With the rapid development of mobile internet technology, mobile health application (mHealth APP) are increasingly widely used in the field of health management and have been proven to play an important role in the management of chronic diseases. Solid organ transplant recipients face complex health management needs after surgery, including postoperative follow-up, medication management, prevention and treatment of complications and comorbidities, and lifestyle adjustment. mHealth APP can provide solid organ transplant recipients with convenient self-management tools. Although some progress has been made in this field, there are still many challenges, such as insufficient user experience, technological dependence, and data security risks. Therefore, this article discusses the development process, main functions and current application status of mHealth APP, and analyzes its advantages in improving the self-management ability of solid organ transplant recipients, promoting doctor-patient communication and reducing the incidence of complications. At the same time, based on the practical experience of author’s team in developing the “TransMate” mHealth APP, we propose the directions that mHealth APPs should focus on in the future, in order to provide more effective support and services for the health management of solid organ transplant recipients.

Objective: To examine the application of multi-disciplinary treatment (MDT) in the diagnosis and management of recurrence and metastasis of adenoid cystic carcinoma (ACC) of the palate, as well as the treatment of concurrent massive palatal bleeding. This article aimed to provide references for the diagnosis and treatment of patients with advanced oral cancer, along with strategies for managing massive hemorrhage. Methods: This article reported on the MDT process for a patient diagnosed with ACC of the left upper palate, who experienced skull base recurrence and lung metastasis following surgery and radiotherapy. The case was further complicated by massive palatal hemorrhage. Additionally, the article analyzed patients with ACC recurrence and significant hemorrhage in the context of relevant literature. The patient was a 36-year-old female with ACC located in the left palate, initially diagnosed at clinical stage T3N0M0 in 2013. She underwent an extensive resection of the palatal lesion, followed by radioactive 125I seed implantation, which was guided by a radiotherapy planning system (TPS) and a digital guide. The patient was monitored for four years post-surgery, during which no signs of tumor recurrence were observed. However, at the fifth year of follow-up, the patient developed recurrence with lung metastasis, classified as T4N0M1. Following a multidisciplinary consultation involving the oral and maxillofacial surgery, radiotherapy, medical oncology, and thoracic surgery, the patient underwent a procedure comprising left subtotal maxillary resection, autologous free flap transplantation, and thoracoscopic resection of pulmonary metastases. After surgery, the patient received 60 Gy of radiotherapy and was orally administered Anlotinib hydrochloride capsules to suppress tumor growth. After 31 months of follow-up, the patient reported experiencing slight bleeding in the mouth. A craniomaxillofacial CT scan revealed that the tumor had grown aggressively, resulting in destruction of the skull base. Consequently, the patient was admitted to the hospital. On the second day of admission, she experienced a sudden episode of oral bleeding. Despite the application of pressure, the bleeding continued unabated. An emergency tracheotomy was performed to relieve the obstruction of the patient’s respiratory tract, and a red blood cell suspension was transfused to address the hemorrhagic shock. Following an urgent consultation with the vascular interventional surgery department, super-selective embolization was promptly employed to effectively halt the bleeding and achieve rapid vascular occlusion. An individualized treatment plan was developed under MDT, incorporating postoperative radiotherapy, targeted therapies, and immunotherapy to manage the tumor. Results: Through the MDT model, the patient successfully achieved emergency hemostasis, and normal vital signs were restored. With the addition of radiotherapy and immune-targeted drug treatment, tumor progression was effectively controlled, leading to an improved quality of life for the patient, who successfully survived for 129 months with the tumor by July 2024. A review of the relevant literature indicated that MDT offered significant advantages in the management of adenoid cystic carcinoma. In selecting surgical methods, the team administering MDT could comprehensively evaluate factors such as the patient’s age, physical condition, tumor location, size, and extent of invasion to develop a personalized treatment plan. Radical surgical resection was a common treatment option for ACC. Postoperative tissue defects could be restored to their corresponding functions and aesthetic appearance through autologous tissue reconstruction, utilizing techniques such as peroneal myocutaneous flaps or iliac myocutaneous flaps, or by the implantation of artificial materials. In complex cases involving positive margins, recurrence, and metastasis, the MDT model employed interdisciplinary collaboration to devise a comprehensive treatment plan that may have included re-operation, radiotherapy, and chemotherapy, with the aim of minimizing the risk of ACC recurrence and controlling distant metastasis. Massive bleeding resulting from advanced oral cancer presented a complex medical challenge, influenced by various risk factors such as tumor type, metastasis, treatment options, and the patient’s overall condition. Early identification of bleeding risks, along with strategies to mitigate the adverse effects of bleeding on disease progression—through supportive care, medical treatment, surgical intervention, and interventional therapy—could significantly enhance patients’ quality of life. Conclusion The MDT model can provide comprehensive, precise, and personalized treatment plans for patients with advanced oral cancer and massive hemorrhage and improve the effectiveness of treatment strategies.

