Objective: To assess parental expectations for the development of children with autism spectrum disorder (ASD) and identify factors associated with these expectations, so as to provide references for improving rehabilitation outcomes and long term development in children with ASD. Methods: From June 2024 to January 2026, a total of 877 children with ASD and their parents were recruited from 27 rehabilitation institutions in Hefei. The children had been diagnosed by chief physicians at tertiary level hospitals. Demographic characteristics and data on parental expectations were collected by the Parental Expectations Questionnaire. Differences in parental expectations between groups were assessed using the Mann-Whitney U- test and Kruskal-Wallis H-test, and associated factors were examined using quantile regression. Results: The mean item score for overall parental expectations among parents of children with ASD was (4.55±0.47), and scores for all dimensions were higher than those among parents of typically developing children ( t =11.11-31.14, all P <0.01). Child age, school enrollment, and maternal personality were associated with daily living expectation scores, learning and special talents and strengths expectation scores, and special talents and strengths expectation scores, respectively ( H =6.16-8.18, all P <0.05). Parents of preterm children had higher expectations for social interaction, physical and mental well being, and daily living than parents of non-preterm children ( Z =-2.56, -2.48, -2.39, all P <0.05). Multivariate quantile regression analysis showed that children’s age was associated with the expected level of self care ability; school enrollment status was associated with the expected level of learning and specialty strengths; maternal personality was associated with the expected levels of social competence, physical and mental health, self care ability, and specialty strengths; parental age was associated with the expected levels of physical and mental health and specialty strengths; and parental educational attainment was associated with the expected level of self care ability ( β =-0.36-0.41, all P <0.05). Conclusion Parents of children with ASD in Hefei generally have high expectations for their children s development across the domains of learning, daily living, social interaction, and physical and mental well being.

Objective:To analyze the epidemiological characteristics of rabies in China during 2024 to understand the patterns of disease transmission and provide a scientific basis for optimizing prevention strategies and advancing the rabies elimination process.Methods:Data on the national rabies epidemic in 2024 and case-specific information from national surveillance sites were collected from China's National Notifiable Disease Reporting System（NNDRS）. Descriptive epidemiological methods were used to analyze the disease trends and epidemic characteristics.Results:In 2024，China reported 167 human rabies cases across 20 provincial-level administrative divisions（PLADs），resulting in 148 fatalities. This represents a 39.17% increase from 2023（120 cases）and the highest annual incidence recorded since 2019. The epidemic exhibited a distinct geographic clustering in central and southern China，with four provinces（Henan，Guangxi，Hunan，and Hubei）accounting for 62.87%（105/167）of nationally reported cases. October（20 cases）and November（20 cases）recorded the highest monthly incidence，while February had the lowest（2 cases）. Farmers constituted the primary affected demographic（80.84%），with a marked male predominance（male-to-female ratio：2.15∶1）-higher than the 2023 ratio（1.86∶1）. Cases spanned all age groups，predominantly affecting middle-aged and older adults. Analysis of 54 cases revealed dogs as the primary exposure source（93.88%），with domestic dogs constituting 75.00% of these.The laboratory diagnosis rate of rabies cases in 2024 was 43.71%（73/167）.Conclusion:After 16 consecutive years of decline，China's rabies epidemic rebounded in 2024，primarily driven by deficiencies in domestic dog management and weaknesses in post-exposure prophylaxis. Key recommendations include enhancing canine vaccination coverage in high-risk areas，implementing targeted health education for farmers and middle-aged and older adults，improving standardized post-exposure treatment protocols，and optimizing integrated surveillance-alert-response systems，ultimately advancing the achievement of rabies elimination goals.

