Objective: To analyze the epidemiological characteristics and influencing factors of severe fever with thrombocytopenia syndrome (SFTS) in Zhejiang Province from 2019 to 2023, so as to provide the reference for strengthening SFTS prevention and control. Methods: Data on laboratory-confirmed SFTS cases in Zhejiang Province from 2019 to 2023 were collected through the Infectious Disease Reporting Information System of Chinese Disease Prevention and Control Information System. Meteorological data, geographic environment and socioeconomic factors during the same period were collected from the fifth-generation European Centre for Medium-Range Weather Forecasts, Geospatial Data Cloud, and Zhejiang Statistical Yearbook, respectively. Descriptive epidemiological methods were used to analyze the epidemiological characteristics of SFTS from 2019 to 2023, and a Bayesian spatio-temporal model was constructed to analyze the influencing factors of SFTS incidence. Results: A total of 578 SFTS cases were reported in Zhejiang Province from 2019 to 2023, with an annual average incidence of 0.23/105. The peak period was from May to July, accounting for 52.60%. There were 309 males and 269 females, with a male-to-female ratio of 1.15∶1. The cases were mainly aged 50-<80 years, farmers, and in rural areas, accounting for 82.53%, 77.34%, and 75.43%, respectively. Taizhou City and Shaoxing City reported more SFTS cases, while Shaoxing City and Zhoushan City had higher annual average incidences of SFTS. The Bayesian spatio-temporal interaction model showed good goodness of fit. The results showed that mean temperature (RR=1.626, 95%CI: 1.111-2.378) and mean wind speed (RR=1.814, 95%CI: 1.321-2.492) were positively correlated with SFTS risk, while altitude (RR=0.432, 95%CI: 0.230-0.829) and population density (RR=0.443, 95%CI: 0.207-0.964) were negatively correlated with SFTS risk. Conclusions SFTS in Zhejiang Province peaks from May to July. Middle-aged and elderly people and farmers are high-risk populations. Taizhou City, Shaoxing City, and Zhoushan City are high-incidence areas. Mean temperature, mean wind speed, altitude, and population density can all affect the risk of SFTS incidence.

Objective To explore the effect of community pharmacy outpatient service on patients with type 2 diabetes mellitus. Methods A non-randomized controlled study was conducted, and type 2 diabetes patients managed in the community were divided into an intervention group of 112 cases and a control group of 110 cases. The control group received routine medication guidance during general practice outpatient visits, while the intervention group received comprehensive pharmacy outpatient service intervention based on routine medication guidance in general practice. Follow-up visits were conducted every 3 months. Repeated measurement analysis of variance and multivariate linear regression analysis were used to evaluate the intervention effect of the pharmacy outpatient service. Results Fasting blood glucose and glycosylated hemoglobin levels in the intervention group showed a decreasing trend with the increase of intervention time compared to pre-intervention time （P<0.01）, with increased duration of weekly exercise, decreased staple food intake, increased vegetable intake, and increased medication adherence score （P<0.01）. After adjusting for confounding factors through multivariate linear regression model, pharmacy outpatient intervention was found to be an independent protective factor for fasting blood glucose level （β=−0.891, P<0.01） and glycosylated hemoglobin level （β=−0.760, P<0.01） in the study subjects. Conclusion The community pharmacy outpatient service could enhance the self-management ability of patients with type 2 diabetes mellitus, and effectively improve patients’ fasting blood glucose and glycosylated hemoglobin.

This artical starts from the perspective of"earth stagnation and wood depression"to analyze the dynamic mutual impairment process between breast cancer and mixed anxiety and depressive disorder(MADD),integrating pathological evidence of mutual causality between physical impairment and internal injury by emotional distress,to provide a theoretical framework elucidating the intrinsic unity of the microbiota-neuro-tumor interaction network in the comorbidity vicious cycle.The comorbidity of breast cancer and MADD manifests dynamic mutually aggravating impairment,with core pathogenesis according to the traditional Chinese medicine theory of"earth stagnation and wood depression":spleen earth stagnation leads to dampness-turbidity obstruction,while dysfunction of the middle jiao pivot result in abnormal liver qi conveyance and dispersion;liver depression transforming into fire further over-restricts on spleen earth.Mutual over-restriction and counter-restriction between the two causes toxic fire,phlegm and blood stasis to conglomerate into masses.The lingering disease progression causes mutual damage between body and spirit,leading to progressive consumption until physical collapse and spiritual decline,ultimately culminating in earth exhaustion and wood withering,toxins infiltrating the extraordinary vessels,and divorce of yin-yang.Gut microbiota dysbiosis induces abnormalities in the metabolic-immune-neuroendocrine network,driving emotional disorders and interacting with the tumor microenvironment to exacerbate deterioration.This mechanism not only validates the concept of"earth stagnation and wood depression-mutual physical-mental impairment",but also elucidates its role in inducing multi-system cascade failure,ultimately culminating in a pathological process marked by the emergence of severe clinical manifestations.

