Objective To develop and validate risk prediction models utilizing five machine learning algorithms for assessing postoperative pulmonary infection(PPI)risk in lung cancer patients undergoing grade Ⅳ thoracoscopic surgery.Methods A retrospective cohort study included 2,380 lung cancer patients who underwent grade Ⅳ thoracoscopic surgery at a tertiary hospital in Shanghai(January 2022 to June 2024).Patients were stratified into training(n=1,665)and validation(n=715)cohorts.Five machine learning algorithms—Logistic regression(LR),artificial neural network(ANN),support vector machine(S VM),random forest(RF),and extreme gradient boosting(XGB)—were employed to construct predictive models.A nomogram was developed for clinical utility.Results Among 2,380 patients,226(9.5％)developed PPI.The Least Absolute Shrinkage and Se-lection Operator(LASSO)regression identified eight predictive variables:daily cigarette consumption,diabetes history,preoperative diffusing capacity,maximal tumor diameter,24-hour postoperative chest drainage volume,perioperative oral nutritional supplementation(ONS),postoperative urinary cathe-terization,and intraoperative pleural adhesion severity.All models demonstrated robust discrimina-tion,with area under the curve(AUC)values ranging from 0.862 to 0.947.The XGB model a-chieved superior performance(AUC=0.947,95％CI,0.937 to 0.962),followed closely by the LR model(AUC=0.926,95％CI,0.918 to 0.933).Conclusion Machine learning-based algo-rithms models effectively stratify PPI risk in lung cancer patients following grade Ⅳ thoracoscopic surgery.The derived nomogram provides a practical tool for perioperative risk management by healthcare providers.

Ultra-high dose-rate (FLASH) radiotherapy is a new mode of radiotherapy that can control tumors while significantly reducing damage to surrounding normal tissues. Since its official naming in 2014, FLASH radiotherapy research has continued to grow, and in 2019 it entered a period of exponential development. Studies have shown that electrons, photons, and protons can all induce the FLASH effect, but the proton beam can overcome the physical limitations of shallow incident depth and high penetration dose, which is considered to be the most effective solution. This article summarizes previous research results of FLASH proton therapy from the research at the cell, animal and clinical levels, and summarizes the hypothesis of the FLASH effect mechanism, aiming to provide reference for promoting the research and clinical transformation of FLASH proton therapy.

Objective:To compare the relative proportion of direct action (ray particles directly destroy biological molecules such as DNA and indirect action (radical-mediated oxidative damage) in the damage caused by X-ray and proton irradiation of lung cancer cells.Methods:Unirradiated human lung adenocarcinoma A549 cells and human large cell lung cancer NCI-H460 cells were cultured in media containing 0, 0.125, 0.25, 0.5, 0.75 mol/L dimethyl sulfoxide (DMSO) for 1 h to obtain plating efficiency (PE) values, thereby determining whether DMSO affected cell survival. Following pretreatment with each DMSO concentration, cells were exposed to X-ray irradiation at physical doses of 2, 4, 6, 8 Gy and proton irradiation at equivalent doses of 2, 4, 6, 8 GyE, respectively. Survival fractions (SF) and maximum protection (MP) values were calculated to evaluate the effects of varying DMSO concentrations on post-irradiation cell survival and to quantify the contribution of indirect radiation damage mechanisms (higher MP indicates greater indirect effect contribution). PE, SF, and MP values were determined using clonogenic assays. Comparisons among multiple groups were performed using one-way ANOVA followed by Tukey's multiple comparison, and comparisons between irradiation groups were analyzed using independent samples t-tests. Results:The PE of unirradiated cells treated with varying DMSO concentrations showed no statistically significant differences. Following pretreatment at different DMSO concentrations and subsequent irradiation with X-rays or protons, the protective effect of DMSO reached saturation at 0.5 mol/L. At this concentration, comparison of the average MP values across 4 radiation doses revealed: In A549 cells, the MP value was 54.21%±1.73% for X-ray irradiation group and 39.69%±0.72% for proton irradiation group ( t=16.82, P<0.001); in NCI-H460 cells, the MP value was 52.04%±1.00% for X-ray irradiation group and 41.31%±0.70% for proton irradiation group ( t=10.19, P<0.001). Conclusions:Under biologically equivalent doses, proton irradiation demonstrates greater reliance on direct effects in lung cancer cells killing compared with X-ray irradiation.

