Objective To evaluate the performance of lightweight Chinese large language models (LLMs) in answering specialized lung cancer questions, and to explore the impact of retrieval-augmented generation (RAG) on model performance. Methods Eleven lightweight Chinese LLMs with parameter sizes ranging from 7B to 32B were included. A lung cancer-specific evaluation dataset consisting of 200 questions [100 A1-type (basic knowledge) and 100 A2-type (clinical case) questions], constructed based on clinical guidelines and thoracic surgery textbooks, was used for assessment. Model performance was evaluated under two conditions (with and without RAG). Accuracy was used to assess model performance, and response latency was recorded to reflect inference efficiency. An accuracy–latency scatter plot was constructed for descriptive analysis of overall model performance. Results All models successfully completed the evaluation. With the introduction of RAG, the overall average accuracy improved from 61.68% to 76.36%. Smaller models demonstrated the most significant improvement (e.g., the accuracy of DeepSeek-7B increased from 32.50% to 60.00%, P<0.001). The average response latency increased from 12.58 s to 13.80 s. The Qwen3 series showed the best overall performance, and Qwen3-32B achieved the highest accuracy under both conditions (76.50% and 84.00%, respectively). After RAG integration, performance differences among model families were markedly reduced. Based on the accuracy-latency trade-off, Qwen3-32B achieved the best balance between accuracy and response latency under the baseline condition, whereas Qwen3-14B demonstrated superior overall performance in terms of accuracy, latency, and computational cost after RAG integration. Conclusion The integration of RAG technology improves the ability of lightweight Chinese LLMs to answer specialized lung cancer questions. Under the dual practical constraints of limited computational resources and medical data security requirements, the "lightweight model+RAG" technical framework may represent a promising deployment solution.

Objective:To evaluate the association between heatwaves and fall-related mortality.Methods:A total of 61 421 fall-related mortality from 2013 to 2022 in 7 provinces of China were included in a time-stratified case-crossover design, with daily meteorological data derived from the fifth generation European Reanalysis dataset produced by the European Centre for Medium-Range Weather Forecasts. Conditional logistic regression chimeric distributed lag nonlinear model was used to analyze the association between heatwaves and fall-related mortality and stratified analysis was conducted according to gender and age.Results:Heatwaves were associated with an increased risk of fall-related morality. The risk of fall-related mortality during heatwaves was higher than during non-heatwave periods ( OR=1.11, 95% CI: 1.05-1.18). The attributable fraction of fall-related motality due to heatwaves was 10.25% (95% CI: 4.49%-15.36%). For each 1 ℃ increase above the heatwave threshold, the risk of fall-related mortality increased by 34% ( OR=1.34, 95% CI: 1.02-1.76). The effect of heatwave duration on fall-related mortality was not statistically significant. Stratified analyses indicated that women experienced a higher risk of fall-related mortality during heatwaves ( OR=1.13, 95% CI: 1.04-1.22) compared to man ( OR=1.10, 95% CI: 1.04-1.17). Conclusions:Heatwave increases the risk of fall-related mortality, and the intensity of heatwaves modify this risk. Women are vulnerable populations.

