Objective: To understand the changing trends and related factors of knowledge, attitude and practice (KAP) regarding the three major infectious diseases (acquired immunodeficiency syndrome, tuberculosis, hepatitis B) among freshmen in Jiangsu from 2019 to 2022, so as to provide a reference basis for the health education of infectious diseases in schools. Methods: From 2019 to 2022, a total of 33 944 freshmen from 20 universities in Jiangsu Province were randomly selected for four consecutive years to investigate their KAP levels online through self designed questionnaires on three major infectious diseases. The multiple linear regression model was used to analyze the changing trends of students KAP levels of the three major infectious diseases, and to explore the influencing factors of KAP. Results: From 2019 to 2022, the knowledge scores(18.0±3.1,18.4±3.2,18.7±3.2,18.8±3.2), related to the three major infectious diseases showed an upward trend ( F=436.50, P <0.01), and the positive attitude reporting rates were 81.77%, 81.46%, 82.68% and 81.74%, respectively. The reporting rates of positive practice were 80.11%, 79.25%, 79.08 % and 79.04%, respectively. Multiple linear regression showed that school type, parental education level, mother s occupation, average income per person in family and living arrangements during high school all had an impact on the knowledge ( β = -1.510 -0.559), attitudes ( β =-0.043-0.065) and practice ( β =-0.028-0.027) of the three major infectious diseases ( P < 0.05 ). The family residence areas only affected the reporting rate of positive attitude scores ( β =0.002-0.065), and whether only children or not affected the reporting rate of positive practice scores ( β =0.009)( P <0.05). The knowledge score showed an upward trend ( β= 0.297, P <0.01), the positive attitude reporting rate showed no statistically significant change ( β=0.001, P =0.22), and the positive practice reporting rate showed a downward trend ( β=-0.005, P <0.01). Conclusions Freshman in Jiangsu Province from 2019 to 2022 have shown a separation in KAP scores regarding the three major infectious diseases. Targeted measures should be taken to improve their health practice level.

Objective: To evaluate the incremental vaccine effectiveness (VE) of two dose of the mumps containing vaccine (MuCV) in chidren, so as to provide a basis for optimizing mumps immunization strategies. Methods: A 1∶2 frequency matched case-control study was conducted by using reported mumps cases in childcare centers or schools from Lu an, Hefei, Ma anshan and Huainan cities of Anhui Province from September 1, 2023 to June 30, 2024, as a case group(383 cases). And healthy children in the same classroom were selected as a control group(766 cases). The MuCV immunization histories of participants were collected to estimate the incremental VE of the second dose of MuCV against mumps. Group comparisons were performed using the Chi square test or t-test. For matched case-control pairs, the Cox regression model was employed to calculate the odds ratio (OR) with 95% confidence interval (CI) for two dose MuCV vaccination and to estimate the incremental vaccine effectiveness (VE). Results: There were no statistically significant differences between the case and control groups regarding gender, age, dosage of MuCV vaccination and the time interval since the last dose vaccination( χ 2/t=0.05, 0.20, 0.94, -0.02, P >0.05). The proportions of the case and control groups vaccinated with two doses of MuCV were 26.63% and 29.37%, respectively, and the overall incremental VE of the second dose of MuCV was 40.73% (95% CI=3.03%-63.77%, P <0.05). Subgroup analyses revealed that the incremental VE for children with a period of ≥1 year between the two doses of MuCV was 54.13% (95% CI=1.90%-78.56%, P <0.05), while for children with a period of <1 year, it was 30.63% (95% CI=-28.59%-62.58%, P >0.05). The incremental VE of the second dose of MuCV was 30.36% (95% CI=-25.95%-61.50%, P >0.05) in kindergarten children and 66.73% (95% CI=14.92%-86.99%, P <0.05) in elementary and secondary school students. The incremental VE was 28.78% (95% CI=-27.46%-60.21%, P >0.05) within five years of the last dose of MuCV vaccination and 66.07% (95% CI=-41.56%-91.87%, P >0.05) for vaccinations administered beyond five years. Conclusions The second dose of MuCV may offer additional protection for children; however, extending the interval between two dose of MuCV (<1 year) has shown limited incremental protective effects. Therefore, it is crucial to consider optimizing current immunization strategies for mumps.

