Objective: To investigate the status of comorbidity of six common diseases among primary and middle school students in Shaoxing City, Zhejiang Province, so as to provide evidence for formulating strategies for comorbidity management, prevention, and control among primary and middle school students. Methods: From September to November 2023, students from 12 primary schools, 12 junior high schools, and 12 senior high schools in Shaoxing City were selected as study participants using stratified cluster random sampling method. Six common diseases, including myopia, malnutrition, overweight and obesity, dental caries, abnormal blood pressure, and abnormal spinal curvature, were assessed by vision measurement, physical examination, dental examination, blood pressure measurement, and spinal examination, respectively. Comorbidity was defined as the coexistence of ≥2 diseases. The detection rate and distribution of comorbidity patterns among the six common diseases were analyzed. Results: A total of 11 887 students were surveyed, including 6 187 boys (52.05%) and 5 700 girls (47.95%). The mean age of the participants was (12.37±3.20) years. Myopia, dental caries, overweight and obesity, abnormal blood pressure, malnutrition, and abnormal spinal curvature were detected in 7 224, 3 721, 3 199, 1 880, 952, and 272 students, with detection rates of 60.77%, 31.30%, 26.91%, 15.82%, 8.01%, and 2.29%, respectively. Comorbidity was detected in 5 340 students, with a detection rate of 44.92%. Comorbidity involving two diseases was detected in 3 853 students, with a detection rate of 32.41%; comorbidity involving three diseases was detected in 1 335 students, with a detection rate of 11.23%; and comorbidity involving ≥4 diseases was detected in 152 students, with a detection rate of 1.28%. The comorbidity patterns with relatively high detection rates were myopia combined with dental caries, myopia combined with overweight and obesity, and myopia combined with abnormal blood pressure, involving 1 111, 1 008, and 495 students, with detection rates of 9.35%, 8.48%, and 4.16%, respectively. The detection rates of comorbidity involving myopia and dental caries were relatively high among primary school students and junior high school students, at 7.31% and 12.05%, respectively. Among senior high school students, comorbidity involving myopia and overweight and obesity had a relatively high detection rate of 11.16%. Conclusions The detection rate of comorbidity of six common diseases among primary and middle school students in Shaoxing City was 44.92%, mainly involving myopia combined with dental caries, overweight and obesity, or abnormal blood pressure. The distribution of comorbidity patterns differed across school stages, with myopia combined with dental caries being more common among primary school students and junior high school students, and myopia combined with overweight and obesity being more common among senior high school students.

OBJECTIVE To understand the drug resistance among the acquired immune deficiency syndrome(AIDS)population who failed in the antiviral therapy from 2022 to 2023 and analyze the molecular network.METHODS The plasma specimens were collected from the population with viral load no less than 1000 cps/ml who received antiviral therapy for more than 6 months in Aksu area from 2022 to 2023,which were delivered to Aksu Regional Center for Disease Control and Prevention for test.MEGA5 and the Stanford University drug resistance database were employed to determine the subtypes and drug resistance after the sequences of human immunodefi-ciency virus type Ⅰ polymerase gene region(HIV-1pol)were obtained,and the molecular network was established by HIV-trace.RESULTS Totally 648 sequences of HIV-1pol region were obtained,CRF07_BC(97.69％)was the major subtype,and the drug resistance rate was 58.33％;the drug resistance rates to non-nucleoside reverse transcriptase inhibitor(NNRTI),nucleoside reverse transcriptase inhibitor(NRTI)and protease inhibitor(PI)were 51.70％,19.75％and8.64％,respectively.The univariate analysis showed that year(x2=6.341),age(x2=18.455)and route of infection(x2=14.061)had remarkable effects on the drug resistance among the population with failed ART(P＜0.05).Multivariate regression analysis indicated that the drug resistance rate was higher in 2022 than in 2023(95％CI:1.132 to 2.191),and the drug resistance rate was higher among the population aged less than 60 years old than among the population more than 6 years old(95％CI:3.647 to 70.268,95％CI:1.435 to 8.235,95％CI:1.061 to 6.164,re-spectively).With 1.5％of the genetic distance set as the threshold,the molecular network was established,the network access rate was 49.07％,77.14％of the clusters had drug-resistant mutation sites,and the male population was at higher risk of network access than the female population.CONCLUSIONS The drug resistance rate is relatively high among the AIDS population with failed ART,and the drug-resistant strains appear in clusters in the molecular network.It is neces-sary to further strengthen the monitoring of drug resistance and improve the quality of the follow-up so as to reduce the occurrence of drug resistance and transmission of virulent strains.

