Objective To explore the incidence rate and independent risk factors of synchronous multiple early gastric cancer (SMEGC) in patients with early gastric cancer, and to provide evidence for early screening and intervention of high-risk population. Methods A retrospective analysis was performed on 308 patients with early gastric cancer who received treatment in the hospital from March 2019 to March 2024. The incidence rate of SMEGC was counted, and the risk factors were analyzed by univariate and multivariate Logistic regression analyses. Results Among the 308 patients with early gastric cancer in this study, 23 cases were SMEGC and 285 were single early gastric cancer, which were included in the SMEGC group and the single group respectively. The incidence rate of SMEGC was 7.47% (23/308). Compared with the single group, the proportions of male, smoking history, tumor diameter≤2 mm, chronic atrophic gastritis and intestinal metaplasia degree were higher in the SMEGC group (2=4.331、8.608、4.618、6.490、4.897，P=0.037、0.003、0.032、0.001、0.027). Logistic regression analysis suggested that chronic atrophic gastritis (OR=3.133, 95%CI: 1.240-7.918) and moderate-to-severe intestinal metaplasia (OR=3.171, 95%CI: 1.252-8.029) were independent risk factors for SMEGC (P<0.05). Conclusion Some patients with early gastric cancer are SMEGC. Chronic atrophic gastritis and moderate-to-severe intestinal metaplasia are independent risk factors affecting the occurrence of SMEGC. It is recommended to regularly screen high-risk patients and optimize management strategies to reduce the risk of SMEGC.

Objective To analyze the status quo and related factors of treatment compliance in elderly patients with advanced gastric cancer complicated with cancer pain. Methods Three hundred and ten elderly patients with advanced gastric cancer from January 2021 to June 2024 were selected, and their general data were collected. Hospital Anxiety and Depression Scale (HADS), Beliefs about Medicines Questionnaire (BMQ), Numerical Rating Scale (NRS) and 8-item Morisky Medication Adherence Scale (MMAS-8) were adopted to investigate the psychological status, necessity of medication belief, degree of cancer pain and treatment compliance. Univariate analysis, correlation analysis and multivariate logistic regression analysis were used to describe and analyze the treatment compliance status and related factors in elderly advanced gastric cancer with cancer pain. Results A total of 310 patients were divided into group A (good compliance, 93 cases), group B (moderate compliance ,102 cases) and group C (poor compliance , 115 cases) by means of compliance degree. There were significant differences in education level , pain duration and intensity and analgesic category (P<0.05). Treatment compliance was associated with education level, analgesic category, psychological status, medication belief and pain degree (P<0.05). The necessity of medication belief and pain duration and degree were influencing factors of treatment compliance. Conclusion The treatment compliance in advanced gastric cancer with cancer pain is poor, and can be affected by the necessity of medication belief and duration and degree of pain.

Objective To explore the rehabilitation effect of abdominal breathing training and the improvement status of cardiopulmonary function in elderly patients with chronic obstructive pulmonary disease (COPD) over 60 years old. Methods A total of 520 COPD patients over 60 years old admitted to the hospital were selected from June 2021 to March 2024 as the research subjects. The patients were divided into reference group (routine intervention, n=260) and abdominal rehabilitation group (abdominal breathing training on the basis of routine intervention, n=260) by adopting computer random function. Cardiopulmonary tolerance, respiratory muscle condition and pulmonary function markers were compared between the two groups before and after intervention. Results Compared with the reference group after intervention, the abdominal rehabilitation group had higher maximum oxygen uptake and minute ventilation volume, lower anaerobic threshold, and higher maximal expiratory pressure (MEP). The maximal inspiratory pressure (MIP), forced expiratory volume in one second (FEV1), forced expiratory volume (FVC), ratio of forced expiratory volume to forced vital capacity in one second (FEV1/FVC), the percentage of FEV1 to the predicted value (FEV1%pred) and 1 min maximum ventilation volume (MVV) (P<0.05) were all higher in the abdominal rehabilitation group than the reference group after intervention. Conclusion Abdominal breathing training for patients with COPD over 60 years old can effectively enhance cardiopulmonary tolerance, and improve respiratory muscle physiology and pulmonary function.

