AIM:To analyze the effect of conbercept treatment on different types of macular edema secondary to retinal vein occlusion(RVO-ME)using optical coherence tomography(OCT)images.METHODS: This retrospective study included patients who first received conbercept injections for RVO-ME at Yijishan Hospital of Wannan Medical College from December 1, 2017, to March 31, 2022. Data on disease duration, age, hypertension, OCT images, central macular thickness(CMT), and best-corrected visual acuity(BCVA)were collected before and at 4-6 wk after treatment. Patients were divided into 4 groups according to different types of macular edema: cystoid macular edema(CME), sponge-like diffuse retinal thickening(SDRT), serous retinal detachment(SRD), and mixed type(FULL). Changes in CMT and visual acuity before and after treatment were compared among the groups to analyze differences in the effect of conbercept treatment on different ME types, and the effect of baseline CMT and visual acuity on post-treatment visual acuity.RESULTS: Totally 139 patients(139 eyes)were classified as having macular edema, including 62 males(44.6%)and 77 females(55.4%), with a mean age of 58.9±10.9 years, and they were divided into 4 groups based on different types of macular edema, including 54 cases(54 eyes)(mean age 59.6±11.1 years)in the CME group, 23 cases(23 eyes; mean age 56.6±10.2 years)in the SDRT group, 22 cases(22 eyes; mean age 57.8±12.0 years)in the SDR group, and 40 cases(40 eyes; mean age 60.0±10.7 years)in the FULL group. There were no significant differences in the duration of disease or age between groups(P>0.05). There was a significant difference in preoperative CMT between groups(P=0.01, one-way ANOVA), with the CMT in the FULL group being significantly greater than that in the SDRT group(P=0.03). There were no significant differences in pre-treatment visual acuity between the four groups(P=0.26). After conbercept treatment, the macular central recess thickness was reduced and visual acuity was improved in all four groups, among which the CMT in the CME and FULL groups was reduced significantly compared with the other two groups(P<0.05), and the visual acuity in the CME and SRD groups was improved significantly compared with the other two groups(P<0.05). Postoperative visual acuity was negatively correlated with preoperative CMT(P=0.044)and positively correlated with preoperative visual acuity(P<0.01).CONCLUSION:The efficacy of intravitreal conbercept in the treatment of RVO and macular edema may be related to the type of edema observed on OCT images, in which the efficacy is best in patients with CME but poor in patients with SDRT.

Objective: To explore the impact of adverse childhood experiences (ACEs) on health risk behaviors (HRBs) among college students and the mediating role of psychological symptoms, so as to provide a basis for developing intervention strategies. Methods: From March to April 2023, a convenience cluster sample of 1 801 students from 12 universities in Nanning, Liuzhou, Guilin, Wuzhou of Guangxi completed an online survey. A self designed questionnaire, Adverse Childhood Experiences-International Questionnaire (ACE-IQ) and Symptom Checklist-90 (SCL-90) were used for evaluation tools. Binary Logistic regression, structural equation modeling (SEM) and Bootstrap methods were used to analyze the associations and mediating effects. Results: Overall, 71.2% of college students experienced at least one type of ACE, with emotional neglect (40.3%) and emotional abuse ( 25.2 %) having the highest detection rates. The top three HRBs were unhealthy diet (77.8%), physical inactivity (54.1%), and smoking/alcohol use (18.5%). Logistic regression showed that poor family functioning, abuse, and extra familial violence were each associated with an increased risk of smoking/alcohol use ( OR =1.14, 1.11, 1.18) and deliberate self harm ( OR =1.26, 1.19,1.30) (all P <0.05). Experience of abuse increased the risk of high risk sexual behavior and family dysfunction increaded the risk of physical inactivity, respectively ( OR = 1.07 , 1.04, both P <0.05). Mediation analysis revealed that anxiety ( β =0.20) and depression ( β = 0.09 ) partially mediated the pathway from poor family functioning to deliberate self harm; paranoia ( β =0.02) partially mediated the pathway from abuse to high risk sexual behavior; and obsessive-compulsive symptoms ( β =0.26) and depression ( β =0.10) partially mediated the pathway from extra familial violence to deliberate self harm (all P <0.05). Conclusion Psychological symptoms play a mediating role in the association between ACEs and HRBs, and mental health interventions may reduce the risk of HRBs among college students.

