Bisphenols (BPs) are extensively used in food packaging, personal care products, and plastics, making them prevalent in both living and working environments, which has raised significant concern. As endocrine-disrupting chemicals, BPs exert toxic effects on the female reproductive system by binding to estrogen receptors, thereby activating or inhibiting the expression of genes related to reproductive functions, which disrupts the normal function of the endocrine system. This paper reviewed the effects of bisphenol A (BPA), bisphenol S (BPS), and bisphenol F (BPF) on female reproductive function, focusing on three key aspects: the effects on the female reproductive organs, the occurrence of associated reproductive disorders, and the mechanisms of toxicity. Specifically, this review highlighted the effects on ovarian function, uterine morphology and function, and fallopian tube function, as well as their correlation with polycystic ovary syndrome, endometriosis, miscarriage, and eclampsia. Additionally, the toxic mechanisms of BPs exposure were summarized, providing a scientific basis for future research on the impact of BPs on the female reproductive system, as well as for the assessment of potential health risks and the development of preventive measures.

ObjectiveTo explore the correlation between skeletal muscle mass and metabolic syndrome （MS） disease risk among middle-aged and elderly community residents in Urumqi， and to provide a theoretical basis for understanding the relationship between skeletal muscle mass and MS among middle-aged and elderly community residents in China. MethodsA total of 1 438 community residents ≥ 50 years old were selected as the research subjects from July 2018 to January 2019 in Urumqi. They were selected from a multi-ethnic natural population cohort in Xinjiang. Data were collected through questionnaires， physical examination， bioelectrical impedance analysis （BIA）， laboratory tests， etc. Skeletal muscle mass was evaluated using the limb skeletal muscle mass index （SMI） corrected for body weight； MS was defined as it at least includes three of the following： abdominal obesity， hypertension， hyperglycemia， high triglycerides and low high-density lipoprotein cholesterol. SMI was divided into four quantile arrays of Q₁‒Q₄. Trend χ² test was applied to explore whether there was a correlation between SMI changes and MS. A multivariate logistic regression model was used to analyze whether there is a difference in the risk of MS between the higher SMI group （Q₂， Q₃， Q₄） and the reference group Q₁. ResultA total of 560 MS patients were detected in this study， with a prevalence rate of 38.94%. Among them， the prevalence rate of MS was 39.16% in males and 38.80% in females. The increase in male SMI grading level is not correlated with the prevalence of MS （trend P>0.05）； After adjusting for confounding factors （model 4）， the increase in SMI was still not related to the prevalence of MS （P_trend=0.995）. There was no statistical difference in the risk of MS between the lowest quartile group Q₁ and the highest quartile group Q₄ （OR=1.01， 95%CI： 0.69‒1.78）. The prevalence of MS in women gradually decreased with the increase of SMI grading level （P_trend<0.001）； After adjusting for confounding factors （model 4）， there was still a correlation between the increase of SMI and the prevalence of MS （P_trend=0.005）. With the lowest quartile of SMI Q₁ as the reference group， the risk of MS in Q₂ （OR=0.63， 95%CI： 0.40‒1.00）， Q₃ （OR=0.56， 95%CI： 0.34‒0.94）， Q₄ （OR=0.42， 95%CI： 0.23‒0.76） decreased. ConclusionAn increase in skeletal muscle mass may be beneficial for preventing MS， especially among middle-aged and elderly female residents. Considering the intensification of aging in China and the close relationship between MS and related comorbidities， managing skeletal muscle mass may contribute to potential MS prevention.

