Objective:To develop and validate a deep learning-based multimodal model integrating clinical and radiomic features for predicting acute kidney injury（AKI）risk after partial nephrectomy.Methods:A retrospective analysis was conducted on 416 patients who underwent partial nephrectomy at Zhongshan Hospital，Fudan University from January 2023 to January 2025. The cohort included 100 AKI patients［defined by a ≥ 25% reduction in postoperative evaluated glomerular filtration rate（eGFR）within 48 hours sustained for >24 hours］and 316 non-AKI patients（1∶3 ratio，randomly matched with 16 additional cases for redundancy）. Clinical and radiomic features were extracted from preoperative contrast-enhanced CT scans using PyRadiomics. Demographics included 259 males and 158 females，with a median age of 57（49，65）years，body mass index of（24.1 ± 3.3）kg/m2，preoperative eGFR of（88.5 ± 18.3）ml/（min·1.73 m2），postoperative eGFR（48-hour）of（76.0 ± 21.9）ml/（min·1.73 m2），Zhongshan Score（ZSscore）of 7.34 ± 2.01，and R.E.N.A.L. score of 7.50 ± 1.71. All tumors were T 1a stage. Patients were divided into training（n = 312）and test（n = 104）sets（3∶1 ratio）. A clinical model was constructed via multivariate logistic regression，while radiomic and combined（clinical + radiomic）models utilized an artificial neural network（ANN）with 1 input layer，5 hidden layers，1 output layer，and 10 5 training epochs. Model performance was evaluated by using receiver operating characteristic（ROC）curves and area under the curve（AUC），and was compared to the Martini model. Feature contributions were interpreted via SHapley Additive exPlanations（SHAP）. Results:In the test set，the results of multivariate logistic regression showed that patient’s weight，preoperative eGFR，R.E.N.A.L. score，surgical approach，and operation time were risk factors for AKI（ P < 0.05）. The AUC of the clinical feature prediction model constructed based on the above factors was 0.852（95% CI 0.775?0.929）. In the test set，the AUC of the Martini model was 0.725（95% CI 0.565?0.791）. The radiomic model，trained on 1 315 imaging features，achieved an AUC of 0.898（95% CI 0.804?0.993）with 94.2%（98/104）accuracy. The combined clinical and radiomic model，integrating 1 315 radiomic features and clinical features，demonstrated superior performance with an AUC of 0.946（95% CI 0.887?1.000）and 96.2%（100/104）accuracy，outperforming both the clinical model（ P = 0.03）and the Martini model（ P < 0.01）. SHAP analysis identified the top five predictors in the combined model：ZSscore（SHAP value：0.78），long-run low gray-level emphasis（SHAP value：0.61），run-length non-uniformity（SHAP value：0.58），size-zone non-uniformity（SHAP value：0.46），and gray-level co-occurrence matrix joint energy（SHAP value：0.36）. Conclusions:The deep learning-based multimodal model integrating clinical and radiomic features accurately predicts AKI risk after partial nephrectomy，offering a novel strategy for preoperative risk stratification and personalized intervention.

Objective To evaluate the efficacy of elastic appliances in the early correction of Class Ⅱmalocclusions in the replacement dentition.Methods A total of 15 children aged 7-9 years who were admit-ted to the Affiliated Stomatology Hospital of Southwest Medical University from June 2018 to August 2023 were selected as the observation group,and 15 children who were consulted but not treated in the hospital dur-ing the same period were selected as the control group.The changes of bone tissue,dental and alveolar tissue,soft tissue and occlusal relationship before and after treatment were evaluated in the two groups.In addition,X-ray images of the observation group were collected every 8 to 10 months for the whole process dynamic mo-nitoring.Results Before treatment,there was no significant difference in all indexes between the two groups(P＞0.05).After treatment,there were statistical significances in the upper and lower alveolar base Angle(ANB),mandibular branch length(GO-CO),mandibular height(ANS-Me),mandibular position(S-GO),up-per central incisor inclination(U1-NA Angle),upper central incisor inclination convexity(U1-NA),lower central incisor process distance(L1-APo),the Z Angle and FH-N'Pg'Angle of soft tissue between the two groups(P＜0.05).After treatment,the covering OB and covering OJ in the observation group were lower than those in the control group,and the proportion of ClassⅠ patients in molar relationship was higher than that in the control group,with statistical significance(P＜0.05).After 3-4 years of treatment,ANB gradual-ly decreased,and the anterior-basilar plane-mandibular plane Angle(SN-MP)remained basically stable,and had a slight decreasing trend in the later period.The U1-NA Angle and the lower central incisor inclination(L1-NB Angle)were close to the normal mean during the whole treatment.Conclusion Using elastic appli-ances to treat patients with early replacement Class Ⅱ malocclusion,after 3-4 years monitoring and guid-ance,it can effectively improve the molar relationship,promote forward jaw growth,and create a harmonious and aesthetically pleasing facial soft tissue.

