Objective In response to the practical issues of pilot ground simulation ejection training relying on subjective evaluation,which requires high professionalism and lacks objectivity and systematicity,an objective evaluation system and method for ejection training based on pressure detection has been designed.Methods According to the rules of ejection training about posture,maneuver and time,and utilizing technologies such as pressure detection,infrared detection,and time-triggered detection,this paper designed separate modules for ejection posture detection,ejection timing detection,and comprehensive analysis and evaluation.These modules are closely integrated with the ejection training process,achieving objective evaluation of the ejection training.Results This system and method can provide a scientific and real-time objective evaluation of the posture,movements,and time in ejection training without affecting the normal organization and process.Conclusion The objective evaluation system can provide a new approach that is highly objective and easy to operate for comprehensively evaluating and enhancing the effectiveness of ejection training,as well as for scientifically conducting ejection training and assessment.

With the rapid development of aviation technology,the ability of pilots to fly successfully and safely has attracted much attention.Improving pilots'emergency evacuation capabilities is the responsibility of every aviation worker.The injury caused by pilot parachute jumping is an important issue in flight safety.During the parachute jumping process,the pilot will be subjected to various impact forces and aerodynamic forces,which can cause damage to the pilot's spine,nervous system,circulatory system,and multiple parts of the body,and even endanger lift.This article focuses on exploring the characteristics of pilot ejection parachute injuries,categorizing and summarizing them according to the location and factors of the injuries,and analyzing their protective strategies.Targeted ground ejection simulation training is conducted for pilots in different batches to improve the combat effectiveness of the armies.

Objective A new type fighter pilot's helmet comfort was investigated to provide basis for generalization and popularization.Methods A quantitative questionnaire was designed to evaluate the comfort of current helmets and new helmets by pilots of series A and B fighters,and compare the new helmets with the current helmets.Thirdly,quantitative statistics of questionnaires were carried out to analyze the pilot's opinions on current helmets and new helmets.Based on the structure and quality characteristics of current helmets and new helmets,the investigation results were analyzed and discussed.Results A total of 167 pilots from series A and B fighter aircraft participated in trial wear and questionnaire investigation of new helmets.Among them,103 pilots from series A fighters and 64 pilots from series B fighters.Compared with the pilot's current helmet,the new helmet is lightweight and comfortable.Among them,92.2%of the pilots of the series A believe that the new helmet is more comfortable than the current helmet,and 90.3%of pilots think it is necessary to replace the current helmet with the new helmet.90.6%of the pilots of the Series B think the new helmet is more comfortable than the current helmet,and 92.2%of pilots think it is necessary to replace the current helmet with the new helmet.Conclusion The new fighter pilot's helmet is light and comfortable,and has been widely praised by pilots.The research results provide data support and decision-making basis for its universalization and popularization.