Background Hypertension is one of the chronic diseases with the highest prevalence in China, and a history of hypertension may potentially exacerbate hearing loss. Investigating the association between long-term blood pressure trends and hearing thresholds could contribute to hearing protection efforts for occupationally noise-exposed populations. Objective By investigating hearing thresholds and blood pressure levels among occupationally noise-exposed workers in an urban rail transit enterprise, and conducting a comprehensive analysis of the association between long-term blood pressure changes and hearing thresholds, to provide data references for health management strategies targeting occupationally noise-exposed workers. Methods Workers exposed to occupational noise at a rail transit enterprise were enrolled as study subjects and underwent pure-tone audiometry. Group-based trajectory modeling was employed to identify blood pressure trajectories. Categorical data were compared using chi-square tests, while normally distributed continuous variables were analyzed via t-tests and analysis of variance (ANOVA). Generalized linear mixed models (GLMMs) were subsequently applied toexamine associations between these trajectory groups and high-frequency hearing thresholds. Results Among 2 002 occupationally noise-exposed workers, the median (P₂₅, P₇₅) age was 32 (28, 35) years, with a median (P₂₅, P₇₅) working tenure of 7 (3, 10) years. In 2019, the positive hypertension rate was 9.04%, with a mean systolic blood pressure (SBP) of (122.97±11.60) mmHg and a mean diastolic blood pressure (DBP) of (76.37±9.02) mmHg. The hearing loss prevalence was 10.1%, showing bilateral high-frequency average hearing thresholds of (17.18±8.71) dB and speech-frequency average thresholds of (13.79±3.46) dB. Three distinct trajectory groups were identified for both SBP and DBP. Compared with other trajectory groups, the high-stable DBP group exhibited significantly higher hearing loss prevalence (χ²=6.34, P=0.042) and elevated high-frequency hearing thresholds (all Ps<0.05). Specifically, within the 30-39 age subgroup, the moderate-stable DBP group demonstrated 1.96 dB lower high-frequency thresholds than the high-stable group [β(95%CI): −1.96 (−3.61, −0.32), P=0.020]. Conclusion Among occupationally noise-exposed workers in a municipal rail transit enterprise, DBP trajectories demonstrated a positive association with high-frequency hearing thresholds. Notably, in young and middle-aged occupationally noise-exposed populations, DBP may exert a more critical influence than SBP on the progression of hearing loss.

AIM:To investigate the influencing factors of dry eye in elderly people aged over 60 years, and to construct a risk nomogram prediction model, so as to provide a reference for the identification of high-risk individuals and the development of preventive strategies.METHODS:A convenience sampling method was used to select 301 people aged over 60 years who attended the ophthalmology outpatient clinic or were hospitalized at the Second Affiliated Hospital of Guangzhou Medical University between July 2023 and December 2023. They were divided into a dry eye group(n=173)and a non-dry eye group(n=128)based on the presence or absence of dry eye. Data from the two groups were compared and a risk prediction model was constructed.RESULTS:Gender, hypertension, meibomian gland dysfunction, frequent use of eye drops, frequent use of electronic products, and frequent exposure to dry environments were significant influencing factors for the occurrence of dry eye in people aged over 60 years(all P<0.05). The nomogram prediction model demonstrated excellent discrimination(AUC=0.86, 95% CI: 0.81-0.90). The calibration curve showed good fit with the ideal curve, indicating high predictive accuracy. The Hosmer-Lemeshow test yielded a P-value of 0.424. The sensitivity was 73% and the specificity was 86%.CONCLUSION:The nomogram predictive model for the risk of dry eye in elderly people aged over 60 years constructed in this study showed good discrimination and calibration. It can serve as an intuitive and effective clinical risk assessment tool, providing a basis for the early identification of high-risk populations and the development of individualized intervention strategies.

