Objective To explore the efficiency improvement in segmenting neural network with the application of Transformer + U-Net artificial intelligence (AI) and modeling with the application of Python scripts in three-dimensional (3D) printing brachytherapy. Methods A Transformer + U-Net AI neural network model was constructed, and Adam optimizer was used to ensure rapid gradient descent. Computed tomography or magnetic resonance imaging data of patients were standardized and processed as self-made data sets. The training set was used to train AI and the optimal result weight parameters were saved. The test set was used to evaluate the AI ability. Python programming language was used to write an automated script to obtain the output segmentation image and convert it to the STL file for import. The source applicator and needle could be automatically modeled. The time of automatic segmentation and modeling and the time of manual segmentation and modeling were entered by two people, and the difference was verified by paired t-test. Results Dice similarity coefficient (DSC), mean intersection over union (MIOU), and Hausdorff distance (HD95) were used for evaluation. DSC was 0.9341, MIOU was 0.8762, and mean HD95 was 2.516. The mean time of manual segmentation was 1187 s, and the mean time of AI segmentation was 145 s (P < 0.01). The mean time of manual modeling was 321 s, and the mean time of modeling with Python automated scripts was 18 s (P < 0.01). Conclusion The application of Transformer + U-Net automatic segmentation and Python automated scripts can effectively improve work efficiency in the 3D printing brachytherapy for cervical cancer.

Objective To explore the short-term efficacy and safety of AngioJet mechanical thrombus removal,large lumen cathe-ter thrombus aspiration,and simple catheter-directed thrombolysis(CDT)for the treatment of acute deep venous thrombosis(DVT)of lower extremity.Methods A total of 75 patients with acute lower extremity DVT received interventional therapy were analyzed retrospectively,including 22 patients in AngioJet mechanical thrombus removal(group A),32 patients in large lumen catheter thrombus aspiration(group B),and 21 patients in simple CDT(group C).The short-term efficacy,health economics index,laboratory index and complications of the three groups were compared.Results The success rate of the three groups was 100％.Group A had superior thrombus clearance rates,lower dosages of urokinase,shorter thrombolysis durations,and shorter hospital stays compared to groups B and C.However,the hospitalization costs in group A were significantly higher than those in groups B and C,with statistically significant differences(P＜0.05).No significant renal dysfunction and severe complications were observed in the three groups.Post-operative creatinine levels in group A were higher than those in groups B and C,with statistically significant differences(P＜0.05).Both groups A and B experienced significant decreases in hematocrit postoperatively,and the absolute decrease and percentage decrease in hematocrit in group A were significantly greater than those in group C,with statistically significant differences(P＜0.05).Conclusion Compared to large lumen catheter thrombus aspiration and simple CDT treatment,AngioJet mechanical thrombus removal demonstrates higher efficiency in thrombus clearance rate but is associated with higher costs and risks of renal dysfunction.Postoperative care should focus on protecting renal function.