This artical starts from the perspective of"earth stagnation and wood depression"to analyze the dynamic mutual impairment process between breast cancer and mixed anxiety and depressive disorder(MADD),integrating pathological evidence of mutual causality between physical impairment and internal injury by emotional distress,to provide a theoretical framework elucidating the intrinsic unity of the microbiota-neuro-tumor interaction network in the comorbidity vicious cycle.The comorbidity of breast cancer and MADD manifests dynamic mutually aggravating impairment,with core pathogenesis according to the traditional Chinese medicine theory of"earth stagnation and wood depression":spleen earth stagnation leads to dampness-turbidity obstruction,while dysfunction of the middle jiao pivot result in abnormal liver qi conveyance and dispersion;liver depression transforming into fire further over-restricts on spleen earth.Mutual over-restriction and counter-restriction between the two causes toxic fire,phlegm and blood stasis to conglomerate into masses.The lingering disease progression causes mutual damage between body and spirit,leading to progressive consumption until physical collapse and spiritual decline,ultimately culminating in earth exhaustion and wood withering,toxins infiltrating the extraordinary vessels,and divorce of yin-yang.Gut microbiota dysbiosis induces abnormalities in the metabolic-immune-neuroendocrine network,driving emotional disorders and interacting with the tumor microenvironment to exacerbate deterioration.This mechanism not only validates the concept of"earth stagnation and wood depression-mutual physical-mental impairment",but also elucidates its role in inducing multi-system cascade failure,ultimately culminating in a pathological process marked by the emergence of severe clinical manifestations.

AIM:To quantitatively assess the early alterations of retinal and choroidal microcirculation and microstructure in systemic lupus erythematosus(SLE)patients without coexisting retinopathy via ultra-widefield swept-source optical coherence tomography angiography(UWF SS-OCTA).METHODS:Cross-sectional study. Totally 64 cases(64 eyes)that diagnosed as SLE without associated retinopathy at the Affiliated Hospital of Xuzhou Medical University from May to October 2024 were enrolled as the study group(Randomly assign one eye to the study group). Simultaneously, age-and gender-matched healthy individuals were recruited as the control group. All participants underwent UWF SS-OCTA. The deep capillary plexus(DCP), superficial capillary plexus(SCP), total retina, choriocapillaris(CC), as well as the choroidal medium and large vessel density(VD)in both the central and peripheral retinal areas of both groups of patients were compared. Additionally, parameters such as choroidal vascularity volume(CVV), choroidal vascularity index(CVI), thickness of the inner retina, outer retina, entire retina, and choroid in both central and peripheral area. SLE patients were categorized into three subgroups based on the SLE disease activity index(SLEDAI-2K), including 20 cases(20 eyes)in mild-and no-activity group(SLEDAI-2K≤6), 20 cases(20 eyes)in moderate-activity group(7

AIM:To evaluate the clinical efficacy of 0.05% cyclosporine eye drops(Ⅱ)combined with sodium hyaluronate eye drops in treating patients with type 2 diabetes mellitus(T2DM)and moderate-to-severe dry eye.METHODS:A total of 120 T2DM patients(120 eyes)with moderate-to-severe dry eye, treated at the endocrinology and ophthalmology departments at the Affiliated Hospital of Xuzhou Medical University from January 2024 to September 2024, were enrolled in the study. The patients were randomly divided into two groups: combination group [0.05% cyclosporine eye drops(Ⅱ)+ sodium hyaluronate eye drops] and control group(sodium hyaluronate eye drops alone), with 60 cases(60 eyes)in each group. Assessments were conducted at baseline and at 1, 2, and 3 mo post-treatment, including the ocular surface disease index(OSDI), non-contact tear meniscus height(NITMH), first non-invasive tear breakup time(NIBUTf), meibomian gland loss score, lipid layer thickness grade, conjunctival hyperemia grade, and corneal fluorescein staining(FL)score. At 3 mo after treatment, changes in tear inflammatory factors were observed, and corneal subbasal nerve plexus(SBN)morphology/density were analyzed using in vivo confocal microscopy(IVCM).RESULTS:At 1, 2, and 3 mo post-treatment, both groups showed statistically significant increases in NITMH and NIBUTf compared to baseline(all P<0.05), with greater improvement observed in the combination group(both P<0.05). OSDI and FL scores significantly decreased from baseline(all P<0.05), with more pronounced reductions in the combination group(both P<0.05). Meibomian gland loss scores showed no significant improvement in either group(all P>0.05). At 3 mo after treatment, tear levels of interleukin 6(IL-6)and matrix metalloproteinase-9(MMP-9)significantly decreased in both groups(all P<0.001), with a greater reduction noted in the combination group(both P<0.001). The combination group displayed increased corneal nerve branch density and nerve fiber density, along with decreased nerve tortuosity and dendritic cell(DC)density compared to baseline(all P<0.001), while the control group did not show significant changes(all P>0.05).CONCLUSION: The combination of 0.05% cyclosporine eye drops(Ⅱ)and sodium hyaluronate eye drops significantly improves clinical outcomes in T2DM patients with moderate-to-severe dry eye. This treatment effectively alleviates ocular surface inflammation, restores corneal nerve morphology and density, and demonstrates a favorable safety profile.

