Objective To analyze the incidence of congenital syphilis in four regions of China from 2005 to 2020 and predict its change trend, and to provide a scientific basis for the prevention and control of congenital syphilis. Methods The incidence data of congenital syphilis in eastern, western, central and northeastern China from 2005 to 2020 were collected. The annual change percentage (APC) and average annual change percentage (AAPC) were calculated by Joinpoint software, and the change trend was analyzed. The ARIMA model was established by SPSS26.0 software to predict the incidence from 2021 to 2025. Results From 2005 to 2020, there were 107 504 cases of congenital syphilis, and the incidence reached the peak in 2011, which was 0.90/100 000, and decreased to 0.09/100 000 in 2020. The incidence of congenital syphilis in the eastern, central, western, and northeastern regions of China decreased to 0.07/100 000, 0.06/100 000, 0.12/100 000, and 0.15/100 000 in 2020, respectively. Joinpoint regression analysis found that from 2005 to 2020, the incidence of congenital syphilis showed a downward trend in the whole country (AAPC=-8.68%, t=-5.18, P＜0.05), the eastern region (AAPC=-12.01%, t=-6.81, P＜0.05), the central region (AAPC=-5.45%, t=-2.09, P＜0.05), and the western region (AAPC=-6.05%, t=-3.00, P＜0.05), while the incidence in the northeast region was relatively stable (AAPC=-1.66%, t=-1.18，P＞0.05). The ARIMA (2,2,0) model was constructed to predict that the annual incidence of congenital syphilis from 2021 to 2025 would be 0.06/100,000, 0.03/100,000, 0.02/100,000, 0.01/100,000, and 0.01/100,000, respectively. Conclusion From 2005 to 2020, the incidence of congenital syphilis in China shows an overall downward trend. The western and northeastern regions are the key prevention and control areas, and the work of ^"eliminating mother to child transmission of syphilis^" needs to be continuously promoted.

AIM:To evaluate the optimal timing of preoperative intravitreal anti vascular endothelial growth factor(VEGF)therapy in proliferative diabetic retinopathy(PDR)using intraoperative fluorescein angiography(IOFA).METHODS:A retrospective case series study was conducted on patients who underwent vitrectomy for PDR with vitreous hemorrhage(VH)at Sichuan Provincial People's Hospital from January 2023 to February 2025. Patients were divided into three groups according to the interval between intravitreal conbercept injection and surgery: Group A(3 d before surgery), Group B(7 d before surgery), and Group C(14 d before surgery). IOFA was used to assess the number and size of retinal neovascularization(NV). Additional data were collected including preoperative best corrected visual acuity(BCVA), vitreous hemorrhage grading, operative time, frequency of intraoperative endodiathermy, duration of high perfusion pressure, vitreoretinal adhesion grade, postoperative BCVA, and central macular thickness(CMT). Multidimensional analyses were performed.RESULTS:This study enrolled a total of 91 patients(94 eyes)with PDR accompanied by vitreous hemorrhage. Among them, Group A consisted of 31 patients(31 eyes; 18 males, 13 females; mean age 53.26±12.38 y), Group B consisted of 34 patients(37 eyes; 21 males, 13 females; mean age 51.61±14.16 y), and Group C consisted of 26 patients(26 eyes; 18 males, 8 females; mean age 51.00±12.02 y), with baseline characteristics comparable among the three groups(all P>0.05). Comparative analysis of NV visualized via IOFA revealed that both the number and size of NVs were significantly lower in Groups B and C than in Group A(all P<0.0167), while no statistically significant differences were observed between Groups B and C(both P>0.05). No significant differences were found among the three groups regarding other intraoperative parameters, including operation time, frequency of electrocoagulation application, duration of high perfusion pressure, or grading of vitreoretinal adhesion(all P>0.05).CONCLUSION:IOFA confirms that preoperative anti-VEGF therapy administered 7 or 14 d before surgery is more effective than a 3 d interval in suppressing retinal NV activity in PDR patients.