ObjectiveTo investigate the level of hepatitis B surface antibody (anti-HBs) among preschool children (aged 3‒6 years) and primary and secondary school students in Tonglu County, Zhejiang Province, to evaluate the effectiveness of hepatitis B vaccination, and to provide a basis for hepatitis B prevention and control in the region. MethodsAs part of the 2023 Tonglu County Urban and Rural Residents Health Examination Program, blood samples were collected during health check-ups. Fingertip blood samples were obtained from preschool children, while venous blood samples were collected from primary and secondary school children. The anti-HBs levels in blood (positive + / negative -) were qualitatively tested using hepatitis B surface antibody test kits (latex method). The differences in anti-HBs positivity rates among different age groups were analyzed. ResultsBetween April 1, 2023 and June 30, 2023, a total of 52 919 individuals were surveyed, including 11 973 preschool children and 40 946 primary and secondary school students. The overall anti-HBs positivity rate was 39.74%, with the highest positivity rate observed among preschool children (60.20%). Age was negatively correlated with the anti-HBs positivity rate (P<0.001). No significant gender differences in anti-HBs positivity rates were observed. The anti-HBs positive rate in rural areas was higher than that in urban areas, with statistically significant differences across school grade groups (primary grades 1‒3, grades 4‒6, middle school, and high school) (P<0.001). ConclusionThe anti-HBs positivity rate among preschool and school-age children in Tonglu County decreases with age and remains relatively low. It is recommended to strengthen the monitoring of hepatitis B antibody levels and promote health education among preschool and school-age children. Children who have not completed the full hepatitis B vaccination should receive timely catch-up vaccination.

Objective:To analyze the infection status and influencing factors of Helicobacter pylori ( Hp) in healthy children. Methods:This is a cross-sectional study. The data of 684 children aged 3 to 14 years who underwent the 13C urea breath test in the Health Management Center of Fuwai Central China Cardiovascular Hospital from December 2022 to December 2023 were retrospectively collected, and 652 of them who met the criteria were included in the analysis. According to whether they were infected with Hp, the children were divided into the infected group and the non-infected group, and the differences in age, gender, living habits and other aspects between the two groups were compared. Multivariate logistic regression analysis was used to analyze the factors influencing Hp infection. Results:Among the 652 children, there were 134 cases in the infected group and 518 cases in the non-infected group, with an Hp infection rate of 20.6%. The Hp infection rate showed an upward tendency with age. The Hp infection rates in children aged 3 to 5 years, 6 to 11 years, and 12 to 14 years were 12.6%, 22.0%, and 25.2% respectively ( χ 2=9.862, P=0.007). Univariate analysis showed that the proportions of Hp infection were higher in children who never washed their hands, ate in school cafeterias, did not have separate meals, were fed with chewed food, bit their fingers or toys, lived with relatives who had a history of gastrointestinal diseases, had low family income, had parents with low educational level, and were mixed/artificially fed during infancy, which were 26.1%, 24.1%, 25.4%, 25.7%, 26.0%, 25.8%, 25.1%, 23.7%, and 23.6% respectively (all P<0.05). Multivariate analysis showed that separate meals, good handwashing habits, and high family income were protective factors against Hp infection ( OR=0.689, 0.779, 0.602, P=0.004, 0.013, 0.019), while feeding with chewed food was a risk factor for Hp infection ( OR=1.998, P=0.001). Conclusion:The Hp infection rate of children undergoing health examination in Zhengzhou is at low level, and the main influencing factors are separate meals, handwashing habits, feeding with chewed food, and family income.

Objective:To analyze the correlation between poor sleep status in late pregnancy and postpartum depression and anxiety.Methods:In this prospective cohort study, a total of 401 women in early pregnancy were consecutively enrolled at Beijing Tian Tan Hospital, Capital Medical University, from December 2020 to April 2021. The Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS) were used to assess the sleep status in late pregnancy. The Edinburgh Postnatal Depression Scale (EPDS) and the 7-item Generalized Anxiety Disorder Scale (GAD-7) were used to assess the emotional status in late pregnancy and 6 weeks after delivery. During the follow-up, 123 subjects did not complete the sleep and emotional assessment in late pregnancy, 77 subjects did not complete the postpartum emotional assessment, and 201 cases were finally included in the study. Multivariate logistic regression analysis was used to analyze the correlation between poor sleep status in late pregnancy and postpartum depression and anxiety.Results:Among 201 women in early pregnancy included in the analysis, the detection rate of postpartum depression and anxiety was 15.4% (31/201) and 27.4% (55/201), respectively. Poor sleep quality ( OR=2.49, 95% CI: 1.02-6.07), difficulty falling asleep ( OR=6.74, 95% CI: 2.31-19.70), and excessive daytime sleepiness ( OR=6.34, 95% CI: 2.08-19.32) in late pregnancy were positively correlated with postpartum depression (all P0.05). Poor sleep quality ( OR=3.89, 95% CI: 1.81-8.40), difficulty falling asleep ( OR=6.75, 95% CI: 2.43-18.77), short-time sleep ( OR=2.89, 95% CI: 1.36-6.11), fragmented sleep ( OR=5.69, 95% CI: 2.27-14.28) and excessive daytime sleepiness ( OR=3.07, 95% CI: 1.07-8.78) in late pregnancy were positive correlation factors for postpartum anxiety (all P0.05). Conclusions:Poor sleep status in late pregnancy is associated with postpartum depression and anxiety. Strengthening screening and management of poor sleep status in late pregnancy may help maintain healthy postpartum emotion.

