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Gastric cancer ranks fifth in global cancer mortality, which is highly aggressive and heterogeneous. However, the research and treatment of gastric cancer is hindered by short of research models that may characterize the developmental properties of gastric cancer. Gastric cancer organoid is a multicellular three-dimensional structure developed in vitro, which can mimic the structure and function of native gastric cancer. Gastric cancer organoids have great application potential and development prospects in establishing gastric cancer research models, mimicking the tumor microenvironment, high-throughput screening of drugs, discovering new therapeutic targets, predicting clinical therapeutic responses, and guiding individualized treatment. In this paper, the progress of gastric cancer organoids in basic research and clinical application is reviewed aiming for promoting the progress of preclinical research and supporting the clinical treatment of gastric cancer.

The low-pressure and low-oxygen environment at high altitude causes a series of changes in the metabolic level in the human body. The high altitude environment increases the level of oxidative stress and homocysteine in the body, which damages vascular endothelial cells. Hyperhomocysteinemia exacerbates oxidative stress, further aggravates the damage to the vascular endothelium, and accelerates the occurrence and development of hypertension. The combination of antioxidant drugs on the basis of traditional antihypertensive drug treatment provides a new direction for the treatment of H-type hypertension in high-altitude areas. This article reviews the relationship between vascular endothelial function and oxidative stress in patients with H-type hypertension in high-altitude areas, and explores its pathogenesis and possible treatments.

BackgroundCognitive behavioral therapy （CBT） is a widely used and empirically supported psychotherapy method. In recent years， the localization of CBT related to culture has received increasing attention from Chinese scholars. However， there is still a lack of systematic research on the localization of CBT using idioms as materials.ObjectiveTo explore whether idioms reflect the mutual influence between the two core therapeutic elements of CBT （cognition and emotion） and to use them as CBT treatment tools among college students， so as to provide references for the localization of CBT.MethodsUsing the Xinhua Idiom Dictionary （second edition） published by the Commercial Press， a three-round manual screening method was used to select idioms that reflected the mutual influence between cognition and emotion in CBT. Based on the selected idioms， a survey questionnaire titled "survey on idiom understanding level" was developed. From August to October， 2022， stratified sampling was conducted among college students from different majors and universities， and 815 valid questionnaires were obtained through the Questionnaire Star platform. By analyzing the understanding of each idiom among college students， idioms that could be used as CBT treatment tools were identified.ResultsIn the Xinhua Idiom Dictionary （second edition）， there were 13 idioms that reflected the influence of cognition on emotion and 5 idioms that reflected the influence of emotion on cognition. 12 idioms could be used as CBT treatment tools， including 8 idioms that reflected the influence of cognition on emotion and 4 idioms that reflected the influence of emotion on cognition.ConclusionThere may be idioms that reflect the mutual influence between the two core therapeutic elements of CBT （cognition and emotion） and these idioms can be attempted as a therapeutic tool for CBT among college students.

ObjectiveCurrently, pig farming facilities mainly rely on manual counting for tracking slaughtered and stored pigs. This is not only time-consuming and labor-intensive, but also prone to counting errors due to pig movement and potential cheating. As breeding operations expand, the periodic live asset inventories put significant strain on human, material and financial resources. Although methods based on electronic ear tags can assist in pig counting, these ear tags are easy to break and fall off in group housing environments. Most of the existing methods for counting pigs based on computer vision require capturing images from a top-down perspective, necessitating the installation of cameras above each hogpen or even the use of drones, resulting in high installation and maintenance costs. To address the above challenges faced in the group pig counting task, a high-efficiency and low-cost pig counting method was proposed based on improved instance segmentation algorithm and WeChat public platform.MethodsFirstly, a smartphone was used to collect pig image data in the area from a human view perspective, and each pig's outline in the image was annotated to establish a pig count dataset. The training set contains 606 images and the test set contains 65 images. Secondly, an efficient global attention module was proposed by improving convolutional block attention module (CBAM). The efficient global attention module first performed a dimension permutation operation on the input feature map to obtain the interaction between its channels and spatial dimensions. The permuted features were aggregated using global average pooling (GAP). One-dimensional convolution replaced the fully connected operation in CBAM, eliminating dimensionality reduction and significantly reducing the model's parameter number. This module was integrated into the YOLOv8 single-stage instance segmentation network to build the pig counting model YOLOv8x-Ours. By adding an efficient global attention module into each C2f layer of the YOLOv8 backbone network, the dimensional dependencies and feature information in the image could be extracted more effectively, thereby achieving high-accuracy pig counting. Lastly, with a focus on user experience and outreach, a pig counting WeChat mini program was developed based on the WeChat public platform and Django Web framework. The counting model was deployed to count pigs using images captured by smartphones.Results and DiscussionsCompared with existing methods of Mask R-CNN, YOLACT(Real-time Instance Segmentation), PolarMask, SOLO and YOLOv5x, the proposed pig counting model YOLOv8x-Ours exhibited superior performance in terms of accuracy and stability. Notably, YOLOv8x-Ours achieved the highest accuracy in counting, with errors of less than 2 and 3 pigs on the test set. Specifically, 93.8% of the total test images had counting errors of less than 3 pigs. Compared with the two-stage instance segmentation algorithm Mask R-CNN and the YOLOv8x model that applies the CBAM attention mechanism, YOLOv8x-Ours showed performance improvements of 7.6% and 3%, respectively. And due to the single-stage design and anchor-free architecture of the YOLOv8 model, the processing speed of a single image was only 64 ms, 1/8 of Mask R-CNN. By embedding the model into the WeChat mini program platform, pig counting was conducted using smartphone images. In cases where the model incorrectly detected pigs, users were given the option to click on the erroneous location in the result image to adjust the statistical outcomes, thereby enhancing the accuracy of pig counting.ConclusionsThe feasibility of deep learning technology in the task of pig counting was demonstrated. The proposed method eliminates the need for installing hardware equipment in the breeding area of the pig farm, enabling pig counting to be carried out effortlessly using just a smartphone. Users can promptly spot any errors in the counting results through image segmentation visualization and easily rectify any inaccuracies. This collaborative human-machine model not only reduces the need for extensive manpower but also guarantees the precision and user-friendliness of the counting outcomes.

目的 探索脑血管病患者主观性失眠与慢性期功能预后的关系。 方法 本研究是对多中心、大型前瞻性研究——中国卒中后抑郁发生及其结局的前瞻性队列研究（prospective cohort study on the incidence and outcome of patients with post-stroke depression in China，PRIOD）的事后分析。选取PRIOD中入组患者人数较多的15个中心，对入组的脑血管病患者进行发病5年后的电话随访。收集患者的一般资料、临床特点。根据《精神障碍诊断与统计手册》（第五版）中失眠的诊断标准编制调查问卷，收集失眠及相关睡眠问题，评估患者是否存在主观性失眠以及睡眠时间。采用mRS评估患者的功能预后。采用多因素logistic回归分析脑血管病患者主观性失眠与功能预后的关系。 结果 本研究共纳入698例患者，其中319例（45.70%）为主观性失眠患者，仅17.55%（56/319）服用助眠药物。logistic回归分析显示，主观性失眠与脑血管病患者功能预后存在显著关联：校正协变量后，与无失眠患者相比，主观性失眠患者功能残疾风险较高（OR 1.64，95%CI 1.11～2.42，P=0.013）；亚组分析显示，在基线为首次脑血管病发作患者中，与无失眠患者相比，主观性失眠患者功能残疾的风险较高（OR 1.74，95%CI 1.13～2.68，P=0.013）。 结论 主观性失眠是导致脑血管病慢性期功能残疾的危险因素。 Abstract: Objective To explore the relationship between subjective insomnia and functional prognosis in the chronic phase of patients with cerebrovascular disease. Methods This study is a post-hoc analysis of the multicenter, large-scale prospective study— prospective cohort study on the incidence and outcome of patients with post-stroke depression in China (PRIOD). Fifteen centers with a high number of patients enrolled in the PRIOD were selected, and the patients were followed up by telephone 5 years after the onset of cerebrovascular disease. General information and clinical characteristics were collected. According to the diagnostic criteria of insomnia in the Diagnostic & Statistical Manual of Mental Disorders (Fifth Edition), a questionnaire was compiled to collect data on insomnia and related sleep issues, and to assess the presence of subjective insomnia and sleep duration. The functional prognosis was evaluated by mRS. Multivariate logistic regression was used to analyze the relationship between subjective insomnia and functional prognosis in cerebrovascular disease patients. Results A total of 698 patients were included, of which 319 (45.70%) had subjective insomnia. Only 17.55%(56/319) were taking sleep aids. Logistic regression analysis revealed a significant association between subjective insomnia and functional prognosis in cerebrovascular disease patients: after adjusting for covariates, subjective insomnia patients had a higher risk of functional disability compared to those without insomnia (OR 1.64, 95%CI 1.11-2.42, P=0.013). Subgroup analysis showed that among patients experiencing their first cerebrovascular event at baseline, those with subjective insomnia had a higher risk of functional disability compared to those without insomnia (OR 1.74, 95%CI 1.13-2.68, P=0.013). Conclusions Subjective insomnia is a risk factor for functional disability in the chronic phase of patients with cerebrovascular disease.

