Objective:To establish a predictive model of neoadjuvant chemotherapy for human epidermal growth factor receptor 2 (HER2) positive breast cancer based on magnetic resonance imaging (MRI) parameters and multimodal ultrasound.Methods:The medical records of 279 patients with HER2 positive breast cancer admitted to Linyi People’s Hospital, Tai’an Central Hospital Affiliated to Qingdao University and Shandong First Medical University affiliated Provincial Hospital from Mar. 2021 to Nov. 2023 were retrospectively analyzed, and randomly divided into a training set ( n=223) and a validation set ( n=56) according to the 8∶2 law. All patients received neoadjuvant chemotherapy combined with targeted therapy and were divided into non-pathologic complete response (NpCR) and pathologic complete response (pCR) groups according to chemotherapy effect. By comparing MRI parameters and multimodal ultrasound parameters of the two groups, and the pCR risk model after neoadjuvant chemotherapy for HER2 positive breast cancer patients was constructed and verified. Results:After 3 cycles of chemotherapy, the incidence of pCR in 223 patients in the training set was 42.15%. Among 56 patients in the validation set, the incidence of pCR was 42.86%. The apparent diffusion coefficient (ADC) of pCR group was higher than NpCR group ( P<0.05). The peak systolic flow velocity (PSV), resistance index (RI), maximum radial change rate, area under the curve (AUC) and peak intensity (PI) in pCR group were higher than NpCR group ( P<0.05), and the ultrasound elastic score in pCR group was lower than NpCR group ( P<0.05). ΔADC ( OR=4.141, 95% CI: 1.820-9.421), maximum diameter change rate ( OR=5.212, 95% CI: 2.291-11.857), PI ( OR=4.802, 95% CI: 2.111-10.923) and ultrasonic elasticity score ( OR=6.629, 95% CI: 1.595-8.256) were the influencing factors of pCR after neoadjuvant chemotherapy for HER2 positive breast cancer ( P<0.05). The sensitivity and specificity of pCR predicted by the training set model after neoadjuvant chemotherapy for HER2 positive breast cancer were 90.43% (95% CI: 82.15%-95.26%), 91.47% (95% CI: 84.91%-95.45%), and the AUC was 0.904 (95% CI: 0.834-0.968). Validation set model predicted the pCR sensitivity after neoadjuvant chemotherapy for HER2 positive breast cancer was 87.50% (95% CI: 66.54%-96.71), specificity was 90.63% (95% CI: 73.83%-97.55%), and AUC was 0.897 (95% CI: 0.821-0.954) . Conclusion:The histogram model based on ΔADC, maximum radial rate of lesion change, PI and ultrasonic elasticity score can be used to evaluate the risk of pCR after neoadjuvant chemotherapy for HER2 positive breast cancer.

Objective:To establish a predictive model of neoadjuvant chemotherapy for human epidermal growth factor receptor 2 (HER2) positive breast cancer based on magnetic resonance imaging (MRI) parameters and multimodal ultrasound.Methods:The medical records of 279 patients with HER2 positive breast cancer admitted to Linyi People’s Hospital, Tai’an Central Hospital Affiliated to Qingdao University and Shandong First Medical University affiliated Provincial Hospital from Mar. 2021 to Nov. 2023 were retrospectively analyzed, and randomly divided into a training set ( n=223) and a validation set ( n=56) according to the 8∶2 law. All patients received neoadjuvant chemotherapy combined with targeted therapy and were divided into non-pathologic complete response (NpCR) and pathologic complete response (pCR) groups according to chemotherapy effect. By comparing MRI parameters and multimodal ultrasound parameters of the two groups, and the pCR risk model after neoadjuvant chemotherapy for HER2 positive breast cancer patients was constructed and verified. Results:After 3 cycles of chemotherapy, the incidence of pCR in 223 patients in the training set was 42.15%. Among 56 patients in the validation set, the incidence of pCR was 42.86%. The apparent diffusion coefficient (ADC) of pCR group was higher than NpCR group ( P<0.05). The peak systolic flow velocity (PSV), resistance index (RI), maximum radial change rate, area under the curve (AUC) and peak intensity (PI) in pCR group were higher than NpCR group ( P<0.05), and the ultrasound elastic score in pCR group was lower than NpCR group ( P<0.05). ΔADC ( OR=4.141, 95% CI: 1.820-9.421), maximum diameter change rate ( OR=5.212, 95% CI: 2.291-11.857), PI ( OR=4.802, 95% CI: 2.111-10.923) and ultrasonic elasticity score ( OR=6.629, 95% CI: 1.595-8.256) were the influencing factors of pCR after neoadjuvant chemotherapy for HER2 positive breast cancer ( P<0.05). The sensitivity and specificity of pCR predicted by the training set model after neoadjuvant chemotherapy for HER2 positive breast cancer were 90.43% (95% CI: 82.15%-95.26%), 91.47% (95% CI: 84.91%-95.45%), and the AUC was 0.904 (95% CI: 0.834-0.968). Validation set model predicted the pCR sensitivity after neoadjuvant chemotherapy for HER2 positive breast cancer was 87.50% (95% CI: 66.54%-96.71), specificity was 90.63% (95% CI: 73.83%-97.55%), and AUC was 0.897 (95% CI: 0.821-0.954) . Conclusion:The histogram model based on ΔADC, maximum radial rate of lesion change, PI and ultrasonic elasticity score can be used to evaluate the risk of pCR after neoadjuvant chemotherapy for HER2 positive breast cancer.