Objective: To investigate the clinical efficacy of oral microscope-assisted microflap periodontal bone grafting in treating class Ⅱ furcation involvement in mandibular molars, and to provide clinical evidence for its treatment in furcation involvement. Methods: This study was reviewed and approved by the institutional ethics committee, and informed consent was obtained from all patients. Sixty mandibular molars with class II furcation involvement caused by periodontitis were enrolled in a randomized controlled clinical study, utilizing a random number table method. Patients were categorized into a control group (n=30) and an experimental group (n=30) based on the surgical procedure employed. The control group underwent periodontal flap surgery with an internal oblique incision and vertical incision; this procedure was performed without the aid of a microscope. Conversely, the experimental group underwent micro flap periodontal bone grafting surgery without vertical incision; an oral microscope was used for this procedure. Both groups were analyzed 6 months after surgery, and postoperative gingival recession (GR), probing depth (PD), bleeding index (BI), vertical bone height increase (VBHI), pain level, and complications were recorded. Results: Both groups showed improvement in PD and BI after 6 months compared to preoperative levels: the control group had a preoperative PD of (7.33 ± 1.72 mm) and a 6-month postoperative PD of (3.37 ± 0.96 mm), with statistically significant differences (P<0.001). The preoperative PD of the experimental group was (7.27 ± 1.57 mm), and the 6-month postoperative PD was (3.00 ± 0.69 mm), with statistically significant differences (P<0.001). The BI of the control group decreased from 3.03 ± 1.03 before surgery to 0.77 ± 0.82 at 6 months after surgery (P<0.001), while the BI of the experimental group decreased from 3.20 ± 1.09 before surgery to 0.73 ± 0.64 at 6 months after surgery (P<0.001), and the differences were statistically significant. The experimental group showed a significant improvement in GR (0.70 ± 0.59 mm) compared to preoperative GR (1.26 ± 0.94 mm) at 6 months after surgery (P=0.007), while the control group showed an increase in GR (1.37 ± 0.89 mm) at 6 months after surgery compared to preoperative GR (1.13 ± 0.97 mm), but the difference was not statistically significant (P=0.337). The inter group comparison results showed that there were no statistically significant differences in PD and BI between the two groups at 6 months after surgery (PD: P=0.096, BI: P=0.861); The GR of the experimental group was lower than that of the control group, and the difference was statistically significant (P=0.001). There was no statistically significant difference in postoperative VBHI between the two groups (P=0.128). The pain level scores of the experimental group were lower than those of the control group at 4 and 24 hours after surgery (P<0.001). None of the patients experienced complications. Conclusion Microflap periodontal bone grafting assisted by an oral microscope effectively improves the periodontal condition of patients with grade Ⅱ root bifurcation lesions of mandibular molars, and the bone grafting effect is good, with mild pain and good safety.

Falls are one of the most common injuries, with a high prevalence and risk of disability, which poses the greatest threat to the health of the elderly. Falls are influenced by a variety of factors, including environmental factors such as slippery pavements, poor meteorological conditions, and inadequate lighting. The Sixth Assessment Report of the United Nations Intergovernmental Panel on Climate Change (IPCC) stated that climate change has become more frequent and stronger in recent years, which may threat people's health and lives. This review summarized the progress of epidemiological studies on the association between meteorological factors (e.g. temperature, precipitation, frost, and snowfall) and falls, and found that most of the studies focused on the association between temperature and falls, and the results of different studies varied greatly. While the studies on the association between other meteorological factors and falls were relatively few. Moreover, the mechanisms behind the associations were unclear. Therefore, we point out that it is necessary to further conduct large-sample and multi-centre studies to evaluate the effects of exposure to multiple meteorological factors, and further to explore the mechanisms of the associations, which may provide scientific evidence for better response to climate change.

Objective:To evaluate the association between heatwaves and fall-related mortality.Methods:A total of 61 421 fall-related mortality from 2013 to 2022 in 7 provinces of China were included in a time-stratified case-crossover design, with daily meteorological data derived from the fifth generation European Reanalysis dataset produced by the European Centre for Medium-Range Weather Forecasts. Conditional logistic regression chimeric distributed lag nonlinear model was used to analyze the association between heatwaves and fall-related mortality and stratified analysis was conducted according to gender and age.Results:Heatwaves were associated with an increased risk of fall-related morality. The risk of fall-related mortality during heatwaves was higher than during non-heatwave periods ( OR=1.11, 95% CI: 1.05-1.18). The attributable fraction of fall-related motality due to heatwaves was 10.25% (95% CI: 4.49%-15.36%). For each 1 ℃ increase above the heatwave threshold, the risk of fall-related mortality increased by 34% ( OR=1.34, 95% CI: 1.02-1.76). The effect of heatwave duration on fall-related mortality was not statistically significant. Stratified analyses indicated that women experienced a higher risk of fall-related mortality during heatwaves ( OR=1.13, 95% CI: 1.04-1.22) compared to man ( OR=1.10, 95% CI: 1.04-1.17). Conclusions:Heatwave increases the risk of fall-related mortality, and the intensity of heatwaves modify this risk. Women are vulnerable populations.