Objective To address the compatible access issue of other types of citizen card and ticket in ticketing system during urban rail transit operation, a unified planning on the compatible access of citizen cards within Suzhou pan-urban area is required to form a comprehensive solution for the compatible access. Method Based on the current citizen card accessibility situation in Suzhou urban rail transit ticketing system, the access service of Suzhou citizen cards is sorted, and the requirements and work content of citizen cards compatible access are analyzed. The implementation difficulties and reasonable solution ideas for citizen card accessibility are analyzed from aspects including preferential policies, technical standards, ticket card structure, and three compatible access solutions are proposed based on transaction settlement methods: indirect access, direct access, and mixed access. Solutions are compared and selected regarding economy, security, and convenience, and suggestions for the specific implementation of compatible access is proposed from two aspects of standards formulation and parameterization configuration. Result & Conclusion The research and solution comparison results show that the citizen card compatible access in ticketing system involves many difficulties, requiring coordination and resolution by multiple parties; the mixed access solution takes into account both the renovation workload and the rights and interests of each accessing party, displaying strong flexibility and better applicability; developing compatible access standards for citizen cards can effectively reduce the difficulties and cost of access.

Background Smoking cessation related behavior change techniques (BCTs) are defined as interventions that can change smokers' smoking behavior. At present, there are no studies to explore the current status of BCTs usage among outpatient healthcare workers for smoking cessation in China. Objective The current study aims to describe the frequency and perceived effect of medical staff using BCTs in smoking cessation clinics, and to investigate the association between the usage of BCTs by medical staff and successful quitting rate among smokers in smoking cessation clinics. Methods From February 2022 to March 2023, online questionnaire was distributed to medical staff in smoking cessation clinics in China through "WJX" to evaluate the frequency and perceived effect of 44 smoking cessation BCTs used, the success rate of smoking cessation, as well as the demographic characteristics such as age and gender. The hierarchical linear regression model and simple slope analysis were utilized to explore the factors affecting the success rate of quitting in smoking cessation clinics and to examine the interaction between frequency and perceived effect of BCTs used for promoting smoking cessation. Results Two-hundred and eighty-five healthcare professionals who had experience in smoking cessation clinics over one year were included in this study. On average, it is reported that healthcare professionals have used (29±13) smoking cessation related BCTs. The perceived average score for effectiveness of BCTs used was (3.15±0.96). The self-reported average success rate of smoking cessation was (37.0±24.3) %. There were statistically significant differences in the number of BCTs used and the perceived effect of medical staff with different highest education level and whether tracking smoking cessation rate of smokers (P0.05). When the interaction item of BCTs used × effect perception was further included, the explanatory of the model for the success rate of smoking cessation in the smoking cessation clinic increased by 2.2%, and the perceived effect of BCTs [b (95%CI) =11.711 (8.548-14.874), P

This article presents a case study of a patient who had Cronkhite-Canada syndrome in combination with an asymptomatic novel coronavirus infection. The patient exhibited clinical symptoms of loss of appetite, hair and nail loss, and skin pigmentation. Digestive endoscopy revealed widespread and varying-sized polypoid changes in the mucosa of the stomach, duodenum, and colon. During the course of the illness, the patient tested positive for novel coronavirus nucleic acid. Treatment with moderate doses of prednisone resulted in the patient's hair regrowth and decreased skin hypopigmentation. The article provides a summary of the patient's diagnosis and treatment and a review of relevant literature, with the aim of enhancing clinicians' understanding of the disease.

Maintaining long-term stability of patient's condition is crucial in the treatment for bipolar disorder， while accurately assessing the patient's disease status is important and challenging in maintaining treatment. Excessive status expectation is common in patients with bipolar depression， which would warp the patient's perception of his or her own disease status and， thus， ultimately interfere with clinical decisions. Heightened vigilance should be given to such phenomenon. This paper explores the phenomenon and potential mechanisms of excessive status expectation in patients with bipolar disorder， providing ideas for related diagnosis， treatment and research. ［Funded by Jiangsu Provincial Science and Technology Project （number， BE2015609）］

Objective To investigate the effect of tetrandrine (Tet) on injury of primary human articular chondrocytes induced by interleukin-1β (IL-1β). Methods Human articular chondrocytes were divided into control group, IL-1β group, hypoxia inducible factor(HIF-1α) inhibitor group [2-methoxyestradiol(2-ME2) group], Tet groups containing low, medium and high concentrations. Each group has six replicated samples. MTT assay was used to detect the viability of cells; cell apoptosis was detected by flow cytometry; the level of inflammatory related factors like tumor necrosis factor-α (TNF-α), matrix metalloproteinase 3(MMP-3), inducible nitric oxide synthase (iNOS), cyclooxygenase-2(COX-2) and the activity of antioxidant factors like super oxide dismutase (SOD) and glutathione peroxides (GPx) in cells were detected by ELISA; Western blot was used to detect the expression of HIF-1α and VEGF in cells. Results Compared with the control group, the apoptosis rate, level of TNF-α,MMP-3, iNOS,COX-2 and the protein expression of HIF-1α and VEGF in IL-1β group all increased, the cell survival rate and the activity of SOD and GPx significantly decreased (P＜0.05); compared with IL-1β group, the apoptosis rate, the level of TNF-α, MMP-3, iNOS, COX-2 and the protein expression of HIF-1α and VEGF in 2-ME2 group and Tet groups with low, medium, and high concentration significanthy decreased(P＜0.05). The cell survival rate and the activity of SOD and GPx significantly increased(P＜0.05). Conclusions Tetrandrine attenuates IL-1β-induced injury of human articular chondrocytes.

ObjectiveTo analyze the research trends and cutting-edge hot spots in the field of multimorbidity in older adults from 2000 to 2023 to provide reference for related research.MethodsWe conducted a search in the Web of Science Core Collection database, specifically looking for articles or reviews in English on multimorbidity in older adults published between January 1, 2000 and October 24, 2023. VOSviewer 1.6.18 software was used to extract the contents in the literature and draw the cooperative network diagram of high-producing countries(≥30 articles) and institutions(≥43 articles) as well as the timeline diagram of high-frequency keywords(≥74 occurrences) co-occurrence relationship. CiteSpace 6.1.R6 software was used to co-occur and cluster analyze the information of authors, research institutions and countries. The "bibliometrix" package in R was used to analyze the evolution of keywords in the literature.ResultsA total of 2590 documents consisting of 2230 Articles and 360 Reviews were obtained. The worldwide publication count significantly increased since 2000. Among the countries, the United States had the highest number of publications (35.02%, 907/2590) and total citations(31 343 times) in this field. The University of Toronto in Canada had the largest number of articles(2.59%, 67/2590). Jenny Ploeg of McMaster University was recognized as the most prolific author(1.24%, 32/2590). When it came to journals, BMC Geriatrics had the highest amount of literature related to multimorbidity(3.82%, 99/2590). The key areas of research in this field included multimorbidity, older adults, frailty, aging, and polypharmacy. Notably, there was growing interest in studying the relationship between multimorbidity and aging in older adults, as well as the impact of frailty and polypharmacy on multimorbidities.ConclusionsIn recent years, research on multimorbidities in the elderly has primarily centered around examining the correlation between comorbidities and aging, as well as exploring the impact of frailty and polypharmacy on individuals with multimorbidities. Future research could delve into primary health care, comprehensive geriatric assessment for older adults with multimorbidities, and maintenance of their overall quality of life.

