Objective To investigate the correlation between levels of intercellular adhesion molecule-1 (ICAM-1), platelet surface P-selectin (CD62P), and inflammatory factors and cerebral artery stenosis in patients with acute cerebral infarction (ACI). Methods A total of 305 patients with ACI complicated with cerebral artery stenosis admitted to Zhongwu Hospital of Suqian City and Xinyi People's Hospital from January 2021 to December 2023 were selected as the research subjects. According to the degree of cerebral artery stenosis, they were divided into grade I group (stenosis degree<50%, n=85), grade II group (stenosis degree of 50%-75%, n=128), and grade III group (stenosis degree>75%, n=92). Sixty-eight ACI patients without cerebral artery stenosis during the same period were included in the reference group. The levels of serum inflammatory factors [C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-8 (IL-8)], ICAM-1 and CD62P were compared among the four groups. Spearman analysis was used to analyze the correlation between each factor and degree of cerebral artery stenosis. Results The levels of CRP, TNF-α, IL-6, IL-8, ICAM-1 and CD62P in the grade I, II and III groups were higher than those in the reference group. The levels of these factors were higher in the grade II and III groups than those in the grade I group, while the levels of various factors were higher in the grade III group than those in the grade II group (P<0.05). Spearman analysis showed that CRP, TNF-α, IL-6, IL-8, ICAM-1, and CD62P were positively correlated with the degree of cerebral artery stenosis in patients with ACI complicated with cerebral artery stenosis (P<0.05). Conclusion The levels of serum inflammatory factors, ICAM-1 and CD62P are significantly correlated with cerebral artery stenosis degree in patients with ACI.

Objective The prediction model of recurrence within two years after complete remission of diffuse large B-cell lymphoma(DLBCL)patients was constructed based on frienemy indecision region dynamic ensemble selection(FIRE-DES)to provide decision-making basis for the treatment of patients.Methods To collect data of 498 patients who achieved complete response after treatment from January 2010 to January 2020 in a Grade-A hospital in Shanxi Province.A FIRE-DES combination prediction model based on four common category-disequilibrium treatment methods was constructed and compared with five traditional single classifiers and two integrated classifiers.Results Among the four categories of unbalance algorithms,synthetic minority oversampling technique and edited nearest neighbor(SMOTE-ENN)algorithm has obtained the optimal classification performance.On this basis,the classification effect of dynamic ensemble selection performance(DESP),K-nearest oracle union(KNORAU)and meta-learning for dynamic ensemble selection(META-DES)dynamic integration selection algorithms is obviously superior to the traditional single classifier and ensemble classifier model.The classification effect of the improved DESP,KNORAU and META-DES dynamic selection algorithms based on Frienemy Indecision Region is further improved.The classification performance of FIRE-META-DES was the best(Accuracy=0.909,Precision=0.906,Recall=0.967,AUC=0.879,F1-Score=0.936,Brier Score=0.088).Conclusion Aiming at the actual DLBCL data set,SMOTE-ENN+FIRE-META-DES combined prediction model for recurrence used in this paper achieves the optimal performance and low computational complexity,which can provide a strong reference for DLBCL recurrence prediction.

Hepatic osteodystrophy is a common complication in patients with chronic liver disease and is influenced by various risk factors， and it has become one of the important influencing factors for the prognosis of liver transplantation. By analyzing the influencing factors for bone health and bone metabolism during the perioperative period of liver transplantation， this article emphasizes the importance of a comprehensive assessment of bone health and necessary interventions at this stage， with an aim to reduce the risk of postoperative complications and improve the long-term prognosis of patients. A deeper exploration of the association between hepatic osteodystrophy and the prognosis of liver transplantation can help to reveal the key influencing factors for postoperative outcomes， thus providing a theoretical basis for optimizing postoperative management strategies. Furthermore， advances in this research field will offer new insights into the treatment of patients receiving liver transplantation， and it is expected to further improve quality of life and long-term survival rate.

