Objective To investigate the relationship between cerebrovascular reactivity(CVR)and emotional disorders in the patients undergoing continuous hemodialysis for end-stage renal disease(ESRD).Methods The clinical data of the ESRD patients undergoing continuous hemodialysis were collected.Anxiety and depression of the patients were assessed by the Hamilton anxiety scale(HAMA)and Beck depression inven-tory,respectively.The cerebral hemodynamic changes during the breath holding test were monitored by transcrani-al Doppler sonography,and the breath-holding index(BHI)was calculated.The BHI≥0.69 and BHI＜0.69 indi-cate normal CVR and abnormal CVR,respectively.Binary Logistic regression was employed to analyze the factors affecting the depressive state of ESRD patients.Results The group with abnormal CVR exhibited higher total cholesterol level(P=0.010),low density lipoprotein level(P=0.006),and incidence of depression(P=0.012)than the group with normal CVR.Compared with the non-depression group,the depression group dis-played prolonged disease course(P=0.039),reduced body mass index(P=0.048),elevated HAMA score(P=0.001),increased incidence of anxiety(P＜0.001),decreased BHI(P=0.015),and increased incidence of abnormal CVR(P=0.012).Binary Logistic regression analysis indicated anxiety as a contributing factor(OR=22.915,95％CI=2.653-197.956,P=0.004)and abnormal CVR as a risk factor(OR=0.074,95％CI=0.008-0.730,P=0.026)for depression.Conclusion Impaired CVR could pose a risk for depression in the patients with ESRD.

Objective To compare and analyze the differences between customized models and commercial universal models in the segmentation of organs-at-risk in cervical cancer,and to investigate the feasibility of customized models.Methods A retrospective analysis was conducted on 270 cervical cancer patients.Senior clinicians manually delineated organs-at-risk,including the bladder,rectum,small intestine,pelvic bone marrow,femoral heads,and kidneys.The cases were randomly selected to develop customized models,with 202 cases allocated to the training set,38 cases to the test set,and 30 cases to the validation set.The universal and customized models were used for segmentation on the test set,and the automatic segmentation results obtained by the two models were compared with manual segmentation results to assess the performance of the customized model.Results Both customized model and universal model had comparable DSC values to manual segmentation,demonstrating satisfactory delineation outcomes(DSC values ranging from 0.7 to 0.9).However,in terms of deviation of centroid and 95％Hausdorff distance,the customized model surpassed the universal model.Conclusion Compared with the universal model,the customized model offers superior accuracy in delineating the structures of organs-at-risk in cervical cancer.As the customized model is optimized based on specific datasets,it provides precise support for clinical decision-making and holds promising applications in the treatment of cervical cancer.

Objective:To investigate the value of artificial intelligence (AI) cytomorphologic analysis system in the cytomorphological diagnosis and therapeutic evaluation of acute myeloid leukemia (AML).Methods:Bone marrow smear samples were collected from 150 patients with newly diagnosed and treated acute myeloid leukemia who were inpatients and outpatients at the Department of Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College from June 1, 2021 to July 31, 2022 for retrospective analysis. Among them, there were 50 patients in the newly diagnosed group, including 28 males and 22 females, with the onset age of 43.5(32.3,58.8)years. There were 100 patients in the post-treatment group, including 36 males and 64 females, with the onset age of 34.5(23.0,47.0)years. The results from cytomorphology expert were used as the gold standard and the Python 3.6.7 was used for analysis to evaluate the accuracy, sensitivity, and specificity of the AI cytomorphologic analysis system for blast cell recognition in AML diagnosis and treatment.Results:The proportion of blasts in AI analysis of 50 samples in the newly diagnosed group was≥20%, which met the diagnostic criteria of AML. AI analysis of blasts had an accuracy of 90.3%, sensitivity of 85.5%, and specificity of 98.0%. The correlation coefficient between AI and the proportion of blasts analyzed by experts was positively correlated( r=0.882, P<0.001). Meanwhile, in the post-treatment group, the sensitivity and specificity of AI analysis of blasts were 89.7% and 99.2%, respectively. The correlation coefficient between AI and the proportion of blasts analyzed by experts was positively correlated( r=0.957, P<0.001). According to AI analysis data, there are 8 samples in this group whose AI efficacy evaluation results on AML are inconsistent with expert analysis. Conclusion:AI cytomorphologic analysis system has high accuracy, sensitivity and specificity for blast cell recognition in AML morphological diagnosis and therapeutic evaluation.