Objective:To explore the value of a model combining 18F-FDG PET/CT radiomics and clinical factors in prediction of lymphovascular invasion (LVI) in rectal cancer. Methods:This retrospective cohort study was conducted on 120 patients (86 males and 34 females; age (62.2±11.6) years) with rectal adenocarcinoma from the Affiliated Hospital of Qingdao University between January 2017 and November 2023. Patients were divided into a training set ( n=96) and testing set ( n=24) at the ratio of 8∶2 using simple random sampling without replacement with a fixed random seed. An external validation cohort consisted of 31 patients (17 males and 14 females; age (61.2±8.2) years) with rectal adenocarcinoma from Affiliated Hospital of Jining Medical University and Linyi Cancer Hospital between January 2020 and June 2024 was obtained. PET/CT-derived features were selected to build radiomics model. The χ2 test and logistic regression were used to identify clinical predictors of LVI for clinical modeling. A combined radiomics-clinical nomogram was developed, after that ROC analysis was conducted to evaluate the predictive performance. Results:Significant differences were found between LVI-positive ( n=40) and LVI-negative ( n=56) subgroups in body weight, carbohydrate antigen (CA) 19-9, metabolic tumor volume (MTV), and peak of SUV (SUV peak) in the training set ( χ2 values: 4.01-13.64, all P<0.05). Binary logistic regression identified body weight (odds ratio ( OR)=0.320, 95% CI: 0.095-0.906, P=0.033), CA19-9 ( OR=0.402, 95% CI: 0.120-0.917, P=0.033), and MTV ( OR=0.192, 95% CI: 0.090-0.575, P=0.002) as independent predictors of LVI, forming the clinical model. Thirteen PET features and fifteen CT features were selected and a radiomics model was built. ROC curve analysis showed that AUCs for the clinical model in the training, testing, and external validation sets were 0.765, 0.567, and 0.777, respectively; AUCs for the radiomics model were 0.925, 0.881, and 0.823; AUCs for the joint model were 0.938, 0.889, and 0.841. Conclusion:The joint model of 18F-FDG PET/CT radiomics and clinical factors can effectively predict LVI in rectal cancer, guiding preoperative therapy and surgical planning.

Objective:To explore the value of a model combining 18F-FDG PET/CT radiomics and clinical factors in prediction of lymphovascular invasion (LVI) in rectal cancer. Methods:This retrospective cohort study was conducted on 120 patients (86 males and 34 females; age (62.2±11.6) years) with rectal adenocarcinoma from the Affiliated Hospital of Qingdao University between January 2017 and November 2023. Patients were divided into a training set ( n=96) and testing set ( n=24) at the ratio of 8∶2 using simple random sampling without replacement with a fixed random seed. An external validation cohort consisted of 31 patients (17 males and 14 females; age (61.2±8.2) years) with rectal adenocarcinoma from Affiliated Hospital of Jining Medical University and Linyi Cancer Hospital between January 2020 and June 2024 was obtained. PET/CT-derived features were selected to build radiomics model. The χ2 test and logistic regression were used to identify clinical predictors of LVI for clinical modeling. A combined radiomics-clinical nomogram was developed, after that ROC analysis was conducted to evaluate the predictive performance. Results:Significant differences were found between LVI-positive ( n=40) and LVI-negative ( n=56) subgroups in body weight, carbohydrate antigen (CA) 19-9, metabolic tumor volume (MTV), and peak of SUV (SUV peak) in the training set ( χ2 values: 4.01-13.64, all P<0.05). Binary logistic regression identified body weight (odds ratio ( OR)=0.320, 95% CI: 0.095-0.906, P=0.033), CA19-9 ( OR=0.402, 95% CI: 0.120-0.917, P=0.033), and MTV ( OR=0.192, 95% CI: 0.090-0.575, P=0.002) as independent predictors of LVI, forming the clinical model. Thirteen PET features and fifteen CT features were selected and a radiomics model was built. ROC curve analysis showed that AUCs for the clinical model in the training, testing, and external validation sets were 0.765, 0.567, and 0.777, respectively; AUCs for the radiomics model were 0.925, 0.881, and 0.823; AUCs for the joint model were 0.938, 0.889, and 0.841. Conclusion:The joint model of 18F-FDG PET/CT radiomics and clinical factors can effectively predict LVI in rectal cancer, guiding preoperative therapy and surgical planning.

