Prolonged disorders of consciousness(pDoC)are complex and prolonged conditions that severely impact patient prognosis and remain a clinical treatment challenge.In recent years,neural regulation-based awakening therapies have been widely applied in the assessment and treatment of pDoC patients.Repetitive transcranial magnetic stimulation(rTMS)technology can regulate neural activity and improve patients'consciousness states,demonstrating positive awakening effects for pDoC patients.However,the optimal stimulation parameters and awakening mechanisms of rTMS remain unclear.This article reviews the pathological mechanisms of pDoC,clinical applications of rTMS at different targeting sites and stimulation frequencies,and focuses on exploring how rTMS promotes consciousness recovery through neural mechanisms such as altering neural pathways,reshaping brain networks,promoting synaptic plasticity and neurotransmitter release,regulating neurotrophic factor expression,and modulating cerebral hemodynamics.Based on artificial intelligence,the article also prospects the future clinical research applications of rTMS.

Accurate segmentation of oral surgery-related tissues from cone beam computed tomography(CBCT)images can significantly accelerate treatment planning and improve surgical accuracy.In this paper,we propose a fully automated tissue segmentation system for dental implant surgery.Specifically,we propose an image preprocessing method based on data distribution histograms,which can adaptively process CBCT images with different parameters.Based on this,we use the bone segmentation network to obtain the segmentation results of alveolar bone,teeth,and maxillary sinus.We use the tooth and mandibular regions as the ROI regions of tooth segmentation and mandibular nerve tube segmentation to achieve the corresponding tasks.The tooth segmentation results can obtain the order information of the dentition.The corresponding experimental results show that our method can achieve higher segmentation accuracy and efficiency compared to existing methods.Its average Dice scores on the tooth,alveolar bone,maxillary sinus,and mandibular canal segmentation tasks were 96.5%,95.4%,93.6%,and 94.8%,respectively.These results demonstrate that it can accelerate the development of digital dentistry.

Anaplastic thyroid carcinoma(ATC)is the most aggressive malignancy with poor prognosis.The pathogenesis of ATC is complex,and there is no effective treatment at present.In recent years,with the deep understanding of the genetic(such as BRAF V600E,TP53,TERT,PIK3CA mutations,etc.)and epigenetic(such as histone methylation,histone deacetylation,microRNA regulatory pathways,etc.)changes driving ATC,molecular targeted therapy has brought new hope to ATC patients.This article reviews the molecular mechanisms of ATC and the latest achievements in targeted therapy and other therapies.

Objective:To investigate the expression of HBB in anaplastic thyroid cancer(ATC)cells and its regulatory effect on proliferation,invasion,migration and apoptosis of ATC cells and its potential mechanism.Methods:The expression of HBB in thyroid cancer and paracancerous tissues was analyzed through TIMER database.The correlation between the expression of HBB and the overall survival time of thyroid cancer patients was analyzed through KM-plotter database.The expression of HBB mRNA in ATC cells was detected by RT-qPCR.The HBB knockout or overexpression plasmid was transfected into ATC cells.The expression of HBB protein was detected by Western blot.The proliferation activity was detected by CCK-8 assay.The migration and invasion ability was detected by Transwell assay.The apoptosis was detected by flow cytometry.The expression of β-catenin was detected by Western blot.Results:The expression of HBB was low in thyroid cancer,and the overall survival time of patients with high expression of HBB was high.The expression of HBB protein was down-regulated in ATC cells.Knockout of HBB increased the ability of proliferation,migration and invasion of ATC cells and the expression of β-catenin protein,and inhibited apoptosis.However,overexpression of HBB decreased the ability of proliferation,migration and invasion of ATC cells and the expression of β-catenin protein,and promoted apoptosis.Conclusions:High HBB expression is associated with higher overall survival in patients with thyroid cancer.It may inhibit the proliferation,migration and invasion of ATC cells and promote apoptosis through Wnt/β-catenin signal pathway.

