Objective To explore the expression of hsa_circ_0023984 in hepatic celluler cancer(HCC)and its adjacent tissues and to analyze its clinical significance,and to construct an endogenous competitive RNA regulatory network.Methods CircRNA expression profiles of cancer tissue and adjacent tissue samples from GES97332 dataset in Gene Expession Omnibus database were downloaded and circRNA differential expression was screened.The expression of hsa_circ_0023984 was detected in the tissues of 34 HCC patients,and the relationship between it and the clinicopathological features was analyzed.The protein interaction network was constructed,and the function was further understood by gene ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analysis.Results The expression of hsa_circ_0023984 was lower in tumor tissues than in adjacent tissues.The expression level of hsa_circ_0023984 was related to the envelope condition(F=3.47,P＜0.05).Three targeted miRNAs were obtained,and the Hub genes were PARGC1,GNG 4,WNT 5 A,CDK 6,SP 1,KRAS,GNAI 3,NCOA3,PIK3R1,and MAPK 8.GO analysis and KEGG analysis indicated that downstream mRNAs of hsa_circ_0023984 may be involved in cancer pathways and the choline metabolism pathway in cancer.Conclusion High expression of hsa_circ_0023984 in primary HCC,and high expression of hsa_circ_0023984 may be related to the malignant development of primary HCC.

Objective To analyze the case distribution, trends and dispute causes in initial verification of occupational disease diagnosis (VODD) in Guangzhou City from 2015 to 2024. Methods A total of 1 006 cases applying for initial VODD in Guangzhou City from 2015 to 2024 were selected as the study subjects using the convenience sampling method. Data on their basic information, disease category distribution, acceptance status, and dispute-related characteristics were collected and analyzed. Results Among the 1 006 VODD application cases, 884 completed the verification process, accounting for 87.9%. Cases withdrawn by applicants, suspended appraisals, and non-accepted applications accounted for 8.7%, 2.3%, and 1.1%, respectively. Among the 884 cases that completed verification, the most prevalent occupational diseases were occupational noise-induced hearing loss, occupational tumors (benzene-induced leukemia), occupational pneumoconiosis, and occupational chronic benzene poisoning, accounting for 77.0%. Cases appraised as occupational diseases accounted for 41.5%, and the proportion showed a decreasing trend over the years (P<0.01). The inconsistency rate between VODD conclusions and occupational disease diagnostic conclusions was 4.4%, mainly attributable to insufficient cooperation during clinical examinations and incomplete submission of required materials. Conclusion The initial VODD in Guangzhou City from 2015 to 2024 demonstrated relatively concentrated disease categories and controllable dispute levels. Clinical examination compliance and standardization of material submission were key factors affecting consistency of appraisal conclusions. It is proposed that effective measures be adopted to rectify existing deficiencies, with the aim of further enhancing the standardization and refinement of VODD practice.

Objective:To propose a semi-supervised learning method for dynamic generation of organ geometric contours, leveraging bladder volume variations and its relative position to the uterus to accurately generate uterine contours in cervical cancer radiotherapy.Methods:A total of 120 sets of pelvic planning CT images (including both full and empty bladder scans) from 60 patients with cervical cancer treated at the Department of Radiation Oncology, Nanfang Hospital of Southern Medical University between January and December 2023 were retrospectively collected. A conditional generative adversarial network (CGAN) based on a squeeze-and-excitation channel attention mechanism was proposed to accurately generate uterine geometric contours under varying bladder filling states. By emphasizing the critical spatial relationships between the bladder and uterus, the model learned the relative anatomical positions of pelvic organs and their motion correlations. The generative performance was quantitatively evaluated using the average Dice similarity coefficient (DSC), intersection over union (IoU), and the 95 th percentile Hausdorff distance (HD95), and was compared with GAN model, CGAN model, and Pix2Pix model. Pairwise comparisons were perfomed by paired-sample t-test. Results:The proposed SE-CGAN model achieved the best performance on the test set, with DSC of 0.83±0.09, IoU of 0.71±0.05, HD95 of (6.74±1.23) mm, improving DSC by 7.5%, 4.9%, and 3.6% compared to the GAN, CGAN, and Pix2Pix models, respectively (all P<0.001), and reducing the mean HD95 by 32.9%-45.3%. Statistical analysis revealed significant differences between SE-CGAN model and the other 3 baseline models, whereas no significant difference was observed between CGAN model and Pix2Pix model. The visualization results further demonstrated that the GAN model produced uterine contours deviated greatly from the real shape, and the edge was fuzzy; CGAN and Pix2Pix model achieved better overlap but lacked of precision in boundary reconstruction. In contrast, the contours generated by SE-CGAN model closely matched the ground truth with clearly defined edges, indicating superior reconstruction accuracy. Conclusions:In this study, we propose a generative adversarial network method that establishes a dynamic modulation mechanism by which the bladder state influences the uterine geometric contour, enabling accurate generation of the uterine contours from the bladder contours of any given localization CT scan. This approach effectively addresses the uncertainty in radiotherapy target delineation caused by pelvic organ motion.

