Alzheimer’s disease (AD) is a chronic neurodegenerative disorder that severely affects the health of the elderly, marked by its incurability, high prevalence, and extended latency period. The current approach to AD prevention and treatment emphasizes early detection and intervention, particularly during the pre-AD stage of mild cognitive impairment (MCI), which provides an optimal “window of opportunity” for intervention. Clinical detection methods for MCI, such as cerebrospinal fluid monitoring, genetic testing, and imaging diagnostics, are invasive and costly, limiting their broad clinical application. Speech, as a vital cognitive output, offers a new perspective and tool for computer-assisted analysis and screening of cognitive decline. This is because elderly individuals with cognitive decline exhibit distinct characteristics in semantic and audio information, such as reduced lexical richness, decreased speech coherence and conciseness, and declines in speech rate, voice rhythm, and hesitation rates. The objective presence of these semantic and audio characteristics lays the groundwork for computer-based screening of cognitive decline. Speech information is primarily sourced from databases or collected through tasks involving spontaneous speech, semantic fluency, and reading, followed by analysis using computer models. Spontaneous language tasks include dialogues/interviews, event descriptions, narrative recall, and picture descriptions. Semantic fluency tasks assess controlled retrieval of vocabulary items, requiring participants to extract information at the word level during lexical search. Reading tasks involve participants reading a passage aloud. Summarizing past research, the speech characteristics of the elderly can be divided into two major categories: semantic information and audio information. Semantic information focuses on the meaning of speech across different tasks, highlighting differences in vocabulary and text content in cognitive impairment. Overall, discourse pragmatic disorders in AD can be studied along three dimensions: cohesion, coherence, and conciseness. Cohesion mainly examines the use of vocabulary by participants, with a reduction in the use of nouns, pronouns, verbs, and adjectives in AD patients. Coherence assesses the ability of participants to maintain topics, with a decrease in the number of subordinate clauses in AD patients. Conciseness evaluates the information density of participants, with AD patients producing shorter texts with less information compared to normal elderly individuals. Audio information focuses on acoustic features that are difficult for the human ear to detect. There is a significant degradation in temporal parameters in the later stages of cognitive impairment; AD patients require more time to read the same paragraph, have longer vocalization times, and produce more pauses or silent parts in their spontaneous speech signals compared to normal individuals. Researchers have extracted audio and speech features, developing independent systems for each set of features, achieving an accuracy rate of 82% for both, which increases to 86% when both types of features are combined, demonstrating the advantage of integrating audio and speech information. Currently, deep learning and machine learning are the main methods used for information analysis. The overall diagnostic accuracy rate for AD exceeds 80%, and the diagnostic accuracy rate for MCI also exceeds 80%, indicating significant potential. Deep learning techniques require substantial data support, necessitating future expansion of database scale and continuous algorithm upgrades to transition from laboratory research to practical product implementation.

