Objective:To investigate the employment status of graduates from standardized residency training in Hubei Province, China and provide strategies for improving the quality of medical education after graduation.Methods:A cross-sectional survey was conducted in August 2022. Graduates from the first and second batches of 29 national standardized residency training bases in Hubei Province from 2017 to 2022 were surveyed using an online questionnaire. A total of 4 344 valid responses were collected, with a response rate of 95.78%. The survey was conducted online using a self-designed questionnaire titled "Employment Status Survey of Residency Training Graduates in Hubei Province".Results:Among the graduates, 3 505 (80.69%) were directly employed after completing the training, while 428 (9.85%) were unemployed. The primary reason for unemployment was ongoing job searching or application processes (268, 62.61%). Of the employed graduates, 3 082 (87.63%) worked in hospitals, including 1 799 (58.37%) in grade A tertiary hospitals, 485 (15.74%) in grade B tertiary hospitals, and 618 (20.05%) in grade A secondary hospitals. A total of 2 936 (83.48%) graduates worked in physician positions aligned with their training specialties, while 500 (14.22%) worked in physician positions unrelated to their training specialties. Additionally, 1 349 (38.35%) graduates reported that their current income met their personal consumption needs, while 2 138 (61.65%) stated that their income barely met or failed to meet their needs. Moreover, 2 466 (70.12%) graduates felt that their current work status generally met their expectations, while 968 (27.52%) reported that it fell below their expectations. Of the graduates, 2 927 (67.40%) believed that the residency training significantly helped them perform their current jobs, whereas 1 417 (32.60%) perceived the training as providing limited or moderate assistance.Conclusions:The re-employment rate of residency training graduates in Hubei Province is relatively high. However, the recognition of standardized residency training and the salary levels of re-employment are relatively low.

Objective:To investigate the employment status of graduates from standardized residency training in Hubei Province, China and provide strategies for improving the quality of medical education after graduation.Methods:A cross-sectional survey was conducted in August 2022. Graduates from the first and second batches of 29 national standardized residency training bases in Hubei Province from 2017 to 2022 were surveyed using an online questionnaire. A total of 4 344 valid responses were collected, with a response rate of 95.78%. The survey was conducted online using a self-designed questionnaire titled "Employment Status Survey of Residency Training Graduates in Hubei Province".Results:Among the graduates, 3 505 (80.69%) were directly employed after completing the training, while 428 (9.85%) were unemployed. The primary reason for unemployment was ongoing job searching or application processes (268, 62.61%). Of the employed graduates, 3 082 (87.63%) worked in hospitals, including 1 799 (58.37%) in grade A tertiary hospitals, 485 (15.74%) in grade B tertiary hospitals, and 618 (20.05%) in grade A secondary hospitals. A total of 2 936 (83.48%) graduates worked in physician positions aligned with their training specialties, while 500 (14.22%) worked in physician positions unrelated to their training specialties. Additionally, 1 349 (38.35%) graduates reported that their current income met their personal consumption needs, while 2 138 (61.65%) stated that their income barely met or failed to meet their needs. Moreover, 2 466 (70.12%) graduates felt that their current work status generally met their expectations, while 968 (27.52%) reported that it fell below their expectations. Of the graduates, 2 927 (67.40%) believed that the residency training significantly helped them perform their current jobs, whereas 1 417 (32.60%) perceived the training as providing limited or moderate assistance.Conclusions:The re-employment rate of residency training graduates in Hubei Province is relatively high. However, the recognition of standardized residency training and the salary levels of re-employment are relatively low.

Objective This study aims to explore the associations between threat and deprivation childhood traumas and dysfunctional attitudes among patients with major depressive episode,based on the dimensional model of adversity and psychopathology(DMAP).Methods Data from 970 patients with major depressive episode were collected and categorized based on the childhood trauma questionnaire-short form(CTQ-SF)scores into no trauma(426),threat-only(86),deprivation-only(210),and mixed groups(248).Cognitive distortions were assessed using the dysfunctional attitudes scale(DAS),with scores above the upper quartile indicating significant distortions.Multifactorial logistic regression analysis was employed to examine the association between threat and deprivation and dysfunctional attitudes.Results There were significant differences in the proportion of cognitive distortions among the no trauma,threat-only,deprivation-only,and mixed groups(19.25% vs.30.23% vs.20.00% vs.35.89%,P<0.001),with differences across all dimensions(P≤0.001).Multifactorial logistic regression revealed a positive correlation between threat and overall cognitive distortions(OR=2.031,P<0.001),and specific positive correlations with dimensions such as vulnerability(OR=1.709,P<0.001),appeal and repulsion(OR=2.088,P<0.001),perfectionism(OR=2.321,P<0.001),compulsivity(OR=1.765,P=0.001),approval seeking(OR=1.837,P<0.001),dependency(OR=1.554,P=0.006),and autonomous attitudes(OR=1.864,P<0.001).In contrast,deprivation was only positively correlated with the cognitive philosophy dimension(OR=1.495,P=0.015).Conclusion Childhood trauma is closely associated with dysfunctional attitudes in patients with major depressive episode.Threat correlates positively with cognitive distortions in all dimensions except cognitive philosophy,whereas deprivation correlates only with the cognitive philosophy dimension.

