Objective This study reports on the obligatory parasitism of water mites Arrenurus sp. on Anopheles messeae at the Manzhouli Port, Inner Mongolia, China. Methods Duing July 2024, a survey on the mosquito diversity was conducted at the Manzhouli Port. Captured mosquitoes and their ectoparasites were identified to species level. Results A total of 1840 adult mosquitoes were collected, representing species from three genera: Culex(Cx. modestus, Cx. pipiens pallens), Aedes(Ae. dorsalis, Ae. flavidorsalis, Ae. flavescens), and Anopheles (An. messeae). Among all the mosqutioes specimens,3 out of 150 captured An. messeae were found to carry ectoparasitic mites, with number of 2,4,27 mites separately. Morphological and molecular identification reached the same result as water mites(Hydrachnidiae, Hydracrina). COI gene sequence showed 94% similarity with the closest species Arrenurus truncatellus. Conlusions Literature review suggests water mites are host-specific parasitism of mosquito species and herein with the first record of Arrenurus sp. parasiting on An. Messeae in the most high-latitude region globally.

Spine fracture and dislocation are common traumatic spinal conditions that often require surgical intervention due to compromised spinal stability. Surgical approaches include anterior, posterior, and combined anterior-posterior spinal procedures. According to the specific surgical requirements, patients may be placed in the prone position or repositioned between prone and supine positions during surgery. Intraoperative repositioning has become an essential step in patient positioning. However, during repositioning, patients with spinal fracture and dislocation are at increased risk for complications such as hemodynamic instability, nerve injury, and pressure injuries to the skin and soft tissue. Notably, due to the instability of the spinal cord, even minor manipulations can further exacerbate the damage, potentially leading to severe outcomes like paraplegia. Although the current clinical guidelines provide instructive recommendations for standard position, there remains no specific protocols for intraoperative repositioning in patients with spine fracture and dislocation. With a concern for the lack of clinical studies on positioning techniques, risk prevention, and operational norms for special patients, no applicable guidelines or standards are available. A consensus was required to provide clinical reference, meet the requirements of surgical treatment, and minimize the safety risks of patients caused by improper placement of positions. Professional Committee of Operating Room Nursing of Shaanxi Nursing Association organized experts in nursing management and operating room nursing from major hospitals across China to formulate Expert consensus on intraoperative repositioning for patients with spinal fracture and dislocation ( version 2025). The consensus provides 11 recommendations covering pre-repositioning preparation, intraoperative maneuvers, and post-repositioning observation, aiming to provide references for clinical standardization of the intraoperative repositioning process and protection of patients′ safety.

Objective:To observe any effect of supplementing treatment according to the Early Start Denver model (ESDM) with repeated transcranial magnetic stimulation (rTMS) in the treatment of children with autism spectrum disorder (ASD).Methods:Sixty-seven children on the autism spectrum aged 2 or 3 years were randomly divided into a control group of 33 and an observation group of 34. Both groups were treated as specified by the ESDM for 24 weeks, but the observation group additionally received rTMS. At 12 and 24 weeks, both groups were evaluated using the Autism Behavior Checklist, the Childhood Autism Rating Scale (CARS), the revised version of the Repetitive Behavior Scale (RBS-R), Gesell Development Schedules, and the Autism Treatment Evaluation Checklist (ATEC).Results:The CARS, Gesell, RBS-R and ATEC results of both groups had improved significantly after 12 weeks, with further improvements observed another 12 weeks later, when the average Autism Behavior Checklist scores had also improved significantly. At that point the results of the observation group were significantly better than those of the control group, on average.Conclusions:Combining ESDM and rTMS can significantly relieve the main symptoms of autism and improve the comprehensive development of children on the autism spectrum 2 or 3 years old. Therefore, such combination is worthy of application in clinical practice.

Objective:To investigate the prevalence of work-related musculoskeletal disorders (WMSDs) in right-hand ultrasound physicians and identify contributing factors for carpal tunnel syndrome (CTS) .Methods:From May 2023 to February 2025, 188 ultrasound physicians from 15 hospitals in Heilongjiang Province were surveyed using questionnaires to assess their prevalence of wrist-specific mechanical strain disorders (WMSDs) over the past year. Neurophysiological tests were conducted, and logistic regression analysis was performed to identify factors affecting the right carpal tunnel syndrome (CTS) .Results:The prevalence of wrist WMSDs among ultrasound physicians was 48.4% (91/188) . Multivariate logistic regression analysis revealed that age and frequent probe pressure application were associated with 2.14-fold and 4.04-fold increased CTS risk, respectively.Conclusion:Enhance society's attention to the health of noise-exposed physiciansand providing a foundation for implementing targeted interventions.