Objective: To investigate the influencing factors for vaccination willingness of herpes zoster vaccine (HZV) among the elderly, so as to provide the basis for improving the HZV vaccination strategy for the elderly. Methods: From July 2023 to June 2024, permanent residents aged ≥60 years in Yangzhou City, Jiangsu Province were selected using the multistage random sampling method and probability proportionate to size sampling method. Basic information, disease history, awareness of herpes zoster (HZ) and HZV, vaccination history, and vaccination willingness of HZV were collected through questionnaire surveys. Multivariable logistic regression model was used to analyze the influencing factors for vaccination willingness of HZV among the elderly. Results: Totally 1 209 valid questionnaires were recovered, with an effective recovery rate of 95.95%. The respondents included 657 males (54.34%) and 552 females (45.66%). Among them, 626 (51.78%) individuals were aged 60 -<70 years. There were 113 individuals had vaccination willingness of HZV, with a vaccination willingness rate of 9.35%. The multivariable logistic regression analysis showed that female (OR=2.872, 95%CI: 1.624-5.080), urban (OR=4.909, 95%CI: 2.732-8.818), individual monthly income of 1 000-<2 000 yuan (OR=3.085, 95%CI: 1.602-5.940), accessibility of vaccination clinics (OR=5.717, 95%CI: 1.109-29.462), presence of chronic diseases (OR=2.423, 95%CI: 1.325-4.431), history of varicella infection (OR=2.114, 95%CI: 1.213-3.684), awareness of HZ (OR=2.194, 95%CI: 1.096-4.394), awareness of HZV (OR=3.562, 95%CI: 2.005-6.330), history of influenza vaccine vaccination (OR=7.833, 95%CI: 4.189-14.645), and history of 23-valent pneumococcal vaccine vaccination (OR=2.955, 95%CI: 1.603-5.449) were promoting factors for vaccination willingness of HZV. Conclusion The vaccination willingness rate of HZV among the elderly is relatively low, which is mainly affected by factors such as gender, residence, individual monthly income, accessibility of vaccination clinics, presence of chronic diseases, history of varicella infection, awareness of HZ and HZV, and history of influenza vaccine and 23-valent pneumococcal vaccine vaccination.

An important issue facing university education is the adaptation and transformation of freshmen.In order to guide students to adapt to the needs of research-based learning,Jilin University has opened a freshman seminar for all first-year undergraduate students,emphasizing the cultivation of students'thinking patterns and learning abilities.For medical students,it is necessary to ap-ply the learned medical knowledge to clinical problem analysis.Therefore,it is particularly important to cultivate students'integrated thinking from basic to clinical at the beginning of enrollment.In recent years,organ system integration has gradually been carried out in medical schools both domestically and internationally.In the course of integrating the immune system and diseases,the morphology of the immune system is relatively abstract and difficult to observe.In the early stages of enrollment,students still lack the thinking of organ system integration,and the initial stage of immune system integration courses is difficult to carry out.Therefore,we aimed to guide students towards adaptability and academic transformation through freshman seminars,explored the integration of the immune system's organ system as a pathway,and used the BOPPPS teaching model as a means for preliminary exploration.In the freshman seminar,the main focus is on the"morphology and structure-mechanism and function-disease-diagnosis-treatment"of the immune sys-tem,helping students establish a learning mindset that integrates disease diagnosis and treatment based on basic medical courses such as immunology and anatomy.Using BOPPPS to reform the"teaching"of teachers,establishing a student-centered teaching model from six aspects:bridge,objective,pre-assessment,participatory learning,post-assessment and summary,can better guide students to actively think and participate in the entire learning process,focus on the construction of students'fragmented knowledge thinking mode,internalize medical humanities literacy,and improve the quality of medical talent cultivation in colleges and universities.

