In 2022， Hainan provincial government launched the project for the prevention and control of viral hepatitis with the goals of a hepatitis B screening rate of 90%， a diagnostic rate of 90%， and a treatment rate of 80% among people aged 18 years and above by the year 2025， and the main intervention measures include population-based prevention， case screening， antiviral therapy， and health management. As of December 31， 2024， a total of 6.875 million individuals in the general population had been screened for hepatitis B， with a screening rate of 95.6%. A total of 184 710 individuals with positive HBsAg were identified， among whom 156 772 were diagnosed through serological reexamination， resulting in a diagnostic rate of 84.9%. A total of 50 742 patients with chronic hepatitis B were identified， among whom 42 921 had hepatitis B-specific health records established for health management， with a file establishment rate of 84.6%. A total of 31 553 individuals received antiviral therapy， with a treatment rate of 62.2%. A total of 2.503 million individuals at a high risk of hepatitis C were screened， among whom 4 870 tested positive for HCV antibody and 3 858 underwent HCV RNA testing， resulting in a diagnostic rate of 79.2%， and 1 824 individuals with positive HCV RNA were identified， among whom 1 194 received antiviral therapy， with a treatment rate of 65.5%. In addition， 159 301 individuals with negative HBsAg and anti-HBs and an age of 20 — 40 years were inoculated with hepatitis B vaccine free of charge. Through the implementation of the project for the prevention and control of viral hepatitis， a large number of hepatitis patients have been identified， treated， and managed in the province within a short period of time， which significantly accelerates the efforts to eliminate the crisis of viral hepatitis.

ObjectiveTo explore the effect of Shenge Bushen Capsules （SBC） on sexual development in normal 3-week-old mice. MethodsThe experiment consisted of two parts. In the first part， mice were divided into four groups： The control group and the low， medium， and high-dose SBC groups （234.7， 469.4， 938.7 mg·kg^-1， respectively）. In the second part， mice were divided into four groups： Control group， Pseudostellariae Radix polysaccharide （PRP） group， total flavonoids group， and SBC group， all receiving a dose of 469.4 mg·kg^-1. After 7 days of administration， the vaginal opening of female mice and the descent of testes and scrotum in male mice， as well as the ovarian and testicular organ indices， were observed. After 4 weeks of administration， female and male mice were housed together for 2 days， and the pregnancy rate of females was monitored. After delivery， the pregnant female mice continued receiving the treatment for 4 weeks， and the sexual development of their offspring， including vaginal opening， testicular descent， and organ indices of ovaries and testes， was observed. Serum sex hormones were measured by enzyme-linked immunosorbent assay （ELISA）， and the expression of gonadotropin-releasing hormone （GnRH） and growth hormone （GH） proteins in the hypothalamus was assessed by Western blot. ResultsCompared with the control group， there was no significant effect on the vaginal opening of female mice or the descent of testes in male mice after 7 days of SBC administration. After 4 weeks of administration， the pregnancy rate in the low-dose group was significantly reduced （P<0.05）， but no significant effects were observed in the other groups. The three doses of SBC did not significantly affect the ovarian or testicular organ indices， and there was no significant upregulation in the expression of GnRH or GH in the hypothalamus. The primary component of SBC， Pseudostellariae Radix polysaccharide， significantly reduced the vaginal opening in female mice after 7 days of administration （P<0.05）. After 4 weeks， the serum estradiol levels of non-pregnant female mice were decreased （P<0.05）， but there was no significant effect on the expression of GnRH or GH proteins in the hypothalamus of either male or female mice. Additionally， there were no significant effects on precocious puberty indicators， such as vaginal opening and testicular descent， in the offspring mice. ConclusionSBC does not significantly promote precocious puberty in young mice， and it does not have any noticeable effects on the pregnancy rate of adult mice or the sexual development of their offspring.