Objective To understand the epidemiological characteristics and risk factors of hospital-acquired pneumonia in elderly diabetic patients. Methods Elderly patients with diabetes mellitus who were hospitalized in the hospital were selected from October 2020 to October 2023 as the research subjects. The epidemiological characteristics of hospital-acquired pneumonia were analyzed, and the risk factors affecting hospital-acquired pneumonia in elderly patients with diabetes mellitus were analyzed . Results There were 65 cases of hospital-acquired pneumonia in 388 elderly patients with diabetes mellitus, with an incidence of 16.75%, of which 56.92% were males and 43.08% were females. The proportion of patients aged≥80 years was higher than that of patients aged<80 years. There were no significant differences in gender, body mass index, education level, course of diabetes mellitus, smoking history, drinking history, hypertension, coronary heart disease and anemia between groups (P>0.05), but significant differences were shown in age, hospitalization time, tracheal invasive operation, types of antibacterial drug use and dysphagia between both groups (P<0.05). Logistic multivariate analysis showed that age≥80 years old, hospitalization time≥30 d, tracheal invasive operation, use of antibacterial drugs≥ 2 types, and dysphagia were independent risk factors for hospital-acquired pneumonia in elderly diabetic patients (P<0.05). Conclusion The risk of hospital-acquired pneumonia is high in elderly patients with diabetes mellitus. Patients with age≥80 years old, hospitalization time≥30 days, tracheal invasive operation, abuse of antibacterial drugs and dysphagia are high-risk population. It is necessary to take active intervention measures for such patients.

Objective To explore the rehabilitation effect of abdominal breathing training and the improvement status of cardiopulmonary function in elderly patients with chronic obstructive pulmonary disease (COPD) over 60 years old. Methods A total of 520 COPD patients over 60 years old admitted to the hospital were selected from June 2021 to March 2024 as the research subjects. The patients were divided into reference group (routine intervention, n=260) and abdominal rehabilitation group (abdominal breathing training on the basis of routine intervention, n=260) by adopting computer random function. Cardiopulmonary tolerance, respiratory muscle condition and pulmonary function markers were compared between the two groups before and after intervention. Results Compared with the reference group after intervention, the abdominal rehabilitation group had higher maximum oxygen uptake and minute ventilation volume, lower anaerobic threshold, and higher maximal expiratory pressure (MEP). The maximal inspiratory pressure (MIP), forced expiratory volume in one second (FEV1), forced expiratory volume (FVC), ratio of forced expiratory volume to forced vital capacity in one second (FEV1/FVC), the percentage of FEV1 to the predicted value (FEV1%pred) and 1 min maximum ventilation volume (MVV) (P<0.05) were all higher in the abdominal rehabilitation group than the reference group after intervention. Conclusion Abdominal breathing training for patients with COPD over 60 years old can effectively enhance cardiopulmonary tolerance, and improve respiratory muscle physiology and pulmonary function.

Objective To understand the epidemiological characteristics and risk factors of hospital-acquired pneumonia in elderly diabetic patients. Methods Elderly patients with diabetes mellitus who were hospitalized in the hospital were selected from October 2020 to October 2023 as the research subjects. The epidemiological characteristics of hospital-acquired pneumonia were analyzed, and the risk factors affecting hospital-acquired pneumonia in elderly patients with diabetes mellitus were analyzed . Results There were 65 cases of hospital-acquired pneumonia in 388 elderly patients with diabetes mellitus, with an incidence of 16.75%, of which 56.92% were males and 43.08% were females. The proportion of patients aged≥80 years was higher than that of patients aged<80 years. There were no significant differences in gender, body mass index, education level, course of diabetes mellitus, smoking history, drinking history, hypertension, coronary heart disease and anemia between groups (P>0.05), but significant differences were shown in age, hospitalization time, tracheal invasive operation, types of antibacterial drug use and dysphagia between both groups (P<0.05). Logistic multivariate analysis showed that age≥80 years old, hospitalization time≥30 d, tracheal invasive operation, use of antibacterial drugs≥ 2 types, and dysphagia were independent risk factors for hospital-acquired pneumonia in elderly diabetic patients (P<0.05). Conclusion The risk of hospital-acquired pneumonia is high in elderly patients with diabetes mellitus. Patients with age≥80 years old, hospitalization time≥30 days, tracheal invasive operation, abuse of antibacterial drugs and dysphagia are high-risk population. It is necessary to take active intervention measures for such patients.

