Objective:To investigate the status of fear of progression (FoP) in patients with esophageal gastric variceal bleeding (EGVB) due to liver cirrhosis and analyze its influencing factors.Methods:A convenience sampling method was used to select 210 patients with liver cirrhosis and EGVB who were hospitalized at Shanxi Bethune Hospital and Shanxi Provincial People's Hospital between May and December 2023. Data were collected using a general information questionnaire, the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), the Brief Illness Perception Questionnaire (BIPQ), the Medical Coping Modes Questionnaire (MCMQ), and the Perceived Social Support Scale (PSSS) .Results:A total of 210 questionnaires were distributed and 200 valid questionnaires were recovered, with a valid recovery rate of 95.24%. Among 200 EGVB patients, the FoP-Q-SF score was (31.82±10.02). Multiple linear regression analysis showed that gender, number of bleeding episodes, illness perception, coping strategies, and social support were significant influencing factors of FoP in these patients ( P<0.05) . Conclusions:The incidence of FoP is relatively high in patients with liver cirrhosis and EGVB. Healthcare providers should pay attention to the impact of gender, bleeding episodes, illness perception, coping strategies, and social support on FoP and implement targeted interventions to reduce its levels.

Xiaoxuming decoction is one of the classical prescriptions in ancient times,mainly used for treating stroke syndrome,with significant therapeutic effects.Recent studies have found that it is also effective for other neurological diseases besides stroke,such as facial paralysis and vertigo,but there are few reports on related achievements,lacking systematic organization and summary.This article systematically summarizes the application practice and mechanism of Xiaoxuming decoction in the above-mentioned diseases,aiming to provide a solid foundation and scientific reference for deepening the exploration of Xiaoxuming decoction in the field of nervous system disease.

Osteoporosis (OP) is a systemic skeletal disease that primarily affects the elderly population, which greatly increases the risk of fractures. Here we report that Kindlin-2 expression in adipose tissue increases during aging and high-fat diet fed and is accompanied by decreased bone mass. Kindlin-2 specific deletion (K2KO) controlled by Adipoq-Cre mice or adipose tissue-targeting AAV (AAV-Rec2-CasRx-sgK2) significantly increases bone mass. Mechanistically, Kindlin-2 promotes peroxisome proliferator-activated receptor gamma (PPARγ) activation and downstream fatty acid binding protein 4 (FABP4) expression through stabilizing fatty acid synthase (FAS), and increased FABP4 inhibits insulin expression and decreases bone mass. Kindlin-2 inhibition results in accelerated FAS degradation, decreased PPARγ activation and FABP4 expression, and therefore increased insulin expression and bone mass. Interestingly, we find that FABP4 is increased while insulin is decreased in serum of OP patients. Increased FABP4 expression through PPARγ activation by rosiglitazone reverses the high bone mass phenotype of K2KO mice. Inhibition of FAS by C75 phenocopies the high bone mass phenotype of K2KO mice. Collectively, our study establishes a novel Kindlin-2/FAS/PPARγ/FABP4/insulin axis in adipose tissue modulating bone mass and strongly indicates that FAS and Kindlin-2 are new potential targets and C75 or AAV-Rec2-CasRx-sgK2 treatment are potential strategies for OP treatment.

In recent years, the task of object detection and segmentation in medical image is the research hotspot and difficulty in the field of image processing. Instance segmentation provides instance-level labels for different objects belonging to the same class, so it is widely used in the field of medical image processing. In this paper, medical image instance segmentation was summarized from the following aspects: First, the basic principle of instance segmentation was described, the instance segmentation models were classified into three categories, the development context of the instance segmentation algorithm was displayed in two-dimensional space, and six classic model diagrams of instance segmentation were given. Second, from the perspective of the three models of two-stage instance segmentation, single-stage instance segmentation and three-dimensional (3D) instance segmentation, we summarized the ideas of the three types of models, discussed the advantages and disadvantages, and sorted out the latest developments. Third, the application status of instance segmentation in six medical images such as colon tissue image, cervical image, bone imaging image, pathological section image of gastric cancer, computed tomography (CT) image of lung nodule and X-ray image of breast was summarized. Fourth, the main challenges in the field of medical image instance segmentation were discussed and the future development direction was prospected. In this paper, the principle, models and characteristics of instance segmentation are systematically summarized, as well as the application of instance segmentation in the field of medical image processing, which is of positive guiding significance to the study of instance segmentation.
Imaging, Three-Dimensional/methods* ; Image Processing, Computer-Assisted ; Tomography, X-Ray Computed/methods* ; Algorithms

Remarkable results have been realized by the U-Net network in the task of medical image segmentation. In recent years, many scholars have been researching the network and expanding its structure, such as improvement of encoder and decoder and improvement of skip connection. Based on the optimization of U-Net structure and its medical image segmentation techniques, this paper elucidates in the following: First, the paper elaborates on the application of U-Net in the field of medical image segmentation; Then, the paper summarizes the seven improvement mechanism of U-Net: dense connection mechanism, residual connection mechanism, multi-scale mechanism, ensemble mechanism, dilated mechanism, attention mechanism, and transformer mechanism; Finally, the paper states the ideas and methods on the U-Net structure improvement in a bid to provide a reference for later researches, which plays a significant part in advancing U-Net.
Image Processing, Computer-Assisted/methods*

Objective:The investigation and research on the application status of Hepatic Venous Pressure Gradient (HVPG) is very important to understand the real situation and future development of this technology in China.Methods:This study comprehensively investigated the basic situation of HVPG technology in China, including hospital distribution, hospital level, annual number of cases, catheters used, average cost, indications and existing problems.Results:According to the survey, there were 70 hospitals in China carrying out HVPG technology in 2021, distributed in 28 provinces (autonomous regions and municipalities directly under the central Government). A total of 4 398 cases of HVPG were performed in all the surveyed hospitals in 2021, of which 2 291 cases (52.1%) were tested by HVPG alone. The average cost of HVPG detection was (5 617.2±2 079.4) yuan. 96.3% of the teams completed HVPG detection with balloon method, and most of the teams used thrombectomy balloon catheter (80.3%).Conclusion:Through this investigation, the status of domestic clinical application of HVPG has been clarified, and it has been confirmed that many domestic medical institutions have mastered this technology, but it still needs to continue to promote and popularize HVPG technology in the future.