Objective: To analyze the impact of premature death due to four major chronic diseases on life expectancy in Yangpu District, Shanghai Municipality from 2010 to 2021, so as to provide the evidence for formulating chronic disease prevention and control strategies. Methods : Mortality data of registered residents in Yangpu District from 2010 to 2021 were collected through the Death Information Registration and Management System of the Shanghai Municipal Disease Control and Prevention Information Management Platform. The premature death probability of malignant tumors, diabetes, cardiovascular and cerebrovascular diseases, and chronic respiratory diseases, and life expectancy of residents were calculated using the abridged life table method. Trends in premature death probability for four types of chronic diseases were analyzed using the average annual percent change (AAPC). The impact of premature death probability due to four chronic diseases on life expectancy was assessed by Arriaga's decomposition method. Results : The premature death probability due to four major chronic diseases in Yangpu District decreased from 9.88% in 2010 to 9.22% in 2021, showing an overall declining trend (AAPC=-0.540%, P<0.05). Among females, the premature death probability declined from 6.71% to 4.90% (AAPC=-2.715%, P<0.05), whereas no statistically significant trend was observed in males (P>0.05). Life expectancy increased from 82.52 years in 2010 to 84.50 years in 2021, with an overall upward trend (AAPC=0.244%, P<0.05). Life expectancy rose by 1.71 years for males and 2.34 years for females (AAPC=0.197% and 0.303%,both P<0.05). Declines in premature death probability from malignant tumors (AAPC=-0.967%, P< 0.05) and chronic respiratory diseases (AAPC=-3.071%, P<0.05) contributed to gains in life expectancy of 0.30 years and 0.03 years, with contribution rates of 12.18% and 1.29%, respectively. Changes in premature death probability due to diabetes as well as cardiovascular and cerebrovascular diseases were not statistically significant (both P>0.05), resulting in reductions in life expectancy of 0.05 years and 0.10 years, with contribution rates of -2.40% and -5.05%, respectively. Notably, an increase in premature death probability due to cardiovascular and cerebrovascular diseases among males (AAPC=1.673%) contributed to a decrease of 0.22 years in male life expectancy, whereas a decrease among females (AAPC=-3.824%) contributed to an increase of 0.03 years in female life expectancy, with contribution rates of -13.03% and 1.14%, respectively. Conclusions From 2010 to 2021, Yangpu District experienced an overall decline in premature death probability due to four major chronic diseases and an increase in life expectancy. Greater attention should be paid to the negative impacts of premature death probability from diabetes as well as cardiovascular and cerebrovascular diseases among males on life expectancy.

OBJECTIVE To form an expert consensus addressing clinical issues regarding the use of parenteral direct thrombin inhibitors （DTIs） in special populations. METHODS Led by the Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital（the Affiliated Hospital of UESTC）， a multidisciplinary working group was formed comprising experts from multiple fields， including clinical pharmacy， cardiac surgery， obstetrics， pediatrics and evidence-based medicine. Through literature review and the Delphi method， clinical questions regarding the efficacy and safety of parenteral DTIs used in special populations were identified. A structured design was adopted using the “Population-Intervention-Comparison-Outcome” （PICO） framework；systematic searches were conducted in CJFD， PubMed， Embase and other databases. Relevant evidence from randomized controlled trials，cohort studies and systematic reviews were included and synthesized. Evidence quality was assessed using the Grading of Recommendations Assessment，Development and Evaluation （GRADE） approach， and recommendations were formulated through three rounds of Delphi surveys and expert consensus meetings. RESULTS &CONCLUSIONS Seven clinical questions were ultimately selected （with a consensus rate exceeding 90%）， resulting in the formulation of seven recommendations on the use of parenteral DTIs in special populations， including children， pregnant women， patients with hepatic or renal impairment， patients with mesenteric venous thrombosis， and individuals with thrombophilia. These recommendations clarify the preferred agents， dosing ranges， monitoring parameters， and safety management strategies for parenteral DTIs in these special populations. This expert consensus， which is formulated based on the best available evidence， provides evidence-based guidance for standardized and individualized use of parenteral DTIs in special populations.

