Objective To observe the value of augmented reality(AR)navigation system for assisting CT-guided puncture of pulmonary nodules in dog models.Methods Five healthy dogs were selected,and 4 target lung rings were implanted in each dog to build pulmonary nodule models.Deferring to crossover design,CT-guided punctures were performed with or without AR navigation 2 and 4 weeks after successful modeling,respectively,while punctures with AR navigation were regarded as AR group and the others as conventional group,respectively.The time duration of puncturing,the times of CT scanning,of needle adjustment,and the deviation distance between needle pinpoint to the center of pulmonary nodule shown on three-dimensional reconstruction were compared between groups.Results The duration time of puncture in AR group and conventional group was(13.62±5.11)min and(20.16±4.76)min,respectively.In AR group,the times of CT scanning,of needle adjustment,and the deviation distance was 2.40±0.50,2.75±0.44 and(2.94±1.92)mm,respectively,while in conventional group was 3.10±0.64,3.70±0.57 and(4.90±3.38)mm,respectively.The introduction of AR navigation was helpful to shortening the duration of puncture,reducing times of CT scanning and needle adjustment,also decreasing positioning error of needle pinpoint(all P＜0.05).In contrast,the variance of puncture sequences and dogs had no obvious effect on the results(both P＞0.05).Conclusion AR navigation system could improve accuracy and efficiency in CT-guided puncture of pulmonary nodules in dog models.

Objective To investigate a novel stroke recurrence risk prediction model,which utilized radiomics machine learning methods and specifically combined carotid computed tomography angiography(CT A)with the Essen stroke risk score(ESRS).Methods A total of 136 patients who underwent carotid CT A were analyzed retrospectively.The features of carotid plaque were extrac-ted by machine learning to construct a radiomics feature model,as well as combined with ESRS.Based on clinical outcomes at one-year follow-up,the stroke recurrence risk prediction model was constructed using the logistic regression(LR)machine learning model.To construct an effective and robust model,the dataset was divided into a training set and a validation set in a ratio of 7∶3.The performance of this model was evaluated using area under the curve(AUC)of receiver operating characteristic(ROC)curve,sensi-tivity and specificity.Results The model had strong predictive value.In the training set,AUC,sensitivity and specificity of this model were 0.903,0.796 and 0.761,respectively.In the validation set,AUC,sensitivity and specificity of this model were 0.869,0.667 and 0.850,respectively.Conclusion The stroke recurrence risk prediction model constructed based on radiomics analysis of carotid plaque characteristics in carotid CTA,in combination with the ESRS,can provide reliable predictions for stroke prognosis.

Oral microbiome consists of diverse bacteria, viruses, fungi, and protozoan populations, with whose stability, functionality, and assembly process are regulated by complex interactions between the host and microbes. High-throughput sequencing technology provides insights into the classification structure, genomic composition, function, and dynamical changes of oral microbiome under healthy and morbid conditions. This review aims to outline the establishment and homeostasis maintenance of regulating oral microbiome, as well as the common oral disease-related microbial imbalance, influencing factors and emerging methods. With perspectives from microbiology, immunology, and multi-omics, we can delve into the complex molecular dialogue between the human body and microbes. Deep understandings of the assembly principles, intercellular signals, stress adaptability, and triggering factors of microbial imbalance are crucial for developing new diagnostic technologies, treatment plans, and custom probiotics. These methods can precisely target and minimize disruption to the oral microbiome. Regulating oral microbiome by using methods such as small molecules, diet, prebiotics, probiotics, phages offers new opportunities to enhance oral and overall health.

