Objective To explore the value of a CT radiomics model in differentiating Xpert MTB/RIF-negative pulmonary tuber-culosis(PTB)from non-tuberculous mycobacteria pulmonary disease(NTM-PD).Methods A retrospective analysis was performed on 90 patients with Xpert MTB/RIF-negative PTB and 127 patients with NTM-PD.All patients were randomly divided into training set and testing set at the ratio of 7∶3.Radiomics features were extracted from chest CT images.Feature dimensionality reduction and selection were sequentially performed using the maximum relevance and minimum redundancy(mRMR)algorithm and the least absolute shrinkage and selection operator(LASSO)algorithm.Clinical,radiomics,and combined models were constructed by multi-variable logistic regression.The area under the curve(AUC)of receiver operating characteristic(ROC)curve was utilized to assess the model diagnostic performance.Calibration curves were used to evaluate model stability,and the decision curve analysis(DCA)was used to evaluate the clinical utility.Results The combined model had the highest diagnostic performance in both training and testing sets,with AUC of 0.90 and 0.86,respectively,which were higher than clinical and radiomics models.The calibration curve showed that the combined model had a good consistency between the predicted and the actual observations,and DCA revealed the highest clinical benefit.Conclusion The clinical-radiomics combined model has excellent predictive ability in differentiating Xpert MTB/RIF-negative PTB from NTM-PD,which can provide robust support for clinical diagnosis.

Acute lateral ankle sprain (ALAS) is one of the most common sport injuries, with high incidence, recurrence and disability rates. Currently, exercise rehabilitation-based non-surgical treatment is the primary management approach for ALAS. However, there remain improper practices such as excessive immobilization or uncontrolled activity, which contribute to recurrent sprains and chronic ankle instability, significantly impairing patients′ athletic function and quality of life. To standardize the non-surgical management of ALAS, improve the cure rates, and reduce the recurrence and disability rates, Chinese Sports Rehabilitation Medicine Training Project of Chinese Medical Association, Foot and Ankle Basics and Orthopedics Group, Orthopedic Branch of Chinese Medical Doctor Association, and Sports Medicine Branch of Jiangsu Medical Association organized relevant experts to formulate Expert consensus on non-surgical treatment for acute lateral ankle sprain ( version 2025), following the principles of scientific vigor, practicality, and innovation. Thirteen recommendations were proposed for standardized treatment protocols across different healing phases, aiming to provide references for standard management of ALAS and improve the therapeutic outcomes.

To explore an effective health management model for obese students,a comprehensive intervention was carried out for obese students with cardiovascular and metabolic risks,and the effectiveness of this intervention model was evaluated.From Jan to Apr 2024(excluding the winter vacation),300 students were selected from 6 primary schools in Qibao Community,Minhang District,Shanghai,to participate in the study(28 students dropped out during the study period).The study subjects were divided into two intervention groups(pilot intervention group:equipped with a health vice principal;general intervention group:not equipped with a health vice principal)and a control group.The intervention group received comprehensive intervention measures such as science popularization,diet,exercise and psychology,while the control group received daily health management.The post-intervention results showed that the intervention group had significant improvements in healthy diet,scientific exercise and positive psychology,with significant differences compared to the control group(P<0.05).At the same time,the intervention group had a reduced detection rate of obesity(BMI≥P95),and a decreased detection rate of abnormal metabolic indicators such as blood pressure,fasting blood glucose and triglyceride,especially significant differences in fasting blood glucose and triglyceride compared with the control group(P<0.001).In addition,the pilot intervention group under the operation of health vice principal showed better effects in changing healthy behaviors and improving some metabolic indicators compared with the general intervention group.The implementation of this project provided a scientific basis for the promotion of a comprehensive intervention model for student health under the oprtation of health vice principle.