Objective To explore the short-term and long-term efficacy of arthroscopic surgery,different non-surgical ther-apy and sham operation intervention in the treatment of meniscus related injuries,and to compare their advantages and disadvan-tages,so as to provide guidance for clinical practice.Methods Randomized controlled trials on arthroscopic surgery,meniscecto-my and other surgical and non-surgical treatments for knee meniscus injury were searched in PubMed,Embase,Cochrane Librar-y and Web of Science,and the search time was from its inception to July 2023.Two researchers independently screened the liter-ature according to the established literature ranking criteria,and the Cochrane Risk of Bias Assessment Tool was used to evalu-ate the risk of bias of the included literature,while the PEDro Scale Evaluation Tool was used to evaluate the quality of the liter-ature of the randomized controlled trials,and the collected data were quantitatively analyzed using RevMan 5.3 software.Results From the qualitative analysis,it was clear that surgical therapies might be more appropriately applied to patients without osteo-arthritis and without mechanical symptoms,and that meniscal suture repair surgery had a more favorable long-term outcome compared with traditional partial meniscectomy.Quantitative analysis showed that there was no statistical significance between arthroscopic surgery and other non-surgical therapies in several short and long term efficacy(all P＞0.05).For example,MD=0.15,95％CI:-4.05～4.35,I2=0％in the short-term comparison of Lysholm knee score;MD=-1.30,95％CI:-3.16～0.57,I2=0％;Short-term VAS score MD=-0.18,95％CI:-0.59～0.23,I2=45％;MD=-0.01,95％CI:-0.20～0.19,I2=36％.In addition,in the subgroup analysis of degenerative meniscus injury alone,the difference in clinical efficacy between the two therapies was also not statistically significant(all P＞0.05).Conclusion There is no practical difference between surgi-cal therapy and non-surgical therapy in the short-term and long-term outcomes.For single type injury,such as degenerative me-niscus injury,there is no practical difference between the two therapies.

Objective To explore the effects of the long non-coding RNA(lncRNA)NK2 homeobox 1-antisense RNA 1(NK2-1-AS1),which mediates the microRNA(miR)-96-5p/PR domain-containing protein 16(PRDM16)axis,on anaplastic thyroid cancer(ATC)cell proliferation,migration,and invasion in vitro and transplanted tumor growth in vivo.Methods The differentially expressed lncRNA NKX2-1-AS1 in ATC tissues and cells,its target miRNA miR-96-5p,and its downstream target gene PRDM16 were screened using a bioinformatics analysis.The dual-luciferase reporter assay validated the relationship between NKX2-1-AS1 and miR-96-5p as well as the connection between miR-96-5p and PRDM16.Western blotting was performed to detect the effect of miR-96-5p overexpression on PRDM16 in CAL-62 cells overexpressed with NKX2-1-AS1.Plate clone formation,scratch,and Transwell assays were used to detect the effects of PRDM16knockdown on the proliferation,migration,and invasion of CAL-62 cells overexpressing NKX2-1-AS1.CAL-62 cells were injected subcutaneously into nude mice and the effect was observed of PRDM16knockdown on the growth of transplanted tumors of CAL-62 cells overexpressing NKX2-1-AS1.Results The bioinformatics analysis revealed that the NK2-1-AS1/miR-96-5p/PRDM16 axis was involved in regulating ATC development.The dual-luciferase reporter assay demonstrated that NKX2-1-AS1 bound to miR-96-5p and miR-96-5p bound to PRDM16.NKX2-1-AS1 overexpression upregulated PRDM16 protein expression in CAL-62 cells,while miR-96-5p overexpression reversed this phenomenon.NKX2-1-AS1 overexpression inhibited CAL-62 cellular proliferation,migration,and invasion in vitro and transplanted tumor growth in vivo,while knocking down PRDM16 reversed these phenomena.Conclusion NK2-1-AS1 may compete with miR-96-5p as an endogenous RNA to bind to its downstream target gene,PRDM16,and upregulate its expression,thus inhibiting ATC cell proliferation,migration,and invasion in vitro and transplanted tumor growth in vivo.