Objective To investigate the regulatory effect of nobiletin (NOB) at typical effective doses on intestinal stem cells in vivo and in vitro. Methods After a 3D culture model of mouse colorectal tumor cell line MC38 was constructed, the death and survival of the obtained colonies were observed after treatment of different concentrations of NOB. Mouse small intestinal crypts were cultured in the Matrigel to generate organoids. Different concentrations of NOB were added to the culture system, and the sprouting and growth of the organoids were observed. MTT assay was used to calculate the area and absorbance values of the organoids after staining. The organoid growth was observed by removing 50 and 100 μmol/L NOB for different periods. The effects of exogenous R-spondin1 and CHIR99021 (activators of Wnt pathway) on the growth of organoids were observed in the culture system with 50 and 100 μmol/L NOB treatment. C57/B6J mice were infused with different concentrations of NOB by gavage for 4 consecutive days. The ratio of intestinal crypt to villus length, cell apoptosis, and number of OLfm4 and BrdU double positive cells were calculated and observed. Results Compared with the control group, 50 μmol/L NOB significantly promoted the death of MC38 cells after sphere formation and significantly reduced the colony formation rate (P < 0.001). The dose also significantly inhibited the budding of intestinal organoids, and 50~200 μmol/L NOB significantly inhibited the growth of intestinal organoids in a dose-dependent manner when compared with the control group (P < 0.001). After NOB withdrawal, the growth of intestinal organoids in the 50 μmol/L group was partially recovered, but it was difficult to recover to normal level in the 100 μmol/L NOB group. Enhanced Wnt pathway activation could partially rescue the inhibitory effect of NOB on intestinal organoids. In vivo administration of higher concentrations of NOB did not induce apoptosis of intestinal crypt cells, did not affect the crypt to villus ratio, and had no effects on the number and proliferation status of intestinal stem cells. Conclusion NOB possesses the ability to inhibit normal intestinal stem cells by regulating stem cell-related pathways such as Wnt, but this cellular inhibition cannot be phenocopied in vivo. Our study suggests the safety of NOB at regular concentration and also raises a caution to explain the inhibitory role of NOB in cancer models.

Healthy eating behavior is one of the leading lifestyle factors that influence people’s health status. Increasing incidents of noncommunicable diseases such as obesity， hypertension， cardiovascular diseases， and diabetes caused by unhealthy eating habits are among the major public health challenges in China. To deal with this challenge， the Healthy China 2030 committee proposed the “Promoting a balanced diet” action as one of the 15 specialized strategies for achieving this goal. However， how to put this initiative into practices reamins a big public health challenge in China. Recent research in behavioral sciences provides valuable insights for dealing with this challenge. Behavioral science-based nudge strategies can promote healthy eating by making healthy eating more convenient and preferrable， promoting healthy eating through social influences， and enhancing healthy eating at the right moment without constraining people's freedom of choosing what to eat. These strategies could inspire the development of culturally appropriate and context-sensitive behavioral nudges to promote healthy eating in China.

Objective To explore the molecular mechanism of SHMT2 regulating the invasion and migration of breast cancer cells. Methods Bioinformatics analysis was used to verify the role of SHMT2 in breast cancer tissues. Transwell assay was used to detect the changes of invasion and migration abilities of breast cancer cells. Co-immunoprecipitation, knockdown plasmid transfection and Western blot were used to determine the regulatory relationship between different proteins. Results Bioinformatics analysis showed that the expression level of SHMT2 in invasive breast cancer tissues was significantly higher than that in adjacent normal tissues (P < 0.001). The 5-year disease-specific survival and overall survival in the SHMT2 high expression group were significantly lower than those in the SHMT2 low expression group (both P < 0.001). Transwell assay showed that SHMT2 knockdown significantly reduced the invasion ability (t=5.375, P=0.0058) and migration ability (t=6.274, P=0.0033) of MCF7 cells. Western blot showed that SHMT2 could combine to HAX1, and knockdown of SHMT2 reduced the protein level of HAX1. Transwell assay showed that the inhibitory effect of SHMT2 knockdown on the migration of MCF7 cells could be reversed by overexpression of HAX1 (t=6.274, P=0.0033; t=8.041, P=0.0013), while SHMT2 inhibitor (SHIN1, 10 nmol/L) significantly inhibited the migration of MCF7 cells induced by SHMT2 overexpression (t=10.16, P=0.0005; t=8.741, P=0.0009). Conclusion SHMT2 was closely related to the poor prognosis of breast cancer, and was a key factor in the invasion and migration of breast cancer cells. The mechanism was that SHMT2 increased the invasion and migration ability of breast cancer cells by binding to and up-regulating HAX1. It was verified that SHMT2 inhibitor could significantly reduce the migration ability of breast cancer cells. This study explored the therapeutic potential of SHMT2 inhibitor in metastatic breast cancer, and found potential intervention targets for its clinical treatment.

In this paper, we report an elderly patient who had been experiencing poor appetite for one month and yellowing of the skin and sclera for two months before visiting the Department of Geriatrics at Peking Union Medical College Hospital. The patient's blood tests revealed significantly elevated levels of serum total bilirubin, direct bilirubin, and blood sugar. The serum IgG4 level nearly tripled. Abdominal imaging examinations revealed diffuse pancreatic lesions, narrowing of the intrapancreatic segment of the common bile duct, and thickening and marked enhancement of the common hepatic duct, left and right hepatic ducts, and branches. Blood glucose was also significantly elevated during the course of the disease. Moreover, nutritional assessment found that the patient was malnourished. After multidisciplinary discussion, a medium dose of oral methylprednisolone was prescribed to the patient due to his advanced age and multiple chronic conditions. The dose was then quickly reduced while the patient simultaneously received low-dose mycophenolate mofetil (MMF) treatment. As a result, the patient's bilirubin level significantly decreased, jaundice subsided, and his body weight returned to normal with improved physical function. Throughout the diagnosis and treatment process, a multidisciplinary team actively participated in discussions and gradually identified the underlying cause. This exemplifies the crucial role of interdisciplinary collaboration in effectively diagnosing and treating complex illnesses in elderly patients.

