Objective: To understand the epidemiological characteristics and disease burden of influenza like illness (ILI) among student populations, so as to provide data support for policy formulation and optimal allocation of health resources. Methods: From January 2024 to February 2025, a questionnaire survey was conducted among parents of kindergarten, primary school, junior and senior high school students in 9 districts of Shenzhen, including Longhua, Futian, Bao an, Longgang, Luohu, Nanshan, Guangming, Pingshan and Yantian. Parents were asked to complete the questionnaire based on whether their children had fever, cough, vomiting, diarrhea, rash and other common symptoms in 2024. A total of 3 537 parents were investigated, and 444 ILI cases were included as study subjects. The epidemiological burden, including incidence rate of influenza, visitation rate, years lived with disability (YLDs) and economic burden (including direct economic burden, indirect economic burden and intangible burden) were analyzed. Results: The incidence rate of influenza among students in Shenzhen in 2024 was 12.55%. The ILI incidence rates in kindergarten, primary school, junior and senior high school were 14.01%, 11.69% and 5.23%, respectively, with a statistically significant difference ( χ 2= 45.20, P <0.01). The ILI consultation rate among students was 85.36%, and the consultation rates in kindergarten (87.36%) and primary school students (84.62%) were higher than those in junior and senior high school students ( 56.52 %) ( χ 2=16.47, P <0.01). A total of 78.88% of cases did not receive etiological detection.The median total economic burden per ILI case was 2 354.62 yuan, including direct medical costs of 300.00 yuan, direct non medical costs of 212.50 yuan, indirect costs of 1 000.00 yuan, and intangible burden of 500.00 yuan. Conclusions Schools are high risk environment for influenza, and younger students are a high risk group for ILI. The disease burden caused by student ILI remains substantial.

Objective:To explore the application effects of a method combining progressive case study and fishbone diagram in clinical teaching of interns in general surgery, and evaluate its impact on medical students' theoretical knowledge mastery, clinical practice ability development, and systematic thinking cultivation.Methods:Sixty undergraduate clinical medicine students who interned in the Department of General Surgery from July 2022 to December 2023 were selected as the research subjects and randomly divided into a control group ( n=30) and an observation group ( n=30). The control group received traditional case-based teaching through centralized lectures, group discussions, and review/Q&A sessions. The observation group received an integrated teaching approach combining progressive case study and fishbone diagram through the design of progressive cases and fishbone diagrams. Teaching effectiveness was evaluated through theoretical assessment, practical assessment, and teaching satisfaction survey. SPSS 22.0 was used for t-test and χ2 test. Results:The total score of theoretical assessments for the observation group interns was higher than that of the control group [(86.97±4.60) vs. (66.06±5.96), t=-17.79, P<0.001]. The differences in scores of diagnosis and treatment standards [(17.03±1.82) vs. (14.07±2.35)] and differential diagnosis [(12.85±1.42) vs. (8.92±2.37)] were particularly significant. In the practical assessments, the total score of the observation group interns [(90.19±5.04) vs. (68.63±4.30), t=-17.82, P<0.001] and their scores in individual assessments were higher than those of the control group, especially in acute abdomen evaluation [(18.23±1.72) vs. (14.37±2.05)], laparoscopic spatial positioning [(8.83±0.95) vs. (5.92±1.38)], and intraoperative emergency management [(8.95±0.97) vs. (6.05±1.23)]. The satisfaction scores of the observation group interns were higher than those of the control group ( P<0.001), with the greatest improvement in clinical thinking [(4.65±0.61) vs. (3.10±0.71)] and teacher-student interaction quality [(4.72±0.53) vs. (3.11±0.63)]. Conclusions:The teaching method combining progressive case study and fishbone diagram significantly improved interns' theoretical assessment scores, practical operation ability, and clinical decision-making level through the dynamic presentation of case evolution processes and the application of structured analysis tools, and also enhanced the teaching satisfaction.