Objective:To investigate the evaluation efficacy and predictive prognostic value of alpha-fetoprotein (AFP) response in tyrosine kinase inhibitors (TKIs) in combination with PD-1 inhibitors (α-PD-1) for intermediate-to-advanced hepatocellular carcinoma (HCC).Methods:The retrospective cohort study was conducted. The clinicopathological data of 205 patients with intermediate-to-advanced HCC who were admitted to 9 medical centers, including Mengchao Hepatobiliary Hospital of Fujian Medical University et al, from March 2020 to July 2022 were collected. There were 178 males and 27 females, aged (52±12)years. Based on AFP response at 6-8 weeks after treatment, patients were divided into the AFP response group (AFP level decreased by ≥50% compared to baseline) and the AFP no response group (AFP level decreased by <50% compared to baseline). Observation indicators: (1) AFP response evaluation of anti-tumor efficacy; (2) comparison of patient prognosis; (3) analysis of factors affecting patient prognosis. Measurement data with normal distrubution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(range) and M( Q1, Q3). Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test. The Kaplan-Meier method was used to draw survival curve and calculate survival rate, and the Log-Rank test was used for survival analysis. The COX proportional risk model was used for univariate analysis and the COX stepwise regression model was used for multivariate analysis. Results:(1) AFP response evaluation of anti-tumor efficacy. Before treatment, all 205 patients were positive of AFP, with a baseline AFP level of 1 560(219,3 400)μg/L. All 205 patients were treated with TKIs in combination with α-PD-1, and the AFP level was 776(66,2 000)μg/L after 6 to 8 weeks of treatment. Of the 205 patients, 88 cases were classified as AFP response and 117 cases were classified as AFP no response. According to the response evaluation criteria in solid tumors version 1.1, the objective response rate (ORR) and disease control rate (DCR) were 42.05%(37/88) and 94.32%(83/88) in patients of the AFP response group and 16.24% (19/117) and 64.10% (75/117) in patients of the AFP no response group, showing significant differences between them ( χ2=16.846, 25.950, P<0.05). According to the modified response evaluation criteria in solid tumors, the ORR and DCR were 69.32% (61/88) and 94.32% (83/88) in patients of the AFP response group and 33.33% (39/117) and 64.10% (75/117) in patients of the AFP no response group, showing significant differences between them ( χ2=26.030, 25.950, P<0.05). (2) Comparison of patient prognosis. All 205 patients were followed up for 12.4(range, 2.4-34.0)months after treatment. The median progression free survival time and total survival time were 5.5 months and 17.8 months, respectively. The 1-year, 2-year progression free survival rates were 20.8% and 7.2%, and the 1-year, 2-year overall survival rates were 68.7% and 31.5%, respectively. The median progression free survival time, 1-year and 2-year progression free survival rates were 9.7 months, 39.6% and 14.2% in patients of the AFP response group and 3.7 months, 7.8% and 2.0% in patients of the AFP no response group, showing a significant difference in progression free survival between them ( χ2=43.154, P<0.05). The median overall survival time, 1-year and 2-year overall survival rates were not reached, 85.2% and 56.3% in patients of the AFP response group and 14.6 months, 56.3% and 14.5% in patients of the AFP no response group, showing a significant difference in overall survival between them ( χ2=33.899, P<0.05). (3) Analysis of factors affecting patient prognosis. Results of multivariate analysis showed that invasion of large blood vessels, extrahepatic metastasis, combined hepatic artery intervention therapy, and AFP response were independent factors influencing progression free survival in patients with intermediate-to-advanced HCC who were treated with TKIs in combination with α-PD-1 ( hazard ratio=1.474, 1.584, 0.631, 0.367, 95% confidence interval as 1.069-2.033, 1.159-2.167, 0.446-0.893, 0.261-0.516, P<0.05), and Eastern Cooperative Oncology Group score, invasion of large blood vessels, extrahepatic metastasis, and AFP response were independent factors influencing overall survival in patients with intermediate-to-advanced HCC who were treated with TKIs in combination with α-PD-1 ( hazard ratio= 1.347, 1.914, 1.673, 0.312, 95% confidence interval as 1.041-1.742, 1.293-2.833, 1.141-2.454, 0.197-0.492, P<0.05). Conclusions:AFP response at 6-8 weeks after treatment can effectively evaluate anti-tumor efficacy of TKIs in combination with α-PD-1 for intermediate-to-advanced HCC. AFP response is the independent factor influencing progression free survival and overall survival in patients with intermediate-to-advanced HCC who were treated with TKIs in combination with α-PD-1.