Objective:To analyze the correlation between the recovery of postoperative function of hip joint in patient underwent total hip arthroplasty(THA)and anatomical parameters of femur under computed tomography(CT)three-dimensional(3D)reconstruction.Methods:From January 2022 to October 2024,a total of 120 THA patients were treated at the 904th Hospital of People's Liberation Army Joint Service Support Force were selected.At the third month post-surgery,the Harris Hip Score(HHS)system was used to assess the recovery of the function of hip joint of THA patients,and they were divided into favorable recovery group(72 cases,HHS score≥80)and poor recovery group(48 cases,HHS score<80).The femoral offset(FO),collodiaphyseal angle(CDA),and femoral neck anteversion(FNA)in anatomical parameters of femur under CT CD reconstruction for patients of two groups after surgery were measured and compared.The correlation between each parameter and the recovery of postoperative function of hip joint in THA patients was analyzed.The receiver operating characteristic(ROC)curve was plotted to analyze the assessment value of each parameter for the recovery of the function of hip joints in THA patients.Results:In the follow-up at the third month,120 patients were assessed by using the HHS scoring system.The recovery of 72 patients(60.00%)was favorable,with an average HHS score of 84.45±5.19.The recovery of 48 patients(40.00%)was poor,with an average HHS score of 73.31±4.78.Postoperative CDA and FO scores were higher than preoperative values,while FNA scores were lower than preoperative value in 120 patients.After surgery,the CDA and FO scores of favorable recovery group were lower than those of poor recovery group,and FNA was higher than that of favorable group,and the differences between the two groups were statistically significant(t=7.938,9.574,10.391,P<0.05).Pearson correlation coefficient test showed that postoperative function(HHS score)of hip joint negatively correlated with FNA in THA patients(r=-0.511,P<0.05),and it positively correlated with CDA and FO(r=0.408,0.359,P<0.05).ROC curve analysis indicated that the area under curve(AUC)values of ROC curves of single CDA,FO,FNA and the combined detection of them were respectively 0.761,0.855,and 0.827 in assessing the poor recovery of the function of hip joint,which had a certain of assessment values.The combined detection can improve the diagnostic value.Conclusion:The postoperative recovery of the function of hip joint of THA patients relates to CDA,FO and FNA parameters,and the single and combined detections of each parameter all have a certain of assessment value for the poor recovery of joints'function of patients.

Objective To explore the short-term efficacy and safety of AngioJet mechanical thrombus removal,large lumen cathe-ter thrombus aspiration,and simple catheter-directed thrombolysis(CDT)for the treatment of acute deep venous thrombosis(DVT)of lower extremity.Methods A total of 75 patients with acute lower extremity DVT received interventional therapy were analyzed retrospectively,including 22 patients in AngioJet mechanical thrombus removal(group A),32 patients in large lumen catheter thrombus aspiration(group B),and 21 patients in simple CDT(group C).The short-term efficacy,health economics index,laboratory index and complications of the three groups were compared.Results The success rate of the three groups was 100％.Group A had superior thrombus clearance rates,lower dosages of urokinase,shorter thrombolysis durations,and shorter hospital stays compared to groups B and C.However,the hospitalization costs in group A were significantly higher than those in groups B and C,with statistically significant differences(P＜0.05).No significant renal dysfunction and severe complications were observed in the three groups.Post-operative creatinine levels in group A were higher than those in groups B and C,with statistically significant differences(P＜0.05).Both groups A and B experienced significant decreases in hematocrit postoperatively,and the absolute decrease and percentage decrease in hematocrit in group A were significantly greater than those in group C,with statistically significant differences(P＜0.05).Conclusion Compared to large lumen catheter thrombus aspiration and simple CDT treatment,AngioJet mechanical thrombus removal demonstrates higher efficiency in thrombus clearance rate but is associated with higher costs and risks of renal dysfunction.Postoperative care should focus on protecting renal function.

Objective:To analyze the correlation between the recovery of postoperative function of hip joint in patient underwent total hip arthroplasty(THA)and anatomical parameters of femur under computed tomography(CT)three-dimensional(3D)reconstruction.Methods:From January 2022 to October 2024,a total of 120 THA patients were treated at the 904th Hospital of People's Liberation Army Joint Service Support Force were selected.At the third month post-surgery,the Harris Hip Score(HHS)system was used to assess the recovery of the function of hip joint of THA patients,and they were divided into favorable recovery group(72 cases,HHS score≥80)and poor recovery group(48 cases,HHS score<80).The femoral offset(FO),collodiaphyseal angle(CDA),and femoral neck anteversion(FNA)in anatomical parameters of femur under CT CD reconstruction for patients of two groups after surgery were measured and compared.The correlation between each parameter and the recovery of postoperative function of hip joint in THA patients was analyzed.The receiver operating characteristic(ROC)curve was plotted to analyze the assessment value of each parameter for the recovery of the function of hip joints in THA patients.Results:In the follow-up at the third month,120 patients were assessed by using the HHS scoring system.The recovery of 72 patients(60.00%)was favorable,with an average HHS score of 84.45±5.19.The recovery of 48 patients(40.00%)was poor,with an average HHS score of 73.31±4.78.Postoperative CDA and FO scores were higher than preoperative values,while FNA scores were lower than preoperative value in 120 patients.After surgery,the CDA and FO scores of favorable recovery group were lower than those of poor recovery group,and FNA was higher than that of favorable group,and the differences between the two groups were statistically significant(t=7.938,9.574,10.391,P<0.05).Pearson correlation coefficient test showed that postoperative function(HHS score)of hip joint negatively correlated with FNA in THA patients(r=-0.511,P<0.05),and it positively correlated with CDA and FO(r=0.408,0.359,P<0.05).ROC curve analysis indicated that the area under curve(AUC)values of ROC curves of single CDA,FO,FNA and the combined detection of them were respectively 0.761,0.855,and 0.827 in assessing the poor recovery of the function of hip joint,which had a certain of assessment values.The combined detection can improve the diagnostic value.Conclusion:The postoperative recovery of the function of hip joint of THA patients relates to CDA,FO and FNA parameters,and the single and combined detections of each parameter all have a certain of assessment value for the poor recovery of joints'function of patients.