Objective:To analyze the current situation and influencing factors of work-related musculoskeletal disorders (WMSDs) among scientific researchers in a computer workstation of a high-tech aerospace enterprise, and to provide data support for the improvement of occupational health management policies in this type of enterprise.Methods:From March to April 2023, using convenient sampling method, 1398 scientific researchers using computer workstations in an aerospace high-tech enterprise in Beijing were selected as the research subjects. The incidence of WMSDs in various parts of the body was investigated by using the Musculoskeletal Disorders Questionnaire, and the influencing factors of WMSDs in neck, lower back, shoulder and upper back were analyzed by logistic regression.Results:The total incidence of WMSDs was 55.4% (774/1398) in the scientific researchers who used computer workstations. The top 4 body parts in WMSDs incidence were neck (24.3%, 340/1398), lower back (20.4%, 285/1398), shoulder (18.7%, 262/1398), upper back (12.7%, 177/1398). The results of multivariate logistic regression analysis showed that feeling slightly tired and tired after work, setting a rest/break time of 10 to 15 min before the next continuous job, and operating computer for 2 to 4 hours and >4 hours were the influencing factors for the occurrence of neck WMSDs ( OR=3.08, 1.90, 0.60, 2.00, 1.49, P<0.05). Female, 5-<10 years of working experience, feeling slightly tired, tired and very tired after work, operating computer for 6-<8 hours and 8-10 hours a day were all the influencing factors for the occurrence of WMSDs in the lower back ( OR=1.82, 0.64, 2.95, 1.80, 1.61, 1.82, 1.73, P<0.05). Female, feeling slightly tired and tired after work were the influencing factors of shoulder WMSDs occurrence ( OR=2.42, 2.09, 2.00, P<0.05). Female, 5-<10 years, 10-15 years of working age, 1-3 times of physical exercise/quarter, feeling slightly tired, tired and very tired after work were the influencing factors for the occurrence of upper back WMSDs ( OR=2.76, 2.19, 2.78, 0.48, 4.20, 2.66, 2.19, P<0.05) . Conclusion:The incidence of WMSDs among scientific researchers in computer workstations of aerospace high-tech enterprises is high, which is closely related to individual characteristics and workstation usage characteristics. Measures should be taken to prevent and improve the WMSDs status of scientific researchers.

Objective:To analyze the current situation and influencing factors of work-related musculoskeletal disorders (WMSDs) among scientific researchers in a computer workstation of a high-tech aerospace enterprise, and to provide data support for the improvement of occupational health management policies in this type of enterprise.Methods:From March to April 2023, using convenient sampling method, 1398 scientific researchers using computer workstations in an aerospace high-tech enterprise in Beijing were selected as the research subjects. The incidence of WMSDs in various parts of the body was investigated by using the Musculoskeletal Disorders Questionnaire, and the influencing factors of WMSDs in neck, lower back, shoulder and upper back were analyzed by logistic regression.Results:The total incidence of WMSDs was 55.4% (774/1398) in the scientific researchers who used computer workstations. The top 4 body parts in WMSDs incidence were neck (24.3%, 340/1398), lower back (20.4%, 285/1398), shoulder (18.7%, 262/1398), upper back (12.7%, 177/1398). The results of multivariate logistic regression analysis showed that feeling slightly tired and tired after work, setting a rest/break time of 10 to 15 min before the next continuous job, and operating computer for 2 to 4 hours and >4 hours were the influencing factors for the occurrence of neck WMSDs ( OR=3.08, 1.90, 0.60, 2.00, 1.49, P<0.05). Female, 5-<10 years of working experience, feeling slightly tired, tired and very tired after work, operating computer for 6-<8 hours and 8-10 hours a day were all the influencing factors for the occurrence of WMSDs in the lower back ( OR=1.82, 0.64, 2.95, 1.80, 1.61, 1.82, 1.73, P<0.05). Female, feeling slightly tired and tired after work were the influencing factors of shoulder WMSDs occurrence ( OR=2.42, 2.09, 2.00, P<0.05). Female, 5-<10 years, 10-15 years of working age, 1-3 times of physical exercise/quarter, feeling slightly tired, tired and very tired after work were the influencing factors for the occurrence of upper back WMSDs ( OR=2.76, 2.19, 2.78, 0.48, 4.20, 2.66, 2.19, P<0.05) . Conclusion:The incidence of WMSDs among scientific researchers in computer workstations of aerospace high-tech enterprises is high, which is closely related to individual characteristics and workstation usage characteristics. Measures should be taken to prevent and improve the WMSDs status of scientific researchers.

