Objective To develop an innovative recognition algorithm that aids physicians in the identification of pulmonary nodules. Methods Patients with pulmonary nodules who underwent thoracoscopic surgery at the Department of Thoracic Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School in December 2023, were enrolled in the study. Chest surface exploration data were collected at a rate of 60 frames per second and a resolution of 1 920×1 080. Frame images were saved at regular intervals for subsequent block processing. An algorithm database for lung nodule recognition was developed using the collected data. Results A total of 16 patients were enrolled, including 9 males and 7 females, with an average age of (54.9±14.9) years. In the optimized multi-topology convolutional network model, the test results demonstrated an accuracy rate of 94.39% for recognition tasks. Furthermore, the integration of micro-variation amplification technology into the convolutional network model enhanced the accuracy of lung nodule identification to 96.90%. A comprehensive evaluation of the performance of these two models yielded an overall recognition accuracy of 95.59%. Based on these findings, we conclude that the proposed network model is well-suited for the task of lung nodule recognition, with the convolutional network incorporating micro-variation amplification technology exhibiting superior accuracy. Conclusion Compared to traditional methods, our proposed technique significantly enhances the accuracy of lung nodule identification and localization, aiding surgeons in locating lung nodules during thoracoscopic surgery.

Objective:To explore the mediating role of disease progression′s fear and positive affect in the relationship between disease perception and demoralization in patients with chronic heart failure. It provided a theoretical basis for targeted interventions for healthcare workers.Methods:From October 2022 to March 2023, 320 patients with chronic heart failure in the First Affiliated Hospital of Zhengzhou University were selected as the research objects by convenience sampling. The General Information Questionnaire, Demoralization Scale Redacted Mandarin Version, Brief Illness Perception Questionnaire, Fear of Progression Questionnaire-Short Form, Positive and Negative Affect Schedule (Positive Affect Schedule) were used to conduct the questionnaire survey exploring the mediating effects of fear of disease progression and positive emotions between disease perception and disorientation by construction structural equation model.Results:There were 268 valid questionnaires. Of the 268 patients, 168 were male and 100 were female, 3.36% (9/268) were ≤40 years old, 55.22% (148/268) were 41-65 years old, and 41.42% (111/268) were >65 years old. Correlation analysis showed that disease perception was positively correlated with disease progression ′s fear, and every dimension of demoralization ( r values were 0.300-0.586, all P<0.01), and negatively correlated with positive affect ( r=-0.374, P<0.01); disease progression′s fear was negatively correlated with positive affect ( r=-0.318, P<0.01), and positively correlated with every dimension of demoralization ( r values were 0.339-0.464, all P<0.01); positive affect was negatively correlated with every dimension of demoralization ( r values were -0.430--0.334, all P<0.01). Structural equation model analysis showed that the direct effect of disease perception on demoralization was significant ( β=0.407, P<0.01), and both mediating effects of disease progression ′s fear and positive affect between disease perception and demoralization in patients with chronic heart failure were significant ( β=0.074, 0.079, both P<0.01). The chain mediating effect of disease progression ′s fear and positive effect was also significant ( β=0.019, P<0.01). Conclusions:Disease perception could directly predict the demoralization of patients with chronic heart failure and indirectly predict the demoralization of patients with chronic heart failure through the mediating effect of disease progression ′s fear, positive affect, and the chain mediating effect of disease progression ′s fear and positive affect.

