Health communication aims to improve public health attitudes and behaviors by propagating health information. It plays an important role in promoting public health literacy and "Healthy China Initiative". The basic theories of health communication include "7 W" and Theory of Planned Behavior. Clinicians with profound medical expertise and a wealth of clinical practice play key roles in the communication, and they hold an unparalleled advantage in health communication by delivering authoritative and trustworthy information to the public. The capacity of health communication among clinicians in the nation is determined by various factors including professional characteristics, policy support, dissemination platforms and pathways, time and effort. Meanwhile, some problems in the research on the health communication capacity of clinicians remain, such as lack of well-established motivation systems, limited dissemination pathways, and imperfect evaluation frameworks. In some regions of China, health communication performance has been considered as part of the professional title evaluation for clinical physicians. Medical institutions and universities have also initiated relevant training and practice programs. It is crucial to improve evaluation frameworks, strengthen training pathways and effectiveness assessment, promote interdisciplinary integration, and enhance the role of clinicians in health communication in the future.

BACKGROUND:Socket-shield technique can effectively maintain labial soft and hard tissues,but the incidence of postoperative complications such as exposure and displacement of root shield is relatively high.It is speculated that the root shield may be exposed and displaced due to excessive load after long-term function of dental implants. OBJECTIVE:Through three-dimensional finite element analysis,we aim to study the influence of varying root shield thicknesses on the stress distribution,equivalent stress peaks,and displacement in the root shield,periodontal ligaments,implant,and surrounding alveolar bone under normal occlusal loading.We also attempt to analyze the correlation between the thickness of the root shield and occurrence of mechanical events such as root shield exposure,displacement,and fracture. METHODS:Cone-beam CT data of a patient who met the indication standard of socket-shield technique for maxillary central incisor were retrieved from database.Reverse engineering techniques were used to build models of the maxillary bone and root shield,while forward engineering was used to create models for the implant components based on their parameters.Models depicting various root shield thicknesses(0.5,1.0,1.5,and 2.0 mm)were created using Solidworks 2022 software.ANSYS Workbench 2021 software was then used to simulate and analyze the effects of varying root shield thicknesses on stress distribution,equivalent stress peaks,and displacement of the root shields,periodontal ligaments,implants,and surrounding alveolar bone under normal occlusion. RESULTS AND CONCLUSION:(1)In all root shield models,the stress was concentrated on the palatal cervical side,both sides of the edges and the lower edge of the labial side.As the thickness of the root shield increased,the equivalent stress peak and displacement showed a decreasing trend.The 0.5 mm thickness model produced a stress concentration of 176.20 MPa,which exceeded the yield strength(150 MPa)of tooth tissue.(2)The periodontal ligament stress in each group was concentrated in the neck margin and upper region.With the increase of root shield thickness,the equivalent stress peak and displacement of periodontal ligament showed a decreasing trend.(3)Implant stress in all models was concentrated in the neck of the implant and the joint of the implant-repair abutment,and the labial side was more concentrated than the palatal side.With the increase of root shield thickness,the equivalent stress peak of the implant in the model showed an increasing trend.(4)In each group of models,stress of cortical bone concentrated around the neck of the implant and the periphery of the root shield,and the labial side was more concentrated than the palatal side.With the increase of the thickness of the root shield,the equivalent stress peak around the root shield decreased;the peak value of the equivalent stress of the bone around the neck of the implant showed an increasing trend.In the model,the stress of cancellous bone was mainly concentrated around the neck of the lip of the implant,the top of the thread,the root tip and the lower margin of the root shield,and the labial side was more concentrated than the palatal side.With the increase of the thickness of the root shield,the peak value of the equivalent stress of the bone around the root shield in the model showed a decreasing trend.The minimum principal stress of cortical bone in each group of models was concentrated around the neck of the implant,exhibiting a fan-shaped distribution.As the thickness of the root shield increased,the minimum principal stress of cortical bone showed an increasing trend.(5)These results indicate that different thicknesses of the root shield have different biomechanical effects.The root shield with a thickness of 0.5 mm is easy to fracture.For patients with sufficient bone width,the root shield with a thickness of 2.0 mm is an option to reduce the risk of complications such as root shield exposure,fracture,and displacement.Meanwhile,it should be taken into account to protect the periodontal ligament in the preparation process,and rounding treatments ought to be carried out on both sides and the lower edge of the root shield.