Objective:To investigate the value of preoperative enhanced CT combined with serum cytokeratin fragment 19 (CYFER21-1) and neuron-specific enolase (NSE) in the diagnosis of lymph node metastasis in patients with non-small cell lung cancer (NSCLC).Methods:160 patients with NSCLC admitted to Linyi Cancer Hospital from October 2018 to October 2021 were retrospectively selected. All patients received surgical treatment in our hospital, and 84 patients with lymph node metastasis (metastatic group) and 76 patients without lymph node metastasis (non-metastatic group) were confirmed after surgery. The features of enhanced CT images and serum CYFER21-1 and NSE levels were compared between the two groups before operation, and the value of each index in the diagnosis of lymph node metastasis in patients with NSCLC alone and in combination was analyzed by receiver operating characteristic (ROC) curve.Results:The proportions of patients with lesion diameter ≥3.0 cm, pleural depression, lymph node enlargement shown by CT, lymph node short diameter ≥10 mm, lymph node boundary ambiguity and lymph node enhancement in metastatic group were significantly higher than those in non-metastatic group, with statistical significance (all P<0.05). Serum CYFER21-1 and NSE levels in metastatic group were significantly higher than those in non-metastatic group, with statistical significance (all P<0.05). The area under curve (AUC) of CYFER21-1 and NSE levels in the diagnosis of lymph node metastasis in NSCLC patients were 0.652 and 0.845, respectively, and the diagnostic cut-off values were 4.81 ng/ml and 24.14 ng/ml, respectively. The sensitivity and specificity of CYFER21-1+ NSE+ enhanced CT in the diagnosis of lymph node metastasis in NSCLC patients were 91.67% and 94.74%. Conclusions:Preoperative enhanced CT is of certain clinical value in the diagnosis of lymph node metastasis in NSCLC patients. Combined with serum CYFER21-1 and NSE levels, enhanced CT can further improve the sensitivity and specificity of diagnosis.

OBJECTIVE：To comprehensi vely evaluate the application progress of network pharmacology methods in TCM compound prescription research ，and to provide reference for modernization of TCM compound prescription research. METHODS ： Taking“network pharmacology ”and“TCM compound prescription ”as keywords ，the literatures were retrieved from CNKI ， Wanfang database and VIP during May 2006 to May 2020. Screening literature ，the databases ，analysis platforms ，and software used of the literature were summarized ；on the basis of quantitative analysis ，the application of network pharmacology in the research of traditional Chinese medicine compound were summarized. RESULTS & CONCLUSIONS ：There were a total of 761 valid literatures ，among which the number of literatures that could be retrieved in 2019 reached 313. In the modernization research of TCM compound prescription ，network pharmacology methods were mainly usedmechanism ，material basis of pharmacodynamics ， compatibility law ，compound optimization ，and“effect-toxic”network. Commonly used databasesand platforms included traditional chinese medicine information database （TCMSP and TCMID ），therapeutic target database （TTD，OMIM），drug targets and target prediction platform （Drugbank，SwissTargetPrediction，TargetNet，PharmMapper），network pharmacology analysis and prediction software and platform （CytoScape），etc. Network pharmacology method was widely used in the field of TCM compound prescription research ，and provided new ideas and methods for the modernization of TCM compound prescription research. In the future，the related research can be combined with the pharmacokinetic parameters ，the efficacy of active compounds and related basic experiments ，use the weighted method to carry out network pharmacology analysis ，and integrate the information of multiple databases to improve the scientificity of research results.

