ObjectiveThis study aims to develop and validate a novel multimodal predictive model， termed criss-cross network（CCNet）-directed graph neural network（DGNN）（CGN）， for accurate assessment of pulmonary nodule progression in high-risk individuals for lung cancer， by integrating longitudinal chest computed tomography（CT） imaging with both traditional Chinese and western clinical evaluation data. MethodsA cohort of 4 432 patients with pulmonary nodules was retrospectively analyzed. A twin CCNet was employed to extract spatiotemporal representations from paired sequential CT scans. Structured clinical assessment and imaging-derived features were encoded via a multilayer perceptron， and a similarity-based alignment strategy was adopted to harmonize multimodal imaging features across temporal dimensions. Subsequently， a DGNN was constructed to integrate heterogeneous features， where nodes represented modality-specific embeddings and edges denoted inter-modal information flow. Finally， model optimization was performed using a joint loss function combining cross-entropy and cosine similarity loss， facilitating robust classification of nodule progression status. ResultsThe proposed CGN model demonstrated superior predictive performance on the held-out test set， achieving an area under the receiver operating characteristic curve（AUC） of 0.830， accuracy of 0.843， sensitivity of 0.657， specificity of 0.712， Cohen's Kappa of 0.417， and F₁ score of 0.544. Compared with unimodal baselines， the CGN model yielded a 36%-48% relative improvement in AUC. Ablation studies revealed a 2%-22% increase in AUC when compared to simplified architectures lacking key components， substantiating the efficacy of the proposed multimodal fusion strategy and modular design. Incorporation of traditional Chinese medicine （TCM）-specific symptomatology led to an additional 5% improvement in AUC， underscoring the complementary value of integrating TCM and western clinical data. Through gradient-weighted activation mapping visualization analysis， it was found that the model's attention predominantly focused on nodule regions and effectively captured dynamic associations between clinical data and imaging-derived features. ConclusionThe CGN model， by synergistically combining cross-attention encoding with directed graph-based feature integration， enables effective alignment and fusion of heterogeneous multimodal data. The incorporation of both TCM and western clinical information facilitates complementary feature enrichment， thereby enhancing predictive accuracy for pulmonary nodule progression. This approach holds significant potential for supporting intelligent risk stratification and personalized surveillance strategies in lung cancer prevention.

Objective To understand the health-related quality of life (HRQOL) of migrant workers with pneumoconiosis who received basic medical treatment in Hunan Province. Methods A total of 613 migrant workers with pneumoconiosis who received basic medical treatment and assistance in Hunan Province was selected as the study subjects using stratified random sampling method. The European Quality of Life-5 Dimensions (EQ-5D) questionnaire was used to assess their HRQOL. Results The abnormality of the five dimensions of the EQ-5D health description system, from high to low, were as follows： daily activities, mobility, pain/discomfort, anxiety/depression, and self-care, with the abnormal rates of 50.9%, 46.8%, 41.1%, 21.0%, and 14.5%, respectively. The visual analogue scale (VAS) score of EQ-5D was (63.5±18.6) points. Patients with stage Ⅲ pneumoconiosis had high abnormality in mobility, daily activities, and pain/discomfort compared with those with stage Ⅰ and Ⅱ disease (all P<0.02). Patients in stage Ⅱ and Ⅲ of pneumoconiosis had higher incidence of anxiety/depression compared with those with stage I disease (all P<0.02). Patients with complications in addition to pneumoconiosis had higher abnormality in mobility, self-care, and pain/discomfort compared to those with simple pneumoconiosis or those eligible for lung lavage treatment (all P<0.02). Patients with simple pneumoconiosis had a higher incidence of anxiety/depression compared with those eligible for lung lavage treatment (P<0.02). Patients with stage Ⅲ pneumoconiosis had lower average VAS scores compared with stage Ⅰ and Ⅱ patients (all P<0.02). Patients with simple pneumoconiosis or those with complications had lower average VAS scores compared with those eligible for lung lavage treatment (all P<0.05). Conclusion The HRQOL of pneumoconiosis patients among migrant workers needs improvement, especially for patients with stage Ⅲ disease and those with complications. This study indicates the need of optimizing policies, raising the hospitalization expense limit for critically ill patients with stage Ⅲ pneumoconiosis or with complications, and improving their HRQOL.

