Objective:To develop and evaluate a medical visual question answering (VQA) model for neonatal lung ultrasound (LUS) images to enhance intelligent auxiliary diagnosis of neonatal pulmonary diseases.Methods:Using data from neonates admitted to Beijing Obstetrics and Gynecology Hospital, Capital Medical University (January 2023 to December 2024), an image-question-answer dataset comprising 251 LUS images was constructed [43 pneumonia (17.1%), 42 neonatal respiratory distress syndrome (16.7%), 83 transient tachypnea (33.1%), and 83 normal (33.1%) images] with a four-tier medical question-answer framework. Building upon the Qwen2.5-VL-7B base model and integrating LoRA fine-tuning with chain-of-thought prompting, we developed the NLUS-VQA model to enhance visual-language semantic alignment and enable stepwise clinical reasoning, achieving efficient small-sample adaptation. Model performance was comprehensively assessed through natural language generation metrics (BLEU-4, ROUGE-1/2/L), qualitative evaluation of characteristic recognition, and clinical consistency analysis.Results:(1) Quantitative evaluation demonstrated that NLUS-VQA achieved scores of 22.38 (BLEU-4), 48.26 (ROUGE-1), 22.40 (ROUGE-2), and 37.20 (ROUGE-L), representing significant improvements over baseline models. (2) Qualitatively, the model exhibited strong performance in identifying lung consolidation, coalescent B-lines, and snowflake signs, with its chain-of-thought strategy enhancing clinical interpretability and answer accuracy. (3) Clinically, NLUS-VQA achieved a Cohen's Kappa coefficient of 0.78 and diagnostic accuracy of 80.8% (21/26), indicating substantial agreement with clinical experts.Conclusion:The NLUS-VQA model demonstrates robust interpretability in recognizing key sonographic patterns (e.g. lung consolidation, confluent B-lines, and snowflake signs), providing a scalable framework for small-sample medical image analysis, though diagnostic performance on complex conditions remains limited by dataset scale and minority class representation.

When performing motorized flight missions,the pilots often receive strong vestibular stimulation and then induce the flight illusion,which produces great interference to the flight safety.Previous studies have suggested that vestibular stimulation has some effect on cognitive function.Through reviews of relevant literatures at home and abroad,this paper focuses on summarizing the influence of vestibular stimulation on spatial memory ability,attention,sensory perception,executive ability,spatial viewpoint selection and control ability,aiming to improve the understanding of the relationship between vestibular stimulation and cognitive function,to provide a reference for the future vestibular stimulation training.

Objective To investigate the distribution and antibiotic resistance profiles of clinical isolates in Beijing Children's Hospital,Capital Medical University from 2016 to 2022.Methods All the strains isolated from inpatients in Beijing Children's Hospital during the period from 2016 to 2022 were analyzed.Antimicrobial susceptibility test was conducted by Kirby-Bauer method or automated system.Results were interpreted according to the breakpoints recommended in the CLSI Ml00 2022 edition.Results A total of 24 904 isolates were analyzed,including Gram-positive bacteria(49.4％)and Gram-negative bacteria(50.6％).The top three Gram-positive bacteria were Staphylococcus aureus(15.6％),coagulase-negative Staphylococcus(14.0％),and Streptococcus pneumoniae(8.9％).The top three Gram-negative bacteria were Klebsiella spp.(8.6％),Pseudomonas aeruginosa(8.6％),and Haemophilus influenzae(8.1％).The prevalence of methicillin-resistant strains was 30.9％in SS.aureus(MRSA)and 82.7％in coagulase-negative Staphylococcus(MRCNS).The prevalence of PRSP was 75.0％(24/32)in meningitis isolates and 2.6％(57/2 195)in non-meningitis isolates.Five strains of E.faecium and 10 strains of E.faecalis were found resistant to linezolid.Two strains of E.faecium were resistant to vancomycin.The prevalence of extended-spectrum beta-lactamases(ESBLs)and carbapenem-resistant strains(CREco)in E.coli isolates was 69.0％and 9.7％,respectively.The prevalence of ESBLs and carbapenem-resistant strains(CRKpn)in K.pneumoniae isolates was 73.7％,and 37.2％,respectively.The prevalence of carbapenem-resistant strains was 21.9％in P.aeruginosa isolates and 59.3％in A.baumannii isolates.β-lactamase was detected in 68.3％of the H.influenzae isolates.Conclusions Antimicrobial resistance is still serious in children.It is necessary to strength the surveillance of bacterial resistance and use antibiotics rationally in order to curb the spread of drug-resistant strains.