Objective: To investigate the availability and use of child safety seats among children aged 0-3 years, so as to provide the basis for improving riding safety for children. Methods: Parents of children aged 0-3 years in Huangpu District, Shanghai Municipality, were recruited using the stratified multistage random sampling method from May to July 2024. Demographic information, family travel patterns, the use of child safety seat and related health beliefs were collected using questionnaire surveys. Factors affecting the use of child safety seats were identified using a multivariable logistic regression model. Results: Totally 514 valid questionnaires were recovered, with an effective rate of 96.98%. The respondents included 122 fathers (23.74%) and 392 mothers (76.26%), with a median age of 34.00 (interquartile range, 5.00) years. There were 446 families equipping with child safety seats, accounting for 86.77%; and 169 families using child safety seats, accounting for 32.88%. Multivariable logistic regression analysis showed that the parents who had children aged >1-2 years (OR=0.597, 95%CI: 0.366-0.973), travelled 2-4 times per month (OR=0.359, 95%CI: 0.213-0.607) or once per month or less (OR=0.384, 95%CI: 0.202-0.729), and scored high in perceived barrier (OR=0.634, 95%CI: 0.486-0.827) were less likely to use child safety seats; the parents who had children with local household registration (OR=2.506, 95%CI: 1.356-4.633), travelled 5-<10 km (OR=1.887, 95%CI: 1.148-3.101) or ≥10 km (OR=2.319, 95%CI: 1.355-3.967), always wore seat belts (OR=2.342, 95%CI: 1.212-4.524), scored high in perceived susceptibility (OR=1.392, 95%CI: 1.091-1.778) and self-efficacy (OR=1.413, 95%CI: 1.156-1.727) were more likely to use child safety seats. Conclusions Equipping family cars with child safety seats and using them can prevent and reduce traffic injuries among children aged 0-3 years. It is recommended to strengthen publicity to promote the use of child safety seats.

Background::Clinical opportunistic screening is a cost-effective cancer screening modality. This study aimed to establish an easy-to-use diagnostic model serving as a risk stratification tool for identification of individuals with malignant gastric lesions for opportunistic screening.Methods::We developed a questionnaire-based diagnostic model using a joint dataset including two clinical cohorts from northern and southern China. The cohorts consisted of 17,360 outpatients who had undergone upper gastrointestinal endoscopic examination in endoscopic clinics. The final model was derived based on unconditional logistic regression, and predictors were selected according to the Akaike information criterion. External validation was carried out with 32,614 participants from a community-based randomized controlled trial.Results::This questionnaire-based diagnostic model for malignant gastric lesions had eight predictors, including advanced age, male gender, family history of gastric cancer, low body mass index, unexplained weight loss, consumption of leftover food, consumption of preserved food, and epigastric pain. This model showed high discriminative power in the development set with an area under the receiver operating characteristic curve (AUC) of 0.791 (95% confidence interval [CI]: 0.750–0.831). External validation of the model in the general population generated an AUC of 0.696 (95% CI: 0.570–0.822). This model showed an ideal ability for enriching prevalent malignant gastric lesions when applied to various scenarios.Conclusion::This easy-to-use questionnaire-based model for diagnosis of prevalent malignant gastric lesions may serve as an effective prescreening tool in clinical opportunistic screening for gastric cancer.

Objective:To systematically evaluate the qualitative researches on cardiac telerehabilitation experience of patients with cardiovascular disease (CVD), so as to provide reference for clinical development and improvement of cardiac telerehabilitation services.Methods:Qualitative studies on cardiac telerehabilitation experience of CVD patients in PubMed, Web of Science, Embase, CINAHL, Cochrane Library, Scopus, China National Knowledge Infrastructure, China Biology Medicine disc, Wanfang Database and VIP were searched by computer. The search period was from establishment of the databases to August 2023. The quality of the literature was evaluated according to the quality evaluation criteria of the Evidence-Based Health Care Center of the Joanna Briggs Institute in Australia, and the results were integrated by aggregative integration method.Results:A total of 13 articles were included, 52 research results were extracted and classified into 11 categories. Four integrated results were formed, including the benefits, promoting factors, obstacle, expectations and suggestions for cardiac telerehabilitation experience in CVD patients.Conclusions:CVD patients benefit significantly from participating in cardiac telerehabilitation. In the future, it is supposed to pay more attention to the factors that affect patients' participation in cardiac telerehabilitation, actively develop domestic cardiac telerehabilitation tools and optimize the cardiac telerehabilitation model according to the needs and suggestions of patients.

Objective:To investigate the relationship between walking speed, life-space mobility (LSM), cognitive function and mild cognitive impairment (MCI) in elderly patients with type 2 diabetes mellitus in community, and compare the predictive value of walking speed and LSM alone and combined in elderly patients with type 2 diabetes mellitus.Methods:This was a cross-sectional study. Using the convenient sampling method, a total of 448 elderly patients with type 2 diabetes mellitus from three communities in Hefei City were selected as the research objects from September 2022 to May 2023. Daily walking speed was measured using the 4-Meter Walking Speed, LSM was assessed using the Chinese version of Life-Space Assessment (LSA), and cognitive function was evaluated using the Chinese version of Montreal Cognitive Assessment (MoCA). Participants were divided to the MCI group and non-MCI group. Spearman correlation analysis was used to explore the relationships between walking speed, LSM and cognitive function. Logistic regression analysis was used to analyze the relationship between walking speed, LSM and MCI. Area under the curve ( AUC) of receiver operating characteristic (ROC) curve analysis was performed to compare the effects of walking speed and Chinese version LSA score on the prediction of MCI alone and in combination. Results:The walking speed and the Chinese version LSA score were both positively correlated with the Chinese version MoCA score ( r=0.598, 0.543; P<0.05). Chinese version LSA score ( OR=0.942) and walking speed score ( OR=0.490) were influencing factors for MCI in elderly patients with type 2 diabetes mellitus ( P<0.05). The AUC for walking speed in predicting MCI was 0.875, with a cutoff value of 3 points. Chinese version LSA score in predicting MCI had an AUC of 0.887 with a cutoff value of 59 points. When used in combination, they achieved an AUC of 0.915, with cutoff values of 55 points for Chinese version LSA scores and 3 points for walking speed scores. Conclusions:The combination of walking speed and LSM can more accurately predict the occurrence of MCI in elderly patients with type 2 diabetes mellitus than the single application, which provide a reference for improving the cognitive function of elderly patients with type 2 diabetes mellitus.

