To review the clinical characteristics, short-term outcomes, and risk factors of patients with infective endocarditis(IE) who underwent surgical treatment at a single center, and to summarize treatment experience.

The comorbidity of depression and cancer represents a significant global public health challenge,severely impacting patients' quality of life and clinical outcomes.This systematic review considers the epidemiological characteristics,clinical implications,and major challenges in current research regarding comorbid depression and cancer,focusing on the role of depression in promoting tumor progression and suppressing immune function via the neuroendocrine-immune regulatory network.We discuss the dynamic changes and interaction mechanisms of depression-related neurotransmitters(such as serotonin and norepinephrine)and stress hormones(such as cortisol)within the tumor microenvironment.We also reveal the molecular mechanisms by which depression regulates malignant biological behaviors such as tumor immune evasion,metastasis,and angiogenesis via activation of the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system.This review also evaluates the application value and limitations of existing animal models for studying the mechanisms underlying the comorbidity of depression and cancer,emphasizing the importance and urgency of developing more precise comorbidity models to uncover the mechanisms and explore management strategies.This review aims to raise awareness of risk prediction,clinical interventions,and basic research on the comorbidity of depression and cancer,to provide a theoretical foundation and new research directions for developing depression-cancer comorbidity models.

The comorbidity of depression and cancer represents a significant global public health challenge,severely impacting patients' quality of life and clinical outcomes.This systematic review considers the epidemiological characteristics,clinical implications,and major challenges in current research regarding comorbid depression and cancer,focusing on the role of depression in promoting tumor progression and suppressing immune function via the neuroendocrine-immune regulatory network.We discuss the dynamic changes and interaction mechanisms of depression-related neurotransmitters(such as serotonin and norepinephrine)and stress hormones(such as cortisol)within the tumor microenvironment.We also reveal the molecular mechanisms by which depression regulates malignant biological behaviors such as tumor immune evasion,metastasis,and angiogenesis via activation of the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system.This review also evaluates the application value and limitations of existing animal models for studying the mechanisms underlying the comorbidity of depression and cancer,emphasizing the importance and urgency of developing more precise comorbidity models to uncover the mechanisms and explore management strategies.This review aims to raise awareness of risk prediction,clinical interventions,and basic research on the comorbidity of depression and cancer,to provide a theoretical foundation and new research directions for developing depression-cancer comorbidity models.

The construction of smart hospital is an important part of modern hospital management system,and it is also the key way to build the new system of high-quality hospital development.In terms of building smart hospitals,multi-campus hos-pitals face more difficulties and challenges than single campus hospitals,such as the lack of top-level design,the difficulty of in-tegrated management,the uneven development of hospitals and the widespread phenomenon of information islands.This study summarizes and analyzes the difficulties encountered in the construction and application of smart hospitals in multi-hospital areas.Guided by problems,it puts forward countermeasures and suggestions for the construction of refined and high-quality smart hospi-tals in multi-campus hospitals,including strengthening overall and forward-looking awareness,integrating management according to hospital conditions,characteristic development under demand guidance,establishing a data integration center for smart hospi-tals,scientific planning of talent reserve and discipline layout,etc.