Objective:To explore the effect of the forward moving pelvic floor exercise program in urinary incontinence management among patients undergoing radical prostatectomy.Methods:From June 2022 to January 2024, 150 patients undergoing radical prostatectomy of the Urology Surgery Department, the First Affiliated Hospital of Zhengzhou University were selected using convenience sampling. Patients were randomly divided into an observation group and a control group, with 75 cases in each group. Control group received conventional perioperative management for prostate cancer, while observation group implemented a forward moving pelvic floor exercise program in addition to conventional management. The incidence of urinary incontinence, urinary control capabilities before and after intervention (including maximum urinary flow rate, average urinary flow rate, voided urine volume, and residual urine volume), and quality of life scores [evaluated using the Chinese version of the Incontinence Quality of Life Questionnaire (I-QOL) ] were compared between two groups of patients.Results:The incidence of urinary incontinence of observation group was lower than that of control group. Furthermore, patients with urinary incontinence in observation group exhibited significantly lower urine leakage volume and fewer episodes of urinary incontinence over 24 hours at one month postoperatively compared to control group, with statistically significant differences ( P<0.05). There were no statistically significant differences in maximum urinary flow rate, average urinary flow rate, voided urine volume, or residual urine volume between the two groups before intervention ( P>0.05). Following intervention, both groups demonstrated increased maximum urinary flow rate, average urinary flow rate, and voided urine volume compared to baseline, with observation group exhibiting higher values than control group ( P<0.05), and residual urine volume of both groups decreased compared to baseline, with observation group showing lower values than control group, these differences were statistically significant ( P<0.05). The difference in I-QOL scores between the two groups before intervention was not statistically significant ( P>0.05). Following intervention, I-QOL scores decreased in both groups, but observation group had higher score than control group, and the difference was statistically significant ( P<0.05) . Conclusions:The forward moving pelvic floor exercise program effectively reduces the incidence of urinary incontinence in patients undergoing radical prostatectomy, alleviates the severity of incontinence, and improves both urodynamic outcomes and quality of life.

Objective:To explore the effect of the forward moving pelvic floor exercise program in urinary incontinence management among patients undergoing radical prostatectomy.Methods:From June 2022 to January 2024, 150 patients undergoing radical prostatectomy of the Urology Surgery Department, the First Affiliated Hospital of Zhengzhou University were selected using convenience sampling. Patients were randomly divided into an observation group and a control group, with 75 cases in each group. Control group received conventional perioperative management for prostate cancer, while observation group implemented a forward moving pelvic floor exercise program in addition to conventional management. The incidence of urinary incontinence, urinary control capabilities before and after intervention (including maximum urinary flow rate, average urinary flow rate, voided urine volume, and residual urine volume), and quality of life scores [evaluated using the Chinese version of the Incontinence Quality of Life Questionnaire (I-QOL) ] were compared between two groups of patients.Results:The incidence of urinary incontinence of observation group was lower than that of control group. Furthermore, patients with urinary incontinence in observation group exhibited significantly lower urine leakage volume and fewer episodes of urinary incontinence over 24 hours at one month postoperatively compared to control group, with statistically significant differences ( P<0.05). There were no statistically significant differences in maximum urinary flow rate, average urinary flow rate, voided urine volume, or residual urine volume between the two groups before intervention ( P>0.05). Following intervention, both groups demonstrated increased maximum urinary flow rate, average urinary flow rate, and voided urine volume compared to baseline, with observation group exhibiting higher values than control group ( P<0.05), and residual urine volume of both groups decreased compared to baseline, with observation group showing lower values than control group, these differences were statistically significant ( P<0.05). The difference in I-QOL scores between the two groups before intervention was not statistically significant ( P>0.05). Following intervention, I-QOL scores decreased in both groups, but observation group had higher score than control group, and the difference was statistically significant ( P<0.05) . Conclusions:The forward moving pelvic floor exercise program effectively reduces the incidence of urinary incontinence in patients undergoing radical prostatectomy, alleviates the severity of incontinence, and improves both urodynamic outcomes and quality of life.

