Objective:To construct life context by modifying instructional settings and explore its application effectiveness in teaching the "dietary survey" practice course.Methods:The investigation was carried out on the senior students majoring in preventive medicine at medical colleges. The study was conducted using a pilot-control methodology. The experimental group ( n=76) engaged in a hands-on activity where students independently selected and weighed food in the campus cafeteria, followed by a paired 24-hour dietary recall survey conducted in class. The control group ( n=84) received traditional teaching method involving the 24-hour dietary recall survey only within the classroom setting. The scores, questionnaires, and qualitative interviews were used to compare the learning outcomes and professional competence of the two groups. SPSS 22.0 was used for chi-square test and t test. Results:Compared with the median scores of the experimental reports and thinking questions of the students in the control group (90 and 70), that median scores of the students in the experimental group were significantly improved (95 and 80) ( P<0.001). The score ratios of the dietary survey in the test paper in the two groups were 85.53% (65/76) (experimental group) and 65.48% (55/84) (control group), showing a statistically significant difference ( P=0.003). Moreover, the results showed that the scores of knowledge, experimental skills, and professional competence in the experimental group were significantly higher than those in the control group ( P<0.01). Over 90% of the students expressed satisfaction with the teaching. Conclusions:The life context-based teaching method applied in dietary survey practice course can improve the teaching effectiveness and professional competence.

Objective To identify risk factors associated with lymphatic leakage after laparoscopic radical prostatectomy(LRP)and to develop a machine learning-based nomogram for predicting such outcomes to support clinical prevention strategies.Methods We retrospectively analyzed perioperative data from 248 patients who underwent radical prostatectomy for prostate cancer between January 2020 and January 2024.Independent risk factors were identified through univariate and multivariate logistic regression analyses.A predictive model was developed,and its diagnostic performance was assessed by the area under the receiver operating characteristic curve(AUC).Five-fold cross-validation was performed to evaluate the model's generalizability.A nomogram was subsequently constructed to facilitate individualized risk quantification.Results Among the 248 patients,89(35.9%)developed lymphatic leakage,while 159(64.1%)did not.Independent risk factors for lymphatic leakage included intraopera-tive lymph node dissection(OR=5.415,95%CI:2.167～13.532,P<0.001),intraoperative plasma transfusion(OR=2.952,95%CI:1.524～5.718,P=0.001),and postoperative fasting duration of≥2 days(OR=1.412,95%CI:1.089～1.829,P=0.009).The predictive model showed good discrimination and calibration(AUC=0.711,95%CI:0.647～0.776,P<0.001;sensitivity:0.764;specificity:0.597).Model robustness was confirmed through five-fold cross-validation(training set AUC=0.822;test set AUC=0.829).The nomogram provided a clinically useful tool for quantifying individual risk of lymphatic leakage.Conclusions Intraoperative lymph node dissection,plasma transfusion,and postoperative fasting lasting≥2 days are independent risk factors for lymphatic leakage following radical prostatectomy.The validated predictive model demonstrates favorable clinical utility.