Objective A comparison of two method of establishing pressure ulcer rat models to determine which is the most suitable for experimental use.Methods 18 male SD rats were randomly divided into control(n=6),model A(n=6)and model B(n=6)groups.In the control group,iodophor treatment was given after hair removal at the simulated modeling site.In model group A,longitudinal compression was performed by simple deep-tissue foreign body implantation.In model group B,transverse compression was performed via the magnet compression method.The times required to complete the process and for each stage of pressure ulcer model establishment in each group were recorded.The general condition of the rats was observed,and the modeling rate,mortality rate,and infection rate were compared.Results By naked eye,we observed that the model A and model B groups gradually developed redness and swelling,ulceration,bleeding,exudation,and necrosis.Comparison of the whole time to produce pressure uler between model A and model B groups:the difference between the two groups was statitically significant(P＜0.05).Comparison of the time to produce pressure injury between Model A and Model B:The difference between the two groups at stage Ⅰ was not statistically significant(P＞0.05);the difference between the two groups at stage Ⅱ was statistically significant(P＜0 05);the difference between the two groups at stage Ⅲ was statistically significant(P＜0 05);the difference between the two groups at stage Ⅳ was statistically significant(P＜0 05).The mental and sports scores of the rats in the control group were significantly different from those in the model A and model B groups(P＜0.05).The general state of rats in the model group A was significantly different from that in the model B group,and coat color was dimer and activity decreased in the model group A.The modelling rate of rats in both model A and model B groups was 100％.The mortality and infection rates of the model group A were higher than those of the model group B,which were 33.34％and 16.70％,respectively.Conclusions Successful preparation of a four-stage model of pressure ulers in both modalities.The two method have both commonalities and distinct characteristics.The magnet compression method required less time,the rats were generally in good condition,and the mortality and infection rates were low;thus it is suitable for short-term intervention research.The simple deep-tissue foreign body implantation method took longer,required rats to have a certain level of tolerance,had high infection and mortality rates,and is more suitable for use for long-term observations of pressure ulcers.

Heart valve disease (HVD) is one of the common cardiovascular diseases. Heart sound is an important physiological signal for diagnosing HVDs. This paper proposed a model based on combination of basic component features and envelope autocorrelation features to detect early HVDs. Initially, heart sound signals lasting 5 minutes were denoised by empirical mode decomposition (EMD) algorithm and segmented. Then the basic component features and envelope autocorrelation features of heart sound segments were extracted to construct heart sound feature set. Then the max-relevance and min-redundancy (MRMR) algorithm was utilized to select the optimal mixed feature subset. Finally, decision tree, support vector machine (SVM) and k-nearest neighbor (KNN) classifiers were trained to detect the early HVDs from the normal heart sounds and obtained the best accuracy of 99.9% in clinical database. Normal valve, abnormal semilunar valve and abnormal atrioventricular valve heart sounds were classified and the best accuracy was 99.8%. Moreover, normal valve, single-valve abnormal and multi-valve abnormal heart sounds were classified and the best accuracy was 98.2%. In public database, this method also obtained the good overall accuracy. The result demonstrated this proposed method had important value for the clinical diagnosis of early HVDs.
Humans ; Heart Sounds ; Heart Valve Diseases/diagnosis* ; Algorithms ; Support Vector Machine ; Signal Processing, Computer-Assisted

Objective:To explore the application effects of the mode of "Multidisciplinary integration, Doctors & patients co-teaching, Simulated practice" in the teaching of spinal surgery.Methods:A total of 64 eight-year program clinical medical students who practiced in Peking Union Medical College Hospital in 2021 were taken as research objects and randomly divided into experimental group ( n=33) and control group ( n=31). The experimental group received the new teaching mode of "Multidisciplinary integration, Doctors & patients co-teaching, Simulated practice", and the control group received regular teaching mode. At the end of teaching, the teaching effects were evaluated from several aspects, including the scores of theoretical examinations, anatomical marks identification tests, and anonymous questionnaires. SPSS 22.0 software was used for paired t-test and two independent-samples t-test. Results:The theoretical test scores [(51.25±6.99) points] and anatomical structure identification scores [(37.56±1.83) points] of the experimental group were higher than those of the control group [(42.46±6.13) points and (30.37±3.46) points], and the differences were statistically significant ( P<0.001). The effective recovery rate of the questionnaire was 100%. The results of the questionnaire showed that the experimental group was significantly higher than the control group in terms of teaching attractiveness, attention, learning interest, learning efficiency, anatomical identification ability, problem-finding and problem-solving ability and overall teaching method satisfaction ( P<0.05). Conclusion:The teaching mode of "Multidisciplinary integration, Doctors & patients co-teaching, Simulated practice" can effectively improve students' theoretical knowledge, learning interest, learning efficiency, operation proficiency and problem-finding and problem-solving ability, which is worth promoting.

