ObjectiveTo compare the effect of diaphragmatic and abdominal breathing training on the morphology and function of deep trunk muscles in patients with chronic nonspecific low back pain. MethodsFrom March to May, 2025, a total of 37 patients with chronic nonspecific low back pain recruited at Xi 'an Physical Education University, were randomly divided into control group (n = 12), abdominal breathing group (n = 12) and diaphragmatic breathing group (n = 13). All groups received transcutaneous electrical nerve stimulation and core stability training. On this basis, the abdominal breathing group was added with abdominal breathing training, and the diaphragmatic breathing group was added with diaphragmatic breathing training, for six weeks. The degree of pain was evaluated with Visual Analogue Scale (VAS) before and after intervention, while the activation levels of multifidus and transversus abdominis were evaluated with the root mean square value (RMS) of surface electromyography, and the thickness of the multifidus muscle, transverse abdominis muscle, diaphragm and diaphragm mobility were evaluated with musculoskeletal ultrasound. ResultsAfter intervention, all the indicators improved in all the groups (P < 0.001), except for the diaphragm thickness and mobility in the control group. All the effects (F > 4.634, P < 0.016) of VAS score were significant, and were better in the diaphragmatic/abdominal breathing groups than in the control group (P < 0.01). The intra-group effects (F > 64.869, P < 0.001) and interaction effects (F > 12.379, P < 0.001) of muscle morphology and function indexes were significant, and the RMS of multifidus and transversus abdominis, left multifidus thickness, bilateral transversus abdominis thickness, diaphragm thickness, and diaphragm excursion was better in the diaphragmatic breathing group than in the control group and the abdominal breathing group (P < 0.001), while bilateral transversus abdominis RMS, diaphragm excursion, and right multifidus thickness were better in the abdominal breathing group than in the control group (P < 0.037). ConclusionThe combination of diaphragmatic/abdominal breathing exercises can further improve the morphology and function of the deep muscles of trunk in patients with chronic nonspecific low back pain, and diaphragmatic breathing may be superior to abdominal breathing.

This article outlines the systematic radiological approach preoperative evaluation of perihilar cholangiocarcinoma (pCCA) using CT and MRI to provide key information regarding the suitability for curative surgical resection. It discusses older classification systems (BismuthCorlette, Memorial Sloan Kettering Cancer Center T staging) and follows the Korean Society of Abdomi­nal Radiology 2019 consensus recommendations for step-by-step assessment.The correlation between radiological, surgical, and pathological findings is illustrated through a pictorial review of pathologically proven cases. Benign and malignant mimics of pCCA are included to provide a comprehensive overview.

This article outlines the systematic radiological approach preoperative evaluation of perihilar cholangiocarcinoma (pCCA) using CT and MRI to provide key information regarding the suitability for curative surgical resection. It discusses older classification systems (BismuthCorlette, Memorial Sloan Kettering Cancer Center T staging) and follows the Korean Society of Abdomi­nal Radiology 2019 consensus recommendations for step-by-step assessment.The correlation between radiological, surgical, and pathological findings is illustrated through a pictorial review of pathologically proven cases. Benign and malignant mimics of pCCA are included to provide a comprehensive overview.

This article outlines the systematic radiological approach preoperative evaluation of perihilar cholangiocarcinoma (pCCA) using CT and MRI to provide key information regarding the suitability for curative surgical resection. It discusses older classification systems (BismuthCorlette, Memorial Sloan Kettering Cancer Center T staging) and follows the Korean Society of Abdomi­nal Radiology 2019 consensus recommendations for step-by-step assessment.The correlation between radiological, surgical, and pathological findings is illustrated through a pictorial review of pathologically proven cases. Benign and malignant mimics of pCCA are included to provide a comprehensive overview.

Neuroimmunological diseases are immune-mediated neurological disorders, such as neuromyelitis optica spectrum disorders, multiple sclerosis, and myasthenia gravis. With several monoclonal antibodies that target B cells approved and marketed, the treatment of neuroimmune diseases experienced rapid advances. Despite these successes, challenges remain, particularly for patients who do not respond to conventional therapies, underscoring the need for innovative approaches. Since initial success in the treatment of B cell-derived malignancies, chimeric antigen receptor T (CAR-T) cell therapy as a novel cellular therapy has shown dramatic therapeutic potential in neuroimmunological diseases recently. In this review, the therapeutic evidence, research progress and the challenges of CAR-T cell therapies targeting B cells in neuroimmunological diseases are summarized, providing a novel perspective for the treatment of neuroimmunological diseases.

