Objective:To explore the value of machine-learning models based on magnetic resonance imaging(MRI)radiomics features for the preoperative prediction of the blood supply in pituitary neuroendocrine tumors.Methods:A retrospective analysis was performed on the clinical and imaging data of 136 patients with pathologically confirmed pituitary neuroendocrine tumors(diameter>10 mm)from April 2013 to April 2023 at Yi Jishan Hospital of Wannan Medical College.Based on the intraoperative findings,the patients were assigned into richly vascularized(n=50)and normally vascularized(n=86)groups.All patients were allocated randomly in a 7:3 ratio into a training(n=96)or a validation group(n=40).Three machine-learning algorithms,multivariate Logistic regression(LR),random forest(RF),and support vec-tor machine(SVM),were used to establish radiomics prediction models.Receiver operating characteristic(ROC)curves were plotted to eval-uate the diagnostic performance of the models;decision curve analysis(DCA)was used to assess the net clinical benefit of the models.Res-ults:The clinical model achieved areas under the ROC curve(AUC)of 0.74 and 0.82 in the training and validation groups,respectively.The radiomics models using T1-weighted imaging(WI),T2WI,T1WI-enhanced,and combined sequences achieved AUCs of 0.80,0.84,0.82,and 0.84 in the training group and 0.82,0.80,0.85,and 0.83 in the validation group,respectively.The LR,RF,and SVM models had AUCs of 0.85,0.87,and 0.84 in the training group and 0.85,0.85,and 0.83 in the validation group,respectively.All radiomics models demonstrated great-er diagnostic efficacy than the clinical model.DCA indicated that the LR,SVM,and combined-sequence models achieved good net clinical be-nefits;the LR model showed the best results.Conclusions:Machine-learning models based on MRI radiomics exhibit high predictive value,surpassing the clinical judgment of radiologists based on MRI images alone,and offer a favorable net clinical benefit.

Objective:To analyze the changes in the management methods of large medical equipment in China, evaluate the equity of large medical equipment allocation planning from the 13th Five-Year Plan to the 14th Five-Year Plan.Methods:The literature research was used to sort out the characteristics and changes of the management of large medical equipment in China. The database was established to quantitatively analyze the existing number of large medical equipment at the end of the 13th Five-Year Plan and the planned number of large medical equipment at the end of the 14th Five-Year Plan, and then the fairness evaluation was carried out based on the Lorenz curve and Gini coefficient.Results:Since the 1980s, the management measures of large-scale medical equipment in China have been introduced and updated iteratively to meet the needs of social development and medical services. In addition to conventional radiotherapy equipment, the number of large medical equipment per million population in China at the end of the 14th Five-Year Plan at least doubled compared with the end of the 13th Five-Year Plan, among which the heavy ion radiotherapy system and the laparoscopic surgery system increased by more than two times. Lorenz curve analysis showed that the fairness of large medical equipment based on population distribution at the end of the 14th Five-Year Plan was better than that at the end of the 13th Five-Year Plan, especially for heavy ion proton radiotherapy system, high-end radiotherapy equipment and PET/MR. The Gini coefficient of large medical equipment planning based on population distribution during the 14th Five-Year Plan was generally smaller than that of the 13th Five-Year Plan. Except for the heavy ion proton radiotherapy system and PET/MR in North China, the Gini coefficient of the planned number of all kinds of equipment in the six regions of the country during the 14th Five-Year Plan was less than 0.4 based on population distribution, which was in a relatively fair state.Conclusions:The management of large medical equipment in China keeps pace with the times and constantly adapts to the new development stage of health care. The fairness of large medical equipment allocation planning based on population distribution in six regions of China has been steadily improved, and it is suggested that the fairness based on population distribution and the clinical application of existing equipment should be taken into account in the allocation planning.

Objective To analyze and assess the postoperative motor function in children with spastic cerebral palsy (SCP) by surface electromyography (sEMG) and joint angle. Methods Sixteen children with SCP were involved in this study. The sEMG of rectus femoris, biceps femoris, semitendinosus, tibialis anterior, lateral gastrocnemius and medial gastrocnemius muscles and joint angles of the hip, knee and ankle during straight walking were collected preoperatively and postoperatively. In every gait phase, the mean values of joint angles, root mean square and integrated electromyography of sEMG were calculated, to evaluate muscle strength and muscular tension quantitatively. Results The muscle tension of lower limbs was significantly decreased (P<0.05). The muscle strength of rectus femoris and biceps femoris was decreased in the swing phase. At the midswing and terminal swing phase, the strength of tibialis anterior increased significantly (P<0.05). The flexion angle of hip and knee decreased significantly (P<0.05). The dorsiflexion angle of ankle increased significantly (P<0.05), and the varus angle decreased significantly (P<0.05). Conclusions After operation, the crouching gait and clubfoot were improved positively. Therefore, the motor function of children was improved. Combining sEMG and joint angle can evaluate the muscle function of patients quantitatively, and it also can provide references for clinical diagnosis.

