Objective:To discuss the diagnostic value of levels of growth stimulation expressed gene 2 protein(ST2),carbohydrate antigen 125(CA125),and human epididymis protein 4(HE4)in serum of the ovarian cancer patients,and to clarify their relationships with clinicopathological parameters of the ovarian cancer patients.Methods:A total of 136 patients with ovarian benign lesions or primary ovarian malignancies in our hospital confirmed by postoperative histopathology were randomly selected,including 53 cases in ovarian benign ovarian disease group and 83 cases in ovarian cancer group.Additionally,55 healthy female volunteers during the same period were enrolled as healthy control group.The fasting venous blood from all the subjects was collected on the first day of admission,and serum was retained;cyclic enhanced fluorescence immunoassay was used to detect ST2 levels of the subjects in various groups;chemiluminescence method was used to detect serum CA125 and HE4 levels of the subjects in various groups;receiver operating characteristic(ROC)curve was used to assess the diagnostic performance of each indicator;the Cut-off value and area under the ROC curve(AUC)were calculated,with AUC representing the diagnostic performance;Kendall's method was used to analyze the correlations between serum ST2 levels and TNM stage,maximum tumor diameter,distant metastasis,lymphnode metastasis,peritoneal metastasis,carcinoembryonic antigen(CEA),CA125,carbohydrate antigen 199(CA199),HE4,P53,and Kiel-67(Ki67)in the ovarian cancer patients.Results:Compared with healthy control group,the serum CA125 level of the patients in ovarian benign ovarian disease group was significantly increased(P<0.05).Compared with healthy control group and ovarian benign group,the serum levels of ST2,CA125,and HE4 of the patients in ovarian cancer group were significantly increased(P<0.05).The AUC values were 0.719(95%CI:0.616-0.822)for ST2,0.868(95%CI:0.794-0.942)for CA125,and 0.867(95%CI:0.793-0.942)for HE4.The combined detection of ST2+CA125+HE4 yielded an AUC of 0.894(95%CI:0.832-0.955).Significant differences were observed in serum ST2,CA125,and HE4 levels among ovarian cancer patients with different TNM stages,lymph node metastasis,distant metastasis,and peritoneal metastasis(P<0.05),while there were no significant differences in the patients with different ages or maximum tumor diameters(P>0.05).The ST2 level in serm of the ovarian cancer patients was positively correlated with TNM stage,distant metastasis,lymph node metastasis,peritoneal metastasis,CA125 level,HE4 level,and Ki67 level(P<0.05),but was not correlated with maximum tumor diameter,CEA,CA199 level,or P53 level(P>0.05).Conclusion:ST2,CA125,and HE4 are highly expressed in the serum of the ovarian cancer patients.Combined detection of serum ST2,CA125,and HE4 exhibits good sensitivity and specificity for ovarian cancer screening and improves diagnostic efficacy.ST2 is associated with advanced TNM stage and metastasis in ovarian cancer and may participate in the occurrence and progression of ovarian cancer.

Objective To investigate the correlation between serum levels of collagen triple helix repeat containing protein 1(CTHRC1)and galectin-10 and disease severity in patients with psoriasis vulgaris(PV).Methods From October 2021 to March 2023,a total of 105 confirmed PV patients treated in the hospital were regarded as the research objects.According to the disease severity,they were separated into a severe group(46 cases)and mild to moderate group(59 cases).Additionally,105 healthy individuals who came to the hospital for physical examination were selected as the control group.The levels of CTHRC1 and galectin-10 in serum were compared and analyzed.Multivariate Logistic regression analysis was conducted to identify the influen-cing factors for the development of severe PV in patients.Receiver operating characteristic(ROC)curve was applied to analyze the predictive value of serum CTHRC1 and galectin-10 levels for the development of severe PV in patients.Results Compared with the control group,the serum levels of CTHRC1 and galectin-10 in the severe group and mild to moderate group were significantly increased(P＜0.05).Compared with the mild to moderate group,the serum levels of CTHRC1 and galectin-10 in the severe group were significantly increased(P＜0.05).Compared with the mild to moderate group,the levels of inflammatory factors interleukin-26(IL-26),interleukin-22(IL-22),and interleukin-17(IL-17)were all increased in the severe group(P＜0.05).Ser-um IL-26,IL-22,CTHRC1,and galectin-10 levels were all influencing factors for the development of severe PV in patients(P＜0.05).The area under the curve(AUC)of serum IL-26,IL-22,CTHRC1 and galectin-10 levels for predicting the development of severe PV in patients were 0.809,0.784,0.863 and 0.874,respective-ly,the AUC predicted by the combination of the four was 0.966,and the combined prediction of the four was better than the prediction of the four separately(Z combination of the four-IL-26=3.581,Zcombination of the four-IL-22=3.285,Zcombination of the four-CTHRC1=2.671,Zcombination of the four-galectin10=2.434,P＜0.05).Conclusion The increased levels of CTHRC1 and galectin-10 in the serum of PV patients are related to the severity of the disease.

