Osteoporotic proximal humeral fracture (OPHF) is one of the common osteoporotic fractures in the aged, with an incidence only lower than vertebral compression fracture, hip fracture, and distal radius fracture. OPHF, secondary to osteoporosis and characterized by poor bone quality, comminuted fracture pattern, slow healing, and severely impaired shoulder joint function, poses a big challenge to the current clinical diagnosis and treatment. In the field of diagnosis, treatment, and rehabilitation of OPHF, traditional Chinese and Western medicine have accumulated rich experience and evidence from evidence-based medicine and achieved favorable outcomes. However, there is still a lack of guidance from a relevant consensus as to how to integrate the advantages of the two medical systems and achieve the integrated diagnosis and treatment. To promote the diagnosis and treatment of OPHF with integrated traditional Chinese and Western medicine, relevant experts from Orthopedic Expert Committee of Geriatric Branch of Chinese Association of Gerontology and Geriatrics, Youth Osteoporosis Group of Orthopedic Branch of Chinese Medical Association, Osteoporosis Group of Orthopedic Surgeon Branch of Chinese Medical Doctor Association, and Osteoporosis Committee of Shanghai Association of Integrated Traditional Chinese and Western Medicine have been organized to formulate Expert consensus on the diagnosis and treatment of osteoporotic proximal humeral fracture with integrated traditional Chinese and Western medicine ( version 2024) by searching related literatures and based on the evidences from evidence-based medicine. This consensus consists of 13 recommendations about the diagnosis, treatment and rehabilitation of OPHF with integrated traditional Chinese medicine and Western medicine, aimed at standardizing, systematizing, and personalizing the diagnosis and treatment of OPHF with integrated traditional Chinse and Western medicine to improve the patients ′ function.

Objective To investigate the effect of visceral fat area (VFA) on perioperative related indi-cators and short-term prognosis of patients with colorectal cancer (CRC).Methods Clinical data of 102 pa-tients who underwent laparoscopic radical surgery for CRC in the First Affiliated Hospital of Baotou Medical College from September 2020 to August 2023 were retrospectively analyzed.All patients underwent preopera-tive abdominal CT examination,and the transverse CT images at the level of the third lumbar vertebra (L3) were selected.VFA was measured using Slice-O-Matic software,and patients were divided into the high VFA group (VFA≥100 cm2) and the low VFA group (VFA<100 cm2) based on the measurement results.Clinical data,patho-logical data,surgical data,postoperative complications,and perioperative coagulation and inflammation indicators were collected.Results Compared with the low VFA group,the high VFA group had higher BMI,longer hospital stay,greater intraoperative blood loss,and fewer lymph node dissections (P<0.05).The WBC and PCT lev-els before and after surgery in the high VFA group were higher than those in the low VFA group (P<0.05). Compared with preoperative levels,WBC,C-reactive protein (CRP),PCT,plasma prothrombin time (PT), plasma fibrinogen (FIB),and international standardized ratio (INR) increased and PLT decreased in both groups after surgery,the differences were statistically significance (P<0.05);Compared with preoperative conditions,the activated partial prothrombin time (APTT) in the high VFA group and the thrombin time (TT) decreased in the low VFA group decreased after surgery,the differences were statistically significant (P<0.05).The total incidence of postoperative complications (21.2％) and the incidence of incision compli-cations (15.4％) in the high VFA group were higher than that in the low VFA group (4.0％,2.0％),the differences were statistically significant (P<0.05).Conclusion Colorectal cancer patients with high VFA during the perioperative period exhibit higher levels of inflammation indicators and poorer prognosis.