Objective : To investigate the role of N-methyladenosine(m6 A) demethylase ALKBH5 in the prolifera- tion and activation of cardiac fibroblasts( CFs) in rats． Methods : The CFs taken from SD rats in 1 to 3 days were isolated by differential adhesion and observed under microscope．After cells were adherently grown to appropriate density，the cells were induced by TGF-β1 for modeling．The model cells were divided into the overexpression of ALKBH5 group infected by lentivirus and the negative control group for 24－48 hours. RT-qPCR was used to detect mRNA expression of ALKBH5，α-smooth muscle actin( α-SMA) ，type I collagen ( Collagen Ⅰ ) and proliferating cell nuclear antigen (PCNA) ．The expression of ALKBH5、α-SMA、Collagen Ⅰ and PCNA were assayed by West- ern blot．The cell proliferation activity was tested by CCK-8 assay and EdU. Results : Compared with the control group，the protein and mRNA of ALKBH5 were reduced in the model group active by TGF-β1．Meanwhile，the bi- omarkers of activation，such as PCNA，α-SMA and Collagen Ⅰ , increased significantly．Besides，the protein and mRNA of PCNA、α-SMA and Collagen Ⅰ were lower in overexpression of ALKBH5 group than those of the negative control group．CCK-8 assay and EdU suggested that the proliferation viability of CFs was reduced evidently in over- expression of ALKBH5 group，compared with the negative control group． Conclusion Overexpression of ALKBH5 can inhibit the proliferation of CFs，suggesting that ALKBH5 may be a key regulatory point in the development of myocardial fibrosis.

Cinnamomum migao plants often face different degrees of drought in karst habitats, which can lead to plants’ death, especially in the seedling stage. Widespread of arbuscular mycorrhizal (AM) fungi in karst soils have the potential to address this drought, which is a threat to C. migao seedlings. We inoculated C. migao seedlings with spores from Glomus lamellosum and Glomus etunicatum, two AM fungi widely distributed in karst soils, to observe seedling growth response after simulated drought. Our results showed that 40 g of G. lamellosum and G. etunicatum significantly promoted the growth of C. migao seedlings, 120 days after inoculation. Following a 15-day drought treatment, root colonization of the seedlings with G. lamellosum or G. etunicatum had lower the accumulation of malondialdehyde (MDA) and increased the accumulation of enzymes and osmotic substances in the seedlings. The relative water content in different organs (roots, stems, and leaves) of the drought-stressed seedlings was higher in plants with G. lamellosum or G. etunicatum than in plants without AM fungi colonization. Our results showed that inoculation with AM fungi was an effective means to improve the drought resistance of C. migao seedlings.

Cinnamomum migao plants often face different degrees of drought in karst habitats, which can lead to plants’ death, especially in the seedling stage. Widespread of arbuscular mycorrhizal (AM) fungi in karst soils have the potential to address this drought, which is a threat to C. migao seedlings. We inoculated C. migao seedlings with spores from Glomus lamellosum and Glomus etunicatum, two AM fungi widely distributed in karst soils, to observe seedling growth response after simulated drought. Our results showed that 40 g of G. lamellosum and G. etunicatum significantly promoted the growth of C. migao seedlings, 120 days after inoculation. Following a 15-day drought treatment, root colonization of the seedlings with G. lamellosum or G. etunicatum had lower the accumulation of malondialdehyde (MDA) and increased the accumulation of enzymes and osmotic substances in the seedlings. The relative water content in different organs (roots, stems, and leaves) of the drought-stressed seedlings was higher in plants with G. lamellosum or G. etunicatum than in plants without AM fungi colonization. Our results showed that inoculation with AM fungi was an effective means to improve the drought resistance of C. migao seedlings.

Wuhan is the city with the most serious outbreak of corona virus disease 2019 (COVID-19) in China. The outbreak of community has exhausted the current medical resources. With integrating local and support medical resources from other province, Wuhan City has rapidly rebuilt a new emergency medical system of classified treatment, and effectively responded to the overload medical demand after the outbreak in the community.