ObjectiveThe fruit load estimation of fruit tree is essential for horticulture management. Traditional estimation method by manual sampling is not only labor-intensive and time-consuming but also prone to errors. Most existing models can not apply to edge computing equipment with limited computing resources because of their high model complexity. This study aims to develop a lightweight model for edge computing equipment to estimate fruit load automatically in the orchard.MethodsThe experimental data were captured using the smartphone in the citrus orchard in Jiangnan district, Nanning city, Guangxi province. In the dataset, 30 videos were randomly selected for model training and other 10 for testing. The general idea of the proposed algorithm was divided into two parts: Detecting fruits and extracting ReID features of fruits in each image from the video, then tracking fruit and estimating the fruit load. Specifically, the CSPDarknet53 network was used as the backbone of the model to achieve feature extraction as it consumes less hardware computing resources, which was suitable for edge computing equipment. The path aggregation feature pyramid network PAFPN was introduced as the neck part for the feature fusion via the jump connection between the low-level and high-level features. The fused features from the PAFPN were fed into two parallel branches. One was the fruit detection branch and another was the identity embedding branch. The fruit detection branch consisted of three prediction heads, each of which performed 3×3 convolution and 1×1 convolution on the feature map output by the PAFPN to predict the fruit's keypoint heat map, local offset and bounding box size, respectively. The identity embedding branch distinguished between different fruit identity features. In the fruit tracking stage, the byte mechanism from the ByteTrack algorithm was introduced to improve the data association of the FairMOT method, enhancing the performance of fruit load estimation in the video. The Byte algorithm considered both high-score and low-score detection boxes to associate the fruit motion trajectory, then matches the identity features' similarity of fruits between frames. The number of fruit IDs whose tracking duration longer than five frames was counted as the amount of citrus fruit in the video.Results and DiscussionsAll experiments were conducted on edge computing equipment. The fruit detection experiment was conducted under the same test dataset containing 211 citrus tree images. The experimental results showed that applying CSPDarkNet53+PAFPN structure in the proposed model achieved a precision of 83.6%, recall of 89.2% and F1 score of 86.3%, respectively, which were superior to the same indexes of FairMOT (ResNet34) model, FairMOT (HRNet18) model and Faster RCNN model. The CSPDarkNet53+PAFPN structure adopted in the proposed model could better detect the fruits in the images, laying a foundation for estimating the amount of citrus fruit on trees. The model complexity experimental results showed that the number of parameters, FLOPs (Floating Point Operations) and size of the proposed model were 5.01 M, 36.44 G and 70.2 MB, respectively. The number of parameters for the proposed model was 20.19% of FairMOT (ResNet34) model's and 41.51% of FairMOT (HRNet18) model's. The FLOPs for the proposed model was 78.31% less than FairMOT (ResNet34) model's and 87.63% less than FairMOT (HRNet18) model's. The model size for the proposed model was 23.96% of FairMOT (ResNet34) model's and 45.00% of FairMOT (HRNet18) model's. Compared with the Faster RCNN, the model built in this study showed advantages in the number of parameters, FLOPs and model size. The low complexity proved that the proposed model was more friendly to edge computing equipment. Compared with the lightweight backbone network EfficientNet-Lite, the CSPDarkNet53 applied in the proposed model's backbone performed better fruit detection and model complexity. For fruit load estimation, the improved tracking strategy that integrated the Byte algorithm into the FairMOT positively boosted the estimation accuracy of fruit load. The experimental results on the test videos showed that the AEP (Average Estimating Precision) and FPS (Frames Per Second) of the proposed model reached 91.61% and 14.76 f/s, which indicated that the proposed model could maintain high estimation accuracy while the FPS was 2.4 times and 4.7 times of the comparison models, respectively. The RMSE (Root Mean Square Error) of the proposed model was 4.1713, which was 47.61% less than FairMOT (ResNet34) model's and 22.94% less than FairMOT (HRNet18) model's. The R2 of the determination coefficient between the algorithm-measured value and the manual counted value was 0.9858, which was superior to other comparison models. The proposed model revealed better performance in estimating fruit load and lower model complexity than other comparatives.ConclusionsThe experimental results proved the validity of the proposed model for fruit load estimation on edge computing equipment. This research could provide technical references for the automatic monitoring and analysis of orchard productivity. Future research will continue to enrich the data resources, further improve the model's performance, and explore more efficient methods to serve more fruit tree varieties.

Objective: To solve the problem that the roller is inconvenient to operate and the concept of rolling friction coefficient and sliding friction coefficient is confused. Methods: EDEM software was used to simulate the white milling process. Taking MNAW18 rice mill as a reference and taking Feng Liangyou series brown rice as a sample, a set of method for measuring discrete element simulation parameters of rice mill was established by independently setting up an experimental bench and combining with simulation calibration. Results: Using the self-made collision coefficient experimental device and video motion processing software, the collision recovery coefficients between brown rice and brown rice, roller and screen were 0.34, 0.24 and 0.43 respectively. Based on the relationship between inclined angle and static friction coefficient, the static friction experiment is designed. The static friction coefficients between brown rice and brown rice, roller and screen were 0.467, 0.881 and 0.550 respectively. The rolling friction coefficient was calibrated through the combination of brown rice stacking angle experiment, brown rice inclined plane rolling experiment and discrete element simulation experiment. The rolling friction coefficients between brown rice and brown rice, roller and screen were 0.013, 0.101 and 0.159 respectively. Conclusion: Through the secondary simulation, the error between the simulation results and the measured results is within a reasonable range, which indicates that the parameter calibration data is reliable.

This article summarized integrated traditional Chinese and western medicine nursing management for a lung cancer patient with pain after chemotherapy. Routing nursing interventions included routine nursing risk assessment, scientific analgesic strategy and health education. Traditional Chinese Medicine nursing techniques such as Chinese herbal medicine external application, moxibustion, acupoint application and emotion care were carried out to relieve the cancer-related pain after chemotherapy and improve the patient’s quality of life. (本文总结1例肺癌患者化疗后并发疼痛的中西医结合护理经验。护理人员在护理评估、科学止痛、健康教育等常规护理的基础上融入中医特色护理, 运用辨证施护, 开展中药贴敷、艾灸、穴位按摩、情志护理等中医护理适宜技术, 有效改善患者化疗后的癌痛反应, 提高患者生活质量。)

Objective To observe the clinical effect of external application of Rutongyu medicine film in the treatment of hyperplasia of mammary gland. Methods Totally 96 patients with hyperplasia of mammary gland were randomly divided into the treatment group (n=48) and control group (n=48). The treatment group was treated by external application of Rutongyu medicine film, and the control group was treated with XiaoJinPian orally. The medication was taken for 2 menstrual cycles. The visual analogue scale (VAS) score of breast pain, duration of breast pain, and the maximum diameter of breast target mass were compared between the two groups before and after treatment, and the clinical efficacy was summarized and evaluated. Results After treatment, VAS score of breast pain, duration of breast pain, and maximum diameter of target mass in the two groups were significantly improved compared with those before treatment (P＜0. 01), and the improvement in the treatment group was better than that in the control group (P＜0. 01). The total effective rate of the treatment group was 89. 58%(43/48), which was significantly higher than 68. 75% (33/48)of the control group (P＜0. 05). Conclusion External application of Rutongyu medicine film can effectively treat hyperplasia of mammary gland, relieve pain and reduce breast mass. (目的 观察乳痛愈药膜治疗乳腺增生病的临床疗效。方法 96例乳腺增生病患者随机分为治疗组(n=48)与对照组(n=48)。治疗组给予乳痛愈药膜外敷, 对照组给予口服小金片治疗, 用药时间均为2个月经周期。比较2组患者治疗前后乳房疼痛视觉模拟评分(VAS)、乳房疼痛天数、乳房肿块最大径, 总结评估临床疗效。结果 治疗后两组组患者乳房疼痛VAS评分、乳房疼痛天数、肿块最大径均较治疗前改善(P＜0. 01), 且治疗组改善优于对照组(P＜0. 01)。治疗组总有效率为89. 58%(43/48), 高于对照组的68. 75%(33/48), 差异有统计学意义(P＜0. 05)。结论 乳痛愈药膜能够治疗乳腺增生症效果明确, 能有效缓解疼痛, 缩小乳房肿块。)

This paper summarized the nutrition support and nursing management for a patient with unstageable pressure injuries. Based on the assessment of wound condition, pain and nutrition, appropriate nutrition support combined with nursing interventions such as debridement and wound dressing change, Traditional Chinese Medicine nursing, pain management, in order to improve the wound healing. (本文总结1例不可分期压力性损伤患者的营养干预及相关护理技术。在完善伤口评估、疼痛评估和营养评估的基础上, 通过开展适宜的营养干预方案, 同时配合清创换药、中医护理技术、疼痛护理等干预措施, 促进压力性损伤伤口愈合。)

As the most common type of arrhythmia, atrial fibrillation has proven to be associated with serious adverse cardiovascular and cerebrovascular events, such as heart failure, stroke and myocardial infarction. The global number of patients with atrial fibrillation has exceeded 33 million, and it is estimated to be more than doubled in the next 40 years. Although years of efforts have been made to the research on pathophysiological mechanism, and the exploration of new treatments and improvement of treatments regarding atrial fibrillation, the management of atrial fibrillation is still a difficult problem in clinical medicine, and there is no consensus on the best treatment and the choice of energy source for ablation in atrial fibrillation with the increasing advances made in surgical and catheter ablative techniques. Catheter ablation often requires multiple operations with unsatisfactory success rate and surgical ablation is often associated with high risk of postoperative adverse events. Hybrid ablation, a new treatment recently developed by the joint efforts of cardiac surgeons and electrophysiologists, integrates the merits of catheter ablation and minimally invasive surgical ablation but overcomes the limitations of the two, has proven to be effective in reducing the risk of postoperative adverse outcomes, and considerably efficacious in treating persistent atrial fibrillation, especially long-term persistent atrial fibrillation. We reviewed the advances in atrial fibrillation ablation, and comparatively analyzed existing studies of hybrid ablation, and summarized the advantages and challenges of this treatment, hoping to provide one more option for clinical treatment of atrial fibrillation.

