Abstract Adverse childhood experiences (ACEs) exposure is a pressing and severe global public health issue. Children and adolescents exposed to multiple ACEs are highly susceptible to toxic stress and impaired physiological functioning, which significantly jeopardize their physical and mental health. Effective prevention and intervention strategies can reduce the prevalence of ACEs and mitigate their severe impacts, thereby minimizing the long term detrimental consequences on future outcomes. The review provides a comprehensive review of intervention strategies across four dimensions: individual, family, school, and public services/policy, so as to establish a theoretical foundation for implementing effective interventions for children and adolescents exposed to adverse childhood experiences.

Objective To investigate the species of sandflies and the prevalence of Leishmania infections in sandflies from selected areas of northern and northwestern China, so as to provide insights into identification of leishmaniasis vectors and assessment of epidemiological trends of leishmaniasis in China. Methods Sandfly samples were collected from Mentougou District of Beijing Municipality, Xiangning County in Linfen City of Shanxi Province, Ejin Banner in Alxa League of Inner Mongolia Autonomous Region, and Payzawat County of Karamay District of Karamay City, Gaochang District of Turpan City in Xinjiang Uygur Autonomous Region from July 2023 to July 2024. Approximately 100 intact female sandfly samples were randomly selected from each site and the species of sandflies was identified according to morphological characteristics and molecular assays. Female sandflies originating from the same habitat were grouped into pools of 10 individuals. Leishmania infection was detected using polymerase chain reaction (PCR) assay targeting the internal transcribed spacer 1 (ITS-1) gene, and the prevalence of Leishmania infection was calculated in sandflies from different sampling sites using the minimum infection rate (MIR) method. In addition, positive amplicons were sequenced and subjected to phylogenetic analysis. Results A total of 6 155 sandflies were collected from different environments at sampling sites across the six aforementioned regions from July 2023 to July 2024. Phlebotomus chinensis (96.00%) was the dominant sandfly species in Mentougou District, Beijing Municipality, with a small proportion of Ph. sergenti (4.00%), and only Ph. chinensis was found in Xiangning County, Linfen City, Shanxi Province. Ph. wui was the only sandfly species detected in Ejin Banner, Alxa League, Inner Mongolia Autonomous Region, and Payzawat County, Kashgar City, Xinjiang Uygur Autonomous Region, and Ph. caucasicus (97.70%) was the dominant sandfly species in Karamay District, Karamay City, Xinjiang Uygur Autonomous Region, with a small proportion of Ph. wui (2.30%), while Ph. alexandri was the only species in Gaochang District, Turpan City, Xinjiang Uygur Autonomous Region. A total of 40, 60, 34, 18, 18, and 22 pools of sandfly samples were tested from Mentougou District in Beijing Municipality, Xiangning County in Linfen City of Shanxi Province, Ejin Banner in Alxa League of Inner Mongolia Autonomous Region, Payzawat County in Kashgar City, Karamay District in Karamay City, and Gaochang District in Turpan City of Xinjiang Uygur Autonomous Region, respectively. L. infantum was detected in Ph. chinensis samples from Mentougou District in Beijing Municipality, and Xiangning County of Linfen City in Shanxi Province, with MIR of 0.25% to 1.00%, and L. donovani was detected in Ph. wui from Ejin Banner in Alxa League of Inner Mongolia Autonomous Region, and Payzawat County in Kashgar City of Xinjiang Uygur Autonomous Region, with MIR of 0.56% to 0.88%; however, no Leishmania infection was detected in Ph. caucasicus from Karamay District in Karamay City or Ph. alexandri from Gaochang District in Turpan City of Xinjiang Uygur Autonomous Region. Phylogenetic analysis showed that the Leishmania ITS-1 gene sequences obtained from Mentougou District in Beijing Municipality and Xiangning County in Linfen City of Shanxi Province were clustered into the same clade with the reference sequences of L. infantum ITS-1 gene, while the Leishmania ITS-1 gene sequences obtained from Ejin Banner in Alxa League of Inner Mongolia Autonomous Region and Payzawat County in Kashgar City of Xinjiang Uygur Autonomous Region were clustered into the same clade with the reference sequences of L. donovani ITS-1 gene. Conclusions There are variations in sandfly species in selected areas of northern and northwestern China, and variations in the species of Leishmania infecting sandflies. Improved surveillance of sandfly vectors and targeted control strategies with adaptations to geographical features and leishmaniasis vectors are recommended.