Neuroimmunological diseases are immune-mediated neurological disorders, such as neuromyelitis optica spectrum disorders, multiple sclerosis, and myasthenia gravis. With several monoclonal antibodies that target B cells approved and marketed, the treatment of neuroimmune diseases experienced rapid advances. Despite these successes, challenges remain, particularly for patients who do not respond to conventional therapies, underscoring the need for innovative approaches. Since initial success in the treatment of B cell-derived malignancies, chimeric antigen receptor T (CAR-T) cell therapy as a novel cellular therapy has shown dramatic therapeutic potential in neuroimmunological diseases recently. In this review, the therapeutic evidence, research progress and the challenges of CAR-T cell therapies targeting B cells in neuroimmunological diseases are summarized, providing a novel perspective for the treatment of neuroimmunological diseases.

ObjectiveTo describe the epidemic characteristics of COVID-19 after policy adjustment from “Category B notifiable disease with category A management” to “Category B notifiable disease with category B management”， and to explore the protective effect of previous infection with SARS-CoV-2 on common symptoms of reinfection. MethodsHealthcare workers infected with SARS-CoV-2 in a grade A tertiary hospital in Shanghai were included in the study from December 4， 2022 to January 11， 2023. Data on demographic characteristics， clinical symptoms， medical history， and COVID-19 vaccination history were collected. We determined the epidemiological curve and characteristics， and then compared the difference in the severity of clinical symptoms between primary and reinfection subjects. ResultsA total of 2 704 cases were included in the study， of which 45 had reinfection， 605 （22.4%）were males， 608 （22.5%）were doctors， 1 275 （47.2%） were nurses， and 2 351 （86.9%） received ≥3 doses of COVID-19 vaccination. The average age of these healthcare workers was （34.9±9.1） years old. The number of cases with mild/moderate illness， asymptomatic infection， fever， headache， dry cough， expectoration， and chest tightness were 2 704 （100.0%）， 92 （3.4%）， 2 385 （88.2%）， 2 066 （76.4%）， 1 642 （60.7%）， 1 807 （66.8%）， and 439 （16.2%）， respectively. Reinfection was a protective factor for fever （OR=0.161， P<0.001）， headache （OR=0.320， P<0.001）， and peak body temperature （β=-0.446， P<0.001）. ConclusionFollowing the COVID-19 policy adjustment as a category B notifiable disease， healthcare workers at a grade A tertiary hospital in Shanghai predominantly experiences mild to moderate COVID-19 symptoms. Reinfection results in milder clinical manifestations， with a lower proportion of being asymptomatic.

Objective:To build a data-driven operation and maintenance management model for large-scale medical imaging equipment,and to analyze its application value in medical equipment management.Methods:The data-driven operation and maintenance management mode of large-scale medical imaging equipment was composed of operation and maintenance management mode architecture,equipment health status monitoring management platform architecture,historical data fault diagnosis model architecture and operation and maintenance management.16 medical imaging equipment in clinical use in Chengdu Public Health Clinical Medical Center from January 2020 to February 2022 were selected,and the traditional medical imaging equipment operation and maintenance management mode(referred to as traditional mode)and data-driven large-scale medical imaging equipment operation and maintenance management mode(referred to as data-driven mode)were adopted respectively for management according to different management modes.The imaging effect of equipment image,the frequency of equipment failure,the cost effectiveness of equipment and the satisfaction score of equipment management personnel were compared between the two management modes.Results:The scores of accuracy of diagnosis results,accuracy of patient information,image position qualification rate,image clarity,image pass rate,image quality rate and total image imaging score of the data-driven model were(9.78±1.25)points,(9.88±1.11)points,(9.54±1.08)points,(9.66±1.27)points and(9.83±1.43)points,(9.86±1.63)points and(58.55±1.44)points,respectively,which were higher than those in the traditional mode,the difference was statistically significant(t=4.958,5.268,6.522,4.327,9.765,3.923,21.474,P<0.05).The self-repair and human-made failures occurred 22 times and 10 times respectively in the data-driven model,which were lower than those of the traditional model,and 24 times of long-term use faults,which was higher than that of the traditional model,the difference was statistically significant(x2=4.363,4.294,18.692,P<0.05).The satisfaction scores of radiologists,equipment maintenance personnel,imaging technicians and patients with the data-driven mode were(94.52±6.15)points,(91.19±5.35)points,(89.27±4.93)points and(92.24±5.51)points,respectively,which were higher than those of the traditional mode,the difference was statistically significant(t=6.504,5.534,6.821,9.556,P<0.05).Conclusion:The operation and maintenance management mode based on data driven of large medical imaging equipment can improve the imaging quality of imaging equipment,reduce the incidence of failure,reduce equipment maintenance and maintenance costs,and improve user satisfaction.