OBJECTIVE To analyze the selection and rationales of comparators for pharmaceutical enterprises in their medical insurance access application， so as to provide a reference for promoting communication and consensus between enterprises and medical insurance authorities in this process. METHODS The application materials for drugs outside the catalogue that passed formal review published by the National Healthcare Security Administration from 2021 to 2025 were extracted， and then content analysis was used to systematically sort out relevant information of the declared drugs and comparators； the specific situations and rationales of pharmaceutical enterprises’ selection of comparators were analyzed. RESULTS A total of 1 341 declared drug documents were collected. Data analysis showed that 1 035 （77.18%） were submitted with positive comparators and 306 （22.82%） used blank comparators； 58 drugs （4.33%） took combination therapy as the reference， and 5 drugs （0.37%） referred to non-pharmacological （or non-single pharmacological） treatment regimens. Among competitive drugs declared by multiple enterprises， 50.00% of the enterprises submitted different comparators. A total of 4 basic conditions and 39 additional conditions were extracted as the rationales for selecting positive comparators. For blank comparators， 12 drug-related factors， 2 administrative factors， and 1 other factor were identified. More than 10% of the drugs did not state the rationale for comparator selection， and over 44% of drugs using blank comparators provided only one justification. CONCLUSIONS Pharmaceutical enterprises mainly select comparators based on their own interests in the medical insurance access application， and there are deficiencies in the adequacy and standardization of their selection basis and reasoning. It is recommended that enterprises follow the principled requirements of medical insurance authorities， and fully and normatively explain the reasons for selecting comparators in combination with the characteristics of their own products. Meanwhile， it is advisable to change the current open-ended statement form of selection reasons into a closed-ended answering mode， so as to highlight the priority of selection， standardize the declaration behavior of enterprises， and reduce communication divergences between the two parties.

Objective To explore the feasibility of magnetic compression technique (MCR) in the treatment of severe single mid-ureteral stricture in a rabbit model. Methods After 10 female New Zealand rabbits were selected, the distal end of the right ureter was ligated with silk thread. Two weeks after the operation, when the right ureter was dilated, the mid-ureter was ligated again with silk thread to create a severe single mid-ureteral stricture animal model. Longitudinal incisions were made at the upper and lower ends of the ligation site, and cylindrical NdFeB magnets with central holes (sub-magnets and main magnets) were placed to anastomose and recanalize the mid-ureteral stricture. The magnets were adjusted to the appropriate position to automatically align and attract each other. The longitudinal incision sites of the ureter were sutured with 6-0 Prolene thread, and the abdominal cavity was closed layer by layer. The operation time was recorded. X-ray films were taken every two days to confirm the position of the magnets and record the time of magnet detachment. Three weeks after the operation, the anastomotic specimens were obtained, and the formation of the anastomosis was evaluated with gross observation and histological staining. Results Two weeks after ligation, all experimental rabbits showed obvious dilation of the right ureter. The mid-ureteral ligation and placement of the male and female magnets were successfully completed in all 10 experimental rabbits, with an operation time of (24.00±5.15)minutes. The male and female magnets attracted each other well. X-ray examination showed that the magnets detached and entered the distal ureter (14.0±1.9) days after magnetic compression. The recanalization of the severe single mid-ureteral stricture was successfully achieved. The gross specimens and histological examination of the anastomosis showed that the anastomosis remained patent and the mucosal healing was good. All experimental rabbits survived well after the operation without serious complications. Conclusion MCT provides a new idea and novel method for the treatment of mid-ureteral stricture. This study confirmed the feasibility of this technique in treating severe single mid-ureteral stricture in a rabbit model. The operation is relatively simple and has potential for clinical application.