The goal of Medical Immunology is to enable students to pay attention to integration of immunology theory with clini-cal practice,be familiar with professional English,consciously pay attention to cutting-edge knowledge,and can learn independently and lifelong.However,existing teaching models lack explanation of clinical disease related events,and arrangement of experimental content and projects is seriously disconnected from clinical practice,scientific research on solving clinical problems is clearly insuffi-cient.We established a"B to B"cycle model for immunology teaching by starting from clinical practical problems(Bedside),return to basic research(Bench),and then solve clinical problem(Bedside),which will comprehensively cultivate senior medical profession-als with clinical competence,scientific research thinking ability,innovative spirit,and international perspective.

Objective:To explore the chain mediating effect of self-rated health and aging attitudes on the relationship between life space and psychological distress of community-dwelling older adults.Methods:From August to November 2023, convenience sampling was used to select older adults from three communities of Baohe District in Hefei City as subjects. General Information Questionnaire, Life Space Assessment (LSA), Self-Rated Health (SRH), Attitudes to Aging Questionnaire (AAQ), and 10-item Kessler Psychological Distress Scale (K10) were used for the survey. Spearman correlation was used to analyze the correlation between life space and self-rated health, aging attitudes, and psychological distress. Process macro program of SPSS 25.0 software was used to test for mediating effects.Results:A total of 700 questionnaires were distributed and 669 valid questionnaires were collected, with a valid response rate of 95.57%. Among 669 community-dwelling older adults, the LSA, SRH, AAQ, and K10 scores were (74.35±19.39), (3.23±0.96), (80.66±13.43), and (19.29±6.26), respectively. Spearman correlation analysis showed a positive correlation between life space and attitudes to aging ( rs=0.568, P<0.01) and negative correlations between life space and self-rated health and psychological distress ( rs=-0.334 and -0.455; both P<0.01). The mediating effect test showed that self-rated health and aging attitudes had chain mediating effects on life space and psychological distress, with a mediating effect value of -0.053, accounting for 11.60% of the total effect. Conclusions:Life space can not only directly affect the psychological distress of community-dwelling older adults but also indirectly predict psychological distress through the mediating effect of self-rated health and aging attitudes.