Objective:To explore high-risk sexual behaviors of HIV/AIDS and related factors in young students in Guangzhou.Methods:A cross-sectional survey was conducted in 5 different types of Guangzhou colleges by convenience sampling with minimum number of classes per grade and 600 samples per school from September to November 2021. The R 4.2.2 software was used to consolidate databases. Simultaneously, a logistic regression model and a decision tree algorithm model, stratifying by whether sexual behaviors had occurred before, were constructed. In each layer, the prediction performance of the two models was evaluated through area under receiver operating characteristic and the confusion matrix, and then the model with high prediction performance was retained.Results:A total of 7 346 students were surveyed. The proportion of the respondents reporting sexual experience were 9.08% (667/7 346), in whom 26.24% (175/667) had risky sexual activity in the past year. The decision tree algorithm model performs well in predicting whether high-risk sexual behaviors have occurred in the past year. When the complexity parameter value is 0.018, and nsplit reaches 4, which means there are 5 leaf nodes in the model, the cross error of the tree will be the smallest. The first best grouping variable in the decision tree was whether to use condoms throughout the first sexual behavior. If condoms were used at their sexual debut, but homosexual practices have occurred in the past year, the probability of risky sexual behavior will increase. If homosexual practices have not occurred in the past year, but the age of sexual debut was below 18 years old while the period of HIV education was after high school, the probability of risk sexual behavior will also increase.Conclusions:AIDS-related risky behaviors of young students still deserved attention. The experience of sexual debut and whether AIDS-related health education has been received before the sexual debut were significant predictors for the occurrence of high-risk sexual behavior. The decision tree algorithm model has particular applicability for predicting and screening potential risk populations.

Objective To explore the status quo and influencing factors of impaired self-care ability of amputee patients during rehabilitation period.Methods The convenience sampling method was used to select the convalescent amputee patients hospitalized in a tertiary hospital of Chengdu City from April 2022 to Febru-ary 2023 as the survey subjects.The General Information Questionnaire,Barthel Index Rating Scale,Berg Balance Scale(BBS)and Family Resilience Assessment Scale(FRAS-C)were used for the survey.Results Among 194 included convalescent amputee patients,the score of the Barthel Index Rating Scale was 95(85,100)points,and the self-care ability was impaired in 121 cases(62.4％).The results of univariate analysis showed that there were statistically significant differences in the occupational status,monthly income,amputation time,residual limb length,residual limb pain,BBS score and FRAS-C score between the rehabilitated amputee patients with normal self-care ability and the rehabilitated amputee patients with impaired self-care ability(P＜0.05).The results of logistic regression analysis showed that amputation time,residual limb length,re-sidual limb pain,BBS score and FRAS-C score were the influencing factors of impaired self-care ability in re-habilitated amputee patients(P＜0.05).Conclusion The incidence rate of impaired self-care ability in reha-bilitated amputee patients is high,which is affected by the factors such as amputation time,residual limb length,residual limb pain,balance function and family resilience.

Objective To investigate the changes in blood microbiota in patients with high altitude polycythemia(HAPC)and the correlation with the risk of HAPC.Methods A cross-sectional trial was carried out among 41 HAPC patients(HAPC group)and 41 healthy plateau individuals(control group)who took physical examination in the Health Management Department of No.953 Hospital of PLA Army in 2021.High-throughput sequencing technology was used to detect the V3-V4 variable region of the 16S ribosomal RNA(16S rRNA)gene in the blood smaples,and the composition and difference of the blood microbiota were compared and analyzed between the 2 groups.Results All the participants were male and Han people,and there were no significant differences in baseline data such as age,body mass index and plateau migration time between the 2 groups(P＞0.05).The α-diversity of blood microbiota in the HAPC group,including the Simpson index(0.931±0.005 vs 0.907±0.008,P＜0.05),Goods Coverage index(0.998±0.001 vs 0.997±0.001,P＜0.001)and Pielou index(0.597±0.011 vs 0.567±0.009,P＜0.05)were significantly higher than those in the control group.Meanwhile,obvious difference was observed in the β diversity between the 2 groups(P＜0.01).The relative abundance analysis of bacteria showed that Pelomonas(0.046±0.004 vs 0.033±0.003,P＜0.05),Azospirillum(0.046±0.006 vs 0.021±0.003,P＜0.01),Acidovorax(0.032± 0.003 vs 0.019±0.002,Azospirillum(0.046±0.006 vs 0.021±0.003,P＜0.01)and Acidovorax(0.032± 0.003 vs 0.019±0.002,P＜0.05)were statistically higher in the HAPC group than the control group.LEfSe analysis showed that the characteristic blood microbiota of the HAPC group were α-Proteobacteria,and those of control group were Trichospiridae.Conclusion Significant changes are found in diversity,relative abundance and characteristic bacteria of the blood microbiota between the HAPC patients and healthy people at the high altitude,which might be closely associated with the occurrence and development of HAPC.