Objective:To explore any effect of combining robot-assisted virtual scenario training of the upper limbs with scalp acupuncture on post-stroke cognitive impairment.Methods:Ninety patients with post-stroke cognitive impairment (PSCI) were divided at random into a control group, a scalp acupuncture group and a comprehensive group, each of 30. In addition to routine health education and rehabilitation training, the scalp acupuncture group was given scalp acupuncture, while the comprehensive group was treated with scalp acupuncture and virtual scenario training with an upper limb robot. Before and after 4 weeks of the treatment, the subjects′ cognitive functioning was assessed using the Mini-mental State Examination (MMSE) and the Montreal Cognitive Assessment scale (MoCA). Ability in the activities of daily living (ADL) was quantified using the Modified Barthel Index (MBI).Results:After the intervention, significant improvement was observed in the average MMSE, MoCA and MBI scores of all three groups. The average MMSE and MBI scores of the scalp acupuncture group were then significantly higher than the control group′s averages, while the average MMSE, MoCA and MBI scores of the comprehensive group were all significantly better than those of the other two groups.Conclusion:Robot-assisted virtual scenario upper limb training combined with scalp acupuncture can significantly improve the cognition and ADL ability of PSCI patients.

Objective:To study the epidemic characteristics of scrub typhus in Yantai City from 2006 to 2022, and provide a scientific basis for prevention and control of scrub typhus in Yantai City.Methods:In the subsystem "Infectious Disease Monitoring System" of the "China Disease Prevention and Control Information System", data on the outbreak of scrub typhus in Yantai City from January 1, 2006 to December 31, 2022 were collected and processed using software such as SPSS 23.0 for descriptive statistics.Results:A total of 599 scrub typhus cases were reported in Yantai City from 2006 to 2022, with an average annual reported incidence of 0.51/100 000. The reported incidence showed an upward trend year by year from 2006 to 2014 (χ 2trend = 144.72, P < 0.001), and reached a peak in 2014 (1.04/100 000). There was another small peak in 2019 (0.91/100 000). The incidence of scrub typhus showed a clear seasonal unimodal distribution, with October being the peak, accounting for 72.62% (435/599). In addition to Changdao County, other 12 cities (districts) reported scrub typhus cases. The top 3 cities with average annual reported incidence were Zhaoyuan City (1.58/100 000), Laizhou City (1.47/100 000) and Laiyang City (0.75/100 000). In all reported cases, the male to female ratio was 1.00∶1.07 (289∶310). The cases were mainly concentrated in the age range of 50 to 79, accounting for 74.46% (446/599). There was a statistically significant difference in the number of patients in different age groups in different years ( H = 38.71, P = 0.001). Farmers accounted for 88.65% (531/599) of the affected population. Conclusions:The incidence of scrub typhus in Yantai City shows an increasing trend and is widely distributed. It is recommended to strengthen the diagnosis, monitoring and infection management of scrub typhus.

The syndrome/pattern of defensive qi deficiency is a common basic syndrome of traditional Chinese medicine in clinical practice. However,there is a lack of standardized and operable diagnostic specifications in practical applications. Based on the previous literature,this study proposed the idea of starting from the elements of the syndrome,qualitative diagnostic criteria for the syndrome/pattern of defensive qi deficiency oriented to the entire region of the disease were constructed based on the two dimensions of " deficient defensive qi failing to consolidate the exterior" and " qi deficiency" and constructing a set of quantitative evaluation criteria as the supporting content for the diagnostic items. The core members of the research group attempted to formulate the draft standard,then reached a consensus through the Delphi method expert questionnaire consultation and the Nominal group technique,and finally evaluated the reliability and validity of the standard through clinical verification to provide ideas for the standardization and normalization of research on syndromes.

