Objective To evaluate the application of the Huaxi Intelligent Endoscopic Skill Training and Assessment System in minimally invasive surgery (MIS) skills training and provide insights for optimizing MIS training models, we analyzed trainee performance during training and assessment. Methods A retrospective analysis was conducted on the use of this system across 28 medical institutions from January 2022 to January 2025. Results By January 2025, the standardized deployment of 139 simulation units had been completed. A total of 403 trainees from various surgical specialties, including thoracic surgery and general surgery, participated in five customized endoscopic skill training modules: endoscopic recognition, grasping training, positioning and placement, cutting training, and suturing training. Throughout the training period, a total of 78 participants took part in 27 formal assessments. Correlation analysis based on Spearman showed that pre-assessment training pass rates were significantly correlated with final assessment scores, indicating enhancing the quality of each training module and overall training efficacy is a key to improving the effectiveness of MIS training. Conclusion The Huaxi Intelligent Endoscopic Skill Training and Assessment System effectively supports MIS training and evaluation.

Objective To explore the automated identification and diameter measurement methods for inferior vena cava (IVC) based on clinical ultrasound images of IVC. Methods An automated identification and localization method based on topology and automatic tracking algorithm was proposed. Tracking algorithm was used for identifying and continuously locating to improve the efficiency and accuracy of measurement. Tests were conducted on 18 sets of ultrasound data collected from 18 patients in intensive care unit (ICU),with clinicians' measurements as the gold standard. Results The recognition accuracy of the automated method was 94.44％ (17/18),and the measurement error of IVC diameter was within the range of±1.96s (s was the standard deviation). The automated method could replace the manual method. Conclusion The proposed IVC automated identification and localization algorithm based on topology and automatic tracking algorithm has high recognition success rate and IVC diameter measurement accuracy. It can assist clinicians in identifying and locating IVC,so as to improve the accuracy of IVC measurement.

Objective To explore the influence of organizational support on the career satisfaction of doctors in public hospitals and the mediating effect of role stress.Methods Using the survey data of 523 public hospital doctors from 9 medical institutions in 4 places in 2022,OLS linear regression model was used to analyze the influence of organizational support on career satisfaction,and Bootstrap test was used to explore the mediating effect of role stress.Results Organizational support had a positive effect on the career satisfaction of doctors in public hospitals,and for every unit increase in organizational support score,career satisfaction score will increase by 0.528 points.And role stress had a negative effect on the career satisfaction of doctors in public hospitals.Conclusion Organizational managers should take measures to promote the positive impact of organizational support on doctors'career satisfaction in public hospitals,reduce doctors'role stress,and continuously improve their career satisfaction.

As a new group of stem cells found in the human breast in the 21st century, stem cells in human breast milk have the potential to differentiate into ectoderm, mesoderm, and endoderm cells.It is not only rich in sources, but also can be obtained in a non-invasive way.At present, there are relatively few ethical disputes.First, as a potential source of stem cells, it has a great prospect in the field of alternative medicine and regenerative medicine.Second, it can promote newborns early growth and development, repair the damaged tissues, and prevent as well as treat some early diseases.This review summarized stem cells from human breast milk, from aspects of distribution, acquisition, and functional characteristics, and discussed their application in newborns.

Objective:Healthy life expectancy (HLE), which combines life expectancy with health, is an essential comprehensive measure of life length and quality. This article aimed to systematically review the methods for defining and measuring HLE and describe application studies published, providing a reference for decision makers to select and develop methods suitable for China's conditions to measure HLE.Methods:Seven Chinese and English literature databases were searched up to May 7, 2022, and several related reviews and bibliography were manually retrieved. Systematic reviews and empirical research were included concerning HLE indicators and measurement of HLE. Information including the study area, type of the study, study population, HLE index, measurement method, data sources, and results from application studies published in the last five years were extracted. The evolution of the definition of HLE, the scope of different indicators, the measurement scale of health, and measurement methods, were all collected. Results of the empirical research related to measurement methods of indicators were summarized. The study followed the scoping review framework and was written according to the PRISMA-ScR statement.Results:A total of 84 articles were included, including 13 reviews, 17 original studies related to HLE index definition, ten original studies related to index measurement, and 44 empirical studies conducted in the past five years. There were as many as 20 indicators related to HLE, and each scale had its emphasis. A total of ten methods measuring HLE were identified, which vary in the definition of health, whether using weight, and the data type. The most commonly used indicators in the past five years were disability-free life expectancy and HLE. For the method of HLE calculation, Sullivan's method was mainly used for cross-sectional data, and the multistate life table was mainly used for longitudinal data.Conclusions:There are various definitions and measurement methods of HLE, but none are suitable for all scenarios. To summarize the HLE concept, health evaluation techniques, measurement methods, and application studies published worldwide can provide a reference for the localization of HLE measurement in China.