ObjectiveTo investigate the optimal ratio of goat horn replacing antelope horn in Fufang Lingjiao Jiangya pills and the blood pressure-lowering mechanism of this medicine. MethodsThe blood pressure-lowering efficacy of Fufang Lingjiao Jiangya pills with varying proportions of goat horn replacing antelope horn was evaluated on spontaneous hypertensive rats （SHR）. In this experiment， 50 SHR rats were randomly grouped as follows： model （n=8）， captopril （0.01 g·kg^-1） （n=6）， low-dose blank Fufang Lingjiao Jiangya pills （0.342 g·kg^-1） （n=6）， high-dose blank Fufang Lingjiao Jiangya pills （0.684 g·kg^-1） （n=6）， low-dose antelope horn-containing Fufang Lingjiao Jiangya pills （0.378 g·kg^-1） （n=6）， high-dose antelope horn-containing Fufang Lingjiao Jiangya pills （0.756 g·kg^-1） （n=6）， low-dose goat horn-containing Fufang Lingjiao Jiangya pills （0.378 g·kg^-1） （n=6）， and high-dose goat horn-containing Fufang Lingjiao Jiangya pills （0.756 g·kg^-1） （n=6）. Additionally， 8 WKY rats were used as the normal group. Drugs were administered by gavage for 4 weeks while an equal volume of distilled water was administered for the normal and model groups. Blood pressure was measured before administration， 3 h post administration， and biweekly thereafter. In the experiment for Fufang Lingjiao Jiangya pills with goat horn replacing antelope horn in different proportions， 48 SHR rats were randomly grouped as follows： model， blank Fufang Lingjiao Jiangya pills （0.684 g·kg^-1）， antelope horn-containing Fufang Lingjiao Jiangya pills （0.756 g·kg^-1）， 2× goat horn-containing Fufang Lingjiao Jiangya pills （0.824 g·kg^-1）， 4× goat horn Fufang Lingjiao Jiangya pills （0.969 g·kg^-1）， and 6× goat horn Fufang Lingjiao Jiangya pills （1.112 g·kg^-1）. The normal group included 8 WKY rats， and the normal group and model group received an equal volume of distilled water. The treatment lasted for 2 weeks， and blood pressure was recorded at various time points （pre-administration， 3 h post administration， and on days 4， 7， 10， and 14 of administration）. Serum levels of angiotensin-converting enzyme （ACE）， angiotensin Ⅱ（Ang Ⅱ）， renin， and interleukin-6 （IL-6） were measured by enzyme-linked immunosorbent assay. Histopathological changes in the heart， kidney， and thoracic aorta were observed by hematoxylin-eosin staining. The protein levels of ACE2， angiotensin Ⅱ type 1 receptor （AT1R）， and angiotensinogen （AGT） in the kidney tissue were determined by Western blot， while the expression of nuclear factor （NF）-κB p65 and Toll-like receptor 4 （TLR4） in the thoracic aorta tissue was assessed by immunohistochemistry. ResultsCompared with the model group， all treatment groups showed lowered blood pressure （P<0.05， P<0.01）， and the 6× goat horn-containing Fufang Lingjiao Jiangya pills group showed consistent blood pressure-lowering effect with the antelope horn-containing Fufang Lingjiao Jiangya pills group. Compared with the normal group， the model group showed elevated serum levels of ACE， Ang Ⅱ， renin， and IL-6， while the elevations were declined in the Fufang Lingjiao Jiangya pills groups （P<0.05， P<0.01）. Pathological changes in the heart， kidney， and thoracic aorta were alleviated in all the treatment groups， with the 6× goat horn- and antelope horn-containing Fufang Lingjiao Jiangya pills groups exhibited the best effect. Western blot and immunohistochemistry results showed that all the treatment groups exhibited down-regulated protein levels of AT1R， AGT， NF-κB p65， and TLR4 and up-regulated protein levels of ACE2 （P<0.05， P<0.01） compared with model group， with the 6×goat horn- and antelope horn-containing Fufang Lingjiao Jiangya pills groups showcasing the best effect. ConclusionReplacing antelope horn with 6×goat horn in Fufang Lingjiao Jiangya pills can achieve consistent blood pressure-lowering effect with the original prescription. The prescription may exert the effect by inhibiting the renin-angiotensin-aldosterone system （RAAS） and TLR4/NF-κB signaling pathways.

ObjectiveTo investigate the clinical efficacy of lumbar core muscle stability training combined with kinesiology taping technique in the rehabilitation treatment of lumbar disc herniation （LDH）. MethodsA total of 99 LDH patients treated in Ningbo Yinzhou No. 2 Hospital from January 2018 to January 2020 were selected and divided into control group （n=49） and observation group （n=50）. Kinesiology taping technique was applied to patients in the control group and patients in the observation group were treated with lumbar core muscle stability training combined with kinesiology taping technique， then we compared the therapeutic effect， lumbar function and pain degree， surface electromyography of lumbar extensor muscles， lumbar range of motion， LDH recurrence and skin allergies before and after the treatment between the two groups. ResultsAfter 4 weeks of treatment， compared with those in the control group， in the observation group， the visual analogue scale （VAS） and Oswestry disability index （ODI） scores were significantly lower （P<0.05）； the Japanese Orthopaedic Association （JOA） score， mean power frequency of lumbar extensor muscles， integral electromyography value and lumbar function score were significantly higher （P<0.05）. During the treatment， there was no significant difference in the incidence of complications between two groups （P>0.05）. After 4 weeks of treatment， the observation group had a significantly lower LDH recurrence rate than the control group （P<0.05）. ConclusionLumbar core muscle stability training combined with kinesiology taping technique achieves a significantly better therapeutic effect than kinesiology taping technique in the rehabilitation treatment of LDH and can effectively relieve muscle fatigue， help alleviate lumbar spine pain and improve the function of lumbar spine.