Objective To explore the predictive value of radiomics for postoperative pancreatic fistula, infection, and long-term survival in patients with pancreatic ductal adenocarcinoma (PDAC). Methods 206 patients who received radical resection of pancreatic cancer in Zhongshan Hospital, Fudan University from January 2014 to December 2020 and were pathologically confirmed as PDAC after surgery were retrospectively selected, all of whom had complete surgical data and long-term follow-up data. Pyradiomics was used to analyze the enhanced CT images of all patients and extract radiomics features. LASSO dimensionality reduction combined with logistic regression analysis was used to construct a predictive model for pancreatic fistula and abdominal infection after PDAC surgery, and evaluating the model’s effectiveness using ROC curves. A long-term survival prediction model for PDAC patients was constructed using LASSO dimensionality reduction combined with Cox regression analysis, and patient risk scores were calculated. The patients were divided into high-risk and low-risk groups based on the median, and the survival curves were compared to evaluate the effectiveness of the model. The imaging omics features with the highest weight were divided into high expression group and low expression group according to the median, and the prognostic differences and clinical features were compared. Radiomics and clinical features were combined to analyze the influencing factors of long-term prognosis and construct a clinical imaging comprehensive model. Results A total of 1 595 radiomics features were extracted. A predictive model for pancreatic fistula and infection after PDAC surgery was constructed, with AUC values of 0.81 and 0.79, respectively. The PDAC long-term survival prediction model was successfully constructed, and the prognosis of the high-risk group was worse than that of the low-risk group (P<0.001). The weight of the radiomics feature “log-sigma-5-mm-3D_glszm_ZonePercentage” was 59.557. The CA19-9 level in the high expression group is higher than that in the low expression group (P=0.017), and there is a statistically significant difference in survival curves between the two groups (P=0.021). The comprehensive clinical imaging model suggested that age, AJCC stage, lymph infiltration, CA19-9 level and imaging characteristics were risk factors for long-term prognosis of PDAC patients (HR=1.028, 4.084, 2.566, 1.232 and 2.536). Conclusions The predictive model based on radiomics has good predictive performance for pancreatic fistula, infection, and long-term prognosis after PDAC surgery. Patients with high expression of the radiomics feature “log-sigma-5-mm-3D_glszm_ZonePercentage” face poorer prognosis.

Objective:To develop the Adolescent Mental Health Computerized Adaptive Test(AMH-CAT)for assessing psychological crises in adolescents using item response theory(IRT).Methods:A total of 8 679 students,aged 9 to 19 years,were sampled from 14 primary and secondary schools.The item bank was constructed by examining unidimensionality,independence,discrimination,and Differential Item Functioning(DIF).The AMH-CAT algorithm was developed using R software and validated for reliability and validity through real and simulated data.The School Psychological Interview Evaluation Form served as the criterion tool to assess the predictive validi-ty of AMH-CAT in evaluating psychological crises levels.Results:The item bank,consisting of 43 items,demon-strated unidimensionality and independence,with discrimination values＞0.80 and no DIF across genders.Under va-rious stopping rules,AMH-CAT showed ABS values＜0.40,RMSE values＜0.50,and a correlation(r)＞0.87(P＜0.001)between estimated and true psychological crises levels.Real participants answered an average of 10 items under the SE(θ)≤0.4 stopping rule,with a reliability of 0.89,and the scores were positively correlated with the complete item bank scores(r=0.95,P＜0.001).The predictive accuracy for Level 1 and Level 2 concerns was 0.89 and 0.90,respectively.Conclusion:The Adolescent Mental Health Computerized Adaptive Test(AMH-CAT)demonstrates excellent validity,reliability and assessment efficiency for evaluating adolescent psychological crises.

Objective:To develop the Adolescent Mental Health Computerized Adaptive Test(AMH-CAT)for assessing psychological crises in adolescents using item response theory(IRT).Methods:A total of 8 679 students,aged 9 to 19 years,were sampled from 14 primary and secondary schools.The item bank was constructed by examining unidimensionality,independence,discrimination,and Differential Item Functioning(DIF).The AMH-CAT algorithm was developed using R software and validated for reliability and validity through real and simulated data.The School Psychological Interview Evaluation Form served as the criterion tool to assess the predictive validi-ty of AMH-CAT in evaluating psychological crises levels.Results:The item bank,consisting of 43 items,demon-strated unidimensionality and independence,with discrimination values＞0.80 and no DIF across genders.Under va-rious stopping rules,AMH-CAT showed ABS values＜0.40,RMSE values＜0.50,and a correlation(r)＞0.87(P＜0.001)between estimated and true psychological crises levels.Real participants answered an average of 10 items under the SE(θ)≤0.4 stopping rule,with a reliability of 0.89,and the scores were positively correlated with the complete item bank scores(r=0.95,P＜0.001).The predictive accuracy for Level 1 and Level 2 concerns was 0.89 and 0.90,respectively.Conclusion:The Adolescent Mental Health Computerized Adaptive Test(AMH-CAT)demonstrates excellent validity,reliability and assessment efficiency for evaluating adolescent psychological crises.