Objective To observe the effect of different Nasointestinal feeding tube catheterization techniques on patients with ICU brain dysfunction.Methods Totally 51 patients were divided into the traditional blind intubation group(26 cases)and the ultrasound guided group(25 cases)according to the random number table.The efficacy of catheterization was evaluated using first catheterization success rate,final catheterization success rate,catheterization time,and complications.Results The ultrasound guided catheterization group has a higher success rate for the first catheterization compared to the traditional blind insertion group;There was no statistically significant difference in general information,final catheterization success rate,catheterization time,and incidence of complications between the two groups.Conclusion The two kinds of nasogastric tube placement techniques are safe and effective in patients with ICU brain dysfunction,ultrasound guided catheterization can improve the success rate of first catheterization and have better efficiency.

This article takes the setting of children's rehabilitation specialty in the rehabilitation therapy of Xiamen Medical College as an example, and expounds that in the process of cultivating talents in children's rehabilitation, theoretically, a training model of "2.5+0.5+1" has been built closely around the training goals of "solid foundation, wide caliber and strong skills", highlighting basic pediatric courses, core skills courses for children's rehabilitation therapy and special courses for children's rehabilitation. In practice, the training of "early clinical practice and early probation" for children's rehabilitation skills is stressed. The results show that students have greatly improved their professional knowledge and practical ability, and the effect of "early clinical practice and early probation" is obvious. Among the students who choose the direction of children's rehabilitation, 95% of the students want to engage in the career of children's rehabilitation and believe that the curriculum system will be of great help to their future employment.

OBJECTIVETo explore the repair effects of acupuncture for promoting the governor vessel and tranquilizing the mind (acupuncture technique) on cerebral white matter injury of premature infants.

METHODSA total of 56 cases of cerebral whiter matter injury of premature infants, the fetal age less than 35 weeks were selected and randomized into an observation group (27 cases) and a control group (29 cases). The routine basic rehabilitation therapy was used in the two groups. Additionally, in the observation group, the acupuncture technique was added, once a day and the treatment for 15 days was as 1 course. Totally, 3 courses of treatment were required. Before and after treatment, the cranial magnetic resonance imaging (MRI) and the diffusion tensor imaging (DTI) were adopted to observe the location and severity of cerebral white matter injury. The Gesell developmental scale was used to assess the nerve motor development.

RESULTSAfter treatment, the difference was not significant statistically in the severity of cerebral white matter injury in the infants between the two groups (>0.05). The FA value of cerebral white matter in the interesting zone was increased as compared with that before treatment in the infants of the two groups (both<0.05). The result in the observation group was higher than that in the control groups (<0.05). After treatment, DQ value of each function zone in Gesell scale was all increased as compared with that before treatment in the two groups (all<0.05). After treatment, the DQ values of gross motor, fine motor and social adaptability in the observation group were higher than those in the control group (all<0.05). After treatment, the difference was not significant in DQ value of individual-social and speech behaviors between the two groups (both>0.05).

CONCLUSIONAcupuncture technique for promoting the governor vessel and tranquilizing the mind promotes the repair of the function in the premature infants with cerebral white matter injury and further benefits the promotion of the intelligence.

Objective: To evaluate the influence of fracture resistance of endodontically treated teeth with different thickness of ferrule by mechanical fatigue test and static loading test, and so as to provide a reference for the clinical treatment planning. Methods: Fifty bovine incisors were divided into 5 groups by random number table method (n=10). Group A was the control group in which the incisors were prepared without a ferrule design (0 mm). The other four groups (B, C, D, E) were experimental groups, and the thickness of the dentin ferrule prepared for specimens in each group was 0.5, 1.0, 1.5, and 2.0 mm. The height of ferrules in all the specimens was 2 mm. Cyclic fatigue loading (2.33 Hz, 50 N) was applied on each specimen until either the specimen was dislodged/fractured or the 300 000 cycles were finished. After fatigue loading, the mode of failure was observed. Those intact specimen after fatigue loading were tested under a gradually increasing force using a universal testing machine (0.05 mm/min) until fracture occurred. The forces required to fracture and failure model was recorded. Results: The results of cyclic loading tests showed that: all specimens survived the 300 000 cycles of intermittent loading. The results of static loading tests showed that: the fracture force of A, B, C, D and E groups respectively were (226.4±67.7), (369.7±34.5), (400.7±48.2), (528.1±56.3), and (555.4±98.5) N (F=15.227, P=0.000). There was a significant difference in fracture resistance between group A and the other four groups, and between group B, C and group D, E (P<0.05). No statistical difference were found in fracture resistance among the other groups (P>0.05). There was strong correlation between the thickness of ferrule and the fracture force by Pearson correlation analysis (r=0.973, P=0.002). Conclusions Within the limitations of this study, the following conclusions can be drawn: The different thickness of ferrule can influence the fracture resistance of the teeth, and when the height of the ferrule is 2.0 mm, the fracture force increased significantly with an increasing ferrule thickness.