Objective To investigate the distribution and antibiotic resistance profiles of clinical isolates in Beijing Children's Hospital,Capital Medical University from 2016 to 2022.Methods All the strains isolated from inpatients in Beijing Children's Hospital during the period from 2016 to 2022 were analyzed.Antimicrobial susceptibility test was conducted by Kirby-Bauer method or automated system.Results were interpreted according to the breakpoints recommended in the CLSI Ml00 2022 edition.Results A total of 24 904 isolates were analyzed,including Gram-positive bacteria(49.4％)and Gram-negative bacteria(50.6％).The top three Gram-positive bacteria were Staphylococcus aureus(15.6％),coagulase-negative Staphylococcus(14.0％),and Streptococcus pneumoniae(8.9％).The top three Gram-negative bacteria were Klebsiella spp.(8.6％),Pseudomonas aeruginosa(8.6％),and Haemophilus influenzae(8.1％).The prevalence of methicillin-resistant strains was 30.9％in SS.aureus(MRSA)and 82.7％in coagulase-negative Staphylococcus(MRCNS).The prevalence of PRSP was 75.0％(24/32)in meningitis isolates and 2.6％(57/2 195)in non-meningitis isolates.Five strains of E.faecium and 10 strains of E.faecalis were found resistant to linezolid.Two strains of E.faecium were resistant to vancomycin.The prevalence of extended-spectrum beta-lactamases(ESBLs)and carbapenem-resistant strains(CREco)in E.coli isolates was 69.0％and 9.7％,respectively.The prevalence of ESBLs and carbapenem-resistant strains(CRKpn)in K.pneumoniae isolates was 73.7％,and 37.2％,respectively.The prevalence of carbapenem-resistant strains was 21.9％in P.aeruginosa isolates and 59.3％in A.baumannii isolates.β-lactamase was detected in 68.3％of the H.influenzae isolates.Conclusions Antimicrobial resistance is still serious in children.It is necessary to strength the surveillance of bacterial resistance and use antibiotics rationally in order to curb the spread of drug-resistant strains.

Objective:To develop and evaluate a medical visual question answering (VQA) model for neonatal lung ultrasound (LUS) images to enhance intelligent auxiliary diagnosis of neonatal pulmonary diseases.Methods:Using data from neonates admitted to Beijing Obstetrics and Gynecology Hospital, Capital Medical University (January 2023 to December 2024), an image-question-answer dataset comprising 251 LUS images was constructed [43 pneumonia (17.1%), 42 neonatal respiratory distress syndrome (16.7%), 83 transient tachypnea (33.1%), and 83 normal (33.1%) images] with a four-tier medical question-answer framework. Building upon the Qwen2.5-VL-7B base model and integrating LoRA fine-tuning with chain-of-thought prompting, we developed the NLUS-VQA model to enhance visual-language semantic alignment and enable stepwise clinical reasoning, achieving efficient small-sample adaptation. Model performance was comprehensively assessed through natural language generation metrics (BLEU-4, ROUGE-1/2/L), qualitative evaluation of characteristic recognition, and clinical consistency analysis.Results:(1) Quantitative evaluation demonstrated that NLUS-VQA achieved scores of 22.38 (BLEU-4), 48.26 (ROUGE-1), 22.40 (ROUGE-2), and 37.20 (ROUGE-L), representing significant improvements over baseline models. (2) Qualitatively, the model exhibited strong performance in identifying lung consolidation, coalescent B-lines, and snowflake signs, with its chain-of-thought strategy enhancing clinical interpretability and answer accuracy. (3) Clinically, NLUS-VQA achieved a Cohen's Kappa coefficient of 0.78 and diagnostic accuracy of 80.8% (21/26), indicating substantial agreement with clinical experts.Conclusion:The NLUS-VQA model demonstrates robust interpretability in recognizing key sonographic patterns (e.g. lung consolidation, confluent B-lines, and snowflake signs), providing a scalable framework for small-sample medical image analysis, though diagnostic performance on complex conditions remains limited by dataset scale and minority class representation.

Trace amines(TAs)are metabolically related to catecholamine and associated with cancer and neuro-logical disorders.Comprehensive measurement of TAs is essential for understanding pathological pro-cesses and providing proper drug intervention.However,the trace amounts and chemical instability of TAs challenge quantification.Here,diisopropyl phosphite coupled with chip two-dimensional(2D)liquid chromatography tandem triple-quadrupole mass spectrometry(LC-QQQ/MS)was developed to simul-taneously determine TAs and associated metabolites.The results showed that the sensitivities of TAs increased up to 5520 times compared with those using nonderivatized LC-QQQ/MS.This sensitive method was utilized to investigate their alterations in hepatoma cells after treatment with sorafenib.The significantly altered TAs and associated metabolites suggested that phenylalanine and tyrosine metabolic pathways were related to sorafenib treatment in Hep3B cells.This sensitive method has great potential to elucidate the mechanism and diagnose diseases considering that an increasing number of physiological functions of TAs have been discovered in recent decades.