Rare diseases have become an issue of public health concern globally. In China, two rare diseases lists have been released officially in 2018 and 2023, respectively. However, due to its importance in research, clinical management , therapeutic drug development and health security, we still need a clear definition of rare diseases in China. Considering the current actual condition of our country and our population size, we would suggest a prevalence of less than 1/10 000 to define a rare disease in China.

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.

Objective:To investigate the dynamic characteristics of human papillomavirus (HPV) genomic integration during cervical lesion progression and the clinical value of HPV integration detection in stratify HPV-positive women, and to explore its molecular mechanisms in cervical carcinogenesis.Methods:A prospective cohort study was designed to enroll high-risk HPV (HR-HPV) positive women who underwent cervical cancer screening in Drum Tower Hospital Affiliated to Nanjing University Medical School and Nanjing Maternity and Child Health Care Hospital from July 2022 to July 2024. Cervical exfoliated cells samples were collected, and HPV whole genome targeted capture and high-throughput sequencing technology were used. The HPV integration patterns, host gene functional region distribution and pathway enrichment characteristics of 157 samples with different cervical lesions grades were analyzed, including 31 cases of normal cervix, 40 cases of cervical intraepithelial neoplasia (CIN) Ⅰ, 32 cases of CIN Ⅱ, 42 cases of CIN Ⅲ, and 12 cases of cervical cancer.Results:HR-HPV integration was detected in 80.2% (126/157) of the 157 HR-HPV positive samples. The incidence of HR-HPV integration in cervical cancer patients was 12/12, which was higher than that in normal women (77%, 24/31). The incidence of HPV16 integration was significantly higher in high-grade lesions, and the incidence of HPV16 integration was 43% (18/42) in CIN Ⅲ patients and 8/12 in cervical cancer patients ( P<0.001). A total of 14 438 integration events were detected in 126 samples with HPV integration. The integration sites were mainly distributed in the host intergenic region (51.0%, 7 359/14 438) and intronic region (38.1%, 5 494/14 438), and the integration frequency of viral L1 gene was the highest (28.4%, 4 498/16 781). Functional enrichment analysis showed that HPV integration-related host genes were significantly enriched in transport of small molecules,cyclic guanosine monophosphate (cGMP)-protein kinase G (PKG) signaling pathway, and purine ribonucleotide biosynthetic process, which synergistically drove carcinogenesis through multiple mechanisms. Conclusions:HPV integration events are significantly associated with the progression of cervical lesions. HPV integrated detection based on cervical exfoliated cells is expected to optimize the current screening strategy, reduce excessive intervention of HPV positive women and facilitate their accurate triage management.

Objective To investigate the effect of senkyunolide I(SEN I)on neuronal apoptosis in sepsis-associated encephalopathy(SAE)rats via modulation of the mixed-lineage kinase 3(MLK3)/c-Jun N-terminal kinase 3(JNK3)signaling pathway.Methods Screening for a SAE model by monitoring neurobehavioral and electroencephalographic alterations in rats with sepsis induced by cecal ligation and puncture(CLP).Divided into normal control group,sham operation group,sepsis without encephalopathy group,SAE model group,SAE+MLK3/JNK3 signaling pathway inhibitor(URMC-099)group,SAE+low-dose SEN I group(36 mg/kg),and SAE+high-dose SEN I group(144 mg/kg),with 10 animals in each group.After 30 minutes of successful modeling,intraperitoneal injection was administered according to the group,and the administration was completed within 24 hours.HE staining was used to observe the pathological conditions of hippocampal tissue under a light microscope,transmission electron microscopy was used to observe changes in the morphology of neuronal nuclei,cytoplasm,and mitochondrial ultrastructure,TUNEL staining was used to detect hippocampal neuronal apoptosis,and Western blotting was used to detect the expression levels of p-JNK3,JNK3,p-MLK3,MLK3,and Fas ligand(Fas-L)proteins.Results Compared with the normal control group and sham surgery group,the sepsis without encephalopathy group showed no significant changes in neuronal structural morphology and neuronal apoptosis,and there were no significant differences in the expression of p-JNK3,JNK3,p-MLK3,MLK3,and Fas-L proteins(P＞0.05).However,the SAE model group had aggravated neuronal structural morphology damage,increased neuronal apoptosis rate,and increased expression level of p-JNK3,JNK3,p-MLK3,MLK3,and Fas-L proteins(P＜0.01);Compared with the SAE model group,the inhibitor URMC-099 and SEN I treatment groups showed significant improvement in neuronal structural and morphological damage,decreased neuronal apoptosis rates,and reduced p-JNK3,JNK3,p-MLK3,MLK3,and Fas-L protein expression(P＜0.01),with the high-dose SEN I group showing more significant improvement.Conclusion SEN I effectively reduces neuronal apoptosis in SAE and exerts neuroprotective effects on SAE by inhibiting the activation of the MLK3/JNK3 signaling pathway.

