Objective:To investigate the influencing factors of falls in patients with chemotherapy-induced peripheral neuropathy for gynecological cancer, and establish a Nomogram model based on independent influencing factors.Methods:A total of 216 patients with peripheral neuropathy who received chemotherapy for gynecological cancer in The First Affiliated Hospital of Army Military Medical University of the People′s Liberation Army from February 2021 to April 2023 were retrospectively selected, and were divided into the modeling set and the validation set according to the ratio of 7∶3 using random number table method. According to the occurrence of falls in the modeling set, the patients were divided into the fall group and the non-fall group. Independent influencing factors were obtained through univariate analysis and multivariate Logistic regression analysis, and a prediction model was constructed based on the regression analysis. A Nomogram map was drawn using R language software. Receiver operating characteristic curve (ROC) and calibration curve were used to test the prediction efficiency, and the predictive benefits were evaluated by clinical decision curve.Results:Among the 216 patients, 151 were included in the modeling set and 65 in the validation set. Among the patients in the modeling set, 53 cases were in the fall group, aged (62.89 ± 8.58) years old, and 98 cases were in the non-fall group, aged (59.48 ± 8.12) years old. Chemotherapy cycle, Neuropathy Impairment Score-Lower Limbs, Barthel index, Home Falls and Accidents Screening Tool, regular exercise habits, diabetes and depression were all independent influencing factors for falls in patients with chemotherapy-induced peripheral neuropathy of gynecologic cancer ( OR values were 0.312-3.727, all P<0.05). The area under the curve (AUC) of the established Nomogram model was 0.873, with good discriminating ability. The mean absolute error (MAE) of calibration curve was 0.048, which fitted the ideal curve, indicating that the model has good calibration performance. The AUC of the validation set was 0.873 and the MAE of calibration curve was 0.073, indicating that the model has good external prediction efficiency. Conclusions:This Nomogram model can predict falls in patients with chemotherapy-induced peripheral neuropathy of gynecological cancer and provide evidence for clinical prevention of falls.

Objective To develop and evaluate the equivalence of the Mandarin test material for tracking of noise tolerance(TNT)test.Methods Six different speech materials were developed(themes including daily life,entertainment,family,festivals,outdoors,and school).Four-minute TNT tests were measured in 21 normal hear-ing subjects using six different test materials.For each session,the tolerable noise level(TNL)and TNT scores were acquired and calculated for 3 time windows(31～240 s,31～120 s,151～240 s).Results Statistic analysis showed significant differences in the TNL(F=43.611,P＜0.05)among the normal hearing listeners.There were statistically significant differences in standardize z-scored TNT scores of the six different materials in the three time windows(P＜0.05).Post-hoc comparisons revealed that all significant differences involved the family and daily life themes.Conclusion Entertainment,festival,outdoors and school themed test materials can serve as the materials of Mandarin tracking of noise tolerance test and can be appied in research and clinical testing.

Objective To evaluate the Mandarin tracking of noise tolerance(TNT)test material and compare the differences between the average tolerable noise level(aTNL)value obtained from assessment and the program-estimated tolerable noise level(eTNL).Methods A total of 25 subjects with normal hearing and aural communica-tional ability were selected to undergo two of the mandarin TNT tests successively(respectively test 1,C1;test 2,C2),and 13 of them completed the third test(C3)under the same test condition as test 2 at least 1 week later.The stimulus for the three test conditions was presented with"speech 0°,continuous noise 180°".Results The aTNL of 25 participants for C1 and C2 was 83.42±3.09 dB SPL and 83.50±3.18 dB SPL,respectively.The eTNL of 25 participants for C1 and C2 were 84.08±3.53 dB SPL and 83.95±3.85 dB SPL,respectively.The aTNL and eT-NL for 13 subjects who participated in C3 was 83.16±2.13 dB SPL and 83.18±2.64 dB SPL,respectively.The intra-session(C1 vs C2)and inter-session(C2 vs C3)test-retest reliability were 2.36 dB and 2.75 dB,respectively.Pearson correlation analysis showed that intra-session(r=0.837,P＜0.001)and inter-session(r=0.867,P＜0.001)test-retest reliability was good.There was no statistical difference between aTNL and eTNL in the other TNT tests(P＞0.05 for both)except that aTNL and eTNL were statistically different in C1(P＜0.01),and more than 90％of the subjects could obtain eTNL within 1 minute.Conclusion The test-retest reliability of Mandarin tracking of noise tolerance test is good,with advantages of high reliability and efficiency.