OBJECTIVE：To estab lish“TCM Data Analysis Platform Based on Strategy Pattern ”（TCMDP），and to analyze the medication rules of TCM prescription against primary hepatic carcinoma （PHC），so as to provide reference for TCM prescription screening. METHODS ：According to the idea of strategy pattern ，TCMDP software was developed ，and the frequency statistics，association，clustering，classification and other methods and the different algorithms covered were encapsulated. Effective TCM prescriptions against PHC were collected and screened from 4 tertiary-grade class-A hospitals in Nanchang city and CNKI ， PubMed. A database of prescriptions for PHC （PDOPHC）was established ，and TCM prescriptions in the data base were put into TCMDP. Clustering algorithm modified by CMC-DD ，modified WD-Get Rules algorithm after merging depth and width search and frequency statistics were used to analyze the distribution of prescription syndrome. Taking phlegm-blood stasis syndrome type （TYPHC）as example ，data mining was carried out on drug efficacy category ，four properties ，five flavors and channel tropism ， drug property combination ，key couplet medicines and key drug combination. RESULTS ：A total of 907 TCM prescriptions against PHC were collected ，mainly involving 10 syndrome types ，such as phlegm-blood stasis syndrome ，deficiency of the vital essential and blood stasis syndrome and liver and spleen blood stasis syndrome. TCM related to TYPHC commonly used in pre- scriptions were tonifying deficiency medicine ， phlegm-re- solving medicine ，promoting blood circulation and removing blood stasi s medicine ，etc．Four properties were mostly cold ，warm and calm ；the five flavors were most ly swe et，bitter and pungent ；channel tropism were mostly spleen ，liver，stomach， lung，heart and kidney ；drug combination were mostly warming-sweet-spleen ，warming-pungent-spleen and cold-bitter-liver ，etc.； there were 36 couplet medicines with frequency ≥30 times；there were 31 strong association rules and 8 key drug combinations in the prescriptions. WD-Get Rules results showed that in the TCM prescriptions against PHC ，Atractylodes macrocephala ，Codonopsis pilosula，Poria cocos and Glycyrrhiza uralensis were in the key position. They were often combined with many kinds of drugs ， which were related to the effect of Sijunzi decoction on strengthening Qi and tonifying spleen. CMC-DD results showed that therapy for TYPHC focused on strengthening the spleen and stomach ，replenishing Qi and blood ；and at the same time ，it treated TYPHC with phlegm-blood stasis syndrome from multiple angles ，such as soothing the liver and regulating Qi ，eliminating phlegm ，clearing heat and detoxification ，promoting blood circulation and nourishing Yin. CONCLUSIONS ：Clinical treatment of TYPHC mainly adopts the methods of invigorating the spleen and replenishing Qi ，soothing the liver and regulating Qi ，promoting blood circulation and removing blood stasis ，which conforms to the medication principle of “strengthening the body and eliminating pathogenic factors”. The application of TCMDP can realize the data mining and analysis of TCM in multi-level and multi-directional way ， which provides a new and effective way for the mining and research of compatibility rules of TCM prescriptions.

Objective To compare the clinical efficacy of proximal femoral nail anti-rotation ( PFNA ) fixation and hemiarthroplasty in the treatment of elderly unstable intertrochanteric fractures .Methods 72 cases with unstable intertrochanteric fractures were divided into the two groups by random number table ,each group had 36 ca-ses,the control group was given implementation of hemiarthroplasty while the observation group was given PFNA fixa -tion,the clinical therapeutic effect were compared between the two groups .Results It showed no significant differ-ence in operative time between the two groups (t =2.58,P>0.05);the blood loss of the observation group was (187.52 ±10.83)mL,which was significantly less than that of the control group (t=9.56,P<0.05),the load time of the observation group was (33.52 ±3.28)d,which was significantly more than that of the control group (t=10.31, P<0.05);there were no significant differences in the hip function excellent rate after 1 year and postoperative com-plication rate between the two groups (94.44% or 91.67%,11.11% or 8.33%,χ2 =2.01,1.69,all P>0.05). Conclusion PFNA fixation and hemiarthroplasty for treatment in elderly unstable intertrochanteric fractures have good effect ,and the patients should be based on the specific clinical circumstances , under strict control of surgical contraindications choose the right surgery .