Objective To compare the predictive effects of logistic regression and machine learning models on occurrence of low peripheral oxygen saturation(SpO2)during one-lung ventilation(OLV)in pa-tients undergoing thoracoscopic partial pulmonary resection(TPPR),and to explore risk factors of low SpO2.Methods A total of 127 patients undergoing unilateral TPPR from August 1,2022 to April 30,2023 were enrolled,61 males and 66 females,aged 18-80 years,ASA physical status Ⅰ-Ⅲ.Based on whether intraoperative SpO2 during OLV was less than 90％,the patients were divided into two groups:low SpO2 group(n=21)and normal SpO2 group(n=106).Perioperative data were collected and a predic-tive model was constructed using logistic regression.This model was compared with predictive models con-structed using five machine learning models,including random forest(RF),extreme gradient boosting(XGBoost),decision tree(DT),logistic regression(LogR),and support vector machine(SVM).The re-ceiver operating characteristic(ROC)curve was plotted,and the performance of the predictive models were evaluated by the area under the curve(AUC).The best output model was interpreted using Shapley additive explanations(SHAP)to identify the risk factors of low SpO2 during OLV in patients undergoing TPPR.Results Multivariate logistic regression analysis showed that increased age(OR=1.087,95％CI 1.006-1.175,P=0.036),increased BMI(OR=1.299,95％CI 1.050-1.608,P=0.016),increased pre-operative blood glucose(OR=2.028,95％CI 1.378-2.983,P＜0.001),and decreased RV/TLC％Pred(OR=0.936,95％CI 0.892-0.983,P=0.008)were independent risk factors of low SpO2 during OLV.The predictive model was Logit(p)=-10.098+0.08 × age+0.231 × BMI+0.633 × blood glu-cose-0.059 × RV/TLC％Pred,with an AUC of 0.873(95％CI 0.803-0.943,P＜0.001).After optimi-zing parameters of machine learning models using grid search combined with five-fold cross-validation,the model training results were satisfactory.ROC curve analysis showed that the AUC for RF was 0.921(95％CI 0.840-0.979),XGBoost was 0.940(95％CI 0.812-0.981),DT was 0.919(95％CI 0.828-0.982),LogR was 0.892(95％CI 0.831-0.980),and SVM was 0.922(95％CI 0.832-0.982).XG-Boost had the highest AUC,surpassing the logistic regression model.SHAP analysis indicated that the most important risk factors in the XGBoost output model were increased age,BMI,and preoperative blood glucose concentration.Conclusion Increased age,BMI,and preoperative blood glucose concentration are signifi-cant risk factors for low SpO2 during OLV in patients undergoing TPPR.The XGBoost machine learning model outperformed traditional logistic regression in predicting the occurrence of low SpO2 during OLV.XG-Boost can analyze more complex relationships between variables and outcomes and provide more accurate in-dividualized predictions of the risk of low SpO2 during OLV.

Objective The objective of this study is to examine the expression level of the S100A7A protein in both gastric cancer tissues and cells,as well as to evaluate its impact on the malignant phenotype of gastric cancer(GC)cells.Methods Immunohistochemical assay was used to detect the expression characteristics of S100A7A in 21 gastric cancer tissues and their corresponding paracancerous tissues,as well as to investigate its correlation with gastric cancer clinicopathological factors.Gastric cancer cells were genetically modified to overex-press S100A7A through plasmid transfection.Subsequently,the impact of S100A7A on the proliferation,migra-tion,and invasion capacities of gastric cancer cells was assessed using cell proliferation assays(EdU assay and plate cloning assay)as well as cell migration and invasion assays(Transwell assay and scratch assay).Results The expression of S100A7A protein was higher in GC tissues than in paracancerous tissues;Overexpression of S100A7A may increase gastric cancer cell proliferation,migration,and invasion.Conclusion S100A7A is a possible oncogene in GC and is predicted to serve as a new diagnostic and therapeutic target for the disease.