Objective:To investigate the current application of blood purification in the treatment of acute poisoning within Jiangsu Province and to evaluate the impact of extracorporeal blood purification on the clinical outcomes of critically poisoned patients.Methods:This multicenter, cross-sectional real-world observational study followed patients presenting with poisoning to the emergency departments of nine hospitals in Jiangsu Province between June 2015 and May 2019. Data were collected on demographic characteristics, vital signs within the first hour of emergency presentation, treatment modalities, length of hospital stay, and survival outcomes. Clinical data from patients who underwent extracorporeal blood purification were compared with those who did not, using the Wilcoxon rank-sum test and Chi-square test.Results:A total of 4 178 poisoning cases were included between June 2015 and May 2019. Among them, 21.7% (908/4 178) received blood purification therapy, while 78.3% (3 270/4 178) did not. Hemoperfusion (90.4%) was the most frequently employed method, followed by continuous renal replacement therapy (CRRT) (4.4%). In combined blood purification modalities, 4.8% underwent hemoperfusion combined with CRRT, 0.1% received hemoperfusion with plasma exchange, and another 0.1% underwent hemoperfusion combined with both CRRT and plasma exchange. Among patients who underwent blood purification, pesticide poisoning was the most prevalent (76.3%), with the most common toxic agents being paraquat (23.7%), dichlorvos (8.7%), methamidophos (5.2%), omethoate (4.0%), and glyphosate (3.7%). Compared to the non-blood purification group, patients in the blood purification group were more likely to present within the first hour with a low Glasgow Coma Scale (GCS) score (3-8) (22.6% vs. 9.7%, P <0.05), low mean arterial pressure (8.0% vs. 3.2%, P <0.05), longer hospital stays [5(3,9) days vs. 2(1,4) days, P <0.05] and a higher in-hospital mortality rate (21.1% vs. 5.3%, P <0.05). Follow-up via telephone 28 days after discharge revealed a survival rate of 78.9%, with a mortality rate of 21.1% in the blood purification group. Conclusions:Hemoperfusion is the most commonly utilized blood purification technique for treating poisoning in Jiangsu Province, with pesticides being the primary toxic agents treated. Although the mortality rate is higher in the blood purification group, the intervention may still contribute to improved patient outcomes.

Objective:To evaluate the clinical performance of high-risk human papillomavirus (HR-HPV) genotyping in cervical cancer screening.Methods:Between June and July 2017, a prospective cervical cancer screening cohort was established in Xiaye Town, Jiyuan City, Henan Province, China by recruiting 3 254 women aged 21 to 64 years. At baseline screening, cervical exfoliated cell specimens were collected for HR-HPV genotyping and liquid-based cytology testing. Follow-ups were conducted over a 3-year period, with cytology testing in the first and second years and both HR-HPV genotyping and cytology testing in the third year. Women meeting the referral criteria were referred for colposcopy, with cervical biopsy and histopathological diagnosis performed as necessary. The endpoint was defined as cervical intraepithelial neoplasia grade 2 (CIN2) or higher confirmed by histopathological diagnosis. The sensitivity and specificity for detecting CIN2 or higher lesions of HR-HPV genotyping were calculated, as well as the cumulative risk of developing CIN2 or higher lesions over the 4-year study period in women with different baseline HR-HPV genotyping results.Results:A total of 2 741 women were included in the statistical analysis. Baseline HR-HPV genotyping detected 453 HR-HPV positive cases (16.53%), including 98 HPV 16/18 positive cases (3.58%) and 355 other HR-HPV positive cases (12.95%). During the 4-year period, 83 cases of CIN2 or higher were diagnosed. The sensitivity and specificity of baseline HR-HPV positivity for CIN2 or higher were 89.16% (95% CI: 80.66%-94.19%) and 85.74% (95% CI: 84.36%-87.02%), respectively. The corresponding rates for HPV 16/18 positivity were 43.37% (95% CI: 33.24%-54.09%) and 97.67% (95% CI: 97.02%-98.18%). The 4-year cumulative absolute risk of CIN2 or higher was highest in the HPV 16/18 positive group (36.73%, 95% CI: 27.85%-46.62%), followed by other HR-HPV positive groups (10.70%, 95% CI: 7.87%-14.38%), and the HR-HPV negative group was the lowest (0.39%, 95% CI: 0.19%-0.76%). Conclusions:HR-HPV genotyping testing exhibits high sensitivity and specificity for detecting CIN2 or higher lesions in cervical cancer screening. It also provides a scientific basis for stratifying the individual risk of developing CIN2 or higher lesions to guide subsequent management. Therefore, the HR-HPV genotyping testing can be considered as an effective method for cervical cancer screening.