This study aimed to investigate the prevalence, clinical characteristics, and prognostic impact of 1p32.3 deletion in patients with newly diagnosed multiple myeloma (MM). A retrospective analysis was conducted on 411 patients with newly diagnosed MM; among which, 270 received bortezomib-based therapies, and 141 received thalidomide-based therapies. Fluorescence in situ hybridization (FISH) was performed to detect six cytogenetic abnormalities, namely, del(1p32.3), gain(1q21), del(17p13), del(13q14), t(4;14), and t(11;14). Results showed that 8.3% of patients with MM were detected with del(1p32.3) and had significantly more bone marrow plasma cells (P = 0.025), higher β2-microglobulin levels (P = 0.036), and higher lactate dehydrogenase levels (P = 0.042) than those without del(1p32.3). Univariate analysis showed that patients with del(1p32.3) under thalidomide-based therapies (median PFS 11.6 vs. 31.2 months, P = 0.002; median OS 16.8 vs. 45.9 months, P < 0.001) were strongly associated with short progression-free survival (PFS) (P = 0.002) and overall survival (OS) (P < 0.001). Multivariate analysis revealed that del(1p32.3) remained a powerful independent factor with worse PFS (P = 0.006) and OS (P = 0.016) for patients under thalidomide-based treatments. Patients with del(1p32.3) under bortezomib-based treatments tended to have short PFS and OS. In conclusion, del(1p32.3) is associated with short PFS and OS in patients with MM who received thalidomide- or bortezomib-based treatments.

OBJECTIVETo investigate the relationship between cytogenetic markers with World Health Organization (WHO) classification, disease progress and prognosis in cases with primary myelodysplastic syndromes (MDS).

METHODS298 patients with de novo MDS from the first affiliated hospital of medical school, Zhejiang University were enrolled in the retrospective analysis of WHO classification, karyotype, and prognosis. Follow-up study was also conducted.

RESULTSThe WHO classifications at first diagnosis were as follows: refractory cytopenia with unilineage dysplasia (RCUD), 18 cases; refractory anemia with ring sideroblasts (RARS), 8 cases; refractory cytopenia with multiline dysplasia (RCMD), 104 cases; refractory anemia with excess blasts-1, 76 cases; refractory anemia with excess blasts-2, 85 cases; MDS unclassified (MDS-U), 5 cases involved; and single del (5q), 2 cases. 39.6% of MDS patients carried karyotypic abnormalities. Among them, the frequency of numerical abnormalities, structural abnormalities and the existence of composite abnormalities were 45, 31, and 42, respectively. The composite abnormalities were unbalanced translocations and complex chromosomal abnormalities. The incidence of both karyotypic abnormalities and complex chromosomal abnormalities in RAEB group was higher than that in non-RAEB group (P<0. 05). An analysis based on IPSS-R Scoring System showed that advanced risk stratification (except the low-risk group) gradually enhanced the incidence of karyotypic abnormalities (P<0.05). In addition, the probability of evolution to leukemia increased with the higher IPSS-R score (P<0.05). In RAEB group, the cases with +8 chromosome, accounting for 19.5% of karyotypic abnormalities, had worse prognosis than those with normal chromosomes.

CONCLUSIONKaryotype was identified with an independent risk factor in MDS patients. Therefore, the information on cytogenetic analysis was critical for diagnosis, prognosis and individual treatment. MDS patients presenting+8 chromosome, an intermediate risk factor, were associated with a poorer outcome compared to cases with normal chromosomes in RAEB group.

