Objective: To conduct a scoping review on the types, construction methods and predictive performance of health literacy prediction models based on machine learning methods, so as to provide the reference for the improvement and application of such models. Methods: Publications on health literacy prediction models conducted using machine learning methods were retrieved from CNKI, Wanfang Data, VIP, PubMed and Web of Science from inception to May 1, 2024. The quality of literature was assessed using the Prediction Model Risk of Bias ASsessment Tool. Basic characteristics, modeling methods, data sources, missing value handling, predictors and predictive performance were reviewed. Results: A total of 524 publications were retrieved, and 22 publications between 2007 and 2024 were finally enrolled. Totally 48 health literacy prediction models were involved, and 25 had a high risk of bias (52.08%), with major issues focusing on missing value handling, predictor selection and model evaluation methods. Modeling methods included regression models, tree-based machine learning methods, support vector machines and neural network models. Predictors primarily encompassed factors at four aspects: individual, interpersonal, organizational and society/policy aspects, with age, educational level, economic status, health status and internet use appearing frequently. Internal validation was conducted in 14 publications, and external validation was conducted in 4 publications. Forty-two models reported the areas under the receiver operating characteristic curve, which ranged from 0.52 to 0.983, indicating good discrimination. Conclusion Health literacy prediction models based on machine learning methods perform well, but have deficiencies in risk of bias, data processing and validation.

Objective To investigate the clinical features and genetic characteristics of patients with late-onset Pompe disease(LOPD).Methods A total of 13 patients diagnosed with LOPD in the First Affilia-ted Hospital of Zhejiang University School of Medicine from September 2020 to December 2023 were selected,and all patients were subjected to clinical investigation,GAA activity detection and GAA gene testing.Results Among the 13 patients,7 were males and 6 were females;5 were family patients and 8 were sporadic patients;and the median age of onset was 17 years(8-52 years),the median age of presentation was 24 years(10-52 years),and the median age of diagnosis was 31 years(14-58 years).In terms of the first symptoms,10 pa-tients presented with limb weakness and 3 patients presented with dyspnea.The average serum creatine kinase level was 552 U/L(55-1084 U/L),and the serum creatine kinase level was normal in one patient.All pa-tients had scoliosis and different degrees of restrictive ventilatory dysfunction.Neuroelectrophysiological exami-nations of 9 patients showed myogenic damage,and 8 of them had muscle tonic discharge.The mean value of GAA activity was 0.3 μmol/(L·h)[0.17-0.5 μmol/(L·h)].A total of 13 mutations were detected in GAA gene,and the most common mutation was c.2238G＞C(p.W746C).There were five new variant sites:c.543del(p.F181Lfs*40),c.839_840insCC(p.R281Pfs*34),c.1800_1823del(p.S601_R608del),c.2296T＞C(p.Y766H)and c.995C＞A(p.S332*).Conclusions LOPD is a rare disease that tends to delay diagnosis.Proximal limb weakness,decreased respiratory function,mild-to-moderate elevation of creatine kinase,scoliosis,and clinical inferior tonic discharge on electromyography are high-risk images of LOPD.c.2238G＞C(p.W746C)is a hotspot mutation,and the discovery of five new mutations enriches the GAA gene mutations lineage.

Pyroptosis, a form of inflammatory cell death mediated by the Gasdermins family, promotes the release of inflammatory mediators and activates immune cell populations such as NK cells, T cells and macrophages in the tumor microenvironment(TME) to exert immune-regulating and anti-tumor effects. Glioblastoma(GBM) is the most serious and malignant glioma, and the median survival of patients diagnosed with GBM is less than 2 years, and the presence of the blood-brain barrier makes it difficult to deliver drugs to the brain, thus affecting the effect of drugs against GBM. Therefore, it is important to explore new measures and mechanisms to treat GBM, which has a complex TME with a large number of immune cell populations that are often immunosuppressed by GBM. Cellular pyroptosis as a mode of cell death capable of activating immunity, has the effect of activating the body’s immunity to help reverse TME immunosuppression. This review will focus on the relationship between cell pyroptosis and the immune system, how cell pyroptosis affects the immune cell population of TME in GBM, and the new progress in drug research on cell pyroptosis pathways in GBM treatment, providing new directions and strategies for future clinical treatment of GBM.