Objective To explore the nutritional risk investigation and influencing factors of elderly patients with community-acquired pneumonia (CAP). Methods The clinical data of 239 elderly patients with CAP in Western Theater General Hospital were retrospectively analyzed from January 2022 to January 2024. Nutritional risk screening scale (NRS2002) was used to investigate the nutritional risk of patients. According to the nutritional risk investigation results, 239 elderly patients with CAP were divided into higher risk group (NRS2002≥3 points) and lower risk group (NRS2002<3 points). Univariate analysis was used to compare the gender, age, education level, body mass index (BMI), family monthly income, living condition, severity of pneumonia, smoking history, presence or absence of chronic diseases, cognitive dysfunction and self-care ability. The independent risk factors of nutritional risk in elderly patients with CAP were analyzed by binary logistic regression analysis. Results According to NRS2002 score, there were 87 cases (36.4%) in higher risk group and 152 cases (63.6%) in lower risk group. The NRS2002 scores in higher risk group were significantly higher than those in lower risk group (P<0.05). There were no obvious differences in gender, BMI, family monthly income and presence or absence of smoking history between groups (P>0.05). The higher risk group had significantly higher rates of age>70 years old, education level (high school and below), living condition (living alone), severity of pneumonia (high-risk pneumonia), chronic disease, cognitive dysfunction and poor self-care ability than the lower risk group (P<0.05). Binary logistics regression analysis showed that age>70 years old , education level of high school and below, living condition (living alone), severity of pneumonia (high-risk pneumonia), chronic diseases, cognitive dysfunction and self-care ability (poor) were independent risk factors for nutritional risk in elderly CAP patients (P<0.05). Conclusion Elderly patients with CAP have high nutritional risk, which may be affected by many factors such as age, education level, living condition, severity of pneumonia, presence or absence of chronic diseases, cognitive dysfunction and self-care ability. It is necessary to formulate targeted intervention measures according to the above factors to improve the nutritional risk of patients.

Purpose::To identify the risk factors for training-related lower extremity muscle injuries in young males by a non-invasive method of body composition analysis.Methods::A total of 282 healthy young male volunteers aged 18 -20 years participated in this cohort study. Injury location, degree, and injury rate were adjusted by a questionnaire based on the overuse injury assessment methods used in epidemiological studies of sports injuries. The occurrence of training injuries is monitored and diagnosed by physicians and treated accordingly. The body composition was measured using the BodyStat QuadScan 4000 multifrequency Bio-impedance system at 5, 50, 100 and 200 kHz to obtain 4 impedance values. The Shapiro-Wilk test was used to check whether the data conformed to a normal distribution. Data of normal distribution were shown as mean ± SD and analyzed by t-test, while those of non-normal distribution were shown as median (Q 1, Q 3) and analyzed by Wilcoxon rank sum test. The receiver operator characteristic curve and logistic regression analysis were performed to investigate risk factors for developing training-related lower extremity injuries and accuracy. Results::Among the 282 subjects, 78 (27.7%) developed training injuries. Lower extremity training injuries revealed the highest incidence, accounting for 23.4% (66 cases). These patients showed higher percentages of lean body mass ( p = 0.001), total body water (TBW, p=0.006), extracellular water ( p=0.020) and intracellular water ( p=0.010) as well as a larger ratio of basal metabolic rate/total weight ( p=0.006), compared with those without lower extremity muscle injuries. On the contrary, the percentage of body fat ( p=0.001) and body fat mass index ( p=0.002) were lower. Logistic regression analysis showed that TBW percentage > 65.35% ( p=0.050, odds ratio =3.114) and 3rd space water > 0.95% ( p=0.045, odds ratio =2.342) were independent risk factors for lower extremity muscle injuries. Conclusion::TBW percentage and 3rd space water measured with bio-impedance method are potential risk factors for predicting the incidence of lower extremity muscle injuries in young males following training.

