ObjectiveTo explore the effect of tele-supervised home-based pulmonary music therapy on respiratory function, exercise capacity and clinical symptoms in patients with chronic obstructive pulmonary disease (COPD). MethodsA total of 96 COPD patients admitted to the Second People's Hospital of Lianyungang from January, 2023 to June, 2024 were selected. They were divided into control group and observation group (48 cases each) using block randomization combined with a random number table. The control group received routine treatment and nursing intervention, while the observation group added tele-supervised home-based pulmonary music therapy, for six months. Evaluations were conducted before intervention and one, three and six months after intervention. ResultsThree cases in the control group and two in the observation group dropped out. Compared to the control group, the observation group was better in forced expiratory volume in one second percentage of predicted (FEV₁%) level six months after intervention (χ² = 10.481, P < 0.001), maximal inspiratory pressure three months (Z = -2.045, P = 0.044) and six months (Z = -3.643, P = 0.033) after intervention, maximal expiratory pressure three months (Z = 2.111, P = 0.036) and six months (Z = 4.025, P < 0.001) after intervention, exercise capacity one month (t = 2.266, P = 0.028), three months (t = 3.943, P = 0.028) and six months (t = 6.703, P < 0.001) after intervention, fatigue scores three months (Z = -4.352, P < 0.001) and six months (Z = -5.718, P < 0.001) after intervention, clinical symptoms three months (t = -2.698, P = 0.007) and six months (t = -2.898, P = 0.003) after intervention, and clinical control levels three months (t = -3.402, P < 0.001) and six months (t = -5.036, P < 0.001) after intervention. ConclusionTele-supervised home-based pulmonary music therapy is beneficial in improving respiratory function, exercise capacity, fatigue, clinical symptoms and clinical control levels in patients with COPD.

ObjectiveTo explore the effect of tele-supervised home-based pulmonary music therapy on respiratory function, exercise capacity and clinical symptoms in patients with chronic obstructive pulmonary disease (COPD). MethodsA total of 96 COPD patients admitted to the Second People's Hospital of Lianyungang from January, 2023 to June, 2024 were selected. They were divided into control group and observation group (48 cases each) using block randomization combined with a random number table. The control group received routine treatment and nursing intervention, while the observation group added tele-supervised home-based pulmonary music therapy, for six months. Evaluations were conducted before intervention and one, three and six months after intervention. ResultsThree cases in the control group and two in the observation group dropped out. Compared to the control group, the observation group was better in forced expiratory volume in one second percentage of predicted (FEV₁%) level six months after intervention (χ² = 10.481, P < 0.001), maximal inspiratory pressure three months (Z = -2.045, P = 0.044) and six months (Z = -3.643, P = 0.033) after intervention, maximal expiratory pressure three months (Z = 2.111, P = 0.036) and six months (Z = 4.025, P < 0.001) after intervention, exercise capacity one month (t = 2.266, P = 0.028), three months (t = 3.943, P = 0.028) and six months (t = 6.703, P < 0.001) after intervention, fatigue scores three months (Z = -4.352, P < 0.001) and six months (Z = -5.718, P < 0.001) after intervention, clinical symptoms three months (t = -2.698, P = 0.007) and six months (t = -2.898, P = 0.003) after intervention, and clinical control levels three months (t = -3.402, P < 0.001) and six months (t = -5.036, P < 0.001) after intervention. ConclusionTele-supervised home-based pulmonary music therapy is beneficial in improving respiratory function, exercise capacity, fatigue, clinical symptoms and clinical control levels in patients with COPD.

ObjectiveTo explore the effect of tele-supervised home-based pulmonary music therapy on respiratory function, exercise capacity and clinical symptoms in patients with chronic obstructive pulmonary disease (COPD). MethodsA total of 96 COPD patients admitted to the Second People's Hospital of Lianyungang from January, 2023 to June, 2024 were selected. They were divided into control group and observation group (48 cases each) using block randomization combined with a random number table. The control group received routine treatment and nursing intervention, while the observation group added tele-supervised home-based pulmonary music therapy, for six months. Evaluations were conducted before intervention and one, three and six months after intervention. ResultsThree cases in the control group and two in the observation group dropped out. Compared to the control group, the observation group was better in forced expiratory volume in one second percentage of predicted (FEV₁%) level six months after intervention (χ² = 10.481, P < 0.001), maximal inspiratory pressure three months (Z = -2.045, P = 0.044) and six months (Z = -3.643, P = 0.033) after intervention, maximal expiratory pressure three months (Z = 2.111, P = 0.036) and six months (Z = 4.025, P < 0.001) after intervention, exercise capacity one month (t = 2.266, P = 0.028), three months (t = 3.943, P = 0.028) and six months (t = 6.703, P < 0.001) after intervention, fatigue scores three months (Z = -4.352, P < 0.001) and six months (Z = -5.718, P < 0.001) after intervention, clinical symptoms three months (t = -2.698, P = 0.007) and six months (t = -2.898, P = 0.003) after intervention, and clinical control levels three months (t = -3.402, P < 0.001) and six months (t = -5.036, P < 0.001) after intervention. ConclusionTele-supervised home-based pulmonary music therapy is beneficial in improving respiratory function, exercise capacity, fatigue, clinical symptoms and clinical control levels in patients with COPD.