Objective:To explore the impact of the hospital health literacy environment on patients′ postoperative pain self-management behaviors, aiming to provide insights for hospitals to implement the Comprehensive Pain Management Pilot Work Program in hospitals and to promote self-health management among patients with other diseases or symptoms. Methods:From November to December 2023, a convenience sampling method was used to select postoperative patients from three grade A tertiary general hospitals in Zhejiang Province for an on-site questionnaire survey. The Chinese version of brief health literacy screen (BHLS), short-form health literacy environment scale (SF-HLES) and postoperative pain self-management behavior questionnaire (PPSMB) were used as survey tools to investigate the health literacy level of patients, the health literacy environment of the hospital, and the postoperative pain management behaviors of patients. Two-way ANOVA was used to compare the impact of different dimensions of the hospital health literacy environment on postoperative pain management behaviors among patients with different levels of health literacy. Multiple linear regression analysis was used to explore the relationship between the hospital health literacy environment, individual health literacy, and patients′ postoperative pain self-management behaviors, and to discuss the impact of individual health literacy on patients′ postoperative pain self-management behaviors under different hospital health literacy environments.Results:341 valid questionnaires were collected. The average score of the hospitals′ SF-HLES was (73.62±19.54) points. The average score of the patients′ BHLS was (9.65±2.88) points. The average score of the patients′ PPSMB was (25.99±6.35) points. Two-way ANOVA results showed that the interaction between individual health literacy and the clinical dimension ( F=5.463, P=0.020) and structural dimension ( F=6.470, P=0.011) of the hospital health literacy environment had a statistically significant impact on patients′ postoperative pain self-management behaviors, while the interaction with the interpersonal dimension ( F=0, P=0.984) had no statistically significant impact on pain self-management behaviors. Simple effect analysis indicated that only in the high health literacy environment of the clinical and structural dimensions did the difference in pain self-management behaviors between patients with good health literacy and those with limited health literacy had statistical significance ( P<0.001). Multiple linear regression analysis results showed that for each 1-point increase in the patients′ BHLS score, their PPSMB score increased by 3.74 points ( β1=0.832, P<0.001); for each 1-point increase in the hospital′s SF-HLES score, the patients′ PPSMB score could increase by 0.198 points ( β2=0.610, P<0.001). In a low health literacy environment, individual health literacy did not affect pain self-management behaviors ( P>0.05); however, in a high health literacy environment, for each 1-point increase in the patients′ BHLS score, their PPSMB score correspondingly increased by 4.037 points ( β4=0.317, P<0.001). Conclusions:The positive impact of individual health literacy on pain self-management is contingent upon a high-quality hospital health literacy environment. This suggests that optimizing the hospital health literacy environment is a necessary precondition for implementing the relevant content of the Comprehensive Pain Management Pilot Work Program and can provide a reference for promote self-health management among patients with pain and other diseases or symptoms.

