Breast cancer has become the most common malignant tumour in Chinese women, accounting for 12.2% of newly diagnosed breast cancer worldwide (Chen et al., 2022;Fan et al., 2014). According to China's cancer statistics report (Cao et al., 2021;Chen et al., 2022;Xia et al., 2022), the incidence of breast cancer increases by 3%-4% every year, the growth rate is two to three times of the world average level, and this trend will continue in the future. The incidence of breast cancer is high, but with the popularization of early screening and the continuous improvement of comprehensive treatment technology, the mortality rate of breast cancer patients in most countries and regions can remain stable, or even fall steadily (Boere et al., 2022;Mattick et al., 2022;Wilkinson & Gathani, 2022). According to the National Institutes of Health statistics from 2010 to 2016, the 5-year survival rate of breast cancer patients after surgery is 90%, and 82% in China (Zeng et al., 2018). It can be seen that breast cancer patients have better cure prospects and longer, higher quality survival (Fei et al., 2015).In China, most breast cancer patients are middle-aged and young women, who are at an important stage of career development (Liu

When dealing with engineering projects, there are many kinds of planning schemes. There are many problems to be solved in the performance and economic conditions of these indicators and engineering contents we study. Recently, many researchers have made great achievements in optimizing various subject projects. One of its purposes is to optimize and improve intelligent multi-objectives to make it more effective. Therefore, it is of great significance to develop intelligent multi-objective projects in academia and more engineering fields. The purpose of this study is to make efforts to strengthen the learning and construction of rapidly developing multi-objective optimization programs, and closely link these programs with neural network, fuzzy technology, interactive technology, and give a lot of examples of multi-objective optimization improvement program methods, which can eliminate the uncertainty in the multi-objective project plan, The purpose is to solve some difficult problems of multi-objective optimization and give the best suggestions. In this study, the strengthening of learning construction is combined with the clinical experiment, and most of this teaching method is put in the clinical management experiment of medical teaching. At the end of this study, we compared the performance of deep reinforcement learning with its dual structure version and interleaved structure version in different medical teaching clinical management environments and make a detailed analysis. Deep reinforcement learning provides a new idea for the improvement of intelligent multi-objective optimization and clinical management of medical teaching.

IntroductionIt is necessary to investigate the effects of progressive resistance exercise (PRE) in patients with pituitary adenomas after surgery, to provide insights to the clinical management of pituitary adenomas.Material and methodsThis study is a pre- and post-control experimental study design with hypothesis that PRE can reduce the postoperative fatigue. Patients with pituitary adenoma were included. The control group received conventional postoperative rehabilitation guidance, and the PRE group received the PRE on the basis of routine rehabilitation. We measured the patient's muscle mass, muscle strength, vital capacity and postoperative fatigue level 1 day before and 12 weeks after the operation. SPSS 22.0 was used for data analysis.ResultsA total of 89 patients were enrolled, including 44 in the control group and 45 in the PRE group. There was no significant difference in muscle mass between the two groups in the 12th week after surgery, but the muscle loss of the left upper limb, trunk, and lower limbs of the control group was significantly higher than that of the PRE group (all P<0.05). The muscle strength and vital capacity of the control group were significantly lower than that of the intervention group, and the fatigue level was significantly higher than that of the PRE group(all P<0.05).ConclusionsProgressive resistance exercise is helpful to combat muscle loss, muscle strength and lung function decline caused by long-term bed rest in patients with pituitary adenoma after operation, thereby improving the postoperative fatigue level of patients.