Objective To analyze the infection status and epidemic trends of soil-borne nematode infections in Yubei, Chongqing City, in 2010,2021, and 2022. Methods The local populations from four survey sites of four towns in 2010 and five sites of five towns in 2021 and 2022 were surveyed regarding their basic information using a unified form. Fecal samples of the participants were collected and tested for soil-borne nematode infections using the modified Kato-Katz thick smear method. Results In 2010, 2 049 participants were surveyed, followed by 1 000 participants in 2021 and 2022. The overall prevalence of parasitic infections declined significantly from 3.86% to 0.20%. In 2010, soil-transmitted nematode included hookworms(3.81%) and roundworms(0.29%). In 2021, the infection rates of roundworms and hookworms were 1.70% and 0.10% respectively. Notably, only Ascaris was identified in 2022(0.20%). The≥60 age group consistently exhibited the highest infection rates across all surveys, followed by the 40-59 age group. The infection rates of males in the three surveys were 3.31%,1.92%, and 0.20% respectively, and those of females were 4.37%, 1.46%, and 0.20% respectively. There was no statistically significant difference in the infection rates between males and females. Educational attainment was inversely associated with infection; in 2010, the highest prevalence was observed among those with primary education or below, whereas in 2021, illiterate or semi-literate individuals showed the highest susceptibility. The occupational distribution of infections in 2010 indicated that retirees (8.33%), farmers(4.86%), and homemakers or unemployed individuals(3.45%)were the most affected. However, in 2021 and 2022, farmers emerged as the predominant occupational group with soil-transmitted nematode infections. Conclusions The infection rate of soil-borne nematodes showed a decreasing trend in Yubei, and the infection species changed from hookworms in 2010 to Ascaris in 2022. Farmers, the elderly, and people with low education levels should continue to be the focus of preventive and control efforts.

To summarize the clinical practice of continuous medical service for patients at Shanghai Children′s Medical Center, affiliated with Shanghai Jiao Tong University School of Medicine, from September 2023 to December 2024, following the approval of its extended care qualification. This study utilized a mixed-methods research design that integrates quantitative and qualitative approaches. The quantitative study included a total of 117 subjects, with an age range of 18 to 35 years, an average age of 21.56 years, and a median age of 19 years; there were 59 males and 58 females. The disease types covered four major categories: childhood leukemia and solid tumors (68 cases), congenital structural malformations (25 cases), congenital hereditary metabolic diseases (4 cases), and rare diseases (20 cases). Among the subjects, 57.26% (67 cases) were first-time visitors to SCMC. The patients came from 20 provinces, autonomous regions, and municipalities across the country, with 88.03% (103 cases) from outside Shanghai. The treatment outcomes showed improvement or cure in 80.34% (94 cases) of the subjects, and there were no medical complaints. In addition, a qualitative study was conducted to deeply explore the experiences, confusions, and challenges of receiving or implementing continuous medical services from the perspectives of patients and their families, as well as medical staff. According to the inclusion and exclusion criteria, a total of 44 subjects were included in the study, among them, there were 12 patients, 12 family members who were taking care of the patients in SCMC, and 20 corresponding medical staff members. The results of the qualitative study showed that trust in the attending physicians of the children′s specialty hospital, a good doctor-patient relationship, satisfactory treatment outcomes, and support from medical insurance policies are the main driving forces for patients over 18 years old to receive continuous treatment at children′s specialty hospitals. The medical staff of the hospital also believed that this model can promote patient benefits. In conclusion, under the policy support of the Shanghai Municipal Health Commission, the "Six Fixed" Model for continuous treatment established by SCMC has achieved certain positive results in practice. This provides practical references for the development of continuous treatment in China and offers new strategies for the application of preventive medicine in the field of children′s health.

