ObjectiveTo investigate the value of preoperative dual-layer spectral detector CT （DLCT） parameters in predicting lymph node metastasis （LNM） of non-functional pancreatic neuroendocrine neoplasms （NF-pNENs）. MethodsA retrospective study was conducted on patients with pathologically confirmed NF-pNENs who underwent preoperative contrast-enhanced DLCT examination between September 2019 and July 2024. Regions of interest （ROIs） were manually delineated on three representative slices of the solid component of the lesion， and the mean values were recorded. Conventional CT parameters， monochromatic energy images （40 keV， 70 keV， 100 keV）， iodine concentration maps， and effective atomic number （Z_eff） maps in the pancreatic parenchymal phase and portal venous phase were acquired. A total of 34 parameters， including clinical characteristics， imaging features， conventional CT and DLCT quantitative parameters， were analyzed. Intergroup differences were compared between the LNM and non-LNM groups. Independent predictive factors were screened using logistic regression and least absolute shrinkage and selection operator （LASSO） regression. Receiver operating characteristic （ROC） curves were generated for each predictive model， and the area under the curve （AUC） was calculated to evaluate the predictive efficacy. ResultsA total of 82 patients with NF-pNENs were enrolled， including 37 males and 45 females， with a mean age of 49.7±14.7 years. Thirty patients were performed with LNM and 52 were with non-LNM. After univariate logistic regression， LASSO regression and multivariate stepwise logistic regression analyses， body mass index （BMI）， organ invasion， normalized CT value in the portal venous phase （nCTv） and normalized iodine concentration in the portal venous phase （nICv） were identified as independent predictive factors. The AUCs of the clinical-radiological qualitative model （BMI+organ invasion）， conventional CT model （nCTv）， DLCT model （nICv） and comprehensive model （organ invasion+nICv） were 0.815 （0.719， 0.910）， 0.750 （0.642， 0.858）， 0.829 （0.733， 0.925） and 0.865 （0.879， 0.953）， respectively. The comprehensive model combining clinical-radiological and DLCT characteristics exhibited superior predictive performance. ConclusionDLCT parameters are more effective than conventional CT parameters in predicting LNM in NF-pNENs， enabling non-invasive preoperative prediction and assisting clinical decision-making.

ObjectiveTo investigate the value of preoperative dual-layer spectral detector CT （DLCT） parameters in predicting lymph node metastasis （LNM） of non-functional pancreatic neuroendocrine neoplasms （NF-pNENs）. MethodsA retrospective study was conducted on patients with pathologically confirmed NF-pNENs who underwent preoperative contrast-enhanced DLCT examination between September 2019 and July 2024. Regions of interest （ROIs） were manually delineated on three representative slices of the solid component of the lesion， and the mean values were recorded. Conventional CT parameters， monochromatic energy images （40 keV， 70 keV， 100 keV）， iodine concentration maps， and effective atomic number （Z_eff） maps in the pancreatic parenchymal phase and portal venous phase were acquired. A total of 34 parameters， including clinical characteristics， imaging features， conventional CT and DLCT quantitative parameters， were analyzed. Intergroup differences were compared between the LNM and non-LNM groups. Independent predictive factors were screened using logistic regression and least absolute shrinkage and selection operator （LASSO） regression. Receiver operating characteristic （ROC） curves were generated for each predictive model， and the area under the curve （AUC） was calculated to evaluate the predictive efficacy. ResultsA total of 82 patients with NF-pNENs were enrolled， including 37 males and 45 females， with a mean age of 49.7±14.7 years. Thirty patients were performed with LNM and 52 were with non-LNM. After univariate logistic regression， LASSO regression and multivariate stepwise logistic regression analyses， body mass index （BMI）， organ invasion， normalized CT value in the portal venous phase （nCTv） and normalized iodine concentration in the portal venous phase （nICv） were identified as independent predictive factors. The AUCs of the clinical-radiological qualitative model （BMI+organ invasion）， conventional CT model （nCTv）， DLCT model （nICv） and comprehensive model （organ invasion+nICv） were 0.815 （0.719， 0.910）， 0.750 （0.642， 0.858）， 0.829 （0.733， 0.925） and 0.865 （0.879， 0.953）， respectively. The comprehensive model combining clinical-radiological and DLCT characteristics exhibited superior predictive performance. ConclusionDLCT parameters are more effective than conventional CT parameters in predicting LNM in NF-pNENs， enabling non-invasive preoperative prediction and assisting clinical decision-making.

