Objective To construct a support vector machine (SVM) model based on magnetic resonance imaging (MRI) T₂WI turbo inversion recovery magnitude (TIRM) and diffusion-weighted imaging (DWI) sequences, and evaluate its predictive performance for expression levels of human epidermal growth factor receptor-2 (HER-2) and hormone receptor (HR) in breast cancer. Methods A total of 128 breast cancer lesions underwent breast MRI before surgery or treatment were collected, and were grouped according to immunohistochemical (IHC) method or in situ fluorescence hybridization (FISH) results. ITK-SNAP software was used to outline the three-dimensional volume region of interest (VOI) on magnetic resonance TIRM and DWI sequence images, and Pyradiomics program was introduced to extract the image omics features. After normalization of the data, a recursive feature elimination method based on support vector machine-recursive feature elimination (SVM-RFE) was used to filter the features. A total of 108 cases were divided into training group and verification group according to 8∶2 ratio by random stratified sampling method, and the other 20 cases were used as external test group. SVM machine learning classifier was used to construct the image omics model. Receiver operating characteristic (ROC) curve was used to evaluate the prediction efficiency of the model. DeLong test was used to evaluate the area under the curve (AUC) of each image omics model. SHAP algorithm was used for visual analysis, and the most contributing prediction features were screened. Results The prediction efficiency of the combined model (training group AUC=0.94, verification group AUC=0.90) for HER-2 was higher than that of TIRM model(training group AUC=0.85, verification group AUC=0.80) and single DWI model(training group AUC=0.88, verification group AUC=0.66). The AUC of combined model in the external test group was 0.89. The feature contribution of DWI sequence obtained by SHAP algorithm was great. The image omics model based on the combination of TIRM and DWI sequence features (training group AUC=0.96, verification group AUC=0.88) and the single DWI sequence features (training group AUC=0.92, verification group AUC=0.86) was better than the model based on the single TIRM sequence features (training group AUC=0.84, verification group AUC=0.68) in HR prediction. The external test group proved that the combined model had good predictive efficiency, with an AUC of 0.90. The feature contribution of TIRM sequence obtained by SHAP algorithm was great. Conclusion The imaging omics model constructed based on the combined features of TIRM and DWI sequences in magnetic resonance imaging has good predictive efficacy for HER-2 level, and has great potential in predicting HR expression, which can provide a basis for the formulation of personalized treatment for breast cancer patients.

PBL (Problem-based learning) is a kind of teaching method, which is helpful for guiding students to solve practical and complex problems. The compiling of PBL teaching plans is the key to the implementation of PBL teaching. According to the teaching outline of internal medicine, we set the PBL teaching plan, formulated the teaching goal, collected the clinical real cases, finished the compiling of PBL cases of student version and teacher version, and preceded teaching practice accord-ing to the PBL cases. Improving and constructing the compiling framework of internal medicine PBL teaching plan laid the theoretical foundation for carrying out internal medicine PBL teaching.

Objective To study the defects of bone marrow-derived endothelial progenitor cells (EPCs) in number ratio and biological abilities (proliferation, adhesion and migration) in diabetic rats. Methods (1) Establishment of diabetic rat model:1%STZ solution was quickly injected into the abdominal cavity of the male SD rats with the dose of 60 mg/kg. (2). Isolation, culture and identification of bone marrow-derived EPCs in diabetic and normal rats. Bone marrow mononuclear cells were isolated from diabetic and normal rats by density gradient centrifugation methods and cultured by EGM-2 MV medium. The cells were identified by morphological observation, FITC-UEA-1 binding and Dil-Ac-LDL uptake assay, and fluorescent immunocytochemistry was used for detection of CD34 , CD133 and VEGFR-2 expression. CCK-8 method and Transwell kit method were used to determine biological activities of EPCs. Results (1) When cultured in vitro, both bone marrow-derived EPCs in diabetic and normal rats were fusiform in shape, the cells snuggled up to the wall. The expression of CD34, CDl33, VEGFR-2 could be detected in these cells, and the cells could uptake Dil-Ac-LDL and bind FITC-UEA-1, which proved that these cells were EPCs. (2) No significant difference in the number of EPCs derived from bone marrow existed between diabetic rats and normal rats, but the proliferation ability, migration ability and adhesion ability of bone marrow-derived EPCs in diabetic rats were obviously lower than those in normal rats. Conclusion The number of bone marrow-derived EPCs in diabetic rats is not obviously different from that in normal rats, but the biologic activity of EPCs derived from bone marrow in diabetic rats is degraded, which is manifested as weakened abilities of the proliferation, adhesion and migration.