Objective To evaluate the recognition capability of AI-enabled Cellsee CS-BM1 automatic cell morphology analyzer for pe-ripheral blood smears and its roles in assisting manual classification,and explore the application value of AI system in the diagnosis network of tiered primary medical units.Methods The blood samples which triggered the re-examination rules were collected from six primary medical units,including the Laboratory Department of Shanghai Jiahui International Hospital,and so on,from March to No-vember 2023.The smears of peripheral blood were prepared and AI analyzer was used for pre-classification to evaluate its recognition performance in identifying the samples with abnormal WBC and RBC.The sensitivity,specificity,and accuracy of WBC classification by six junior and intermediate technicians,both with and without AI assistance,were analyzed.Additionally,the roles of the AI system in tiered diagnosis of primary medical units were also evaluated.Results The sensitivity,specificity,and accuracy of AI system in recognizing malignant primitive cells were 92.86％,95.16％,and 95.10％,respectively.The sensitivities of AI system in recognizing immature granulocytes,reactive lymphocytes,and nucleated RBCs were all greater than 90％.The sensitivity of AI system in identif-ying abnormal morphology of RBCs reached 99.59％,along with rapid quantitative analysis for various anomalous types of RBCs.In AI-assisted mode,the sensitivity of recognition for all cell types was improved to varying degrees by junior and intermediate technicians,and the sensitivity for recognizing malignant primitive cells,reactive lymphocytes,and immature granulocytes increased to 58.24％,53.39％,and 62.37％for junior technicians,and to 92.06％,83.24％,and 83.12％for intermediate technicians,respectively.The improvements for junior technicians were particularly significant,with increases of 12.46％,10.61％,and 3.71％for each cell type,respectively.Both groups achieved higher specificity and accuracy.Through AI pre-classification and manual review,a variety of pe-ripheral blood cell-related diseases were accurately diagnosed in the tiered healthcare practice of primary medical units,including 339 cases(11.13％)of red blood cell diseases,5 cases(0.16％)of platelet diseases,2 343 cases(76.90％)of infection-related disea-ses,and 28 cases(0.92％)of malignant hematological diseases.In addition,332 cases(10.90％)which lacked an obvious related cause or required further examinations were identified as well.Conclusion AI pre-classification has demonstrated strong cell recogni-tion capabilities and may assist technicians in improving the sensitivity,specificity,and accuracy of blood cell classification.AI could en-hance the disease-screening capabilities in the tiered diagnosis network of primary medical units,presenting a broad application prospect.

Umbilical cord inflammatory myofibroblastic tumor is rare. This article reports a case of a male patient admitted to the hospital due to “difficulty in urination for 1 month”. Physical examination revealed a soft abdomen without tenderness or rebound tenderness in the bladder area，and no abnormal masses were palpated. CT imaging showed a cord-like structure connecting to the mass and extending towards the umbilicus，leading to the anatomical localization diagnosis of an umbilical cord origin. The ring-like enhancement of the tumor capsule was its radiological feature. After completing preoperative preparations，the patient underwent laparoscopic umbilical cord tumor resection and transurethral bladder lesion resection under general anesthesia. During the operation，the bladder was filled with fluid，and a localized mucosal protrusion measuring 3.0 cm × 3.0 cm was observed at the bladder dome. The tumor margin was identified with the guidance of the cystoscope light beam. The bladder tissue was incised layer by layer from the outside to the inside under laparoscopy，and the bladder wall was incised 2 cm away from the tumor margin. After the bladder mucosa was exposed，the bladder was emptied，and the tumor was completely resected. This surgical approach ensured negative surgical margins while maximizing the preservation of bladder tissue. The postoperative pathology indicated inflammatory myofibroblastic tumor of the urachus，with no recurrence observed during a 4-month follow-up.