Objective:To analyze the relationship between 24-hour urinary calcium (24 h UCa) level and the risk of end-stage kidney disease (ESKD), cardiovascular disease (CVD), and all-cause mortality.Methods:In the Chinese Cohort Study of Chronic Kidney Disease, we examined 3 375 patients aged 18-74 years with CKD stages 1-4. Kaplan-Meier survival and Cox proportional hazard regression models were used to test a time-to-event association between levels of 24 h UCa and incidence of ESKD, CVD, and all-cause mortality.Results:During a follow-up of 4.17 (3.37, 5.20) years, 179, 145, 104 and 38 ESKD events occurred in <0.60, 0.60-, 1.20-, ≥2.32 mmol 24 h UCa groups. Higher levels of 24 h UCa (1.20-,≥2.32 mmol) were independently associated with a lower incidence of ESKD events in patients with CKD, with HR (95% CI) of 0.71 (0.54-0.93) and 0.43 (0.29-0.64), respectively. No significant associations with CVD and all-cause mortality endpoints were detected. Conclusion:Among patients with CKD, levels of 24 h UCa displayed an association with the risk of ESKD among patients with CKD stages 1-4.

Objective To compare the changes in biological indicators of human corneal epithe-lial(HCET)cells and rabbit corneas after exposure to different doses of ultraviolet B(UVB)radia-tion,so as to evaluate the impact of UVB radiation on corneal injury effects.Methods In cell exper-iment,HCET cells were divided into groups with radiation doses of 0,6,12,18,and 24 mJ/cm2.The effect of UVB radiation on HCET cell viability was detected using the CCK-8 assay,and the level of intracellular DNA damage was assessed by immunofluorescence.In the animal experiment,15 healthy New Zealand white rabbits(30 eyes)were randomly divided into groups with radiation doses of 0,1.35,2.16,4.32,and 6.48 J/cm2.The UVB exposure time for the radiation groups was 30 minutes per day for 3 consecutive days.Corneal injury was evaluated using methods such as slit-lamp microscopy,sodium fluorescein staining,central corneal thickness measurement,optical coherence tomography(OCT)imaging,and hematoxylin and eosin(HE)staining.Results Compared with the control group,cell viability in the radiation groups gradually decreased,and the level of DNA damage gradually increased with increasing radiation dose.As the radiation dose increased in the radiation groups,the degree of corneal opacity in rabbits gradually worsened,the central corneal area gradu-ally thickened,and OCT revealed high-intensity scattered light signals with the formation of shadow areas.Results from HE staining,immunohistochemistry,Western blot(WB),and sodium fluores-cein staining showed that the 1.35 J/cm2 group caused mild corneal injury,with damage reaching the corneal epithelial layer.In the 2.16 J/cm2 group,the corneal injury presented as dense punctate distribution,with damage extending from the epithelial layer to the superficial stroma.The number of ephrin type-A receptor 2(EphA2)protein-stained cells was relatively small,and the staining was light,showing a weak positive result.In the 4.32 J/cm2 and 6.48 J/cm2 groups,the corneal injury was irreversible,with damage gradually progressing from the corneal epithelial layer and superficial stroma to the endothelial layer.The number of EphA2 protein-stained cells was relatively large,and the staining was dark,showing a strong positive result.Conclusion This study comprehensively e-valuates the dose-dependent injury effects of UVB on HCET cells and New Zealand white rabbit cor-neas through cell and animal experiments.It elucidates that UVB radiation could induce corneal cell DNA damage,promote inflammatory responses,and trigger apoptosis by upregulating γ-phosphoryla-ted histone H2AX(γH2AX)and EphA2.The self-repair ability and process of corneal injury are preliminarily explored,providing a basis for further research on mechanisms of corneal injury caused by ultraviolet radiation and the development of protective drugs.

High intensity ultraviolet radiation exists in special military operation environments such as oceans,plateaus,polar regions and deserts,which is a leading contributor to eye damage and can lead to luminous keratitis,dry eyes,pterygium,cataract and macular degeneration.Ultraviolet radiation can cause acute and chronic injury to eyes by inducing DNA damage,oxidative stress and inflammatory reaction.The commonly used clinical drugs have played a role in relieving symptoms and promoting the repair of ocular tissues,but there are still limitations.The research on targeted therapeutic drugs,proteins and their derived peptides,vitamins and their coenzymes,as well as natural active ingredients of animals and plants has provided new ideas for the development of more effective drugs that can protect eyes from ultraviolet and for medical support to China's army in special environments.Based on the literature currently available,this paper reviews the eye injury caused by ultraviolet radiation and therapeutic drugs in terms of types of eye diseases,injury mechanisms,treatment strategies and drug development.

