Objective:To explore the relationship of metacognitive regulation, self-efficacy, and motivation regulation with learning engagement among medical students in military academies.Methods:A total of 439 students from the Air Force Medical University were selected by convenience sampling in March to April 2023. The Metacognitive Self-Regulation Scale, Self-Efficacy Scale, Learning Engagement Scale, and Motivation Regulation Questionnaire were adopted for investigation. SPSS 25.0 was used for Pearson correlation analysis, and the Process procedure for analysis and testing of mediating effects.Results:A total of 436 usable questionnaires were collected. Metacognitive regulation, self-efficacy, motivation regulation, and learning engagement were significantly positively correlated ( r>0.477, P<0.01). The mediating effect of self-efficacy and motivation regulation and the chain mediating effect of self-efficacy-motivation regulation were significant between metacognitive regulation and learning engagement, and the effect sizes were 0.449, 0.244, and 0.130, accounting for 44.37%, 24.11%, and 12.85% of the total effect, respectively. The proportion of the total indirect effect was 81.32%. Conclusions:The metacognitive regulation of medical students in military academies directly affects learning engagement, which is also indirectly affected through the independent mediating effect of self-efficacy and motivation regulation or the chain mediating effect of self-efficacy-motivation regulation.

Objective:To explore the relationship of metacognitive regulation, self-efficacy, and motivation regulation with learning engagement among medical students in military academies.Methods:A total of 439 students from the Air Force Medical University were selected by convenience sampling in March to April 2023. The Metacognitive Self-Regulation Scale, Self-Efficacy Scale, Learning Engagement Scale, and Motivation Regulation Questionnaire were adopted for investigation. SPSS 25.0 was used for Pearson correlation analysis, and the Process procedure for analysis and testing of mediating effects.Results:A total of 436 usable questionnaires were collected. Metacognitive regulation, self-efficacy, motivation regulation, and learning engagement were significantly positively correlated ( r>0.477, P<0.01). The mediating effect of self-efficacy and motivation regulation and the chain mediating effect of self-efficacy-motivation regulation were significant between metacognitive regulation and learning engagement, and the effect sizes were 0.449, 0.244, and 0.130, accounting for 44.37%, 24.11%, and 12.85% of the total effect, respectively. The proportion of the total indirect effect was 81.32%. Conclusions:The metacognitive regulation of medical students in military academies directly affects learning engagement, which is also indirectly affected through the independent mediating effect of self-efficacy and motivation regulation or the chain mediating effect of self-efficacy-motivation regulation.

Objective By population survey,to explore the epidemiological characteristics of gastric precancerous lesions in Lishui District of Nanjing and provide objective basis for the prevention and treatment of early gastric cancer.Methods From July 2021 to December 2022,21 977 patients who received endoscopy and/or 13C-UBT in Lishui District People's Hospital and 6 medical community units in Nanjing City were retrospectively analyzed for demography characteristics,detection rate of gastric precancerous lesions,and H.Pylori infection rate.Results(1)590 cases of gastric precancerous lesions were detected(detection rate 2.68%);(2)The total detection rate of precancerous lesions and three pathological types in males were all higher than those in females(all P<0.001);(3)The minimum age for the total detection rate of precancerous lesions in males and the mini-mum age for each pathological type were lower than in females(P<0.001,0.009,0.005,0.002);(4)The popu-lation total H.pylori infection rate was 23.10%,the H.pylori infection rate in patients with precancerous lesions was higher than that in non-precancerous lesions(P<0.001),both H.pylori infection rate of male and female in precancerous lesions were all higher than those of non-precancerous lesions of the same sex(all P<0.001),in addition,the H.pylori infection rate of male whether in precancerous or non-precancerous lesions was higher than that of female(all P<0.001);(5)The precancerous lesions detection rate in male,female,and the overall age range of 20～29 to 70～79 years is positively correlated with age growth(P<0.001),and rapidly decreases after the age of 79,the of H.pylori infection rate was also positively correlated with age growth(P<0.001),and the trend of age change(P<0.001)was parallel to the precancerous lesions detection rate.Conclusions The detec-tion rate of gastric precancerous lesions in this region is above the average level in China;the total H.pylori infec-tion rate is at a relatively low level in China;the H.pylori infection rate is parallel to the age trend of the detection rate of gastric precancerous lesions,and increases with age.

