ObjectiveTo assess the performance of preoperative serum Golgi protein 73 （GP73） in diagnosing liver fibrosis degree in patients with resectable hepatocellular carcinoma （HCC）， to investigate its value in predicting postoperative survival， and to provide a basis for risk stratification and individualized decision-making in this population. MethodsA total of 631 patients with HCC who underwent liver resection at The First Hospital of Jilin University from March 1， 2009 to December 31， 2022 were enrolled. The demographic， pathological， and serological features of the patients were collected， and the serum level of GP73 was measured before surgery. Scheuer score determined by liver biopsy was used as the gold standard for diagnosing liver fibrosis； the Spearman correlation analysis was used to investigate the correlation between GP73 and liver fibrosis； the receiver operating characteristic （ROC） curve and the area under the ROC curve （AUC） were used to assess the value of serum GP73 and compound serological markers in the diagnosis of liver fibrosis， and the Delong test was used for comparison of AUC. With all-cause mortality as the outcome， X-Tile 3.6.1 software was used to determine the optimal cut-off value of GP73； the univariate and multivariate Cox regression analyses were used to identify independent influencing factors for prognosis， and a nomogram model was constructed. Ten-fold cross-validation was used for internal validation； index of concordance （C-index）， integrated discrimination improvement （IDI） index， and net reclassification improvement （NRI） index were calculated； calibration curve and decision curve analysis were used to assess the predictive performance of the model. ResultsThe serum level of GP73 was positively correlated with Scheuer liver fibrosis stage （r_s=0.255， P<0.001）. Serum GP73 had a significantly higher AUC than gamma-glutamyl transferase-to-platelet ratio （0.704 vs 0.634， Z=2.00， P=0.046） and S index （0.704 vs 0.637， Z=1.98， P=0.048） in the diagnosis of significant liver fibrosis， with no significant difference compared with aspartate aminotransferase-to-platelet ratio index （AUC=0.722） and fibrosis-4 index （AUC=0.695） （both P>0.05）. During a median follow-up time of 48.66 months， 239 patients （37.9%） died. GP73 had an optimal cut-off value of 65 ng/mL in predicting postoperative mortality in patients with resectable HCC， and high GP73 expression （≥65 ng/mL） alone achieved a C-index of 0.617 for predicting the prognosis of HCC patients， which was better than the C-index of 0.551 for Barcelona Clinic Liver Cancer （BCLC） stage （P<0.001）. The multivariate Cox regression analysis showed that serum GP73 （hazard ratio ［HR］=2.56， 95% confidence interval ［CI］： 1.86 — 3.52， P<0.001）， sex （HR=1.58， 95%CI： 1.10 — 2.28， P=0.014）， vascular invasion （HR=1.69， 95%CI： 1.30 — 2.21， P<0.001）， total bilirubin （HR=1.49， 95%CI： 1.16 — 1.93， P=0.002）， and maximum tumor diameter （HR=1.07， 95%CI： 1.04 — 1.11， P<0.001） were independent risk factors for all-cause mortality after hepatectomy in patients with HCC. In order to assess whether the addition of GP73 to the other four variables could further improve model performance， the model based on GP73， sex， vascular invasion， total bilirubin， and maximum tumor diameter was defined as the GP73-included model， and the model based on all five variables except GP73 was defined as the GP73-excluded model. The GP73-included model achieved an AUC of 0.704 （95%CI： 0.656 — 0.753） for predicting 5-year survival rate after surgery， and ten-fold cross-validation showed that this model had a mean C-index of 0.716 （95%CI： 0.682 — 0.750）， which was higher than the C-index of the GP73-excluded model （C-index=0.682， 95%CI： 0.645 — 0.719， P=0.008） and BCLC stage （C-index=0.551， 95%CI： 0.523 — 0.580， P<0.001）. Compared with the GP73-excluded model， the GP73-included model yielded an IDI index of 0.039 （95%CI： 0.016 — 0.069， P<0.001） and an NRI index of 0.259 （95%CI： 0.179 — 0.335， P<0.001）， and compared with BCLC stage， the GP73-included model had an IDI index of 0.112 （95%CI： 0.069 — 0.163， P<0.001） and an NRI index of 0.272 （95%CI： 0.169 — 0.380， P<0.001）. Calibration curve and decision curve analyses showed that the GP73-included model had good calibration and net clinical benefit. ConclusionGP73 can be used as a serological biomarker for diagnosing liver fibrosis in patients with resectable HCC， and preoperative GP73 level has a certain value in predicting the survival of these patients after hepatectomy. The integrated prognostic model incorporating GP73 can help to optimize postoperative risk stratification， thereby providing a basis for decision-making in precise treatment of HCC.

