Objective:To evaluate the clinical equivalence between a domestic calcipotriol/betamethasone dipropionate ointment and the originator product in the treatment of stable plaque psoriasis.Methods:A multicenter, randomized, double-blind, three-arm, parallel-group, active- and placebo-controlled study was conducted, and 449 patients aged 18 - 65 years with stable plaque psoriasis were enrolled from 25 hospitals (such as the First Affiliated Hospital of China Medical University). Eligible patients had a baseline physician's global assessment (PGA) score of ≥ 3 points, baseline body surface area (BSA) involvement of 5% - 30%, and a target lesion psoriasis area and severity index (TL-PASI) for plaque elevation of ≥ 3 points. Participants were randomly assigned in a 2:2:1 ratio to the test group ( n = 179), reference group ( n = 180), and placebo group ( n = 90), and applied the domestic calcipotriol/betamethasone dipropionate ointment, originator product, and ointment base respectively, once daily in the evening for 4 weeks. Efficacy and safety were assessed at weeks 1, 2, and 4. The primary efficacy endpoints were the treatment success rates and clinical success rates in each group at week 4. The per-protocol set (PPS) was used for the primary efficacy analysis, and the intention-to-treat (ITT) set for supplementary efficacy analysis. Equivalence between the test and reference preparations was tested using the Cochran-Mantel-Haenszel method adjusted for randomization strata. Superiority of the test and reference preparations over the placebo was also tested. Measurement data were compared among the 3 groups using analysis of variance or non-parametric tests, while treatment success rates, clinical success rates, and incidence rates of adverse reactions were compared using the chi-square test. Results:The ITT, PPS, and safety sets included 447, 420, and 448 patients, respectively. In the ITT set, patients were aged 43.6 ± 12.8 years, including 320 (71.6%) males and 127 (28.4%) females, and the disease duration was 11.21 ± 9.05 years; 316 (70.7%) had a PGA score of 3 points and 131 (29.3%) had a PGA score of 4 - 5 points. No significant differences in the baseline characteristics (including age, sex, disease duration and disease severity) were observed among the 3 groups (all P > 0.05). Based on the PPS analysis, the treatment success rates were 57.9% (99/171) in the test group, 50.3% (86/171) in the reference group, and 7.7% (6/78) in the placebo group, and the clinical success rates were 57.9% (99/171), 50.3% (86/171), and 10.3% (8/78), respectively; both the test and reference groups were superior to the placebo group in both treatment and clinical success rates (all P < 0.001) ; the rate differences for treatment success (90% confidence interval [ CI]: -1.3% - 16.4%) and clinical success (90% CI: -1.3% - 16.3%) between the test and reference groups were entirely within the pre-defined equivalence margin (-20% - 20%). Subgroup analyses by baseline PGA scores: for patients with a baseline PGA score of 3 points, the treatment success rates in the test, reference, and placebo groups were 60.8% (73/120), 52.1% (62/119), and 11.1% (6/54), respectively, and the corresponding clinical success rates were 61.7% (74/120), 53.8% (64/119), and 13% (7/54), respectively; the test and reference groups did not differ significantly in treatment or clinical success rates (both P > 0.05), but both showed higher success rates than the placebo group (all P < 0.001) ; the results of statistical comparisons among the 3 groups in patients with a baseline PGA score of 4 - 5 points were consistent with those observed in patients with a baseline PGA score of 3 points. The percentage reductions in PGA and TL-PASI scores from baseline to weeks 1, 2, and 4 showed significant differences among the 3 groups, which were significantly higher in the test and reference groups than in the placebo group (all P < 0.001), but did not differ between the test and reference groups (all P > 0.05). The primary adverse reactions were local skin reactions, such as pruritus, pain, and erythema. The incidence rates of adverse reactions were 8.9% (16/179) in the test group, 7.3% (13/179) in the reference group, and 7.8% (7/90) in the placebo group, with no significant difference among the 3 groups ( P > 0.05) . Conclusions:The domestic calcipotriol/betamethasone dipropionate ointment demonstrated clinical equivalence to the originator product in the treatment of stable plaque psoriasis, and the two agents exhibited comparable efficacy for patients with varying degrees of disease severity, and were comparable in the speed and degree of clinical improvement, with similar favorable safety profiles.