Objective To analyze the epidemiological characteristics and spatiotemporal clustering of varicella in Lu'an City from 2005 to 2023, and to provide a scientific basis for optimizing varicella prevention and control strategies. Methods Data on varicella cases were collected through the Chinese Center for Disease Control and Prevention Information System. Descriptive epidemiology, temporal trend analysis, seasonal analysis, spatiotemporal clustering analysis, and spatial autocorrelation analysis were conducted using QGIS, JoinPoint, SaTScan and GeoDa software. Results The average annual reported incidence rate of varicella in Lu'an City from 2005 to 2023 was 34.55/100,000, showing a trend of initial increase followed by a decrease. The peak incidence occurred from October to January of the following year (RR=1.97, LLR=1743.95, P=0.001). Students aged 0 to 19 was the primary affected group. Spatiotemporal scan analysis revealed four types of spatiotemporal clusters, with the cluster in Jin'an District from October 2017 to December 2023 being particularly prominent (RR=2.87，LLR=1734.15，P<0.001). Spatial autocorrelation analysis indicated significant clustering of varicella cases in the main urban area (Moran's I=0.216，Z=4.786，P=0.003). Conclusion The incidence of varicella in Lu'an City exhibits distinct seasonal and spatial clustering, and schools and kindergartens in the main urban area are the key to varicella prevention and control. It is necessary to enhance the monitoring of disease outbreaks during peak periods and in key areas, and to increase the two-dose vaccination rate for varicella in areas with case aggregation and among key populations.

Objective To evaluate the effect of water exchange method versus conventional methods including air insufflation and carbon dioxide insufflation method for the quality of colonoscopy.Methods We searched related randomized controlled trials published up to October 2022 from PubMed,Web of Science,the Cochrane Library,SinoMed databases,CNKI,Wanfang data.Two reviewers independently searched the literatures based on standards to extract the data and evaluate the quality.Meta-analysis was conducted by RevMan 5.4.1.Results 23 studies involving 10654 patients were included.Although cecal intubation time was prolonged in water exchange(MD=1.81,95％CI:1.28～2.35,P=0.000),but water exchange had higher adenoma detection rate(ADR)(O(R)=1.40,95％CI:1.26～1.55,P=0.000),cecal intubation rate(O(R)=1.62,95％CI:1.24～2.10,P=0.000)and scores of bowel preparation quality(MD=0.61,95％CI:0.42～0.79,P=0.000)compared with conventional colonoscopy.In addition,WE had significantly lower pain sores(MD=-1.07,95％CI:-1.39～-0.76,P=0.000),number of abdominal compression(O(R)=0.42,95％CI:0.29～0.60,P=0.000)and number of position change(O(R)=0.59,95％CI:0.42～0.82,P=0.002)than conventional colonoscopy.Conclusion Although water exchange colonoscopy prolongs cecal intubation time,but it can significantly increase ADR,cecal intubation rate and scores of bowel preparation quality.Beyond that,water exchange reduces patient pain,the proportion of abdominal compression and position change.Water exchange is a better choice for high-quality colonoscopy.

Objective:To compare the eradication rate and incidence of adverse reactions between cefuroxime-containing and amoxicillin-containing bismuth quadruple regimen in the treatment of Helicobacter pylori ( H. pylori), and to evaluate the efficacy and safety of cefuroxime in the H. pylori infection patients with positive penicillin skin test results. Methods:From December 2020 to December 2021, a total of 498 patients who received initial H. pylori eradication treatment at the H. pylori Specialized Outpatient Clinic of the First Affiliated Hospital of Soochow University were selected to participate in this prospective cohort study. According to the history of penicillin allergy or positive penicillin skin test results, the patients were divided into amoxicillin group and cefuroxime group. A total of 394 patients were included in the amoxicillin group, and the treatment regimen was esomeprazole 20 mg, bismuth 220 mg, amoxicillin 1 g and clarithromycin 500 mg orally twice a day. A total of 104 patients were included in the cefuroxime group, and the treatment regimen was esomeprazole 20 mg, bismuth 220 mg, cefuroxime 500 mg and clarithromycin 500 mg orally twice a day. The treatment period was 14 days. 13C-urea breath test was conducted during 4 to 8 weeks after the treatment. The eradication rates of the 2 groups were compared by intention-to-treat (ITT) analysis and per-protocol (PP) analysis. The incidence of adverse reactions was compared between the 2 groups. Chi-square test was used for statistical analysis. Results:The results of ITT analysis and PP analysis indicated that the eradication rates of amoxicillin group were 84.3% (332/394, 95% confidence interval (95% CI) 80.6% to 87.6%) and 90.5% (332/367, 95% CI 87.2% to 93.3%), respectively, and the eradication rates of cefuroxime group were 62.5% (65/104, 95% CI 52.7% to 71.7%) and 69.1% (65/94, 95% CI 58.8% to 78.7%), respectively. The eradication rates of amoxicillin group in ITT and PP analysis were both higher than those of cefuroxime group, and the differences were statistically significant ( χ2=24.11 and 28.44, both P<0.001). The incidence of adverse reactions of amoxicillin group and cefuroxime group was 10.9% (43/394) and 14.4% (15/104), respectively, and there was no significant difference ( P>0.05). Conclusion:Cefuroxime and clarithromycin containing bismuth quadruplex regimen failed to achieve a satisfactory eradication rate in patients with H. pylori infection and penicillin allergy.