Recruitment is a critical part of human resource management.Conducting recruitment with competency models can significantly enhance match candidates to positions.This paper outlines the theoretical support for competency models.By analyzing the construction process of competency models in public hospitals and their application in recruitment,it aims to explore problems in the implementation of competency models in recruitment and provide suggestions.

Recruitment is a critical part of human resource management.Conducting recruitment with competency models can significantly enhance match candidates to positions.This paper outlines the theoretical support for competency models.By analyzing the construction process of competency models in public hospitals and their application in recruitment,it aims to explore problems in the implementation of competency models in recruitment and provide suggestions.

Objective To understand the barriers of surrogate decision-makers participating in the advanced care planning(ACP)for patients with advanced cancer,and to provide references for the construction and intervention of educational programs.Methods Under the guidance of ternary reciprocal determinism,qualitative research method was used to conduct semi-structured interviews with 12 surrogate decision makers of advanced cancer patients in 2 tertiary hospitals of Zhejiang Province,and the data was analyzed using targeted content analysis.Results Based on the theory,the influencing factors of participating in ACP of the surrogate decision-makers of patients with advanced cancer were summarized into 3 themes:individual level-dual restriction of subjective thought and objective ability(value restriction,cognitive understanding deviation,economic condition restriction,patient's situation control),environment level-synergistic influence of medical environment and social environment(limited medical conditions,pressure from public moral opinion,insufficient policy guarantee,lack of family consensus),behavior level-interaction of external guidance and internal feedback(lack of guidance of medical staff,experience support of medical decision-making).Conclusion Surrogate decision-makers of patients with advanced cancer face many pressures before participating in the ACP.Under the guidance of the theory of knowledge,belief and practice,medical staff can give them pre-established medical care knowledge to correct their cognitive bias.Medical staff can guide the realization of"family-centered"decision-making mode to strengthen the family support of surrogate decision-makers.Medical staff also can lead the establishment of a surrogate decision-makers support group to share decision-making experience and provide medical decision-making assistance.

Objective : To analyze the association between multiple loci of genes and the risk of early⁃onset pre⁃ eclampsia (EOPE) with pregnancy induced hypertension. Methods : Among 382 EOPE patients who had lived in Yanbian area for more than 10 years , 192 patients were randomly selected as case group. At the same time , 192 cases of natural delivery in the hospital were randomly selected as the control group. PCR⁃RFLP method was used to determine the specific genotype and allele distribution information , and non⁃conditional Logistic method was used to obtain odds ratio (OR) and 95% confidence interval (CI) to confirm the risk of various genotypes. Results : There were two alleles of T and C at the GRB2 rs8082005 locus , TC , TT , and CC genotypes. There were two alleles of T and C at the RXRA rs3849222 locus , TC , TT , and CC genotypes. Through unconditional logistic regression analysis , in the GRB2 rs8082005 locus , compared with the TT genotype , the CC genotype was more susceptible to EOPE ( OR = 3. 155 , 95% CI = 1. 513 - 6. 579 , P = 0. 002) . In the explicit model , compared to patients with TT+ TC genotype , patients with CC genotype increased the risk of EOPE ( OR = 3. 000 , 95% CI = 1. 495 - 6. 022 , P = 0. 002) . In the RXRA rs3849222 locus , compared with the CC genotype , the TT genotype was more susceptible to EOPE ( OR = 2. 031 , 95% CI = 1. 077 - 3. 820 , P = 0. 028) . In the invisible model , compared to patients with CC + CT genotype , patients with TT genotype had an increased risk of EOPE ( OR = 2. 549 , 95% CI = 1. 421 - 4. 573 , P = 0. 002) . Conclusion There is a significant correlation between single nucleotide polymorphism (SNP) at the GRB2 rs8082005 and RXRA rs3849222 loci and the risk of EOPE in pregnant women with gestational hypertension in Yanbian area.