Objective:To develop and validate a deep learning-based multimodal model integrating clinical and radiomic features for predicting acute kidney injury（AKI）risk after partial nephrectomy.Methods:A retrospective analysis was conducted on 416 patients who underwent partial nephrectomy at Zhongshan Hospital，Fudan University from January 2023 to January 2025. The cohort included 100 AKI patients［defined by a ≥ 25% reduction in postoperative evaluated glomerular filtration rate（eGFR）within 48 hours sustained for >24 hours］and 316 non-AKI patients（1∶3 ratio，randomly matched with 16 additional cases for redundancy）. Clinical and radiomic features were extracted from preoperative contrast-enhanced CT scans using PyRadiomics. Demographics included 259 males and 158 females，with a median age of 57（49，65）years，body mass index of（24.1 ± 3.3）kg/m2，preoperative eGFR of（88.5 ± 18.3）ml/（min·1.73 m2），postoperative eGFR（48-hour）of（76.0 ± 21.9）ml/（min·1.73 m2），Zhongshan Score（ZSscore）of 7.34 ± 2.01，and R.E.N.A.L. score of 7.50 ± 1.71. All tumors were T 1a stage. Patients were divided into training（n = 312）and test（n = 104）sets（3∶1 ratio）. A clinical model was constructed via multivariate logistic regression，while radiomic and combined（clinical + radiomic）models utilized an artificial neural network（ANN）with 1 input layer，5 hidden layers，1 output layer，and 10 5 training epochs. Model performance was evaluated by using receiver operating characteristic（ROC）curves and area under the curve（AUC），and was compared to the Martini model. Feature contributions were interpreted via SHapley Additive exPlanations（SHAP）. Results:In the test set，the results of multivariate logistic regression showed that patient’s weight，preoperative eGFR，R.E.N.A.L. score，surgical approach，and operation time were risk factors for AKI（ P < 0.05）. The AUC of the clinical feature prediction model constructed based on the above factors was 0.852（95% CI 0.775?0.929）. In the test set，the AUC of the Martini model was 0.725（95% CI 0.565?0.791）. The radiomic model，trained on 1 315 imaging features，achieved an AUC of 0.898（95% CI 0.804?0.993）with 94.2%（98/104）accuracy. The combined clinical and radiomic model，integrating 1 315 radiomic features and clinical features，demonstrated superior performance with an AUC of 0.946（95% CI 0.887?1.000）and 96.2%（100/104）accuracy，outperforming both the clinical model（ P = 0.03）and the Martini model（ P < 0.01）. SHAP analysis identified the top five predictors in the combined model：ZSscore（SHAP value：0.78），long-run low gray-level emphasis（SHAP value：0.61），run-length non-uniformity（SHAP value：0.58），size-zone non-uniformity（SHAP value：0.46），and gray-level co-occurrence matrix joint energy（SHAP value：0.36）. Conclusions:The deep learning-based multimodal model integrating clinical and radiomic features accurately predicts AKI risk after partial nephrectomy，offering a novel strategy for preoperative risk stratification and personalized intervention.

