Objective To explore the application of artificial intelligence (AI) in the standardized training of thoracic surgery residents, specifically in enhancing clinical skills and anatomical understanding through AI-assisted lung nodule identification and lung segment anatomy teaching. Methods Thoracic surgery residents undergoing standardized training at Peking Union Medical College Hospital from September 2023 to September 2024 were selected. They were randomly assigned to a trial group and a control group using a random number table. The trial group used AI-assisted three-dimensional reconstruction technology for lung nodule identification, while the control group used conventional chest CT images. After basic teaching and self-practice, the ability to identify lung nodules on the same patient CT images was evaluated, and feedback was collected through questionnaires. Results A total of 72 residents participated in the study, including 30 (41.7%) males and 42 (58.3%) females, with an average age of (24.0±3.0) years. The trial group showed significantly better overall diagnostic accuracy for lung nodules (91.9% vs. 73.3%) and lung segment identification (100.0% vs. 83.70%) compared to the control group, and the reading time was significantly shorter [ (118.5±10.5) s vs. (332.1±20.2) s, P<0.01]. Questionnaire results indicated that 94.4% of the residents had a positive attitude toward AI technology, and 91.7% believed that it improved diagnostic accuracy. Conclusion AI-assisted teaching significantly improves thoracic surgery residents’ ability to read images and clinical thinking, providing a new direction for the reform of standardized training.

Objective: To explore the latent categories and general demographic characteristics of short form video addiction among college students, so as to provide empirical reference for prevention and intervention of short form video addiction among college students. Methods: Convenience sampling method was used to select 1 386 college students from a certain university in Anhui Province in June 2023. A questionnaire survey was conducted among college students by using the Short Video Addiction Scale. The latent profile analysis method of "individual center" was used to explore the categories of college students short form video addiction, and multiple Logistic regression was used to explore the influence of demographic variables on the latent classification of short form video addiction. Results: College students with short form video addiction were divided into three latent categories:non addiction group (22.15%, n =307), low addiction group (63.28%, n =877) and high addiction group (14.57%, n =202). The results of multiple Logistic regression analysis showed that gender, major type and family location were related with short form video addiction among college students:male students (low addiction group: OR =0.47; high addiction group: OR =0.41), cultural and historical majors (low addiction group: OR =0.66), and students from cities (high addiction group: OR =0.51) were less likely to be involved in short form video addiction ( P <0.05). Conclusions There is significant group heterogeneity in short form video addiction among college students. Families, schools and society should attach importance and pay attention to the phenomenon of short form video addiction among college students, actively take targeted intervention measures to prevent and reduce the occurrence of short form video addiction symptoms among college students.

Objective:To analyze the differentially expressed genes of human respiratory syncytial virus (RSV) subtype A genotype ON1, a predominant genotype in Beijing, after infecting A549 cells using transcriptomic sequencing, and provide potential targets for RSV prevention and treatment.Methods:A local strain (61397-ON1) identified by whole-genome sequencing as ON1 genotype of RSV subtype A was selected to infect A549 cells. Total mRNA was extracted, and the differentially expressed genes in infected and uninfected A549 cells were screened by transcriptomic sequencing. GO analysis and KEGG pathway analysis were performed. Besides, six genes with differential expression ratio greater than two times were randomly selected for qRT-PCR verification.Results:There were 1 632 differentially expressed genes between infected and uninfected A549 cells, of which 807 genes were up-regulated and 825 genes were down-regulated. The differentially expressed genes were mainly involved in immune response-related biological processes such as cytokine response and positive regulation of MAPK cascades, and were enriched in MAPK signaling pathway, NOD-like receptor signaling pathway, p53 signaling pathway, TNF signaling pathway, IL-17 signaling pathway and NF-κB signaling pathway. The results of qRT-PCR for six differentially expressed genes were consistent with the trend of transcriptome data.Conclusions:The differentially expressed genes of RSV A subtype ON1 genotype after infecting A549 cells are mainly involved in cytokine response and immune-related signaling pathways. This study provides basic data for further study of the molecular mechanism of RSV infection and the development of prevention and treatment strategies.