Objective:To describe demographic,clinical and physiological characteristics,treatment between first-episode major depressive disorder(MDD)and relapse MDD,and to explore characteristics of relapse MDD.Methods:Totally 858 patients who met the diagnostic criteria for depression of the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5),were included by using the Mini International Neuropsychiatric Interview(MINI),Clinician-Rated Dimensions of Psychosis Symptom Severity,and Hamilton Depression Scale etc.Among them,529(58.6％)were first-episode depression and 329(36.0％)were relapsed.The differences of demographic characteristics,clinical and physiological characteristics,treatment were compared byx2test and Kruskal-Wallis rank sum test.Multivariate logistic regression was used to explore the characteristics of MDD recur-rence.Results:Compared to first-episode MDD,relapse MDD had more comorbidity(OR=2.11,95％CI:1.00-4.44),more days out of role(OR=1.26,95％CI:1.01-1.56),more history of using psychiatric drug more than one month(OR=1.41,95％CI:1.02-1.97)and electroconvulsive therapy(OR=3.23,95％CI:1.42-7.36),and higher waist-hip ratio(OR=33.88,95％CI:2.88-399.32).Conclusion:Relapse MDD has positive as-sociation with comorbidity of mental disorders,out of role,and higher waist-hip ratio.

Purpose To evaluate the diagnostic value of Chinese thyroid imaging reporting and data system(C-TIRADS)and American thyroid association(ATA)guidelines in papillary thyroid carcinoma(PTC).Materials and Methods A total of 259 patients(339 nodules)with definite pathological results after thyroid nodule surgery in the 909th Hospital of the Joint Logistic Support Force(the Affiliated Southeast Hospital of Xiamen University)from July 2019 to May 2021 were divided into benign thyroid nodule group(150 cases,210 nodules)and PTC group(109 cases,129 nodules).General data and nodule ultrasonographic characteristics of the two groups were retrospectively analyzed.Nodules were classified by the two guidelines,and were compared with surgical pathological results,the receiver operating characteristic curve was drawn to evaluate the diagnostic value of the two guidelines for PTC.Results There were statistically significant differences between the two groups in the malignant ultrasonographic features of"solid,blurred/irregular edges or extrathyroid invasion,verticality,low or very low echo,microcalcification"(χ2=123.67,132.71,103.82,4.58,137.93,all P<0.05),and most commonly seen in the PTC group.Unlike C-TIRADS,61 nodules were not clearly classified in the ATA guidelines,accounting for 17.99%(61/339).The areas under the curves of C-TIRADS and ATA guidelines were 0.952(0.924-0.972)and 0.942(0.911-0.964),with no statistically significant differences(Z=0.943,P=0.346).The optimal cutoff values of the two groups were 4b and highly suspicious malignancy,and the sensitivity,specificity and accuracy were 0.930(120/129)vs.0.822(106/129),0.857(180/210)vs.0.943(198/210),0.885(300/339)vs.0.897(300/339),respectively.There were significant differences in sensitivity and specificity(χ2=6.99,8.57,both P<0.01),C-TIRADS had the highest sensitivity,ATA guidelines had the highest specificity,but there was no significant difference in accuracy(χ2=0.24,P=0.622).Conclusion Both C-TIRADS and ATA guidelines may be highly effective in the diagnosis of PTC,but C-TIRADS can be applied to the ultrasonographic manifestations of all thyroid nodules,and is less affected by the clinical experience of sonographers,so it is easier to be promoted in clinical practice.