Objective:To investigate the clinical efficacy of 3D printed metal augment or tibial prosthesis for reconstruction of large bone defects in total knee arthroplasty (TKA) and knee revision surgery.Methods:A total of 7 patients (7 knees) with TKA or knee revision who were admitted to the Department of Orthopaedics of the Second Affiliated Hospital of Zhejiang University School of Medicine with large bone defects from July 2018 to December 2023 were retrospectively analyzed, including 4 patients with TKA and 3 patients with knee revision. There were 3 males and 4 females, aged 58.7±7.6 years (range, 54-68 years), 3 patients with left knee and 4 patients with right knee. All the patients had bone defects in the knee joint (AORI type III), 2 cases had bone defects only in the femur, 4 cases had bone defects only in the tibia, and 1 case had bone defects in both the tibia and femur, which were treated with personalized reconstruction using 3D printing. Hip-knee-ankle angles, American Knee Society score (KSS) before and after surgery were compared, and postoperative complications were observed.Results:All patients successfully completed the operation, and the operation time was 189.3±35.5 min (range, 125-240 min). Complex TKA was performed in 4 cases with surgical times of 175, 195, 210, and 240 min, and revision surgery was performed in 3 cases with surgical times of 125, 180, and 200 min, respectively. Intraoperative blood loss was 114±24.4 ml (range, 100-150 ml). Five cases used 3D printed metal augment, and two used 3D printed one-piece tibial components. All patients were followed up for 2, 2, 5, 6, 7, 20, 57 months, respectively. The KSS of the five patients at 3 months postoperatively were 56, 61, 66, 56, and 56 points, respectively, greater than the preoperative scores of 35, 44, 36, 27, and 41 points. The KSS functional scores of the five patients at 3 months postoperatively were 45, 45, 45, 30, and 45 points, respectively, which were greater than the preoperative scores of 30, 30, 15, 20, and 20 points. The hip-knee-ankle angle was 181.8°±3.4° (range, 177.9° to 188.0°) at the final follow-up and 175.8°±12.4° (range, 153.3° to 192.1°) before surgery, with no significant difference ( t=-1.230, P=0.242). At the final follow-up, the 3D printed component was well integrated with the bone surface, the prosthesis was securely positioned, and the force lines of the lower limbs were normal. There were no postoperative complications such as poor wound healing, infection, fat liquefaction, nerve injury, deep vein thrombosis of lower limbs, knee joint stiffness, periprosthesis infection and loosening. Conclusion:Using 3D printed metal augment or tibial prosthesis to reconstruct the huge bone defect in TKA and revision has a satisfactory early clinical effect, satisfactory joint function and good surgical safety.

Dry eye disease(DED)refers to a condition characterized by reduced stability of the tear film or an imbalance in the microenvironment of the ocular surface, resulting from abnormalities in quality, quantity and kinetics of tear. This condition leads to various ocular discomforts and even visual impairment. The pathogenesis of DED is multifactorial and current treatment mainly focuses on symptom relief and preservation of visual function. Acupuncture has shown effectiveness in treating dry eye, although its underlying mechanism remains incompletely understood. Proteomics technology offers a comprehensive and systematic approach to studying the functions, structures and interactions of proteins. Its application in DED research can provide valuable insights into the dynamic changes in protein levels associated with different etiology or the course of DED and facilitate the identification of potential biomarkers. Furthermore, proteomics can systematically explore the regulatory mechanisms underlying acupuncture treatment for DED, providing a theoretical basis for acupuncture treatment research and contributing to the understanding of its effects at a fundamental level. This paper aims to explore the potential application of proteomics in both clinical and basic research on DED. Ultimately, it strives to offer scientific and effective strategies for the diagnosis and treatment of DED and advance our knowledge of the mechanisms underlying acupuncture therapy.

Objective:To explore the predictive value of red blood cell distribution width-to-platelet ratio (RPR) on arteriovenous fistula (AVF) dysfunction in maintenance hemodialysis patients with end-stage renal disease (ESRD).Methods:One hundred and five ESRD patients who underwent maintenance hemodialysis with autologous AVF in Jiangdu People′s Hospital from March 2021 to March 2023 were selected. The red blood cell distribution width (RDW) and platelet (PLT) levels were measured before the start of dialysis, and the RPR was calculated. All patients were followed up for 6 months, and AVF dysfunction was recorded and divided into dysfunction group and non dysfunction group. The levels of RDW, PLT, and RPR before dialysis were compared between the two groups. Univariate and multivariate Logistic regression analyses were used to examine the relationship between RDW, PLT, RPR and AVF dysfunction in ESRD maintenance hemodialysis patients. Receiver operating characteristic (ROC) curves were plotted to obtain the area under the curve (AUC) for RDW analysis the predictive value of PLT and RPR for AVF dysfunction in ESRD maintenance hemodialysis patients.Results:Among the 105 patients, 4 were excluded due to interruption of treatment and transfer to another hospital. Among the 101 patients ultimately enrolled, 19 patients experienced AVF dysfunction (dysfunction group), with an incidence rate of 18.81% (19/101); 80 patients did experience AVF dysfunction (non dysfunction group). C-reactive protein, RDW and RPR in the dysfunction group were higher than those in the non dysfunction group: (7.36 ± 1.92) mg/L vs. (5.90 ± 2.40) mg/L, (17.98 ± 2.40)% vs. (14.96 ± 2.29)%, 0.14 ± 0.03 vs. 0.11 ± 0.02, the proportion of diabetes patients was higher than that in the non dysfunction group, while albumin was lower than that in the non dysfunction group: (33.49 ± 2.78) g/L vs. (35.01 ± 3.02) g/L, with a statistical significant difference ( P<0.05). Multivariate Logistic regression analysis showed that C-reactive protein, RDW, RPR were all associated with AVF dysfunction in ESRD maintenance hemodialysis patients ( P<0.05). ROC curve was drawn, and the results showed that the AUC of RDW and RPR predicting AVF dysfunction in ESRD maintenance hemodialysis patients was greater than 0.7, and the AUC of RPR was higher, 0.840 (95% CI 0.752 to 0.928), with an optimal cutoff value of 0.125, specificity of 78.90%, and sensitivity of 73.20%. Conclusions:RDW and RPR are both associated with AVF dysfunction in ESRD maintenance hemodialysis patients, and may have certain predictive value for AVF dysfunction.