Objective:To investigate the risk factors for lung metastasis from differentiated thyroid cancer (DTC), predict the occurrence of lung metastasis, and diagnose lung metastasis early.Methods:From April 2013 to May 2023, 442 DTC patients (145 males, 297 females; age (41.6±13.1) years) who received 131I treatment in the First Affiliated Hospital of the Air Force Medical University were retrospectively analyzed. All patients were divided into lung metastasis group ( n=124) and non-lung metastasis group ( n=318) according to pathology or clinical, imaging and laboratory test results. Patients were randomly divided into training set ( n=309) and validation set ( n=133) at the ratio of 7∶3. The differences of clinical data between the two groups were compared by χ2 test and Mann-Whitney U test. Factors affecting lung metastasis were analyzed by multivariate logistic regression analysis. ROC curve analysis was used to evaluate the predictive ability of the model. Results:The differences of sex, primary tumor type, multifocal, extra thyroid tissue invasion, number of operations, thyroglobulin (Tg) level before 131I treatment, maximum diameter of primary lesion, lymphocyte absolute value, neutrophil absolute value and B-Raf proto-oncogene, serine/threonine kinase (BRAF) V600E mutation between the two groups were statistically significant ( χ2 values: 7.72-107.77, z values: from -6.50 to -2.44, all P<0.05). Multivariate logistic regression analysis showed that multifocal (odds ratio ( OR)=5.646, 95% CI: 1.763-18.089, P=0.004), BRAF V600E mutation ( OR=0.184, 95% CI: 0.062-0.543, P=0.002), Tg level before 131I treatment ( OR=1.015, 95% CI: 1.004-1.025, P=0.005), lymphocyte absolute value ( OR=0.395, 95% CI: 0.166-0.940, P=0.036) and maximum diameter of primary lesion ( OR=1.932, 95% CI: 1.207-3.093, P=0.006) were independent factors affecting lung metastasis. The AUCs of the training set and validation set obtained by the nomogram prognostic model were 0.899 and 0.889, respectively. Conclusion:Large primary tumor, multiple focus, non-mutated BRAF V600E gene, high Tg level before 131I treatment and low lymphocyte absolute value may be considered as risk factors for lung metastasis of DTC.

Objective:To analyze the effect of comprehensive rehabilitation intervention on the physical functioning of frail elderly persons.Methods:A total of 318 frail elderly persons were randomly divided into a control group ( n=164) and an observation group ( n=154) to test different interventions. Propensity score matching was used to balance the baseline information between the two groups 1∶1. A total of 200 cases were successfully matched, with 100 cases in each group. Both groups received drug treatment and routine nursing, while the observation group was additionally provided with comprehensive rehabilitation. Before and after 4 weeks of the treatment, both groups were evaluated using visual analogue scale (VAS) scoring for their perception of pain intensity, hand grip strength, gait speed, 6-minute walking distance (6MWD), 5 sit-up time, and the timed up and go test (TUGT). Results:There were no significant differences between the groups in any of the measurements before the experiment. Afterward, all of the outcome measures except gait speed were significantly better among the experimental group than among the controls, on average.Conclusions:Comprehensive rehabilitation can relieve pain, improve the walking, handgrip strength and exercise endurance of the frail elderly.

Objective To explore the efficacy and safety of subretinal injection of conbercept in treating refractory neovascular age-related macular degeneration(nAMD).Methods In this prospective clinical study,17 eyes of 17 pa-tients diagnosed with refractory nAMD at the Department of Fundus Disease,the Affiliated Eye Hospital of Nanchang Uni-versity from March 2022 to September 2023 were enrolled.The 10 g·L-1 conbercept was injected into the subretinal area of the macular area using a 41G ultra-fine microneedle.If retinal exudation was found in the macular area by optical coherence tomography during the follow-up,the intravitreal injection of 10 g·L-1 conbercept was performed.The best corrected vis-ual acuity(BCVA),central macular retinal thickness(CMT),number of injections and complications were recorded before and 1,3,6,and 12 months after the operation.Results Compared with the preoperative values,the BCVA of patients significantly improved(all P＜0.001)1,3,6 and 12 months postoperatively.There was no significant change in BCVA at each time point after operation(all P＞0.05).Compared with pre-operation,CMT of patients significantly decreased at 1,3,6 and 12 months after operation(all P＜0.001).From 1 month to 12 months after the operation,the CMT of patients gradually decreased(all P＜0.001).Pearson correlation analysis showed that there were positive correlations between pre-operative BCVA and preoperative CMT,preoperative BCVA and 12-month postoperative BCVA(r=0.643,P=0.005;r=0.634,P=0.006).During the treatment,the number of anti-vascular endothelial growth factor injections in 17 eyes was(1.35±0.61)times,with 1 time in 12 eyes,2 times in 4 eyes,and 3 times in 1 eye.Correlation analysis showed that the number of injections was positively correlated with preoperative CMT(r=0.664,P=0.004).No intraoperative or postop-erative complications related to the operation occurred in 17 eyes.Conclusion Subretinal injection of conbercept,which can reduce CMT and improve visual prognosis,is a safe and effective treatment method for refractory nAMD.