Objective To discuss the clinical efficacy and safety of hepatic arterial infusion chemotherapy(HAIC)combined with carrelizumab and sorafenib in treating advanced hepatocellular carcinoma(HCC).Methods The clinical data of 36 HCC patients,who were admitted to the Affiliated Nantong Third Hospital of Nantong University of China to receive HAIC combined with carrelizumab and sorafenib from August 2019 to August 2020,were collected.According to modified Response Evaluation Criteria in Solid Tumors(mRECIST),the objective response rate(ORR)and disease control rate(DCR)of the combination therapy were evaluated.The Common Terminology Criteria Adverse Events Version 5.0 developed by American National Cancer Institute was used to evaluate the clinical safety.Results After receiving 4 cycles of FOLFOX-HAIC,the ORR and DCR of the patients were 38.9％and 77.8％respectively.The patients were followed up for 30 months.The median progression-free survival(mPFS)was 306 days(95％CI:242.7-369.3),and the median overall survival(mOS)was 515 days(95％CI:2 482.5-547.5).After HAIC treatment,one patient was successfully changed to surgical operation.The overall incidence of adverse events were 100％.There were 9 adverse events(25％)above grade m,including severe abdominal pain(n=2,5.6％),nausea(n=1,2.8％),vomiting(n=1,2.8％),elevated alanine aminotransferase(n=3,8.3％),elevated aspartate aminotransferase(n=1,2.8％),and death due to pulmonary failure caused by severe immune-induced pneumonia(n=1,2.8％).Conclusion For the treatment of advanced HCC,HAIC combined with carrelizumab and sorafenib has better ORR and DCR with controllable safety,which provides a new option for the treatment of advanced HCC.However,studies with large sample size need to be conducted before its long-term survival benefit of patients can be further validated.