ObjectiveTo observe the clinical efficacy of Tongdu Huoxue decoction in the treatment of acute lumbar disc herniation （LDH）. MethodA total of 316 patients with acute LDH admitted to the orthopedic outpatient department of Hubei Provincial Hospital of Traditional Chinese Medicine and Honghu City Hospital of Traditional Chinese Medicine from January 2020 to June 2023 were randomly divided into two groups. 156 cases in the control group （two cases with stopped follow-up） were treated with meloxicam tablets， while 153 cases in the observation group （five cases with stopped follow-up） were treated with Tongdu Huoxue decoction. Both groups were treated for three months. The clinical efficacy， McGill Pain Score Scale （SF-MPQ）， Oswestry Dysfunction Index （ODI） score， and the Japanese Orthopaedic Association （JOA） scores of the two groups before and after treatment were compared. The serum levels of interleukin-1β （IL-1β）， interleukin-6 （IL-6）， and tumor necrosis factor-α （TNF-α） of the patients before and after treatment were determined by using enzyme-linked immunosorbent assay （ELISA）. The NDI-092 type electromyography-evoked potential instrument was adopted to measure the motor conduction velocity and clinical efficacy of the tibial and common peroneal nerves in patients of the two groups before and after treatment， and the clinical safety of the two groups of patients was compared. ResultAfter treatment， the total effective rate in the observation group was 95.4% （146/153）， significantly higher than that in the control group of 76.3% （119/156） （χ² =23.18， P<0.05）. After treatment， both groups showed significant reductions in SF-MPQ and ODI scores， as well as the levels of IL-1β， IL-6， and TNF-α （P<0.05）， with the observation group showing a more significant reduction （P<0.05）. Both groups showed a significant increase in JOA scores and motor conduction velocities of the tibial and common peroneal nerves after treatment （P<0.05）， with the observation group showing a more significant increase （P<0.05）. ConclusionTongdu Huoxue decoction can alleviate lumbar and leg pain in acute LDH， improve lumbar spine function， and suppress inflammatory reactions. It is highly safe and is worthy of clinical promotion.

BACKGROUND:Peripheral nerves play an important role in bone metabolism.In clinical practice,the specific impact of nerve injury on bone transport technology needs further study. OBJECTIVE:To investigate the effect of tibial nerve injury on the treatment of tibial slip by single-plane osteotomy. METHODS:Thirty-two patients with tibial bone defects admitted to Tangshan Second Hospital from May 2011 to June 2022 were selected.According to the presence or absence of tibial nerve injury,patients were divided into the tibial nerve injury group(n=16)and the non-tibial nerve injury group(n=16).Both groups were treated with single-plane osteotomy and bone slip.After treatment,the patients were followed up to collect the mineralization zone healing index,external fixation index,docking point healing and needle infection.After the removal of external fixation,the bone healing and functional evaluation were evaluated by a classification of the Association for the Study and Application of the Method of Ilizarov(ASAMI). RESULTS AND CONCLUSION:(1)All 32 patients were followed up for(25.28±4.79)months.There were no significant differences in bone healing time,external fixation time,healing index and external fixation index between the two groups(P＞0.05).Needle infection occurred in two cases of the tibial nerve injury group and one case of the non-tibial nerve injury group,all of which were PALEY I,and there was no significant difference between the two groups(P＞0.05).The non-union rate of the occlusal end of the tibial nerve injury group was 31%,and that of the non-tibial nerve injury group was 13%;there was no statistical difference between the two groups(P＞0.05).The excellent and good rate of ASAMI bone healing score in the two groups was 100%;the excellent and good rate of limb score was 81%in the tibial nerve injury group and 94%in the non-tibial nerve injury group;there was no statistical difference between the two groups(P＞0.05).(2)Our research shows that tibial nerve injury has no significant effect on the mineralization speed,external fixation time,union of the occlusal end,infection of the needle tract,and the quality of bone formation in the mineralized area of the single-plane osteotomy.

AIM:To investigate the role of Ywhab in the growth of mouse B-cell lymphoma,and to explore the potential underlying mechanisms.METHODS:The correlation between Ywhab and human diffuse large B-cell lymphoma(DLBCL)was investigated by bioinformatics analysis.Infection with retroviral vector was performed to establish stable mouse B-cell lymphoma 38B9 cell line with overexpression of Ywhab gene,which was verified by RT-qPCR and Western blot.The impact of Ywhab overexpression on 38B9 cell growth both in vitro and in vivo was detected by cell counting,CCK-8 assay,and subcutaneous tumor loading experiments.The expression of apoptosis-related proteins was detected by RT-qPCR and Western blot.Co-immunoprecipitation combined with mass spectrometry(CoIP-MS)was employed to search for proteins specifically binding to Ywhab gene product 14-3-3β,which was confirmed by Western blot and molecu-lar docking analysis.RESULTS:The Ywhab gene exhibited low expression in DLBCL,which was correlated with poor clinical prognosis of DLBCL patients.Compared with normal mouse bone marrow B cells,Ywhab expression was low in 38B9 cells.Overexpression of Ywhab induced apoptosis of 38B9 cells both in vitro and in vivo,promoted the expression of pro-apoptotic proteins Puma,Noxa and Bax at both mRNA and protein levels,and inhibited the mRNA and protein expres-sion of anti-apoptotic protein Bcl2(P＜0.05).The 14-3-3β protein specifically bound to Hsp90aa1 and reduced Hsp90aa1 protein levels,thereby suppressing the growth of 38B9 cells.CONCLUSION:Ywhab promotes the apoptosis of B-cell lymphoma cells by binding to Hsp90aa1 and thereby inhibiting the function of Hsp90aa1.