This paper reviewed the clinical data of a patient with bacterial pneumonia who developed perianal incontinence dermatitis during treatment. The patient was treated with Montmorillonite powder combined with liquid dressing. on the basis of routine perianal care, the dressing exchange method was improved, and the individualized scheme of Montmorillonite powder combined with liquid dressing was adopted. In addition, multidisciplinary consultation and health education were carried out to improve the wound healing, reduce the pain and improve patient’s quality of life. (本文总结1例细菌性肺炎并发肛周失禁性皮炎患者采用蒙脱石散联合液体敷料换药的护理经验。在加强肛周基础护理基础上, 护理人员运用蒙脱石散联合3M液体敷料进行肛周换药, 并通过多学科会诊, 加强健康教育, 提高依从性, 促进伤口快速愈合, 减轻患者的痛苦, 提高生活质量。)

This article summarized the mechanical ventilation and nursing management for a case of severe asthma complicated with intrinsic positive end-expiratory pressure. The mechanical ventilation was adopted to relieve the symptoms of dyspnea. Comprehensive interventions including vital signs monitoring, noninvasive ventilation nursing, basic nursing, nutrition support, psychological care were carried out to reduce the complication during treatment and improve the recovery of the patient. (本文总结1例重症哮喘合并内源性呼气末正压患者机械通气救治和护理经验。机械通气能有效改善患者呼吸困难的症状, 同时配合病情观察、无创通气护理、基础护理、营养支持以及心理干预等优质护理措施, 积极预防并发症, 促进患者早日康复。)

Alzheimer’s disease is known as one of the “top ten killers in the world”. Due to lack of effective therapy at present， early pathological changes have captivated widespread attention. Axonal transport dysfunction has been reported as an early pathological feature of many neurodegenerative diseases. However， multiple factors can cause axonal transport dysfunction. In this article， the relationship between axonal transport dysfunction caused by kinesins， microtubules and mitochondria and Alzheimer’s disease was discussed， aiming to provide new ideas for the prevention and treatment of Alzheimer’s disease by in-depth study on axonal transport mechanism of neure.

The research progress in dynamically vulcanized polyurethane/silicone rubber thermoplastic elastomer was summarized from the aspects of raw material selection, processing technology and compatibilizer with 20 references.

[Purpose/Significance] Chinese ancient books are one of the most important carriers to condense the essence of Chinese traditional culture. However, scholars have found that the database of Chinese ancient books only provides book metadata, which can only meet the basic retrieval and use needs of users, but does not dig and utilize Chinese ancient books in depth from the perspective of knowledge organization. The research in digital humanities is in the ascendant, providing an important modern scientific and technological means for the realization of knowledge correlation of Chinese ancient books. The research on the content mining and knowledge correlation of Chinese ancient books will help to improve the development level and service quality of Chinese ancient books, and promote the creative transformation and innovative development of Chinese excellent traditional culture. [Method/Process] Through literature review and online investigation, this paper summarizes the research of Chinese ancient books' knowledge correlation from the perspective of digital humanities. Based on the research, this paper discusses the differences between traditional database and digital humanistic platforms of Chinese ancient books. First, the organization mechanism is different, and the latter has more diverse and in-depth functions. Second, the scope of collection is expanded. The latter includes not only the original documents, but also the analytical texts and extended documents of ancient books, etc. In the past, most database platforms were "digital" platforms; The digital humanistic platform of Chinese ancient books is a platform of "data", which has been upgraded from "storage" to "analysis" and "correlation". Then, the key links of Chinese ancient books' knowledge correlation are discussed, and the barriers of knowledge correlation are analyzed by examples. [Results/Conclusions] From the perspective of digital humanities, collation of Chinese ancient books has developed from document units to knowledge units by using the data analysis technology, machine learning, visualization technology, etc. The realization of knowledge correlation of Chinese ancient books starts from document organization, based on ancient book data, and its essence is knowledge organization. Knowledge correlation of Chinese ancient books can be used for local chronicles and genealogy mining, seal knowledge network discovery, research context and communication analysis of scholars in specific periods and regions. However, the current knowledge correlation of ancient books still faces barriers such as the difficulty of knowledge element processing, high technical requirements and the lack of integrated platforms in its implementation. Limited by the research conditions, this paper only discusses the research and application, key links and barriers of ancient books' knowledge correlation from a theoretical point of view. In the future work, we will take the opportunity of optimizing and upgrading our ancient books' knowledge platform, to further study the metadata description specification, text conversion and content mining of Chinese ancient books, data exchange and update mechanism among different platforms.

Traditional Chinese Medicine wet compress, a common method for external treatment of Chinese medicine, has been widely used in clinical practice. Through literature review, this paper briefly introduced the definition, historical origin and mechanism of TCM wet compress, and summarized the specific application of TCM wet compress from two aspects of cold- and hot-wet compress, providing reference for clinical research. (中药湿敷属于中医外治法的一种, 在临床应用广泛。本文通过文献整理, 概述了中药湿敷技术的定义、历史渊源、作用机制, 从冷、热湿敷两方面综述了中药湿敷的具体应用情况, 以期为临床研究提供参考借鉴。)

This paper summarized the nursing measures for a patient with chronic obstructive pulmonary disease complicated with type II respiratory failure treated by sequential non-invasive positive pressure ventilation via nasal high-flow oxygen therapy. Nursing interventions were carried out in the following ways: non-invasive positive pressure ventilation, medication nursing, enteral nutrition support, pipeline maintenance, skin care and psychological nursing and other issues. Efforts were made to improve the respiratory failure status and various vital signs, control of carbon dioxide retention and reduce the occurrence of complications. By providing patients with a constant, adjustable, high-speed breathing gas mixture formed from air and oxygen, it was aimed to crush the gas left in the nasal cavity, oral cavity and pharynx, and significantly reduce the amount of carbon dioxide inhaled during the next inhalation. The application of sequential treatment with transnasal high-flow oxygen therapy has achieved positive therapeutic results in patients with hypoxic respiratory failure. (本文总结经鼻高流量氧疗序贯无创正压通气治疗1例慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭患者的护理干预措施, 主要从无创正压通气护理、用药护理、肠内营养支持、管路护理、皮肤护理及心理护理等方面进行干预, 旨在改善患者呼吸衰竭状况和各项生命体征, 控制二氧化碳潴留病情, 减少并发症的发生。通过为患者提供恒定的、可调节的高速空氧混合气体, 冲刷患者呼气末残留在鼻腔、口腔及咽部的解剖无效腔的气体, 可明显减少患者下一次吸气时吸入的二氧化碳的含量。经鼻高流量氧疗序贯治疗的应用, 对低氧性呼吸衰竭患者具有积极的治疗效果。)