Objective To evaluate the recognition capability of AI-enabled Cellsee CS-BM1 automatic cell morphology analyzer for pe-ripheral blood smears and its roles in assisting manual classification,and explore the application value of AI system in the diagnosis network of tiered primary medical units.Methods The blood samples which triggered the re-examination rules were collected from six primary medical units,including the Laboratory Department of Shanghai Jiahui International Hospital,and so on,from March to No-vember 2023.The smears of peripheral blood were prepared and AI analyzer was used for pre-classification to evaluate its recognition performance in identifying the samples with abnormal WBC and RBC.The sensitivity,specificity,and accuracy of WBC classification by six junior and intermediate technicians,both with and without AI assistance,were analyzed.Additionally,the roles of the AI system in tiered diagnosis of primary medical units were also evaluated.Results The sensitivity,specificity,and accuracy of AI system in recognizing malignant primitive cells were 92.86％,95.16％,and 95.10％,respectively.The sensitivities of AI system in recognizing immature granulocytes,reactive lymphocytes,and nucleated RBCs were all greater than 90％.The sensitivity of AI system in identif-ying abnormal morphology of RBCs reached 99.59％,along with rapid quantitative analysis for various anomalous types of RBCs.In AI-assisted mode,the sensitivity of recognition for all cell types was improved to varying degrees by junior and intermediate technicians,and the sensitivity for recognizing malignant primitive cells,reactive lymphocytes,and immature granulocytes increased to 58.24％,53.39％,and 62.37％for junior technicians,and to 92.06％,83.24％,and 83.12％for intermediate technicians,respectively.The improvements for junior technicians were particularly significant,with increases of 12.46％,10.61％,and 3.71％for each cell type,respectively.Both groups achieved higher specificity and accuracy.Through AI pre-classification and manual review,a variety of pe-ripheral blood cell-related diseases were accurately diagnosed in the tiered healthcare practice of primary medical units,including 339 cases(11.13％)of red blood cell diseases,5 cases(0.16％)of platelet diseases,2 343 cases(76.90％)of infection-related disea-ses,and 28 cases(0.92％)of malignant hematological diseases.In addition,332 cases(10.90％)which lacked an obvious related cause or required further examinations were identified as well.Conclusion AI pre-classification has demonstrated strong cell recogni-tion capabilities and may assist technicians in improving the sensitivity,specificity,and accuracy of blood cell classification.AI could en-hance the disease-screening capabilities in the tiered diagnosis network of primary medical units,presenting a broad application prospect.

Objective:To explore the safety and efficacy of camrelizumab combined with tegafur gimeracil oteracil potassium (S-1) and albumin-bound paclitaxel in the treatment of initially unresectable cholangiocarcinoma.Methods:From October 2022 to August 2024, 17 patients with unresectable intrahepatic cholangiocarcinoma and 4 patients with hilar cholangiocarcinoma were admitted to Xiangyang Central Hospital. They received treatment with camrelizumab combined with S-1 and nab-paclitaxel. Their short-term efficacy and adverse reactions were evaluated, and their long-term survival was followed up.Results:Of the 21 patients, 2 were in complete remission, 6 were in partial remission, 12 had stable disease, and 1 had progressive disease. The objective remission rate was 38.10% (8/21), and the disease control rate was 95.23% (20/21). Five patients were converted to resectable cholangiocarcinoma, with a conversion success rate of 23.81%,2 patients had complete postoperative pathological remission, and 3 patients had major pathological remission. The median progression-free survival time was 11 months (95% CI: 8.37-13.62), and the 1-year progression-free and overall survival rates were 28.57% and 95.23%, respectively. The overall adverse event rate was 90.48% (19/21), and the grade 3 adverse event rate was 28.57% (6/21). Conclusion:The combination of camrelizumab with S-1 and nab-paclitaxel for initially unresectable cholangiocarcinoma has favorable short-term efficacy, tolerable adverse reactions, and improved long-term survival for patients.

Objective To investigate the effect of local histopathological changes of thyroid nodules after ultrasound-guided fine needle aspiration biopsy(US-FNBA)on laparoscopic thyroid surgery.Methods The clinical data of 120 patients with thyroid malignant tumors admitted to Xiaogan Hospital of Wuhan University of Science and Technology from January 2020 to December 2022 were retrospectively analyzed,and according to whether received US-FNAB before surgery they were divided into the observation group(with US-FNAB)and the control group(without US-FNAB),with 60 cases in each group.The operation time,change of parathyroid hormone(ΔPTH)before and after surgery,change of serum Ca2+concentration(serum ΔCa2+)before and after surgery,drainage volume 24 hours after surgery and incidence of complications were compared between the two groups.According to fine needle aspiration-to-surgery(FTS),the patients in the observation group were further divided into the group A(FTS≤3 days)and the group B(FTS>3 days),and the effect of US-FNAB on laparoscopic thyroid surgery was explored combined with the pathological changes of the thyroid puncture capsule of the two groups.Results The operation time of the observation group was longer than that of the control group(P<0.05),and there was no significant difference in the drainage volume 24 hours after surgery,ΔPTH,serum ΔCa2+,or proportions of facial or limb numbness,hypoparathyroidism,recurrent laryngeal nerve integrity,and hypocalcemia between the two groups(P>0.05).There was no significant difference in the operation time,ΔPTH,serum ΔCa2+,drainage volume 24 hours after surgery,hypocalcemia,recurrent laryngeal nerve integrity or hypothyroidism between the group A and group B(P>0.05).The proportion of patients with facial or limb numbness after surgery in the group A was significantly lower than that in the group B(P<0.05).Conclusion Preoperative US-FNAB for thyroid nodules may prolong the operation time in patients undergoing laparoscopic thyroid surgery,and surgical treatment in early aspiration can help decrease this effect and reduce the incidences of postoperative hypocalcemia and hypothyroidism.