ObjectiveTo develop a nomogram-based risk prediction model for chronic obstructive pulmonary disease (COPD) incidence among the community-dwelling population aged 40 years old and above, so as to provide targeted references for the screening and prevention of COPD. MethodsBased on a natural population cohort in suburban Shanghai, a total of 3 381 randomly selected participants aged ≥40 years underwent pulmonary function tests between July and October 2021. Cox stepwise regression analysis was used to develop overall and gender-specific risk prediction models, along with the construction of corresponding risk nomograms. Model predictive performance was evaluated using the C-indice, area under the curve (AUC) values, and Brier score. Stability was assessed through 10-fold cross-validation and sensitivity analysis. ResultsA total of 3 019 participants were included, with a median follow-up duration of 4.6 years. The COPD incidence density was 17.22 per 1 000 person-years, significantly higher in males (32.04/1 000 person-years) than that in females (7.38/1 000 person-years) (P<0.001). The overall risk prediction model included the variables such as gender, age, education level, BMI, smoking, passive smoking, and respiratory comorbidities. The male-specific model incorporated the variables such as age, BMI, respiratory comorbidities, and smoking, while the female-specific model included age, marital status, respiratory comorbidities, and pulmonary tuberculosis history. The C-indices for the overall, male-specific, and female-specific models were 0.829, 0.749, and 0.807, respectively. The 5-year AUC values were 0.785, 0.658, and 0.811, with Brier scores of 0.103, 0.176, and 0.059, respectively. Both 10-fold cross-validated C-indices and sensitivity analysis (excluding participants with a follow-up duration of <6 months) yielded C-indices were above 0.740. ConclusionThis study developed concise and practical overall and gender-specific COPD risk prediction models and corresponding nomograms. The models demonstrated robust performance in predicting COPD incidence, providing a valuable reference for identifying high-risk populations and formulating targeted screening and personalized management strategies.

ObjectiveTo evaluate the efficacy of three screening questionnaires for COPD in the community residents of Songjiang District， Shanghai， and to provide a basis for selecting COPD screening questionnaire and process that are more suitable. MethodsCommunity residents aged 40 years or over were randomly selected from the Shanghai Suburban Adult Cohort and Biobank for the study with screening questionnaires and spirometry. Questionnaires included the COPD screening questionnaire （COPD-SQ）， the COPD population screener （COPD-PS） and the revised COPD diagnostic questionnaire （revised-CDQ）. Evaluation of the efficacy of these questionnaires was based on the area under the receiver operating characteristic curve （AUC） of the subjects. DeLong test was used to compare the accuracy of different questionnaires； Z test was used to compare the accuracy of different cut-off values for the same questionnaire. ResultsAmong 3 184 community residents， a total of 259 （8.1%） COPD patients were screened by spirometry. AUC values of these 3 screening questionnaires were >0.7 indicating that they were reliable COPD screening tools. The sensitivity and specificity of the questionnaires at the recommended cut-off values were COPD-SQ （63.7% and 72.2%）， COPD-PS （12.0% and 96.1%）， and revised CDQ （78.8% and 52.7%）， with the COPD-SQ having the highest screening accuracy （AUC=0.754）. The optimal and recommended cut-off values for the three questionnaires differed in this population， but the difference in accuracy was statistically significant only for COPD-PS. The optimal cut-off values for the three questionnaires differed between male and female， and the sensitivity and accuracy of COPD-SQ and COPD-PS improved when lower cut-off values were used for women. The AUC was greater when two questionnaires were utilized simultaneously for screening， but the differences were not statistically significant. ConclusionThe COPD-SQ is recommended for primary COPD screening； a lower cut-off value for women should be considered. The COPD screening questionnaire needs to be further improved for the early diagnosis and treatment of COPD patients.

Objective To compare the application value of Azurion comprehensive large plate imaging system based on 3D road map technology and conventional road map in interventional treatment of intracranial aneurysms.Methods A total of 73 patients with intracranial aneurysms,who received treatment at the Department of Neurosurgery of Ganzhou Municipal Hospital of China from February 2021 to May 2023,were enrolled in this study.The patients were divided into study group(n=73,under the guidance of 3D real-time road map)and control group(n=75,under the guidance of conventional road map).The surgery-related indicators,embolization density,image quality,serological indicators,and quality of life were compared between the two groups.The patients were followed up for 6 months.The recurrence rate and prognosis were compared between the two groups.Results Compared with the control group,in the study group the accurate location rate of microcatheter with single catheterization manipulation was higher(P＜0.05),the incidence of intraoperative rupture bleeding was lower(P＜0.05),the time spent for operation was shorter(P＜0.05),and the amount of the contrast agent used and the machine radiation dose were lower(P＜0.05).The Raymond grade distribution in the study group was better than that in the control group(P＜0.05).The excellent rate of image quality in the study group was higher than that in the control group(P＜0.05).The differences of matrix metalloproteinase 9(MMP-9)and neuron-specific enolase(NSE)before and after treatment in the study group were higher than those in the control group(both P＜0.05).The differences of material well-being life,social function,mental health and physical health scores before and after treatment in the study group were higher than those in the control group(all P＜0.05).The postoperative recurrence rate in the study group was lower than that in the control group(P＜0.05).No statistically significant difference in Glasgow prognostic Scale(GOS)score existed between the two groups(P＞0.05).Conclusion Compared with the conventional road map,the use of Azurion comprehensive large plate imaging system based on 3D road map technology has a definite and excellent effect in the interventional treatment of intracranial aneurysms,which can shorten the operation time,reduce the used dose of contrast agent,decrease the risk of intraoperative rupture with bleeding and postoperative recurrence,regulate the expression of serum NSE and MMP-9,improve the quality of life of patients,and ensure a satisfactory prognosis.