Objective To observe the effects of Shengxue Tongbian Granules on colonic myoelectricity and Ca2+/CaM/MLCK signaling pathway in rats with slow transit constipation(STC)of blood deficiency and intestinal dryness syndrome;To explore its mechanism for the treatment of STC.Methods The STC model of blood deficiency and intestinal dryness syndrome was established by intragastric administration of loperamide combined with tail bloodletting.The rats were divided into control group,model group,mosapride citrate group and Shengxue Tongbian Granules group,with 8 rats in each group.The administration group was given corresponding drugs by gavage for 14 days.The general condition of rats before and after treatment was observed,the fecal water content was detected,the slow wave frequency,amplitude,and coefficient of variation of colonic electromyography were detected using a biological function experimental system,and intestinal propulsion rate was detected.HE staining was used to observe the pathological changes of colon tissue,the concentration of Ca2+ in colonic smooth muscle cells was detected by colorimetry,the expression of Cx43,calmodulin(CaM),myosin light chain kinase(MLCK)and p-MLC20 in smooth muscle tissue were detected by Western blot.Results Compared with the control group,the body mass,fecal water content and intestinal propulsion rate of rats in the model group decreased(P<0.01),the slow wave frequency of colonic electromyography slowed down,the coefficient of variation of frequency increased(P<0.01),and the amplitude and coefficient of variation of slow wave increased(P<0.01);colonic mucosal structure was damaged,with visible inflammatory changes and significant erosion,and the concentration of Ca2+ and the expressions of Cx43,CaM,MLCK,p-MLC20 proteins in colonic smooth muscle cells were significantly decreased(P<0.01).Compared with the model group,the body mass,fecal water content and intestinal propulsion rate of the rats in the mosapride citrate group and the Shengxue Tongbian Granules group significantly increased(P<0.05,P<0.01),the slow wave frequency of colonic electromyography increased and the coefficient of variation of frequency decreased(P<0.01),and the slow wave amplitude and amplitude variation coefficient decreased(P<0.05,P<0.01);the colonic mucosal structure was relatively intact,the erosion situation was improved,and the Ca2+ concentration,Cx43,CaM,MLCK and p-MLC20 protein expressions in colonic smooth muscle cells significantly increased(P<0.01).Conclusion Shengxue Tongbian Granules can improve defecation symptoms and promote colonic motility in STC rats with blood deficiency and intestinal dryness syndrome,which may be related to regulating colonic myoelectric rhythm and activating Ca2+/CaM/MLCK signaling pathway.

Objective:To examine the burden and trends of acute viral hepatitis in Guangdong Province from 1990 to 2019, and provide reference evidences for hepatitis prevention and control in the province.Methods:Data on acute viral hepatitis (hepatitis A, B, C, and E) in Guangdong from 1990 to 2019 were extracted from the Global Burden of Disease Study 2019 database. The incidence, prevalence, mortality, and disability-adjusted life years (DALY) data were analyzed by age and gender, and the estimated annual percentage change (EAPC) was calculated to describe the changing trends in disease burden.Results:From 1999 to 2019, the standardized incidence, prevalence, mortality, and DALY of acute viral hepatitis in Guangdong were higher than the national averages. In 2019, 51.43% (2 245 087/4 365 221) of acute viral hepatitis cases in Guangdong Province were mainly attributed to hepatitis B, and 77.18% (106/138) of deaths were due to acute hepatitis B. In different age groups, except for acute hepatitis B, which was more common in adults, the incidence rates of other types of viral hepatitis such as hepatitis A, B, and E showed an overall decreasing trend with age. The mortality rates of different types of acute viral hepatitis, except for the <5 age group, increased with age. The overall incidence and mortality rates of acute viral hepatitis were higher in men than in women.Conclusions:The overall burden of acute viral hepatitis in Guangdong declined in 2019, but remained higher than the national level. Further efforts are needed to strengthen hepatitis prevention and screening in different population in Guangdong Province, especially in children and the elderly.

Objective:To compare the immunogenicity of the prefusion (PreF) and postfusion (PostF) conformations of the respiratory syncytial virus (RSV) F protein.Methods:The expression of PreF and PostF recombinant proteins was analyzed by SDS-PAGE and Western blot. The binding affinity between F protein and its specific antibodies was detected by Octet. The binding antibodies and neutralizing antibodies in immune serum were detected after immunizing mice with PreF or PostF recombinant protein.Results:PreF protein was stable in the form of a trimer after modification with higher binding affinity with monoclonal antibodies such as D25, 8897, AM14, Palivizumab and Motavizumab. PostF protein lacked the antigenic site ? and showed a monomer conformation. Besides, it was unable to bind to D25, 8897 and AM14 antibodies. Animal experiments showed that AS01 adjuvant was better than aluminum adjuvant in inducing binding antibodies and neutralizing antibodies against RSV Long strains. The binding antibodies induced by PreF and PostF recombinant proteins had similar binding ability to PreF protein, while the binding antibodies induced by PostF recombinant protein showed stronger binding ability to PostF than to PreF.Conclusions:PreF has more epitopes and the trimer form of PreF recombinant protein after modification is more stable and can induce stronger neutralizing antibodies. Moreover, the immunopotentiating effect of AS01 adjuvant is better than that of aluminum adjuvant. Therefore, stabilization-based trimer structure modification of PreF and the development of adjuvants are crucial for the development of RSV vaccines.