This study aims to investigate the function of lmo2363 gene in stress resistance of Liste-ria monocytogenes strain LM83-1.In this study,the lmo2363 gene deletion strain and complement-ation strain of Listeria monocytogenes were constructed using overlapping extended PCR and ho-mologous recombination techniques,and the growth ability,stress survival rate and biofilm forma-tion ability of wild,deletion strain and complementation strain were compared under different stress environments.lmo2363 gene deletion strain and complementation strain of Listeria monocy-togenes were successfully constructed in this experiment.The growth curves showed that the growth capacity of the deletion strain was weaker than the wild strain LM83-1 under 4 ℃,7％NaCl,10％NaCl,3.5％ethanol,4.0％ethanol and pH5 stress(P＜0.001).The results of stress survival test showed that the survival rate of the deletion strain was significantly lower than the wild strain after 1 h treatment with pH3 and 10 mmol/L H2 O2 stress(P＜0.010).The biofilm forming ability of the deletion strain was decreased compared with that of the wild strain(P＜0.050).This study confirmed that lmo2363 gene mediated the adaptation of LM to low temperature,high osmotic pressure,ethanol and acid stress environment and affected the formation of LM bio-film.This study laid a foundation for further exploring the function of lmo2363 gene in the stress resistance process of Listeria monocytogenes.

Objective:To assess the correlation and consistency of electrochemiluminescence and direct chemiluminescence in detecting 12 tumor markers.Methods:A total of 2426 serum specimens were selected from the physical examination in Beijing Tiantan Hospital,Capital Medical University from March to August 2023.These specimens included 446 cases for alpha fetoprotein(AFP),284 cases for carcinoembryonic antigen(CEA),289 cases for carbohydrate antigen 72-4(CA72-4),87 cases for carbohydrate antigen 19-9(CA19-9),205 cases for carbohydrate antigen 125(CA-125),216 cases for carbohydrate antigen 15-3(CA 15-3),292 cases for total prostate specific antigen(TPSA),292 cases for free prostate specific antigen(FPSA),84 cases for serum cytokeratin 19 fragment(Cyfra21-1),84 cases for neuron specific enolase(NSE),84 cases for squamous cell carcinoma associated antigen(SCC)and 63 cases for pro-gastrin-releasing peptide(PROGrp).The electrochemiluminescence and direct chemiluminescence methods were respectively used to detect the above 12 indexes,and then,the correlation and consistency between the two detection methods were analyzed.Results:The results of Pearson and Spearman correlation analysis showed that there were significantly positive correlations between electrochemiluminescence and direct chemiluminescence methods in detecting 12 tumor indexes(AFP,CEA,CA72-4,CA19-9,CA125,CA15-3,TPSA,FPSA,Cyfra21-1,NSE,SCC and PROGrp)(r=0.971,0.934,0.945,0.975,0.900,0.948,0.994,0.984,0.982,0.828,0.879,0.922,P<0.05),respectively.The total coincidence rates between the two methods were respectively 98.21%,98.24%,98.27%,98.85%,97.07%,99.54%,99.66%,99.32%,92.86%,92.86%,95.24%and 96.83%.There were consistencies between electrochemiluminescence and direct chemiluminescence methods for 10 indexes excepted CA15-3 and NSE that could not calculate Kappa values due to data reasons(Kappa=0.848,0.728,0.930,0.794,0.485,0.887,0.664,0.540,0.477,0.652,P<0.05),respectively.Conclusion:In the detections of electrochemiluminescence and direct chemiluminescence methods for tumor indexes,there are favorable correlations and consistencies between them in detecting AFP,CA72-4,CA19-9 and TPSA,and there are favorable correlations between them in detecting CEA,CA125,FPSA,Cyfra21-1,SCC and PROGrp but the consistencies between them are average in detecting these indexes,and there are favorable correlations between them in detecting CA15-3 and NSE.Clinical detection should pay attention to there may be differences in the results between different detection methods when the detection is conducted in reference laboratory.