Objective:To investigate the dose characteristics of the Zeiss INTRABEAM system in air and water, providing dose reference for electronic brachytherapy.Methods:A Monte Carlo program was used to establish a three-dimensional model of a miniature X-ray source vacuum drift tube and a 4 cm spherical applicator. The process of electron beam bombardment on a gold target to generate X-rays was simulated, and parameters such as photon fluence spectrum, percentage depth dose, and half-value layer were calculated. Additionally, the radial dose uniformity in water was measured.Results:The average energy of X-rays at 3 cm in air was 20.8 keV, with a half-value layer of 0.08 mm Al. Under the influence of the applicator, the spectrum becomes hardened, with axial and radial average energies of 28.7 and 29.0 keV, respectively. In water, the percentage depth dose (PDD) curve follows an inverse cubic decay with depth, indicating strong dose concentration and rapid fall-off in near-field irradiation. The radial dose uniformity in water exceeded 99.5%.Conclusions:The INTRABEAM device emits low-energy X-rays characterized by shallow penetration depth, and concentrated dose delivery. Its highly uniform dose distribution ensures comprehensive coverage of the target area, making it particularly suitable for treating superficial tumors and for intraoperative radiotherapy at close range.

Objective: To investigate the clinical efficacy and safety of pudendal nerve modulation (PNM) in the treatment of female pudendal neuralgia (PN)，so as to promote the clinical application of this technique. Methods: A retrospective analysis was conducted on 20 female PN patients who failed conservative treatment at Gongli Hospital during Nov.2020 and Oct.2023.All patients underwent simultaneous PNM and sacral nerve modulation (SNM) with the assistance of 3D printing navigation.Dual-stage test electrodes for PNM and SNM were implanted，followed by alternate therapeutic trial for each modality.Secondary conversion rates and longitudinal outcomes，including visual analogue score (VAS)，patient health questionnaire-9 (PHQ-9)，and quality of life (QoL) scores were compared preoperatively，post-stage Ⅰ，and at 3，6，and 12 months post-stage Ⅱ. Results: All operations were successful.After the trial phase，the secondary conversion rate for PNM was significantly higher than that for SNM; 16 patients (16/20，80%) chose the second-phase PNM implantation surgery，3 (3/20，15%) chose second-phase SNM implantation，and 1 (1/20，5%) had electrodes removed due to ineffective results from both trials.Further assessment revealed that the improvements in VAS，PHQ-9，and QoL scores for PNM patients were significantly better than those for SNM patients after the first phase of surgery and at 3，6 and 12 months after the second-phase conversion (P<0.05).No complications such as electrode migration or infection were observed during the follow-up of 12-15 months. Conclusion: PNM provides more effective relief of pain symptoms and improvements in depressive states for female PN patients compared to SNM.With the assistance of 3D printing navigation，the operation is simple and safe，and offers stable therapeutic effects.It is worthy of clinical promotion and application.

Objective To investigatethe relationship between gastroesophageal reflux disease (GERD) symptoms and clinicopathological characteristics, p53 expression, and survival of Chinese patients with esophageal adenocarcinoma. Methods A total of 3882 patients with esophageal adenocarcinoma, 970 matched patients with esophageal squamous cell carcinoma, and 970 matched patients with gastric cardia adenocarcinoma were included to compare the incidence of GERD symptoms. Patients with esophageal adenocarcinoma were divided into two groups according to the presence and absence of GERD symptoms. The differences in clinicopathological characteristics and p53 expression between the two groups were compared by chi-square test, and the differences in survival between the two groups were compared by landmark analysis. Results The incidence of GERD symptoms increased successively in esophageal squamous cell carcinoma, esophageal adenocarcinoma, and gastric cardia adenocarcinoma. In patients with esophageal adenocarcinoma, the proportions of male, less than 65 years old, lower thoracic tumors, tumors without squamous cell carcinoma, poorly differentiation, early tumors (stage 0-I), and p53-positive tumors in the group with GERD symptoms were higher than those in the group without GERD symptoms; moreover, the long-term survival (≥15 years) was better. Conclusion GERD symptom is an important clinical sign of esophageal adenocarcinoma. It is closely related to specific clinicopathological characteristics, p53 overexpression, and good long-term prognosis.