Objective:To investigate the training needs of general practitioners in community health center in health care and management of older patients for developing a curriculum for the Extension for Community Health Outcomes (ECHO) project accordingly.Methods:This was a qualitative study. The semi-structured interviews were conducted with 20 community health center general practitioners (GPs) using focus groups between March 2024 and April 2024. The interview data were collated using Nvivo12 software and coded using thematic analysis. The focus of the interviews was on the challenges GPs face in health care of older people in the community and relevant training needs.Results:Three male and 17 female GPs took part in the interviews. The interviews showed that GPs in comminity health service centers faced multiple challenges in the helth management of older patients, including implementation of holistic treatment plans, time-consuming comprehensive patient assessment, lack of standardized medication selection, unclear referral processes and difficulties in establishing a trusting doctor-patient relationship. The study suggested that the design and development of training programs should encompass eight core components: differentiated end-of-life care for patients, nutritional advice, positive psychological intervention, software data-based health assessment, systematic geriatric medicine, updated clinical research findings, medication selection and treatment guidelines, and insulin resistance management.Conclusion:Through qualitative investigation, this study explored the challenges faced by general practitioners in providing health care for older patients and relevant training needs, which provids evidence for designing and developing corresponding curricula for ECHO projects.

Objective:To explore school-refusing adolescents'subjective experience of helpful interventions in family-doctor-school meetings.Methods:Semi-structured interviews were conducted with 12 school-refusing ado-lescents after they participated in family-doctor-school meetings to understand the psychological interventions they perceived.Thematic analysis was used to analyze the transcripts and construct a thematic framework of useful inter-ventions.Results:Six themes were identified by thematic analysis:fairness and restraint of doctors,emotions and demands being heard,negotiate based on facts,proper science popularization,helping us check resources and vie-wing things more three-dimensionally.Conclusion:Family-doctor-school meeting facilitate effective communication between home and school,providing a supportive environment that helps school-refusing adolescents express their e-motions and demands and prepare for returning to school.

Objective To evaluate the application value of aspiration catheter and debulking technology in the treatment of patients with intermediate-and high-risk pulmonary thromboembolism(PTE).Methods The clinical data of 28 patients with intermediate-and high-risk PTE were analyzed retrospectively.All subjects received thrombectomy using a 7F JR Guiding catheter.The success rate of surgery and the incidence of complications were counted,and the preoperative and postoperative values in heart rate(HR),systolic blood pressure(SBP),oxygen saturation(SO2),partial pressure of oxygen(PO2),Miller index,and mean pulmonary arterial pressure(MPAP)were compared.Results All patients were successfully treated,of which 26 cases obtained symptomatic relief after surgery.There were 2 cases of death in high-risk patients,of whom one died of myocardial infarction,and the other died of cerebral herniation after the procedure.One case reported the formation of pulmonary artery small dissection which disappeared within 2 months during conservative observation.The postoperative HR,Miller index,and MPAP decreased and SBP,SO2,and P()2 increased significantly than those of preoperative(P＜0.05).The follow-up period for this group ranged from 7 to 29 months,with a median follow-up of 14.6(7,19)months.During the follow-up period,no recurrences were observed.Conclusion The aspiration catheter and debulking technology demonstrate efficacy in treating intermediate-and high-risk PTE,and is associated with favourable success rates and low complication rates.The findings suggest its potential for wider clinical use.

Objective The prediction model of recurrence within two years after complete remission of diffuse large B-cell lymphoma(DLBCL)patients was constructed based on frienemy indecision region dynamic ensemble selection(FIRE-DES)to provide decision-making basis for the treatment of patients.Methods To collect data of 498 patients who achieved complete response after treatment from January 2010 to January 2020 in a Grade-A hospital in Shanxi Province.A FIRE-DES combination prediction model based on four common category-disequilibrium treatment methods was constructed and compared with five traditional single classifiers and two integrated classifiers.Results Among the four categories of unbalance algorithms,synthetic minority oversampling technique and edited nearest neighbor(SMOTE-ENN)algorithm has obtained the optimal classification performance.On this basis,the classification effect of dynamic ensemble selection performance(DESP),K-nearest oracle union(KNORAU)and meta-learning for dynamic ensemble selection(META-DES)dynamic integration selection algorithms is obviously superior to the traditional single classifier and ensemble classifier model.The classification effect of the improved DESP,KNORAU and META-DES dynamic selection algorithms based on Frienemy Indecision Region is further improved.The classification performance of FIRE-META-DES was the best(Accuracy=0.909,Precision=0.906,Recall=0.967,AUC=0.879,F1-Score=0.936,Brier Score=0.088).Conclusion Aiming at the actual DLBCL data set,SMOTE-ENN+FIRE-META-DES combined prediction model for recurrence used in this paper achieves the optimal performance and low computational complexity,which can provide a strong reference for DLBCL recurrence prediction.