Here, we report a previously unrecognized syndromic neurodevelopmental disorder associated with biallelic loss-of-function variants in the RBM42 gene. The patient is a 2-year-old female with severe central nervous system (CNS) abnormalities, hypotonia, hearing loss, congenital heart defects, and dysmorphic facial features. Familial whole-exome sequencing (WES) reveals that the patient has two compound heterozygous variants, c.304C>T (p.R102*) and c.1312G>A (p.A438T), in the RBM42 gene which encodes an integral component of splicing complex in the RNA-binding motif protein family. The p.A438T variant is in the RRM domain which impairs RBM42 protein stability in vivo. Additionally, p.A438T disrupts the interaction of RBM42 with hnRNP K, which is the causative gene for Au-Kline syndrome with overlapping disease characteristics seen in the index patient. The human R102* or A438T mutant protein failed to fully rescue the growth defects of RBM42 ortholog knockout ΔFgRbp1 in Fusarium while it was rescued by the wild-type (WT) human RBM42. A mouse model carrying Rbm42 compound heterozygous variants, c.280C>T (p.Q94*) and c.1306_1308delinsACA (p.A436T), demonstrated gross fetal developmental defects and most of the double mutant animals died by E13.5. RNA-seq data confirmed that Rbm42 was involved in neurological and myocardial functions with an essential role in alternative splicing (AS). Overall, we present clinical, genetic, and functional data to demonstrate that defects in RBM42 constitute the underlying etiology of a new neurodevelopmental disease which links the dysregulation of global AS to abnormal embryonic development.
Female ; Animals ; Mice ; Humans ; Child, Preschool ; Intellectual Disability/genetics* ; Heart Defects, Congenital/genetics* ; Facies ; Cleft Palate ; Muscle Hypotonia

Objective: To understand the trends and associated factors of tuberculosis knowledge and behavior among freshmen from Jiangsu Province, 2019 to 2022, so as to provide theoretical support for the popularization of tuberculosis knowledge and the prevention and control of tuberculosis in universities. Methods: From 2019 to 2022, a total of 33 944 freshmen from 20 universities in Jiangsu Province were selected by stratified random sampling, and tuberculosis knowledge and behavior were surveyed online using a selfdesigned questionnaire. Oneway variance trend test and multiple linear regression analysis were used to analyze the trend of knowledge and behavior levels, and a multiple linear regression model was used to analyze the influencing factors. Results: The overall awareness rate of tuberculosis among freshmen from Jiangsu Province was 90.6%, and the overall awareness rates from 2019 to 2022 were 88.4%, 90.4%, 91.7%, and 91.8%, respectively. The overall behavioral accuracy rate was 92.3%, with the annual rates from 2019 to 2022 being 91.8%, 92.3%, 92.7%, and 92.4%, respectively. Both the awareness rate and accuracy behavior rate increased annually (F=216.67, 11.75, P<0.01). The multiple linear regression analysis showed that school type, ethnicity, fathers educational level, mothers educational level, mothers occupation, family per capita monthly income, and living arrangement in high school affected both personal knowledge awareness rate and personal behavioral accuracy rate (β=-0.047-0.035, P<0.01), while region, gender, family residence, and being an only child only affected behavioral accuracy rate (β=-0.003-0.032, P<0.05). Conclusions The tuberculosis knowledge and behavior levels of freshmen from Jiangsu Province have been increasing by year. Targeted health education should be carried out based on the relevant influencing factors to further enhance the tuberculosis prevention and control literacy.

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Congenital heart disease is one of the most common birth defects, and its structural changes often require surgical or non-surgical intervention after delivery. Some scholars believe that because early primary intrauterine heart abnormalities may hinder the normal development of the heart and cause irreversible secondary structural changes, the current treatment of congenital heart disease focuses on prenatal diagnosis and fetal intervention. Since the first successful fetal surgery in 1984, and with the development and progress of diagnostic techniques such as fetal cardiac ultrasound, the treatment of congenital heart disease has gradually become the focus of research. This article will focus on the intrauterine cardiac intervention of a specific type of congenital heart disease, fetal cardiac surgery guided by fetal scope, the impact of cardiopulmonary bypass on the fetus or the mother, intrauterine cardiac surgery and targeted therapy of fetal congenital heart disease are summarized in this article.

Background: Helicobacter pylori (Hp) is closely associated with peptic ulcer, gastric cancer and other gastrointestinal diseases. Eradication therapy is the main approach to prevent and treat Hp-associated diseases, and patient management is crucial for improving the efficacy of eradication therapy. Aims: To explore the effect of whole-course management on medication adherence and reexamination rate of Hp eradication therapy. Methods: Patients who received Hp eradication therapy in the Hp Specialist Clinic of the First Affiliated Hospital of Soochow University from June 2020 to November 2020 were recruited consecutively. One hundred and twelve patients who received eradication therapy between June 2020 and August 2020 were served as the control group, and 112 patients who received eradication therapy between September 2020 and November 2020 were served as the observation group. Patients in control group were informed only the medication method and reexamination time, while patients in observation group were given the whole-course management composed of informing medication method and reexamination time plus following up online by WeChat and reminding the reexamination by WeChat and by phone. Patients in both groups received a 14-day bismuth quadruple therapy, and were told to undergo