Objective To explore the effect of applying comprehensive interventions on promoting pathogen detec-tion before antimicrobial therapy in hospitalized patients.Methods Hospitalized patients who received therapeutic use of antimicrobial agents in a tertiary first-class hospital from January 2020 to December 2021 were selected as the research subjects.Comprehensive intervention measures were implemented from January 2021.The pathogen detec-tion rates,detection classification,and detection rates of key monitored departments before antimicrobial therapy were compared between the pre-intervention group(January-December 2020)and the post-intervention group(Janu-ary-December 2021).Results A total of 10 239 hospitalized patients who received therapeutic use of antimicrobial agents were included in analysis,4 526 cases were in the pre-intervention group and 5 713 cases in the post-interven-tion group.The pathogen detection rates before antimicrobial therapy,before restricted grade antimicrobial therapy,and before special grade antimicrobial therapy after intervention were 94.56％,94.72％,and 96.03％,respective-ly,which were higher than 83.74％,84.47％,and 84.95％before intervention,with statistical significance(all P＜0.05).The detection rate of targeted pathogens after intervention was 64.87％,higher than that before interven-tion(28.04％),with statistically significant difference(P＜0.05).The pathogen detection rates before therapeutic use of antimicrobial agents in departments of critical care medicine,pulmonary and critical care medicine,pediatrics,neurosurgery,and general surgery after intervention were 93.20％,91.17％,92.20％,94.12％,and 91.15％,re-spectively,higher than the rates before intervention,namely 85.00％,82.19％,83.20％,83.33％,and 83.03％,respectively,with statistical significance(all P＜0.05).Conclusion The application of comprehensive intervention measures can improve the pathogen detection rate before antimicrobial therapy of hospitalized patients.Close atten-tion should be paid to the pathogen detection indicators related to healthcare-associated infection diagnosis and for the detection of sterile body fluid.

Objective:To construct a comprehensive evaluation model of equipment operation efficiency,and to explore its application value in process management of large medical equipment.Methods:Based on the driving-pressure-state-impact-response(DPSIR)model,22 evaluation indicators of the operation efficiency of large medical equipment were selected,and the importance of the indicators was evaluated by the composite weight evaluation method.According to the comprehensive evaluation results of the operation efficiency,the management countermeasures for optimal allocation of large medical equipment,the improvement of management processes,the technical support and the improvement of efficiency were formulated.The 61 large medical equipment in clinical use in Public Health Clinical Medical Center of Chengdu from 2019 to 2022 was selected,and the traditional demonstration mode was adopted for process management for 57 devices from 2019 to 2020,the 60 devices(including 56 in the traditional demonstration mode and 4 new ones)from 2021 to 2022 adopted comprehensive evaluation mode for process management.The comprehensive evaluation index,the increase in operating benefit and the recognition of equipment use were compared between the two management modes of large medical equipment.Results:The operation benefit closeness and comprehensive coordination index of large medical equipment managed by comprehensive evaluation mode were(0.91±0.03)and(0.89±0.05),respectively,which were higher than those of the traditional demonstration mode,and the obstacle factor was(0.30±0.09),which was lower than that of the traditional demonstration mode,the difference was statistically significant(t=3.387,3.539,2.912,P<0.05).The increases of the cost-effectiveness,service benefit and development benefit of large medical equipment managed by comprehensive evaluation mode were(2.72±0.97)%,(3.16±0.97)%and(3.90±1.26)%,which were higher than those of traditional demonstration mode,the difference was statistically significant(t=3.428,4.130,4.135,P<0.05).The average scores of the recognition of users for the basic allocation,operation quality,service effect and management level of large medical equipment managed by comprehensive evaluation mode were(90.93±4.26)points,(92.14±4.32)points,(89.75±3.93)points and(92.67±2.94)points,respectively,which were higher than those of the traditional demonstration mode,the difference was statistically significant(t=4.042,5.294,4.438,6.142,P<0.05).Conclusion:The comprehensive evaluation model can improve the process management quality of large medical equipment,improve the operation efficiency of large medical equipment,and improve the recognition of the use of the use of large medical equipment.