Objective:To explore school-refusing adolescents'subjective experience of helpful interventions in family-doctor-school meetings.Methods:Semi-structured interviews were conducted with 12 school-refusing ado-lescents after they participated in family-doctor-school meetings to understand the psychological interventions they perceived.Thematic analysis was used to analyze the transcripts and construct a thematic framework of useful inter-ventions.Results:Six themes were identified by thematic analysis:fairness and restraint of doctors,emotions and demands being heard,negotiate based on facts,proper science popularization,helping us check resources and vie-wing things more three-dimensionally.Conclusion:Family-doctor-school meeting facilitate effective communication between home and school,providing a supportive environment that helps school-refusing adolescents express their e-motions and demands and prepare for returning to school.

Objective To evaluate the application value of aspiration catheter and debulking technology in the treatment of patients with intermediate-and high-risk pulmonary thromboembolism(PTE).Methods The clinical data of 28 patients with intermediate-and high-risk PTE were analyzed retrospectively.All subjects received thrombectomy using a 7F JR Guiding catheter.The success rate of surgery and the incidence of complications were counted,and the preoperative and postoperative values in heart rate(HR),systolic blood pressure(SBP),oxygen saturation(SO2),partial pressure of oxygen(PO2),Miller index,and mean pulmonary arterial pressure(MPAP)were compared.Results All patients were successfully treated,of which 26 cases obtained symptomatic relief after surgery.There were 2 cases of death in high-risk patients,of whom one died of myocardial infarction,and the other died of cerebral herniation after the procedure.One case reported the formation of pulmonary artery small dissection which disappeared within 2 months during conservative observation.The postoperative HR,Miller index,and MPAP decreased and SBP,SO2,and P()2 increased significantly than those of preoperative(P＜0.05).The follow-up period for this group ranged from 7 to 29 months,with a median follow-up of 14.6(7,19)months.During the follow-up period,no recurrences were observed.Conclusion The aspiration catheter and debulking technology demonstrate efficacy in treating intermediate-and high-risk PTE,and is associated with favourable success rates and low complication rates.The findings suggest its potential for wider clinical use.

Objective:To investigate the training needs of general practitioners in community health center in health care and management of older patients for developing a curriculum for the Extension for Community Health Outcomes (ECHO) project accordingly.Methods:This was a qualitative study. The semi-structured interviews were conducted with 20 community health center general practitioners (GPs) using focus groups between March 2024 and April 2024. The interview data were collated using Nvivo12 software and coded using thematic analysis. The focus of the interviews was on the challenges GPs face in health care of older people in the community and relevant training needs.Results:Three male and 17 female GPs took part in the interviews. The interviews showed that GPs in comminity health service centers faced multiple challenges in the helth management of older patients, including implementation of holistic treatment plans, time-consuming comprehensive patient assessment, lack of standardized medication selection, unclear referral processes and difficulties in establishing a trusting doctor-patient relationship. The study suggested that the design and development of training programs should encompass eight core components: differentiated end-of-life care for patients, nutritional advice, positive psychological intervention, software data-based health assessment, systematic geriatric medicine, updated clinical research findings, medication selection and treatment guidelines, and insulin resistance management.Conclusion:Through qualitative investigation, this study explored the challenges faced by general practitioners in providing health care for older patients and relevant training needs, which provids evidence for designing and developing corresponding curricula for ECHO projects.