Objective To investigate the clinical efficacy of platelet-rich plasma (PRP) therapy for interstitial cystitis/bladder pain syndrome (IC/BPS). Methods This single-center prospective study involved 97 IC/BPS patients treated in our hospital during Sep.2023 and Apr.2025, who underwent transurethral bladder injection of PRP. The injections were administered once a month for four sessions. The global response assessment (GRA) score,24-hour urinary frequency, maximum single voiding volume, visual analogue scale (VAS) score, O'Leary score, pelvic pain, urgency and frequency (PUF) score, and Zung self-rating anxiety scale (SAS) score were analyzed. Results All 97 patients completed four injections. The GRA score,24-hour urinary frequency, VAS score, O'Leary score and PUF score were improved significantly after treatment (P<0.007). Intraoperative bladder capacity with significant improvement were observed after the first injection (P<0.01), and the maximum urine output were observed after the fourth injection (P<0.007). The SAS score was not significantly improved. Conclusion Repeated PRP injections can effectively alleviate bladder pain, improve frequent and urgent urination symptoms, and increase the bladder capacity.

Objective To analyze the efficacy of self-formulated Bushen Qianyang Decoction combined with alendronate sodium and vitamin D3 in treating osteoporosis(OP)and to observe its effect on bone metabolism and trimethylamine oxide(TMAO)-nuclear factor κB(NF-κB)/activated T nuclear factor c1(NFATc1)pathway.Methods A total of 102 cases of patients with OP of spleen and kidney yang deficiency type who admitted to Taizhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2021 to January 2023 were randomly divided into an observation group and a western medicine group according to the random number table method,51 cases in each group.The western medicine group was treated with alendronate sodium and vitamin D,and the observation group was treated with self-formulated Bushen Qianyang Decoction on the basis of treatment for the western medicine group,and the course of treatment covered for 12 weeks.The changes of traditional Chinese medicine(TCM)syndrome score,Oswestry Disability Index(ODI)score,pain visual analogue scale(VAS)score,bone metabolism indicators,and levels of TMAO-NF-κB/NFATc1 pathway related factors before and after treatment in the two groups were observed.Moreover,the clinical efficacy and medication safety of the two groups were evaluated.Results(1)After 12 weeks of treatment,the total effective rate of the observation group was 96.08%(49/51),and that of the western medicine group was 78.43%(40/51).The intergroup comparison(tested by chi-square test)showed that the efficacy of the observation group was significantly superior to that of the western medicine group(P<0.01).(2)After treatment,the two groups presented the decreased scores of TCM symptoms such as cold pain in the lower back,soreness and fatigue,shortness of breath and reluctance to talk,vertigo and dizziness when compared with those before treatment(P<0.05),and the decrease of TCM syndrome scores in the observation group was significantly superior to that in the western medicine group(P<0.01).(3)After treatment,the ODI scores and pain VAS scores of patients in the two groups were decreased when compared with those before treatment(P<0.05),and the decrease in the observation group was significantly superior to that in the western medicine group(P<0.01).(4)After treatment,the serum osteocalcium(BGP)level in the two groups of patients was increased when compared with that before treatment(P<0.05),and the serum total procollagen type 1 intact N(amino)-terminal propeptide(PINP)and β-collagen degradation product(β-CTX)levels were decreased when compared with those before treatment(P<0.05),and the increase of the serum BGP level and the decrease of the serum PINP and β-CTX levels in the observation group were significantly superior to those in the western medicine group(P<0.01).(5)After treatment,the levels of serum TMAO,NF-κB,and NFATc1 in the two groups of patients were all decreased when compared with those before treatment(P<0.05),and the decrease of the above indicators in the observation group was significantly superior to that in the western medicine group(P<0.01).(6)The total incidence of adverse reactions in the observation group was 5.88%(3/51)and that in the western medicine group was 9.80%(5/51),and the intergroup comparison showed that the difference was not statistically significant between the two groups(P>0.05).Conclusion Self-formulated Bushen Qianyang Decoction combined with alendronate sodium and vitamin D3 exerts certain efficacy in treating OP patients with spleen and kidney yang deficiency type,which can effectively alleviate the symptoms such as cold pain in the lower back,alleviate the degree of dysfunction,improve bone metabolism,and inhibit the high-expressed TMAO,NF-κB,and NFATc1 in the serum.Moreover,the combined therapy does not cause serious adverse reactions,with high safety.