Objective:To analyze the relationship between 24-hour urinary calcium (24 h UCa) level and the risk of end-stage kidney disease (ESKD), cardiovascular disease (CVD), and all-cause mortality.Methods:In the Chinese Cohort Study of Chronic Kidney Disease, we examined 3 375 patients aged 18-74 years with CKD stages 1-4. Kaplan-Meier survival and Cox proportional hazard regression models were used to test a time-to-event association between levels of 24 h UCa and incidence of ESKD, CVD, and all-cause mortality.Results:During a follow-up of 4.17 (3.37, 5.20) years, 179, 145, 104 and 38 ESKD events occurred in <0.60, 0.60-, 1.20-, ≥2.32 mmol 24 h UCa groups. Higher levels of 24 h UCa (1.20-,≥2.32 mmol) were independently associated with a lower incidence of ESKD events in patients with CKD, with HR (95% CI) of 0.71 (0.54-0.93) and 0.43 (0.29-0.64), respectively. No significant associations with CVD and all-cause mortality endpoints were detected. Conclusion:Among patients with CKD, levels of 24 h UCa displayed an association with the risk of ESKD among patients with CKD stages 1-4.

BACKGROUND:Cervical instability is a common orthopedic disease in young and middle-aged people,and is the early manifestation of cervical spondylosis,which has a great impact on the quality of life of patients.Therefore,early diagnosis of cervical instability to implement early intervention has positive clinical and social significance.OBJECTIVE:The clinical prediction model of cervical instability in young and middle-aged people was constructed based on machine learning to realize early screening of cervical instability in young and middle-aged people before X-ray examination.METHODS:From September 2022 to October 2023,155 young and middle-aged adults with cervical instability and 88 with non-cervical instability recruited through recruitment advertisements and spinal department outpatient of Wangjing Hospital,China Academy of Chinese Medical Sciences were selected as research subjects.The research subjects'general information,living and working habits,discomfort symptoms,visual analog scale score,Neck Disability Index,and 36-ltem Short Form Health Survey were collected on site based on questionnaires.The above information was used as predictive factors.After screening,six machine learning algorithms of Support Vector Machine,LightGBM,RandomForest,Logistic,AdaBoost,and XGBClassifier were used to train the model by ten-fold cross-validation method,and the clinical prediction model of cervical instability was constructed.Area under the curve was used as the main evaluation index.Univariate analysis was performed on the predictors,and SHAP method was used to rank the importance of the predictors.Correlation heat maps were used to show the degree of linear correlation between the predictors and the cervical instability.RESULTS AND CONCLUSION:(1)Among the six machine learning models,RandomForest model was chosen as the final prediction model,including nine predictors,such as age,body mass index,neck circumference/neck length,visual analog scale score,Neck Disability Index,bodily pain,general health,vitality,and mental health,area under the curve=0.725 4,and the calibration degree was good.It could be used as a reference tool for early screening of cervical instability in young and middle-aged people.(2)There were significant differences in age,visual analog scale score,Neck Disability Index,bodily pain,general health,and vitality between the two groups(P＜0.05).(3)The order of importance of predictors was age,Neck Disability Index,visual analog scale score,general health,body mass index,vitality,bodily pain,neck circumference/neck length,mental health,among which age,visual analog scale score,Neck Disability Index were positively correlated with cervical instability,while general health,body mass index,vitality,bodily pain,neck circumference/neck length,and mental health were negatively correlated with cervical instability.