【Objective】 To explore the factors influencing the survival and prognosis of patients with bladder urothelial carcinoma (BUC) after surgical treatment, and to establish an artificial intelligence algorithm to predict the effects of different surgical regimens. 【Methods】 BUC patients treated with surgery during Jan.2007 and Jan.2019 in The Second Hospital of Dalian Medical University and Nanfang Hospital of Southern Medical University were enrolled. The complete clinical and follow-up data were collected. Deep neural network (DNN) was used to establish an artificial intelligence algorithm model. A prediction model of survival and prognosis was established, and the influencing factors of survival were explored and ranked by the artificial intelligence algorithm. 【Results】 A total of 832 patients were involved, including 438 (52.64%) treated in The Second Hospital of Dalian Medical University, and 394 (47.36%) treated in Nanfang Hospital of Southern Medical University. Of all cases, 579 (69.6%) were non-muscle invasive bladder cancer, and 253 (30.4%) were muscle invasive bladder cancer. Transurethral resection of bladder tumor was conducted in 539 (64.8%) cases, partial cystectomy in 66 (7.9%) cases, and total cystectomy in 227 (27.3%) cases. The data of patients treated in Second Hospital of Dalian Medical University were used for DNN modeling, and the data of patients treated in Nanfang Hospital of Southern Medical University were used for external verification after modeling. Finally, it was concluded that the factors affecting survival and prognosis were T stage, pathological grade, hypertension or cardiovascular and cerebrovascular disease, hemoglobin, blood calcium, smoking, albumin, lymphocytes, age, ratio of albumin/globulin, operation method, N stage, and creatinine clearance rate in descending order. The model could be used for preoperative prediction. 【Conclusion】 Through DNN modeling and external verification, the influencing factors of postoperative survival can be predicted for patients with bladder cancer, and the surgical effects can also be predicted before operation. The model can provide artificial intelligence algorithm support for the selection of surgical methods and postoperative follow-up plans.

Pain assessment is the key to preventing and managing neonatal pain, and artificial intelligence plays an important role in neonatal pain assessment. This article reviews the definition of artificial intelligence, its application foundation, current status, and development trends in neonatal pain assessment, and analyzes the feasibility and limitations of the promotion and application of artificial intelligence in neonatal pain assessment, in order to provide reference for the effective application of artificial intelligence technology.

Objective:To investigate how medical students process Western medicine(WM)terms vs.traditional Chinese medicine(TCM)terms and how this is impacted by analogical priming from the perspective of cognitive neuroscience.Methods:The experiments were designed as a 2(TCM terms vs.WM terms)x 2(correct terms vs.incorrect terms)x 2(analogical priming task vs.non-priming task)scheme.A total of 26 medical stu-dents completed a non-priming judgment task and an analogical priming judgment task on medical terms.During the tasks,the participants were asked to make correct/incorrect judgments on WM terms and TCM terms,and their behavioral data and event-related potentials(ERPs)were recorded.Results:Behaviorally,the response speed and accuracy of WM terms were higher than those of TCM terms(both P＜.001),indicating a prominent concreteness effect.Analogical priming shortened the response time to medical terms(P＜.001),and the response time to TCM terms was shortened more significantly(P=.001).For ERPs,WM terms induced a larger P200(an early positive ERP component),a smaller N400(a negative ERP component),and a higher late positive ERP component,indicating supe-riority of attention adjustment,smaller-scale semantic activation,and a higher cost of late semantic analysis and integration.However,the analogical priming eliminated the difference between WM and TCM terms in P200 and N400 while maintaining it in the LPC.This suggests that WM terms are sensitive to analogical attention adjustment,and TCM terms are susceptible to analogical semantic integration.Conclusion:Our findings suggest that WM and TCM disease behavior terms may initially differ in concreteness or the use of a verbal-linguistic system.Analogy is more conducive to understanding TCM terms.This research provides important neuroscientific evidence of the difference in thinking between TCM and WM.