Objective To observe the effect of deglycerolized red blood cells suspended in MAP on preservation and ex-plore the most effective preservation method.Methods Concentrated red blood cells were prepared by centrifuging 400 mL of whole blood on the third day after collection.40%compound glycerol solution was added using the ACP 215 automatic blood cell analyzer,and the resulting mixture was stored in an ultra-low temperature refrigerator at-65℃for 30 days.After thawing and washing,it was equally separated into two bags.The control group received 0.9%sodium chloride solution,while the experimental group received MAP.Both groups were stored at 2-6℃.Hematological parameters,hemolysis inde-xes and cell metabolism indexes were measured on day 0,1,3,5,7 and 14 after storage.The quality changes of both groups were observed during the 14-day storage period.Results The quality of red blood cells in both groups was assessed through a panel of quality tests,including volume,hemoglobin content,free hemoglobin content,white blood cell residue,glycerin residue and sterility.These results met the Quality Requirements outlined in the"Quality Requirements of Whole Blood and Component Blood"(GB18469-2012),Hematocrit,red blood cell count,Hb recovery rate after washing and MCV meet the detection limit outlined in the"Expert Consensus on Quality Evaluation Indicators for Frozen Red Blood Cells",and the residual amount of platelets exceeds the detection limit(≤1%).There were no significant differences in RBC,Hct,MCV and hemoglobin between the two groups during the 14 day storage period.The level of free hemoglobin,hemolysis rate and K+value increased in both groups over time.Significant differences in free hemoglobin were found on day 3,5,7 and 14 between the two groups(P<0.05).Hemolysis rate was significantly different on days 3,5,7 and 14,while K+value was significantly different only on day 14(P<0.05).On day 14,the osmotic fragility of red blood cells was higher in the control group than in the experimental group(P<0.05);The ATP and pH values of both groups decreased as storage time in-creased,and significant differences in ATP and pH value were found on day 3,5,7 and on day 1,3,5,7 and 14,respec-tively(P<0.05).Conclusion Deglycerolized red blood cells suspended in MAP additive solution can extend the storage period of blood to 7 days.This study provides a reference for the formulation of relevant standards.

Objective:To document any effect of combining kinesiotaping (KT) with Monitored Rehab Systems biofeedback training (MRS training) on the recovery of knee function after anterior cruciate ligament reconstruction (ACLR).Methods:Twenty-two patients after ACLR were randomly divided into an MRS group and a combined group, each of 11. In addition to conventional rehabilitation training, the MRS group had placebo taping in place during their MRS training, while the combined group had KT applied. Each training session lasted 45 minutes, with three sessions per week. Before the experiment and after 8 weeks of treatment, the affected foot support phase, impulse of each area of the affected foot′s sole, and lower limb reaction time were measured.Results:Significant improvement in the affected foot′s support phase and lower limb reaction time was documented in both groups, as well as in the average impulse percentage of the affected foot′s plantar forefoot area (F area), mid-foot area (MF area), and heel area (H area). All were significantly better in the combined group than in the MRS group, on average.Conclusion:Supplementing MRS biofeedback training with kinesiotaping can more effectively improve the knee joint functioning and postural control of patients after ACLR surgery. The combination is worthy of clinical promotion and application.

Objective:To examine the correlation factors of acute appendicitis associated with appendiceal neoplasms.Methods:Consecutive 712 patients with acute appendicitis who treated at Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University from January 2002 to December 2016 were analyzed retrospectively. There were 314 females and 398 males, aging (42.5±16.2) years (range: 14 to 94 years). Among the 712 cases, 36 patients were diagnosed with acute appendicitis associated with appendiceal neoplasms, the other 676 patients had no appendiceal neoplasm. The patients ′ clinical baseline characteristics and clinical parameters were compared between the two groups. The correlation factors of acute appendicitis associated with appendiceal neoplasms were evaluated by using the univariate (χ 2 test or t test) and multivariate Logistic regression analysis. The area under curve of receiver operating characteristic curves was utilized to evaluate the discriminatory power of the predictive models. Results:According to the univariate analysis, gender, age, body mass index, the duration of chronic right low abdominal pains≥3 months, the frequency of recurrently acute right lower abdominal pain≥2, the frequency of acute right lower abdominal pain, past history of diabetes, hypertension or coronary heart disease, the level of neutrophils and leukocytes preoperatively, stercolith and periappendiceal effusion, and modified Alvarado score were positively correlated with appendiceal neoplasms (all P<0.05). Then four variables were incorporated into the model eventually by multivariate Logistic regression analysis, which were as follows: age (increased per decade) ( OR=2.23, 95% CI: 1.68 to 2.95, P<0.01), gender (female) ( OR=4.21, 95% CI: 1.74 to 10.19, P=0.001), the duration of chronic right low abdominal pains (more than 3 months) ( OR=2.53, 95% CI: 1.01 to 3.37, P=0.048), and modified Alvarado score (decreased per 1 score) ( OR=2.54, 95% CI: 1.87 to 3.34, P<0.01). The area of curve was 0.93 (95% CI: 0.88 to 0.97), which indicated that the model exhibits an excellent ability to discriminate between appendiceal neoplasms and acute appendicitis. Conclusions:The older age, female, the duration of chronic right low abdominal pains, and lower modified Alvarado score are independent correlation factors for acute appendicitis associated with appendiceal neoplasms. Clinicians should be alert for the above clinical characteristics and choose optimal treatment for acute appendicitis associated with appendiceal neoplasms.