Objective To propose a YOLOv5 lightweight network-based face mask recognition method to solve the problems due to limited storage and computation resources of edge and mobile devices.Methods A YOLOv5 model composed of a backbone network(Backbone),a neck module(Neck)and a head module(Head)was selected as the base framework.Firstly,the Backbone part was modified and replaced using the ShuffleNetv2 lightweight network;secondly,a Ghost module and a C3_S module were introduced in the Neck part;finally,a Shuffle_Yolo_GS_CBAM model was formed by incorporating a convolutional block attention module(CBAM)to improve the detection accuracy.The model was trained and verified with the AIZOO dataset,which was evaluated for face mask recognition by mean average precision(mAP),frames per second(FPS),giga floating-point operations per second(GFLOPS)and parameters.Results The model proposed recognized face masks with the mAP being 89.5％,FPS being 158.7 frames/s,parameters being 2.38 M and and GFLOPS being 4.5 GFLOPS,which had the detection speed enhanced by 39.7％,parameters decreased by 67.3％and operations reduced by73.8％when compared with the YOLOv5s model.Conclusion The method proposed behaves well in increasing detection speed,decreasing parameters and operations and ensuring detection precision,and thus is worthy promoting for face mask recognition on edge and mobile devices.[Chinese Medical Equipment Journal,2024,45(9):7-13]

Objective:To study the molecular mechanism of functional defect of protein C (PC) caused by point mutations of human protein C gene (PROC) N355S,G392E and T314A. Methods:The wild-type and mutant plasmids (PCWT,PCN355S,PCG392E,PCT314A) of PROC gene were constructed and transiently transfected into HEK293 cells. The expression of mutant proteins in vitro were tested. The mRNA level changes of wild-type and mutant PC after 24 h of transfection were detected by real-time PCR. Western blot and ELISA were used to detect the changes of intracellular and extracellular protein levels of wild-type and mutant PC. The supernatant of cells transfected for 24-48 h was concentrated by ultrafiltration. The protein in the concentrated solution was quantified,and PC activation and enzyme kinetics tests were performed. Clustal Omega multiple sequence alignment was used to analyze the conservation of amino acid mutation sites. The effect of mutation on PC protein structure was analyzed by PyMOL software. Results:The relative expression abundances of PROC mRNA in PCN355S,PCG392E and PCT314A groups were 1.14±0.46,0.96±0.08 and 1.08±0.17,respectively,and there were no significant differences compared with 1.02±0.24 in PCWT group (P>0.05). Western blot analysis of the lysates of transfected cells showed that the content of PCT314A recombinant protein slightly decreased and the band became relatively lighter. The ELISA results of the concentrated cell culture supernatants showed that the PC:Ag levels of PCN355S and PCG392E were 98.8％±2.4％ and 101.4％±3.1％,respectively,with no significant differences compared with PCWT,while PCT314A decreased compared with PCWT (PC:Ag:88.6％±3.2％) (P<0.05). The results of enzyme kinetics test showed that APCN355S (Km=338.3±43.2,Vmax=2.015±0.12),APCG392E (Km=292.2±28.4,Vmax=1.893±0.07) and APCT314A (Km=299.5±24.6,Vmax=1.775±0.06) showed an increase in Km and a decrease in Vmax compared with APCWT (Km=238.2±4.58,Vmax=3.205±0.06). Multiple sequence alignment suggested that the three mutations be highly conservative in different species. The structural model suggested that the amino acid substitutions of N355S,G392E and T314A mutations collide with the surrounding amino acid groups,causing distortion of the surrounding structure,which may have adverse effects on the folding and biological function of PC. Conclusion:The N355S,G392E and T314A mutations in the PROC gene cause functional defects in PC by weakening the binding between PC and substrate. These three mutations have caused serious spatial collisions in the protein structure,affecting the folding of PC and the reactivity of active sites.