Objective:To investigate the application value of major anatomical structure recognition model of minimally invasive liver resection based on deep learning.Methods:The retrospective and descriptive study was conducted. The 31 surgical videos of laparoscopic left lateral sectionectomy performed in Zhujiang Hospital of Southern Medical University from January 2019 to April 2023 were collected. Video clips containing the surgical procedure of left lateral lobe liver pedicle and left hepatic vein were screened by 2 liver surgeons. After quality control, screening and frame extraction, the major anatomical structures on the images of these clips were annotated. After pre-processing, these images were transported to the DeepLab v3+neural network framework for model training. Observation indicators: (1) video annotation and classification; (2) results of arti-ficial intelligence anatomical recognition model testing. Measurement data with normal distribution were represented as Mean± SD, and count data were described as absolute numbers. Results:(1) Video annotation and classification. A total of 4 130 frames of images were annotated in the 31 surgical videos, including 2 083 frames of annotated images for the left lateral lobe liver pedicle, 1 578 frames of annotated images for the left hepatic vein and 469 frames of annotated images for both the left lateral lobe liver pedicle and left hepatic vein. (2) Results of artificial intelligence anatomical recognition model testing. In four application scenarios (clean scene, bloodstain scene, partially obstruction by instrument scene, and small exposed area scene), the model was able to successfully recognize the left lateral lobe liver pedicle and left hepatic vein, with a recognition speed for anatomical markers >13 frames/s. When performing anatomical recognition on images with only the left lateral lobe liver pedicle, the Dice coefficient, intersection over union, accuracy, sensitivity and specificity of the model were 0.710±0.110, 0.560±0.120, 0.980±0.010, 0.640±0.030, and 0.980±0.010, respectively. The above indicators of the model were 0.670±0.180, 0.530±0.200, 0.980±0.010, 0.600±0.040, and 0.990±0.010 when performing anatomical recognition on images with only the left hepatic vein, and 0.580±0.180, 0.430±0.190, 0.980±0.010, 0.580±0.020, and 0.990±0.010 when per-forming anatomical recognition on images with both the left lateral lobe liver pedicle and left hepatic vein.Conclusion:The major anatomical structure recognition model of minimally invasive liver resection based on deep learning can be applied in identifying liver pedicle and hepatic vein.

Objective:To investigate the application value of augmented reality navigation combined with indocyanine green(ICG) fluorescence imaging technology in laparoscopic anatomical segment 8 liver resection.Methods:Clinical and pathological data from 8 patients with hepatocellular carcinoma located in segment 8 of the liver admitted to the First Department of Hepatobiliary Surgery,Zhujiang Hospital,Southern Medical University from October 2021 to October 2022 were collected restrospectively. Among them,there were 5 males and 3 females,aged between 40 and 72 years. During the operation,the self-developed laparoscopic augmented reality surgical navigation system was used to integrate the three-dimensional liver model with the laparoscopic scene,and ICG fluorescence imaging technology was used to guide the anatomical liver resection of segment 8. The predicted liver resection volume and actual liver resection volume,related surgical indicators and postoperative complications were analyzed.Results:Among the 8 patients, 4 underwent laparoscopic anatomical segment 8 liver resection,1 underwent laparoscopic anatomical ventral subsegment of segment 8 liver resection,2 underwent laparoscopic anatomical ventral subsegment combined with medial subsegment of segment 8 liver resection, and 1 underwent laparoscopic anatomical dorsal subsegment of segment 8 liver resection. All operations were completed under the guidance of augmented reality navigation combined with ICG fluorescence imaging,without conversion to open surgery. The operation time was (276.3±54.8)minutes(range:200 to 360 minutes). Intraoperative blood loss was (75.0±35.4)ml(range:50 to 150 ml). No blood transfusion was performed during the operation. The length of postoperative hospital stay was (7.6±0.8)days(range:7 to 9 days). There were no deaths or postoperative complications such as bleeding or biliary fistula during the perioperative period.Conclusion:Augmented reality navigation combined with ICG fluorescence imaging technology can guide the implementation of laparoscopic anatomical segment 8 liver resection.