This paper summarized the clinical treatment and nursing measures of incontinence associated dermatitis complicated with fungal infection in a critically ill patient. Targeted plan of catheter maintenance and skin care was made based on the assessment of patient conditions. The Traditional Chinese Medicine collapse stains method was used to relieve the pain and inflammation, and accelerate the wound healing. (本文总结 1 例危重症患者失禁性皮炎合并真菌感染的临床治疗及护理措施。根据患者个体情况, 制定针对性的管路护理和皮肤护理措施, 同时基于中医理论指导, 运用中药塌渍法缓解疼痛、促进炎症吸收, 加快皮肤创面愈合。)

Early childhood caries (ECC) is not only harmful to children's oral cavity and even the whole body, the government and relevant health departments pay more and more attention to the prevention and treatment of early childhood caries. However, at present, the primary treatment for ECC is the traditional filling therapy. The chronic disease management model can conduct regular testing of chronic non-communicable diseases and their risk factors, and provide long-term and effective professional management to patients by supervision and advice by doctors, nurses and pharmacists. This model has a good effect on slowing down the development of the disease, improving the quality of life of patients and saving public health resources. As a common chronic non-communicable disease, ECC is very suitable for prevention and treatment through chronic disease management. In recent years, chronic disease management models have also been increasingly used in the management of caries. The current common chronic disease management models include the chronic care model, innovative care for chronic condition, and British chronic disease management system models. And above models have certain applications in the management of ECC. How to establish the caries risk assessment system suitable for the diagnosis and treatment model of our country, and how to screen the children with high risk of caries by step-by-step prevention and control network for personalized prevention needed to be further studied in the future.

Background and Purpose: Liver metastases are common in neuroendocrine neoplasm (NEN). Cystic NEN liver metastases (cNENLM) are rare, and the efficacy of transarterial embolization (TAE) has not been reported. This study summarized and analyzed the efficacy and safety of TAE for cNENLM. Methods: From January 2016 to April 2022, 10 patients with cNENLM were enrolled in this study among 440 patients under TAE treatment at The First Affiliated Hospital, Sun Yat-sen University and Fudan University Shanghai Cancer center. The efficacy was evaluated according to Response Evaluation Criteria in Solid Tumors (RECIST) 1.1. Objective response rate (ORR), disease control rate (DCR) and progression-free survival (PFS) were analyzed as well. The common terminology criteria for adverse events (CTCAE) v5.0 was applied to evaluate the adverse effects. Results: With 80.0% ORR and 100.0% DCR according to RECIST 1.1, 3 cases achieved PFS. Among them, the longest one was 25.0 months. Disease progression was not observed in the remaining patients. The common complications were fever, hepatalgia and transient liver dysfunction, which could be alleviated by symptomatic treatment. No severe complication occurred. Conclusion: cNENLM are infrequent. TAE had significant curative effect on cNENLM, and complications were manageable.

Accurate detection and recognition of plant diseases is the key technology to early diagnosis and intelligent monitoring of plant diseases, and is the core of accurate control and information management of plant diseases and insect pests. Deep learning can overcome the disadvantages of traditional diagnosis methods and greatly improve the accuracy of diseases detection and recognition, and has attracted a lot of attention of researchers. This paper collected the main public plant diseases image data sets all over the world, and briefly introduced the basic information of each data set and their websites, which is convenient to download and use. And then, the application of deep learning in plant disease detection and recognition in recent years was systematically reviewed. Plant disease target detection is the premise of accurate classification and recognition of plant disease and evaluation of disease hazard level. It is also the key to accurately locate plant disease area and guide spray device of plant protection equipment to spray drug on target. Plant disease recognition refers to the processing, analysis and understanding of disease images to identify different kinds of disease objects, which is the main basis for the timely and effective prevention and control of plant diseases. The research progress in early disease detection and recognition algorithm was expounded based on depth of learning research, as well as the advantages and existing problems of various algorithms were described. It can be seen from this review that the detection and recognition algorithm based on deep learning is superior to the traditional detection and recognition algorithm in all aspects. Based on the investigation of research results, it was pointed out that the illumination, sheltering, complex background, different disorders with similar symptoms, different changes of disease symptoms in different periods, and overlapping coexistence of multiple diseases were the main challenges for the detection and recognition of plant diseases. At the same time, the establishment of a large-scale and more complex data set that meets the specific research needs is also a difficulty that need to face together. And at further, we point out that the combination of the better performance of the neural network, large-scale data set and agriculture theoretical basis is a major trend of the development of the future. It is also pointed out that multimodal data can be used to identify early plant diseases, which is also one of the future development direction.

Objective To study the mechanism of miR-30b by regulating fragile histidine triad gene(FHIT) on cell activity diffuse large B-cell lymphoma(DLBCL). Methods The tumor paraffin specimens of DLBCL patients and the paraffin markers of lymph node hyperplasia at the same time were selected from the Shanghai Minhang District Tumor Hospital (February 2017-June 2019) and divided them into the DLBCL group and the control group. DLBCL cells were divided into the WW group (DLBCL non transfected group), WZ group (DLBCL transfected NC group )and ZR group (DLBCL transfected miR-30b group). RT-qPCR method was used to detect miR-30b expression; Western blot was used to detect FHIT protein expression; colorimetric method was used to detect caspase-3 activity; Flow cytometry was used to detect DLBCL cell apoptosi and Transwell method was applied to detect cell invasion. Results The expression of miR-30b and FHIT in the control group was significantly higher than those in the DLBCL group (P＜0.05); the expression of miR-30b, FHIT and caspase-3 in the ZR group was higher than those in the WW and WZ groups (P＜0.05) The apoptosis rate of ZR group was time-dependently higher than that of WW and WZ groups(P＜0.05); the counting of DLBCL cell invasion in ZR group was significantly less than that of WW and WZ groups (P＜0.05). Conclusions After miR-30b transfection, the apoptosis of diffuse large B-cell lymphoma cells increases and the counting of invasion cells decreases. The mechanism of this result may be related to the enhancement of miR-30b, FHIT, and caspase-3 level.

The Ca-based organic framework (Ca-SINAP-1) loaded with silver was successfully prepared, which has a certain γ-ray irradiation resistance of 50 kGy. X-ray diffraction, scanning electron microscopy, Brunauer-Emmett-Teller specific surface area analysis, and pore volume analysis were used to characterize the sample and its Xe adsorption capacity. The results showed that loading of silver on the sample surface did not change the original structure of Ca-SINAP-1. However, the Xe uptake reached a maximum of 3.29 mmol/g and the Xe/Kr separation coefficient was 10.71 when silver loading was 0.93%. With increasing AgNO3 concentration in ethanol, the Xe adsorption quantity decreased because excess silver loading blocked the channels, and thus prevented Xe adsorption. The good irradiation resistance and high Xe/Kr selectivity make Ca-SINAP-1 a potential material for treating radioactive off-gas emitted from molten salt reactors.

An elderly woman with a chronic course of disease presented with progressive weakness of lower limbs, heart failure, carbon dioxide retention, periorbital pigmentation, increased hair around the eyebrows, as well as multiple positive autoantibodies. After multidisciplinary team discussion, restrictive ventilatory dysfunction caused by significantly decreased diaphragm movement was taken as a breakthrough to sort out the etiology step by step. Based on clinical manifestations, serological and imaging features, as well as immunohistochemical staining of quadriceps femoris pathological complement, the final diagnosis of inflammatory myopathy associated with anti-mitochondrial antibodies was established. After correcting heart failure, intermittent non-invasive ventilation and rehabilitation training, clinical symptoms and functional status of the patient were significantly improved. The joint participation of the multidisciplinary team to identify the causes and solve problems in diagnosis and treatment decision-making reflects the great significance of multidisciplinary collaboration in rare diseases.