Objective To create a semi-automatic technology based on convolutional neural networks for saccular aneurysm segmentation.Methods The single-center data of Xuanwu Hospital of Capital Medical University in the database of"China Intracranial Aneurysm Program"from July 2017 to July 2020 were retrospectively included,and all data were anonymized before analysis.Baseline data were collected from all patients,including sex,age(≥60 years and＜60 years),DSA model,number of DSA sequences,and aneurysm information,including the number of aneurysms,diameter(≥5 mm and＜5 mm),neck width(wide neck,narrow neck),and location(bifurcation,sidewall).According to the ratio of 8∶1∶1,the data were randomly divided into training set,test set and validation set by random number table method.The DSA 3D tomography data of all patients were completed in the contrast machine using the 3D rotary DSA mode,and the aneurysms shown in the DSA 3D tomography data were annotated by 3 experienced neurosurgeons,and the standard label of the aneurysm was finally generated.The proposed aneurysm segmentation method consisted of a training stage and a segmentation stage.In the training stage,the model was trained end-to-end by using the DSA 3D tomography image data of the training set,the segmentation label of the aneurysm and the vascular edge information extracted by the Marching Cubes algorithm,and the segmentation index of the model was monitored on the test set to retain the model with the highest segmentation index.In the segmentation stage,the physician selects a point inside the aneurysm on the DSA 3D tomography image of the aneurysm in the validation set,intercepts the volume of interest(VOI),inputs the trained optimal model of vascular and aneurysm segmentation,obtains the segmentation result of the aneurysm,and locates the segmented VOI back to the original DSA 3D tomography image to obtain the final aneurysm outline.The segmentation results of the segmentation network model were compared with standard labels to calculate the Dice similarity coefficient(DSC).The validation set data was stratified by aneurysm diameter,neck width,and location to compare the segmentation results in different datasets.We calculated the bounding boxes for the length,width,and height of the aneurysm segmentation mask,and used the maximum of these as the longest diameter of the aneurysm compared to the maximum diameter in the standard label.In the validation set,the standard label manual acquisition time was counted and compared with the segmentation network model acquisition time(from the time of locating the aneurysm to obtaining a satisfactory aneurysm neck segmentation).Results Finally,969 DSA sequences from 756 patients were included to show 3D tomographic data for 1 094 aneurysms.Among them,604 patients with 877 aneurysms with a total of 783 DSA sequences were included in the training set,117 aneurysms with a total of 100 DSA sequences in 77 patients were included in the test set,and 100 aneurysms with a total of 86 DSA sequences were included in 75 patients in the validation set.(1)The baseline comparison results of each dataset showed that there were statistically significant differences between the datasets of aneurysm diameter(P=0.003)and aneurysm location(P=0.003).There was no significant difference between the remaining baseline data sets(all P＞0.05).(2)The mean DSC of centralized aneurysm segmentation was 0.868±0.078.The mean DSC of aneurysm segmentation≥5 mm diameter was higher than that of aneurysms with＜5 mm diameter(0.891±0.041 vs.0.855±0.088,P=0.038).The DSC values of narrow-necked,wide-necked,bifurcated and lateral wall aneurysms were 0.882±0.065,0.859±0.085,0.876±0.072 and 0.863±0.080,respectively,and there was no significant difference between the groups(all P＞0.05).(3)The maximum diameter of the mask obtained by the aneurysm segmentation model in the validation set was in good agreement with the maximum diameter of the standard label obtained by manual segmentation([5.78±3.18]mm vs.[5.37±2.92]mm,r=0.97).In the validation set,the average time of manual segmentation and neural network segmentation of aneurysms was 2.5 min and 34 s,respectively.Conclusion In this study,a semi-automatic saccular aneurysm segmentation technique based on convolutional neural network can accurately segment aneurysms and is helpful to improve aneurysm morphology analysis.