Objective:To explore the mechanism of illness perception between the perceived burden and quality of life of the primary caregivers of patients with persistent vegetative state or minimally conscious state, so as to provide reference for improving the quality of life of primary caregivers.Methods:This study was a cross-sectional study. From August 2021 to January 2022, the primary caregivers of 160 patients with persistent vegetative state or minimally conscious state in the Hyperbaric Oxygen Ward of the Second People's Hospital of Hefei were selected as the research object by the convenience sampling. The General Information Questionnaire, Perceived Caregiver Burden Scale for Caregivers, Brief Illness Perception Questionnaire, and the CarerQol Instrument were used for investigation. Pearson correlation was used to analyze the correlation of illness perception, perceived burden, and quality of life of the primary caregivers of patients with persistent vegetative status or minimally conscious state. Stepwise regression was used to analyze the mediating effect of illness perception, and structural equation model was constructed and verified using AMOS23.0.Results:The scores of illness perception, perceived burden and quality of life of the primary caregivers of patients with persistent vegetative state or minimally conscious state were (60.54±9.48) , (32.08±5.83) and (7.83±2.31) respectively. The total score of illness perception was positively correlated with the total score of quality of life ( r=0.597, P<0.01) , the total score of quality of life was negatively correlated with the total score of perceived burden ( r=-0.630, P<0.01) , and the total score of perceived burden was negatively correlated with the total score of illness perception ( r=-0.623, P<0.01) . Illness perception played a part of mediating effect between the perceived burden and quality of life of the primary caregivers of patients with persistent vegetative state or minimally conscious state, and the mediating effect accounted for 20.22% of the total effect value. Conclusions:The perceived burden of caregivers can directly predict the quality of life, and can also indirectly affect the quality of life through illness perception. Reducing the illness perception level of the primary caregivers is conducive to decreasing the illness perception burden, improving their quality of life and the level of care.

Objective To systematically review reports dealing with the efficacy of pulmonary rehabilitation for patients with acute exacerbation of chronic obstructive pulmonary disease.Methods The PubMed,EMbase,China National Knowledge Infrastructure,VIP and Wan Fang databases were searched to collect reports of randomized and controlled trials of pulmonary rehabilitation for patients with acute exacerbation of chronic obstructive pulmonary disease.The search covered from each database's inception to August 1,2016.Two reviewers screened the literature independently,extracted data and assessed the risk of bias for the studies eventually included.A meta-analysis was performed using version 5.3 of the RevMan software.Results After the initial selection,a total of 7 reports covering 486 patients were included in the meta-analysis.The results of the meta-analysis showed that the average mMRC score,the 6-minute walk distance and Borg score in the pulmonary rehabilitation group were all significantly higher than in the control group.There was,however,no significant difference between the two groups' average pulmonary function values.Conclusion Pulmonary rehabilitation is safe for patients experiencing an acute exacerbation of chronic obstructive pulmonary disease.It can effectively improve their exercise tolerance,expiratory dyspnea and daily living ability.

Occupational Therapist Registered (OTR) Exam is established and managed under the national certification body for occupa-tional therapy professionals-National Board for Certification in Occupational Therapy (NBCOT). The OTR Exam is designed based on reg-ular practical analysis on the entry-level front-line occupational therapists in the United States, conducted by the Certification Examination Development Committee (CEDC). The panel will follow four steps, including drafting the exam blueprint, designing the questions, rounds of discussion and validation and finally putting the questions into confidential question bank for random selection by computer during exam. The OTR Exam is featured by its close relevance and update with clinical status of the States, high-standard professional requirement based on broadest public consensus within the profession as well as its evidence-based and scientific procedure throughout the designing process, which may benefit the development and standardization of Occupational Therapy Profession in China.