Objective:To study the relationship between red blood cell distribution width(RDW)and short-term mortality in elderly patients with hip fragility fractures.Methods:The clinical data and blood routine test at admission of 205 elderly patients with brittle hip fractures who were admitted to our hospital from 2020 to 2021 and were followed up for one year were retrospectively analyzed.The comorbid conditions, RDW and cumulative mortality at 6 months and 1 year after fractures were counted, and the relationship between RDW and short-term mortality were analyzed.Results:The 6-month(6.7% and 20.8%, χ2=8.591, P=0.003)and 1-year(6.7% and 26.7%, χ2=14.818, P<0.001)mortality of patients with ≤1 comorbidity were significantly lower than those of patients with ≥2 comorbidities.Moreover, the 6-month and 1-year mortality in patients with RDW>13.5% were significantly higher than those of patients with RDW ≤ 13.5%.The proportion of RDW>13.5 % in patients with at least two comorbidities was significantly higher than that in patients with ≤1 comorbidity.Taking RDW=13.6% as the cut-off value of 6-month and 1-year mortality, the sensitivity and specificity for predicting 6-month mortality were 71.4 % and 59.9 %, respectively, and the sensitivity and specificity for predicting 1-year mortality were 64.7 % and 59.6 %, respectively. Conclusions:Red cell distribution width is associated with short-term mortality, and higher RDW is associated with a higher risk of mortality among elderly patients with brittle hip fractures.

Objective:To explore the current situation of nurses' turnover intention and its influencing factors based on the intergenerational differences, analyze the similarities and differences.Methods:From January to March 2018, 12 291 nurses from 23 general hospitals were selected by stratified cluster sampling. The nurses were investigated with the Turnover Intention Questionnaire, Work-Family Conflict Scale and Perceived Person-Environment Fit Scale. Pearson correlation analysis was used to explore the correlation between nurses' work-family conflict, person-environment fit and turnover intention. Multiple linear regression analysis was used to explore the influencing factors of nurses' turnover intention among different generations. A total of 12 291 questionnaires were distributed and 12 291 were retrieved. After eliminating the questionnaires with obvious logical errors, 11 753 valid questionnaires were finally recovered, with an effective recovery rate of 95.62% (11 753/12 291) .Results:The turnover intention of post-70s nurses was lower than that of post-80s and post-90s nurses. Work-family conflict, person-environment fit and whether the nurses have experienced negative events in the past year were the common influencing factors of nurses' turnover intention among different generations ( P<0.01) . The professional title, the number of night shifts and the fertility were the specific influencing factors of the post-90s nurses' turnover intention ( P<0.05) . The employment form was the specific influencing factor of post-80s nurses' turnover intention ( P<0.05) . Conclusions:The turnover intention of post-80s and post-90s nurses were higher than that of the post-70s nurses. There are differences in the current situation and influencing factors of nurses' turnover intention in different birth years. It is suggested that intervention strategies should be formulated according to the intergenerational characteristics of nurses to effectively reduce nurses' turnover intention.

Objective:To review the research status, international cooperation, hot topics and development trends of frailty intervention based on the perspective of scientometrics, so as to provide references for the development of relevant intervention research in this field.Methods:The studies on frailty intervention included in Web of Science Citation Database was retrieved, and the retrieval period was from the establishment of the databases to December 31, 2021. Bibliometric analysis was conducted using VOSviewer and R-bibliometrix.Results:From 1992 to 2021, the overall number of literature on intervention studies on senile frailty worldwide showed an increasing trend year by year, and a relatively stable network of cooperative relationships between countries and regions has been formed internationally. The intervention mode for frailty was mainly based on nutrition combined with exercise intervention, and intervention research on frailty was gradually being carried out in the field of chronic diseases.Conclusions:Frailty intervention will be the focus of future research, nutrition combined with exercise and cognitive intervention mode will be the main research trend of future research, and more frailty intervention studies will be carried out in the elderly population with chronic diseases.

This article introduces the epidemiological characteristics of malnutrition in the elderly, and reviews the screening and assessment tools for malnutrition in the elderly from the high-risk population and comorbidities of malnutrition, the applicable objects of the tools, assessment items, scoring methods, and result determination. This article also distinguishes between screening and assessment tools for malnutrition in the elderly, so as to provide reference for medical and nursing staff to screen and assess the nutritional status of the elderly.