Objective To analyze the electrophysiological and genetic examination results of children with congenital stationary night blindness(CSNB)without fundus abnormalities.Methods A retrospective study was conducted on 11 children diagnosed with CSNB in our department from August 2019 to March 2025.Their full-field electroretinogram(ffERG)and the results of genetic testing were analyzed.Results Among the 11 patients,there were 10 males and 1 female,at a mean age of 7.5±2.1 years.In the optometry,1 patient had hyperopia and the other had myopia,and all of them obtained a corrected visual acuity of 0.48±0.11 after wearing glasses.In fundus photography examination,except for the leopard pattern changes in high myopia,no obvious abnormalities were found in the remaining fundus.In ffERG examination for all patients,the amplitude of the a-wave of scotopic ERG 3.0/10.0 was normal or slightly to moderately decreased,the amplitude of the b-wave was decreased significantly,and the amplitude ratio of the b-wave to the a-wave was<1,showing a negative-phase wave,which belonged to the CSNB Schubert-Bornschein waveform.The results of genetic test revealed that all the 11 patients carried pathogenic mutations,including 6 cases with CACNA1F mutations,2 cases with GPR179 mutations,2 cases with NYX mutations,and 1 case with GRM6 mutation.Conclusion For children with normal fundus manifestations but corrected visual acuity lower than normal after wearing glasses,ffERG examination should be carried out as soon as possible to screen for CSNB,and a diagnosis should be made in combination with genetic testing.This is helpful for evaluating the heredity and prognosis of the disease,increasing the chance of early detection,and reducing excessive amblyopia training and treatment.

OBJECTIVE To systematically analyze the functional system and construction requirements for infection prevention and control('infection control system'in short)in medical institutions so as to facilitate the effective,standardized and practical construction of the infection control system.METHODS The questionnaires were de-signed based on the relevant criteria and literatures that were released in China with the combination of expect con-sultant and were distributed to experts or professionals involving multiple fields such as hospital infection manage-ment,clinical medical treatment and information technology.The questionnaires were recycled,summarized and analyzed.RESULTS The list of functions of the infection control system(consultative draft)was formulated after review of literatures and expert consultation,including fundamental functions such as data management,case sur-veillance and intervention feedback as well as the advanced functions like target surveillance,occupational protec-tion and interconnection.The surveyed subjects agreed unanimously after the questionnaire survey that all of the function modules and elements enlisted were important,the average score of importance was more than 4 points,the score of coefficient of variable(CV)for importance of the function modules was less than 0.25,indicating that there was high consistency in the opinions among the surveyed subjects.The element of tracing and epidemiologi-cal survey function was adopted and added according to the feedback suggestions from some of the subjects;two function elements including data query and clinical interaction were revised,and the list of function requirements for the infection control systems was finally defined.CONCLUSION The requirements for functions of the infection control system that are determined in the study can provide important bases and data support for the research and standardized development of future infection control system.

[This corrects the article DOI: 10.1016/j.apsb.2022.03.002.].

Metastasis serves as an indicator of malignancy and is a biological characteristic of carcinomas. Epithelial-mesenchymal transition (EMT) plays a key role in the promotion of tumor invasion and metastasis and in the enhancement of tumor cell aggressiveness. Prostaglandin E synthase 3 (p23) is a cochaperone for heat shock protein 90 (HSP90). Our previous study showed that p23 is an HSP90-independent transcription factor in cancer-associated inflammation. The effect and mechanism of action of p23 on lung cancer metastasis are tested in this study. By utilizing cell models in vitro and mouse tail vein metastasis models in vivo, the results provide solid evidence that p23 is critical for promoting lung cancer metastases by regulating downstream CXCL1 expression. Rather than acting independently, p23 forms a complex with RNA-binding motif protein 14 (RBM14) to facilitate EMT progression in lung cancer. Therefore, our study provides evidence for the potential role of the RBM14-p23-CXCL1-EMT axis in the metastasis of lung cancer.

