This paper proposes a two-stage method integrating visual foundation models （VFM） and diffusion models. The segment anything model （SAM） as VFM is combined with the SegRefiner diffusion model to construct the SAM-SegRefiner framework for automated segmentation of edema， inflammation， and thrombus regions in histopathological images of hemorrhoidal tissue， providing a reproducible technical tool for the objective quantification of pathological morphology and its application in traditional Chinese medicine （TCM） syndrome research. Trained and validated on multi-center retrospective data， the SAM-SegRefiner model achieved an average pixel accuracy of 95.32% and a mean intersection over union （mIoU） of 66.81% on an independent test set， significantly outperfor-ming comparative models such as U-Net， MixU-Net， and SAM-Med2D， and also demonstrating robust cross-center generalization capability. Furthermore， by correlating the quantitatively segmented results from the model with the patients' TCM syndrome types， the potential associations between pathomorphological features and TCM syndrome differentiation have been explored. The analysis revealed no statistically significant differences in the degree of inflammatory infiltration and thrombus formation among different syndrome types， suggesting a complex relationship between local pathological changes and systemic syndrome manifestations.

Objective:To investigate the spatial distribution pattern of local tumor progression (LTP) for hepatocellular carcinoma (HCC) ≤5 cm after microwave ablation.Methods:A retrospective analysis was performed on 169 HCCs with matched MRI before and after ablation from December 2009 to December 2019. A tumor MRI was reconstructed using three-dimensional visualization technology. LTP was classified as contact or non-contact, early or late stage, according to whether LTP was in contact with the edge of the ablation zone and the occurrence time (24 months). The tumor-surrounded area was divided into eight quadrants by using the eight-quadrant map method. An analysis was conducted on the spatial correlation between the quadrant where the ablative margin (AM) safety boundary was located and the quadrant where different types of LTP occurred. The t-test, or rank-sum test, was used for the measurement data. 2-test for count data was used to compare the difference between the two groups.Results:The AM quadrant had a distribution of 54.4% LTP, 64.2% early LTP stage, and 69.1% contact LTP, suggesting this quadrant was much more concentrated than the other quadrants ( P ?

Objective To investigate the QCC activities to reduce the effect of noise on the ward. Methods Formulate and adopt the measures by setting up QQC team to analyze the factors of the ward noise. Results Ward noise reduction rate was more than 80%, including all types of wheel noise reduction rate was up to 92.31%, the family talking loudly and the eachinstrument noise were respectively 88.24% and 88.10%. Conclusion The application of QQC reduces the ward’s noise, improves patient’s satisfaction and nursing quality.

Objective To explore the effect of nursing intervention on compliance of Budesonide/Formoterol inhalation in patients with COPD.Methods 135 patients with COPD were randomly divided into observation group and control group.68 cases in the observation group inhaled Budesonide /Formoterol and were additional given comprehensive nursing interventions;67 cases in the control group inhaled Budesonide /Formoterol alone.The compliance and effect were detected before and after treatment.Results After intervention,the Budesonide /Formoterol in-halation rate in the observation group was significantly improved.Conclusion The nursing inter-vention can raise the compliance of inhalation treatment of Budesonide /Formoterol in COPD pa-tients and improve the lung function of the patients.

Objective To explore the effect of nursing intervention on compliance of Budesonide/Formoterol inhalation in patients with COPD.Methods 135 patients with COPD were randomly divided into observation group and control group.68 cases in the observation group inhaled Budesonide /Formoterol and were additional given comprehensive nursing interventions;67 cases in the control group inhaled Budesonide /Formoterol alone.The compliance and effect were detected before and after treatment.Results After intervention,the Budesonide /Formoterol in-halation rate in the observation group was significantly improved.Conclusion The nursing inter-vention can raise the compliance of inhalation treatment of Budesonide /Formoterol in COPD pa-tients and improve the lung function of the patients.

Objective To explore the application effect of the adult education theory in the nursing round. Methods 340 trainee nurses, who were trained at our surgical department between June 2008 and December 2009, were randomly divided into the experimental group(178 cases)and the control group(162cases). The adult education theory was adopted in the experimental group, whereas the traditional education method was used in the control group, a questionnaire was carried out after the nursing visit. Results The experimental group was more satisfied with the round visit than the control group. Conclusions The application of the adult education theory in the round visit is beneficial not only to the students' selection of the topics of nursing visit, but also to the improvement of the students' understanding and communicating capacity, the students' studying interests and the students' creative thinking, finally the degree of satisfaction to the round visit is increased by the adoption of this theory.