Cervical cancer is the leading cause of cancer death in women in the developing countries.The treatment based on surgery,radiotherapy and chemotherapy is often accompanied by intolerable complications.Clinical practice has proved that TCM therapy has a positive effect on the complications related to the treatment of cervical cancer,but there is still a lack of scientific and standardized application reference opinions.Based on Delphi method,our research group constructed and formulated an expert consensus study on the complications related to the treatment of cervical cancer with TCM therapies,so as to provide a reference for clinical treatment of such diseases.

ObjectiveTo investigate the characteristics of electromyography (EMG) and postural stability of lower limb muscles during Y-balance test (YBT) and their relationship. MethodsFrom October to November, 2021, a total of 26 female students aged 18 to 22 years were recruited from Binzhou Medical University to complete YBT; while the EMG of rectus femoris, biceps femoris, tibialis anterior and gastrocnemius of supporting legs were collected synchronously to measure root mean square (RMS), integral electromyography (iEMG), and muscle contribution rate; and the postural stabilities were measured with three-dimensional force platform, to record total, antero-posterior (A/P) and medio-lateral (M/L) path length of center of pressure (COP). ResultsIn three directions of YBT, the RMS of rectus femoris was the most (χ² > 56.952, P < 0.001), and the iEMG and contribution rate of the tibialis anterior were the most (χ² > 38.507, P < 0.001). All the path length of COP was the shortest in the anterior (P < 0.05). In the anterior, the total path length of COP correlated with iEMG of biceps femoris (r = 0.452, P = 0.02) and gastrocnemius (r = 0.397, P = 0.045); in the postero-medial, the total path length of COP correlated with iEMG of gastrocnemius (r = 0.478, P = 0.014); and in the postero-lateral, the total path length of COP correlated with iEMG of tibialis anterior (r = 0.437, P = 0.026). ConclusionFor YBT, the activation of rectus femoris, tibialis anterior and gastrocnemius muscles of supporting legs are significant, and different with the indicators of EMG. Postural stability is the best in the posterolateral. The joint extensors or flexors play a different role for dynamic postural stability in the different directions.

Objective To establish an artificial intelligence deep learning model using clinical colonoscopy images and video to assist the diagnosis by colonoscopy. Methods More than 600000 colonoscopy images were collected in endoscopic center of the Second Affiliated Hospital of Zhejiang University School of Medicine from 2014 to 2018, and endoscopic experts recorded a large number of high-quality operation video of colonoscopy as analysis data. After repeated discussion by six experts, the classified intestinal sites and pathological features were determined, and fuzzy and confusable images were deleted. The final selection result was approximately 1 out of 4. And then the features of images were marked using an independently developed software. The deep learning algorithm was developed using TensorFlow platform of Google. Results After repeated comparison and analysis of the results of machine training and judgment results combined with pathology from endoscopic experts, the sensitivity of the model for some diseases ( such as colon polyps) was 99％ under laboratory conditions. In the clinical colonoscopy test, the sensitivity, specificity, and overall accuracy of this model for diagnosis of colon polyps were 98. 30％(4187/4259), 88. 10％ (17620/20000), and 92. 92％ [2×98. 30％×88. 10％/(98. 30％+88. 10％)], respectively. The sensitivity and specificity for ulcerative colitis were 78. 32％ ( 2671/3410) , and 67. 06％(13412/20000), respectively. The diagnosis time spent on a single image was 0. 5±0. 03 s, and it was the real time for application, including system recognition, text prompt in video image, background record and storage. Conclusion The artificial intelligence assisted diagnosis model developed by our team can identify colonic polyps, colorectal cancer, colorectal eminence, colonic diverticulum, ulcerative colitis, etc. The auxiliary diagnosis model of colon disease can guide beginners to carry out colonoscopy, and can improve lesion detection rate, reduce misdiagnosis rate, and improve the overall operating efficiency of endoscopic center, which is conducive to the quality control of colonoscopy.

Objective To investigate the CT features of pulmonary mucosa-associated lymphoid tissue (MALT)lymphoma. Methods The data of 20 cases with pathologically confirmed pulmonary MALT lymphoma were collected.All cases underwent CT plain and enhanced scan,and the CT features were analyzed retrospectively.Results Among the 20 cases,15 cases showed multiple consolidations,accompanied by mass and small nodules,1 case had solitary consolidation with multiple micronodules,2 cases had solitary consolidation,2 cases had diffuse micronodules.The sign of dilated air bronchograms was found in 10 cases with pulmonary consolidation lesions, reaching the margin of lesion.All lesions and masses were mildly and moderately homogenous enhanced.Pulmonary thin-wall cystic cavity was seen in 7 cases of diseased tissue and surrounding lung tissue.Conclusion CT manifestation of pulmonary MALT lymphoma mainly shows multiple lung consolidation,which includes the signs of consolidation with dilated air bronchograms,homogenous enhancement, and accompanying with signs such as mass,micronodules and pulmonary thin-wall cystic cavity.