Objective To explore the impact of suture configuration and fixation type on the biome-chanical strength of rotator cuff repair,using a factorial design study.Methods Sixteen fresh-frozen porcine shoulder samples were randomized into an anchorless double-row suture bridge transosseous su-tures(DS)group,an anchored double-row suture bridge transosseous-equivalent(DE)group,an an-chorless X-BOX construct transosseous sutures(XS)group,and an anchored X-BOX construct transos-seous-equivalent(XE)group,each of four,according to suture configuration(double-row suture bridge,traditional X-BOX construct)and fixation type(suture anchors,transosseous sutures).Then,their fatigue resistance(first-cycle excursion,gap length difference ratio,and the percentage of ex-posed footprints)and the failure strength(the maximum failure load and the re-tear type)were mea-sured using a biomechanical material testing machine.Results Different suture configurations affected failure strength(F=39.559,P<0.001),with the double-row suture bridge groups(693.07±58.35 N,746.76±138.57 N)showing significantly higher failure strength,compared to the traditional X-BOX groups(462.90±18.91 N,421.43±90.76 N).However,the fixation type did not significantly im-pact failure strength(F=1.161,P=0.302).Moreover,the suture configuration influenced the gap differ-ence ratio(F=7.781,P=0.016),but had no significant correlation with other fatigue resistance indica-tors(P>0.05).Meanwhile,failure strength and fatigue resistance were not correlated with fixation type,and the interaction between suture and fixation type(P>0.05).The incidence of failure types for the four suture configurations was as follows:Type I tendon tear:XS>XE>DS=DE;type II tendon tear:DS>XE>XS=DE;fixing material-related failure:DE>DS=XE=XS.Conclusion The failure strength and gap formation ratio in rotator cuff repair under fatigue loading are influenced by suture configuration,whereas no significant association has been observed with respect to fixation method,whether using transosseous sutures or suture anchors.

Objective To explore the callsal association between intrahepatic cholestasis of pregnancy(ICP)and offspring attention-deficit hyperactivity disorder(ADHD)and Tourette's syndrome(TS)and its potential mechanisms.Methods Genome wide association study(GWAS)in public datasets was used to extract data.Among them,exposure was ICP(n=123 579),which stems from FinnGen dataset.Outcome was defined as ADHD,TS and other tic disorders(n=23 918),which is extracted from GWAS Catalog.Among mediators,total cholesterol in high-density lipoprotein(TC in HDL)were from the genetic map of the human plasma proteinome(n=21 558),and Obg-like ATPase 1 was from whole-genome study of circulating metabolites(n=3 301).In this study,we chose instrumental variables(IVs)that meets the Mendelian randomization(MR)hypothesis.When using two-sample MR,inverse variance weighted(IVW)was adopted as the primary method,and MR-Egger regression,weighted median,weighted mode,and simple mode were also utilized to analyse the robustness.Cochran's Q test,MR-Egger intercept test and leave-one-out sensitivity analysis were performed to verify the reliability.Significant threshold was set up as P<0.05.When using two-step MR,the first step is two-sample MR from exposure to mediator,and the second step is multivariable MR(MVMR),which is from mediator to outcome.At this time,conditional F-statistic was adopted to test the strength of IVs.At last,product distribution test was applied to determine the significance of mediation effects.Results ICP was significantly related to ADHD and TS as well as other tic disorders in offspring(IVW:OR=1.003,95%CI:1.000～1.006,P=0.035),and sensitivity analysis verified the robustness of the results.The potential positive mediators included TC in HDL[total effect(TE)=2.855×10-3;mediated effect(ME)=8.628×10-4;mediated proportion(MP)=30.217%,95%CI:0.878%～73.954%],and Obg-like ATPase 1(TE=2.855×10-3;ME=1.216×10-3;MP=42.572%,95%CI:6.356%～90.195%).Conclusion ICP is possible to elevate the incidence rate of ADHD and TS and other tic disorders via reducing TC in HDL and Obg-like ATPase 1.

Post-traumatic stress disorder (PTSD) is a relatively common but complex mental illness with a range of diverse risk factors. Typical symptoms include the re-experience or avoidance of traumatic events, cognitive impairment, and hypervigilance. While the exact pathogenesis of PTSD is unclear, many studies indicate that epigenetic regulation plays a key role in its development. Specifically, numerous studies have indicated that the levels of histone acetylation and methylation, DNA methylation, and noncoding RNA are altered in PTSD patients. Further to this, natural products have been found to achieve epigenetic regulation of PTSD by regulating the expression of epigenetic enzymes, long noncoding RNA (lncRNA), and miRNA, thereby playing a role in improving PTSD symptoms. To date, however, no epigenetic regulation related drugs have been used in the treatment of PTSD. Furthermore, while natural products that can epigenetically regulate PTSD have received increasing levels of attention, there have not yet been any systematic reports on the topic. Here, we summarized the roles and mechanisms of natural products in the epigenetic regulation of PTSD, providing a novel and unique perspective that will help to guide the development and application of new PTSD treatments.