Respiratory syncytial virus (RSV) is the most common respiratory pathogen in infants and young children, which can lead to severe pneumonia and even death. Early diagnosis and intervention are crucial for reducing complications and sequelae and improving prognosis. This study presents the complete diagonsis and treatment process of a typical severe RSV pneumonia patient. For high-risk children, the condition can progress rapidly after RSV infection, and may present with respiratory failure and multiple extrapulmonary complications, such as heart failure, liver and kidney function impairment, coagulation dysfunction. After active symptomatic and supportive treatment, the prognosis is generally good. RSV infection will not lead to long-lasting immunity, but as the child grows older and their immune function gradually improves, the condition of a secondary infection is generally relatively mild. Currently, there are no specific antiviral drugs or safe and effective vaccines for RSV. Long-acting monoclonal antibodies are one of the effective means to prevent RSV infection in infants and young children and have been approved for use in China.

Objective To explore the influence of general medicine combined with family motivation management on the prognosis of cardiovascular and cerebrovascular disease patients.Methods A total of 120 cardiovascular and cerebrovascular diseases patients who received medical care at the First People's Hospital ofFuyang District from October 2023 to October 2024 were selected as subjects.They were divided into control group(n=60)and study group(n=60)by using a random number table method.Control group received standard nursing interventions,while study group underwent combined general medicine and family motivation management.Psychological status was assessed using the self-rating anxiety scale(SAS)and self-rating depression scale(SDS),with quality of life and self-management ability evaluated using the World Health Organization quality of life brief scale(WHOQOL-BREF)and exercise of self-care agency scale(ESCA).The triglycerides(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C)and low density lipoprotein cholesterol(LDL-C),readmission rate and average length of stay before and after intervention were compared between two groups.Results After intervention,both groups showed decreased SAS and SDS scores,while WHOQOL-BREF scores and ESCA levels increased.Score of study group were statistically significant better than that of control group(P＜0.05).After intervention,HDL-C levels rose in both groups,whereas LDL-C,TG,and TC levels decreased.The improvement of each index in study group was better than that in control group(P＜0.05).The rehospitalization rate and average length of stay in study group were significantly lower than those in control group(P＜0.05).Conclusion The combination of general medicine and family motivation management can effectively optimize the prognosis of cardiovascular and cerebrovascular disease patients.

Objective:To evaluate the clinical efficacy of methylation sensitive-high resolution melting curve (MS-HRM) detection of IFN-induced protein 44-like (IFI44L) gene methylation in the diagnosis of systemic lupus erythematosus (SLE), as well as the relationship between IFI44L gene markers and the early onset of SLE.Methods:From February 2020 to September 2022, the MS-HRM was used to detect the methylation level of the IFI44L gene in peripheral blood mononuclear cells of 602 SLE patients and 524 other autoimmune disease patients (excluding SLE) from Beijing Peking Union Medical College Hospital, Guangdong Provincial People′s Hospital, and Shenzhen People′s Hospital, totaling 1 126 patients. Compared with the 2012 SLICC criteria, the suspected cases were followed up for 6 months until the onset and clinical diagnosis of SLE were confirmed. The measurement data of normal distribution were expressed as mean±SD, and the consistency analysis was performed using the Kappa consistency test. The clinical diagnostic efficacy indicators were calculated using the receiver operating characteristic (ROC) curve. Results:RR (95% CI) of early suspected cases was 17.06 (9.43, 30.82). The results of IFI44L gene methylation level were in good agreement with the 2012 SLICC criteria, and the sensitivity, specificity and total coincidence rate were 90.53%, 92.56% and 91.47%, respectively. The Kappa value (95% CI) was 0.829(0.796, 0.862) ( P<0.001). The diagnostic efficiency of IFI44L gene methylation level ( Kappa value 0.817) was superior to anti-nuclear antibody, anti-SM antibody and anti-dsDNA antibody ( Kappa value 0.418, 0.216 and 0.440, respectively). The Kappa values (95% CI) of methylation between MS-HRM and pyrosequencing was 0.861(0.806, 0.916), P<0.001. Conclusion:The hypomethylation of IFI44L gene methylation level detected by MS-HRM is closely related to the occurrence and development of SLE, and its diagnostic performance is better than that of three autoantibodies in SLE diagnosis, which can be used for the early diagnosis of SLE.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

With the acceleration of aging society in China, acute obstructive suppurative cholangitis (AOSC) in the extremely elderly (≥80 years) patients has become a common and frequent acute abdominal disease, which seriously threatens national strategy of "healthy aging" in China. Endoscopic retrograde cholangiopancreatography (ERCP) is currently the mainstream treatment for AOSC, but emergency ERCP treatment for elderly patients with AOSC is limited. In recent years, laparoscopic surgery targeting laparoscopic transcystic common bile duct exploration (LTCBDE) has been an ideal treatment method, but it has a high surgical risk. The authors′ team has conducted in-depth exploration into the advantages and disadvantages of ERCP treatment, strategies for repairing Oddi sphincter function, selection of laparoscopic surgical methods, and formulation of safety guarantee measures, and has carried out the technical improvements on LTCBDE, aiming to enhance the feasibility and safety of this surgical method in the treatment of AOSC in extremely elderly patients.

