Objective To investigate the prevalence of common diseases among primary and secondary school students in Yichang City from 2019 to 2022, and to provide a scientific basis for formulating effective intervention measures in the future. Methods By random cluster sampling , 7 schools in urban areas and 5 schools in suburban counties were selected to screen common diseases such as myopia, dental caries, obesity and abnormal spinal curvature. Descriptive epidemiological methods were employed for statistical analysis. Results A total of 17 023 primary and secondary school students were screened from 2019 to 2022. The overall detection rate of common diseases from high to low was myopia (54.12%), caries (36.75%), overweight (15.17%), obesity (11.88%), malnutrition (5.80%), and abnormal spinal curvature (3.49%). The detection rates of myopia and abnormal curvature of the spine showed an increasing trend with years and school stages, while the detection rates of malnutrition and dental caries showed a decreasing trend with years and school stages. The detection rates of overweight and obesity showed no trend difference with years, and the detection rates of obesity showed a decreasing trend with school stages. The rates of myopia, overweight and obesity were higher in urban areas than those in suburban counties, and the rate of dental caries was higher in suburban counties than that in urban areas. The prevalence of overweight, obesity, and malnutrition in boys was higher than that in girls. The prevalence of myopia and dental caries in girls was higher than that in boys. The above differences were statistically significant (all P<0.05). Conclusion Myopia, dental caries, obesity, and abnormal curvature of the spine are the current focus of the prevention and treatment of common diseases in students. There are great differences between different regions, school stages, and genders. The ^“tripartite linkage^” of schools, families, and communities should be achieved with the joint efforts of the education and health departments to actively take targeted intervention measures to reduce the prevalence.

Definitive treatment of lung cancer with radiotherapy is challenging, as respiratory motion and anatomical changes can increase the risk of severe off-target effects during radiotherapy. Online adaptive radiotherapy (ART) is an evolving approach that enables timely modification of a treatment plan during the interfraction of radiotherapy, in response to physiologic or anatomic variations, aiming to improve the dose distribution for precise targeting and delivery in lung cancer patients. The effectiveness of online ART depends on the seamless integration of multiple components: sufficient quality of linear accelerator-integrated imaging guidance, deformable image registration, automatic recontouring, and efficient quality assurance and workflow. This review summarizes the present status of online ART for lung cancer, including key technologies, as well as the challenges and areas of active research in this field.
Humans ; Lung Neoplasms/radiotherapy* ; Radiotherapy Planning, Computer-Assisted/methods*

Tuberculosis (TB) is a prominent infectious disease globally that imposes a substantial health burden. Genital TB (GTB), an extrapulmonary manifestation, leads to complications such as tubal adhesions, blockage, and diminished ovarian function, culminating in infertility, and is recognized as a prevalent cause of infertility in nations with high-burden TB. In regions with low TB rates, infertility and active TB during pregnancy have been reported to be most common among female immigrants from countries with high-burden TB. In the context of TB, pregnant women often exhibit exacerbated symptoms after in vitro fertilization-embryo transfer (IVF-ET), heightening the risk of dissemination. Miliary pulmonary TB and tuberculous meningitis pose a serious threat to maternal and fetal health. This article integrates recent epidemiological data and clinical research findings, delineating the impact of TB on infertility and assisted reproduction and particularly focusing on the diagnosis and treatment of GTB, underscored by the imperative of TB screening before IVF-ET. Our objective is to increase awareness among respiratory and reproductive health professionals, promoting multidisciplinary management to enhance clinical vigilance. This approach seeks to provide patients with judicious reproductive plans and scientifically rigorous pregnancy management, thereby mitigating adverse pregnancy outcomes related to TB activity.

Objective To investigate the differences in treatment experience and quality of life between adolescent orthodontic pa-tients using clear aligners and fixed braces.Methods A total of 104 adolescent patients were selected who underwent orthodontic treat-ment with either clear aligners or fixed braces at Nanjing Medical University Affiliated Stomatological Hospital from January 2022 to June 2022.The patients were divided into two treatment groups based on the type of orthodontic appliance,with 52 patients in each group.Within a 6-month period of using clear aligners or fixed braces,adolescent orthodontic patients were surveyed using the child oral health impact profile-short form 19(COHIP-SF19)and other individual items.The differences in mean satisfaction,quality of life,and statistical scores were compared using independent samples t-tests,while the differences in subjective responses were compared using the Wilcoxon rank-sum test.Results There were no significant differences in mean quality of life and statistical scores between the two groups,but patients in the clear aligner group reported higher satisfaction.The clear aligner group reported greater difficulty with eating,while patients with fixed braces were more likely to experience negative emotions.Additionally,there were no significant differences between the two groups in terms of adaptation time to the appliance,maintaining dental hygiene,and feeling attractive.Conclusion Patients in both groups were generally satisfied with their treatment.Adolescent orthodontic patients treated with clear a-ligners or fixed braces for at least 6 months exhibit similar overall quality of life.