Objective:To establish an automatic classification approach for bone marrow cells based on microscopic hyperspectral imaging and three-dimensional spectral convolutional neural network (Spec-CNN).Methods:The research type is establishment of methodology. The study included 306 newly diagnosed patients' bone marrow smears under Wright's staining from the Department of Hematology of the First Medical Center of the PLA General Hospital from November 1st, 2013 to April 30th, 2024. The high-spectrum data and 4k image data of bone marrow cells were simultaneously collected using a microscopic hyperspectral-4k optical path integrated imaging system (with a spectral resolution of 400—1 000 nm). The high-spectrum data was used for model training, while the 4k image data recognized by morphologists was only used as a reference for labeling the high-spectrum data. The high-spectrum data set was divided into training set, validation set and test set in a ratio of 14∶6∶5. The training set and validation set were used to train and fine-tune the Spec-CNN model, and the test set was used to evaluate the model performance. The sensitivity, specificity ,accuracy ,and Kappa coefficient were calculated for comparing the manual annotation results as gold standard with the intelligent identification results of the Spec-CNN model. Five non-data set samples were used for external validation.Results:The acquired hyperspectral data and 4k imaging dataset comprised of 32 categories and 64 800 bone marrow cells. In the test set, the Spec-CNN model demonstrated weighted-average indicators on classification metrics across 32 cell types: sensitivity 87.79%, specificity 99.31%, and accuracy 98.78%, and Kappa coefficient 0.869. For external validation, the mean correct identification rate of bone marrow cells reached 83.28%.Conclusion:We successfully established an automatic classification method of bone marrow cells based on microscopic hyperspectral imaging and three-dimensional Spec-CNN. This method has a good automatic classification ability for 32 types of bone marrow nucleated cells, which has a certain auxiliary effect on improving the diagnosis efficiency of blood diseases for bone marrow morphologists.

Objective:To evaluate the clinical equivalence between a domestic calcipotriol/betamethasone dipropionate ointment and the originator product in the treatment of stable plaque psoriasis.Methods:A multicenter, randomized, double-blind, three-arm, parallel-group, active- and placebo-controlled study was conducted, and 449 patients aged 18 - 65 years with stable plaque psoriasis were enrolled from 25 hospitals (such as the First Affiliated Hospital of China Medical University). Eligible patients had a baseline physician's global assessment (PGA) score of ≥ 3 points, baseline body surface area (BSA) involvement of 5% - 30%, and a target lesion psoriasis area and severity index (TL-PASI) for plaque elevation of ≥ 3 points. Participants were randomly assigned in a 2:2:1 ratio to the test group ( n = 179), reference group ( n = 180), and placebo group ( n = 90), and applied the domestic calcipotriol/betamethasone dipropionate ointment, originator product, and ointment base respectively, once daily in the evening for 4 weeks. Efficacy and safety were assessed at weeks 1, 2, and 4. The primary efficacy endpoints were the treatment success rates and clinical success rates in each group at week 4. The per-protocol set (PPS) was used for the primary efficacy analysis, and the intention-to-treat (ITT) set for supplementary efficacy analysis. Equivalence between the test and reference preparations was tested using the Cochran-Mantel-Haenszel method adjusted for randomization strata. Superiority of the test and reference preparations over the placebo was also tested. Measurement data were compared among the 3 groups using analysis of variance or non-parametric tests, while treatment success rates, clinical success rates, and incidence rates of adverse reactions were compared using the chi-square test. Results:The ITT, PPS, and safety sets included 447, 420, and 448 patients, respectively. In the ITT set, patients were aged 43.6 ± 12.8 years, including 320 (71.6%) males and 127 (28.4%) females, and the disease duration was 11.21 ± 9.05 years; 316 (70.7%) had a PGA score of 3 points and 131 (29.3%) had a PGA score of 4 - 5 points. No significant differences in the baseline characteristics (including age, sex, disease duration and disease severity) were observed among the 3 groups (all P > 0.05). Based on the PPS analysis, the treatment success rates were 57.9% (99/171) in the test group, 50.3% (86/171) in the reference group, and 7.7% (6/78) in the placebo group, and the clinical success rates were 57.9% (99/171), 50.3% (86/171), and 10.3% (8/78), respectively; both the test and reference groups were superior to the placebo group in both treatment and clinical success rates (all P < 0.001) ; the rate differences for treatment success (90% confidence interval [ CI]: -1.3% - 16.4%) and clinical success (90% CI: -1.3% - 16.3%) between the test and reference groups were entirely within the pre-defined equivalence margin (-20% - 20%). Subgroup analyses by baseline PGA scores: for patients with a baseline PGA score of 3 points, the treatment success rates in the test, reference, and placebo groups were 60.8% (73/120), 52.1% (62/119), and 11.1% (6/54), respectively, and the corresponding clinical success rates were 61.7% (74/120), 53.8% (64/119), and 13% (7/54), respectively; the test and reference groups did not differ significantly in treatment or clinical success rates (both P > 0.05), but both showed higher success rates than the placebo group (all P < 0.001) ; the results of statistical comparisons among the 3 groups in patients with a baseline PGA score of 4 - 5 points were consistent with those observed in patients with a baseline PGA score of 3 points. The percentage reductions in PGA and TL-PASI scores from baseline to weeks 1, 2, and 4 showed significant differences among the 3 groups, which were significantly higher in the test and reference groups than in the placebo group (all P < 0.001), but did not differ between the test and reference groups (all P > 0.05). The primary adverse reactions were local skin reactions, such as pruritus, pain, and erythema. The incidence rates of adverse reactions were 8.9% (16/179) in the test group, 7.3% (13/179) in the reference group, and 7.8% (7/90) in the placebo group, with no significant difference among the 3 groups ( P > 0.05) . Conclusions:The domestic calcipotriol/betamethasone dipropionate ointment demonstrated clinical equivalence to the originator product in the treatment of stable plaque psoriasis, and the two agents exhibited comparable efficacy for patients with varying degrees of disease severity, and were comparable in the speed and degree of clinical improvement, with similar favorable safety profiles.