Objective:To explore the effect of Simo decoction improving the low duodenal inflammation and protecting the du-odenal mucosal barrier in rats with functional dyspepsia(FD).Methods:Sixty SD rats were randomly divided into control group(10 rats)and model group(50 rats),and the modeling rats were prepared by multivariate intervention method.After successful modeling,the modeling rats were randomly divided into model group,Simo decoction high-dose,medium-dose,low-dose group and mosapride group,with 10 rats in each group.The high-dose,medium-dose,and low-dose groups of Simo decoction were ga-vage given 5.62 g/kg,2.81 g/kg,and 1.40 g/kg,respectively,and the mosapride group was gavage given 0.305 mg/kg of mosapride,and the control group and model group were gavage given the same amount of distilled water for 14 days.The body weight of rats was observed;gastric emptying rate and small bowel propulsion rate were measured;transmission electron microscopy was used to observe the morphology of duodenal epithelial cells;ELISA detected serum levels of IL-17A and IL-22;Western blot and immunohistochemis-try were used to detect the expressions of protease-activated receptor 2(PAR-2)and tight junction protein(ZO-1,claudin-1)in the duodenum.Results:Compared with the control group,the body weight,gastric emptying rate and small intestinal propulsion rate of the model group were significantly reduced(P<0.01),transmission electron microscopy showed widening of the duodenal epithelial cell space,serum IL-17A and IL-22 levels were significantly increased(P<0.01),the expression of PAR-2 in duodenal tissue was in-creased,and the expressions of ZO-1 and claudin-1 were downregulated(P<0.01).Compared with model group,the gastric emptying rate and small intestinal propulsion rate in Simo decoction high-dose,medium-dose and mosapride group were increased(P<0.05,P<0.01),the contents of IL-17A and IL-22 in serum decreased(P<0.05,P<0.01),and the expression of PAR-2 in duodenal tissues was down-regulated,the expressions of ZO-1 and claudin-1 was significantly increased(P<0.01).The low-dose group of Simo soup could improve weight loss(P<0.01),reduce IL-17A content and PAR-2 expression,and increase ZO-1 and claudin-1 expression(P<0.05,P<0.01),while the effect on other indexes was not obvious.Conclusion:Simo decoction may reduce low-grade duodenal in-flammation to repair the mucosal barrier by down-regulating the levels of IL-17A and IL-22 and the expression of PAR-2,and up-regu-lating the expression of ZO-1 and claudin-1,so as to exert the effect of FD treatment.

Objective:To analyze and validate the reliability and validity of the social skills improvement system-rating scales Chinese version (parent version) (SSIS-RS-C) in middle school students.Method:A total of 1 486 parents of middle school students were recruited according to the cluster sampling method.The social responsiveness scale and strengths and difficulties questionnaire were used as criterion validity tools.A retest was conducted one month later.SPSS 27.0 was used for descriptive statistics, item analysis, internal consistency test, test-retest reliability test and criterion validity test. AMOS 24.0 was used to perform confirmatory factor analysis .Results:Item analysis indicated significant positive correlations between each item and the subscales ( r=0.293-0.782, all P<0.01), with significant differences in scores between high and low groups ( t=10.079-37.038, all P<0.01).Confirmatory factor analysis supported a seven-factor structure for the social skills subscale(communication, cooperation, assertion, responsibility, empathy, engagement and self control) and a five-factor structure for the problem behavior subscale (externalizing, bullying, hyperactivity/inattention, internalizing and autism spectrum) of the SSIS-RS-C.There was a positive correlation between the social skills subscale and prosocial behavior ( r=0.637, P<0.001), and between the problem behavior subscale and social impairments and difficult behaviors ( r=0.765, 0.688, both P<0.001).The Cronbach's α coefficients for the total scale, social skills subscale and problem behavior subscale were 0.934, 0.972 and 0.963, respectively.The test-retest correlation coefficients for the total score and the two subscales were 0.665, 0.871 and 0.598, respectively (all P<0.001). Conclusion:The SSIS-RS-C demonstrated good reliability and validity in the Chinese adolescent population.