Objective To explore the safety and short?term efficacy of irreversible electroporation (IRE)ablation which is a novel ablation technology in unresectable hepatic neoplasms. Methods Patients with pathologically diagnosed as liver cancer or liver metastases were prospectively enrolled. The patients were not suitable for surgery with PS score ≤ 2. Exclusion criteria included who was not tolerate general anesthesia, severe liver and kidney dysfunction, and with cardiac pacemaker. A total of 16 patients were included in this study. There was 12 males and 4 females, aged 40 to 86 years with mean age (60 ± 10)y. Ultrasound and CT guided percutaneous IRE ablation was performed. Perioperative hemodynamic changes were reviewed. Liver and kindey function before and 7 d after ablation was compare by t test. The adverse reactions within 30 d after ablation treatment were recorded. CT and MR scans within 1 month were performed and the 30 d curative effect was evaluated by the modified RECIST criteria. Results All patients received IRE treatment successfully, and some patients experienced adverse reactions within 30 days after ablation, including abdominal pain in 7 cases, peritoneal effusion in 5 cases, hydrothorax in 4 cases, fever in 3 cases, cough, nausea and vomiting in 2 cases, biliary tract infection and thrombocytopenia in 1 case. After symptomatic treatment, these symptoms were improved. Severe complications, such as massive haemorrhage and bile leakage didn't occur. At 30 days after ablation, the curative effects were evaluated. Complete response (CR) was achieved in 1 patient , partial response (PR) was achieved in 12 patients, stable disease (SD) was in 2 patients , and progressive disease(PD) was 1 patients . The tumor relief rate (complete response+partial response) was 81.3%. Conclusions IRE ablation in the treatment of unresectable hepatic malignant tumor could have many advantages, including high safety, mild adverse reactions, and short?term efficacy. However, its long?term effect still need further observation.

Objective To investigate the difference of leucorrhea routine tests results among 3 periods of pregnancy in pregnant women.Methods Vaginal cleanliness,the presence of clue cells,trichomonas and fungi were tested for 3 103 obstetric outpatients who were pregnant and treated in the hospital.The test results were analyzed and compared.Results Among pregnant women in different periods of pregnancy,the difference in the proportion of vaginal cleanliness degree Ⅲ and fungal infection rates were statis-tically significant(P <0.05).Among pregnant women of different pregnant periods with vaginal cleanliness degree Ⅱ,difference of fungi infection rate was statistically significant(P <0.05).Among pregnant women of different pregnant periods with vaginal clean-liness degree Ⅳ,the difference of positive rates of fungi,trichomonas and clue cells were statistically significant(P <0.05).In addi-tion,there are a number of mixed infections.Conclusion Vaginitis during pregnancy should be early detected,diagnosed and trea-ted.

ObjectiveTo explore the correlation between phosphatase of regenerating liver-3 (PRL-3) and portal vein tumor thrombus in hepatocellular carcinoma (HCC).MethodsClinical data of 248 patients with HCC undergoing hepatectomy in the First People's Hospital of Foshan between December 2003 and December 2008 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval had been received. Among the 248 patients, 193 were males and 55 were females with the age ranging from 18 to 75 years old and the median of 48 years old. Forty-ifve cases were complicated with portal vein tumor thrombus. The expression of PRL-3 in HCC and portal vein tumor thrombus were observed by immunohistochemistry. The correlation between the expression of PRL-3 and the clinicopathological parameters of HCC patients and its signiifcance in portal vein tumor thrombus formation were analyzed. The analysis on the correlation between the expression of PRL-3 and the clinicopathological parameters of HCC was conducted usingχ2 test and the analysis on the risk factors associated with portal vein tumor thrombus formation was conducted using Logistic regression analysis.ResultsThe positive expression rate of PRL-3 in HCC and portal vein tumor thrombus was 70% (174/249) and 98% (44/45) respectively, and the positive expression rate in portal vein tumor thrombus was signiifcantly higher than that in HCC (χ2=15.253,P<0.05). The positive expression of PRL-3 was associated with the serum AFP, tumor diameter, histological differentiation of tumor, portal vein tumor thrombus formation, tumor TNM staging and early recurrence (χ2=4.836, 7.186, 4.226, 5.357, 13.862, 10.824;P<0.05). The positive expression of PRL-3 was the risk factor for portal vein tumor thrombus formation (OR=2.674,P<0.05).ConclusionsPRL-3 expression increases in HCC portal vein tumor thrombus and positive expression of PRL-3 may be closely associated with the invasion and metastasis of HCC.