In-depth study of the components of polymyxins is the key to controlling the quality of this class of antibiotics.Similarities and variations of components present significant analytical challenges.A two-dimensional(2D)liquid chromatography-mass spectrometry(LC-MS)method was established for screening and comprehensive profiling of compositions of the antibiotic colistimethate sodium(CMS).A high concentration of phosphate buffer mobile phase was used in the first-dimensional LC system to get the components well separated.For efficient and high-accuracy screening of CMS,a targeted method based on a self-constructed high resolution(HR)mass spectrum database of CMS components was established.The database was built based on the commercial MassHunter Personal Compound Database and Library(PCDL)software and its accuracy of the compound matching result was verified with six known components before being applied to genuine sample screening.On this basis,the unknown peaks in the CMS chromatograms were deduced and assigned.The molecular formula,group composition,and origins of a total of 99 compounds,of which the combined area percentage accounted for more than 95％of CMS components,were deduced by this 2D-LC-MS method combined with the MassHunter PCDL.This profiling method was highly efficient and could distinguish hundreds of components within 3 h,providing reliable results for quality control of this kind of complex drugs.

Objective:To explore the efficacy and safety of intravascular lithotripsy (IVL) for the treatment of calcified lesions in lower limb peripheral artery disease (PAD).Methods:A literature search was conducted on PubMed, Web of Science, Cochrane Library, and Embase, including studies related to IVL for calcified lesions in PAD published from January 2016 to December 2024. Data on patient baseline characteristics, lesion information, IVL procedural parameters, changes in vascular stenosis, and complication occurrence were extracted and included. The Methodological Index for Non-Randomized Studies (MINORS) was used to assess the quality of the included studies. The meta-analysis was performed using STATA 15.1 software. The heterogeneity of different studies was evaluated using Cochran′s Q test. The publication bias was assessed through funnel plots and Egger test.Results:A total of nine studies were included (1 983 patients, 2 387 lesions). The meta-analysis demonstrated that regarding efficacy, after IVL treatment, the average reduction in vascular stenosis was 52.1% (95% CI 45.3%-58.9%). Regarding safety, the incidence of flow-limiting dissection was only 0.6% (95% CI 0.1%-1.4%), and the perforation rate was 0.4%-0.5%, with no events of severe amputation or death. In combined treatments, the usage rate of drug-coated balloons reached 51.2%, and the stent implantation rate was 20.4%. Conclusions:IVL can effectively reduce the degree of vascular stenosis in calcified lesions and has a high safety profile. Combined treatment with drug-coated balloons can reduce the dependence on stents.

Objective:To explore the diagnostic value of small field of view ZooMit diffusion weighted imaging(Z-DWI)sequence of magnetic resonance imaging(MRI)in assessing benign and malignant pulmonary nodules.Methods:A total of 60 patients with pulmonary nodules who underwent MR examination at the First Affiliated Hospital with Nanjing Medical University from January 2021 to December 2022 were prospectively collected.All patients underwent conventional DWI(C-DWI)and Z-DWI.The signal to noise ratio(SNR),contrast to noise ratio(CNR),and apparent diffusion coefficient(ADC)of them were measured and analyzed.Two physicians with more than 8 years of experience in diagnosing pulmonary nodules implemented subjective scores for the image quality.Then,the ADC values of benign and malignant nodules between two kinds of images were compared.Results:The scores of Z-DWI images quality in terms of artifact,display of anatomical detail,lesion clarity,and image distortion were respectively(3.53±0.52),(3.27±0.70),(2.87±0.64),and(2.93±0.71),which were all higher than those of C-DWI images,and the differences were statistically significant(t=-4.68,-3.56,-2.44,-2.87,P<0.05).The SNR and CNR values of Z-DWI sequence were respectively(123.4±39.9)and(124.9±24.7),all of which were higher than those of C-DWI sequence,and the differences were statistically significant(t=-8.63,-7.09,P<0.05).The ADC values of C-DWI images of benign and malignant nodules were respectively(1.53±0.27)and(1.09±0.22),and the difference of that between them were statistically significant(t=9.88,P<0.001).The ADC values of Z-DWI images of benign and malignant nodules were respectively(1.39±0.18)and(0.99±0.19),and the difference of that between them was statistically significant(t=7.30,P<0.001).The ADC values of benign and malignant nodules of C-DWI images were higher than those of Z-DWI images,and the differences were statistically significant(t=3.40,2.13,P<0.05).Conclusion:Z-DWI can improve the image quality of benign and malignant pulmonary nodules,which has important clinically diagnostic significance in assessing the benign and malignant natures of pulmonary nodules.

