Objective:To analyze the correlation between the skin temperature variation trajectory in the radiation field and the occurrence of grade 2 or higher radiation dermatitis in female breast cancer patients during postoperative radiotherapy.Methods:This prospective cohort study used convenience sampling to select 103 breast cancer patients who underwent modified radical mastectomy and subsequent radiotherapy at the Fourth Hospital of Hebei Medical University from May 2022 to December 2022. All patients received three-dimensional conformal radiotherapy (3D-CRT), with an irradiation field covering the chest wall ± supraclavicular and infraclavicular lymphatic drainage regions, and a prescribed dose of 50 Gy delivered in 25 fractions. Skin temperature in the irradiated area was measured using an infrared thermometer before radiotherapy and on the days of the 5 th, 10 th, 15 th, 20 th, and 25 th fractions. The latent classes of skin temperature variation trajectories were identified using the Mplus latent class growth model, and logistic regression was applied to analyze the correlation between the skin temperature variation trajectory and the occurrence of grade 2 or higher radiation dermatitis. Results:The skin temperature variation trajectories in the irradiated field of breast cancer patients undergoing postoperative radiotherapy could be divided into two groups: the temperature non-increasing group (81/103) and the temperature increasing group (22/103). The Akaike information criterion (AIC) was 66.468, the Bayesian information criterion (BIC) was 116.528, and the entropy was 0.810, with a likelihood ratio test P-value of 0.037, and a Bootstrap-based likelihood ratio test P-value<0.001. After adjusting for covariates such as age and body mass index, logistic regression analysis showed that the risk of developing grade 2 or higher radiation dermatitis in the temperature increasing group was 6.92 times of that in the temperature non-increasing group ( OR=6.92, 95% CI = 2.30-20.82, P=0.001). Conclusions:There is group heterogeneity in the skin temperature variation trajectories of breast cancer patients undergoing radiotherapy, and patients with a rise in skin temperature have a higher risk of developing grade 2 or higher acute radiation dermatitis.

Objective:To propose a deep learning（DL）-based ultrasound imaging auxiliary tool for automatic segmentation and recognition of the brachial plexus（BP），and to enhance the accuracy and safety of clinical procedures.Methods:It was a multicenter study that collected 773 healthy subjects from Peking University Third Hospital and its branch campuses，the Third Medical Center of the Chinese PLA General Hospital，and Shanghai Eighth People's Hospital between August 2024 and February 2025. Brachial plexus（BP）images in the interscalene groove were captured used high-frequency ultrasound by senior sonographers，a dataset comprising 1 289 standardized images were constructed and the improved model（CHA-TransUNet）was trained. The test set was input into 6 different models（CHA-TransUNet，R50-Unet，TransUnet，SegFormer，SwinUnet，MISSFormer）for segmentation. Segmentation accuracy was evaluated using metrics including the Dice similarity coefficient（DSC），95% Hausdorff distance（HD95）and mean intersection over union（mIoU），and was compared with the segmentation results of 3 ultrasound physicians with varying experience levels（junior physicians and senior physicians）to validate the model's segmentation efficacy.Results:The CHA-TransUNet model established based on a dataset of 1 289 standardized images achieved segmentation results for the BP with a DSC of 90.15%，mIoU of 91.02%，and HD95 of 8.08. Its accuracy was higher than other mainstream models（DSC：90.15% vs. 87.60%，87.77%，81.35%，84.78%，84.55%），significantly better than junior physicians（DSC：90.15% vs. 68.73%， Z=-127.76， P<0.001），and approached the level of senior physician（DSC：90.15% vs. 86.15%， Z=-31.33， P=0.549）. The model demonstrated superior boundary recognition in complex anatomical structures（e.g.，C6/C7 nerve roots）compared to ultrasound physicians（junior and senior）（HD95：8.08 vs. 26.34，17.44，56.80）. Conclusions:This study proposes an analysis model for BP ultrasound images，CHA-TransUNet. This model achieves segmentation and recognition of the BP with relatively complex pathways and structures. The model exhibits high accuracy and stability，outperforming current mainstream network models and junior physicians while approaching the performance level of senior physicians. It assists junior physicians or trainees in more accurately identifying and localizing the BP.