Objective To investigate the effect of exosomes derived from human gastric cancer cell line AGS and miR-106a on the phenotype of peritoneal mesothelial cells line HMrSV5. Methods Exosomes from AGS cells were isolated and incubated with HMrSV5 cells. Then exosome secretion inhibitor GW4869 was added. miR-106a expression was detected by qPCR, HMrSV5 cells proliferation and apoptosis were detected by EdU and flow cytometry technology. After the AGS cells were transfected with miR-106a mimic or inhibitor, the migration of HMrSV5 cells was detected by Transwell assay, and the expression of Smad7, TIMP2, MMP2, MMP9 and α-SMA was detected by Western blot. After treatment with TGF-β, the expression of Smad7, Smad2/3 and p-Smad2/3 was detected by Western blot. Results The exosomes of AGS cells highly expressed miR-106a (P＜0.01), and incubation with HMrSV5 cells significantly inhibited its proliferation and promoted the early apoptosis rate(P＜0.05). After transfection of miR-106a mimic, the exosomes from AGS cells promoted the migration of HMrSV5 cells (P＜0.001). Meanwhile, the expression of Smad7 and TIMP2 was decreased, but the expression of MMP2, MMP9 and α-SMA was increased. After treatment with TGF-β, the expression of Smad7 decreased but the expression of Smad2/3 and p-Smad2/3 increased. Conclusions Exosomes derived from human gastric cancer AGS cells can promote apoptosis, inhibit proliferation and enhance migration of human peritoneal mesothelial HMrSV5 cells, which may be related to the transport of miR-106a targeting Smad7 and TIMP2.

Objective To analyze retrospectively the IDH1 mutation and MGMT promoter methylation of malignant glioma patients and to identify potential relation to clinical situation. Methods Twenty-five patients with glioma who were received treatment from October 2017 to October 2019 were selected; the survival rate was calculated by Kaplan-Meier method and analyzed by Log-Rank test. Results Univariate analysis showed that negative status of MGMT gene promoter methylation(χ2=4.22,P＜0.05) was an important factor affecting the survival rates of patients, and patients with both negative status of MGMT gene promoter methylation and mutation of IDH1 had a significantly prolonged survival(P＜0.05). Conclusions IDH mutation and MGMT promoter methylation status are significantly related to the prognosis of malignant glioma patients.

With the widespread development of peripherally inserted central catheter (PICC), a variety of dressing are available for clinic. Selecting appropriate dressings, mastering the operation standard process and correctly evaluating replacement time of dressing can effectively reduce the complications after PICC catheterization, which includes accidental prolapse, ectopic, bleeding, puncture site infection, etc. This paper discussed the characteristics, indications, operation procedures, indications of different dressings in PICC and the different choices to be taken based on patients' own conditions. Therefore, it provides reference for the selection, usage and maintenance of clinical PICC catheterization dressings. (经外周静脉穿刺置入中心静脉导管(PICC)在临床应用广泛, 敷料的选择是PICC维护工作中的重要环节之一, 掌握敷料更换的操作规范流程, 正确评估并掌握敷料的更换时间, 可以有效降低PICC置管后的并发症发生风险。本文论述了不同敷料在PICC中的应用特点、适应症、操作流程和基于患者自身情况要采取的不同选择, 以其为临床PICC置管敷料的选择、使用及维护提供相应的参考。)

Severe pneumonia has a high incidence, fatality rate and poor prognosis in the elderly patients, which posing a great threat to the life safety of elderly patients. This article summarized the application experience of care bundles in an elderly patient with severe pneumonia. Through the development of clustered airway care measures, including effective sputum discharge, posture management, safe nasal feeding, oral care, and hand hygiene, in order to improve the patient’s prognosis. (重症肺炎在老年人中发病率、病死率高, 预后差, 对老年患者生命安全构成极大威胁。本文总结了集束化护理在1例高龄重症肺炎患者气道管理中的应用经验, 通过制定气道集束化护理措施, 包括有效排痰、体位管理、安全鼻饲、口腔护理、手卫生, 旨在改善患者预后。)

Objective To identify the time course of regional cerebral oxygen saturation (rScO2) during laparoscopic surgery with trendelenburg position in gynecology and to quantify the effect of related factors. Methods Data from patients scheduled for elective gynecological laparoscopic surgery were collected and analyzed from June 2017 to Aug 2018 in Peking Union Medical College Hospital. Spline and mixed-effects models were used to investigate the changing trend and affecting factors of rScO2. Results Forty-eight ASA Ⅰ~Ⅱ patients were included. rScO2 presented a U-shaped trend over time with the spline model (P＜0.01 for the non-linear association). Episodes of cerebral deoxygenation were observed in 3 patients during the declining period of rScO2. Mean blood pressure, systolic blood pressure and end-tidal CO2 (ETCO2) were positively associated with rScO2 (P＜0.05). Peak airway pressure (PAP) and body mass index (BMI) were negatively associated with rScO2 (P＜0.05). Compared with other factors, the effects of BMI and ETCO2 on rScO2 were increased significantly over time(P＜0.05). Conclusions During the gynecological laparoscopic surgery with trendelenburg position, rScO2 changes significantly over time. BMI and ETCO2 exhibite greater effects on rScO2, and the effects increase significantly over time.

Objective To determine the effect of intraoperative methylene blue infusion on postoperative liver and kidney functions in patients with obstructive jaundice. Methods A total of 50 patients with serum total bilirubin level higher than 34.2 μmol/L undergoing biliary obstruction surgery in our hospital from July 2019 to December 2020 were included in this study. They were randomly and equally divided into methylene blue group (infusion of 50 mL 2 mg/kg methylene blue before anesthesia intubation followed by 0.5 mg·kg-1·h-1 continuous infusion during the operation) and placebo group (same amount of normal saline throughout the operation). Intraoperative mean arterial pressure, intake and output and norepinephrine usage, and postoperative oxygenation index, and the levels of total bilirubin, total bile acid, aspartate aminotransferase, alanine aminotransferase, creatinine and urea nitrogen were compared between the 2 groups. Results There was no significant difference in the mean arterial pressure between the 2 groups of patients (P>0.05). The methylene blue group had significantly less amounts of Ringer's lactate solution (1 788.22±562.67 vs 2 635.32±633.45 mL) and norepinephrine (1.43±0.42 vs 4.11±1.14 mg), and lower ratio of norepinephrine use (32% vs 52%) than the placebo group (P < 0.01). The extubation time and ICU stay time were obviously shorter in the former than the latter group (P < 0.05). But there were no statistical differences in postoperative oxygenation index or postoperative levels of total bilirubin and total bile acid between the 2 groups (P>0.05). The postoperative levels of aspartate aminotransferase in 24 h (200.21±143.33 vs 362.32±253.64 IU/L) and 72 h (123.32±87.44 vs 184.53±143.25 IU/L) and those of alanine aminotransferase at 24 h (192.52±83.23 vs 254.24±93.22 IU/L) and 72 h (183.31±107.92 vs 276.34±111.95 IU/L) were notably lower in the methyl blue group than the placebo group (P < 0.05). No significant difference were seen in the postoperative levels of creatinine and urea nitrogen between the 2 groups (P>0.05). Conclusion Continuous infusion of methylene blue reduces the use of blood pressure drugs in patients with obstructive jaundice, effectively alleviates postoperative liver damage, and thus improves patient safety during the perioperative period.

Objective To explore the relationship between fall risk and Traditional Chinese Medicine (TCM) constitution of inpatients, and provide reference for reducing the occurrence of fall risk among inpatients. Methods The TCM constitution classification and determination scale was used to evaluate the physique types of patients with high risk falls in hospital, to investigate the risk of falls in hospital and the physical condition of TCM, and to analyze the correlation between fall risk and TCM physique by single factor and multiple stepwise regression. Results Spearman correlation analysis showed that the fall risk score was significantly negatively correlated with the score of peace quality (P

This paper reviewed the clinical data and nursing management of a patient with severe pneumonia and diabetes mellitus. The patient received transnasal feeding tube placement for enteral nutrition support. In addition to enteral nutrition-related nursing management, a care bundle including psychological nursing, oral/nasal cavity and skin care, maintenance of feeding tube and catheter was carried out to improve the treatment efficacy. (本文回顾1例重症肺炎合并糖尿病患者的肠内营养支持与护理措施。护理人员遵医嘱给予患者肠内营养液鼻饲泵入, 在加强肠内营养护理的同时给予心理护理、口鼻腔及皮肤黏膜护理、导管护理等干预措施。)

Due to the lack of communication mechanism between inter-blockchain services, it is difficult to formulate effective interconnection between different blockchain. Under the smart services ecosystem, two parties of the transaction not only execute the single transaction of data assets, but also extend the scope of their services to cover a wider range of digital assets transfer scenarios. An inter-blockchain communication(IBC) framework for smart service transaction is designed. With component-based and modular design, it makes flexible for the subject and object application of smart service transaction to access IBC framework and thus promote inter-blockchain scalability. Finally, a three-phrase inter-blockchain communication protocol for smart service transaction is proposed to ensure the atomicity and consistency of inter-blockchain ecosystem.