Objective:To analyze the efficacy of high-throughput hemodialysis (HFHD) therapy on the application of serum ferritin (SF), transferrin saturation (TSAT), ferromodultin (Hepc) and soluble transferrin receptor (sTfR) levels in maintenance hemodialysis (MHD) with renal anemia.Methods:The uremic patients with MHD treatment in the Third People′s Hospital of Hangzhou City from August 2020 to July 2023 were selected as the study object. They were divided into high throughput (30 cases) and low throughput (30 cases) according the treatment methods. The general data; anemia indexes, including red blood cell count (RBC), hemoglobin (Hb), hematocrit (HCT), percentage of reticulocytes (Ret); iron metabolism indexes (SF, TSAT, Hepc and sTfR); inflammations indexes, including β 2-microglobulin (β 2-MG), C-reactive protein (CRP), interleukin-6 (IL-6); renal function indexes, including blood creatinine (SCr), urine creatinine (Cr), blood urea nitrogen (BUN); and adverse reaction were collected. Results:After treatment, the levels of RBC, Hb, HCT, SF and TSAT in the high-throughput group were increased compared with those before treatment: (3.33 ± 0.43) × 10 12/L vs. (2.12 ± 0.24) × 10 12/L, (118.08 ± 11.36) g/L vs. (98.23 ± 8.58) g/L, 0.354 ± 0.030 vs. 0.228 ± 0.037, (486.23 ± 68.22) μg/L vs. (149.34 ± 39.62) μg/L, (36.24 ± 5.82)% vs. (18.72 ± 6.14)%, After treatment, the levels of RBC, Hb, HCT, SF and TSAT in the low-throughput group were increased compared with those before treatment: (2.79 ± 0.32) × 10 12/L vs. (2.19 ± 0.27) × 10 12/L, (111.98 ± 9.07) g/L vs. (97.60 ± 8.33) g/L, 0.330 ± 0.036 vs. 0.214 ± 0.037, (332.73 ± 56.35) μg/L vs. (151.25 ± 39.90) μg/L, (22.23 ± 6.60)% vs. (17.97 ± 5.72)%. In the high-throughput group, after treatment compared with before treatment, Ret, Hepc, sTfR, β 2-MG, CRP, IL-6, SCr, Cr and BUN levels all decreased: (1.02 ± 0.58)% vs.(1.64 ± 0.99)%, (71.56 ± 5.67) μg/L vs. (89.56 ± 7.62) μg/L, (395.07 ± 37.10) μg/L vs. (471.37 ± 41.18) μg/L, (8.38 ± 1.94) μg/L vs. (13.79 ± 2.09) μg/L, (1.07 ± 0.23) mg/L vs. (2.28 ± 0.20) mg/L, (11.40 ± 2.84) ng/L vs. (22.74 ± 6.38) ng/L, (351.54 ± 62.05) μmol/L vs. (530.04 ± 85.06) μmol/L, (6.32 ± 1.49) nmol/L vs. (11.52 ± 2.37) nmol/L, (6.75 ± 1.51) mmol/L vs. (18.37 ± 4.52) mmol/L, compared with before and after treatment in low throughput group, Ret value, Hepc, sTfR, β 2-MG, CRP, IL-6, SCr, Cr and BUN levels decreased: (1.40 ± 0.65)% vs. (1.67 ± 0.78)%, (84.33 ± 7.45) μg/L vs. (88.97 ± 7.79) μg/L, (431.20 ± 37.59) μg/L vs. (459.56 ± 42.22) μg/L, (11.35 ± 1.06) μg/L vs. (14.00 ± 1.90) μg/L, (1.57 ± 0.27) mg/L vs. (2.19 ± 0.23) mg/L, (16..85 ± 3.02) ng/L vs. (23.38 ± 6.17) ng/L, (389.48 ± 67.03) μmol/L vs. (531.02 ± 78.07) μmol/L, (9.80 ± 1.33) nmol/L vs. (11.34 ± 2.18) nmol/L, (7.55 ± 1.21) mmol/L vs. (18.37 ± 4.52) mmol/L, In addition, RBC, Hb, HCT, SF and TSAT levels in high-flux group were higher than those in low-flux group ( P<0.05), while Ret, Hepc, sTfR, β 2-MG, CRP, IL-6, SCr, Cr and BUN levels were lower than those in low-flux group, with statistical significance ( P<0.05). There was no significant difference in the incidence of adverse drug effects between the two groups ( P>0.05). Conclusions:HFHD treatment for patients with renal anemia in MHD has better treatment effect than LFHD, which can effectively correct the anemia state of patients, improve the body iron metabolism response, reduce inflammatory response and improve kidney function, and has certain clinical application value.