Objective:To investigate the effects of orlistat on the viability of human gall-bladder cancer (GBC) cells.Methods:The experimental study was conducted. The human GBC NOZ cells with high expression of FSAN was screened out through in vitro cultivating human GBC-SD, SGC-996 and NOZ cells. The cell proliferation assay, clone formation assay and protein detection experiment were used to analysis of the effects of orlistat on the viability of human GBC cells. Cell grouping: NOZ cells cultured with medium were set as the control group, cultured with medium + 10 μmol/L orlistat were set as the low-dose orlistat group, cultured with medium + 100 μmol/L orlistat were set as the high-dose orlistat group, respectively. Observation indicators: (1) expression of FASN protein in human GBC cells; (2) effects of orlistat on the proliferation of human GBC NOZ cells; (3) effects of orlistat on apoptosis of human GBC NOZ cells. Measurement data with normal distribution were represented as Mean± SD, the ANOVA test was used for comparison between groups and the least significant difference method was used for pairwise comparison. Results:(1) Expression of FASN protein in human GBC cells. Results of western blot showed that the relative expression of FASN protein in human GBC NOZ, GBC-SD and SGC-996 cells was 0.57±0.06, 0.12±0.04 and 0.10±0.02, respectively, showing a significant difference among them ( F=115.67, P<0.05). There were significant differences between the NOZ cells and the GBC-SD or the SGC-996 cells ( P<0.05), and there was no significant difference between the GBC-SD cells and the SGC-996 cells ( P>0.05). (2) Effects of orlistat on the proliferation of human GBC NOZ cells. ① Results of cell proliferation assay showed that the absorbance value of NOZ cells was 2.34±0.12, 1.57±0.08 and 1.07±0.13 in the control group, low-dose orlistat group and high-dose orlistat group, respectively, showing a significant difference among them ( F=205.88, P<0.05). ② Results of clone formation assay showed that the number of NOZ cells clones was 257±23, 153±11 and 83±11 in the control group, low-dose orlistat group and high-dose orlistat group, respectively, showing a significant difference among them ( F=92.64, P<0.05). ③Results of western blot showed that the relative expression of Cyclin-D1 protein of NOZ cells was 2.31±0.10, 1.52±0.05 and 1.23±0.11 in the control group, low-dose orlistat group and high-dose orlistat group, respectively, showing a significant difference among them ( F=120.73, P<0.05). The relative expression of CDK-4 protein of NOZ cells was 1.58±0.04, 1.21±0.02 and 1.19±0.04 in the control group, low-dose orlistat group and high-dose orlistat group, respectively, showing a signifi-cant difference among them ( F=110.45, P<0.05). (3) Effects of orlistat on apoptosis of human GBC NOZ cells. Results of western blot showed that the relative expression of Bcl-2 protein of NOZ cells was 1.07±0.03, 0.36±0.03 and 0.15±0.02 in the control group, low-dose orlistat group and high-dose orlistat group, respectively, showing a significant difference among them ( F=1 242.93, P<0.05). The relative expression of Bax protein of NOZ cells was 0.51±0.03, 0.38±0.05 and 1.38±0.04 in the control group, low-dose orlistat group and high-dose orlistat group, respectively, showing a signifi-cant difference among them ( F=583.51, P<0.05). Conclusion:Orlistat can inhibit the growth of human GBC NOZ cells and promote their apoptosis.