Objective To construct a health management information service platform for glaucoma patients to achieve continuous care.Methods The architecture of the health management information service platform for glaucoma patients was designed,and the platform was developed and implemented.Results A WeChat mini program-based health management information service platform was developed,consisting of a medical staff interface,a patient interface,and a backend management center.The platform integrates functions such as whole-process disease tracking,surgical management,medication and follow-up record-keeping with reminders,communication for follow-ups,and health education.From March 2021 to March 2024,the platform registered 2764 patients and 45 medical staff,with a total of 10 947 platform interactions.An overall assessment with the post-study system usability questionnaire yielded a mean score of 28.2,indicating good user experience.Conclusion This platform realizes closed-loop management for continuous care of glaucoma patients and provides a practical reference for the development and exploration of health management information service platforms.

(+)-Borneol, the main component of "Natural Borneol" in the Chinese Pharmacopoeia, is a high-end spice and precious medicine. Plant extraction cannot meet the increasing demand for (+)-borneol, while microbial biosynthesis offers a sustainable supply route. However, its production was extremely low compared with other monoterpenes, even with extensively optimizing the mevalonate pathway. We found that the key challenge is the complex and unusual dephosphorylation reaction of bornyl diphosphate (BPP), which suffers the side-reaction and the competition from the cellular dephosphorylation process, especially lipid metabolism, thus limiting (+)-borneol synthesis. Here, we systematically optimized the dephosphorylation process by identifying, characterizing phosphatases, and balancing cellular dephosphorylation metabolism. For the first time, we identified two endogenous phosphatases and seven heterologous phosphatases, which significantly increased (+)-borneol production by up to 152%. By engineering BPP dephosphorylation and optimizing the MVA pathway, the production of (+)-borneol was increased by 33.8-fold, which enabled the production of 753 mg/L under fed-batch fermentation in shake flasks, so far the highest reported in the literature. This study showed that rewiring dephosphorylation metabolism was essential for high-level production of (+)-borneol in Saccharomyces cerevisiae, and balancing cellular dephosphorylation is also helpful for efficient biosynthesis of other terpenoids since all whose biosynthesis involves the dephosphorylation procedure.

Objective To investigate the characteristics of cognitive inhibition in children with hearing impairment and the impact of different types of materials on their cognitive inhibition.Methods From June,2024 to January,2025,21 children with hearing impairment from Liaocheng Special Education School and 20 typically developing children from Guotun Town Central Primary School in Yanggu County,Liao-cheng were randomly selected.A directed forgetting task was used in a mixed experimental design.The experi-mental procedure was presented using Eprime 3.0,and recall performance was recorded through paper-and-pen-cil tests.Results Three children with hearing impairment and two typically developing children were dropped down.The children with hearing impairment scored significantly lower on recall tasks than the typically developing children(F=13.545,P<0.001).In the typically developing children,recall performance under the memory condition was sig-nificantly lower than under the forgetting condition(P<0.001).In the children with hearing impairment,there was no significant difference in recall performance between the memory condition and the forgetting condition(P>0.05).Regardless of whether the materials were letters or figures,all the children showed significantly high-er recall scores under the forgetting condition compared to the memory condition(P<0.01).Conclusion Children with hearing impairment exhibit weaker cognitive inhibition compared to typically developing chil-dren.The type of materials doesn't impact individuals'cognitive inhibition performance.

Objective To investigate the impact of various health education intervention strategies on the proper use of personal respiratory protective equipment (RPE) among workers exposed to dust. Methods Dust-exposed workers were recruited from 60 selected enterprises in Guangdong Province using cluster random sampling method. They were randomly allocated to the control, low-intensity intervention, and high-intensity intervention groups, with 358, 346, and 371 workers in each group, respectively. Workers in the control group received no designed intervention. Workers in the low-intensity intervention group received traditional plus mobile health education on the proper use of RPE. Workers in the high-intensity intervention group received all components of the low-intensity intervention, supplemented with peer education. The intervention lasted for six months. RPE usage was compared among the three groups of workers before and after the intervention. Results Workers in the control, low-intensity intervention, and high-intensity intervention groups showed higher rates of both RPE wearing and correct RPE wearing after the intervention than before it within their respective groups (RPE wearing rate: 94.1% vs 99.2%, 95.7% vs 100.0%, 94.6% vs 100.0%, all P<0.01; correct RPE wearing rate: 66.8% vs 91.1%, 67.3% vs 95.7%, 66.6% vs 96.5%, all P<0.01). Post-intervention correct RPE wearing rates were highest in the high-intensity intervention group, followed by the low-intensity intervention group, and the control group, with the percentage of 96.50%, 95.66% and 91.06%, respectively (P<0.01). Binary logistic regression analysis result showed that different intervention strategies affected the correct use of personal RPE among dust-exposed workers after adjusting for gender, age, and other confounding factors (P<0.05). Compared with the control group, the rates of correct RPE use increased in the low-intensity intervention group and the high-intensity intervention group (odd ratio was 2.14 and 3.01; 95% confidence interval was 1.12 - 4.10 and 1.53 - 5.91, respectively). Conclusion The implementation of traditional plus mobile health education interventions on the proper use of RPE can promote correct RPE utilization among dust-exposed workers, and integrating peer education further enhances the intervention effectiveness.