Objective:To propose a deep learning（DL）-based ultrasound imaging auxiliary tool for automatic segmentation and recognition of the brachial plexus（BP），and to enhance the accuracy and safety of clinical procedures.Methods:It was a multicenter study that collected 773 healthy subjects from Peking University Third Hospital and its branch campuses，the Third Medical Center of the Chinese PLA General Hospital，and Shanghai Eighth People's Hospital between August 2024 and February 2025. Brachial plexus（BP）images in the interscalene groove were captured used high-frequency ultrasound by senior sonographers，a dataset comprising 1 289 standardized images were constructed and the improved model（CHA-TransUNet）was trained. The test set was input into 6 different models（CHA-TransUNet，R50-Unet，TransUnet，SegFormer，SwinUnet，MISSFormer）for segmentation. Segmentation accuracy was evaluated using metrics including the Dice similarity coefficient（DSC），95% Hausdorff distance（HD95）and mean intersection over union（mIoU），and was compared with the segmentation results of 3 ultrasound physicians with varying experience levels（junior physicians and senior physicians）to validate the model's segmentation efficacy.Results:The CHA-TransUNet model established based on a dataset of 1 289 standardized images achieved segmentation results for the BP with a DSC of 90.15%，mIoU of 91.02%，and HD95 of 8.08. Its accuracy was higher than other mainstream models（DSC：90.15% vs. 87.60%，87.77%，81.35%，84.78%，84.55%），significantly better than junior physicians（DSC：90.15% vs. 68.73%， Z=-127.76， P<0.001），and approached the level of senior physician（DSC：90.15% vs. 86.15%， Z=-31.33， P=0.549）. The model demonstrated superior boundary recognition in complex anatomical structures（e.g.，C6/C7 nerve roots）compared to ultrasound physicians（junior and senior）（HD95：8.08 vs. 26.34，17.44，56.80）. Conclusions:This study proposes an analysis model for BP ultrasound images，CHA-TransUNet. This model achieves segmentation and recognition of the BP with relatively complex pathways and structures. The model exhibits high accuracy and stability，outperforming current mainstream network models and junior physicians while approaching the performance level of senior physicians. It assists junior physicians or trainees in more accurately identifying and localizing the BP.

Objective:To analyze the correlation between the skin temperature variation trajectory in the radiation field and the occurrence of grade 2 or higher radiation dermatitis in female breast cancer patients during postoperative radiotherapy.Methods:This prospective cohort study used convenience sampling to select 103 breast cancer patients who underwent modified radical mastectomy and subsequent radiotherapy at the Fourth Hospital of Hebei Medical University from May 2022 to December 2022. All patients received three-dimensional conformal radiotherapy (3D-CRT), with an irradiation field covering the chest wall ± supraclavicular and infraclavicular lymphatic drainage regions, and a prescribed dose of 50 Gy delivered in 25 fractions. Skin temperature in the irradiated area was measured using an infrared thermometer before radiotherapy and on the days of the 5 th, 10 th, 15 th, 20 th, and 25 th fractions. The latent classes of skin temperature variation trajectories were identified using the Mplus latent class growth model, and logistic regression was applied to analyze the correlation between the skin temperature variation trajectory and the occurrence of grade 2 or higher radiation dermatitis. Results:The skin temperature variation trajectories in the irradiated field of breast cancer patients undergoing postoperative radiotherapy could be divided into two groups: the temperature non-increasing group (81/103) and the temperature increasing group (22/103). The Akaike information criterion (AIC) was 66.468, the Bayesian information criterion (BIC) was 116.528, and the entropy was 0.810, with a likelihood ratio test P-value of 0.037, and a Bootstrap-based likelihood ratio test P-value<0.001. After adjusting for covariates such as age and body mass index, logistic regression analysis showed that the risk of developing grade 2 or higher radiation dermatitis in the temperature increasing group was 6.92 times of that in the temperature non-increasing group ( OR=6.92, 95% CI = 2.30-20.82, P=0.001). Conclusions:There is group heterogeneity in the skin temperature variation trajectories of breast cancer patients undergoing radiotherapy, and patients with a rise in skin temperature have a higher risk of developing grade 2 or higher acute radiation dermatitis.

Objective:To explore the common risk factors of intracerebral hemorrhage(ICH) in young people and to establish a predictive model of nomogram.Methods:The relevant data of young patients with ICH (≤45 years ) hospitalized in the Department of Neurosurgery of Dezhou people's Hospital from January 2014 to August 2021 were retrospectively studied, and the young group who underwent physical examination in the Physical Examination Center of Dezhou people's Hospital at the same time were randomly selected as the control group. Analyze the risk factors that may affect cerebral hemorrhage in young people, screen the risk factors with statistical differences through single factor analysis, screen the independent risk factors according to multi factor Logistic regression analysis, construct the risk nomogram model of cerebral hemorrhage in young people, and test the efficiency, goodness of fit and benefit of the constructed model through internal validation.Results:Compared with the control group, there were statistically significant differences in family history (χ 2=115.66, P<0.001), hypertension grade( Z=17.67, P<0.001), smoking history (χ 2=33.91, P<0.001), drinking grade ( Z=4.84, P<0.001), body mass index (BMI) ( t=11.76, P<0.001), low density lipoprotein ( t=4.78, P<0.001), high density lipoprotein cholesterol ( t=5.83, P<0.001),blood glucose ( Z=5.68, P<0.001) and homocysteine ( Z=2.22, P<0.001) in the case group. Binary Logistic regression analysis showed that hypertension grade ( OR=3.457, 95%CI: 2.809-4.254, P<0.001), family history ( OR=2.871, 95%CI:1.868-4.413, P<0.001), BMI ( OR=1.093, 95%CI:1.040-1.148, P<0.001), high density lipoprotein cholesterol ( OR=0.230, 95%CI:0.111-0.480, P<0.001), blood glucose ( OR=3.457, 95%CI:2.809-4.254, P<0.001), homocysteine (O R=3.457, 95%CI:2.809-4.254, P<0.001) was an independent risk factor for intracerebral hemorrhage in young adults. The nomogram prediction model showed that BMI was 96 points, hypertension grade was 100 points, family history was 30 points, high density lipoprotein cholesterol was 76 points, homocysteine was 48 points, blood glucose was 52 points,homocysteine was 48 points and blood glucose was 52 points, respectively. The consistency coefficient of the prediction model was 0.874. The nomogram dependent ROC curve AUC was 0.891, and the corresponding sensitivity and specificity were 74.5% (263/353) and 89.7% (437/487), respectively, a nomogram model was established with good diagnostic efficiency. Conclusion:The nomogram model established in this study can predict the probability of intracerebral hemorrhage in high-risk population, and take intervention measures as early as possible to prevent the occurrence of intracerebral hemorrhage in young people.