Objective:To investigate the knowledge of Sixth Chinese national consensus report on the management of Helicobacter pylori infection ( treatment excluded) (hereinafter referred to as sixth national consensus) and 2022 Chinese national clinical practice guideline on Helicobacter pylori eradication treatment (hereinafter referred to as the guideline)among medical staff from general hospitals in Hainan. Methods:From February 20 to May 7, 2023, a questionnaire survey on the diagnosis and treatment of Helicobacter pylori ( H. pylori) infection was conducted among 1 463 medical staff from 15 general hospitals in Hainan Province. The questionnaire was drawn up according to the sixth national consensus and the guideline, covering knowledge of 6 sections, induding H. pylori related diseases, detection of H. pylori, eradication, prevention and influence factors of eradication of H. pylori, etc. Chi-square test was used for statistical analysis. Results:A total of 1 463 valid questionnaires were collected with the effective responsive rate of 100.00%.The 1 463 subjects included 225 gastroenterologists and 1 238 other medical staff(including 503 physicians from other departments, 264 surgeons and 471 medical technologists and pharmacists). About 78.67%(177/225)of gastroenterologists agreed that the overall infection rate of H. pylori in China was more than 20%, the awareness rate was higher than that of other medical staff (physicians from other departments 65.41%(329/503), surgeons 61.74%(163/264), medical technologists and pharmacists 60.30%(284/471); the following datas were sorted by this position), and the difference was statistically significant ( χ2=30.97, P<0.001). About 51.11%(115/225) of gastroenterologists considered that H. pylori serological antibody test could not be used as a diagnostic method for current infection, the awareness rate was higher than that of other medical staff(22.07%(111/503), 14.02%(37/264), 12.31%(58/471)), and the difference was statistically significant( χ2 =152.66, P<0.001). Proton pump inhibitor and potassium-competitive acid blocker should be discontinued for 2 weeks, and antibiotics and bismuth should be discontinued for 4 weeks before urea breath test, and the awareness rates of gastroenterologists were higher than those of other medical staff (38.67%(87/225) vs. 23.26%(117/503), 19.70%(52/264), 18.47%(87/471); 60.89%(137/225) vs. 26.64%(134/503), 25.76%(68/264), 23.78%(112/471)), and the differences were statistically significant ( χ2 =133.70 and 165.51, both P<0.001). For refractory H. pylori infection, 98.67%(222/225)of gastroenterologists agreed with the individualized diagnosis and treatment of H. pylori infection should be guided by bacterial culture, antibiotic susceptibility test or drug resistance gene test, and the awareness rate was higher than that of other medical staff (91.85%(462/503), 93.56%(247/264), 93.21%(439/471)), and the difference was statistically significant( χ2=20.55, P=0.002). About 70.67% (159/225) of gastroenterologists recommended a bismuth containing quadruple regimen, 80.44% (181/225) supported a 10 to 14 day H. pylori eradication course, and the awareness rates were higher than other medical staff (46.92%(236/503), 33.33%(88/264), 32.91%(155/471); 67.20%(338/503), 59.09%(156/264), 53.93%(254/471)), and the differences were statistically significant ( χ2=111.25 and 59.99, both P<0.001). The understanding rates of the sixth national consensus and the guideline in gastroenterologists was 85.33% (192/225), which was higher than that of other medical staff (64.21%(323/503), 66.67%(176/264), 57.96%(273/471)), and the difference was statistically significant ( χ2=85.47, P<0.001). Conclusions:Gastroenterologists from general hospitals in Hainan Province have a better understanding of the sixth national consensus and the guideline than other medical staff. However, there is still a lack of deep understanding of the sixth national consensus and the guideline, and it is necessary to further strengthen the learning and application of the sixth national consensus and the guideline.

Objective:To develop an evaluation index system for the management ability of general practice team leaders in community health service centers.Methods:Based on literature review, key insider interviews and other methods, the framework and indicator pool for management capability of general practice team leaders were formed. Two rounds of Delphi consultations with 15 experts were conducted from July to October 2021, and the evaluation index system of general practice team leaders' management ability established.Results:All 15 experts had at least 5 years of work experience, including 10 engaging in clinical general practice, 3 in public health and 2 in community management. The response rates for the two rounds of expert consultation was 15/15, and the expert authority coefficient was 0.84, with Kendall's W coefficient of 0.35 ( P<0.001) and 0.46 ( P<0.001), respectively. Finally, the evaluation index system of the management ability of general practice team leaders was established, which consisted of 5 primary indicators (personal quality, special business management, organizational management, teaching and research management, strategy and culture building), 11 secondary indicators and 37 tertiary indicators. Conclusions:The management capability evaluation index system general practitioner team leaders of the community health centers has been established in this stu, which may be used for the training and selection of general practice team leaders in the community health centers.

Posttranslational modifications(PTMs)of proteins,particularly acetylation,phosphory-lation,and ubiquitination,play critical roles in the host innate immune response.PTMs'dynamic changes and the crosstalk among them are complicated.To build a comprehensive dynamic net-work of inflammation-related proteins,we integrated data from the whole-cell proteome(WCP),acetylome,phosphoproteome,and ubiquitinome of human and mouse macrophages.Our datasets of acetylation,phosphorylation,and ubiquitination sites helped identify PTM crosstalk within and across proteins involved in the inflammatory response.Stimulation of macrophages by lipopolysac-charide(LPS)resulted in both degradative and non-degradative ubiquitination.Moreover,this study contributes to the interpretation of the roles of known inflammatory molecules and the dis-covery of novel inflammatory proteins.

Objective    To investigate the effect of artificial colloid on coagulation function in pediatric patients weighing less than 5 kg with congenital heart disease during cardiopulmonary bypass in congenital heart disease surgery by using artificial colloid instead of human serum albumin. Methods    A total of 65 pediatric patients with weight less than 5 kg who underwent congenital heart disease surgery in our hospital from September 2016 to December 2017 were included in the study. They were randomly divided into two groups: an artificial colloid group (the experimental group, n=33) and a human serum albumin combined artificial colloid group (the control group, n=32). Perioperative hemoglobin concentration (Hb), blood products and hemostatic drugs used, postoperative coagulation function index and pleural fluid volume 24 hours after surgery were monitored. Results    There was no significant difference in perioperative Hb and chest tube drainage between the two groups. The platelet utilization rate in the experimental group was significantly lower than that in the control group (P<0.05). No significant difference was found in the dosage of other blood products and hemostatic drugs between the two groups during the perioperative period. There was no significant difference in coagulation parameters between the two groups before and after surgery (P>0.05). Conclusion    The use of artificial colloid as colloid priming solution during cardiopulmonary bypass has no adverse effect on coagulation function in pediatric patients weighting less than 5 kg with congenital heart disease.

