ObjectiveTo investigate the effect and mechanism of polysaccharide in water extract of Cyclocarya paliurus （CPWP） in inhibiting benign prostatic hyperplasia （BPH）. MethodsCPWP was obtained by heating reflux， aqueous extraction， alcohol precipitation， and freeze drying. The chemical composition and structural properties of CPWP were analyzed by high performance liquid chromatography with 1-pheny-3-methyl-5-pyrazolone pre-column derivatization and infrared spectroscopy. Male SD rats were randomly assigned into control， model， finasteride （ig 5 mg·kg^-1）， and low-， medium-， and high-dose （ig 50， 75， 100 mg·kg^-1） CPWP groups， with 8 rats in each group. The BPH model was established by subcutaneously injecting propionate testosterone in castrated rats. The rats in the drug intervention groups were administrated with corresponding drugs， and those in the control group were administrated with an equal volume of normal saline each day. After 30 consecutive days， the rats were sacrificed， and the prostate tissue was separated and weighed. The effects of drug interventions on the body weight， prostate wet weight， and prostate index of rats were examined. The prostate tissue was stained with hematoxylin-eosin （HE） for observation of pathological changes. Enzyme-linked immunosorbent assay was employed to measure the level of dihydrotestosterone （DHT）， and immunohistochemical staining was used to detect the expression of steroid 5 alpha-reductase 2 （SRD5A2） and Ki67 in the prostate tissue. ResultsCPWP was identified as a saccharide， with characteristic absorption peaks of saccharides. CPWP showed the total sugar content of 44.15% and molecular weight within the range of 5.5-78.8 kDa， being composed of mannose， rhamnose， galacturonic acid， glucose， galactose， xylose， and arabinose. Compared with the control group， the model group had significantly increased prostate wet weight and prostate index （P<0.01）， thick and tall prostate epithelial cells， increased internal wrinkles， papillary expansion into the cavity， an elevation in DHT level in the serum， and up-regulated expression of SRD5A2 and Ki67 in the prostate tissue （P<0.05， P<0.01）. Compared with the model group， both the finasteride and CPWP groups showed decreases in prostate wet weight and prostate index （P<0.05， P<0.01）， thinned prostate epithelial cells， with only a small portion of internal wrinkles and papillary expansion into the cavity， shortened papillary protrusions， lowered DHT level in the serum， and down-regulated expression of SRD5A2 and Ki67 in the prostate tissue （P<0.01）. Moreover， CPWP exerted effects in a dose-dependent manner. ConclusionCPWP inhibits BPH by regulating the expression of SRD5A2.

Objective To investigate and analyze the relationship between bone metabolism indicators,bone mineral density(BMD)T value,osteoporosis and fracture risk in patients with type 2 diabetes mellitus(T2DM).Methods A retrospective analysis was conducted on the clinical data of 175 patients with T2DM ad-mitted to the hospital from January to August 2024.According to the T value,they were divided into the oste-oporosis group(n=65),the osteopenia group(n=50),and the normal bone mass group(n=60).The general clinical data and bone metabolism indicators were compared among the three groups,including 25-hydroxyvi-tamin D3[25-(OH)D3],osteocalcin(OC),calcitonin(CT),type Ⅰ procollagen amino-terminal peptide(PⅠNP)and β-collagen degradation products(β-CTX),parathyroid hormone(PTH),T value,and the differences between the fracture risk assessment tools[FRAX,including 10-year major osteoporotic fracture(MOF)risk and 10-year hip fracture(HF)risk],analyzed the influencing factors of osteoporosis in T2DM patients,as well as the relationship between bone metabolism indicators,T values and fracture risk.Results The results of un-ivariate and multivariate logistic regression analyses showed that PⅠNP and β-CTX were risk factors for oste-oporosis in patients with T2DM,while estradiol(E2),testosterone(T),25-(OH)D3,OC,and T values were all protective factors(P<0.05).The 10-year risks of MOF and HF in the osteoporosis group were higher than those in the osteopenia group and the normal bone mass group,while the 10-year risks of MOF and HF in the osteopenia group were higher than those in the normal bone mass group,the differences were statistical-ly significant(P<0.05).According to Pearson correlation analysis,25-(OH)D3 and T values were negatively correlated with the risks of 10-year MOF and HF,while OC,PⅠNP,and β-CTx were positively correlated with the risks of 10-year MOF and HF(P<0.05),CT and PTH were not correlated with the risks of 10-year MOF and HF(P>0.05).Conclusion Bone metabolism indicators and BMD are important influencing factors for the occurrence of osteoporosis in patients with T2DM,and they are closely related to the occurrence of os-teoporotic fractures.Clinically,the monitoring of bone metabolism and BMD in patients with T2DM should be strengthened.