Objective To understand the health-related quality of life (HRQOL) of migrant workers with pneumoconiosis who received basic medical treatment in Hunan Province. Methods A total of 613 migrant workers with pneumoconiosis who received basic medical treatment and assistance in Hunan Province was selected as the study subjects using stratified random sampling method. The European Quality of Life-5 Dimensions (EQ-5D) questionnaire was used to assess their HRQOL. Results The abnormality of the five dimensions of the EQ-5D health description system, from high to low, were as follows： daily activities, mobility, pain/discomfort, anxiety/depression, and self-care, with the abnormal rates of 50.9%, 46.8%, 41.1%, 21.0%, and 14.5%, respectively. The visual analogue scale (VAS) score of EQ-5D was (63.5±18.6) points. Patients with stage Ⅲ pneumoconiosis had high abnormality in mobility, daily activities, and pain/discomfort compared with those with stage Ⅰ and Ⅱ disease (all P<0.02). Patients in stage Ⅱ and Ⅲ of pneumoconiosis had higher incidence of anxiety/depression compared with those with stage I disease (all P<0.02). Patients with complications in addition to pneumoconiosis had higher abnormality in mobility, self-care, and pain/discomfort compared to those with simple pneumoconiosis or those eligible for lung lavage treatment (all P<0.02). Patients with simple pneumoconiosis had a higher incidence of anxiety/depression compared with those eligible for lung lavage treatment (P<0.02). Patients with stage Ⅲ pneumoconiosis had lower average VAS scores compared with stage Ⅰ and Ⅱ patients (all P<0.02). Patients with simple pneumoconiosis or those with complications had lower average VAS scores compared with those eligible for lung lavage treatment (all P<0.05). Conclusion The HRQOL of pneumoconiosis patients among migrant workers needs improvement, especially for patients with stage Ⅲ disease and those with complications. This study indicates the need of optimizing policies, raising the hospitalization expense limit for critically ill patients with stage Ⅲ pneumoconiosis or with complications, and improving their HRQOL.

Nephrotic syndrome (NS) is associated with cerebral venous sinus thrombosis (CVST), which is a rare cerebrovascular disorder in children. Systemic anticoagulation with heparin is the standard therapy for CVST, and mechanical thrombectomy (MT) has been described as a salvage treatment for adult anticoagulant refractory CVST, However, it has never been reported in children. We describe a case of MT for refractory CVST in a child with NS. A 13-year-old boy with newly diagnosed NS presented to an emergency department with acute headache. A head computed tomography showed acute thrombus in the superior sagittal sinus, straight sinus and transverse sinus. The child was started on heparin therapy, but clinically deteriorated and became unresponsive. In view of the rapid deterioration of the condition after anticoagulation treatment, the patient received intravascular treatment. Several endovascular technologies, such as stent retriever and large bore suction catheter have been adopted. After endovascular treatment, the patient’s neurological condition was improved within 24 hours, and magnetic resonance venography of the head demonstrated that the CVST was reduced. The child recovered with normal neurological function at discharge. This case highlights the importance of considering MT for refractory CVST, and we suggest that MT may be considered for refractory CVST with NS in children.

In the past decade, the development of artificial intelligence technology has gradually spread from academia to industry, and its application in the medical field has profoundly deepened. As the driving engine of artificial intelligence, the machine learning and deep learning， based on data and algorithms, contribute the core technology of artificial intelligence (AI), given the limitation of technology and the ethical consideration, AI can be more acceptedits role in auxiliary decision-making instead of independent diagnosis and treatment. Depression is one of the world wide popular mental condition, and its early diagnosis depression promot estimely treatment. AI technology may help to screen depression by analysis of the various characteristics: the physiological indicators, facial expressions, voice intonation, text semantics, gesture behavior, and with all above information calcucated together to establish a model of depression auxiliary diagnosis system. This paper summarizes the literature on the AI auxiliary diagnosis for depression based on different models as well as multimodal data fusion.

In the past decade, the development of artificial intelligence technology has gradually spread from academia to industry, and its application in the medical field has profoundly deepened. As the driving engine of artificial intelligence, the machine learning and deep learning， based on data and algorithms, contribute the core technology of artificial intelligence (AI), given the limitation of technology and the ethical consideration, AI can be more acceptedits role in auxiliary decision-making instead of independent diagnosis and treatment. Depression is one of the world wide popular mental condition, and its early diagnosis depression promot estimely treatment. AI technology may help to screen depression by analysis of the various characteristics: the physiological indicators, facial expressions, voice intonation, text semantics, gesture behavior, and with all above information calcucated together to establish a model of depression auxiliary diagnosis system. This paper summarizes the literature on the AI auxiliary diagnosis for depression based on different models as well as multimodal data fusion.