ObjectiveTo understand the characteristics of high-risk inmates’ impulsivity and to explore the influencing factors of impulsivity， so as to provide a theoretical basis for identifying the high-risk factors and making effective intervention.MethodsA total of 588 male inmates in Nanjing were selected as the research subjects. They were divided into four groups according to their violent crime reasons， high impulsiveness， borderline personality and antisocial personality. The detailed criminal records of inmates， general demographic data questionnaire， self-made substance use questionnaire， Barratt Impulsiveness Scale （BIS-11） and Childhood Trauma Questionaire-Short Form （CTQ-SF） were used to investigate， and multiple stepwise regression analysis was conducted to analysis the influencing factors of impulsivity of high-risk inmates.Results① There were statistically significant differences in age， marital status and drug use history among the four groups （F=4.890、13.945、26.137， P

In order to solve the problem of the lack of the special and reliable equipment in the low and deformation roadway roof and side caving danger areas in coal mines, the selection requirements of the roadway treatment construction model and technology were proposed, and the WPZ-45/700LY remote control repair for coal mine was developed. We studied the key technologies of working mechanism, actuator, quick change device, hydraulic system and remote control system, analyzed the function and technical characteristics of each component of the repair machine, and conducted type tests on the ground. The cumulative ground repair footage was 50 m. The repair thickness was 0.3 m to 1.2 m, the remote control distance was 20 m, and the average lifting efficiency was about 2.8 m/h. The test showed that the remote control roadway repair machine has reasonable structural design, reliable hydraulic and electronic control systems, and high construction efficiency. It satisfies the technical requirements of construction equipment for roadway surrounding rock treatment.

This paper, is mean to summarized the key points and methods in maintenance of central venous catheter(CVC) line, so as to reduce the blockage, disjunction of CVC, catheterrelated blood steam infection through reviewing the standardized nursing care of indwelling central venous catheterization(CVC)in a patient with esophageal cancer. The high-quality maintenance of CVC provides an assurance to the application of various hypertonic rescue drugs and long-term infusion of parenteral nutrition, therefore improving the quality of life of patients. (本文通过回顾1例食管癌患者留置中心静脉导管(CVC)的标准化护理措施, 总结留置CVC的护理方法和要点, 从而降低堵管、脱管、导管相关性血流感染等发生风险, 保持管路通畅, 为各种高渗抢救药物的应用以及肠外营养的长期输注提供保证, 进而提高患者的生命质量。)

Objective: To .study the improving effect of Anemarrhenae Rhizoma-Phellodendri Chinensis Cortex herb pair(Zhi Bai) on cognitive impairment in D-galactose(D-gal) administered mice, and to explore the mechanism of Zhi Bai in improving cognitive impairment through the AMPK/mTOR signaling pathway. Methods: Seventy-five C57BL/6J mice were randomly divided into five groups: the control group, the model group (D-gal 125 mg/kg), the piracetam group (468 mg/kg), the Zhi Bai group (4.5 g/kg), and the mTOR inhibitor group (everolimus, RAD001, 3 mg/kg), with 15 mice in each group. The aging mouse model was established using D-gal, followed by 8 weeks of oral administration of Zhi Bai decoction. Cognitive functions in aging mice were assessed using the Morris water maze and novel object recognition tests. Hippocampal tissue pathology was observed using hematoxylin and eosin (H& E) staining; neuronal and synaptic pathological morphology in the hippocampal region was examined with Nissl and Golgi staining. Hippocampal tissues were collected to determine the levels of adenosine triphosphate (ATP) in the brain. The protein expression levels of ubiquitin-binding protein 62 (P62), Beclin-1 associated with myosin, light chain kinase BCL2 (Beclin-1), synaptophysin (Syn), postsynaptic density protein-95 (PSD-95), AMP-activated protein kinase (AMPK), and mTOR in the hippocampus were detected by Western blot. The gene expression levels of Syn, AMPK, and mTOR in the hippocampus were measured using quantitative real-time PCR (qRT-PCR). Results: Compared to the control group, the model group mice showed significant cognitive impairment in the Morris water maze and novel object recognition tests (P<0.01). In the model group, there was a reduction in cell numbers, loose cell arrangement, and irregular neuronal morphology, a significant decrease in Nissl bodies, and a decrease in dendritic branch and spine density in the hippocampal region. ATP levels, as well as P62, Syn, PSD-95, and mTOR protein expressions in the hippocampus of the model group, were significantly reduced (P<0.01), while Beclin-1 expression was significantly increased (P<0.01). The ratio of pAMPK to AMPK protein content and the expression of AMPK genes were significantly elevated (P<0.01), whereas Syn and mTOR gene expressions were significantly decreased (P<0.01). Compared to the model group, cognitive function was significantly improved in the piracetam and Zhi Bai groups, as evidenced by a significant reduction in the latency period in the Morris water maze test (P<0.01), increased platform crossing numbers and target quadrant dwell time (P<0.01), and a significant increase in the novel object recognition index (P< 0.01). Dendritic spine density in the hippocampal region was significantly increased (P<0.01), and neuronal damage was alleviated to some extent. ATP levels and P62, Syn, PSD-95, and mTOR protein expressions in the hippocampus were significantly increased (P<0.01, P<0.05), Beclin-1 protein expression was significantly reduced (P<0.01), and the ratio of pAMPK to AMPK protein content and AMPK gene expression were significantly decreased (P<0.01, P<0.05), with Syn and mTOR gene expressions significantly elevated (P<0.01). The results for the RAD001 inhibitor group were similar to the model group, but Zhi Bai treatment led to a recalibration of these indicators. Conclusion: Zhi Bai may inhibit excessive autophagy of neurons, enhance synaptic plasticity and improve D-gal-induced cognitive impairment in mice by activating the AMPK/mTOR signaling pathway. [ABSTRACT FROM AUTHOR]

In order to improve efficiency of coal mine equipment management, a coal mine equipment information management method based on Data Matrix code was proposed. The method includes Data Matrix code generation and Data Matrix code recognition. Address of server that stores equipment operation information is encoded with equipment inherent information, so as to generate Data Matrix code of coal mine equipment information. Image of Data Matrix code on coal mine equipment is collected through intelligent mobile terminal. After the image is preprocessed by graying, median filtering, binarization and Canny edge detection, the improved Hough transform is used to detect L -shaped line of Data Matrix code, and tilt correction operation is carried out, so as to accurately locate coordinate position of Data Matrix code. Then equipment information contained in Data Matrix code is identified by decoding. The method can accurately record and identify equipment information and improve equipment management efficiency.

Aiming at the rapid and precise construction requirements for a large number of directional pre-borehole of roof cutting and pressure relief in coal mines, ZDY2-300LM full hydraulic drilling rig with double working arms is developed by means of variable amplitude mechanism with multiple degrees of freedom. LUDV hydraulic system is used to solve the problem of mutual interference when the two power heads work. AMESim software is used to build the simplified model and carry out the simulation research. The results show that the output flow and pressure are independent from each one and do not affect each other. The water way of two position three-way valve is adopted to solve the problem of backwater in the hole of loading and unloading drill pipe and increase the comfort of construction personnel. The test results show that the drilling rig has the advantages of fast angle adjusting speed, more freedom of luffing mechanism, accurate drilling positioning, good hole forming quality, and the construction efficiency meets the requirements of working face advance, which is 67.5% higher than that of other conventional non special drilling rigs.