Objective To discuss the risk of complications occurring after CT-guided percutaneous puncture pulmonary nodule biopsy and to establish its prediction model.Methods The clinical data and imaging materials of 180 patients with small pulmonary nodules,who received CT-guided percutaneous puncture pulmonary nodule biopsy at the Affiliated Hongqi Hospital of Mudanjiang Medical University of China from September 2018 to September 2023,were collected.Logistic regression analysis was used to screen out the independent risk factors for the occurrence of complications after CT-guided percutaneous puncture pulmonary nodule biopsy.Based on the results of logistic regression analysis,a risk prediction model was constructed.Results Of the 180 patients with small pulmonary nodules,42(23.33％)developed postoperative complications(complication group),including pneumothorax(n=18,10.00％),hemorrhage(n=20,11.11％),pleural reaction(n=2,1.11％),and fever(n=2,1.11％).No complication occurred in the remaining 138 patients(76.67％,non-complication group).The differences in the coexisting chronic obstructive pulmonary disease(COPD),nodule diameter,number of needle-passing across the pleura,residence time of puncture needle,and distance between lesion and chest wall between the two groups were statistically significant(all P＜0.05).Multivariate logistic regression analysis showed that coexisting COPD(OR=6.558,95％CI:1.225-9.228,P=0.028),nodule diameter＜8 mm(OR=5.387,95％CI:1.773-16.367,P=0.003),number of puncture needle-passing across the pleura ≥3(OR=2.044,95％CI:1.275-3.278,P=0.003),residence time of puncture needle＞10 min(OR=12.620,95％CI:2.687-18.557,P=0.001)and distance between lesion and chest wall ≥30 mm(OR=1.992,95％CI:1.049-2.217,P=0.035)were the independent risk factors for the occurrence of complications after CT-guided percutaneous puncture pulmonary nodule biopsy.The above determined risk factors were used as the predictors to construct a prediction model.Receiver operating characteristic(ROC)curve analysis indicated that the critical value of this model to predict the occurrence of complications after CT-guided percutaneous puncture pulmonary nodule biopsy was 35.736,the area under ROC curve(AUC)was 0.831(95％CI:0.788-0.913),the sensitivity was 73.7％(95％CI:0.705-0.882),and the specificity was 90.6％(95％CI:0.811-0.985).Conclusion The predictive risk model,which is established based on the indicators of coexisting COPD,nodule diameter＜8 mm,number of puncture needle-passing across the pleura ≥3,residence time of puncture needle＞10 min and distance between lesion and chest wall ≥30 mm,can well predict the occurrence of complications after CT-guided percutaneous puncture pulmonary nodule biopsy,and this model carries high clinical application value.

Objective:To investigate influence of different phantoms on the results of quality control for the images of cone beam computed tomography(CBCT)for breast on the basis of quality control for breast CBCT.Methods:Five different manufacturers'phantoms were selected,and they were placed at the position of testing breast in clinical examination to conduct position for phantom according to the method of the national health industry standard WS 818-2023.The analysis focused on the differences of evaluation results of using different phantoms for image quality on the basis of a series of parameters included uniformity,resolution of high contrast,resolution of low contrast,and CT value of water in scanning images of different phantoms.Data collection and image reconstruction were performed respectively by using commonly clinical procedures.Corresponding module images were selected from the reconstructed images of standard breast phantom.The common layer thickness and projection method of the system were set to record and analyze data.Results:The image uniformity of measured results of the five phantoms were respectively 42.37±2.01,-5.83±0.15,3.76±0.15,2.16±0.06,3.60±0.10.The differences of the image uniformities among the five phantoms were statistically significant(F=1310.02,P<0.001),and the differences of the CT values of the measured water among the five phantoms were statistically significant(F=9 846.46,P<0.001).The differences in the resolution of low contrast among them were also statistically significant(F=27.50,P<0.001).However,the results of the resolution of high contrast were stability,and there was no significant difference in that among the five phantoms.Conclusion:The measured results of quality control of different phantoms are different.

Objective:To investigate the dose characteristics of the Zeiss INTRABEAM system in air and water, providing dose reference for electronic brachytherapy.Methods:A Monte Carlo program was used to establish a three-dimensional model of a miniature X-ray source vacuum drift tube and a 4 cm spherical applicator. The process of electron beam bombardment on a gold target to generate X-rays was simulated, and parameters such as photon fluence spectrum, percentage depth dose, and half-value layer were calculated. Additionally, the radial dose uniformity in water was measured.Results:The average energy of X-rays at 3 cm in air was 20.8 keV, with a half-value layer of 0.08 mm Al. Under the influence of the applicator, the spectrum becomes hardened, with axial and radial average energies of 28.7 and 29.0 keV, respectively. In water, the percentage depth dose (PDD) curve follows an inverse cubic decay with depth, indicating strong dose concentration and rapid fall-off in near-field irradiation. The radial dose uniformity in water exceeded 99.5%.Conclusions:The INTRABEAM device emits low-energy X-rays characterized by shallow penetration depth, and concentrated dose delivery. Its highly uniform dose distribution ensures comprehensive coverage of the target area, making it particularly suitable for treating superficial tumors and for intraoperative radiotherapy at close range.