Objective:To explore the influencing factors of unqualified bowel preparation before colonoscopy in patients with chronic constipation, in order to propose corresponding countermeasures.Methods:Using the convenient sampling method, a total of 146 patients with chronic constipation who underwent colonoscopy in Gastroenterology Department of Shanxi Provincial People's Hospital from February 2018 to April 2020 were selected as the research subjects, and the unqualified conditions of them were counted. Single factor analysis and multivariate Logistic regression analysis were used to screen out the influencing factors of unqualified intestinal preparation and propose the corresponding nursing countermeasures.Results:Among 146 patients with chronic constipation, 15 cases (10.27%) were unqualified in intestinal preparation before colonoscopy, including 7 cases (4.79%) in left colon, 5 cases (3.42%) in transverse colon and 3 cases (2.05%) in right colon. Univariate analysis showed that there were statistically significant differences in intestinal preparation qualification among patients of different ages, whether they had insufficient activity during medication, whether they had a history of diabetes, whether they had a history of abdominal or pelvic surgery and different courses of chronic constipation ( P<0.05). Multivariate Logistic regression analysis showed that age older than 60 years, insufficient activity during medication and history of diabetes were independent risk factors for unqualified bowel preparation before colonoscopy in patients with chronic constipation ( P<0.05) . Conclusions:Old age, insufficient activity during medication and history of diabetes are all risk factors for unqualified bowel preparation before colonoscopy in patients with chronic constipation. And targeted nursing programs should be developed according to the actual conditions of patients to increase the pass rate of bowel preparation.

Objective:To explore the effect of WeChat-supported health education based on the information knowledge attitude practice (IKAP) model in patients with ulcerative colitis (UC) .Methods:From June 2017 to September 2021, 347 UC patients admitted to the Gastroenterology Department of Shanxi Provincial People's Hospital were selected by convenience sampling as the research object. The UC patients admitted from June 2017 to August 2019 were set as the control group ( n=173) and received routine health education. The UC patients admitted from September 2019 to September 2021 were set as the observation group ( n=174) , and they were given WeChat-supported health education based on the IKAP model. The self-management level and quality of life of the two groups of patients before and after the intervention were compared. Results:After the intervention, the scores of each dimension of the Self-management Scale and the Short Form 36 Health Survey Questionnaire of the two groups were higher than those before the intervention, and those of the observation group were higher than those of the control group, with statistical differences ( P<0.05) . Conclusions:WeChat-supported health education based on the IKAP model can improve the self-management and quality of life of UC patients, which is worthy of clinical promotion.

【Objective】 To provide reference for fine management of blood donors by classifying and analyzing different types of blood donors from domestic blood stations. 【Methods】 The resident population of 15 regions in China from 2016 to 2019 were taken as the research object, among which the blood donors were divided into three categories: age-eligible citizens, registered donors and donated donors. The average value and proportion of the three categories were calculated and statistically analyzed. 【Results】 The resident population of the 15 regions varied greatly. The mean 95% CI of the proportion of age-eligible citizens to resident population from 2016 to 2019 was (60.16%, 67.84%); registered donors to age-eligible citizens and resident population was (2.21%, 2.86%) and (1.41%, 1.79%), respectively; donated donors to registered donors, age-eligible citizens and resident population was (84.63%, 91.68%), (1.93%, 2.55%) and(1.23%, 1.59%), respectively. 【Conclusion】 There were differences in the number and proportion of different types of blood donors in different regions. The fine management of blood donors can help blood stations carry out more effective recruitment and retention strategies.

Objective This study aims to investigate the gene expression of P2X7 receptor in retinal ganglion cell line (RGC-5),and to design and select the small interfering RNA (siRNA) which can specifically and effectively downregulate P2X7 receptor expression.Methods The mRNA and protein expressions of P2X7 receptor in RGC-5 cells were examined by real-time polymerase chain reaction (qRT-PCR),Western blot and Immunofluorescence,and compared with those of mouse retina and other tissues.Three P2X7 receptor-specific double stranded siRNAs (P2X7-siRNA-1-3) were designed and delivered into RGC-5 cells by riboFECTTM CP.60 hours after transfection,the expression level of P2X7 receptor was analyzed by qRT-PCR,Western blot and Immunofluorescence.Results The expression of P2X7 receptor was detected in both RGC-5 cell line and mouse retina,and the receptor was mainly expressed in the nucleus and cytoplasm of RGC-5 cells.P2X7-siRNA-3 can effectively down-regulate the mRNA and protein expression of P2X7 at the same time.Conclusions RGC-5 cell line can serve as a good model for studying the biological function of P2X7 receptor in retinal ganglion cells in vitro.We have managed to design and synthesize the siRNA pair that specifically and effectively lowering P2X7 receptor expression.The current study has laid the foundation for future investigations on treating glaucomatous retinopathy by downregulation of P2X7 receptor.