Objective:To analyze the efficacy, safety and learning curve of Thulium laser enucleation of the prostate by laser controller(LC-THuLEP) anchored at six o'clock position of the bladder neck in the treatment of benign prostatic hyperplasia(BPH) with large gland.Methods:The clinical data of the 1st to 45th BPH cases with large gland(prostate volume> 80 ml) treated by a doctor with LC-THuLEP anchored at six o'clock position of bladder neck in Shanghai East Hospital from January to October 2022 were retrospectively analyzed. The patients were divided into groups A, B and C according to the order of operation time, with 15 cases in each group. There were no significant differences among the three groups( P>0.05) in age[(71.8±9.4)years old vs. (73.5±8.2) years old vs.(71.4±5.5)years old], prostate volume[88.3(84.8, 100.6)ml vs.91.5(86.1, 118.4)ml vs. 94.5(84.7, 101.8)ml], prostate specific antigen(PSA)[4.8(2.9, 8.5)ng/ml vs. 7.2(3.2, 11.2)ng/ml vs. 7.8(4.5, 12.7)ng/ml], postvoid residual volume[44.0(34.0, 67.0)ml vs. 60.0(40.0, 76.0)ml vs. 39.0(0, 59.0)ml], maximum urine flow rate(Q max)[8.4(7.6, 11.1)ml/s vs. 8.6(6.5, 10.6)ml/s vs. 10.4(7.8, 13.2)ml/s], international prostate symptom score(IPSS)[20(18, 21) vs. 20(20, 22) vs. 20(20, 25)]and quality of life(QOL)[4(4, 5) vs. 4(4, 4) vs. 4(3, 5)].The doctor had more than 100 cases of TURP surgery experience. LC-THuLEP anchored at six o'clock position of bladder neck was described as follows. The bladder neck at six o'clock position is reserved 0.5-1.0 cm as an "anchor" to fix the prostatic bladder neck when the gland was pushed directly by the laser controller, preventing the detached prostate gland from turning. Finally the bladder neck was cut off at six o'clock position, and the prostate was en-bloc removed. The effect of surgery and postoperative complications were compared. The enucleation efficiency was equal to the weight of prostate tissue removed divided by the time of enucleation. Results:The differences among the three groups in operation time [100.0(90.0, 110.0)min vs. 80.0(70.0, 90.0)min vs. 75.0(70.0, 90.0)min], enucleation time[89.0(72.0, 97.0)min vs. 67.0(64.0, 77.0)min vs. 64.0(60.0, 77.0)min] and the efficiency of enucleation [0.65(0.62, 0.68)g/min vs. 0.84(0.83, 0.94)g/min vs. 0.93(0.82, 1.00)g/min] were statistically significant( P<0.05). The operation time and enucleation time in groups B and C were significantly lower than those in group A, and the enucleation efficiency was significantly higher than that in group A( P<0.05), while there was no significant difference between group B and C. However, the difference of three groups in hemoglobin decrease [8.0(5.0, 11.0)g/L vs. 7.0(2.0, 10.0)g/L vs. 11.0(4.0, 16.0)g/L] and catheter indwelling duration[4.0(2.0, 6.0)d vs. 6.0(3.0, 7.0)d vs. 4.0(3.0, 6.0)d] were not statistically different( P>0.05). All patients were followed up for 6 months after surgery. In three groups, postoperative Q max were 23.2(21.0, 25.1)ml/s, 22.7(21.1, 26.1)ml/s and 22.9(21.5, 25.7)ml/s, IPSS were 6(5, 8), 7(6, 8) and 7(7, 8), QOL were 2(1, 2), 2(1, 2) and 2(1, 2), postvoid residual volume were 20.0(10.0, 25.0)ml, 22.0(15.0, 25.0)ml and 5.0(0, 25.0)ml, respectively, which were all significantly different from that of pre-operation( P<0.05).However, there were no statistically significant differences in the postoperative indicators among the three groups ( P>0.05). No statistical difference was found in postoperative complications among the three groups[26.7%(4/15) vs. 20.0%(3/15) vs. 20.0%(3/15), P>0.05]. Conclusions:LC-THuLEP anchored at six o'clock position of bladder neck was an effective operation in the treatment of BPH with large gland, and the learning curve could be reached after 15 cases.

Objective:To investigate the microsurgical efficacy of large primary intracranial solitary fibrous tumor and influencing factors for its prognoses.Methods:From January 2010 to December 2022, 47 patients with large primary intracranial solitary fibrous tumor admitted to and accepted microsurgery in Department of Neurosurgery, Wuhan Central Hospital and Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, were enrolled. The clinical data, microsurgical efficacy and follow-up results of these patients were retrospectively analyzed, and influencing factors for total resection and prognoses were determined.Results:Thirty-two patients had tumor within the supratentorial region and 15 in the mandibular region, including 24 with sinus involved tumor. According to 2021 WHO Classification of Tumors of the Central Nervous System, 5 patients (10.6%) had grading 1, 32 (68.1%) grading 2, and 10 (21.3%) grading 3. Total resection was achieved in 31 patients (66.0%) and subtotal resection in 16 patients (34.0%). Postoperative complications, such as intraoperative hemorrhage, distant epidural hematoma and subcutaneous effusion, occurred in 7 patients (14.9%) and they were cured after secondary hematoma removal or conservative treatment; residual limb mobility disorder occurred in 3 patients, visual impairment in 3, and postoperative seizures in 2. Adjuvant radiotherapy was performed in 13 patients (27.7%). Follow-up was performed for (69.1±29.6) months and 29 patients (61.7%) had recurrent tumors (6 with intracranial and extracranial metastases and 4 deaths). Mean progression-free survival was (57.5±25.1) months; the 1-, 3-, and 5-year progression-free survival rates were 95.7%, 87.2%, and 59.6%, respectively. Sinus involvement was the independent influencing factor for total tumor resection; and total resection was an independent protective factor for progression-free survival for large primary intracranial solitary fibrous tumor ( HR=4.291, 95% CI: 1.555-11.838, P=0.005). Conclusion:Patients with large primary intracranial solitary fibrous tumor have a high recurrent risk after surgery; and gross-total resection should be strived to prevent tumor recurrence.