Objective To develop a machine learning model integrating preoperative chest CT radiomic features with clinical data for predicting 5-year postoperative recurrence risk in stage Ⅰ non-small cell lung cancer(NSCLC)patients undergoing surgical resection.Methods A total of 217 patients with pathologically confirmed stage Ⅰ NSCLC(selected from 778 initially screened cases based on our inclusion and exclusion criteria)treated in Army Medical Center of PLA between January 2014 and December 2019 were retrospectively enrolled,including 53 recurrence cases and 164 non-recurrence cases within 5-year follow-up.They were randomly divided into a training set(n=173)and a validation set(n=44)in a ratio of 8:2.Radiomic models were established based on extracted features from tumor-dominant regions of interest(ROI)on CT images,while clinical models were developed using demographic characteristics and preoperative laboratory examinations.A combined model was further constructed by integrating both feature sets,and model performance was compared to identify the optimal predictive model.Results This study screened the features from non-contrast CT images and ultimately selected 7 radiomic features for constructing radiomic model.Among 6 machine learning algorithms,the adaptive boosting(Adaboost)model demonstrated the best overall predictive performance,with an area under the curve(AUC)of 0.866(95%CI:0.808～0.923;accuracy:0.832,specificity:0.884)in the training set and of 0.806(95%CI:0.630～0.983;accuracy:0.795,specificity:0.971)in the validation set.Univariate and multivariate logistic regression analyses identified 4 clinical features for clinical model construction.The clinical model achieved an AUC value of 0.874(95%CI:0.821～0.928;accuracy:0.827,specificity:0.891)in the training set and 0.813(95%CI:0.677～0.948;accuracy:0.636,specificity:0.600)in the validation set.By integrating the 7 radiomic features and 4 clinical features using a feature-level fusion strategy,the combined model exhibited further improved predictive performance,with an AUC value of 0.953(95%CI:0.924～0.983;accuracy:0.884,specificity:0.860)and 0.852(95%CI:0.729～0.976;accuracy:0.682,specificity:0.629),respectively in the training set and the validation set.Conclusion The combined model integrating preoperative CT radiomic features with clinical risk factors may provide an evidence-based framework for evaluating 5-year postoperative recurrence risk in stage Ⅰ NSCLC patients.

Increasing age is the most important factor for cognitive impairment.Alzheimer disease(AD)and sarcopenia are significant causes of frailty and disability in older adults.It is important to have an in-depth understanding of the relationship between sarcopenia and AD.Studies have reported that sarcopenia often disturbs the secretion of muscle factors,which may increase the risk of developing dementia.In turn,the pathological feature of dementia,such as the de-position of amyloid β-protein(Aβ),amyloid precursor protein(APP)and tau protein in peripheral neurons,may be related to a decline in muscle function.In particular,the deposition of Aβ and APP may eventually lead to movement disorders and disability.Therefore,we hypothesize that AD and sarcopenia may mutually promote each other's pathological develop-ment.This results in exacerbation of clinical and pathological damage,in which myokine and amyloid proteins play impor-tant roles.However,the interrelationship based on amyloid protein and myokine production has not been discussed in de-tail in other reviews.In this paper,we reference and discuss the studies on this topic,and review the common risk factors for sarcopenia and AD and the potential and mechanisms for mutual improvement.

The current situation of tumor radiotherapy teaching is far behind the development of radiotherapy technologies. The construction of a teaching system based on an artificial intelligence-powered automatic target delineation system and a standardized cancer radiotherapy case library is operable and practical for realizing the standardization and homogenization of clinical target volume delineation teaching, improving students' precision and speed of target volume delineation, and promoting students' learning interest, initiative, and efficiency, which can bring new vitality to the development of radiotherapy education and is worthy of further exploration and promotion.

Objective:To explore the health behavior of middle-aged and young stroke patients and analyze its influencing factors.Methods:From April to July 2023, convenience sampling was used to select 172 middle-aged and young stroke patients admitted to the First Affiliated Hospital of Naval Medical University as the research subject. A survey was conducted using the General Information Questionnaire, Health Behavior Scale for Stroke Patients, Health Belief Scale, and Multidimensional Scale of Perceived Social Support. Spearman correlation was used to analyze the correlation between health behavior, social support, and health beliefs among middle-aged and young stroke patients. Multiple linear regression was used to analysis the influencing factors of health behavior among middle-aged and young stroke patients. A total of 172 questionnaires were distributed, and 8 questionnaires with missing items and short response times were excluded, and 164 valid questionnaires were collected, with a valid response rate of 95.34%.Results:Among 164 middle-aged and young stroke patients, the total score of the Health Behavior Scale for Stroke Patients was 64.50 (57.00, 80.75), and the average score of the items was 2.58 (2.28, 3.23). Multiple linear regression analysis showed that factors affecting the health behavior of middle-aged and young stroke patients were whether it was the first onset, the time required to reach nearby medical institution, health belief, and social support ( P<0.05) . Conclusions:The health behavior of middle-aged and young stroke patients is above the medium level. In the process of intervening in the health behavior of middle-aged and young stroke patients, medical and nursing staff should pay attention to patients with recurrent stroke and poor access to medical services, while also improving patients' health belief and social support to promote patients' health behavior and reduce stroke recurrence.