Objective To investigate the effects of inclined axial compressive force and flexion moment on the anterior and posterior shear stiffness of the lumbosacral segment.Methods Six fresh-frozen human cadaveric L5-S1 segments were tested under intact and two progressively impaired structural conditions:intact,a 4-mm bilateral facet joint gap,and anterior discectomy with nucleus pulposus removal plus circumferential release of the inner annular fibers(disc injury).A 300 N axial compressive force was applied either vertically downward or with a 10° or 20° anterior inclination through the disc's shear center.Anterior(0 N to 250 N)and posterior(-50 N to 0 N)shear tests were conducted using a material testing machine.These tests were repeated under a 5 N-m flexion moment.The relative motion between L5 and Si was measured using a three-dimensional motion capture system.Results In the intact state,the inclination of the axial compressive force did not significantly alter anterior or posterior shear stiffness.However,the application of a flexion moment increased anterior shear stiffness by 49.3％.Progressive structural damage resulted in incremental increases in anteroposterior shear translation and corresponding reductions in stiffness.Notably,under combined loading with axial compression and flexion moment,anterior stiffness decreased from 939 N/mm(intact)to 224 N/mm(disc injury),while posterior stiffness decreased from 572 N/mm to 217 N/mm.Within the low-load range,no significant differences in shear stiffness were observed across any structural conditions,regardless of axial force inclination or combined with a flexion moment.Conclusions This study supports the clinical view that retro-inclination of the pelvis serves as a compensatory mechanism to enhance segmental shear stability.However,this compensatory capacity gradually diminishes and ultimately fails as spinal degeneration progresses.

Objective To investigate the effects of inclined axial compressive force and flexion moment on the anterior and posterior shear stiffness of the lumbosacral segment.Methods Six fresh-frozen human cadaveric L5-S1 segments were tested under intact and two progressively impaired structural conditions:intact,a 4-mm bilateral facet joint gap,and anterior discectomy with nucleus pulposus removal plus circumferential release of the inner annular fibers(disc injury).A 300 N axial compressive force was applied either vertically downward or with a 10° or 20° anterior inclination through the disc's shear center.Anterior(0 N to 250 N)and posterior(-50 N to 0 N)shear tests were conducted using a material testing machine.These tests were repeated under a 5 N-m flexion moment.The relative motion between L5 and Si was measured using a three-dimensional motion capture system.Results In the intact state,the inclination of the axial compressive force did not significantly alter anterior or posterior shear stiffness.However,the application of a flexion moment increased anterior shear stiffness by 49.3％.Progressive structural damage resulted in incremental increases in anteroposterior shear translation and corresponding reductions in stiffness.Notably,under combined loading with axial compression and flexion moment,anterior stiffness decreased from 939 N/mm(intact)to 224 N/mm(disc injury),while posterior stiffness decreased from 572 N/mm to 217 N/mm.Within the low-load range,no significant differences in shear stiffness were observed across any structural conditions,regardless of axial force inclination or combined with a flexion moment.Conclusions This study supports the clinical view that retro-inclination of the pelvis serves as a compensatory mechanism to enhance segmental shear stability.However,this compensatory capacity gradually diminishes and ultimately fails as spinal degeneration progresses.