Objective:To explore the methylation degree of miRNA-4729 (miR-4729) in renal cancer tissues and its impact on the proliferation and migration abilities of renal cancer cell lines.Methods:Data from the SurvivalMeth database (updated in October 2022) was used to analyze the methylation degree of miR-4729 in 178 renal cancer tissues. Target gene with complementary binding sites to miR-4729 was predicted by miRNApath software. The normal renal tubular epithelial cell line HK-2 and the renal cancer cell lines Caki-1, A-498, ACHN, and 786-O were selected. Real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) was used to detect the relative expression of miR-4729 in each cell line and the effect of methylation inhibitor 5-aza-2'-deoxycytidine (5-Aza-CdR) on the expression of miR-4729 in renal cancer cells. A-498 cells with the lowest relative expression of miR-4729 were transfected with miR-4729 mimic (miR-4729 group) and miRNA-NC (NC group), and colony formation assay and scratch assay were used to detect the effect of overexpression of miR-4729 on the proliferation and migration abilities of A-498 cells. Dual-luciferase reporter gene assay was used to verify the targeting relationship between miR-4729 and DEAD box peptide 5 (DDX5). Western blotting was used to detect the effect of miR-4729 overexpression on the expression of DDX5 protein and AKT signaling pathway-related proteins (p-AKT, p-IKKα, p-Tpl2 and AS160) in A-498 cells.Results:The analysis results of data from the SurvivalMeth database showed that the methylation degree of miR-4729 in renal cancer tissues was higher than that in paracancerous tissues ( P < 0.01). The relative expressions of miR-4729 in renal cancer Caki-1, A-498, ACHN, 786-O cells and normal renal tubular epithelial HK-2 cells were 0.62±0.05, 0.16±0.04, 0.53±0.02, 0.69±0.03, and 0.99±0.07, respectively, and the difference was statistically significant ( F = 47.39, P < 0.01). Compared with various cell groups cultured with dimethyl sulfoxide (DMSO), the relative expressions of miR-4729 in renal cancer Caki-1, A-498, ACHN and 786-O cells cultured with 5-Aza-CdR were higher (all P < 0.01). The results of colony formation assay showed that the number of colonies formed in A-498 cells of the miR-4729 group and NC group were 53±6 and 102±10, respectively, and the difference was statistically significant ( t = 4.25, P < 0.01). The results of scratch assay showed that the scratch healing rates of A-498 cells in the miR-4729 group and NC group were (42.3±2.7)% and (67.6±4.8)%, respectively, and the difference was statistically significant ( t = 4.58, P < 0.01). The results of dual-luciferase reporter gene assay showed that miR-4729 directly targeted and bound to DDX5. The relative expressions of DDX5 mRNA in A-498 cells of the miR-4729 group and NC group were 0.93±0.25 and 5.29±0.74, respectively, and the difference was statistically significant ( t = 5.60, P < 0.01). The results of Western blotting showed that compared with the NC group, the expression of DDX5 protein in A-498 cells of the miR-4729 group was lower, and the expressions of AKT signaling pathway-related proteins p-AKT, p-IKKα, p-Tpl2 and AS160 were also lower. Conclusions:Overexpression of miR-4729 decreases the activation level of AKT signaling pathway by targeting and inhibiting the expression of DDX5 gene, thereby inhibiting the proliferation and migration of renal cancer cells.

Objective To explore the application of polysomnography combined with arterial spin labeling(ASL)perfusion magnetic resonance imaging in the diagnosis of insomnia.Methods Forty-two insomnia patients admitted to Department of Neurology were included as insomnia group,while 41 healthy subjects during the same period were included as control group.The two groups were assessed using sleep habits questionnaire,hospital anxiety and depression scale,polysomnography,and ASL perfusion magnetic resonance imaging.Results Compared with control group,insomnia group took significantly more time to fall asleep(P<0.05),and has shorter sleep duration(P<0.05).The differences in the levels of anxiety and depression between two groups were trivial.The total sleep time,rapid eye movement sleep duration,and non-rapid eye movement sleep stage S2-S4were shorter,while the sleep latency and non-rapid eye movement sleep stage S1were longer in insomnia group as compared with control group(all P<0.05).In insomnia group,perfusion was increased in bilateral prefrontal lobes,right temporal lobe,left parietal lobe,right thalamus,and pons(P<0.05),but decreased in bilateral insula and bilateral basal ganglia(P<0.05).Conclusion The combination of polysomnography and ASL perfusion magnetic resonance imaging enables precise quantification of sleep condition.

Objective:To design a visual allocation system of emergency medical equipment based on the Internet of Things technology,and to realize the coordinated allocation of emergency medical equipment in hospitals.Methods:The client and server(C/S)architecture was adopted,and the design of emergency medical equipment visual allocation system was mainly based on Bluetooth 5.1 technology,with automatic acquisition and automatic analysis of Bluetooth positioning tag,low power consumption sensor and signal communication of Bluetooth Internet of Things base station.The sample data of 150 pieces of equipment managed by the traditional allocation center mode of The 900th Hospital of People's Liberation Army Joint Logistics Support Force from January to December 2021 were selected,and the sample data of 150 pieces of equipment allocation during the application of the visual allocation system from June 2022 to June 2023 were randomly selected,and the allocation response time and the allocation warehousing in and out time were compared.A total of 40 ventilator devices were randomly selected during the traditional allocation center mode and the visual allocation period,with 20 ventilators in each mode,the start-up rate,utilization rate and profitability of medical equipment during the service period were compared.Results:The visual allocation system can realize the functions of automatic equipment positioning,emergency deployment,ledger management,remote repair report and benefit analysis.The allocation response time,allocation outbound time and allocation inbound time of the visual allocation system were(19.61±3.119)min,(11.73±2.104)min,(10.21±2.165)min,respectively,which were shorter than(54.98±3.999)min,(21.54±2.811)min,(16.80±2.000)min of the traditional allocation center mode,the difference was statistically significant(t=85.407,34.229,27.395,P<0.05).The start-up rate,utilization rate and profitability of ventilator equipment using visual allocation mode were 78.24%,51.23%and 82.76%,respectively,which were higher than 43.52%,36.26%and 47.83%of the traditional allocation center mode,the difference was statistically significant(x2=8.792,7.813,12.216,P<0.05).Conclusion:The visual allocation system of emergency medical equipment based on the Internet of Things technology can realize the functions of emergency medical equipment allocation and storage,equipment positioning and use status analysis,provide a theoretical basis for the allocation of hospital emergency medical equipment,and maximize the role of emergency medical equipment.

