpression reversed this phenomenon.NKX2-1-AS1 overexpression inhibited CAL-62 cellular proliferation,migration,and invasion in vitro and transplanted tumor growth in vivo,while knocking down PRDM16 reversed these phenomena.Conclusion NK2-1-AS1 may compete with miR-96-5p as an endogenous RNA to bind to its downstream target gene,PRDM16,and upregulate its expression,thus inhibiting ATC cell proliferation,migration,and invasion in vitro and transplanted tumor growth in vivo.

Objective To explore the effect of transcription factor E2F7 on the proliferation,migration,invasion,and tumor growth of anaplastic thyroid cancer(ATC)cells in vitro and to elucidate the underlying mechanisms.Methods Lentivirus transfection was used for a stable E2F7 knockdown in CAL-62 cells,and real-time PCR was used to detect E2F7 expression in these cells to verify the trans-fection efficiency.CAL-62 cells were divided into sh-NC and sh-E2F7 groups,and cell proliferation was measured using the CCK-8 assay,whereas cell migration and invasion abilities were measured using the Transwell assay.CAL-62 cells were subcutaneously injected into nude mice to observe tumor growth.The EPD website predicted an E2F7 binding site on the CXCL5 promoter,and the dual-lucif-erase reporter gene assay measured the effect of E2F7 knockdown on the luciferase activity of the CXCL5 promoter.The impact of E2F7 knockdown on CXCL5 levels in CAL-62 cells was assessed through real-time PCR and ELISA.Further,CAL-62 cells were divided into sh-E2F7+vector and sh-E2F7+CXCL5 groups to study the effects of CXCL5 overexpression on cell proliferation,migration,invasion,and the CXCR2/ERK signaling pathway following E2F7 knockdown.Results E2F7 knockdown inhibited CAL-62 cell proliferation,migra-tion,and invasion in vitro and tumor growth in vivo.The CXCL5 promoter has an E2F7 binding site,and E2F7 knockdown reduced the luciferase activity of the CXCL5 promoter.CXCL5 overexpression reversed the inhibitory effect of E2F7 knockdown on cell proliferation,migration,invasion,and the CXCR2/ERK signaling pathway in CAL-62 cells.Conclusion E2F7 promotes ATC cell proliferation,migra-tion,invasion,and tumor growth in vitro by activating the CXCL5/CXCR2/ERK signaling pathway mediated by CXCL5 transcription.

Anaplastic thyroid carcinoma(ATC)is the most aggressive malignancy with poor prognosis.The pathogenesis of ATC is complex,and there is no effective treatment at present.In recent years,with the deep understanding of the genetic(such as BRAF V600E,TP53,TERT,PIK3CA mutations,etc.)and epigenetic(such as histone methylation,histone deacetylation,microRNA regulatory pathways,etc.)changes driving ATC,molecular targeted therapy has brought new hope to ATC patients.This article reviews the molecular mechanisms of ATC and the latest achievements in targeted therapy and other therapies.