Objective To explore the expression of hsa_circ_0023984 in hepatic celluler cancer(HCC)and its adjacent tissues and to analyze its clinical significance,and to construct an endogenous competitive RNA regulatory network.Methods CircRNA expression profiles of cancer tissue and adjacent tissue samples from GES97332 dataset in Gene Expession Omnibus database were downloaded and circRNA differential expression was screened.The expression of hsa_circ_0023984 was detected in the tissues of 34 HCC patients,and the relationship between it and the clinicopathological features was analyzed.The protein interaction network was constructed,and the function was further understood by gene ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analysis.Results The expression of hsa_circ_0023984 was lower in tumor tissues than in adjacent tissues.The expression level of hsa_circ_0023984 was related to the envelope condition(F=3.47,P＜0.05).Three targeted miRNAs were obtained,and the Hub genes were PARGC1,GNG 4,WNT 5 A,CDK 6,SP 1,KRAS,GNAI 3,NCOA3,PIK3R1,and MAPK 8.GO analysis and KEGG analysis indicated that downstream mRNAs of hsa_circ_0023984 may be involved in cancer pathways and the choline metabolism pathway in cancer.Conclusion High expression of hsa_circ_0023984 in primary HCC,and high expression of hsa_circ_0023984 may be related to the malignant development of primary HCC.

Objective:To propose a semi-supervised learning method for dynamic generation of organ geometric contours, leveraging bladder volume variations and its relative position to the uterus to accurately generate uterine contours in cervical cancer radiotherapy.Methods:A total of 120 sets of pelvic planning CT images (including both full and empty bladder scans) from 60 patients with cervical cancer treated at the Department of Radiation Oncology, Nanfang Hospital of Southern Medical University between January and December 2023 were retrospectively collected. A conditional generative adversarial network (CGAN) based on a squeeze-and-excitation channel attention mechanism was proposed to accurately generate uterine geometric contours under varying bladder filling states. By emphasizing the critical spatial relationships between the bladder and uterus, the model learned the relative anatomical positions of pelvic organs and their motion correlations. The generative performance was quantitatively evaluated using the average Dice similarity coefficient (DSC), intersection over union (IoU), and the 95 th percentile Hausdorff distance (HD95), and was compared with GAN model, CGAN model, and Pix2Pix model. Pairwise comparisons were perfomed by paired-sample t-test. Results:The proposed SE-CGAN model achieved the best performance on the test set, with DSC of 0.83±0.09, IoU of 0.71±0.05, HD95 of (6.74±1.23) mm, improving DSC by 7.5%, 4.9%, and 3.6% compared to the GAN, CGAN, and Pix2Pix models, respectively (all P<0.001), and reducing the mean HD95 by 32.9%-45.3%. Statistical analysis revealed significant differences between SE-CGAN model and the other 3 baseline models, whereas no significant difference was observed between CGAN model and Pix2Pix model. The visualization results further demonstrated that the GAN model produced uterine contours deviated greatly from the real shape, and the edge was fuzzy; CGAN and Pix2Pix model achieved better overlap but lacked of precision in boundary reconstruction. In contrast, the contours generated by SE-CGAN model closely matched the ground truth with clearly defined edges, indicating superior reconstruction accuracy. Conclusions:In this study, we propose a generative adversarial network method that establishes a dynamic modulation mechanism by which the bladder state influences the uterine geometric contour, enabling accurate generation of the uterine contours from the bladder contours of any given localization CT scan. This approach effectively addresses the uncertainty in radiotherapy target delineation caused by pelvic organ motion.