Objective:To observe the clearance strategies of hemiplegic stroke survivors with foot drop.Methods:Thirty hemiplegic stroke survivors with foot drop formed the observation group and 30 healthy counterparts constituted the control group. A three-dimensional motion capture system was used to observe and compare the minimum toe clearance (MTC) and its variability between the two groups to draw the motion trajectory of the toe in the swing phase of their gaits. The gait parameters were correlated with the toe clearance.Results:The average MTC of the observation group subjects on both the hemiplegic and non-hemiplegic side (12.01±3.36 and 22.38±5.51mm) was significantly smaller than the control group′s averages. The variability of their MTCs on both sides was also significantly greater. Clearance on the hemiplegic side was significantly less and its variability was significantly greater. Among the observation group, MTC on the hemiplegic side was positively correlated with walking speed, step length, swing phase percentage, maximum angle of hip extension, maximum angle of knee flexion, maximum angle of ankle dorsiflexion, and the range of motion of the knee and ankle joints.Conclusions:Hemiplegic stroke survivors with foot drop walk unstably with little toe clearance. It is necessary to intervene at the hip, knee and ankle to improve their obstacle clearance.

Under the combination of postgraduate education and standardized medical residents training, via exploring current situation, we put forward the limitations of routine rotation training, disconnection of theory and practice, inefficient of scientific ability. We arouse a new model by improving teaching model, enriching teaching content, optimizing teaching method, making better arrangement of rotations and cultivating scientific ability to provide references for enhancing the ability of clinical thinking, practice, scientific research and communication.

Objective:To compare the protective effects of cerebral blood flow during simulated push pull maneuver (PPM) between lower body negative pressure (LBNP) strategy and thigh cuff (TC) strategy.Methods:It was a repeated cross-over design study. Fifteen healthy young male subjects were recruited. All subjects underwent the control bout (simulated PPM without any intervention), PPM with LBNP bout, and PPM with TC bout. Such position changes as "upright to head down tilt to upright" were performed by tilting table to simulate PPM. The control bout underwent normal PPM. LBNP of -40 mmHg (1 mmHg=0.133 kP) was applied prior to and during -G z stress and released at the subsequent transition to +G z stress in LBNP bout. TC of +200 mmHg was applied at bilateral upper thighs prior to and during simulated PPM. Beat-to-beat cerebral and systemic hemodynamics of the subjects were continuously recorded. Results:During the rapid -G z to +G z transition, the mean cerebral blood flow velocity (CBFVm) was decreased by 0.7-17.3 cm/s [ΔCBFVm=(-7.5±4.5) cm/s], and the mean arterial pressure at the level of middle cerebral artery(MAP MCA) was decreased by 42-76 mmHg [ΔMAP MCA=(-61.0±10.0) mmHg] in control bout. However, the change of CBFVm was -2.4-10.2 cm/s in LBNP bout, whose average value was increased (3.3±4.1) cm/s rather than decreased. The drop of MAP MCA was 23-50 mmHg [ΔMAP MCA=(-41.0±11.0) mmHg], which was significantly reduced than that in control bout ( P<0.05). The change of CBFVm in TC bout was -7.9-1.4 cm/s [ΔCBFVm=(-3.0±4.2) cm/s], and the decrease of ΔMAP MCA was 37-59 mmHg [ΔMAP MCA=(-47.0±13.0) mmHg], both of which were significantly smaller than that in control bout ( P<0.05). There was significant difference in ΔCBFVm between LBNP and TC bouts ( P<0.05), while no significant difference was found in ΔMAP MCA. Conclusions:Both the LBNP and TC strategies can protect the cerebral blood flow during simulated PPM. LBNP strategy showed better improvement of CBFVm than TC. Both strategies demonstrated protective effect by increasing diastolic cerebral blood flow.