Increasing age is the most important factor for cognitive impairment.Alzheimer disease(AD)and sarcopenia are significant causes of frailty and disability in older adults.It is important to have an in-depth understanding of the relationship between sarcopenia and AD.Studies have reported that sarcopenia often disturbs the secretion of muscle factors,which may increase the risk of developing dementia.In turn,the pathological feature of dementia,such as the de-position of amyloid β-protein(Aβ),amyloid precursor protein(APP)and tau protein in peripheral neurons,may be related to a decline in muscle function.In particular,the deposition of Aβ and APP may eventually lead to movement disorders and disability.Therefore,we hypothesize that AD and sarcopenia may mutually promote each other's pathological develop-ment.This results in exacerbation of clinical and pathological damage,in which myokine and amyloid proteins play impor-tant roles.However,the interrelationship based on amyloid protein and myokine production has not been discussed in de-tail in other reviews.In this paper,we reference and discuss the studies on this topic,and review the common risk factors for sarcopenia and AD and the potential and mechanisms for mutual improvement.

Objective To investigate the risk factors of uterine artery embolization(UAE)in treating cesarean scar pregnancy(CSP),and to construct a nomogram prediction model used for providing a basis for individualized treatment.Methods The clinical data of 305 CSP patients,who were admitted to the Shanxi Bethune Hospital from January 2014 to June 2023,were retrospectively analyzed.Multivariate logistic regression was used to analyze the independent risk factors for UAE in patients with CSP,based on which a risk prediction model was constructed.R language was used to draw a nomogram.The receiver operating characteristic(ROC)curve was used to evaluate the predictive power of the model.The model was verified and calibrated,and the decision curve analysis(DCA)curve was drawn to analyze its clinical utility.Results Of the 305 CSP patients,88(28.85％)received interventional operation and 217(71.15％)did not receive interventional operation.Univariate and multivariate analysis showed that gestational sac diameter(OR=1.062,95％CI=1.034-1.091,P=0.001),abdominal pain(OR=0.179,95％CI=0.085-0.379,P=0.001),residual muscle thickness(OR=6.532,95％CI=3.271-13.043,P=0.001),were the independent risk factor for UAE in CSP patients(P＜0.05).The following risk prediction model was established:h(t,X)=h0(t)exp(-1.718X1+1.877X2+0.061X3),which was presented as a nomogram.ROC curve analysis indicated that the overall prediction efficiency of the model was better than that of a single risk factor,and the Hosmer-Lemeshow test of the model had a better fit degree.The consistency index(C-index)was 0.828,suggesting that this model had good discrimination ability.After correction by the Bootstrap method,this model had a relatively high prediction accuracy.DCA curve evaluation revealed that this model had good clinical utilization value.Conclusion The nomogram of the risk prediction model,which is constructed based on the presence or absence of abdominal pain,gestational sac diameter and residual muscle thickness,has high accuracy and differentiation with a good consistency.This model has good clinical utilization value and it can be used to predict and evaluate whether a patient with CSP is at risk of UAE.