Objective To investigate the effects of combined assessment of normal morphology sperm rate(MNS)with sperm DNA fragmentation index(DFI)on the outcomes of in vitro fertilization-embryo transfer(IVF-ET).Methods A retrospective analysis was conducted on the clinical data of 641 patients who underwent IVF-ET in our center from June 2020 to February 2023.According to MNS and DFI levels,the patients were divided into group A(MNS＜4％,DFI＜25％,403 cases),group B(MNS ≥4％,DFI ≥25％,9 ca-ses),group C(MNS≥4％,DFI＜25％,125 cases),group D(MNS＜4％,DFI≥25％,104 cases),group A1(MNS＜1％,DFI＜25％,106 cases)and group D1(MNS＜1％,DFI≥25％,60 cases).The general information,semen parameters,embryo develop-ment and pregnancy outcomes were compared among all the 6 groups.Results No statistically significant differences were found be-tween female and male age among these groups(P＞0.05).Significant differences were observed in sperm motility,progressive motili-ty,sperm concentration and fertilization rates(P＜0.05),but no differences of usable embryo rates,good-quality embryo rates,clinical pregnancy rates,early miscarriage rates,or live birth rates(P＞0.05)among the groups A,B,C,D,A1 and D1.Conclusion The decreased MNS and increased DFI in males were associated with reduced sperm motility and concentration,affecting fertilization rates in IVF-ET,but had no significant impact on clinical pregnancy outcomes.The combined assessment of MNS with DFI had limited pre-dictive value for IVF-ET pregnancy outcomes.

177Lu-prostate specific membrane antigen(PSMA)radio-ligand therapy has been approved abroad for advanced prostate cancer and has been in several clinical trials in China.Based on domestic clinical practice and experimental data and referred to international experience and viewpoints,the expert group forms a consensus on the clinical application of 177Lu-PSMA radio-ligand therapy in prostate cancer to guide clinical practice.

Objective·To verify the performance and explore the clinical application value of a multi-modal pulmonary nodule diagnosis model combined with metabolic fingerprints,protein biomarker CEA and Image-AI via random forest(MPI-RF).Methods·This study enrolled 289 patients with pulmonary nodules who were admitted to the Shanghai Chest Hospital,Shanghai Jiao Tong University School of Medicine and were detected by low-dose helical computed tomography(LDCT).The patients were divided into malignant nodule group(n=197)and benign nodule group(n=92)based on postoperative pathological results,and the basic information of the two groups was collected and compared.Electrochemiluminescence was used to detect the preoperative serum CEA levels of the patients in the two groups,matrix-assisted laser desorption/ionization mass spectrometry(MALDI-MS)was used to detect the serum metabolic fingerprints,and the CT image artificial intelligence model Image-AI was used to calculate the image scores.CEA data,serum metabolic fingerprints data and image scores were integrated and input into MPI-RF to calculate the malignant probability score of each patient.The receiver operator characteristic curve(ROC curve)and area under the curve(AUC)were used to evaluate the performance of different models,and the DeLong test was used for comparative analysis,including the diagnostic performance of MPI-RF in different types(solid nodule,pure ground-glass nodule and part-solid nodule)and sizes(diameter<8 mm and diameter≥8 mm)of pulmonary nodules,the diagnostic performance comparison of MPI-RF with Mayo Clinic model,veterans administration(VA)model and Brock model,and the diagnostic performance comparison of MPI-RF with lung imaging reporting and data system(Lung-RADS)in benign and malignant nodules.Results·MPI-RF had good diagnostic performance in the differentiation of benign and malignant pulmonary nodules(AUC=0.887,95%CI 0.848?0.925,sensitivity 81.22%,specificity 83.70%).Among them,the AUC of MPI-RF for solid nodules was 0.877(95%CI 0.820?0.934),for part-solid nodules was 0.858(95%CI 0.771?0.946),and for pure ground-glass nodules was 0.978(95%CI 0.923?1.000).The AUC of MPI-RF was 0.840(95%CI 0.716?0.963)for nodules within 8 mm diameter and 0.891(95%CI 0.849?0.933)for nodules larger than 8 mm diameter.Compared with the existing models,the diagnostic performance of MPI-RF was better than that of Mayo Clinic model,VA model and Brock model(all P=0.000).Compared with Lung-RADS,MPI-RF had better diagnostic performance in the total samples and different types of nodules(all P=0.000).Conclusion·MPI-RF is a model for the differential diagnosis of benign and malignant pulmonary nodules with excellent performance,and has potential clinical application value.

Objective To establish and validate a Nomogram model for predicting the overall survival(OS)of the patients with intrahepatic cholangiocarcinoma(ICC)based on domestic multicenter data,and screen the beneficiaries of adjuvant chemotherapy based on the prediction model.Methods From December 2011 to December 2017,the data of 278 patients with postoperative pathological diagnosis of ICC from 4 medical centers in our country were collected retrospectively COX regression model was used to screen the independent risk factors of OS and constructed a Nomogram model.This model was used to stratify the risk of OS for all patients and to screen the beneficiaries of adjuvant chemotherapy.Results A total of 278 patients were enrolled,and 23 cases(8.3%)received adjuvant chemotherapy.COX multivariate analysis showed that drinking history,ECOG score,method of hepatectomy,lymph node status,number of tumors,and tumor differentiation were independent risk factors for postoperative OS.The Nomogram model had a C-index of 0.690(95%CI:0.646-0.734)in the training cohort and 0.740(95%CI:0.863-0.617)in the validation cohort.According to risk stratification by Nomogram model,in the high-risk group there was a statistically significant difference in survival between adjuvant chemotherapy and non-adjuvant chemotherapy(P=0.033),whereas in the low-risk group,there was no significant difference in survival(P=0.59).Conclusions Nomogram model based on independent risk factors of OS demonstrated excellent predictive capability for survival and could be used to screen,and identify the patients with ICC who benefit from adjuvant chemotherapy.