AIM:To study the effect of hepatitis B combined with hepatic fibrosis on endogenous and exogenous metabolism of liver and the effect of glycyrrhizic acid combined with tenofovir(TFV)es-ter on anti-HBV efficacy.METHODS:Hepatitis B mouse was induced by chronic CCI4 to form a mod-el of hepatitis B with hepatic fibrosis.H&E staining,Sirius Red Staining,α-SMA immunohistochemistry were used to detect pathological changes in liver tissue.The changes of liver endogenous metabo-lism in mice with hepatitis B and hepatic fibrosis were detected by metabolomics.LC-MS/MS was used to investigate the plasma and liver concentra-tions of TFV and its active metabolite(TFV-DP),for investigating the changes of exogenous metabo-lism.RESULTS:HBV+CCl4 mice showed fibrosis symptoms such as liver injury and collagen deposi-tion.Hepatitis B combined with hepatic fibrosis af-fected nucleotide metabolism,amino acid metabo-lism,tricarboxylic acid cycle,pentose phosphate pathway and other endogenous metabolism,low-ered the hepatic level of TFV-DP,and decreased the antiviral efficacy.By combining with glycyrrhizic acid or forming a self-assembled preparation,the hepatic level of TFV-DP was improved,and the anti-viral efficacy was enhanced.CONCLUSIONS:Hepati-tis B combined with hepatic fibrosis affected both endogenous and exogenous metabolism of liver.Different forms of combination of glycyrrhizic acid and TFV could elevate the level of TFV-DP in liver and improve the antiviral efficacy in HBV+CCI4 mice.

Purpose::To identify the risk factors for training-related lower extremity muscle injuries in young males by a non-invasive method of body composition analysis.Methods::A total of 282 healthy young male volunteers aged 18 -20 years participated in this cohort study. Injury location, degree, and injury rate were adjusted by a questionnaire based on the overuse injury assessment methods used in epidemiological studies of sports injuries. The occurrence of training injuries is monitored and diagnosed by physicians and treated accordingly. The body composition was measured using the BodyStat QuadScan 4000 multifrequency Bio-impedance system at 5, 50, 100 and 200 kHz to obtain 4 impedance values. The Shapiro-Wilk test was used to check whether the data conformed to a normal distribution. Data of normal distribution were shown as mean ± SD and analyzed by t-test, while those of non-normal distribution were shown as median (Q 1, Q 3) and analyzed by Wilcoxon rank sum test. The receiver operator characteristic curve and logistic regression analysis were performed to investigate risk factors for developing training-related lower extremity injuries and accuracy. Results::Among the 282 subjects, 78 (27.7%) developed training injuries. Lower extremity training injuries revealed the highest incidence, accounting for 23.4% (66 cases). These patients showed higher percentages of lean body mass ( p = 0.001), total body water (TBW, p=0.006), extracellular water ( p=0.020) and intracellular water ( p=0.010) as well as a larger ratio of basal metabolic rate/total weight ( p=0.006), compared with those without lower extremity muscle injuries. On the contrary, the percentage of body fat ( p=0.001) and body fat mass index ( p=0.002) were lower. Logistic regression analysis showed that TBW percentage > 65.35% ( p=0.050, odds ratio =3.114) and 3rd space water > 0.95% ( p=0.045, odds ratio =2.342) were independent risk factors for lower extremity muscle injuries. Conclusion::TBW percentage and 3rd space water measured with bio-impedance method are potential risk factors for predicting the incidence of lower extremity muscle injuries in young males following training.