Objective To explore the efficacy of neuromuscular electrical stimulation (NMES) in treating severe and chronic obstructive pulmonary disease (COPD).Methods Seventy-eight COPD patients were randomly divided into an NMES group of 38 and an exercise therapy group of 32.In addition to the routine drug therapy and basic rehabilitation training,the NMES group received 8 weeks of NMES of the lower limbs while the exercise group was provided with strength and endurance training of the lower limbs,also for 8 wceks.Before and after the 8 weeks of treatment,pulmonary function was tested along with isokinetic quadriceps strength,cardiopulnonary capacity,and lung capacity using Saint George's respiratory questionnaire (SGRQ).Results The two groups showed no significant difference in any of the measurements before the treatment.After the treatment,forced expiratory volume in 1 second of (FEV1),FEV1/forced vital capacity (FVC),FEVI in percentage of the predicted value,medical research council dyspnea scale (MRC) score and the 6-minute walk distance (6MWD) improved in both groups.However,the average body mass index and 6 minute walk distance differed significantly between the groups after the treatment.The quadriceps' peak torque increased after the treatment in both groups,but the average in the exercise group was significantly higher than that in the NMES group.VO2max and Wmax also increased significantly in both groups,and the average time to exhaustion increased significantly in the exercise group.Significant improvement was observed in the BODE assessment after the intervention for both groups.Conclusion Neuromuscular electrical stimulation is as effective as therapeutic exercise in promoting the rehabilitation of severe COPD patients.However,lower limbs exercise is still the first choice in managing such patients.

Background and purpose:Adenosine triphosphate-binding cassette superfamily G member 2 (ABCG2), which has been found over-expressed in a variety of cancer cells, takes part in the drug resistance of cancer through effux of anticancer drugs. The purpose of this study was to investigate the mechanisms of human glioblastoma cells sensitivity to pyropheophorbide-a methyl ester (MPPa)-mediated photodynamic therapy (PDT) eradicating tumour cells and its relationship to ABCG2.Methods:U87 and A172 glioma cell lines in the logarithmic growth phase were selected and exposed to the treatment of MPPa-PDT and MPPa-PDT+fumitremorgin C (FTC) respectively. The cell viability was measured with the use of CCK-8 assay. The expression of ABCG2 was detected by Western blot. The intracellular contents of MPPa in each group without illumination were tested by lfow cytometry. Flow cytometry with AnnexinⅤ-FITC/PI double staining was used to detect the cell apoptotic rate. DCFH-DA staining was used to assess the generation of intracellular reactive oxygen species (ROS).Results:The MPPa-mediated PDT could eradicate A172 and U87 cancer cells in an energy-dependent manner. The light energy density in A172 was 8 times of that in U87 when the cell viability reached median lethal dose after MPPa-mediated PDT. The high expression of ABCG2 in A172 cells affected the accumulation of intracellular MPPa. Inhibition of ABCG2, not only could enhance the eradicating effect of MPPa-PDT on A172 cells, but also could increase the yield of ROS triggered by MPPa-PDT and the accumulation of intracellular MPPa.Conclusion:The human glioblastoma cell line A172 is insensitive to MPPa-mediated PDT. The mechanism may relate to ABCG2, which decreases the MPPa content in cancer cells through effux of MPPa, resulting in decline of cytotoxicity.

This study descriptively illustrated the definition of certified hand therapist, eligibility requirement and accreditation system based on the official guidelines from American Society of Hand Therapists (ASHT), Hand Therapy Certification Commission (HTCC) and Handbook of Certified Hand Therapy Examination. Besides, this exam was compared with National Physical Therapy Examination (NPTE) and Occupational Therapist Registered Examination (OTR Exam). The testing domains and contents may help the domestic teaching faculty to standardize the course syllabi, promote divided development of physical therapy and occupational therapy in a specialized manner, and ex-erted positive impact for promoting establishment of the hand specialists and accreditation system of China itself.