OBJECTIVE To evaluate the cost-effectiveness of clopidogrel versus aspirin monotherapy regimens for secondary prevention of ischemic stroke and to provide economic evidence and reference for clinical medication and decision-making. METHODS Based on the CAPRIE trial， a Markov model was constructed； the probabilities of risk events， health utility values， and costs of risk event management were obtained from relevant literature. The cycle length was 6 months， and the time horizon was 10 years. A discount rate of 5% per year was applied. The primary outcomes were total costs， quality-adjusted life-years （QALYs）， and incremental cost-effectiveness ratio （ICER）. Cost-utility analysis was performed for above 2 regimens by using TreeAge Pro software. The one-way sensitivity analysis， probabilistic sensitivity analysis and scenario analysis were conducted to validate the robustness of the analyses. RESULTS Compared with the aspirin regimen （325 mg/d of CAPRIE trial dose）， the ICER values of clopidogrel regimen for secondary stroke prevention for 10 years， 20 years and 30 years were 4 284.06， 4 201.20 and 3 986.78 yuan/QALY， respectively， which were E-mail：liuxiaoyanrj@sjtu.edu.cn all less than the willing-to-pay （WTP） threshold of one time 。 China’s per capita gross domestic product （GDP） in 2021. E-mail：scilwsjtu-wb@yahoo.com Compared with the aspirin regimen （clinically recommended dose in China， 100 mg/d）， the ICER values of clopidogrel regimen for stroke secondary prevention for 10 years， 20 years and 30 years were 58 238.27， 42 164.72 and 36 164.77 yuan/QALY， respectively， which were all less than WTP threshold. When comparing with aspirin regimen of 325 mg/d， results of one-way sensitivity analysis showed that the cost of clopidogrel and aspirin， probability of the first recurrence of ischemic stroke were sensitive factors of model. Results of probabilistic sensitivity analysis showed that when WTP was set at one time GDP per capita in China in 2021， clopidogrel had a probability of being cost- effective of about 66.5%. Results of scenario analysis showed that neither changing the time horizon to 10， 20 or 30 years nor using different doses of aspirin （50， 100， 150， 200 or 250 mg/d） would not alter any conclusions. CONCLUSIONS Compared with aspirin monotherapy， clopidogrel monotherapy is more cost-effective for secondary prevention of ischemic stroke.

Objective To investigate the related factors of fall among community-dwelling and hospitalized elderly.Methods From May to September, 2021, 50 elderly from Tianshenggang Community Health Service Center of Medical Union of Nantong University Affiliated Hospital and 50 elderly in the first ward of Geriatrics Department of Nantong University Affiliated Hospital were selected by random systematic sampling method. Face-to-face questionnaire survey was conducted respectively. All the participants underwent a comprehensive geriatric assessment and blood, neuromusculoskeletal B-ultrasound tests. Univariate and multivariate Logistic regression were used to analyze the status and related factors of falls among community and hospitalized elderly with a history of falls within one year.Results There were significant differences in fall history, the score of Morse Fall Scale (MFS) and hospitalization due to fall history between the hospitalized elderly and the community-dwelling elderly (&chi;2 > 6.250, Z=-3.132, P<0.05). In addition to fall related factors, age, ability of self-care, the score of International Consultation on Incontinence Questionnaire Urinary Incontinence Short Form (ICI-Q-SF), frailty index (FI), the score of Rapid Assessment of Physical Activity (RAPA) part 2, the score of Short Form of Health Survey (SF-36), the score of Memorial University of Newfoudland Scale of Happiness (MUNSH), waist-to-hip ratio, arm and leg circumferences, red blood cell count, hemoglobin and triglyceride were the related factors of fall in hospitalized elderly (|Z| > 0.462, &chi;2=7.447, P<0.05). The scores of Geriatric Depression Scale (GDS)-15, MFS, FI and SF-36, and grip strength were the related factors of fall in community-dwelling elderly (|Z| > 1.758, &chi;2=6.640, P<0.05). Multivariate Logistic regression analysis showed that the risk factors for falls in hospitalized elderly within one year were age, the score of MFS, FI, arm and leg circumferences, the score of SF-36, hemoglobin and triglyceride. The related factors of falls in community-dwelling elderly included the scores of GDS-15, MFS, FI SF-36 and MUNSH, and grip strength (P<0.05). The scores of SF-36 and MUNSH decreased after fall for elderly in both community and hospital (t=-3.108, Z > 2.567, P<0.05).Conclusion The incidence of falls and hospitalization due to falls, and the risk of falls are higher among the hospitalized elderly than that in community, and the related factors are different. Therefore, it is needed to carry out targeted intervention for the corresponding factors to reduce the occurrence of fall.