Objective To explore the occlusal contact designs in accordance with biomechanical principles in the All-on-4 immediate loading scheme of the edentulous maxilla with four kinds of framework materials.Methods Cone beam CT of an edentulous maxilla was selected.The cone beam CT data,crown,framework,abutment and implant data were used and the titanium,cobalt-chromium al-loy,polyetheretherketone(PEEK)and resin framework materials were specified.The finite element models were divided into 4 groups,according to whether the anterior teeth or the cantilever had occlusal contact(AC group:both the anterior teeth and the cantilever were loaded;ANC group:load on the anterior teeth and no load on the cantilever;NAC group:no load on the anterior teeth and load on the cantilever;NANC group:no load on both the anterior teeth and the cantilever).The stress of cortical bone,implant and framework,the micromotion of implant and the deformation of framework were calculated and statistical analysis was then performed.Results Among the four types of framework materials,in terms of cortical bone peak stress,the NAC group had the highest value and the ANC group had the lowest.There was a statistical difference between the NAC group and the other three groups respectively(P＜0.05).With the four framework materials,in terms of the peak stress of implant,the ANC group had the highest.When the framework material was PEEK or resin,there was a significant difference between the ANC group and the other three groups(P＜0.05).The peak stress value of the framework compared,the NAC group had the highest peak stress and was significantly different from the other three groups(P＜0.05).The ANC group had the lowest peak stress and was significantly differ-ent from the other three groups(P＜0.05)when the framework material was titanium or cobalt-chromium alloy.If the framework material was PEEK or resin,there were no statistical differences between the four occlusal schemes.Comparing the peak micromotion of implant or the peak deformation of framework,the ANC/NAC group was significantly higher than the AC/NANC group(P＜0.05).Among the different framework materials,titanium and cobalt-chromium alloy had higher peak stress of framework compared to PEEK and resin(P＜0.05),with less stress transmitted to the cortical bone and implant(P＜0.05).Conclusion ①In terms of occlusal contact design,when the All-on-4 immediate loading scheme is applied to the edentulous maxilla,the scheme that the anterior teeth loaded and the cantilever unloaded(ANC)is more conducive to the stress distribution of bone-implant interface.②The application of load on both anterior teeth and cantilever(AC)or the absence of load on both anterior teeth and cantilever(NANC)is favourable for reducing the peak micromo-tion of implant and the peak deformation of framework.③Among the four types of framework materials,titanium or cobalt-chromium al-loy framework transmit less stress to the bone-implant interface than PEEK or resin framework.

Objective To develop an accurate,rapid and sensitive flow cytometry method for the determination of anti-mesenchymal stem cell antibody in cynomolgus monkey serum.Methods After the solutions of mesenchymal stem cell were centrifuged and washed,and the suspension was taken,positive controls or actual samples were added and incubated with mesenchymal stem cell,then were incubated with protein L-PE solution.After the removal of the free protein L-PE,the mean fluorescence intensity of the PE was detected by flow cytometry.Results The method sensitivity is 115.54 ng·mL-1,far higher than the non-clinical research recommended sensitivity of 250-500 ng·mL-1.The precision of intra-assay and inter-assay were less than 20%.Assay cut points,low positive control concentration determination,sensitivity,precision and stability were validated in this study.Conclusion The method is proved to be sensitive,specific,rapid and suitable for the determination of anti-mesenchymal stem cell antibody in monkey serum and immunogenicity study.