To report 7 Chinese children with characteristic hyperpigmented macules on the forehead and temples. Among the 7 cases, there were 2 males and 5 females, with the age at onset ranging from 9 to 24 months (12.43 ± 5.32 months), and the disease duration being 1 - 4 months (2.57 ± 1.27 months). Skin examination revealed that the children presented with varying numbers of irregular brown macules and patches scattered on their foreheads and temples, without obvious desquamation. Dermoscopic examination revealed multiple yellowish-brown patches with irregular borders, and linear vessels were observable in some skin lesions. A diagnosis of acquired facial hyperpigmented macules was made in these children. The children received no treatment. After 2 years of follow-up, hyperpigmented macules completely subsided in 2 cases and regressed to varying degrees in 4 cases, while 1 case exhibited no changes in the skin lesions. Considering the literature and the cases discussed in this article, it is hypothesized that acquired facial hyperpigmented macules in young children may represent an independent condition.

Objective:To investigate the status quo of sexual function and marital adjustment of postpartum women and their spouses, so as to analyze the subject-object effects of sexual function and marital adjustment.Methods:This was a cross-sectional study. A total of 240 postpartum women and their spouses who gave birth in PLA Rocket Force Characteristic Medical Center from October 2022 to February 2023 were selected as the research objects by the convenient sampling method. The general data questionnaire, Female Sexual Function Index (FSFI), Male Sexual Function Index (MSFI) and Locke-Wallace Marital Adjustment Test were used to investigate them. Pearson correlation analysis and actor-partner interdependence model (APIM) were used to explore the relationship between sexual function and marital adjustment of postpartum women and their spouses.Results:In this study, 480 questionnaires were distributed to 240 couples, and 450 valid questionnaires were collected, with an effective recovery rate of 93.75% (450/480). The sexual function index score of 225 postpartum women was (24.89±4.97), and that of their spouses was (49.64±7.99). The marital adjustment scores of postpartum women was (96.42±22.64) and that of their spouses was (103.38±23.93). The results of APIM showed that the sexual function of postpartum women and their spouses could predict their own marital adjustment (β-values of 0.765 and 0.176, P<0.01). In terms of object effect, the sexual function of postpartum women could predict the marital adjustment of their spouses (β=0.632, P<0.01), but the sexual function of their spouses could not predict the marital adjustment of postpartum women ( P>0.05) . Conclusions:Postpartum women and their spouses have sexual dysfunction and marital disorder, their own sexual function is closely related to marital adjustment, and women's sexual function can also positively affect their spouses' marital adjustment. Medical staff should take postpartum women and their spouses as a whole to formulate intervention measures to promote the recovery of postpartum women's sexual function, balance family relations, enhance the satisfaction of sexual life between husband and wife and improve the level of marital adjustment.

Objective:To evaluate the usability of Gafchromic HD-V2 film for dose dosimetry in the ultra-high dose-rate (UD) electron beam from a modified medical linac, and to investigate the response between the energy and dose-rate dependence to the film.Methods:The HD-V2 film was utilized to measure the average dose-rate of the UD electron beam. The measured result was compared with those by advanced Markus chamber and alanine pellets. And characteristics of the UD electron beam were also measured by HD-V2 film. Energy dependence of HD-V2 film at three beam energies (6 MV X-ray, 9 MeV and 16 MeV electron beam) was investigated by obtaining and comparing the calibration curves based on the clinical linear accelerator in the dose range of 10-300 Gy. The dose-rate dependence of HD-V2 film was also studied by varying the dose rate among 0.03 Gy/s, 0.06 Gy/s and 0.1 Gy/s, and range of 100-200 Gy/s.Results:The measured average maximum dose-rate of 9 MeV UD electron beam at source skin distance (SSD) 100 cm was approximately 121 Gy/s using HD-V2 film, consistent with the results by advanced Markus chamber and alanine pellets. The measured percentage depth dose (PDD) curve parameters of the UD electron beam were similar to the conventional 9 MeV beam. The off-axis dose distribution of the UD electron beam showed the highest central axis, and the dose was gradually decreased with the increase of off-axis distance. The energy dependence of HD-V2 film had no dependency of 6 MV and 9, 16 MeV while measuring the dose in the range from 20 to 300 Gy. The HD-V2 film had no significant dose-rate dependency at the dose rate of 0.03 Gy/s, 0.06 Gy/s and 0.1 Gy/s for the clinical linear accelerator. Likewise, there was also no dose-rate dependence in the range 100-200 Gy/s in the modified machine.Conclusion:HD-V2 film is suitable for measuring ultra-high dose rate electron beam, independent of energy and dose rate.