Enteric human adenovirus(HAdV),a common cause of acute viral gastroenteritis in children,frequently triggers spo-radic infections,nosocomial transmissions,and outbreaks in kindergarten settings.This study was aimed at investigating the molecular characteristics and genetic evolution of enteric HAdV among patients with acute gastroenteritis younger than 5 years in China,to pro-vide foundational data for disease prevention and control.A total of 8 074 stool samples were collected from hospitalized or outpatient children younger than 5 years with acute gastroenteritis in China during 2023.HAdV screening was conducted with real-time fluores-cence PCR.Positive samples were sequenced,then subjected to bioinformatics analysis including genotyping,homology assessment,and phylogenetic analysis with GenBank,BioAider,and MEGA11.0.A total of 370 samples(4.58%)tested positive for HAdV.Two enteric HAdV genotypes were identified:HAdV-F41(which predominated,at 98.09%)and HAdV-F40(1.90%).HAdV-F41 was the dominant genotype among patients with acute gastroenteritis younger than 5 years in China.Bioinformatics analysis indicated that the predominant HAdV lineages in China were lineage 1 and 2,whereas European lineage 3 showed no influence.Systematic and long-term surveillance of HAdV should help elucidate its diversity and evolutionary patterns in China,thereby providing scientific evi-dence for developing more effective prevention strategies.

This study investigated the full-genome molecular characteristics of a rotavirus vaccine-derived strain,G1P[8]geno-type A group rotavirus RVA/Human-wt/CHN/HN1140/2021/G1P[8](referred to as HN1140).The gene fragments of the HN1140 strain were amplified with reverse transcription-polymerase chain reaction(RT-PCR)combined with whole-genome primers to obtain the full genome sequence.Genotyping was performed with the online genotyping tool RotaC 2.0,and similarity and genetic evolution analyses for each gene segment were conducted in DNAstar5.1 and MEGA11.0 software.The genotype of the HN1140 strain was deter-mined to be G1-P[8]-I2-R2-C2-M2-A3-N2-T6-E2-H3.Phylogenetic analysis demonstrated that all 11 genomic segments clus-tered closely with the RotaTeq vaccine strains,sharing 99.7%-100%nucleotide sequence similarity.Notably,VP1,VP2,VP6,and NSP2-NSP5 segments showed 100%nucleotide identity with RotaTeq strains.Comparative genomic analysis identified 13 nucleotide and 8 amino acid substitutions between HN1140 and RotaTeq strains,localized within the VP7,VP4,VP1,VP2,VP3,and NSP1 segments.The HN1140 strain exhibited the genotype G1-P[8]-A3-T6-H3,which was consistent with the typical profile of a vaccine-derived reassortant.This strain demonstrated high genetic similarity to RotaTeq vaccine strains,with nucleotide sequence identity ranging from 99.7%to 100%.These findings suggested that HN1140 evolved from RotaTeq vaccine strains through genetic reassortment.

Objective:To analyze the factors affecting quality of life in patients with early esophageal cancer after endoscopic submucosal dissection (ESD) .Methods:Convenience sampling was used to select 162 early esophageal cancer patients with ESD in Cangzhou Central Hospital from August 2021 to July 2023 who had an on-time follow-up six months as study subjects. General Information Questionnaire and Quality of Life Instruments for Cancer Patients-Esophageal Cancer (QLICP-ES) were used to investigate the patients. Factors affecting the quality of life of patients after ESD for early esophageal cancer were analyzed using univariate analysis and multiple linear regression analysis.Results:Univariate analysis showed statistically significant differences in QLICP-ES scores among patients with different gender, age, marital status, annual income, medical payment method, concomitant diseases, degree of infiltration, vascular invasion, surgical complications, and positive margins ( P<0.05). Multiple linear regression analysis showed that age, marital status, concomitant diseases, vascular invasion, surgical complications, and positive margins were the factors influencing the QLICP-ES scores of patients with ESD for early esophageal cancer, and the differences were statistically significant ( P<0.05) . Conclusions:Quality of life at six months after ESD in patients with early esophageal cancer is at an intermediate to high level. Patients of advanced age, unmarried/divorced/widowed, concomitant diseases, vascular invasion, surgical complications and positive margins have low QLICP-ES scores after ESD for early esophageal cancer. It is recommended that clinical attention be focused on these factors and that targeted nursing measures be taken when necessary.