Objective:To investigate the application value of augmented reality navigation combined with indocyanine green(ICG) fluorescence imaging technology in laparoscopic anatomical segment 8 liver resection.Methods:Clinical and pathological data from 8 patients with hepatocellular carcinoma located in segment 8 of the liver admitted to the First Department of Hepatobiliary Surgery,Zhujiang Hospital,Southern Medical University from October 2021 to October 2022 were collected restrospectively. Among them,there were 5 males and 3 females,aged between 40 and 72 years. During the operation,the self-developed laparoscopic augmented reality surgical navigation system was used to integrate the three-dimensional liver model with the laparoscopic scene,and ICG fluorescence imaging technology was used to guide the anatomical liver resection of segment 8. The predicted liver resection volume and actual liver resection volume,related surgical indicators and postoperative complications were analyzed.Results:Among the 8 patients, 4 underwent laparoscopic anatomical segment 8 liver resection,1 underwent laparoscopic anatomical ventral subsegment of segment 8 liver resection,2 underwent laparoscopic anatomical ventral subsegment combined with medial subsegment of segment 8 liver resection, and 1 underwent laparoscopic anatomical dorsal subsegment of segment 8 liver resection. All operations were completed under the guidance of augmented reality navigation combined with ICG fluorescence imaging,without conversion to open surgery. The operation time was (276.3±54.8)minutes(range:200 to 360 minutes). Intraoperative blood loss was (75.0±35.4)ml(range:50 to 150 ml). No blood transfusion was performed during the operation. The length of postoperative hospital stay was (7.6±0.8)days(range:7 to 9 days). There were no deaths or postoperative complications such as bleeding or biliary fistula during the perioperative period.Conclusion:Augmented reality navigation combined with ICG fluorescence imaging technology can guide the implementation of laparoscopic anatomical segment 8 liver resection.

Objective:To explore the influence of cognitive behavioral intervention on self-perceived burden and coping style of patients with cubital tunnel syndrome (CuTS) , so as to provide theoretical basis and practical guidance for the psychological care of patients with cubital tunnel syndrome.Methods:Using the convenient sampling method, a total of 84 patients with cubital tunnel syndrome who were admitted to the Department of Hand and Foot Surgery of the First Hospital of Jilin University from July 2018 to August 2019 were selected as the research objects. According to the random number table method, they were divided into the intervention group (43 cases) and the control group (41 cases) . The control group was given routine nursing care, while the intervention group was given cognitive behavioral intervention on the basis of the control group. The general situation and injury characteristics questionnaire, Self-Perceived Burden Scale (SPBS) and Medical Coping Modes Questionnaire (MCMQ) were used to compare self-perceived burden and medical response methods of patients in the two groups before and after the intervention.Results:In the end, 42 patients in the intervention group and 40 patients in the control group completed the study. Before the intervention, there was no statistically significant difference in scores of SPBS and MCMQ of patients between the two groups ( P>0.05) . After the intervention, the total score of SPBS and the scores of all dimensions of the intervention group were lower than those of the control group, and the differences were statistically significant ( P<0.05) . After the intervention, the score of MCMQ face style dimension of the intervention group was higher than that of the control group, the score of yielding method dimension was lower than that of the control group, and the differences were statistically significant ( P<0.05) . There was no statistically significant difference in the avoidance style dimension scores between the two groups after the intervention ( P>0.05) . Conclusions:Cognitive behavior intervention can effectively reduce self-perceived burden level of the patients and enable them to adopt a positive coping style during the treatment process, which can help recovery of them.