Objective:This study aims to establish an early warning diagnosis model for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and to provide a simple, rapid, and accurate auxiliary diagnosis basis for clinical practice.Methods:The sample bank of subjects (patients admitted to the Eighth Medical Center of the PLA General Hospital from September 10, 2021, to July 25, 2023) was constructed, including the model establishment cohort [SCOPD group 49, 42 males and 7 females, (69.71±11.16) years old; AECOPD group 53, 49 males and 4 females, (72.60±10.19) years old] and the model validation cohort [SCOPD group 35, 28 males and 7 females, (69.97±10.40) years old; AECOPD group 35, 33 males and 2 females, (71.43±9.67) years old]. Fasting peripheral blood samples were collected, and the expression levels of IL-5, IL-17A, and IFN-α were detected by flow cytometry. Different expression levels were analyzed by Mann-Whitney U test. Binary logistic regression analysis was used to screen the related risk factors of COPD patients in acute exacerbation. The diagnostic efficacy of the model was evaluated by the receiver operating characteristic (ROC) curve.Results:The levels of IL-5 [1.64 (0.60, 2.86) pg/ml], IL-17A [1.42 (0.88, 2.29) pg/ml], and IFN-α [0.91 (0.59, 1.81) pg/ml] in the SCOPD group were significantly decreased compared with the AECOPD group IL-5 [4.68 (2.34, 9.40) pg/ml, Z=-5.033, P<0.001], IL-17A [2.33 (1.59, 4.62) pg/ml, Z=-3.919, P<0.001], IFN-α [2.83 (0.91, 3.75) pg/ml, Z=-4.127, P<0.01] in the cohort of model establishment. The results of binary logistic regression analysis between SCOPD and AECOPD groups showed that IL-5, IL-17A, and IFN-α were independent risk factors for acute exacerbation of patients with COPD ( P<0.05). And the regression equation is Y=-2.861+0.364×IL-5+0.385×IL-17A+0.445×IFN-α. The AUC value of IL-5, IL-17A, IFN-α and combined detection was 0.866 ( P<0.001). Compared to the SCOPD group and the AECOPD group in the cohort of model validation, the receiver operating characteristic (ROC) curve showed that the combined model of three (AUC=0.858, P<0.001) could be used to diagnose the AECOPD. And the Kappa value was 0.773( P<0.05). Conclusion:The combined detection of IL-5, IL-17A, and IFN-α has high diagnostic efficacy for patients with acute exacerbation of COPD. This method provides a new potential tool for the clinical diagnosis of AECOPD and has the value of further exploration and optimization, promotion, and application.

Objective To compare the efficacy of ultrasound-guided microwave ablation versus thyroidectomy in the treatment of benign thyroid nodules (BTN) and to explore the influencing factors of prognosis. Methods A total of 282 BTN patients were enrolled and divided into ablation group (treated with ultrasound-guided microwave ablation, n=172) and resection group (treated with thyroidectomy, n=110) based on treatment methods. Perioperative indicators and thyroid function indices before and after surgery were compared between the two groups. Patients were followed up for 1 year and divided into good prognosis group [volume reduction rate (VRR)≥80%, n=210] and a poor prognosis group (VRR < 80%, n=72) based on the VRR. Factors influencing the prognosis of BTN patients were analyzed. Results The ablation group had shorter operative time and hospital stay, less intraoperative blood loss, and lower postoperative Visual Analogue Scale (VAS) scores compared to the resection group (P < 0.05). One month after surgery, serum thyrotropin (TSH) levels were higher, while free triiodothyronine (FT3) and free thyroxine (FT4) levels were lower than preoperative levels in both groups, however, TSH level was lower, and FT3 and FT4 levels were higher in the ablation group compared to the resection group (P < 0.05). Univariate analysis showed that preoperative TSH levels, the proportion of solid nodules, and the proportion of nodules in the risk zone were lower, while preoperative FT4 levels were higher in the good prognosis group compared to the poor prognosis group (P < 0.05). Binary Logistic regression analysis revealed that nodule type, nodule location, preoperative TSH, and preoperative FT4 were all influencing factors for the prognosis of BTN patients (P < 0.05). Conclusion Compared to thyroidectomy, ultrasound-guided microwave ablation for BTN offers advantages such as less intraoperative blood loss, milder postoperative pain, shorter operative time and hospital stay, and less damage to thyroid function. Preoperative TSH and FT4 levels, nodule type, and nodule location are closely related to the prognosis of BTN patients and should be given attention in clinical practice.

Hip fractures are among the most common fractures in the elderly, presenting to be a leading cause of disability and mortality. Surgical treatment is currently the main treatment method for hip fractures. The incidence of perioperative malnutrition is increased after hip fractures in the elderly due to the comorbidities, decreased basal metabolic rate, accelerated protein breakdown, weakened anabolism and surgical stress. However, malnutrition not only increases the incidence of postoperative complications, but also leads to increased mortality, indicating an important role of perioperative nursing management of nutrition for the elderly patients with hip fractures. At present, there still lacks scientific guidance and application standards on perioperative nursing management of nutrition for the elderly patients with hip fractures. Therefore, the Orthopedic Nursing Committee of Chinese Nursing Association and the Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Expert consensus on perioperative nursing management of nutrition for elderly patients with hip fractures ( version 2023) according to evidence-based medical evidences and their clinical experiences. Fourteen recommendations were made from aspects of nutrition screening, nutrition assessment, nutrition diagnosis, nutrition intervention and nutrition monitoring to provide guidance for perioperative nursing management of nutrition in elderly patients with hip fractures.