Objective:To evaluate the efficacy of combined cricopharyngeal myotomy (CPM) and autologous fat injection laryngoplasty (AFIL) in the management of dysphagia secondary to glossopharyngeal and vagal nerve injury.Methods:This retrospective cohort study collected the clinical data of 18 patients with persistent dysphagia due to glossopharyngeal and vagus nerve injuries, who underwent concurrent cricopharyngeal myotomy (CPM) and autologous fat injection laryngoplasty (AFIL) at the Department of Otolaryngology, Peking Union Medical College Hospital, from January 2017 to December 2024. Pre-and postoperative assessments included electronic flexible laryngoscope, the Chinese version of Swallow Quality-of-Life Questionnaire (CSWAL-QOL), videofluoroscopic swallowing study (VFSS), body weight changes, and nasogastric tube (NGT) removal status with routine follow-up. The comparison of swallowing function before and after surgery was conducted using paired samples t-test and χ2 test. Results:The study cohort comprised 10 male and 8 female patients, with ages ranging from 33 to 70 years (mean±SD: 53.8±10.5). All surgical procedures were completed successfully without complications. During the 6-to 24-month follow-up period, 10 of the 13 patients who were initially nasogastric tube-dependent achieved successful decannulation. Compared with preoperative values, postoperative measurements demonstrated statistically significant improvements across all parameters: mean body weight increased from (56.95±9.14) kg to (59.22±8.72) kg ( t=3.689 , P<0.01), CSWAL-QOL scores improved from 91.89±17.81 to 130.83±25.42 ( t=6.921 , P<0.01), while, both VFSS scales showed marked reductions (VFSS-SWAL: 6.78±1.40 to 3.39±1.61, t=-8.001, P<0.01; PAS: 6.56±1.15 to 2.94±1.26, t=-10.114, P<0.01). Conclusions:Combined CPM and AFIL represents an effective surgical approach for dysphagia following glossopharyngeal and vagal nerve injury, thereby demonstrating significant improvements in both swallowing function and quality of life.

Objective To observe the impact factors of vascular heat sink effect during in vitro microwave ablation(MWA)of porcine lung.Methods Simulation models were established using in vitro porcine lung tissue blocks based on isobaric inflation with an air pump and cyclic perfusion of duck blood with a glass tube and peristaltic pump,etc.MWA was performed under 8 different combining conditions(vessel diameter of 3 or 5 mm,blood perfusion of 30 or 50 cm/s,as well as distance between vessel and ablation antenna of 5 or 10 mm)each for 3 times.The highest temperature TV on vessel side and TC on control side during MWA,and ablation depth DV on vessel side and DC on control side after MWA were recorded.Multi-factor linear regression equations were constructed based on simulated vessel diameters,blood perfusion and distance between vessel and ablation antenna,and the impact factors of|TC-TV|and|DC-DV|were screened,respectively.Results Simulated vessel diameter showed linear positive correlation with both|TC-TV|and|DC-DV|(both P＜0.001).Simulated distance between vessel and ablation antenna showed linear negative correlation with both|TC-TV|and|DC-DV|(both P＜0.001),and the latter had more obvious impact on vascular heat sink effect than the former.Meanwhile,no significant linear relationship was found between simulated blood perfusion and|TC-TV|nor|DC-DV|(both P＞0.05).Conclusion Simulated vessel diameter and distance between vessel and ablation antenna were both impact factors of vascular heat sink effect during in vitro MWA of porcine lung,and the latter was more influential,whereas simulated blood perfusion showed no significant impact on it.

Objective To systematically evaluate robot-assisted gait training(RAGT)on motor function,ambulation and activities of daily living of patients after stroke and spinal cord injury(SCI),and to investigate the clinical value of differ-ent robotic technologies and control strategies.Methods In accordance with PRISMA guidelines,relevant randomized controlled trials(RCTs)published between 2020 and 2024 were identified from databases including Scopus,Web of Science,PubMed,Cochrane Library and CNKI.The PEDro scale was used to assess methodological quality,and a comprehensive analysis was performed on the therapeutic effects of RAGT on walking ability,balance,lower limb muscle strength and functional inde-pendence.Results Eight RCTs involving 702 participants were included,originating from countries such as China,Italy,India,Tur-key and Poland.The population consisted of adult patients with various subtypes of stroke or SCI.These studies were published in journals across geriatric neuroscience,biosciences,medicine and sports science.Interventions involved three categories of lower limb exoskeleton including treadmill-based systems(end-effector and exoskel-eton models),overground exoskeletons and specialized joint/platform-based robots.The training frequency was 20 to 45 minutes a time,once to twice a day,one to seven days a week,for a total of two to ten weeks.RAGT might significant improve gait parameters and lower limb muscle strength,though its impact on functional inde-pendence was heterogeneous.Adaptive control strategies(e.g.,assist-as-needed)proved superior to fixed-parame-ter modes.Treadmill-based systems(e.g.,Lokomat)were well-suited for early-stage rehabilitation,while over-ground exoskeletons(e.g.,EKSO-GT)better facilitated adaptation to real-world environments.Conclusion RAGT is an effective modality for improving gait and lower limb function of patients with stroke and SCI.The therapeutic outcome is contingent upon personalized setup of the exoskeleton and the implementation of adaptive control strategies.Different adaptive control modes have been developed for the three main types of lower limb exoskeleton.Rehabilitation training should consider the specific lower limb tasks with the robot's cor-responding adaptive movement and control modes.