Objective To optimize the ways of extubation after tracheotomy.Methods From August, 2016 to April, 2018, 118 patients after tracheotomy for brain injury were divided into early extubation group (n=74) and conventional extubation group (n=44). The success rate and tolerance of extubation were compared, and the biochemical markers of blood were tested before and seven days after extubation. The early extubation group was divided into disposable extubation group (n=37) and occlusion tube-extubation group (n=37), and their success rates of extubation were compared.Results There was no significant difference in success rate between the early extubation group and the conventional extubation group (χ2=0.016, P>0.05). The tolerance was less in the early extubation group on the first day of extubation (χ2=4.909, P<0.05), and it was not different seven days and 15 days after extubation (χ2<1.995, P>0.05). The procalcitonin, hypersensitive C reactive protein and white blood cell count decreased (t>2.680, P<0.05), and hemoglobin and albumin increased seven days after extubation (t>11.620, P<0.001). There was no significant difference in the success rate between the disposable extubation group and the occlusion tube-extubation group (χ2<2.902, P>0.05).Conclusion Satisfactory cough and deglutition reflex are the core indexes of successful extubation, other indications may not influence on the success of extubation but on tolerance. Extubation may benefit to control the complications of tracheotomy. The disposable extubation is more recommended.

Objective To evaluate the value of volume measured by multi-slice spiral CT in preoperative N staging of gastric canc-er.Methods CT data of 1 93 cases of gastric cancer proven pathologically were collected and analyzed.Volume of the tumor was cal-culated in the portal phase,and the correlation between the results and N staging was evaluated.ROC curve was used to get diagnos-tic value to differentiate N stages.Results Intra-observer Kappa value was 0.77 (P < 0.05 ),0.72 (P < 0.05 ),Inter-observer Kappa value was 0.69 (P <0.05).The tumor volume data was positively correlated with different N stages (r=0.568,P <0.05). ROC curve showed that the volume could help differentiate between stage N0 and stage N1 - N3 (cutoff 12.06 cm3 ,sensitivity 55%,specificity 95%),stage N0-N1 and stage N2-N3 (cutoff 22.35 cm3 ,sensitivity 66%,specificity 86%),stage N0-N2 and stage N3 (cutoff 25.95 cm3 ,sensitivity 62%,specificity 89%)respectively.Conclusion The volume of gastric cancer measured by CT plays an important part in predicting lymph node metastasis staging and optimizing individualized clinical strategy for patients.

Objective To investigate behavior and hippocampal cytoskeletal alterations following re-exposure to chronic unpredictable mild stress(CUMS) and acute swimming stress,and explore the possible mechanism.Methods 40 Male Sprague-Dawley (SD) rats were divided into five groups,with 8 exposed to 21 consecutive days of chronic unpredicted mild stresses (CUMS) and treated with vehicle,8 exposed to CUMS and treated with fluoxetine,8 exposed to CUMS and treated with fluoxetine and re-exposed to acute swimming stress after washout,8 exposed to CUMS and treated with fluoxetine and re-exposed to CUMS after washout,and 8 as normal controls treated with vehicle.Behavioral changes in these rats were analyzed.The expressions of hippocampal cytoskeletal microtubulin were analyzed using Western Blot.Results ( 1 ) Compared with the control and CUMS group,sucrose preference (43.38 ± 7.84 ) ％,total traveling distance ( 859.21 ± 653.62 ) cm,velocity ( 2.05 ± 0.60 ) cm/s and frequencies of rearing(0.12 ±0.30) were reduced (P＜0.01 ) in the re-exposure to CUMS group.After re-exposed to acute stress,these behaviors did not differ from control rats.(2)Compared with the control and CUMS group,the Acet-Tub expression (244.24 ± 8.90 )％ of re-exposure to CUMS group showed a significant increase (P＜ 0.01 ) in rats submitted to re-exposure to CUMS and Tyr-Tub expression (30.92 ± 11.01 )％ was significantly decreased following re-exposure to CUMS (P＜0.01).At the same time,MAP-2 expression did not change while phospho-MAP-2 expression (24.75 ± 8.83 )％ decreased significantly.After re-exposed to acute stress,these prorein expressions did not differ from control rats.Conclusion These findings provide evidence that rats re-exposed to CUMS showed more impairment of cytoskeletal microtubular dynamic and structural neuronal plasticity,this effect appears to be mediated by the degree of phosphorylation of MAP-2.