Objective To design a search and rescue simulation training system to enhance medical command,search and rescue capabilities of the PLA air force.Method A search and rescue simulation training sysgtem was designed based on the war gaming theory and developed with C/S architecture,C++language and MongoDB database for data storage,which was composed of four subsystems for scenario setting,action coordination and commanding operation simulation.The scenario setting subsystem included 3 modules of map editing setting,scenario editing and organization preparation;the action coordination subsystem had 5 modules of deduction process control,deduction coordination intervention,deduction status monitoring,perspective control and addition of deduction conditions;the commanding operation subsystem involved in 3 modules of command and control,real-time information query and operation command;the operation simulation subsy-stem consisted of 3 modules of agent search,rescue and treatment simulation,operation ruling and operation intelligence management.Results The system developed facilitated search,rescue and commanding training-related teaching and search and rescue program rehearsal verification,and thus comprehensively enhanced the trainee's capabilities in search,rescue,commanding and decision making.Conclusion The system developed integrates effectively medical commanding with operational commanding during search and rescue,providing a novel means for air force search and rescue operations and medical service simulation training.[Chinese Medical Equipment Journal,2025,46(4):15-20]

Objective To investigate the relationship between lead exposure and the clinical heterogeneity of amyotrophic lateral sclerosis(ALS).Methods Baseline data were collected from 49 ALS patients hospitalized at the PLA General Hospital.Blood metal levels(copper,zinc,calcium,magnesium,iron,lead)were measured by graphite furnace atomic absorption spectrometry.The Revised ALS Functional Rating Scale(ALSFRS-R)was used to assess the severity of motor function impairment.Patients were grouped by site of onset and ALSFRS-R score,then blood metal levels were compared between two groups.General linear regression,ROC curves and Logistic regression models were applied to analyze the correlation between blood lead levels and disease severity to identify risk factors affecting motor function in ALS patients,and analyze its predictive value.Results The differences of blood metal levels between bulbar onset patients and non-bulbar onset patients were no statistical significance(all P＞0.05).Blood lead levels were significantly lower in the high ALSFRS-R score group than in the low ALSFRS-R score group,and the difference was significant(P=0.02).Blood lead levels were negatively correlated with ALSFRS-R scores in ALS patients(Y=-0.1267X+45.86,R2=0.08937,P=0.04).The area under the ROC curve was 0.70,indicating that blood lead had predictive value for ALS severity.The Logistic regression model demonstrated that elevated blood lead level was an independent risk factor for the severity of ALS disease(OR=1.107,95％CI:1.006-1.219,P=0.04).Conclusions Blood lead levels in ALS patients correlated with disease severity and exhibited predictive utility.Elevated blood lead was an independent risk factor for the severity of motor function impairment in ALS.

Objective:To explore medical students'cognition,current status,and demands regarding practical skills training in a medical college under the background of new medical science.Methods:A cross-sectional survey was conducted among medical undergraduates from Year 1 to Year 5 in a medical college.A self-designed scale was used to investigate the cognition,current status,and demands related to new medical education concepts.Pearson correlation analysis was used to analyze the relationship between satisfaction with practical teaching facilities and variables including understanding of new medical education,curriculum design,and proportion of practical teaching.Multiple linear regression was conducted to investigate the factors influencing satisfaction.Results:Among 1 253 participants,70.71%acquired new medical science information through online media,while 52.99%learned about it via school courses.Over 80%endorsed"whole-cycle health management"(preventive care before disease onset 91.94%,disease treatment 81.72%,and post-illness rehabilitation 82.60%).Experimental courses(85.16%),clinical skills training(66.88%),and social practice(66.24%)were primary practical forms,but the participation rates of research practice(40.78%)and innovation/entrepreneurship practice(34.72%)was comparatively lower.The satisfaction with practical teaching was positively correlated with adequacy of faculty guidance(r=0.707)and curriculum rationality(r=0.522)(P＜0.01).The multiple linear regression analysis showed that faculty guidance(β=0.436)and the proportion of practical teaching(β=0.319)were the key predictors of satisfaction.Conclusion:Medical students'cognition of practical skills training,curriculum optimization,and adequacy of faculty guidance significantly influence satisfaction with practical teaching,with faculty guidance and rationality of practical process playing key roles.