Objective To systematically evaluate robot-assisted gait training(RAGT)on motor function,ambulation and activities of daily living of patients after stroke and spinal cord injury(SCI),and to investigate the clinical value of differ-ent robotic technologies and control strategies.Methods In accordance with PRISMA guidelines,relevant randomized controlled trials(RCTs)published between 2020 and 2024 were identified from databases including Scopus,Web of Science,PubMed,Cochrane Library and CNKI.The PEDro scale was used to assess methodological quality,and a comprehensive analysis was performed on the therapeutic effects of RAGT on walking ability,balance,lower limb muscle strength and functional inde-pendence.Results Eight RCTs involving 702 participants were included,originating from countries such as China,Italy,India,Tur-key and Poland.The population consisted of adult patients with various subtypes of stroke or SCI.These studies were published in journals across geriatric neuroscience,biosciences,medicine and sports science.Interventions involved three categories of lower limb exoskeleton including treadmill-based systems(end-effector and exoskel-eton models),overground exoskeletons and specialized joint/platform-based robots.The training frequency was 20 to 45 minutes a time,once to twice a day,one to seven days a week,for a total of two to ten weeks.RAGT might significant improve gait parameters and lower limb muscle strength,though its impact on functional inde-pendence was heterogeneous.Adaptive control strategies(e.g.,assist-as-needed)proved superior to fixed-parame-ter modes.Treadmill-based systems(e.g.,Lokomat)were well-suited for early-stage rehabilitation,while over-ground exoskeletons(e.g.,EKSO-GT)better facilitated adaptation to real-world environments.Conclusion RAGT is an effective modality for improving gait and lower limb function of patients with stroke and SCI.The therapeutic outcome is contingent upon personalized setup of the exoskeleton and the implementation of adaptive control strategies.Different adaptive control modes have been developed for the three main types of lower limb exoskeleton.Rehabilitation training should consider the specific lower limb tasks with the robot's cor-responding adaptive movement and control modes.

Objective:To explore the application effects of a method combining progressive case study and fishbone diagram in clinical teaching of interns in general surgery, and evaluate its impact on medical students' theoretical knowledge mastery, clinical practice ability development, and systematic thinking cultivation.Methods:Sixty undergraduate clinical medicine students who interned in the Department of General Surgery from July 2022 to December 2023 were selected as the research subjects and randomly divided into a control group ( n=30) and an observation group ( n=30). The control group received traditional case-based teaching through centralized lectures, group discussions, and review/Q&A sessions. The observation group received an integrated teaching approach combining progressive case study and fishbone diagram through the design of progressive cases and fishbone diagrams. Teaching effectiveness was evaluated through theoretical assessment, practical assessment, and teaching satisfaction survey. SPSS 22.0 was used for t-test and χ2 test. Results:The total score of theoretical assessments for the observation group interns was higher than that of the control group [(86.97±4.60) vs. (66.06±5.96), t=-17.79, P<0.001]. The differences in scores of diagnosis and treatment standards [(17.03±1.82) vs. (14.07±2.35)] and differential diagnosis [(12.85±1.42) vs. (8.92±2.37)] were particularly significant. In the practical assessments, the total score of the observation group interns [(90.19±5.04) vs. (68.63±4.30), t=-17.82, P<0.001] and their scores in individual assessments were higher than those of the control group, especially in acute abdomen evaluation [(18.23±1.72) vs. (14.37±2.05)], laparoscopic spatial positioning [(8.83±0.95) vs. (5.92±1.38)], and intraoperative emergency management [(8.95±0.97) vs. (6.05±1.23)]. The satisfaction scores of the observation group interns were higher than those of the control group ( P<0.001), with the greatest improvement in clinical thinking [(4.65±0.61) vs. (3.10±0.71)] and teacher-student interaction quality [(4.72±0.53) vs. (3.11±0.63)]. Conclusions:The teaching method combining progressive case study and fishbone diagram significantly improved interns' theoretical assessment scores, practical operation ability, and clinical decision-making level through the dynamic presentation of case evolution processes and the application of structured analysis tools, and also enhanced the teaching satisfaction.