Objective To investigate the effectiveness of music therapy on patients with post-stroke aphasia.Methods Randomized controlled trials of music therapy for patients with post-stroke aphasia were systematically searched from 9 databases,such as CNKI,WanFang,PubMed,etc.The search time was from the inception of databases to July 2023.The literature was screened and extracted by 2 researchers according to the inclusion criteria,and the quality of the literature was assessed using Cochrane Manual 5.1.0.Revman 5.3 software was used for meta-analysis.Results We selected 22 studies comprising 827 participants comparing with control conditions.The meta-analysis demonstrated that music therapy significantly improved spontaneous speech[SMD=0.60,95％CI(0.40～0.80),P＜0.01],listening comprehension[SMD=0.49,95％CI(0.32～0.67),P＜0.0 1],repetition[SMD=0.77,95％CI(0.60～0.94),P＜0.01],naming[SMD=0.54,95％CI(0.29～0.78),P＜0.01],communication ability[SMD=0.40,95％CI(0.02～0.78),P＜0.01],depression[SMD=-0.75,95％CI(-1.10～-0.40),P＜0.01],but had no significant effect on the severity of aphasia[SMD=0.82,95％CI(-0.26,1.90),P=0.14].Conclusion Music therapy significantly improved language expres-sion and understanding ability,but there was no clear evidence for the improvement of aphasia severity.

Objective:To develop a nomogram model for predicting the risk of medication deviation in ischemic stroke patients after hospital discharge, providing insights for clinical nursing strategies.Methods:A convenience sampling method was used to select 440 ischemic stroke patients hospitalized in the Neurology Department of Nanyang Central Hospital from March 2022 to September 2023. Data on basic patient information and post-discharge medication deviation were collected using the medication deviation assessment tool eight weeks after discharge. Patients were categorized into a no medication deviation group and a medication deviation group. Univariate and binomial logistic regression analyses were conducted to identify independent risk factors for post-discharge medication deviation, and a nomogram prediction model was developed.Results:Data were successfully collected from 424 patients, with a response rate of 96.36% (424/440). The incidence of medication deviation was 58.02% (246/424). Binomial logistic regression analysis identified the absence of a fixed caregiver ( OR=2.113, P=0.001), large number of comorbid chronic diseases ( OR=1.773, P<0.001), medication non-adherence ( OR=2.443, P=0.003), and negative coping ( OR=2.255, P<0.001) as independent risk factors for medication deviation. A nomogram prediction model based on these four risk factors was constructed. The Hosmer-Lemeshow goodness-of-fit test indicated good calibration (χ 2=10.569, P=0.227), with calibration curve closely approximating the ideal line. The area under the receiver operating characteristic curve was 0.770 (95% CI: 0.584-0.866) . Conclusions:The absence of a fixed caregiver, medication non-adherence, negative coping, and large number of comorbid chronic diseases are independent risk factors for medication deviation in ischemic stroke patients. The nomogram model developed in this study demonstrates good discrimination and accuracy, providing a basis for formulating targeted nursing strategies.

Objective:To develop a nomogram model for predicting the risk of medication deviation in ischemic stroke patients after hospital discharge, providing insights for clinical nursing strategies.Methods:A convenience sampling method was used to select 440 ischemic stroke patients hospitalized in the Neurology Department of Nanyang Central Hospital from March 2022 to September 2023. Data on basic patient information and post-discharge medication deviation were collected using the medication deviation assessment tool eight weeks after discharge. Patients were categorized into a no medication deviation group and a medication deviation group. Univariate and binomial logistic regression analyses were conducted to identify independent risk factors for post-discharge medication deviation, and a nomogram prediction model was developed.Results:Data were successfully collected from 424 patients, with a response rate of 96.36% (424/440). The incidence of medication deviation was 58.02% (246/424). Binomial logistic regression analysis identified the absence of a fixed caregiver ( OR=2.113, P=0.001), large number of comorbid chronic diseases ( OR=1.773, P<0.001), medication non-adherence ( OR=2.443, P=0.003), and negative coping ( OR=2.255, P<0.001) as independent risk factors for medication deviation. A nomogram prediction model based on these four risk factors was constructed. The Hosmer-Lemeshow goodness-of-fit test indicated good calibration (χ 2=10.569, P=0.227), with calibration curve closely approximating the ideal line. The area under the receiver operating characteristic curve was 0.770 (95% CI: 0.584-0.866) . Conclusions:The absence of a fixed caregiver, medication non-adherence, negative coping, and large number of comorbid chronic diseases are independent risk factors for medication deviation in ischemic stroke patients. The nomogram model developed in this study demonstrates good discrimination and accuracy, providing a basis for formulating targeted nursing strategies.