Objective To explore the efficacy of the"one disease,one product"rehabilitation nursing under the follow-up nursing mode in the postoperative recovery process of patients with carpal tunnel syndrome(CTS).Methods A total of 100 CTS patients who were admitted to The Second Affiliated Hospital of Naval Medical University from January 2022 to December 2023 were randomly assigned to observation group or control group,with 50 patients in each group.The control group was given a routine postoperative rehabilitation nursing,while the observation group was additionally given the"one disease,one product"rehabilitation nursing under follow-up care.The clinical efficacy,visual analogue scale(VAS)score,quality-of-life score,psychological status score(self-rating depression scale[SDS]and self-rating anxiety scale[SAS]),wrist recovery(grip strength,pinch strength,patient rated wrist evaluation[PRWE]score),and nursing satisfaction were compared between the two groups.Results The total effective rate in the observation group was significantly higher than that in the control group(98.00%[49/50]vs.86.00%[43/50],P<0.05).After treatment,VAS score,SDS score,and SAS score were decreased,and quality-of-life scores,grip strength,pinch strength,and PRWE score were increased in both groups;VAS score,SDS score,and SAS score in the observation group were significantly lower than those in the control group,while quality-of-life scores,grip strength,pinch strength,and PRWE score in the observation group were significantly higher than those in the control group(all P<0.05).Patient satisfaction in the observation group was significantly higher than that in the control group(98.00%[49/50]vs.88.00%[44/50],P<0.05).Conclusion The"one disease,one product"rehabilitation nursing program under the follow-up nursing mode has a better application effect than routine postoperative rehabilitation nursing plan in postoperative nursing of patients with CTS.

Objective To investigate the effect and mechanism of melatonin on the anoikis of melanoma cells.Methods The drug concentration of melatonin inhibiting melanoma cell line B16-F10 was optimized based on the effect on CCK-8 assay.An anti-anoikis of melanoma cell model was developed and divided it into four groups:The blank control group,the TrkB activator group,the melatonin group and the melatonin+TrkB activator group.Calce-in AM/EthD-1 fluorescence double staining was used to detect the anoikis of melanoma cells.Reactive oxygen spe-cies were detected using the fluorescent probe DCFH-DA.Western blot was used to detect the expression of Nrf2 protein and TrkB protein in each group.Results Melatonin significantly inhibited the proliferation of melanoma cells in a time-and dose-dependent manner with IC50 of 1×10-7 μmol/L.Its inhibitory effect was found to be related to in-duction of anoikis of melanoma cells.Melatonin could upregulate the generation of cellular reactive oxygen species(P<0.05),while addition of TrkB activator antagonized this effect.Melatonin could reduce the expression of Nrf2 protein and TrkB protein in melanoma cells(P<0.05),and the addition of TrkB activator could inhibite the effect of melatonin on the expression of Nrf2 protein and TrkB protein(P<0.05).Conclusions Melatonin can inhibit the pro-liferation of melanoma cell line B16-F10 through the mechanism of inducing anoikis.