ObjectiveTo study the possible molecular mechanism of baicalein （BAI）-mediated focal adhesion kinase （FAK） in the regulation of phosphatidylinositol 3-kinase/protein kinase B （PI3K/Akt） signaling pathway to inhibit the proliferation and migration of gastric cancer HGC-27 cells. MethodThe gastric epithelial GES-1 cells and gastric cancer HGC-27 cells were respectively treated with BAI （0， 5， 15， 25， and 50 μmol·L^-1） for 48 h， and then methyl thiazolyl tetrazolium （MTT） assay was adopted to detect effect of BAI on cell proliferation. Western blot （WB） was employed to detect the expression of FAK and the proteins related to epithelial-mesenchymal transition （EMT） and PI3K signaling pathway after intervention with different concentrations of BAI. The HGC-27 cells stably overexpressing FAK were constructed with lentivirus-mediated transfection technique， and the transfection of FAK was detected through WB and green fluorescent protein （GFP）. The cells were divided into empty vector （NC） group， BAI group， FAK overexpression group， and BAI-treated FAK overexpression group， and cell proliferation activity was detected by MTT assay. The colony formation and cell migration were observed via colony formation assay and Transwell migration assay， respectively. The expression of proteins involved in EMT and PI3K signaling pathways were detected by Western blot. ResultCompared with the NC group， BAI （15， 25 and 50 μmol·L^-1） inhibited the proliferation of HGC-27 cells in a dose-dependent manner （P<0.05， P<0.01） while did not affect that of GES-1 cells. BAI （5， 15 and 25 μmol·L^-1） down-regulated the expression level of p-FAK （P<0.05， P<0.01）. Compared with NC group， FAK overexpression group showed up-regulated expression level of FAK in HGC-27 cells. The HGC-27 cells in both NC group and FAK overexpression group had green fluorescence. Compared with NC group， BAI inhibited the growth， colony formation， and migration， while FAK overexpression promoted those of HGC-27 cells. The treatment of FAK overexpression group with BAI inhibited the enhancement of cell proliferation and migration （P<0.05）. WB showed that compared with NC group， BAI （15， 25 μmol·L^-1） significantly up-regulated the expression of E-cadherin protein and down-regulated that of Vimentin， Snail， p-PI3K， and p-Akt protein in HGC-27 cells （P<0.05， P<0.01）. Compared with NC group， FAK overexpression group showed down-regulated expression of E-cadherin， up-regulated expression of p-FAK， Vimentin， and Snail， and increased ratios of p-FAK/FAK， p-PI3K/PI3K and p-Akt/Akt （P<0.05）. This phenomenon would be reversed after BAI treatment. ConclusionBAI can affect the proliferation and migration of gastric cancer HGC-27 cells by mediating FAK to regulate PI3K/Akt signaling pathway.

Objective:To evaluate the methodological quality and evidence quality of outcome of the systematic reviews/meta analyses on traditional exercise for the improvement of cardiopulmonary function.Methods:By searching for PubMed, Cochrane Library, Web of Science, CNKI, Wanfang, VIP and CBM databases in Chinese or English, the Systematic Reviews/meta analysis of traditional exercises for improving cardiopulmonary function was conducted. The retrieval time was March 8th, 2020. The AMSTAR 2 scale was used to evaluate the methodological quality of the systematic review/meta-analysis that met the inclusion criteria. Since the included studies cannot reflect the overall effect of traditional exercises on improving cardiopulmonary function, and the methodological quality of systematic reviews was generally low, a secondary analysis of the RCT studies included in the systematic reviews was conducted. The methodological quality evaluation of the original RCT study adopted the Cochrane Reviewers’ Handbook Version 5.0.0 bias risk assessment method (Risk of Bias, ROB), and applied the Revman 5.3 software to merge the original RCT data. The GRADE system was used for evidence evaluation.Results:A total of 32 systematic reviews/meta analysis were included, and the AMSTAR2 scale indicated that only one of the 32 systematic reviews/meta included was of high-quality, 1 was of low-quality, and the others were of extremely low quality. A total of 57 RCTs were included in the 32 systematic reviews for bias risk assessment and data consolidation. GRADE evidence quality evaluation showed that 14 evidences were of medium quality, 26 evidences were of low quality, and 5 evidences were of extremely low quality.Conclusions:Traditional exercises can improve cardiopulmonary function, but with low evidence quality. Thus, clinicians should make clinical decisions based on conditions.