AIM To investigate the variations in mercury dissolution from HgS-containing traditional medicines in three kinds of simulated gastrointestinal dissolution media.METHODS 39 batches of 15 types of HgS-containing traditional medicines were collected,total mercury content and dissolved mercury concentrations in simulated gastric fluid,simulated intestinal fluid,and L-cysteine-containing simulated intestinal fluid were measured.The maximum daily intake of total mercury and soluble mercury was calculated based on the maximum daily clinical dosage.RESULTS Among the 15 types of medicines,the maximum daily intake of total mercury varied by 156 times,the daily intake of soluble mercury varied by 3 502 times in simulated gastric fluid,313 times in simulated intestinal fluid,and 10 663 times in L-cysteine-containing simulated intestinal fluid,approximately.CONCLUSION For the 15 types of HgS-containing traditional medicines,the daily maximum intake of soluble mercury showed greater variations than that of total mercury.Soluble mercury concentration is more closely correlated with intestinal absorption of mercury and thus represents a more rational quality control indicator for HgS-containing traditional medicines.

Objective:To evaluate the efficacy and safety of peri-diaphragmatic hydrodissection in assisting microwave ablation（MWA）of right subphrenic colorectal liver metastasis（CRLM）.Methods:A retrospective analysis was conducted on 101 patients with right subphrenic CRLMs（206 lesions）who underwent percutaneous ultrasound-guided MWA at the Sixth Affiliated Hospital，Sun Yat-sen University from June 2020 to June 2023. Patients were divided into contrast-enhanced ultrasound（CEUS）with hydrodissection group（ n=63）and artificial ascites/pleural effusion group（ n=38，there were 17 patients with artificial pleural effusion，21 patients with artificial ascites）. In the CEUS with hydrodissection group，the peri-diaphragmatic water dissection was established during the post-vascular phase of CEUS. Lesion detection rates，visualization scores，local tumor progression（LTP），and complications were compared between the two groups. Results:In both the CEUS with hydrodissection group and the artificial ascites/pleural effusion group，the lesion detection rates（96.9% and 98.7%）and visualization scores［（3.7 ± 1.3）points and（4.6 ± 0.7）points］improved with water dissection assistance compared to conventional ultrasound［detection rates of 57.5% and 55.7%，visualization scores of（1.9 ± 1.0）points and（2.6 ± 1.5）points］and CEUS alone［detection rates of 78.0% and 78.5%，visualization scores of（3.1 ± 1.5）points and（3.7 ± 1.6）points］（all P<0.001）. The CEUS with hydrodissection group achieved comparable success rates（96.8% vs. 97.4%， P>0.99）but required less saline［60（30，90）ml vs. 500（500，1 000）ml， P<0.001］than artificial ascites/pleural effusion group. No significant differences were observed in LTP rates，complications，or pain scores（all P>0.05）. Conclusions:CEUS combined with peri-diaphragmatic hydrodissection improves detection rates and visualization of right subphrenic CRLM while reducing fluid volume compared to artificial hydrothorax/ascites，serving as a safe and effective adjunct for percutaneous MWA.

AIM To analyze the dynamic change patterns of aflatoxin B1,aflatoxin B2,aflatoxin G1,aflatoxin G2,T-2 toxin and deoxynivalenol contents during the fermentation of Massa Medicata Fermentata.METHODS The analysis was performed on a 40 ℃ thermostatic Waters ACQUITY UPLC HSS T3 column(100 mm×2.1 mm,1.8 μm),with the mobile phase comprising of 0.01％formic acid-[acetonitrile-methanol(1∶1)]flowing at 0.3 mL/min,and electron spray ionization source was adopted in positive ion scanning with multiple reaction monitoring mode.RESULTS Six mycotoxins showed good linear relationships within their own ranges(R2＞0.998 0),whose average recoveries were 76.1％-119.3％with the RSDs of 0.49％-9.27％,and except for deoxynivalenol,their contents demonstrated the trends of growing out of nothing and gradually increasing.CONCLUSION The risk of mycotoxin infection exists in the fermentation of Massa Medicata Fermentata.This simple,efficient,rapid and sensitive method can provide a reference for whole-process monitoring the fermentation process for Massa Medicata Fermentata.