Objective To address operational challenges in hospital inpatient department layouts,such as resource misallocation,it proposes an integrated Systematic Layout Planningand(SLP)-Quadratic Assignment Problem(QAP)optimization method.By quantifying functional correlations among departments and patient flow density,this approach aims to reconfigure floor layouts to enhance operational efficiency and management effectiveness.Methods Based on three-year disease data,one-year departmental flow data,and inter-floor distance measurements from a tertiary hospital in Deyang City,a dual-dimensional"function-process"correlation matrix was constructed.The QAP model was then applied to transform multi-objective optimization into a mathematical programming problem,and a Hybrid Encoding Genetic Algorithmwas utilized to generate floor allocation schemes prioritizing clinical collaboration and resource-intensive allocation.Results The optimized layout reduced total operational costs(flow×distance)by 27.6%,achieved adjacent placement for high-frequency collaborative departments,and allocated high-traffic departments to floors adjacent to core functional areas.Conclusion From an operational optimization perspective,this study establishes a data-driven decision-making tool for hospital layout reconfiguration.The integrated SLP-QAP model enhances inter-departmental collaboration and resource allocation efficiency,aligning with the requirements of the Healthy China 2030 Planning Outline.Future research should incorporate dynamic cost forecasting and regional disease spectrum adaptation mechanisms to improve the long-term management value of the model.

Objective To address operational challenges in hospital inpatient department layouts,such as resource misallocation,it proposes an integrated Systematic Layout Planningand(SLP)-Quadratic Assignment Problem(QAP)optimization method.By quantifying functional correlations among departments and patient flow density,this approach aims to reconfigure floor layouts to enhance operational efficiency and management effectiveness.Methods Based on three-year disease data,one-year departmental flow data,and inter-floor distance measurements from a tertiary hospital in Deyang City,a dual-dimensional"function-process"correlation matrix was constructed.The QAP model was then applied to transform multi-objective optimization into a mathematical programming problem,and a Hybrid Encoding Genetic Algorithmwas utilized to generate floor allocation schemes prioritizing clinical collaboration and resource-intensive allocation.Results The optimized layout reduced total operational costs(flow×distance)by 27.6%,achieved adjacent placement for high-frequency collaborative departments,and allocated high-traffic departments to floors adjacent to core functional areas.Conclusion From an operational optimization perspective,this study establishes a data-driven decision-making tool for hospital layout reconfiguration.The integrated SLP-QAP model enhances inter-departmental collaboration and resource allocation efficiency,aligning with the requirements of the Healthy China 2030 Planning Outline.Future research should incorporate dynamic cost forecasting and regional disease spectrum adaptation mechanisms to improve the long-term management value of the model.

Objective:To establish an automatic classification approach for bone marrow cells based on microscopic hyperspectral imaging and three-dimensional spectral convolutional neural network (Spec-CNN).Methods:The research type is establishment of methodology. The study included 306 newly diagnosed patients' bone marrow smears under Wright's staining from the Department of Hematology of the First Medical Center of the PLA General Hospital from November 1st, 2013 to April 30th, 2024. The high-spectrum data and 4k image data of bone marrow cells were simultaneously collected using a microscopic hyperspectral-4k optical path integrated imaging system (with a spectral resolution of 400—1 000 nm). The high-spectrum data was used for model training, while the 4k image data recognized by morphologists was only used as a reference for labeling the high-spectrum data. The high-spectrum data set was divided into training set, validation set and test set in a ratio of 14∶6∶5. The training set and validation set were used to train and fine-tune the Spec-CNN model, and the test set was used to evaluate the model performance. The sensitivity, specificity ,accuracy ,and Kappa coefficient were calculated for comparing the manual annotation results as gold standard with the intelligent identification results of the Spec-CNN model. Five non-data set samples were used for external validation.Results:The acquired hyperspectral data and 4k imaging dataset comprised of 32 categories and 64 800 bone marrow cells. In the test set, the Spec-CNN model demonstrated weighted-average indicators on classification metrics across 32 cell types: sensitivity 87.79%, specificity 99.31%, and accuracy 98.78%, and Kappa coefficient 0.869. For external validation, the mean correct identification rate of bone marrow cells reached 83.28%.Conclusion:We successfully established an automatic classification method of bone marrow cells based on microscopic hyperspectral imaging and three-dimensional Spec-CNN. This method has a good automatic classification ability for 32 types of bone marrow nucleated cells, which has a certain auxiliary effect on improving the diagnosis efficiency of blood diseases for bone marrow morphologists.