Objective:To investigate the clinical characteristics,pathological features,treatment,and prognosis of clear cell adenocarcinoma of cervix(CCAC).Methods:Clinical data of 72 CCAC patients treated at Jiangxi Maternal and Child Health Hospital from January 1,1999,to June 20,2024,were retrospectively analyzed.Results:The median age at diagnosis was 50 years.Of the patients,19 were classified as early-stage(IB1,IB2,IIA1),51 as mid-advanced stage(IB3,IIA2-IVB),and 2 were unstaged.Among 38 patients,elevated cancer Antigen 125(CA125)levels were observed in19(50.0%).Abnormal thin-layer liquid-based cytology(TCT)results were de-tected in 14 of 20 patients(70.0%),and human papillomavirus(HPV)positivity was identified in 20 of 45 patients(44.5%).Immunohistochemical analysis revealed hepatocyte nuclear factor-1β(HNF-1β)positivity in 95.2%and paired box gene 8(PAX-8)positivity in 91.3%.Among 32 patients undergoing primary surgery,postoperative pa-thology confirmed pelvic lymph node metastasis in 5(15.6%),lymphovascular and stromal invasion in 9(28.1%),with no ovarian metastasis observed.With a median follow-up of 45 months,the5-year overall survival(OS)rate was 51.4%,with early-stage and mid-advanced stage OS rates of 57.9%and 47.1%,respectively.The 5-year OS rate for surgically managed patients was 52.8%,while preoperative neoadjuvant chemotherapy(9 cases)yielded a 5-year OS of 33.3%.Among38 patients treated primarily with radiotherapy and/or chemotherapy,the5-year OS was 47.1%,with 5 patients undergoing central lesion resection achieving an 80.0%5-year OS.Conclusions:CCAC predominantly affects middle-aged and elderly women,with advanced-stage presentations being common.HPV,TCT,and CA125 testing hold diagnostic value for CCAC.Patients with early-stage CCAC undergoing surgical treatment demonstrated a relatively favorable survival rate;however,individualized assessment remains essential.Neoadjuvant chemotherapy administered prior to surgery may have limited efficacy in improving patient prognosis.For selected patients completing radiotherapy and/or chemotherapy,central lesion resection may potentially im-prove prognosis,although further well-designed studies are required to validate this finding.

Objective To explore the expression and clinical significance of serum C1qA and C1qB in children with idiopathic short stature (ISS). Methods 108 children with ISS (ISS group) and 108 healthy children (control group) who were admitted to the pediatric department of the 910th Hospital of the Joint Logistics Support Force of the People's Liberation Army of China from May 2020 to May 2023 were selected. An enzyme-linked immunosorbent assay was used to detect serum levels of C1qA and C1qB. Pearson correlation analysis was used to investigate the correlation between serum C1qA and C1qB levels,growth and development indicators,and inflammatory markers in children with ISS. Multivariate logistic regression analysis was used to identify the risk factors for the onset of ISS and the value of C1qA and C1qB in diagnosing ISS was analyzed based on the working characteristics of the subjects. Results The levels of C1qA (1206.35±275.15 ng/ml) and C1qB (1084.65±220.48 ng/ml) in ISS group were higher than those in control group (612.35±135.06 ng/ml,501.32±108.77 ng/ml),the differences were statistically significant (t=20.140,24.658,all P<0.05).The height,weight,body mass index(BMI ) and bone age index of the ISS group were lower than those of the control group(t/x2=2.092～10.661),and the ISS family history,tumor necrosis factor-α(TNF-α) and interleukin-6(IL-6) levels were higher than those of the control group(t/x2=4.338,10.550,15.865),the differences were statistically significant (all P<0.05),respectively .The serum levels of C1qA and C1qB in children with ISS were negatively correlated with height,weight,BMI,and bone age index(r=-0.502～-0.352,all P<0.05),and positively correlated with TNF-α and IL-6 levels(r=0.326～0.411,all P<0.05).Low bone age index,high level of TNF-α,high level of IL-6,high level of C1qA and high level of C1qB were risk factors for ISS (waldx2=4.979～7.328,all P<0.05).ROC curve showed that the area under the curve of serum C1qA and C1qB in the diagnosis of ISS was 0.838 and 0.816,respectively. The area under the curve of combined detection of serum C1qA and C1qB in the diagnosis of ISS was 0.931,which was higher than that of two indicators alone (Z=3.812,3.896,all P<0.05).Conclusion The serum levels of C1qA and C1qB are increased in children with ISS,which is related to short stature. Combined detection of serum C1qA and C1qB is helpful to diagnose the risk of ISS.