Objective:To investigate the overall clinical performance of nursing students and analyze its influencing factors to provide evidence for the improvement.Methods:A questionnaire survey was carried out among 288 nursing students from Qilu Hospital of Shandong University in March to May 2020. The survey included a general data questionnaire, Holistic Clinical Assessment Tool, Clinical Learning Environment, Supervision and Nurse Teacher evaluation scale, Medical Student Safety Attitudes and Professionalism Survey of nursing students. The factors associated with overall clinical performance of nursing students were analyzed by t test, analysis of variance, Pearson correlation analysis and multiple linear regression. Results:The total score of Holistic Clinical Assessment Tool was 114.95 ± 22.91. The total score of Clinical Learning Environment, Supervision and Nurse Teacher evaluation scale was 156.70 ± 26.98. The total score of Medical Student Safety Attitudes and Professionalism Survey was 123.65 ± 31.00. The influencing factors included social practice experience and clinical learning environment, which accounted for 28.0% of the total variation of overall clinical performance of nursing students.Conclusions:Educators and managers of nursing students' schools and internship hospitals should actively explore the educational reform practice to promote the improvement of clinical ability, so as to promote the improvement of the overall clinical ability of nursing students.

Objective:To search, evaluate and summarize the best evidence of cognitive management of mild cognitive impairment (MCI) in the elderly patients, so as to provide evidence-based basis for nursing intervention and care.Methods:The article on the management of elderly MCI was systematically searched in UpToDate, National Institute for Health and Care Excellence, National Guideline Clearinghouse, Chinese Guideline Network, Joanna Briggs Institute Evidence-Based Health Care Center in Australia, Registered Nurses' Association of Ontario in Canada, Ovid JBI, Wiley, PubMed, WanFang Data, China National Knowledge Infrastructure, and VIP, including the latest clinical practice guideline, systematic review, expert consensus, and thematic evidence summary, randomized controlled trial and quasi experimental study. The retrieval time limit was from January 1, 2012 to December 31, 2021. Two elderly nursing researchers independently evaluated the article quality and extracted the best evidence.Results:A total of 14 articles were included, involving 3 clinical practice guidelines, 3 expert consensus, 3 systematic reviews, 1 thematic evidence summary, 3 randomized controlled trials, and 1 quasi experimental study. According to the clinical situation and the comprehensive management system of community-outpatient screening-diagnosis-comprehensive intervention-returning to the community, a total of 33 pieces of evidence were formed in 7 aspects, including evaluation object and opportunity, evaluation content and screening tools, disease diagnosis and management, Cognitive Training Nursing Clinic construction, cognitive training and intervention methods, care support management, and effect evaluation.Conclusions:This article summarizes the best evidence of cognitive management of the elderly with MCI, and provides evidence-based basis for medical and nursing staff to carry out targeted cognitive management.

Estrogen receptor (esr) mediates the effects of estrogen on the expression of related genes, thereby regulating the growth and reproduction of mammals. To investigate the effect of retrotransposon insertion polymorphism (RIP) of the porcine esr gene on porcine growth performance, retrotransposon insertion polymorphism of the esr gene were predicted by comparative genomics and bioinformatics, and PCR was used to verify the insertion polymorphisms in different porcine breeds. Finally, the correlation analysis between the genotypes and performance of Large White pigs was conducted. The results showed that four retrotransposon polymorphic sites were identified in the esr1 and esr2 genes, which are esr1-SINE- RIP1 located in intron 2 of the esr1 gene, esr1-LINE-RIP2 and RIP3-esr1- SINE located in intron 5 of the gene, and esr2-LINE-RIP located in intron 1 of the esr2 gene, respectively. Among them, insertion of a 287 bp of SINE into intron 2 of the esr1 gene significantly affected (P<0.05) the live back fat thickness and 100 kg body weight back fat thickness of Large White pigs. Moreover, the live back fat thickness and back fat thickness at 100 kg body weight of homozygous with insertion (SINE+/+) was significantly greater than that of heterozygous with insertion (SINE+/-) and homozygous without insertion (SINE-/-). Therefore, esr1-SINE-RIP1 could be used as a molecular marker to assist the selection of deposition traits in Large White pigs.
Animals ; Genotype ; Introns/genetics* ; Phenotype ; Polymorphism, Genetic/genetics* ; Retroelements/genetics* ; Swine/genetics*