Porcine epidemic diarrhea virus(PEDV)is a highly pathogenic porcine enteric coronavir-us.Porcine epidemic diarrhea(PED)caused by this virus has become widespread around the world since it was reported in the 1970s,caused huge harm to the global breeding industry.The viral structural protein is crucial for invasion,replication,and evasion of natural immunity.The non-structural protein has diverse functions including inhibiting host cell gene expression and counter-acting the host antiviral response.Additionally,the auxiliary protein is essential for virus replica-tion,virulence regulation,and immune evasion.This article focuses on elucidating the genome structure of PEDV and the key roles of its encoded proteins in virus replication and interaction with host cells,offering insights into its pathogenic mechanisms.

Porcine epidemic diarrhea virus(PEDV)is a highly pathogenic porcine enteric coronavir-us.Porcine epidemic diarrhea(PED)caused by this virus has become widespread around the world since it was reported in the 1970s,caused huge harm to the global breeding industry.The viral structural protein is crucial for invasion,replication,and evasion of natural immunity.The non-structural protein has diverse functions including inhibiting host cell gene expression and counter-acting the host antiviral response.Additionally,the auxiliary protein is essential for virus replica-tion,virulence regulation,and immune evasion.This article focuses on elucidating the genome structure of PEDV and the key roles of its encoded proteins in virus replication and interaction with host cells,offering insights into its pathogenic mechanisms.

Objective: This paper discusses a surgical method to improve the middle part of face and the temporal surface by using the patented technology of embedding guidance technology. Methods: On the basis of not removing the skin, the application of embedding guidance technology was applied to achieve the effect of facial lifting by placing a 2-0 polyester knitting line under the scalp with a minimally invasive incision(3-5 mm) , paving up to the skull periosteum and down to the hairline edge for compound fixation. Results: Among the 200 patients, 197 were female and 3 were male. Aging from 23-62 years old, all of the patients suffered from mild to moderate problem of saggy skin.Post-operation follow-up was kept from 3 months to 5 years after the treatment, which demonstrated that all of the patients showed different degrees of facial lifting after edema subsided at 3 months, including improvedfacial skin condition, shallower nasolabial groove, lifting of the lateral canthus and tightening of facial skin. The patients were satisfied with the effect. Conclusions The surgical method is an effective method to solve the problem of facial aging with advantages, such as simple execution, minimized wound, fast recovery, no post-operation bandage requirement and showing great result towards patients suffering from mild and moderate saggy facial skin problem.

OBJECTIVE:To analyze the research and development (R&D) of orphan drug in China from the respect of economics,and to provide suggestions for the development and policy formulation of orphan drug in China.METHODS:The theories of external economy and transaction costs were adopted to analyze the reasons about no enthusiasm in orphan drug R&D,and find some appropriate solutions for them.RESULTS:Orphan drug was still lack of identification standard in China.The extemal economy,much of transaction costs in orphan drug and R&D risk aggravated the economic burden on pharmaceutical enterprises,combated R&D and production enthusiasm of pharmaceutical enterprises.CONCLUSIONS:Chinese pharmaceutical enterprises can take part in orphan drug cooperative R&D,and play the advantage of TCM treatment so as to reduce R&D cost.The government should establish and develop orphan drug system,play the role of taxation and health insurance,accelerate approval,give market exclusivity for pharmaceutical enterprises and encourage cooperative R&D.

Objective: To investigate the therapeuctic effect of one-stage reconstruction of distal urethra with free graft of tublar oral mucosa. Methods: Two strips of oral mucosa graft( 0.4—0.6 cm in width), were harvested and sutured around an oiled silk roll to form mucosa tube. The mucosa tube was used to reconstruct distal urethra. Postoperative pressure dressing and earlier urination were recommended. Results: From May 2007 to October 2015, 16 cases with distal urethra defect or stenosis were treated with this method. The urethra defect was 2—4 cm in length. Urethral fistula happened in 3 patients. All the other 13 cases healed primarily. 10 cases were followed up for 1—5 years by telephone with normal function. Conclusions One-stage reconstruction with free graft of bulbar oral mucosa is suitable and reliable for distal urethra defect less than 4 cm in length.