The aim of this study is to investigate the preventive and therapeutic effects,as well as possible mechanisms,of Modified Ma Xing Shi Gan Decoction.The in vitro antibacterial experi-ment investigated its inhibitory effect on Mannheimia haemolytica of goat origin.The mouse ex-periment included a control group,a prevention group,an infection group,and a treatment group(high and low doses).The prevention group mouse were given 4 g/kg of the Modified Ma Xing Shi Gan Decoction before infection.The high-dose treatment group mouse and low-dose treatment group mouse were given 5 and 3 g/kg of the Modified Ma Xing Shi Gan Decoction after infection,respectively.TLRs/NF-κB receptor-related genes and inflammatory cytokine transcription levels were detected used qPCR.The results showed that the lung pathology of the prevention group mouse was less severe,and neutrophils,monocytes,and CRP were significantly reduced.The respiratory rate of the treatment group mouse decreased,and the lung pathology was significantly alleviated.In the high-dose treatment group,lung index,white blood cells,neutrophils,and CRP were significantly decreased,and monocytes,ALT,ALP were also decreased.In the low-dose treat-ment group,lung index,monocytes,neutrophils,and ALT were significantly decreased,while ALP was extremely significantly decreased.The transcription levels of TLR2,TLR6,MyD88,and IL-6 were significantly decreased in the high-dose treatment group,and the transcription levels of NF-κb1 and TNF-α were extremely significantly decreased.In conclusion,Modified Ma Xing Shi Gan Decoction has in vitro antibacterial activity and has a certain preventive and good therapeutic effect.The possible mechanism of action of the modified Ma Xing Shi Gan Decoction is to down-regulate the transcriptional level of TLRs/NF-κB signaling pathway-related genes and inhibit the secretion of inflammatory cytokines such as TNF-α and IL-6.

Tissue-resident memory T cells(TRM)are a key immune memory cell type responsible for the recurrence of many skin diseases.TRM cells remain in the skin tissue following infection or injury and maintain immune memory by forming a memory reservoir.When the same or similar external stimuli are encountered again,TRM cells can be rapidly activated,releasing inflammatory cytokines and cytotoxic substances,leading to local tissue damage and/or disease recurrence.The formation and function of TRM cells are regulated by various factors,such as T cell receptor signals,cytokines,co-stimulatory molecules,etc.Furthermore,TRM cells may exhibit different phenotypes and functions in different types of skin diseases.Therefore,understanding the characteristics and regulatory mechanisms of TRM cells is of great significance for studying the mechanisms of skin disease recurrence as well as for developing therapeutic strategies targeting TRM cells.

Objective:To explore the safety and efficacy of camrelizumab combined with tegafur gimeracil oteracil potassium (S-1) and albumin-bound paclitaxel in the treatment of initially unresectable cholangiocarcinoma.Methods:From October 2022 to August 2024, 17 patients with unresectable intrahepatic cholangiocarcinoma and 4 patients with hilar cholangiocarcinoma were admitted to Xiangyang Central Hospital. They received treatment with camrelizumab combined with S-1 and nab-paclitaxel. Their short-term efficacy and adverse reactions were evaluated, and their long-term survival was followed up.Results:Of the 21 patients, 2 were in complete remission, 6 were in partial remission, 12 had stable disease, and 1 had progressive disease. The objective remission rate was 38.10% (8/21), and the disease control rate was 95.23% (20/21). Five patients were converted to resectable cholangiocarcinoma, with a conversion success rate of 23.81%,2 patients had complete postoperative pathological remission, and 3 patients had major pathological remission. The median progression-free survival time was 11 months (95% CI: 8.37-13.62), and the 1-year progression-free and overall survival rates were 28.57% and 95.23%, respectively. The overall adverse event rate was 90.48% (19/21), and the grade 3 adverse event rate was 28.57% (6/21). Conclusion:The combination of camrelizumab with S-1 and nab-paclitaxel for initially unresectable cholangiocarcinoma has favorable short-term efficacy, tolerable adverse reactions, and improved long-term survival for patients.