Objective To identify risk factors associated with lymphatic leakage after laparoscopic radical prostatectomy(LRP)and to develop a machine learning-based nomogram for predicting such outcomes to support clinical prevention strategies.Methods We retrospectively analyzed perioperative data from 248 patients who underwent radical prostatectomy for prostate cancer between January 2020 and January 2024.Independent risk factors were identified through univariate and multivariate logistic regression analyses.A predictive model was developed,and its diagnostic performance was assessed by the area under the receiver operating characteristic curve(AUC).Five-fold cross-validation was performed to evaluate the model's generalizability.A nomogram was subsequently constructed to facilitate individualized risk quantification.Results Among the 248 patients,89(35.9%)developed lymphatic leakage,while 159(64.1%)did not.Independent risk factors for lymphatic leakage included intraopera-tive lymph node dissection(OR=5.415,95%CI:2.167～13.532,P<0.001),intraoperative plasma transfusion(OR=2.952,95%CI:1.524～5.718,P=0.001),and postoperative fasting duration of≥2 days(OR=1.412,95%CI:1.089～1.829,P=0.009).The predictive model showed good discrimination and calibration(AUC=0.711,95%CI:0.647～0.776,P<0.001;sensitivity:0.764;specificity:0.597).Model robustness was confirmed through five-fold cross-validation(training set AUC=0.822;test set AUC=0.829).The nomogram provided a clinically useful tool for quantifying individual risk of lymphatic leakage.Conclusions Intraoperative lymph node dissection,plasma transfusion,and postoperative fasting lasting≥2 days are independent risk factors for lymphatic leakage following radical prostatectomy.The validated predictive model demonstrates favorable clinical utility.

Objective:To investigate the clinical efficacy and safety of needle-free and needle-based injections of recombinant human interferon (IFN) -α2a in the treatment of palmoplantar warts.Methods:Patients aged 6 to 75 years with palmoplantar warts were prospectively enrolled from the Department of Dermatology, Zhongda Hospital, Southeast University between March and September 2023, and baseline data were collected. The patients were randomly and equally divided into a needle-free injection group and a needle-based injection group by using a random number table method, and received needle-free and needle-based injections of recombinant human IFN-α2a once every 2 to 3 weeks, respectively, with a maximum of 4 treatment sessions. Efficacy was assessed based on changes in wart size and skin lines under a dermoscope. Pain degrees and adverse reactions were recorded, and patients were followed up for 6 months after the end of treatment. Chi-square test was used to compare the cure rates, recurrence rates, and incidence rates of adverse reactions between the two groups. Logistic regression analysis was employed to identify factors related to the clearance of palmoplantar warts.Results:A total of 160 patients with palmoplantar warts were included, with 80 patients in each group. In the needle-free injection group, there were 45 females (56.2%) and 35 males (43.8%) ; their ages ( M[ Q1, Q3]) were 27 (23, 40) years, and the duration of disease ( M[ Q1, Q3]) was 12 (3, 24) months; warts were located on the hands in 12 cases (15.0%), on the feet in 60 cases (75.0%), and on both sites in 8 cases (10.0%) ; warts measuring ≤ 1 cm in diameter were observed in 71 cases (88.8%), and those measuring > 1 cm were observed in 9 cases (11.3%). In the needle-based injection group, there were 37 females (46.2%) and 43 males (53.8%) ; their ages were 28 (22, 39) years, and the duration of disease was 6 (2, 12) months; warts were located on the hands in 23 cases (28.7%), on the feet in 55 cases (68.8%), and on both sites in 2 cases (2.5%) ; warts measuring ≤ 1 cm in diameter were observed in 67 cases (83.8%), and those measuring > 1 cm in diameter were observed in 13 cases (16.3%). There were no significant differences in gender distribution, age, wart diameters, prior treatment status, or number of warts between the two groups (all P > 0.05). The duration of disease was longer in the needle-free injection group than in the needle-based injection group ( P = 0.041), and the dose of interferon was lower in the needle-free injection group than in the needle-based injection group ( P < 0.001). After treatment, 44 patients (55.0%) were cured in the needle-free injection group, and 39 (48.8%) in the needle-based injection group, with no significant difference in the cure rates between the two groups ( χ2 = 0.63, P = 0.429). Among patients with multiple warts, 54.8% (23/42) were cured in the needle-free injection group, and 47.4% (18/38) in the needle-based injection group, with no significant difference in cure rates between the two groups ( χ2 = 1.28, P = 0.509). The most common adverse reaction was fever or flu-like symptoms (186 instances), which resolved spontaneously in 141 instances and resolved after treatment with oral ibuprofen in 45 instances; the incidence rate of flu-like symptoms was significantly lower in the needle-free injection group (57 instances, 21.6%) than in the needle-based injection group (129 instances, 53.3%; χ2 = 54.63, P < 0.001). The pain score was significantly lower in the needle-free injection group (3.65 ± 1.25 points) than in the needle-based injection group (5.16 ± 1.17 points, t = -7.90, P < 0.001). The logistic regression analysis showed that the duration of disease, lesion sites, patient age, and previous treatment history had no impact on the efficacy in either the needle-free injection group or the needle-based injection group (all P > 0.05) . Conclusions:The efficacy of needle-free and needle-based injections of interferon was similar in the treatment of palmoplantar warts, whereas needle-free injections resulted in less pain and a lower incidence of interferon-related adverse reactions. None of the duration of disease, lesion sites, patient age, or prior treatment status showed significant impact on the efficacy in the two groups.