Objective:To investigate the application value of a multi-dimensional digital moni-toring platform for perioperative period in gastric cancer patients.Methods:The retrospective cohort study was conducted. The clinical data of 50 patients who underwent laparoscopic radical gastrec-tomy in The Affiliated Hospital of Nanjing University of Chinese Medicine from July 2022 to January 2024 were collected. There were 35 males and 15 females, aged (64±12)years. All patients followed the concept of enhanced recovery after surgery, and the multi-dimensional digital monitoring platform based on wearable monitoring equipment was used to implement perioperative management measures. Observation indicators: (1) results of heart rate variability (HRV) monitoring; (2) results of blood glucose and blood oxygen monitoring; (3) results of exercise and sleep monitoring; (4) results of body composition monitoring. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(IQR). Repeated measurement data were analyzed using the repeated ANOVA. Measurement data with skewed distri-bution were transformed to normal distribution by SPSS transformation function before testing. For comparison between pre- and postoperation, paired sample t test was used for measurement data with normal distribution, and nonparametric Wilcoxon signed rank sum test was used for measure-ment data with skewed distribution. Results:(1) Results of HRV monitoring. From preoperation to the third day after surgery, the standard deviation normal to normal heart beat of 50 patients was changed from(103±26)ms to(101±36)ms, the mean of the standard deviations of normal to normal heart beat calculated per 5 min segment was changed from (45±16)ms to(33±12)ms, the number of pairs of adjacent NN intervals differing by more than 50 ms in the entire recording was changed from 6.02%(4.96%) to 5.79%(4.20%), the low frequency power was changed from 376.78(468.96)ms 2 to 742.79(525.20)ms 2, the high frequency power was changed from 273.61(273.58)ms 2 to 397.48(164.87)ms 2, the ratio of low frequency power to high frequency power was changed from 1.6±0.5 to 1.6±0.6, showing significant differences in above indicators before and after operation ( F=34.43, 26.15, 24.58, 5.51, 6.11, 6.02, P<0.05). (2) Results of blood glucose and blood oxygen monitoring. From preoperation to the third day after surgery, the blood glucose of 50 patients was changed from 6.75(2.05)mmol/L to 6.90(2.63)mmol/L, showng a significant difference before and after operation ( F=45.84, P<0.05). The blood oxygen was changed from 97.00%(5.00%) to 97.50%(3.00%), showing no significant difference before and after operation ( F=2.25, P>0.05). (3) Results of exercise and sleep monitoring. From preoperation to the third day after surgery, the number of steps fo 50 pati-ents was changed from 3 043(1 224) to 1 473(767), sleep duration was changed from(8.2±1.1)hours to(7.3±0.8)hours, sleep score was changed from 80±10 to 78±5,showing significant differences in above indicators before and after operation ( F=716.46, 29.02, 47.32, P<0.05).(4) Results of body composition monitoring. The body weight of 50 patients was changed from (63±8)kg to(61±8)kg before and after operation, body fat rate was changed from 24%±8% to 22%±9%, muscle mass was changed from 43 (12)kg to 41(17)kg, body mass index was changed from (23.0±2.6)kg/m 2 to(22.1±2.5)kg/m 2, showing significant differences in above indicators before and after operation ( t=8.19, 3.00, Z=-2.78, t=7.34, P<0.05), while there was no significant difference in basal metabolic indicators from (1 390±134)kcal to (1 379±139)kcal before and after operation ( t=1.02, P>0.05). Conclusion:The multi-dimensional digital monitoring platform for preoperative period can accurately monitor the perioperative stress level and evaluate the postoperative recovery of gastric cancer patients, which can present the visual results.

Objective To establish a nomogram model for predicting clinical pregnancy rate in patients with endometriosis undergoing fresh embryo transfer.Methods We retrospectively collected the data of 464 endometriosis patients undergoing fresh embryo transfer,who were randomly divided into a training dataset(60%)and a testing dataset(40%).Using univariate analysis,multiple logistic regression analysis,and LASSO regression analysis,we identified the factors associated with the fresh transplantation pregnancy rate in these patients and developed a nomogram model for predicting the clinical pregnancy rate following fresh embryo transfer.We employed an integrated learning approach that combined GBM,XGBOOST,and MLP algorithms for optimization of the model performance through parameter adjustments.Results The clinical pregnancy rate following fresh embryo transfer was significantly influenced by female age,Gn initiation dose,number of assisted reproduction cycles,and number of embryos transferred.The variables included in the LASSO model selection included female age,FSH levels,duration and initial dose of Gn usage,number of assisted reproduction cycles,retrieved oocytes,embryos transferred,endometrial thickness on HCG day,and progesterone level on HCG day.The nomogram demonstrated an accuracy of 0.642(95%CI:0.605-0.679)in the training dataset and 0.652(95%CI:0.600-0.704)in the validation dataset.The predictive ability of the model was further improved using ensemble learning methods and achieved predicative accuracies of 0.725(95%CI:0.680-0.770)in the training dataset and 0.718(95%CI:0.675-0.761)in the validation dataset.Conclusions The established prediction model in this study can help in prediction of clinical pregnancy rates following fresh embryo transfer in patients with endometriosis.