Objective To investigate the level of plasma GDF-15 in patients with COPD and its clinical value in the diagnosis of COPD in the stable stage and in acute exacerbation stage. Methods From 2015 to 2016, 58 cases of patients with COPD were enrolled ,including COPD patients in the stable stage and in acute exacerba-tion stage. 29 cases of COPD patients diagnosed in our hospital were enrolled in the experimental group ,and 29 cases of age-,gender and body mass index-matched healthy people were enrolled in the control group. Compared and analyzed the blood cell count ,determination of plasma GDF-15 and C-reactive protein were performed and ana-lyzed. Spearman correlation analysis was conducted to compare levels of GDF-15 and C-reactive protein between pa-tients with the stable stage of COPD and those with acute exacerbation stage of COPD. The diagnostic efficacy was compared between GDF-15 and C-reactive protein in differentiatingthe COPD in acute exacerbation period and in the stable period. Results Level of GDF-15 in the stable COPD patients was significantly increased compared with that in the control group. The plasma GDF-15 level was significantly increased in acute exacerbation COPD patients compared to patient with the stable COPD(P<0.001). For the stable COPD patients,GDF-15 level and C-reactive protein level was positively correlated(r = 0.776,P < 0.001). In acute exacerbation COPD patients, GDF-15 level and C-reactive protein level was positively correlated (r = 0.877,P < 0.001). The ROC curves showed that the GDF-15 level on the diagnosis of acute exacerbation COPD patients with an AUC was 0.783(95%CI,0.666~0.900,P<0.001)and with the diagnostic accuracy was 69%. C-reactive protein in the acute exacer-bation of AUC diagnosis of COPD was 0.686(95%CI:0.549~0.823,P<0.01)and the diagnostic accuracy rate was 59%. Conclusion The plasma level of GDF-15 was significantly increased in COPD patients compared with people in the healthy control group. Plasma GDF-15 and C- reactive protein were highly correlated in the stable stage of COPD patients and in acute exacerbation stage of COPD patients. The diagnostic accuracy of GDF in patients with the stable stage of COPD and with acute exacerbation stage of COPD was higher than C-reactive pro tein.

Objective To explore the airway management strategy of patients with double-lumen tracheal intubation during anesthesia recovery period.MethodsA retrospective analysis of clinical data of 60 patients who underwent double-lumen tracheal intubation were enrolled from december 2014 to december 2016 in oue hospital was conducted.The mean arterial pressure (MAP), blood oxygen saturation (SpO2), heart rate (HR) and respiration (R) of all patients were measured at different time points,before and after operation, before and after extubation.ResultsThere was no significant difference in MAP and SpO2 between before and after operation,the levels of MAP and SpO2 before extubation and in extubation were significantly higher than those before operation (P<0.05), and five to ten minutes after extubation returned to the preoperative level.There was no significant difference in HR and R indexes between before and after operation, and the HR and R indexes in extubation and before extubation were significantly higher than those before operation, the difference was statistically significant(P<0.05), which was returned to preoperative level ten minutes after extubation.ConclusionIn the patients with double-lumen tracheal intubation, the observation and scientific care of the airway in the recovery period of anesthesia can not only ensure the stability of the vital signs, but also improve the safety of the patients.It is worthy of clinical application.

Objective To investigate the effect of simvastatin on oxidative stress and inflammatory reac-tion in patients with stable moderate to severe chronic obstructive pulmonary disease and its mechanism. Meth-ods Sixty patients diagnosed with chronic obstructive pulmonary disease were randomly divided into the simvas-tatin group and the placebo group.The simvastatin group was treated with simvastatin in 40 mg/d for 12 weeks,and the placebo group with placebo.The general clinical features,the concentration of inflammatory factors,pulmonary function,6-minute walk test and MRC score were compared between the two groups.Results There was no signif-icant difference between these two groups in basic features. There was a decrease of IL-6,TNF-a and Hs-CRP in concentration in the simvastatin group after treatment. which was significantly lower than that of the placebo group after treatment.The 6-minute walk test in the simvastatin group was much better than that in the placebo group(P=0.00).MRC score was improved compared with therapy before(P=0.02).There was no significantly difference in 6-minute walk test and MRC score before and after treatment in the placebo group(P=0.81). The PaO2 was im-proved after treatment in the simvastatin group compared with therapy before and that in the placebo group after therapy(P<0.05)respectively.There was no significantly difference in FEV1and FVC between these two groups. Conclusion Simvastatin can decrease the concentration of inflammatory factors in stable moderate to severe chron-ic obstructive pulmonary disease,and improve the pulmonary function.