Objective To explore the feasibility and accuracy of using indocyanine green fluorescence (ICGF) to identify the intersegmental plane after ligation of the target pulmonary vein during thoracoscopic segmentectomy. Methods From December 2022 to June 2023, the patients with pulmonary nodules undergoing video-assisted thoracoscopic anatomical segmentectomy with intersegmental plane displayed using ICGF after ligation of the target pulmonary vein by the same medical team in our hospital were collected. Preoperative three-dimensional reconstruction was used to identify the target segment where the pulmonary nodule was located and the anatomical structure of the arteries, veins, and bronchi in the target segment. The intersegmental plane was first determined by the inflation-deflation method after the target pulmonary vein was ligated during the operation. During the waiting period, the target artery and bronchus could be separated but not cut off. The inflation-deflation boundary was marked by electrocoagulation, and then ICGF was injected via peripheral vein to identify the intersegmental plane again, and the consistency of the two intersegmental planes was finally evaluated. Results Finally 32 patients were collected, including 14 males and 18 females, with an average age of 58.69±11.84 years, ranging from 25 to 76 years. The intersegmental plane determined by inflation-deflation method was basically consistent with ICGF method in all patients. All the 32 patients successfully completed uniportal thoracoscopic segmentectomy without ICGF-related complications or perioperative death. The average operation time was 98.59±20.72 min, the average intraoperative blood loss was 45.31±35.65 mL, and the average postoperative chest tube duration was 3.50±1.16 days. The average postoperative hospital stay was 4.66±1.29 days, and the average tumor margin width was 26.96±5.86 mm. Conclusion The ICGF can safely and accurately identify the intersegmental plane by target pulmonary venous preferential ligation in thoracoscopic segmentectomy, which is a useful exploration and important supplement to the simplified thoracoscopic anatomical segmentectomy.

Organ transplantation is the main treatment for organ failure.Functional protection of donor organs during ex vivo transportation is critical for the success of organ transplantation.How to protect the functions of donor organs during in vitro transportation is an important issue in the field of organ transplantation research.In a hypoxic environment,transcriptional activity of a series of genes in cells is activated.These genes are mainly involved in angiogenesis,iron metabolism,glucose metabolism,and cell proliferation/survival.In aerobic organisms,hypoxia-inducible factor-1α(HIF-1α)is involved in the regulation of the expression of various genes to maintain homeostasis of tissues and cells under hypoxic conditions,thereby adapting to the hypoxia.Many studies have shown that the HIF-1α pathway plays an important role in protecting isolated organs from cold ischemic injury during cold storage.HIF-1α has been a hot topic in research on the protective mechanism of cold ischemic injury of isolated organs.Regulating the HIF-1α-related signaling pathway is expected to be a new strategy to maintain organ functions during cold storage of isolated organs.

Objective:To investigate the correlation between the waiting time for radiotherapy after induction chemotherapy and the prognosis of locally intermediate and advanced nasopharyngeal carcinoma, as well as its optimal time.Methods:Retrospective analysis of 101 patients with locally intermediate and advanced nasopharyngeal carcinoma admitted to the Fifth Affiliated Hospital of Sun Yat-sen University from 2017 to 2020 was performed. All patients received at least 2 courses of induction chemotherapy followed by radical radiotherapy. The waiting time for radiotherapy was defined as the time from the end of induction chemotherapy to the start of the first radiotherapy. The relationship between waiting time for radiotherapy and other factors (age, gender and stage, etc.) with progression-free survival (PFS), local recurrence-free survival (LRFS) and distant metastasis-free survival (DMFS) was analyzed through Cox model. The median waiting time for radiotherapy with 3 weeks was used as the boundary, and all patients were divided into ≤3 weeks and>3 weeks groups. The PFS, LRFS and DMFS between two groups were compared using Kaplan-Meier survival analysis. P<0.05 was considered as statistical significance. Results:Cox-regression analysis showed that the waiting time was correlated with PFS, LRFS, and DMFS (all P<0.05). Kaplan-Meier survival analysis suggested that the PFS, LRFS and DMFS in the ≤3 weeks group were significantly better than those in the >3 weeks group (all P<0.05). Under the premises of the T 3 stage, N 2 stage and the increased EB virus DNA replication levels before treatment, the PFS, LRFS and DMFS in the ≤3 weeks group were significantly better than those in the >3 weeks group (all P<0.05). Conclusions:The waiting time for radiotherapy is one of the factors affecting clinical prognosis of locally intermediate and advanced nasopharyngeal carcinoma. The earlier the time, the better the prognosis. Radiotherapy should be delivered within 3 weeks.