Objective:To explore and improve the teaching model and method of basic courses of computer application in Military Medical University so as to enhance the teaching quality and effect of the courses.Methods: Through analysis and discussion for the facing problem in basic teaching course of computer application of military medical university, and adopting series of teaching methods included that confirmed teaching aim, innovated teaching idea, explored group instruction and emphasized curriculum development, and combining teaching experiences, some opinions and suggestions were proposed to strengthen and improve the teaching quality of basis course of computer application.Results:After improved the teaching methods for basic courses of computer application, the project assessment and actual measurement of students' ability showed that the students' knowledge level and ability were greatly improved than formerly students, and the teaching level of the basic course of computer application also were enhanced.Conclusion: Under the new situation, basic course teaching of computer application in military medical university is facing new challenges, and the corresponding measurements should be adopted to enhance the teaching quality so as to satisfy the requirement of compound talent cultivation for military medicine under the informatization age.

Objective Data from the HIV/AIDS surveillance sentinel sites was used to identify the recent HIV-1 infections and to estimate the HIV-1 incidence and epidemic trends among intravenous drug users (IDU),MSM,female sex workers and men attending the sexually transmitted disease clinics in Sichuan province.Methods Specimens collected from IDUs,MSM,female sex workers and men attending the sexually transmitted disease clinics sentinel sites were confirmed as HIV-I positive and tested with BED-CEIA.Annual HIV-1 prevalence and incidence rates were calculated and the incidence was adjusted by McNermar method.Results A total number of 194 223 serum specimens were collected and HIV antibody tested,with 5 297 HIV-1 positive.4 640 of the positives underwent BED-CEIA,with 749 identified as recent infections.During 2011-2015,HIV-1 incidence rates of the four types of population appeared as 5.16％ (95％CI:4.65-5.66),0.22％ (95％CI:0.16-0.28),0.57％(95％CI:0.45-0.69),7.53％ (95％CI:6.06-9.01) and 0.44％ (95％CI:0.36-0.53) respectively.Significant differences were seen in the HIV-1 incidence rates.Conclusions The HIV-1 incidence rates of IDUs from other sentinel sites in Sichuan province,female sex workers and men attending the sexually transmitted disease clinics appeared low,showing that the AIDS prevention and control activities worked effectively.However,the HIV-1 incidence of MSM was still at high level and even rising,suggesting that HIV-1 transmission between MSM and IDUs was possible.

Objective To investigate the efficacy of endovascular stenting complicating other craniocervical artery stenosis (OCAS) in patients with atherosclerotic subclavian artery stenosis/occlusion (SASO).Methods The clinical data of receiving endovascular stenting therapy in patients with atherosclerotic SASO were analyzed retrospectively,including demographic characteristics,vascular risk factors,complicating OCAS,as well as stenting for SASO and follow-up results.Results A total of 65 patients with SASO were included in the study,47 of them were males and 18 were females (mean age of 64 ± 9 years).Forty-six patients (70.8％ ) complicated OCAS.The overall technical success rate was 95.4％,in which the patients with stenosis (n =58) were 98.1％ and those with complete occlusion (n =7) were 71.4％.The complications occurred in 4 patients.There were no intervention-related serious stroke and death.Mean follow-up was 24 ± 19 months,6 patients with restenosis and 10 with clinically relevant events were found.They mainly occurred in patients with OCAS.The first angioplasty patency rates were 94.5％,81.8％ and 81.8％,respectively at 12 and 24 months after procedure and at the end of follow-up.The survival rates of no clinically relevant events were 92.9％,74.6％ and 68.3％,respectively.Conclusions Endovascular stenting can safely and effectively treat the SASO patients complicating OCAS.Its overall clinical outcome may be affected to some extent by OCAS.

Objective: To explore the effect of the fat-1 gene encoding n-3 fatty acid desaturase on the proliferation and apoptosis of human colon cancer cell line HT-29 and to explore its value in the gene therapy for colorectal cancer. Methods: The fat-1 gene was cloned into adenovirus shuttle vector pAd-CMV and then recombinated with backbone vector to con-struct a recombinant adenoviral vector pAd.GFP.fat1. The vector was transfected into 293 cells to get the recombinant virus infected human colon cancer cell line HT-29. Total RNA of the cells was analyzed by Northern blot. The effect of fat-1 gene on the proliferation and apoptosis of the infected cells was analyzed by flow cytometry. The content of n-6PUFAs/n-3PUFAs was analyzed by Gas Chromatography. The anti-cancer effect of fat-1 gene was studied on HT-29 xenografts in nude mice in vivo. Results: The high titer recombinant virus was obtained. Fat-1 gene can be highly expressed in human colon cancer call line HT-29. Compared with that of the control cells (Ad.GFP), proliferation of HT-29 cells was inhibited by fat-1 gene. Fat-1 gene can lower the ratio of n-6/n-3PUFAs. The growth of tumors in nude mice is also inhibited by fat-1 gene. Conclu-sion: Fat-1 gene is of great value in the gene therapy for colorectal cancer.