Objective:To investigate the changes and clinical significance of multiple cytokine levels in exhaled breath condensate (EBC) in patients undergoing tracheotomy with severe inhalation injury.Methods:A prospective study was conducted. A total of 32 patients with severe burn combined with severe inhalation injury admitted to the department of burns and plastic surgery of Affiliated Suzhou Hospital of Nanjing Medical University from May 2021 to August 2022 were enrolled. Twenty healthy volunteers from the same period were served as controls. EBC of patients at 12 hours after burn and the samples of healthy controls were collected. The levels of 27 cytokines in EBC, including tumor necrosis factor-α (TNF-α) and interleukins (IL-1β, IL-6, IL-8, IL-10, and IL-17), were determined by liquid phase chip technology. Meanwhile, plasma of patients at 12 hours after burn and the plasma of volunteers were collected, and the levels of inflammatory cytokines were detected by liquid chip technology, and the differences between the levels in plasma and those in EBC were analyzed. Plasma and EBC of patients with aspiration injury were collected at 12 hours and 3, 7, 14 and 21 days after burn, and TNF-α levels were determined by enzyme-linked immunosorbent assay (ELISA).Results:Finally, 32 patients were enrolled, and the total burned area was (40±16)% of total body surface area (TBSA). The time of admission was (4.2±2.3) hours after injury. ① Twenty-seven cytokines in EBC: 18 kinds of cytokines including macrophage inflammatory protein-1β (MIP-1β), IL-6, IL-5, IL-2, IL-1β, IL-8, IL-10, IL-15, IL-9, interferon-γ (IFN-γ), IL-1 receptor antagonist (IL-1ra), TNF-α, chemotactic factor for eosinophil (Eotaxin), basic fibroblast growth factor (bFGF), platelet derived growth factor-BB (PDGF-BB), interferon-inducible protein-10 (IP-10), monocyte chemoattractant protein-1 (MCP-1), granulocyte colony-stimulating factor (G-CSF) were significantly increased in patients with severe aspiration injury compared with health controls. Eotaxin was not detected in EBC of healthy controls. Five cytokines, granulocyte-macrophage colony-stimulating factor (GM-CSF), chemokine ligand 5 (CCL5/RANTES), IL-13, IL-4 and MIP-1α, were not detected in EBC of severe inhalation injury patients and healthy controls. Vascular endothelial growth factor (VEGF) and IL-12 p70 in EBC of severe aspiration injury patients were slightly decreased as compared with healthy controls, while IL-7 and IL-17 were slightly increased, but the differences were not statistically significant. ② Six inflammatory cytokines in plasma: the levels of IL-6 and IL-8 in the severe aspiration injury group were significantly increased as compared with healthy controls [IL-6 (ng/L): 18.51 (10.87, 26.21) vs. 0.22 (0.10, 0.36), IL-8 (ng/L): 10.75 (8.58, 18.79) vs. 1.06 (0.81, 2.14), both P < 0.01]. The plasma levels of TNF-α, IL-1β and IL-10 were slightly increased in patients with severe aspiration injury as compared with healthy controls, and IL-17 was slightly decreased, but the difference was not statistically significant. In the EBC collected during the same period, five inflammatory cytokines, including TNF-α, IL-1β, IL-6, IL-8 and IL-10, in patients with severe inhalation injury were significantly increased as compared with healthy controls [TNF-α (ng/L): 16.42 (12.57, 19.21) vs. 7.34 (6.11, 8.69), IL-1β (ng/L): 15.57 (10.53, 20.25) vs. 0.99 (0.67, 1.41), IL-6 (ng/L): 13.36 (9.76, 16.54) vs. 0.70 (0.42, 0.85), IL-8 (ng/L): 1 059.29 (906.91, 1 462.37) vs. 10.36 (8.40, 12.37), IL-10 (ng/L): 2.69 (1.54, 3.33) vs. 1.54 (1.18, 2.06), all P < 0.05]. ③ Dynamic changes of TNF-α in plasma and EBC: the level of TNF-α in EBC of patients with severe aspiration injury was lower than that in plasma. Plasma TNF-α level was increased gradually with the extension of time after injury, and was significantly higher than that of healthy controls on day 3 [ng/L: 30.38 (24.32, 39.19) vs. 22.94 (17.15, 30.74), P < 0.05], and reached the peak on day 14, then fell back. The level of TNF-α in EBC at 12 hours after injury was significantly higher than that in healthy controls [ng/L: 15.34 (11.75, 18.14) vs. 6.99 (6.53, 7.84), P < 0.01], and reached the peak on 3 days after injury, and then gradually decreased. Conclusion:There are changes in the expression of multiple cytokines in EBC of patients with severe inhalation injury, and the changes of many inflammatory cytokines including TNF-α are more sensitive than those in plasma, which can be used to monitor and evaluate the condition of patients with inhalation injury.

Health care workers have higher risk of influenza infection because of their occupational exposure to infected patients. Infection of the health care workers may not only result in the increasing risk of the nosocomial infection and family transmission, but also disrupt the health services due to absence from work. Health care workers were recommended as a priority group of influenza vaccinationin more than 40 countries and regions in the world. In recent years, domestic surveys show that the influenza vaccine coverage among health care workers was low. This paper outlines the current status and related policies of influenza vaccination among health care workers in China and global. Additionally, we analyzed and discussed the proper immunization strategy of influenza vaccine for medical staff in China.

Health care workers have higher risk of influenza infection because of their occupational exposure to infected patients. Infection of the health care workers may not only result in the increasing risk of the nosocomial infection and family transmission, but also disrupt the health services due to absence from work. Health care workers were recommended as a priority group of influenza vaccinationin more than 40 countries and regions in the world. In recent years, domestic surveys show that the influenza vaccine coverage among health care workers was low. This paper outlines the current status and related policies of influenza vaccination among health care workers in China and global. Additionally, we analyzed and discussed the proper immunization strategy of influenza vaccine for medical staff in China.