Objective:To explore the status quo and influencing factors of self-management behavior in high-risk stroke patients, so as to provide a basis for improving their self-management behavior.Methods:From March to June 2023, convenience sampling was used to select 395 high-risk stroke patients admitted to the First Affiliated Hospital of Naval Medical University as the study subject. A survey was conducted on patients using the General Information Questionnaire, Self-management Behavior Scale for High-risk Stroke Patients, and Cerebral Apoplexy Knowledge Questionnaire. Pearson correlation was used to analyze the correlation between self-management behavior and stroke knowledge. A total of 395 questionnaires were distributed, and unqualified questionnaires (such as regular or repetitive responses, conflicting options before and after) were excluded. Finally, 387 valid questionnaires were collected, with an effective response rate of 97.97%.Results:The score of the Self-management Behavior Scale for High-risk Stroke Patients for 387 high-risk stroke patients was (137.60±25.47), with a score indicator of 62.53%, which was at a moderate level. The score of the Cerebral Apoplexy Knowledge Questionnaire was (19.26±10.19), which was at a low level. The random forest algorithm showed that the importance order of influencing factors was stroke knowledge, number of ways to obtain health information, educational level, number of risk factors, frequency of physical examinations, medical insurance, age, work situation, and gender. The Lasso regression indicated that there were four influencing factors corresponding to the minimum error. The top four factors in importance were included in multiple linear regression, and the results showed that educational level, number of risk factors, number of ways to obtain health information, and stroke knowledge were the influencing factors of self-management behavior in high-risk stroke patients ( P<0.05) . Conclusions:The self-management behavior of high-risk stroke patients was at a moderate level. Medical and nursing staff should strengthen stroke knowledge education, provide personalized education for different risk factors, and improve the self-management of the target population to reduce the incidence of stroke.

Objective:To explore the mediating effect of coping style on disease perception and pre-hospital delayed behavioral intention in patients with acute ischemic stroke.Methods:This study was a cross-sectional study. From February to July 2023, convenience sampling was used to select 205 patients with acute ischemic stroke admitted to the First Affiliated Hospital of Naval Medical University as the study subject. The survey was conducted using the General Information Questionnaire, Stroke Pre-Hospital Delay Behavior Intention, Brief Illness Perception Questionnaire, and Simplified Coping Style Questionnaire.Results:205 questionnaires were filled out, 195 valid questionnaires, and the validity rate of the questionnaire was 95.1%. The Stroke Pre-Hospital Delay Behavior Intention score of patients with acute ischemic stroke was (63.61±16.12). Pre-hospital delayed behavioral intention in patients with acute ischemic stroke was positively correlated with disease perception and negative coping ( r=0.360, 0.266; P<0.01), and negatively correlated with positive coping ( r=-0.279, P<0.01). The mediating effects of positive and negative coping on disease perception and pre-hospital delayed behavioral intention in ischemic stroke patients were 0.111 and 0.097, respectively, accounting for 26.89% and 23.49% of the total effect. Conclusions:There is a partial mediating effect of coping strategies between disease perception and pre-hospital delayed behavioral intention in ischemic stroke patients. In the process of stroke management, medical and nursing staff can reduce pre-hospital delayed behavioral intentions by improving disease cognition and coping style.

By referring to the relevant literature on the application of positive psychology in patients with cognitive impairment at home and abroad, this paper reviews the measurement tools, interrelationships and intervention status of positive psychology in patients with cognitive impairment, and explores the prospects of its application in this population. The aim is to provide a basis for nursing decision-making in patients with cognitive impairments.

The extensive use of orthopedic implants in clinical practice has improved the therapeutic effect of osteopathic patient, brought good news to the health of patients. The use of orthopedic implants can help osteopathic patients recover organ functions, However, orthopedic implants are high-risk medical devices and need to be implanted into the human body for a long time. In the process of diagnosis and treatment, it is found that there are ethical problems, such as the informed consent of patients, excessive medical treatment and improper postoperative care leads to adverse events. In view of the above problems, this paper proposed to protect the rights and interests of patients by strengthening the communication between doctors and patients, standardize the informed consent process, standardizing medical behavior, avoid excessive medical treatment, and strengthening the training of medical staff, do a good job in postoperative care.