Objective:To investigate the clinical efficacy and safety of needle-free and needle-based injections of recombinant human interferon (IFN) -α2a in the treatment of palmoplantar warts.Methods:Patients aged 6 to 75 years with palmoplantar warts were prospectively enrolled from the Department of Dermatology, Zhongda Hospital, Southeast University between March and September 2023, and baseline data were collected. The patients were randomly and equally divided into a needle-free injection group and a needle-based injection group by using a random number table method, and received needle-free and needle-based injections of recombinant human IFN-α2a once every 2 to 3 weeks, respectively, with a maximum of 4 treatment sessions. Efficacy was assessed based on changes in wart size and skin lines under a dermoscope. Pain degrees and adverse reactions were recorded, and patients were followed up for 6 months after the end of treatment. Chi-square test was used to compare the cure rates, recurrence rates, and incidence rates of adverse reactions between the two groups. Logistic regression analysis was employed to identify factors related to the clearance of palmoplantar warts.Results:A total of 160 patients with palmoplantar warts were included, with 80 patients in each group. In the needle-free injection group, there were 45 females (56.2%) and 35 males (43.8%) ; their ages ( M[ Q1, Q3]) were 27 (23, 40) years, and the duration of disease ( M[ Q1, Q3]) was 12 (3, 24) months; warts were located on the hands in 12 cases (15.0%), on the feet in 60 cases (75.0%), and on both sites in 8 cases (10.0%) ; warts measuring ≤ 1 cm in diameter were observed in 71 cases (88.8%), and those measuring > 1 cm were observed in 9 cases (11.3%). In the needle-based injection group, there were 37 females (46.2%) and 43 males (53.8%) ; their ages were 28 (22, 39) years, and the duration of disease was 6 (2, 12) months; warts were located on the hands in 23 cases (28.7%), on the feet in 55 cases (68.8%), and on both sites in 2 cases (2.5%) ; warts measuring ≤ 1 cm in diameter were observed in 67 cases (83.8%), and those measuring > 1 cm in diameter were observed in 13 cases (16.3%). There were no significant differences in gender distribution, age, wart diameters, prior treatment status, or number of warts between the two groups (all P > 0.05). The duration of disease was longer in the needle-free injection group than in the needle-based injection group ( P = 0.041), and the dose of interferon was lower in the needle-free injection group than in the needle-based injection group ( P < 0.001). After treatment, 44 patients (55.0%) were cured in the needle-free injection group, and 39 (48.8%) in the needle-based injection group, with no significant difference in the cure rates between the two groups ( χ2 = 0.63, P = 0.429). Among patients with multiple warts, 54.8% (23/42) were cured in the needle-free injection group, and 47.4% (18/38) in the needle-based injection group, with no significant difference in cure rates between the two groups ( χ2 = 1.28, P = 0.509). The most common adverse reaction was fever or flu-like symptoms (186 instances), which resolved spontaneously in 141 instances and resolved after treatment with oral ibuprofen in 45 instances; the incidence rate of flu-like symptoms was significantly lower in the needle-free injection group (57 instances, 21.6%) than in the needle-based injection group (129 instances, 53.3%; χ2 = 54.63, P < 0.001). The pain score was significantly lower in the needle-free injection group (3.65 ± 1.25 points) than in the needle-based injection group (5.16 ± 1.17 points, t = -7.90, P < 0.001). The logistic regression analysis showed that the duration of disease, lesion sites, patient age, and previous treatment history had no impact on the efficacy in either the needle-free injection group or the needle-based injection group (all P > 0.05) . Conclusions:The efficacy of needle-free and needle-based injections of interferon was similar in the treatment of palmoplantar warts, whereas needle-free injections resulted in less pain and a lower incidence of interferon-related adverse reactions. None of the duration of disease, lesion sites, patient age, or prior treatment status showed significant impact on the efficacy in the two groups.