[Objective] To summarize image manifestations in intestinal tuberculosis (ITB) examined by multi-slice computed tomography enteroclysis (MSCT) and evaluate the diagnostic value of MSCTE in ITB,[Methods] The imaging findings were retrospectively analyzed in 15 cases of ITB that were confirmed by endoscopy or postoperative pathologic examination,including the location,number,shape,edge,surrounding tissue alterations of ITB and other associated changes in the peritoneum,mesentery and solid abdominal organs,and compared with endoscopy and pathology.[Results] In 15 patients,ileocecum was involved in 13 cases (87％),4 cases (27％) showed multi-segmental symmetric intestinal mural thickening,9 patients (60％) showed solid masses,1 case (7％) showed multi-segmental symmetric intestinal mural thickening and solid masses,1 case (7％) showed homogenous enhanced masses and perforation,12 cases (86％) showed enlarged lymph nodes (LNs) with rim enhancement,and 2 cases (13％) showed the comb sign of enhanced mesenteric vessels.Based on enhancement pattern of MSCTE,ITB was divided into three types:homogenous enhancement type (n=5);target sign type (n=2);caseous necrosis type (n=2).[Conclusion] The imaging features of ITB are diverse.MSCTE can clearly display the shape of intestinal mucosa,the alterations of intestinal wall and the relationship between lesion and adjacent tissues,which provides valuable information for the clinic diagnosis of ITB.

Objective To investigate the feasibility of utilizing visceral abdominal adiposity tissue (VAT) volume quantification using MRI to predict type 2 diabetes mellitus (T2DM).Methods Forty-eight subjects including 15 T2DM (T2DM group),17 impaired glucose tolerance (IGT,IGT group) and 16 normal glucose tolerance (NGT,NGT group) were enrolled in this study.All subjects underwent upper abdominal iterative decomposition of water and fat with echo asymmetry and least square estimation-image quantification (IDEAL-IQ) MRI scanning.VAT volume of the second and third lumber vertebral body ranges (VATV L2,VATV L3),sum of VATV L2 and L3 (total VATV),hepatic and pancreatic fat were measured in fat fraction mapping of T1WI IDAEL-IQ sequence on post-processing workstation.The accuracy of predicting T2DM using VAT was evaluated by Logistic regression equation via ROC curve.Results The mean of VATV L2,VATV L3 and total VATV in T2DM group were significantly higher than those of IGT group and NGT group (P＜0.05),while there were no significant difference of these metrics between IGT group and NGT group (P＞0.05).Taking 460.34 ml as the cut-off value for VATV L2 to predict T2DM,sensitivity was 73.33％,specificity was 75.76％ and accuracy was 75.00％,respectively.Taking 429.46 ml as the cut-off value for VATV L3 to predict T2DM,sensitivity was 86.67％,specificity was 72.73％ and accuracy was 77.08％,respectively.Taking 887.83 ml as the cut-off value for total VATV to predict T2DM,the sensitivity,specificity and accuracy were 86.67％,72.73％ and 77.08％,respectively.Only VATV L3 was enrolled by Logistic regression equation (P=0.01,OR=1.01),and the sensitivity,specificity and total accuracy of prediction for T2DM were 80.00 ％,88.20 ％,and 84.40 ％,respectively.Conelnsion It is feasible to utilize VAT volume quantification with MRI to predict T2DM.VATV L3 is a better predictor.