Objective:To conduct a scoping review of research on the self-advocacy of adult cancer patients to identify their self-advocacy needs, behaviors, strengths and weaknesses, so as to provide guidance for future research in this field.Methods:Using the scoping review guidelines of Joanna Briggs Institute in Australia as a methodological framework, relevant literatures were searched in PubMed, Web of Science, Cochrane Library, Embase, Science Direct, CINAHL, Scopus, China National Knowledge Infrastructure, Wanfang, VIP and China Biology Medicine disc. The search period was from establishment of the databases to December 2023, and the results were summarized and analyzed.Results:A total of 14 articles were included, and self-advocacy needs included six types of needs, such as symptom management, communication, interpersonal support, disease information, decision-making and emotional management. Self-advocacy included four aspects, including seeking information, self-decision-making, strengthening contact with the outside world and effective communication.Conclusions:Adult cancer patients have diverse types of self-advocacy needs and certain self-advocacy behaviors. Future research should pay attention to self-advocacy needs assessment, develop corresponding tools, focus on self-advocacy behaviors, leverage the advantages of self-advocacy and explore strategies to achieve effective self-advocacy support.

Objective:To conduct a scoping review of the application of mobile health applications (MHA) in the care of patients with colorectal cancer, summarizing the development process, the functions achieved, as well as the evaluation metrics, to provide references for MHA practice and related research.Methods:Following the scoping review framework, a comprehensive search was conducted across both domestic and international databases, including the China Biomedical Literature Database, Wanfang Database, China National Knowledge Infrastructure (CNKI), VIP Database, Cochrane Library, PubMed, Embase, CINAHL, Web of Science, and Scopus. The search period was from the database inception to February, 2024.Results:A total of 16 studies were included. The development of MHA involved multiple methods including literature reviews, qualitative interviews, consultations with multidisciplinary teams, and guidance from theoretical models. The functions of MHA include health education, peer support, guided feedback, monitoring, and reminder features. Evaluation metrics for MHA comprise usability, adherence, and effectiveness.Conclusions:MHA has demonstrated positive effects in enhancing patients' knowledge and alleviating symptoms such as fatigue and vomiting in colorectal cancer patients. However, it is still in its early stages, and further high-quality studies are needed to scientifically develop MHA that meets patients' needs.

Purpose To establish a non-invasive model for predicting axillary lymph node metastasis(ALNM)based on breast cancer related metabolic parameters.Materials and Methods A total of 158 patients diagnosed as breast cancer in Meizhou People's Hospital from January 1,2016 to March 30,2023 were selected,and all of them underwent whole-body PET/CT examination in our department before operation.Metabolic parameters of primary breast cancer[maximum standard uptake value(SUVmax),metabolic volume,total glycolysis(TLG)],highest axillary lymph node uptake SUVmax(SUVmaxALN),axillary lymph node short diameter and clinical related indexes[age,maximum tumor diameter,pathological type and tumor location]were obtained.According to the surgical and pathological results,the patients were divided into ALNM positive[ALNM(+)]group and ALNM negative[ALNM(-)]group.The relationship between the parameters of the two groups was analyzed,the best influencing factors were screened out,and binary Logistic regression was used to establish a prediction model to obtain the primary metabolic parameters of breast cancer.Results There were significant differences in TLG,metabolic volume,axillary lymph node short diameter and SUVmaxALN between ALNM(+)group and ALNM(-)group(Z=-3.924--1.812,all P<0.05),but there were no significant differences in age,tumor maximum diameter,pathological type,tumor location,primary focus SUVmax and SUVavg(all P>0.05).Multivariate Logistic regression analysis showed that TLG of breast cancer primary focus and SUVmaxALN could be used as independent risk factors of ALNM of breast cancer,and the regression model established by using these two factors was Logit(P)=0.142+0.443×SUVmaxALN-0.013×TLG.The area under the curve of ALNM prediction model based on TLG and SUVmaxALN was 0.769(95%CI 0.691-0.841,P<0.001).Conclusion TLG of breast cancer primary focus and SUVmaxALN can be used as independent predictors of ALNM of breast cancer,and the prediction model based on these two factors can predict ALNM well.This non-invasive method may have a certain application prospect in clinic.