OBJECTIVE: To determine the prevalence of GJB2 gene c.109G>A (p.V37I) variant among infants with congenital hearing loss and analyze the initial audiological characteristics of children harboring the variant, compare the audiometric difference among individuals with various genotypes, and explore genetic and audiological manifestations of the affected families. METHODS: One hundred twenty six infants diagnosed with congenital hearing loss at the Neonate Screening Center of Ningbo City from June 2021 to December 2024 were selected as the study subjects. The neonates, in addition with members from 16 of their families, had undergone genetic screening for variants of 208 hotspot sites within 24 deafness-associated genes. For cases identified with monoallelic variants and concurrent hearing loss, the full GJB2 gene was sequenced. Meanwhile, a retrospective analysis was carried out on 23 children whom were confirmed to have hearing loss and the c.109G>A variant by whole exome sequencing from March 2022 to December 2024. And 102 children who were excluded to have hearing loss and pathogenic variants by whole exome sequencing were selected as normal controls. Audiological features of individuals harboring the c.109G>A variant were compared. This study has been approved by the Medical Ethics Committee of The Affiliated Women and Children's Hospital of Ningbo University (Ethics No.: EC2023-009). RESULTS: For the 126 infants with congenital hearing loss, prospective screening has identified 58 (46.03%) to harbor the c.109G>A variant. These included 38 homozygotes and 16 compound heterozygotes. Retrospective review of the 23 c.109G>A positive children has identified 15 as homozygotes and 8 as compound heterozygotes. Genetic testing of the 16 pedigrees has identified 7 homozygotes and 1 compound heterozygote. For the homozygotes combined (n = 53), 96.2% exhibited bilateral symmetric hearing loss, with 78.3% showing high-frequency sloping patterns, and 98.1% having a hearing threshold ranging from 20 to 65 dB. For the compound heterozygotes combined (n = 24), 95.8% showed symmetric loss, with 59.4% having high-frequency sloping, and 97.9% had a hearing threshold ranging from 20 to 65 dB. Both groups showed significantly elevated ABR/PTA thresholds compared with the normal controls (P = 0.000). The compound heterozygous group had higher ABR thresholds (43.3 ± 15.0 dB nHL) compared with the homozygous group (39.1 ± 12.0 dB nHL, P = 0.005). CONCLUSION Infants harboring the GJB2 c.109G>A variant primarily manifest as mild-to-moderate, symmetric, high-frequency sloping hearing loss. Nearly one-third of affected children have thresholds between 20 to 35 dB nHL, suggesting that ABR > 35 dB nHL alone may underestimate the hearing impairment in this population. Compared with homozygotes, compound heterozygotes with the the GJB2 c.109G>A variant can confer a more severe hearing loss.