Objective To investigate the changes of diameter of the main trunk of the extracranial segment of the facial nerve,local hemodynamics and facial muscle thickness in patients with peripheral facial palsy(PFP)at acute stage by high frequency ultrasound(HFUS).Methods Sixty patients with acute PFP were enrolled as the PFP group,and 30 healthy people were selected as the control group.The following facial param-eters were scanned and recorded using HFUS:diameter of the main trunk of the extracranial segment of the facial nerve(FN-d),facial artery diameter(FA-d),facial artery systolic velocity(FA-Vs),facial artery diastolic velocity(FA-Vd),facial artery resistance index(FA-RI),frontalis muscle thickness(FM-t),depressor anguli oris muscle thickness(DAO-t),and depressor labii inferioris muscle thickness(DLI-t).The feasibility of facial param-eters in the diagnosis of acute-phase peripheral facial palsy(PFP)was evaluated,with intra-group and inter-group variability comparisons performed.Pearson correlation analysis was conducted to evaluate the relationship between acute-phase facial parameters and House-Brackmann(H-B)scale scores in PFP patients.Results(1)The H-B score of the PFP group was significantly lower than that of the control group,and the difference was statistically significant(P＜0.05).(2)The reliability of repeated measurements of facial parameters by different testers is good(ICC＞0.75).(3)The FN-d and FA-RI values on the affected side of PFP group were higher than those on the healthy side and control group,and FA-Vs,FA-Vd,DAO-t and DLI-t values were lower than those on the healthy side and control group,with statistical significance(P＜0.05).(4)The FN-d and FA-RI values of the affected side in the PFP group were negatively correlated with the H-S scale score(r=-0.847,P＜0.05;r=-0.863,P＜0.05);FA Vs,FA Vd,DAO-t,DLI-t are positively correlated with H-S scale scores(r=0.808,P＜0.05;r=0.757,P＜0.05;r=0.836,P＜0.05;r=0.694,P＜0.05).Conclusions HFUS can effectively detect the characteristic changes such as the increase in the diameter of the extrcranial facial nerve trunk,local microcircula-tion disturbance and facial muscle atrophy in patients with PFP in the acute stage,and the increase and decrease of FN-d,FA Vs,FA Vd,FA-RI,DAO-t,and DLI-t can accurately reflect the improvement or progress of PFP,which has important guiding significance for clinical disease monitoring and efficacy evaluation.

Objective To investigate the relationship between lead exposure and the clinical heterogeneity of amyotrophic lateral sclerosis(ALS).Methods Baseline data were collected from 49 ALS patients hospitalized at the PLA General Hospital.Blood metal levels(copper,zinc,calcium,magnesium,iron,lead)were measured by graphite furnace atomic absorption spectrometry.The Revised ALS Functional Rating Scale(ALSFRS-R)was used to assess the severity of motor function impairment.Patients were grouped by site of onset and ALSFRS-R score,then blood metal levels were compared between two groups.General linear regression,ROC curves and Logistic regression models were applied to analyze the correlation between blood lead levels and disease severity to identify risk factors affecting motor function in ALS patients,and analyze its predictive value.Results The differences of blood metal levels between bulbar onset patients and non-bulbar onset patients were no statistical significance(all P＞0.05).Blood lead levels were significantly lower in the high ALSFRS-R score group than in the low ALSFRS-R score group,and the difference was significant(P=0.02).Blood lead levels were negatively correlated with ALSFRS-R scores in ALS patients(Y=-0.1267X+45.86,R2=0.08937,P=0.04).The area under the ROC curve was 0.70,indicating that blood lead had predictive value for ALS severity.The Logistic regression model demonstrated that elevated blood lead level was an independent risk factor for the severity of ALS disease(OR=1.107,95％CI:1.006-1.219,P=0.04).Conclusions Blood lead levels in ALS patients correlated with disease severity and exhibited predictive utility.Elevated blood lead was an independent risk factor for the severity of motor function impairment in ALS.