Objective There is a huge demand for rehabilitative services in Chongqing whereas detailed information regarding local clinical services and rehabilitative professionals are unknown. Therefore, a cross-sectional survey was conducted to generate a profile of current rehabilitative status in Chongqing for reference of relevant local parties and peers in other provinces of China to create a larger picture of rehabil-itation in China. Methods The survey began in early January of 2015 and ended on October 20th of 2015. With two categories of information, including background of rehabilitation professionals and rehabilitative clinical services, the self-made questionnaire was sent via email to rehabilitation therapists working in local clinical settings which fulfilled the inclusion criteria. The reminder was sent once a month to those who did not yet replied. The software SPSS 20.0 was used to analyze the data descriptively. Results 7 out of 13 in-volved clinical settings responded with an overall response rate of 53.8%. 98 out of 122 copies were adopted based on filling requirement. The result revealed 68.4%(n=67) of the participants were junior practitioners, 57.1%(n=56) of them had less than 5 years experience and 45.9%(n=45) were holding a diploma with little research experience. As for clinical services, assessment of ROM (94.9%, n=93) and manual muscle testing (94.9%, n=93) were mostly used. The physical therapy service was more prevalent than occupational therapy services. The clinical field mostly involved was adult rehabilitation (77.6%, n=76). Bedside training in the acute phase (81.6%, n=80) and one-to-one treatment (92.9%, n=91) was the most commonly seen mode of service in the departments. Conclusion The local rehabilitative professionals were featured by their young age with comparatively low educational level, qualification and weak research skills. The clinical services they provided were yet quite basic and simple. Thus, a set of policies regarding education and profession in rehabilitation therapy should be facilitated instantly and it also calls for the establishment of local academic society for rehabilitation therapists, thus promoting an all-round development of rehabilitative profession.

Objective To obtain imaging information of the cervical arteries and vertebral structure of rhesus ma -caques and provide useful reference data for medical research works using macaques as animal models .Methods Six a-dult macaques (3 males and 3 females) in age of 3-5 years, body weight from 3.5 to 5 kg, were used to examine the neck by 320 row spiral CT imaging under general anesthesia , and three-dimensional reconstruction was performed to observe the vertebral artery morphology , and to measure the diameter of vertebral artery and the size of transverse foramen of the ma -caques .Color Doppler ultrasound was combined with 320-CT imaging to assess the blood flow velocity in carotid arteries . After CT scan to make sure that the vertebral artery and cervical vertebra of macaques had no deformity , the size of trans-verse foramen and diameter of vertebral artery were measured in the cross-sectional images .Color Doppler ultrasound was used to analyze the peak systolic velocity ( PSV) , diastolic peak flow velocity ( EDV) and the diameter ( D) of common ca-rotid artery (CCA), internal carotid artery (ICA), external carotid artery (ECA), and vertebral artery (VA) of the ma-caques .Results The 320-CT scan showed that in the monkeys , the vertebral artery enters the cervical spine through the intervertebral foramina at C6, and leaves the cervical spine at C 2 level, and the cervical spine has Luschka joint , which is similar to the anatomic structure in humans .The diameter of left and right vertebral arteries was 1.89 ±0.44 mm and 1.72 ±0.39 mm, respectively , with no significant difference between them in the same segment ( P>0.05 ) , and the size of transverse foramen also had no significant difference in the same segment ( P>0.05 ) .Color Doppler ultrasound showed that the left and right side systolic peak velocity (PSV) and diastolic peak velocity (EDV) of CCA and ICA, the left and right side systolic peak velocity (PSV) of ECA and VA had statistically significant difference (P<0.05), and the left ar-teries were predominant in the macaques .Conclusions In this study we obtained some imaging information of vertebral artery morphology and artery blood flow of macaques and these information may provide some useful basic data for further studies using rhesus macaques as animal models .