Objective:To analyze the prognosis of hepatocellular carcinoma (HCC) patients with thrombocytosis (platelet count ≥350×10 9) after transcatheter arterial chemoembolization (TACE), and the effect of thrombocytosis on the prognosis of patients with HCC after TACE. Methods:Clinical data of 867 patients with HCC admitted to the Department of Interventional Radiology, the Affiliated Hospital of Xuzhou Medical University from January 2013 to May 2018 were retrospectively analyzed. After propensity score matching, 99 patients were enrolled, including 70 males and 29 females, aged (60.1±12.1) years. Patients were divided into the groups with thrombocytosis ( n=33) and without thrombocytosis ( n=66). The gender, maximum tumor diameter, Barcelona clinical liver cancer (BCLC) stage, and total bilirubin were compared between the two groups. The association of thrombocytosis with the prognosis of HCC after TACE treatment were analyzed using univariate and multivariate Cox regression. Results:After propensity score matching, the male proportion, maximum tumor diameter, BCLC stage, and serum level of total bilirubin were comparable between the groups (all P>0.05). Before TACE treatment, the platelet count of patients with thrombocytosis was (394.4±54.5)×10 9/L, which was higher than that after TACE [(278.2±86.4)×10 9/L, t=7.63, P<0.001]. The progression-free survival rates after TACE in without thrombocytosis group were 83.3%, 24.2%, and 7.6% at 3, 6 and 9 months, respectively, better than those in thrombocytosis group (51.5%, 3.0%, and 3.0%, respectively; χ2=31.24, P<0.001). The overall survival rates after TACE in without thrombocytosis group were 81.8%, 30.3%, and 4.5% at 1, 2 and 3 years, respectively, better than those in thrombocytosis group (15.2%, 9.1%, and 3.0%, respectively; χ2=27.89, P<0.001). Multivariate Cox regression analysis showed that patients of HCC with thrombocytosis had an increased risk of tumor progression ( HR=5.785, 95% CI: 3.291-10.168, P<0.001) and increased risk of death ( HR=4.090, 95% CI: 2.482-6.740, P<0.001) after TACE. Conclusion:The prognosis of TACE for HCC might be worse in patients with thrombocytosis. Thrombocytosis is a risk factor for cumulative survival and progression-free survival of HCC patients after TACE.

ObjectiveTo observe the effect of enriched environment (EE) combined with acupuncture at head point (HA) on behavior in rats with autism spectrum disorder. MethodsHealthy female Wistar rats were given peritoneal injection of sodium valproate at 12.5 days of gestation. Twenty-four male offspring rats were randomly selected and then randomly divided into model group (n = 6), EE group (n = 6), HA group (n = 6) and EE combined with HA group (the combined group, n = 6). Six male offspring rats born from female mice injected with the same amount of saline intraperitoneally were as control group. After four weeks of treatment, all the five groups were tested with three-chamber test and marble burying test, and the sociability index, the social novelty index and the number of buried marbles were recorded. The levels of interleukin (IL)-1β and IL-6 in peripheral blood were determined by enzyme-linked immunosorbent assay (ELISA). ResultsAfter treatment, compared with the model group, the sociability index and the social novelty index improved (P < 0.05), the number of buried marbles reduced (P < 0.05), and the levels of IL-6 and IL-1β in peripheral blood decreased in EE group, HA group and the combined group (P < 0.05); while the combined group was the best (P < 0.01). ConclusionBoth EE or acupuncture at HA could improve behavioral symptoms, and reduce the expression of inflammatory factors in rats with autism spectrum disorder. The combination of the two methods showed the best result.