Abnormal Karyotype ; Anemia, Refractory ; Chromosome Aberrations ; Chromosomes, Human, Pair 8 ; Follow-Up Studies ; Humans ; Karyotyping ; Myelodysplastic Syndromes ; Prognosis ; Retrospective Studies ; Risk Factors ; World Health Organization

BACKGROUNDTo investigate the expression of vascular endothelial growth factor (VEGF) and CD44v6 in non-small cell lung cancer (NSCLC) and to explore their association with invasion, metastasis and prognosis of NSCLC.

METHODSA rapid immunohistochemical method (streptoavidin-peroxidase, SP) was used to detect VEGF and CD44v6 proteins expression in 43 paraffin-embedded resected NSCLC tissues retrospectively. All the patients were initially treated.

RESULTSThe expression rates of VEGF in squamous cell carcinoma and adenocarcinoma were 62.5% (15/24) and 68.42% (13/19) respectively. The positive rates of CD44v6 expression in squamous cell carcinoma and adenocarcinoma were 58.33% (15/24) and 68.42% (13/19) respectively. The positive expressions of VEGF and CD44v6 were significantly correlated with lymph node metastasis and TNM stage (P < 0.05), and also significantly correlated with postoperative hematogenous metastasis (P < 0.05). The 3- and 5-year survival rates of patients with VEGF positive expression were 19.23% and 6.41% respectively, whereas those with negative expression were 67.41% and 58.82%, there was signi-ficant difference of survival rate between the two groups (P < 0.05). The 3- and 5-year survival rates of CD44v6 positive expression group and negative expression group were 18.67%, 10.67% and 67.83%, 53.50%, there was also significance difference of survival rate between two groups (P < 0.05). The positive expression of VEGF was significantly correated with the positive expression of CD44v6 (P < 0.05).

CONCLUSIONSDetection of VEGF and CD44v6 expression in NSCLC is helpful to evaluate the lymph node metastasis, TNM stage and prognosis. It is also helpful to guide postoperative multiple modality therapy.

Objective To analyze the curative effect of blood transfusion on 100 patients undergoing liver transplantation,to efficiently enhance hemostasis and coagulation function of the patients,to lower the incidence of the operative complications,and to put forward the guideline of blood transfusion to the patients undergoing liver transplantation.Methods The volumes of red blood cells concentrates(RCCs),fresh frozen plasma(FFP),cryopreserved platelets,and cryoprecipitate transfused to the patients undergoing liver transplantation were measured before,during and after the operation respectively.The volumes of blood components transfused to the 50 patients in the former stage and 50 patients in the later stage of liver transplantation in our hospital were also measured respectively.Results The mean volume of the blood components transfused to each patient was 3 334ml.The ratios of the transfused blood volumes to 100 patients were 4.3%,53.4% and 42.3% before,during and after operation respectively.The rate of blood components transfusion was 100% and the ratio of transfused blood volumes to the patients between RCCs and FFP was 1.45:1.The mean volumes of the transfused blood and the operative complications of 50 patients in the former stage of liver transplantation of our hospital were significantly higher than those of the 50 patients in the later stage.Conclusion It is very vital in the scientific,safe and reasonable blood transfusion for the success of liver transplantation,which significantly lowers the incidence of operative complications,such as massive haemorrhage during and after operation,and thrombosis at inosculation of liver artery and portal vein.

Purpose:To investigate the correlation between early postoperative metastasis with occult micrometastasis of mediastinal lymph nodes in patients with stageⅠa non small cell lung carcinoma (NSCLC).Methods:Using RT PCR assay, detection of the expression of MUC1 mRNA was used to diagnose occult micrometastasis in mediastinal lymph nodes. All the patients underwent checked up at least once a year to detect early metastatic lesions after surgery, by means of CT scan of chest and brain, ultrasound examination of liver and adrenal glands, and bone scanning. The patients with and without occult nodal micrometastasis were divided into two different groups. Difference in early metastatic rate between two groups of patients was compared by ? 2 test, and odds ratio (OR) was calculated.Results:Occult nodal micrometastasis was diagnosed in sixteen patients (32.0%). Early metastatic rate (31.25%) in the patients with occult nodal micrometastasis was higher than that (5.88%) in the patients without occult nodal micrometastasis ( P