Objective To explore the value of a CT radiomics model in differentiating Xpert MTB/RIF-negative pulmonary tuber-culosis(PTB)from non-tuberculous mycobacteria pulmonary disease(NTM-PD).Methods A retrospective analysis was performed on 90 patients with Xpert MTB/RIF-negative PTB and 127 patients with NTM-PD.All patients were randomly divided into training set and testing set at the ratio of 7∶3.Radiomics features were extracted from chest CT images.Feature dimensionality reduction and selection were sequentially performed using the maximum relevance and minimum redundancy(mRMR)algorithm and the least absolute shrinkage and selection operator(LASSO)algorithm.Clinical,radiomics,and combined models were constructed by multi-variable logistic regression.The area under the curve(AUC)of receiver operating characteristic(ROC)curve was utilized to assess the model diagnostic performance.Calibration curves were used to evaluate model stability,and the decision curve analysis(DCA)was used to evaluate the clinical utility.Results The combined model had the highest diagnostic performance in both training and testing sets,with AUC of 0.90 and 0.86,respectively,which were higher than clinical and radiomics models.The calibration curve showed that the combined model had a good consistency between the predicted and the actual observations,and DCA revealed the highest clinical benefit.Conclusion The clinical-radiomics combined model has excellent predictive ability in differentiating Xpert MTB/RIF-negative PTB from NTM-PD,which can provide robust support for clinical diagnosis.

To explore an effective health management model for obese students,a comprehensive intervention was carried out for obese students with cardiovascular and metabolic risks,and the effectiveness of this intervention model was evaluated.From Jan to Apr 2024(excluding the winter vacation),300 students were selected from 6 primary schools in Qibao Community,Minhang District,Shanghai,to participate in the study(28 students dropped out during the study period).The study subjects were divided into two intervention groups(pilot intervention group:equipped with a health vice principal;general intervention group:not equipped with a health vice principal)and a control group.The intervention group received comprehensive intervention measures such as science popularization,diet,exercise and psychology,while the control group received daily health management.The post-intervention results showed that the intervention group had significant improvements in healthy diet,scientific exercise and positive psychology,with significant differences compared to the control group(P<0.05).At the same time,the intervention group had a reduced detection rate of obesity(BMI≥P95),and a decreased detection rate of abnormal metabolic indicators such as blood pressure,fasting blood glucose and triglyceride,especially significant differences in fasting blood glucose and triglyceride compared with the control group(P<0.001).In addition,the pilot intervention group under the operation of health vice principal showed better effects in changing healthy behaviors and improving some metabolic indicators compared with the general intervention group.The implementation of this project provided a scientific basis for the promotion of a comprehensive intervention model for student health under the oprtation of health vice principle.

Acute lateral ankle sprain (ALAS) is one of the most common sport injuries, with high incidence, recurrence and disability rates. Currently, exercise rehabilitation-based non-surgical treatment is the primary management approach for ALAS. However, there remain improper practices such as excessive immobilization or uncontrolled activity, which contribute to recurrent sprains and chronic ankle instability, significantly impairing patients′ athletic function and quality of life. To standardize the non-surgical management of ALAS, improve the cure rates, and reduce the recurrence and disability rates, Chinese Sports Rehabilitation Medicine Training Project of Chinese Medical Association, Foot and Ankle Basics and Orthopedics Group, Orthopedic Branch of Chinese Medical Doctor Association, and Sports Medicine Branch of Jiangsu Medical Association organized relevant experts to formulate Expert consensus on non-surgical treatment for acute lateral ankle sprain ( version 2025), following the principles of scientific vigor, practicality, and innovation. Thirteen recommendations were proposed for standardized treatment protocols across different healing phases, aiming to provide references for standard management of ALAS and improve the therapeutic outcomes.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective To compare regional pulmonary ventilation and perfusion and ventilation/perfusion(V/Q)matching in different body positions using electrical impedance tomography(EIT).Methods Ten healthy experimental pigs were selected to collect their EIT lung ventilation and perfusion data in supine,prone,left lateral and right lateral positions.The EIT data underwent analysis and image reconstruction using MATLAB R2022b and EIDORS v3.9.The effective regions with ventilation and perfusion were determined and the V/Q matching regions were computed with the maximum pixel value 20％as the threshold.Comparisons were carried out over the V/Q matching indexes including V/Q match％,dead space％and shunt％and ventilation and perfusion distribution in regions of interest(ROIs)including ROI1,ROI2,ROI3 and ROI4 in different body positions.Results The differences in V/Q match％,dead space％and shunt％of the experimental animals in varied positions were not statistically significant(P＞0.05).The regional distribution of pulmonary ventilation and perfusion changed in different positions,and the regional distributions differed in ROIl,ROI2 and ROI3 for ventilation(P＜0.05)and in ROI1 and ROI2 for perfusion(P＜0.05).The ventilation and perfusion regions were distributed consistently with the gravity-dependent areas in supine and prone positions whereas conversely in the right and left lateral positions.Conclusion The V/Q matching indexes of one subject have high test consistency in different body positions;gravity-dependent areas varied with the changes of the body positions,which affected the distribution of pulmonary ventilation and perfusion regions;EIT can be used for measuring the changed pulmonary ventilation and perfusion due to different positions and determining the influences of position changes on pulmonary ventilation and perfusion and V/Q matching.[Chinese Medical Equipment Journal,2024,45(5):1-7]