Objective To investigate the feasibility of inserting and detaining nasointestinal feeding tube in small bowl guided by bedside ultrasound(US)in critically ill elderly patients.Methods This was a retrospective study.Sixty four aged patients(≥ 60 years)in general ICU,the Second Affiliated Hospital of Jiaxing College,received the US-guided nasointestinal feeding tubes inserting and detaining.Feeding tubes passed through nasal and went into the stomach by manual blind method.Under US-guiding condition,the tube passed through the pyloric sphincter and further into the duodenum or jejunum.Finally the correct position of the tube head was assessed by bedside X-ray examination.Results The US-guided nasointestinal feeding tube-detaining technique was successfully operated in 57 patients(89.1％).The feeding tube heads were in the duodenum in thirty four cases(53.1 ％),and in proximal jejunum in twenty-three cases(35.9％).The untoward reaction included the bleeding of nasal cavity in 1 case,and hypotension in another case.Conclusions Bedside US-guided nasointestinal feeding tube placement is safe and feasible in aged critical patients.

Objective: To investigate the clinical effect and safety of long-acting pegylated interferon-α-2b (Peg-IFN-α-2b) (Y shape, 40 kD) injection (180 μg/week) in the treatment of HBeAg-positive chronic hepatitis B (CHB) patients, with standard-dose Peg-IFN-α-2a as positive control. Methods: This study was a multicenter, randomized, open-label, and positive-controlled phase III clinical trial. Eligible HBeAg-positive CHB patients were screened out and randomized to Peg-IFN-α-2b (Y shape, 40 kD) trial group and Peg-IFN-α-2a control group at a ratio of 2:1. The course of treatment was 48 weeks and the patients were followed up for 24 weeks after drug withdrawal. Plasma samples were collected at screening, baseline, and 12, 24, 36, 48, 60, and 72 weeks for centralized detection. COBAS® Ampliprep/COBAS® TaqMan® HBV Test was used to measure HBV DNA level by quantitative real-time PCR. Electrochemiluminescence immunoassay with Elecsys kit was used to measure HBV markers (HBsAg, anti-HBs, HBeAg, anti-HBe). Adverse events were recorded in detail. The primary outcome measure was HBeAg seroconversion rate after the 24-week follow-up, and non-inferiority was also tested. The difference in HBeAg seroconversion rate after treatment between the trial group and the control group and two-sided confidence interval (CI) were calculated, and non-inferiority was demonstrated if the lower limit of 95% CI was > -10%. The t-test, chi-square test, or rank sum test was used according to the types and features of data. Results: A total of 855 HBeAg-positive CHB patients were enrolled and 820 of them received treatment (538 in the trial group and 282 in the control group). The data of the full analysis set showed that HBeAg seroconversion rate at week 72 was 27.32% in the trial group and 22.70% in the control group with a rate difference of 4.63% (95% CI -1.54% to 10.80%, P = 0.1493). The data of the per-protocol set showed that HBeAg seroconversion rate at week 72 was 30.75% in the trial group and 27.14% in the control group with a rate difference of 3.61% (95% CI -3.87% to 11.09%, P = 0.3436). 95% CI met the non-inferiority criteria, and the trial group was non-inferior to the control group. The two groups had similar incidence rates of adverse events, serious adverse events, and common adverse events. Conclusion In Peg-IFN-α regimen for HBeAg-positive CHB patients, the new drug Peg-IFN-α-2b (Y shape, 40 kD) has comparable effect and safety to the control drug Peg-IFN-α-2a.

Objective To examine the impact of case management on hospitalizations of the chronically and severely mentally ill patients in Zhongshan. Methods Patients with severe and chronic mental illness,aged ≥ 15 years and living in pilot area were divided into two groups naturally since the program of case management launched, 65 cases in the group of case management and 112 patients in the group of standard management. Hospitalizations of the two groups before and after case management were compared. Results Data were analysised with MIXED procedure. Length of stay in days per admission (LOS) of both groups decreased with time in years (F=11.02, P=0.001), and the decline in LOS of case management group was greater than that of standard management group (F=9.02, P=0.003). The average admissions of case management group was more than that of standard management group (F=4.98,P=0.03). There was no significant differences in average hospitalization incidents before and after case management in both groups(case management group 5.13%vs. 5.38%, standard management group 7.14%vs. 8.92%, P>0.05). Conclusions Case management was effective in reducing hospitalizations for a group of Chinese with chronic and severe mental illness, and may contribute to the balance on mental health resources between community and hospital.