Objective:To examine the correlation factors of acute appendicitis associated with appendiceal neoplasms.Methods:Consecutive 712 patients with acute appendicitis who treated at Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University from January 2002 to December 2016 were analyzed retrospectively. There were 314 females and 398 males, aging (42.5±16.2) years (range: 14 to 94 years). Among the 712 cases, 36 patients were diagnosed with acute appendicitis associated with appendiceal neoplasms, the other 676 patients had no appendiceal neoplasm. The patients ′ clinical baseline characteristics and clinical parameters were compared between the two groups. The correlation factors of acute appendicitis associated with appendiceal neoplasms were evaluated by using the univariate (χ 2 test or t test) and multivariate Logistic regression analysis. The area under curve of receiver operating characteristic curves was utilized to evaluate the discriminatory power of the predictive models. Results:According to the univariate analysis, gender, age, body mass index, the duration of chronic right low abdominal pains≥3 months, the frequency of recurrently acute right lower abdominal pain≥2, the frequency of acute right lower abdominal pain, past history of diabetes, hypertension or coronary heart disease, the level of neutrophils and leukocytes preoperatively, stercolith and periappendiceal effusion, and modified Alvarado score were positively correlated with appendiceal neoplasms (all P<0.05). Then four variables were incorporated into the model eventually by multivariate Logistic regression analysis, which were as follows: age (increased per decade) ( OR=2.23, 95% CI: 1.68 to 2.95, P<0.01), gender (female) ( OR=4.21, 95% CI: 1.74 to 10.19, P=0.001), the duration of chronic right low abdominal pains (more than 3 months) ( OR=2.53, 95% CI: 1.01 to 3.37, P=0.048), and modified Alvarado score (decreased per 1 score) ( OR=2.54, 95% CI: 1.87 to 3.34, P<0.01). The area of curve was 0.93 (95% CI: 0.88 to 0.97), which indicated that the model exhibits an excellent ability to discriminate between appendiceal neoplasms and acute appendicitis. Conclusions:The older age, female, the duration of chronic right low abdominal pains, and lower modified Alvarado score are independent correlation factors for acute appendicitis associated with appendiceal neoplasms. Clinicians should be alert for the above clinical characteristics and choose optimal treatment for acute appendicitis associated with appendiceal neoplasms.

Objective To evaluate the clinical application value of portal vein implantation pump for chemotherapy in patients with intrahepatic cholangiocarcinoma (ICC) after radical surgery.Methods The clinical data of 97 patients with ICC who underwent radical surgery in Henan People's Hospital from June 2012 to June 2016 were retrospectively analyzed.Results Among the 97 patients,14 patients received portal venous pump chemotherapy (portal group),33 patients received peripheral venous chemotherapy (peripheral group),and 50 patients did not receive postoperative chemotherapy (control group).There were no statistically significant differences in gender and age between the three groups.The results of survival analysis indicated that the disease-free survival (DFS) period and overall survival (OS) time in the portal group and the peripheral group were significantly better than that in control group (both P ＜ 0.05).In addition,despite the lack of statistical significance (P ＞ 0.05),for the control of intrahepatic metastasis,portal vein pump chemotherapy was better than that of systemic chemotherapy via peripheral vein,and almost all side effects of chemotherapy in the portal group were lower than those in the peripheral group.Conclusion Portal vein pump chemotherapy can improve the prognosis of intrahepatic bile duct patients,especially for the control of intrahepatic metastasis,and can reduce systemic side effects of chemotherapy.