Objective:To explore the effects of hyperbaric oxygen combined with task-oriented mirror therapy on the upper limb motor function (ULMF) recovery and motor evoked potentials (MEPs) in patients with cerebral infarction.Methods:A total of 80 convalescent patients with cerebral infarction admitted to Nanjing Lishui People’s Hospital from January 2017 to June 2020 were selected and divided into control group and observation group according to the random number table method, with 40 cases in each group. The control group was given task-oriented mirror therapy, and the observation group was treated with hyperbaric oxygen therapy on the basis of the treatment in the control group. The ULFM, the cortex latency (CL) of MEPs, the central motor conduction time (CMCT), and patients’ daily functioning before and after treatment were compared between the two groups.Results:Before treatment, there was no significant difference in ULMF score, CL of MEPs, CMCT, and daily functioning between the two groups ( P>0.05). After treatment, the ULMF score in the observation group (41.51±4.28) was higher than that in the control group (34.87±3.44), with a statistically significant difference ( P<0.05); the CL and CMCT in the observation group [(21.89±0.97) ms and (9.24±0.70) ms, respectively] were all shorter than those in the control group [(22.91±0.92) ms and (9.96±0.83) ms, respectively], with statistically significant differences ( P<0.05); the daily functioning score in observation group (65.42±7.90) was higher than that in the control group (58.79±8.32), with a statistically significant difference ( P<0.05). Conclusion:Hyperbaric oxygen combined with task-oriented mirror therapy can improve the central nerve conduction of the convalescent patients with cerebral infarction, thus promoting their recovery of ULMF and daily functioning.

Objective:To explore the effects of hyperbaric oxygen combined with task-oriented mirror therapy on the upper limb motor function (ULMF) recovery and motor evoked potentials (MEPs) in patients with cerebral infarction.Methods:A total of 80 convalescent patients with cerebral infarction admitted to Nanjing Lishui People’s Hospital from January 2017 to June 2020 were selected and divided into control group and observation group according to the random number table method, with 40 cases in each group. The control group was given task-oriented mirror therapy, and the observation group was treated with hyperbaric oxygen therapy on the basis of the treatment in the control group. The ULFM, the cortex latency (CL) of MEPs, the central motor conduction time (CMCT), and patients’ daily functioning before and after treatment were compared between the two groups.Results:Before treatment, there was no significant difference in ULMF score, CL of MEPs, CMCT, and daily functioning between the two groups ( P>0.05). After treatment, the ULMF score in the observation group (41.51±4.28) was higher than that in the control group (34.87±3.44), with a statistically significant difference ( P<0.05); the CL and CMCT in the observation group [(21.89±0.97) ms and (9.24±0.70) ms, respectively] were all shorter than those in the control group [(22.91±0.92) ms and (9.96±0.83) ms, respectively], with statistically significant differences ( P<0.05); the daily functioning score in observation group (65.42±7.90) was higher than that in the control group (58.79±8.32), with a statistically significant difference ( P<0.05). Conclusion:Hyperbaric oxygen combined with task-oriented mirror therapy can improve the central nerve conduction of the convalescent patients with cerebral infarction, thus promoting their recovery of ULMF and daily functioning.

Objective Establishing intelligent nursing clinical decision support system to improve the safety, quality and efficiency of clinical nursing work. Methods Guided by the HIMSS EMRAM Analytics stage 7 evaluation standard, the nursing decision support system is continuously improved through the establishment of knowledge bases such as nursing plans and nursing conventions. Results By comparing the writing time of nursing documents, the correct rate of nursing diagnosis, and the incidence of nursing risk events before and after the used of the system, the results showed that after the used of the nursing decision-making support system, whole hospital′s writing time could save 222.5 hours per day, improved accuracy of nursing diagnosis from 68.33％ (205/300)to 90.67％ (272/300), the difference was statistical significace (χ2=45.907, P<0.05). Decreased incidents, hospital-wide, on falls from 0.127‰(80/631702) to 0.071‰(45/638715),and on pressure ulcer form 0.064‰ (41/631702)to 0.028‰(18/638715), the difference was statistical significace (χ2=13.004～15.071, P<0.05). Conclusion Nursing clinical decision support system is the trend of hospital informatization and is worthy of clinical application.