Chronic hepatitis B(CHB)is an infectious disease caused by persistent infection with the hepatitis B virus(HBV)and is highly prevalent worldwide.Non-alcoholic fatty liver disease(NAFLD)is a group of liver diseases related to metabolic abnormalities,excluding those caused by alcohol consumption or other liver injury factors.In recent years,with improvement of living standards and changes in lifestyle,the incidence of NAFLD has been increasing substantially,becoming the most common type of liver diseases in China and Western countries,and the second leading cause of liver transplantation in the West.The rising prevalence of NAFLD has also led to an increase in the incidence of NAFLD in patients with chronic HBV infection.However,there is considerable controversy both domestically and internationally regarding the relationship between these two diseases,including the disease progression,pathogenesis,impact on antiviral treatment efficacy,and prognosis of these concomitant CHB and NAFLD patients.Currently,both domestic and international guidelines lack detailed descriptions of diagnostic and treatment strategies for these conditions.This article summarizes the recent research progress in concomitant CHB and NAFLD,including epidemiology,diagnostic criteria,the impact of NAFLD on the virology of HBV infection,potential mechanisms of NAFLD-induced negative regulation of HBV,the effect of NAFLD on antiviral therapy effiicacy,and prognosis.This article aims to gain a deeper understanding of the diseases themselves and provide new insights for basic and clinical research as well as diagnostic and treatment approaches.

The military vocational education is facing the reform under the background of "Internet +" education. O2O teaching is a model that combines the online teaching resource platform with the offline traditional education, and it is consistent with the development trend of contemporary military vocational education. In this study, we analyze the comparative advantages of O2O teaching model in military vocational education, including the multi-dimensional teaching content, the interactive teaching method, and the autonomy of teaching design. In this model, students become the subject of learning, and the process of storing knowledge will be transformed into the application and creation of knowledge. This paper also elucidates the feasibility of O2O teaching in the military vocational education, and further discusses its design in application from the point of view of managers, teachers and learners.

High Altitude Military Hygiene is the professional core course of high-altitude medicine, which is significant to the cultivation of military medical talents urgently needed by plateau troops. Under the background of "golden course" construction and army curriculum reform, aiming at the problems such as outdated content of course materials, single teaching mode and insufficient capacity of practical courses, we actively explored the effective path of "golden course" construction, including the renovation of the curriculum-construction concept, the optimization and reorganization of the teaching content, the expansion of case teaching and equipment teaching methods, and the implementation of curriculum ideological and political education and examination reforms. The reform has further improved the learning effect of students and the level of curriculum construction, and also provided beneficial reference for the construction of similar courses in military colleges and universities.

Objective:To investigate the risk perception for risky behavior of HIV/AIDS infection among young students and to analyze the related influencing factors.Methods:A cross-sectional survey was conducted in 5 different types of Guangzhou colleges from September to November 2021, in which convenience sampling and a minimum number of classes per grade and 600 samples per school were used according to the national unity program. Disordered multi-classification logistic regression was used to construct a risk perception model and analyze influencing factors in different risk perception levels.Results:A total of 7 346 young students were surveyed, and most rated themselves at low risk of HIV/AIDS infections (90.58%, 6 654/7 346). A total of 89.10% (6 545/7 346) of subjects' perception of their HIV/AIDS infection risk was consistent with their risk behavior, while 10.90% (801/7 346) was inconsistent. Among those inconsistent subjects, 19.10% (153/801) showed underestimating their risk , while 80.90% (648/801) seen overestimating their risk. Disordered multi-classification logistic regression analysis showed that, after controlling for other factors, compared with the non-sexual group, respondents whose first sex age under 18 had a higher rate of underestimating their risk of infection ( OR=129.39, 95% CI: 73.28-228.48), as well as a higher rate of overestimated their risk of infection ( OR=1.76, 95% CI: 1.04-2.99). First sexual intercourse at age 18 or older was a risk factor for underestimating risk ( OR=70.56, 95% CI: 42.72-116.53), but was not statistically associated with overestimating risk. Being female, other school type, non-heterosexual orientation, and self-rated HIV-related knowledge as fair or no knowledge were risk factors for overestimating risk but were not statistically associated with underestimating risk. Conclusions:Overall, young students in universities of Guangzhou have a good risk perception of HIV/AIDS infection. Individual factors, education factors and sexual experience will influence students' risk perception of HIV/AIDS infection. Raising the awareness rate of HIV/AIDS knowledge and delaying the age of first sexual intercourse will improve the risk perception ability of young students.