Objective To design an exhalation valve reservior cup to solve the problems of removal of the condensate and prevention of aerosol diffusion.Methods The reservior cup was composed of a temporary storage bottle,a liquid collection bottle,a sealing mechanism and a connection mechanism.The temporary storage bottle was connected to the exhalation valve of the ventilator at the upper end,which was provided with an internal holding chamber for temporary storage of the condensate and a through hole at the bottom for connection to the outside.The mouth of the liquid collection bottle could be inserted into the through hole,and there are a number of side holes on the mouth.The sealing mechanism at the bottom of the temporary storage bottle was made up of a magnet and a magnetic sealing plate,of which,the magnet was on the bottom surface of the holding chamber and the magnetic sealing plate was adsorbed to the magnet to seal the through hole.The connection mechanism between the temporary storage bottle and the liquid collection bottle consisted of an annular sleeve,an internal thread and an external thread.Results The reservior cup facilitated timely elimination of the condensate in the ventilator pipeline without removing the access cover,maintaining mechanical ventilation during drainage for the ventilator-assisted therapy and minimizing the risk of aerosol diffusion in the operating area.Conclusion The reservoir cup with high convenience and safety eliminates the condensate quickly and shortens the retention time of bacteria in the ventilator pipeline effectively.[Chinese Medical Equipment Journal,2024,45(9):115-117]

Background::Homoharringtonine (HHT) is an effective anti-inflammatory, anti-viral, and anti-tumor protein synthesis inhibitor that has been applied clinically. Here, we explored the therapeutic effects of HHT in a mouse heart transplant model.Methods::Healthy C57BL/6 mice were used to observe the toxicity of HHT in the liver, kidney, and hematology. A mouse heart transplantation model was constructed, and the potential mechanism of HHT prolonging allograft survival was evaluated using Kaplan–Meier analysis, immunostaining, and bulk RNA sequencing analysis. The HHT-T cell crosstalk was modeled ex vivo to further verify the molecular mechanism of HHT-induced regulatory T cells (Tregs) differentiation. Results::HHT inhibited the activation and proliferation of T cells and promoted their apoptosis ex vivo. Treatment of 0.5 mg/kg HHT for 10 days significantly prolonged the mean graft survival time of the allografts from 7 days to 48 days ( P <0.001) without non-immune toxicity. The allografts had long-term survival after continuous HHT treatment for 28 days. HHT significantly reduced lymphocyte infiltration in the graft, and interferon-γ-secreting CD4 + and CD8 + T cells in the spleen ( P <0.01). HHT significantly increased the number of peripheral Tregs (about 20%, P <0.001) and serum interleukin (IL)-10 levels. HHT downregulated the expression of T cell receptor (TCR) signaling pathway-related genes ( CD4, H2-Eb1, TRAT1, and CD74) and upregulated the expression of IL-10 and transforming growth factor (TGF) -β pathway-related genes and Treg signature genes ( CTLA4, Foxp3, CD74, and ICOS). HHT increased CD4 + Foxp3 + cells and Foxp3 expression ex vivo, and it enhanced the inhibitory function of inducible Tregs. Conclusions::HHT promotes Treg cell differentiation and enhances Treg suppressive function by attenuating the TCR signaling pathway and upregulating the expression of Treg signature genes and IL-10 levels, thereby promoting mouse heart allograft acceptance. These findings may have therapeutic implications for organ transplant recipients, particularly those with viral infections and malignancies, which require a more suitable anti-rejection medication.