Objective: To establish an analytical method for serum prolactin (PRL) based on the photoinduced chemiluminescence technology, and evaluate its performance. Methods: A pair of PRL monoclonal antibodies were labeled with luminescent nanospheres and biotin respectively, and the double antibody sandwich detection system was formed with the serum prolactin and streptavidin-labeled photosensitive microspheres (universal photosensitive solution) under homogeneous conditions. The performance index and correlation of the detection system were evaluated. Results: The precision of intra-assay and within-day (coefficient of variation) of the developed assay were 4.60% and 5.25%, respectively. The functional sensitivity was 2.48 μIU/mL, and its reportable results were ranged from 2.48 to 4 240 μIU/mL. The recovery rates of different PRL calibrators (42.2, 424, 4 240 μIU/mL) added to human sera were ranged from 96.25% to 102.93%. There was no interference from bilirubin＜20 mg/dL, hemoglobin＜200 mg/dL, triglyceride＜3 000 mg/dL and biotin＜20 ng/mL. Also, the light-initiated chemiluminescent assay for PRL (PRL-LICA) correlated well with Beckman Unicel Dxi 800 Access 2. Conclusions LICA showed effective performance for detecting PRL in human serum, and it could meet the basic requirements of clinical diagnosis.

Objective: To explore the application value of closed negative pressure drainage technique in wound healing of hand trauma. Methods: From August 2013 to October 2017, 80 patients with hand trauma in the Traditional Chinese Medicine Hospital of Cixi were divided into two groups according to the random principle, with 40 cases in each group.The control group was treated with conventional wound repair, and the observation group was treated with closed negative pressure drainage.The repair effect, healing, secondary operation, antibiotic use, hospitalization, histopathological score and patients' satisfaction were observed. Results: The total effective rate of the observation group (97.50%) was obviously higher than that of the control group(80.00%)(χ²=6.13, P<0.05). The time of healing, length of hospital stay and the use time of antimicrobial agents in the observation group were (15.11±2.43)d, (16.27±1.79)d and (6.06±0.65)d, respectively, which were all lower than those in the control group(t=14.43, 13.31, 23.29, all P<0.05). The second operation rate of the observation group (5.00%) was lower than that of the control group(P<0.05), and the histopathological score in the observation group (7.11±0.53) was higher than that in the control group(P<0.05). The satisfaction rate of the observation group (100.00%) was obviously higher than that of the control group(χ²=6.49, P<0.05). Conclusion In the treatment of wound healing of hand trauma, the application of closed negative pressure drainage technology is better, which can effectively control the disease and is worthy of further promotion and use.

Objective To investigate the safety and effectiveness of endovascular treatment and surgical clipping for the treatment of intracranial ruptured aneurysms. Methods From January 2012 to December 2017, patients with ruptured intracranial aneurysm treated at the Department of Neurosurgery, the Second People's Hospital of Taizhou were enrolled retrospectively. The demographics, baseline clinical data,outcomes, and complications were compared between the endovascular treatment group and the surgical clip group. Results A total of 220 patients were enrolled, they aged 55. 1 ±11. 8 years. There were 117 patients in the endovascular treatment group and 103 in the surgical clipping group. There were no significant differences in perioperative complications (26. 2％ vs. 19. 6％; χ2 = 1. 340, P = 0. 247), in-hospital mortality (6. 0％vs. 4. 9％; χ2 = 0. 135, P = 0. 713), and good outcomes at discharge (85. 5％ vs. 81. 6％; χ2 =0. 614, P = 0. 433) between the two groups. Multivariate logistic regression analysis showed that age (odds ratio [OR] 1. 072, 95％ confidence interval [CI] 1. 025-1. 124; P < 0. 001), smoking (OR 6. 325, 95％ CI 2. 367-16. 901; P < 0. 001 ), and high World Federation of Neurosurgery Societies (WFNS) grade (OR 5. 218, 95％ CI 1. 881-14. 449; P < 0. 001) had significant independent correlation with the poor clinical outcome at discharge. The imaging follow-up data in 155 aneurysms (81 in the endovascular treatment group and 74 in the surgical clipping group) were available. The follow-up time was 14. 3 ± 6. 9 months (range, 6-36 months); 20 aneurysms (12. 9％) had recurrence. There was no significant difference in the recurrence rate of the endovascular treatment group and surgical clipping group (17. 3％ vs. 8. 1％; χ2 =2. 900, P = 0. 089). The clinical follow-up data of 188 patients (95 in the endovascular treatment group and 93 in the surgical clipping group) were available. The follow-up time was 15. 5 ± 6. 8 months (range, 6- 36 months). There was no significant difference in the good outcome rate between the endovascular treatment group and surgical clipping group (95. 8％ vs. 90. 3％; χ2 = 2. 182, P = 0. 140 ). Multivariate logistic analysis showed that smoking (OR 4. 872, 95％ CI 1. 719-13. 872; P < 0. 001 ) and high WFNS grade (OR 3. 512, 95％ CI 1. 446-8. 583; P < 0. 001) were the independent risk factor for long-term poor outcome. Conclusion The efficacy and safety of surgical clipping for ruptured intracranial aneurysms were comparable to endovascular treatment. Age, smoking, and WFNS grade were the important factors affecting the outcomes of patients.