Objective:To compare the postoperative liver function injury condition in patients with intermediate-and advanced-stage hepatocellular carcinoma (HCC) treated with hepatic artery infusion chemotherapy (HAIC) and hepatic artery chemoembolization (TACE) combined with immune checkpoint inhibitors (ICIs) and multi-target tyrosine kinase inhibitors (TKIs).Methods:Patients with intermediate-and advanced-stage HCC who were admitted and treated with HAIC/TACE+ICIs+TKIs therapy at Nanfang Hospital of Southern Medical University from January 2019 to November 2021, with follow-up up to July 2023, were retrospectively enrolled. The results of liver function tests within one week before interventional surgery and on the first day after surgery were recorded. The degree of postoperative liver injury was graded according to the common terminology criteria for adverse events 5.0 (CTCAE 5.0). The treatment efficacy was evaluated according to RECIST 1.1 criteria. Measurement data were compared between groups using a t-test or a non-parametric rank sum test. Enumeration data were compared between the groups using the χ2 test or Fisher's exact probability method. The survival condition differences were analyzed by the log-rank method. Results:This study included 82 and 77 cases in the HAIC and TACE groups. There were no statistically significant differences between the two groups of patients in terms of gender, age, physical condition score, number of tumors, presence or absence of liver cirrhosis, Child-Pugh grade, albumin-bilirubin (ALBI) grade, and combined ICIs and TKIs . The HAIC group had later tumor staging, a greater tumor burden, poorer liver reserve function, and a larger proportion of patients in stage C (81.7% vs. 63.6%), χ2=6.573, P = 0.01). There were 53 cases (64.6% vs. 32.5%) with a maximum tumor diameter of ≥ 10cm, χ2=16.441, P < 0.001), and more patients had a retention rate of ≥ 10% for indocyanine green (ICG) at 15 minutes (68.3% vs. 51.9%, P = 0.035). The postoperative incidence rate of increased levels of alanine aminotransferase, aspartate aminotransferase, and total bilirubin was significantly lower in the HAIC group than that in the TACE group (28.0% vs. 63.6%, χ2=20.298, P < 0.001, 54.9% vs. 85.7%, χ2=17.917, P < 0.001;40.2% vs. 55.8%, χ2=3.873, P = 0.049). The number of patients with postoperative ALBI grade 3 was significantly lower in the HAIC group than that in the TACE group (6.1% vs. 16.9%, χ2=4.601, P = 0.032). There was no statistically significant difference in the incidence rate of postoperative hypoalbuminemia, activated partial thromboplastin time, or increased international standardized ratio between the two groups of patients. There was no statistically significant difference in median progression-free survival (7.3 months vs. 8.2 months, P = 0.296) or median overall survival (16.5 months vs. 21.9 months, P = 0.678) between the two groups of patients. Conclusion:The incidence rate of postoperative liver injury is higher in patients with intermediate-and advanced-stage HCC treated with TACE combined with ICIs and TKIs than in patients with HAIC combined with ICIs and TKIs.

Objective:To investigate the post-traumatic experience of inpatients with simple maxillofacial trauma, and to provide a theoretical basis for the construction of post-traumatic intervention programs.Methods:A qualitative approach was used to conduct semi-structured interviews with 17 inpatients with simple maxillofacial trauma in Affiliated Hospital of Nantong University from January to April, 2020, and Colaizzi phenomenological analysis was used to analyze the interview data.Results:The post-traumatic experience of inpatients with simple maxillofacial trauma mainly included five themes: acute impairment of maxillofacial function, change of comfort, disorder of self-image, transformation from negative psychological experience to positive psychological experience, and lack of coping resources.Conclusions:Medical staff should pay attention to the functional recovery, body image and psychological intervention of inpatients with simple maxillofacial trauma, provide more professional support, and promote the physical and mental recovery of patients.