Objective To investigate the level of mental health and effect of psychological rehabilitation on paraplegic patients. Methods 38 paraplegic patients were randomly divided into control group (n=19) and treatment group (n=19). Both groups received physical therapy and occupational therapy, while the treatment group received psychotherapy in addition, once a week for 3 weeks. Their mental health level was assessed with Self-reporting Inventory. Results The psychological problems occurred was ranked as somatization, anxiety, fear, interpersonal sensitivity, depression and obsession from more to less. The scores of each factor reduced after treatment (P<0.05). Conclusion The paraplegics are in poor mental health condition, so more psychotherapy intervention should be taken to improve their rehabilitation effect and quality of life.

Abnormal metabolism in vivo of uric acid leads to many diseases.Recent discovery shows that glucose transporter-like protein-9,which belongs to glucose transporter family not only transports glucose,but also plays an important role in the process of uric acid transport,which is also affected by pH,glucose,estrogen,etc.The variation of glucose transporter-like protein-9 results in metabolic diseases.Therefore,the study of glucose transporterlike protein-9 in uric acid transport and related drug will provide new ideas to control the development of hyperuricemia and related cardiovascular disease.

The improvement of diagnostics teaching system,including the establishment of curriculum system and evaluation system,is the base of promoting clinical- medicine teaching.Our study showed that the theoretical knowledge and clinical skill of medical students could be improved by constructing clinical diagnostics curriculum system and improving organization management and assessment system,which could pave the way for the transition from medical students to clinicians.

Objective To explore the effect of core stability training (CST) on motor of upper limbs after stroke. Methods 60 patients with stroke were divided into observation group (n=30) and control group (n=30). Both groups accepted routine medicine and motor relearning program, and the observation group accepted CST before training. They were assessed with Simple Test for Evaluating Hand Function (STEF), modified Barthel index (MBI), and the Trunk Control Test (TCT) before and 4 weeks after treatment. Results The scores of STEF,MBI, and TCT improved after treatment in both groups (P<0.01), and improved more in the observation group than in the control group (P<0.01). Conclusion CST may facilitate the motor recovery of upper limbs after stroke.

The effect of interventional therapy combined with multifactorial intervention on critical limb ischemia in patients with diabetes mellitus was investigated. The patency rate and limb salvage rate were followed up. Interventional therapy is effective in treating diabetic foot with critical limb ischemia. Multifactorial intervention was helpful for reducing amputation.

Objective To investigate the effect of self-efficacy theory in rehabilitation on stroke patients with hemiplegia complicated psychological disorder. Methods 26 cases were divided into the combined therapy group (13 cases, accepted physical therapy with self-efficacy) and the routine physical therapy group (13 cases). They were assessed with General self-efficacy scale (GSES), Fugl-Meyer Assessment before and 1, 3 months after treatment, as well as symptom checklist (SCL-90) before and 1 month after treatment. Results The scores of GSES raise 63% in the combined therapy group 1 month after treatment, obviously different from that of routine physical therapy (P<0.01).The score of Fugl-Meyer Assessment of the combined therapy group were increased from (53.08±13.04) to (90.07±6.54 ) and from (56.46±12.95) to (81.77±8.51)in the routine physical therapy group (F= 85.53,P<0.05). All the scores of depression, anxiety, compulsion, hostility in SCL-90 were markedly lower in the combined therapy group than in the routine physical therapy group(P<0.01). Conclusion Utilization of self-efficacy theory in rehabilitation can improve the emotion and effect of rehabilitation.

Objective To investigate the mental health status of patients with cervical spondylosis and the curative effect of psychotherapy.Methods71 patients of cervical spondylosis with psychological obstacles were randomly divided into the experiment group (32 cases, treated by physiotherapy combined with psychotherapy simultaneously) and control group (39 cases, treated by physiotherapy only). The patients' somzatization and mental health status were evaluated by the Symptom Checklist-90 (SCL-90) and the table of curative effect estimation of cervical syndrome before and four weeks after treatment.ResultsThere was no significant difference between two groups in the degrees of somzatization and scores of SCL-90 before treatment. After four weeks treatment, both two groups had improvement in the physical symptom and psychological condition, but the curative effect of the experiment group was better than the control group ( P<0.05).ConclusionBecause having a long disease course, the patients with cervical spondylosis have different level mental health troubles. Psychotherapy is helpful to improve curative effect.