Objective To explore the relationship of human papilloma virus (HPV) genotype and loading dose with development of cervical intraepithelial neoplasia (CIN) or squamous cell carcinoma of the cervix ( SCC),and explore the relationship of HPV genotype and CIN or SCC.Methods One hundred and twenty four patients in Sun Yat-sen Memoral Hospital of Sun Yat-sen University with CIN or SCC from September 2005 to December 2010 were selected in this study.HPV DNA was detected by Hybrid capture Ⅱand flow-through hybridization and gene chip.The relationship between the infection of HPV and CIN or SCC was analyzed.The influencing factors of CIN or SCC were analyzed by logistic regression.Results The total detection rate of HPV was 75.8％,and it was 44.4％,70.0％,95.7％ and 76.2％ in CIN Ⅰ,CIN Ⅱ,CIN Ⅲ and SCC group,respectively.The detection rate of HPV in high-grade lesion group ( 84.5％ ) was higher than low-grade lesion group(44.4％ ).The median of HPV load decreased in order as CIN Ⅲ,SCC,CIN Ⅱ and CIN Ⅰgroup.Infection of multi-genotypes or single genotype of high-risk HPV accounted for 97.9％.In logistic regression,HPV loading dose had significant influence on degree of cervical lesion.Conclusions Infection of HPV is a main etiological factor for SCC.There is some kind of correlation between HPV loading dose and development of SCC.

Objective To evaluate the efficiency of free myocutaneous flap transfer for the treatment of refractory post-traumatic osteomyelitis of the lower leg and foot. Methods Eleven patients with refractory post-traumatic osteomyelitis of the lower legs and feet were treated between February 2004 and December 2007. There were 9 males and 2 females. The average age was 3.5 years. All patients had at least four to five unsuccessful surgical procedures and prolonged antibiotic treatment prior to presentation. The mean duration of osteomyelitis was 26 months (12-47 months). According to the Ciemy-Mader classification, there were 3 cases for ⅢA, 2 for ⅢBL, 4 for ⅥA and 2 for ⅥBL. After radical debridement, free myocutaneous flaps were immediately performed. Nine latissimus dorsi and 2 rectus abdominis myocutaneous flaps were used.External fixation was applied in 6 patients with skeletal instability due to tibial defects. Results An average follow-up was 3.5 years. Two cases suffered partial necrosis and were managed successfully with split-thickness skin grafts later. In 4 patients of presenting segmental bone defect, autogenous bone grafting was applied in one patient and achieved consolidation after 5 months; bone transplantation in 2 patients and achieved consolidation after 8 and 10 months; and vascularized fibula graft in one patient in whom the gap of the tibia was about 10 cm and achieved consolidation after 4 months. The other 7 patients of this group achieved bone consolidation without bone graft. Conclusion The cornerstone of the treatment of chronic osteomyelitis was to be the radical debridement of all involved necrotic and infected soft tissue and bone.The free myocutaneous flaps transfer which has the advantage of obliteration of dead space and stable coverage of the defect was a safe and viable treatment option in chronic osteomyelitis of the lower leg and foot.

Objective To find out the requirement and to evaluate the effect of post-abortion counseling and education (PACE) among unmarried abortion adolescents.Methods The subjects of the study were unmarried adolescents from 10 to 24 years of age who wanted induced abortion in the Second Affiliated Hospital of Sun Yat-sen University from December 2007 to April 2008.Totally 122 subjects received the intervention of PACE were considered as intervention group.Meanwhile,67 subjects refused the intervention of PACE were considered as no intervention group.Two groups were both investigated the requirements of PACE before abortion and were followed-up at one year after abortion.Results 97.4% (184/189) of 189 unmarried abortion adolescents were willing to receive PACE,48.1% (91/189) of them hoped to receive PACE when saw the doctor,72.0% (136/189) of them required face-to-face counseling during PACE.During the year after abortion,74% (57/77) cases in intervention group and 24% (10/41) cases in no intervention group took effective contraception (P< 0.01 ),while 1% (1/77) of intervention group and 10% (4/41) of no intervention group had unwanted pregnancy.There were significant different for the rate of unwanted pregnancy between two groups (P=0.034).Conclusion For unmarried abortion adolescents,the intervention of PACE may markedly increase the rate of effective contraception used and decrease the rate of another unwanted pregnancy.