Humans ; Connexin 26/genetics* ; Female ; Male ; Infant, Newborn ; Infant ; Hearing Loss/genetics* ; Retrospective Studies ; Child, Preschool ; Child ; Genotype ; Connexins/genetics* ; Mutation

Objective:To investigate the clinical characteristics,pathological features,treatment,and prognosis of clear cell adenocarcinoma of cervix(CCAC).Methods:Clinical data of 72 CCAC patients treated at Jiangxi Maternal and Child Health Hospital from January 1,1999,to June 20,2024,were retrospectively analyzed.Results:The median age at diagnosis was 50 years.Of the patients,19 were classified as early-stage(IB1,IB2,IIA1),51 as mid-advanced stage(IB3,IIA2-IVB),and 2 were unstaged.Among 38 patients,elevated cancer Antigen 125(CA125)levels were observed in19(50.0%).Abnormal thin-layer liquid-based cytology(TCT)results were de-tected in 14 of 20 patients(70.0%),and human papillomavirus(HPV)positivity was identified in 20 of 45 patients(44.5%).Immunohistochemical analysis revealed hepatocyte nuclear factor-1β(HNF-1β)positivity in 95.2%and paired box gene 8(PAX-8)positivity in 91.3%.Among 32 patients undergoing primary surgery,postoperative pa-thology confirmed pelvic lymph node metastasis in 5(15.6%),lymphovascular and stromal invasion in 9(28.1%),with no ovarian metastasis observed.With a median follow-up of 45 months,the5-year overall survival(OS)rate was 51.4%,with early-stage and mid-advanced stage OS rates of 57.9%and 47.1%,respectively.The 5-year OS rate for surgically managed patients was 52.8%,while preoperative neoadjuvant chemotherapy(9 cases)yielded a 5-year OS of 33.3%.Among38 patients treated primarily with radiotherapy and/or chemotherapy,the5-year OS was 47.1%,with 5 patients undergoing central lesion resection achieving an 80.0%5-year OS.Conclusions:CCAC predominantly affects middle-aged and elderly women,with advanced-stage presentations being common.HPV,TCT,and CA125 testing hold diagnostic value for CCAC.Patients with early-stage CCAC undergoing surgical treatment demonstrated a relatively favorable survival rate;however,individualized assessment remains essential.Neoadjuvant chemotherapy administered prior to surgery may have limited efficacy in improving patient prognosis.For selected patients completing radiotherapy and/or chemotherapy,central lesion resection may potentially im-prove prognosis,although further well-designed studies are required to validate this finding.

Objective To explore the expression and clinical significance of serum C1qA and C1qB in children with idiopathic short stature (ISS). Methods 108 children with ISS (ISS group) and 108 healthy children (control group) who were admitted to the pediatric department of the 910th Hospital of the Joint Logistics Support Force of the People's Liberation Army of China from May 2020 to May 2023 were selected. An enzyme-linked immunosorbent assay was used to detect serum levels of C1qA and C1qB. Pearson correlation analysis was used to investigate the correlation between serum C1qA and C1qB levels,growth and development indicators,and inflammatory markers in children with ISS. Multivariate logistic regression analysis was used to identify the risk factors for the onset of ISS and the value of C1qA and C1qB in diagnosing ISS was analyzed based on the working characteristics of the subjects. Results The levels of C1qA (1206.35±275.15 ng/ml) and C1qB (1084.65±220.48 ng/ml) in ISS group were higher than those in control group (612.35±135.06 ng/ml,501.32±108.77 ng/ml),the differences were statistically significant (t=20.140,24.658,all P<0.05).The height,weight,body mass index(BMI ) and bone age index of the ISS group were lower than those of the control group(t/x2=2.092～10.661),and the ISS family history,tumor necrosis factor-α(TNF-α) and interleukin-6(IL-6) levels were higher than those of the control group(t/x2=4.338,10.550,15.865),the differences were statistically significant (all P<0.05),respectively .The serum levels of C1qA and C1qB in children with ISS were negatively correlated with height,weight,BMI,and bone age index(r=-0.502～-0.352,all P<0.05),and positively correlated with TNF-α and IL-6 levels(r=0.326～0.411,all P<0.05).Low bone age index,high level of TNF-α,high level of IL-6,high level of C1qA and high level of C1qB were risk factors for ISS (waldx2=4.979～7.328,all P<0.05).ROC curve showed that the area under the curve of serum C1qA and C1qB in the diagnosis of ISS was 0.838 and 0.816,respectively. The area under the curve of combined detection of serum C1qA and C1qB in the diagnosis of ISS was 0.931,which was higher than that of two indicators alone (Z=3.812,3.896,all P<0.05).Conclusion The serum levels of C1qA and C1qB are increased in children with ISS,which is related to short stature. Combined detection of serum C1qA and C1qB is helpful to diagnose the risk of ISS.