AIM: To explore the risk factors associated with diabetic retinopathy(DR)based on ultra-widefield swept-source optical coherence tomography angiography(UWF-SS-OCTA), and to establish a clinical prediction model.METHODS:A total of 235 patients(235 eyes)with type 2 diabetes mellitus who were treated in the Affiliated Hospital of Xuzhou Medical University from July to November 2024 were selected as the research objects. According to the presence or absence of DR, they were divided into 120 cases(120 eyes)in non-DR group(NDR group)and 115 cases(115 eyes)in non-proliferative DR group(NPDR group). Data on general characteristics, laboratory tests, and OCTA results were collected for both groups. Univariate analysis was employed to identify DR-related risk factors. Logistic regression analysis was conducted to analyze these risk factors and to establish a DR prediction model. The efficacy of the model was evaluated using the receiver operating characteristic(ROC)curve, calibration curve, and decision curve analysis(DCA).RESULTS: The duration of diabetes, fasting blood glucose, blood urea nitrogen(BUN), history of hypertension, and the choroidal vascular index(CVI)were found to be statistically significant in the model(all P<0.05). Specifically, the duration of diabetes, fasting blood glucose, BUN, and history of hypertension were identified as risk factors for DR among diabetic patients, while CVI was recognized as a protective factor. The area under the curve for the model predicting the probability of DR was 0.898(0.859-0.938), with a diagnostic threshold of 0.438. The corresponding sensitivity and specificity were 87.8% and 78.3%, respectively, indicating that the model possesses high predictive value for the occurrence of DR.CONCLUSION: The duration of diabetes, fasting blood glucose, BUN, history of hypertension, and CVI are significantly correlated with DR. The established prediction model demonstrates a substantial screening capability for DR.

To provide auxiliary decision-making support to improve incentive policies for pediatric drug development and approval, we systematically review the current status of research on and approval of anti-epileptic drugs (AEDs) for children at home and abroad, and comprehensively analyze the existing barriers in China’s pediatric AED development and market approval process. Findings reveal that China lags behind some countries and regions included in this comparative study (United State of America, European Union, Japan and Australia, etc.) in terms of research and development (R&D) capability and progress in pediatric AEDs, with significant disparity in the diversity of approved drugs, formulations, and dosage forms. It is recommended that China enhance its policy support for R&D, optimize the drug evaluation and approval system, strengthen the management of drug allocation and utilization, promote rational drug use, reinforce post-marketing incentive policies and help foster a more favorable policy environment for the development and approval of pediatric medications.

Objective To evaluate the outcomes of continuing education program by a survey among 73 participa-ting physicians before and after the course training with 73 and 65 valid responses before and after the workshop col-lected respectively.Methods The questionnaire covered physicians' basic information,their understanding of pre-cision treatment,feedback on the course content and suggestions about the workshop.Data analysis was performed using SPSS 22.0 software,primarily employing descriptive statistics and x2 tests.Results The overall satisfaction rate among participants was 90.77％,with the lung cancer session(90.77％)and practical case analysis(86.15％)being the most popular.The course significantly improved physicians' understanding of proteomics analysis(P＜0.05)and the importance of adjusting treatment plan in precision treatment of tumors(P＜0.05).Ad-ditionally,81.54％of physicians agreed that precision treatment of tumors significantly enhanced patients'quality of life(P＜0.05).Physicians also showed increased attention to multidisciplinary team(MDT)and patient mental health.Suggestions for future courses included optimizing resource provision and increasing interactive sessions.Conclusions This continuing education program has achieved remarkable results in enhancing physicians' knowl-edge and capacity building of precision treatment for cancer.The evaluation of the course suggests that future educa-tion should further focus on the actual needs of physicians and to optimize the content design to support the applica-tion of precision treatment in clinical practice.

Objective:To explore the job preference and willingness to pay of resident training physicians in Chengdu, China.Methods:The questionnaire was designed by means of the discrete choice experiment. The questionnaire contains the basic information of the survey object and the discrete choice set (including workplace, working intensity, monthly salary, staffing of public institution, and career development, each with several levels). A total of 116 resident training physicians recruited by three standardized residents training centers in Chengdu were selected to conduct the questionnaire survey, and grouped based on their identity and major. The mixed logit model was used to analyze job preferences and willingness to pay of resident training physicians.Results:Except for career development, other four attributes had statistically significant effects on job selection of resident training physicians ( P<0.05), of which working intensity was the most influential attribute, with the highest willingness to pay. The subgroup analysis results showed that staffing of public institution was concerned by clinical postgraduates and resident training physicians in non-scarce majors. Conclusions:Economic and non-economic factors both affect the job preferences of resident training physicians, while working intensity is the most important factor. Resident training policy should focus on adjusting the scale and type of resident physician enrollment, and strengthen humanistic care and career education of resident training physicians.