Objective:To comparatively analyze the changes regulation of death attitude and death education needs for undergraduate nursing students in different grades.Methods:From March to June in 2019, 766 undergraduate nursing students from Batch 2015 to Batch 2018 of a medical college were collected in cluster sampling. The investigation was conducted by using the scale of Death Attitude Profile-revised in Chinese version and the scale of death education needs. SPSS 22.0 was used for statistical analysis, LSD test for measurement data, and chi-square test for counting data.Results:There were increasing trends of scores from freshman to junior in dimensions of fear of death, approach-oriented death acceptance and escape-oriented death acceptance ( P < 0.05), and the scores decreased in senior, but without statistical difference compared with junior ( P > 0.05). In neutral death acceptance dimension, the score decreased significantly in the second year ( P = 0.001), and then returned back to the original level in the fourth year. No significantly statistical difference was found in scores of different grades in death escape dimension ( P = 0.038). The score of death education need in the fourth year was the highest ( P < 0.05) and was positively correlated with the score of neutral death acceptance dimension ( P = 0.007). Conclusion:With the increase of school year, nursing students' positive attitude for death demonstrates positive trend, while the level of negative attitude of death are becoming balanced. The fourth year is suggested to be the right time to conduct death education immediately.

Objective:To investigate the prevalence of work-related musculoskeletal disorders among nurses in ClassⅢ Grade A stomatology hospitals.Methods:Using the convenient sampling method, a cross-sectional survey was conducted on general information, prevalence of work-related musculoskeletal disorders and working factors of 496 front-line nurses from two ClassⅢ Grade A stomatology hospitals in Beijing from November 14 to 27, 2019 by using the revised electronic version of Nordic Musculoskeletal Disorders Questionnaire revised based on the Chinese population.Results:A total of 496 questionnaires were collected and 483 were valid. The annual prevalence rate of work-related musculoskeletal disorders among dental nurses was 68.3% (330/483) . Among the 9 body parts, the top 4 affected parts were neck, shoulder, lower back and upper back. Education level was an independent risk factor for work-related musculoskeletal disorders ( P<0.01) , while physical exercise was a protective factor ( P<0.05) . Conclusions:The incidence of work-related musculoskeletal disorders among dental nurses is not optimistic.It is necessary to screen high-risk groups as soon as possible, encourage nurses to strengthen physical exercise and carry out key interventions for neck, shoulder and back musculoskeletal diseases to avoid irreversible decline in musculoskeletal function, which may affect the physical health and career development of dental nurses.

Objective:To systematically evaluate the intervention effect of oral immunotherapy (OIT) on ventilator-associated pneumonia (VAP) of premature infants.Methods:This study searched the Cochrane Library, PubMed, Embase, Web of Science, CINAHL, Chinese Biomedical Literature Service System, China National Knowledge Infrastructure (CNKI) , WanFang Database and VIP Database, and conducted a comprehensive search for randomized controlled trials of OIT applied to premature infants published from database establishment to October 2020. Two researchers independently screened literature, extracted data, and evaluated methodological quality. RevMan 5.3 software was used for Meta-analysis.Results:A total of 8 studies were included, with a total of 351 premature infants in the intervention group and 352 premature infants in the control group. Meta-analysis results showed that OIT could reduce the incidence of VAP in premature infants [ RR=0.36, 95% CI (0.23-0.56) , P<0.05] and the detection rate of pathogenic microorganisms in the tracheal tube [ RR=0.33, 95% CI (0.18-0.59) , P=0.000 2], and could shorten the length of hospital stay [ MD=-6.70, 95% CI (-13.34--0.06) , P=0.05]. However, there was no statistically significant difference in the mechanical ventilation time, detection rate of oropharyngeal pathogenic microorganisms and mortality rate between the two groups after the intervention (all P>0.05) . Conclusions:OIT can reduce the incidence of VAP in premature infants and the detection rate of pathogenic microorganisms in the tracheal tube, and shorten the length of hospital stay to a certain extent. However, high-quality, large-sample, multi-center randomized controlled studies are still needed for further verification in the future.