Objective To explore the distribution of traditional Chinese medicine(TCM)syndrome types of post-infection cough and their relationship with the level of airway immune characteristics and small airway function.Methods A retrospective study was conducted on 216 patients with post infection cough admitted to our hospital from January 2023 to June 2024.Syndrome information was collected and cluster analysis was performed to analyze the correlation between TCM syndrome types and airway immune characteristic indicators.According to the degree of small airway dysfunction,the patients were divided into mild group(n=74),moderate group(n=84)and severe group(n=53).The correlation between airway immune characteristic indicators and small airway function indicators was analyzed,and the relationship between small airway dysfunction degree and TCM syndrome was also correspondingly analyzed.Results In terms of TCM,cough after infection could be divided into five types:wind-heat stagnation of the lung syndrome,wind-cold invasion of the lung syndrome,phlegm-dampness accumulation in lung syndrome,liver fire invading the lung syndrome,and qi-yin deficiency syndrome.Patients with qi-yin deficiency syndrome had specific airway immune characteristics,with an increase in the proportion of neutrophils,eosinophils and lymphocytes,a decrease in the proportion of macrophages(P＜0.05),an increase in the levels of inflammatory factors IL-17 and TNF-α,and a decrease in the levels of IL-10 and TGF-β.The wind-cold attacking lung syndrome and qi-yin deficiency syndrome were positively correlated with the proportion of neutrophils,eosinophils and lymphocytes,while negatively correlated with the proportion of macrophages(P＜0.05).Qi-yin deficiency syndrome was positively correlated with IL-17 and TNF-α levels,while negatively correlated with IL-10 and TGF-β levels(P＜0.05).As the degree of small airway dysfunction worsened,the proportion of neutrophils,eosinophils and lymphocytes increased(P＜0.05),the proportion of macrophages decreased(P＜0.05),the levels of inflammatory factors IL-17 and TNF-αincreased,and the levels of IL-10 and TGF-β decreased(P＜0.05).The indicators of small airway function(FVC％pred,FEV1％pred,FEV1/FVC,PEF％pred,FEF25％pred,FEF50％pred,FEF75％pred,FEF25-75％pred)were negatively correlated with the proportion of neutrophils,eosinophils and lymphocytes,the levels of inflammatory factors IL-17 and TNF-α(P＜0.05),while positively correlated with the proportion of macrophages,the levels of IL-10 and TGF-β(P＜0.05).Conclusion This study not only reveals the correlation of different TCM syndromes of cough after infection with airway immune characteristics and small airway function,but also clarifies the immunological characteristics of qi-yin deficiency syndrome as a key syndrome type,and confirms that the immune imbalance pattern of high neutrophil proportion and low macrophage level in this syndrome type is specifically associated with severe small airway dysfunction.

Objective:To explore the protective effect of knock-down the expression of B lymphocyte induced maturation protein 1(Blimp1)gene on early liver injury in carbon tetrachloride(CCl4)-induced mouse model of liver fibrosis.Methods:C57BL/6 mice were intraderitoneal injected with 5％CCl4 olive oil solution to create mouse model of hepatic fibrosis.The expression of Blimp1 gene in the mice was re-duced by intraderitoneal injection of short hairpin RNA(shRNA)adeno-associated virus(AAV).The mice were randomly divided into 3 groups:blank test group(n=10),CCl4+AAV-shRNA-NC group(n=10)and CCl4+AAV-shRNA-Blimp1 group(n=10).After 27 days of preparation of the CCl4 mouse model,animal materials were carried out.Western blot and real-time PCR were used to detect the levels of Blimp1,α-smooth muscle actin(α-SMA),collagen type Ⅰ alpha 1(COL1A1),collagen typeⅢ alpha 1(COL3A1),and their mRNA expression levels of liver tissue in each group.The serum of each group was separated to measure aspartate transaminase(AST)and alanine transaminase(ALT)by automatic biochemical analyzer.The pathological changes of liver tissue and the degree of liver fibrosis in the mice were detected by pathological staining including hematoxylin-eosin staining,Masson,and Sirius red.Results:The expression levels of Blimp1 protein in the liver of CCl4+AAV-shRNA-NC group(2.036±0.244,t=3.690,P=0.002)were significantly increased than that of the blank test group.In the CCl4+AAV-shRNA-Blimp1 group,the expression of Blimp1 protein decreased to the basal level(0.783±0.249,t=6.223,P=0.003).Compared with the serum levels of ALT[(1 957.8±633.6)U/L]and AST[(1 808.8±260.1)U/L]in the CCl4+AAV-shRNA-NC group,the serum levels of ALT[(894.0±360.1)U/L,t=3.998,P=0.003]and AST[(820.0±100.6)U/L,t=6.141,P=0.004]in the CCl4+AAV-shRNA-Blimp1 group were significantly decreased.The pathological re-sults of the CCl4+AAV-shRNA-Blimp1 group showed that compared with the CCl4+AAV-shRNA-NC group,the infiltration of inflammatory cells in the liver tissue was reduced and the degree of fibrosis was alleviated.The level of α-SMA(0.676±0.064,t=7.930,P=0.001),COL1A1(1.426±0.143,t=6.364,P=0.003)and COL3A1(1.124±0.198,t=3.440,P=0.026)of liver in the CCl4+AAV-shRNA-Blimp1 group were significantly decreased than that of CCl4+AAV-shRNA-NC group,and the mRNA expression levels were altered as well as their protein levels.Conclusion:Blimp1 plays an important role in CCl4-induced liver fibrosis in mice,and knock-down the expression of Blimp1 gene is beneficial to protect early liver injury in mice.