Objective Taking typical cases of Western medicine as an example,this paper explores the connection between Chinese and Western medicine on the understanding of tongue elephants.Methods After collecting the literature with tongue diagram attached to the clinical imaging column published in NEJM magazine,extracting the symptoms,signs and Western medicine disease information recorded in the literature,the tongue diagram was diagnosed from three aspects:tongue quality,tongue moss and sublingual meridians,and whether the symptoms and signs of tongue correspond to a certain diagnosis result,and the results were analyzed.Results A total of 48 articles were included,including 6 literature on abnormal tongue dynamics,which could correspond to abnormal tongue morphology in traditional Chinese medicine.Thirty-four cases of abnormal tongue shape were found.Among them,12 cases could be diagnosed with corresponding TCM tongue diagnosis,including 7 cases of abnormal tongue shape and 5 cases of abnormal coating.The remaining 22 cases were secondary changes in tongue structure.There were 8 articles on abnormal tongue color,including 1 abnormal tongue color,1 abnormal sublingual chord,and 6 abnormal lichen color.Conclusion Starting from the form and function,explore the connection between Chinese medicine and Western medicine in their understanding of tongue diagnosis,and promote the objectification and standardization of Chinese medicine tongue diagnosis.

OBJECTIVE To investigate the positive rates and distribution of multiple allergens in children aged 6 to 14 with allergic rhinitis(AR) in the Chaozhou area,and to explore whether health education plays a positive role in these patients. METHODS A random sample of 100 school-age children diagnosed with AR at the outpatient department of Chaozhou Central Hospital from January to May 2024 was selected for allergen testing. Additionally,100 school-age children diagnosed with AR at the outpatient department of Chaozhou Central Hospital from January to May 2024 were surveyed before and after intervention using the same self-made questionnaire,and the effectiveness of the intervention was evaluated. RESULTS Among school-age children with AR in Chaozhou area,the top three positive rates of allergens were house dust mites/dust mites(42％),milk(29％) and egg(23％),and the top three strong positive rates were also house dust mites/dust mites(27％),milk(18％) and egg(17％). After health education,the correct response rate to questions on how to reduce AR attacks increased compared to before the intervention. The overall awareness of AR health knowledge was 31.7％,which significantly increased to 91.4％ after the intervention,with a statistically significant difference. CONCLUSION Understanding the positive rates and distribution of allergens in the Chaozhou area is very important for diagnosing and managing allergic symptoms,which can help physicians and patients better cope with AR. Health education can significantly improve school-age children's understanding of AR,promote the formation of good hygiene habits and lifestyles,and has a positive impact on the prevention and treatment of AR in school-age children.

Objective To investigate the clinical efficacy and postoperative aortic changes of 3D printing-assisted stent with in-vitro pre-fenestration technique in the treatment of complex type B aortic dissection.Methods A retrospective analysis was conducted on 28 patients with complex type B aortic dissection who underwent thoracic endovascular aortic repair(TEVAR)using stent with in-vitro pre-fenestration technique.The patients were divided into two groups based on the methods of stent with in-vitro pre-fenestration:the 3D printing-assisted stent pre-fenestration group(3D printing group)consisting of 13 patients and traditional stent pre-fenestration group(traditional group)consisting of 15 patients.Various parameters,including hospital duration,surgical duration,duration of stent pre-fenestration in vitro,dose of contrast agent,intraoperative blood loss,immediate postoperative internal leakage rate,30 d postoperative internal leakage rate,30 d postoperative mortality,and the change rate of true and false lumen diameter[the change rate of true and false lumen diameter=(postoperative true and false lumen diameter-preoperative true and false lumen diameter)/preoperative true and false lumen diameter× 100％],were compared between the two groups.Results Compared with the traditional group,the 3D printing group exhibited a considerable reduction in surgical duration[(148.46±27.20)min vs(175.46±22.04)min,P＜0.05].Additionally,the 30 d postoperative type Ⅰ internal leakage rate was lower in the 3D printing group(X2=4.044,P=0.044).Moreover,the change(dilation)rate of true lumen diameter in stent coverage section showed a notable increase in the 3D printing group(P＜0.05).Conclusion The use of 3D printing-assisted stent with in-vitro pre-fenestration has been proven to be safe and effective in the treatment of complex type B aortic dissection.It offers notable advantages,including the reduction of surgical duration,a lower risk of type Ⅰ internal leakage and significant redilation of the true aortic lumen after surgery.