Objective To analyze the spatial and temporal distribution characteristics of hand-foot-mouth disease (HFMD) in Zibo City, to explore the key incidence areas, and to find a suitable prediction model, so as to provide reference for the prevention and control of HFMD. Methods The spatiotemporal clustering characteristics of HFMD in Zibo City from 2018 to 2023 were analyzed by using SaTScan 10.0.2 software and ArcGIS 10.7 software. A combination model of ARIMA and SVM was established, and the prediction results were verified and compared. Results Spatial clustering analysis showed that there was spatial clustering of the incidence of HFMD in various townships of Zibo City from 2020 to 2022. The high-high clustering areas and Getis-Ord hot spot areas were mainly concentrated in some main urban areas of Zhangdian District, Zichuan District, and Huantai County. A total of 2-5 aggregation areas were detected by spatiotemporal scanning analysis. The first-type aggregation areas were mainly concentrated in the towns of Zhangdian District, Huantai County, Linzi District, Zhoucun District and Gaoxin District. The aggregation months were July, August, September and November. The model prediction results showed that the ARIMA-SVM combined model was more accurate than the traditional ARIMA model. Conclusion There is a spatiotemporal clustering of hand-foot-mouth disease in Zibo City. The ARIMA-SVM combined model can be used to predict the incidence of hand-foot-mouth disease in Zibo City, and to strengthen health education and disease monitoring in high-risk areas and populations during the epidemic months.

Objective To investigate the changes of cortical thickness in patients with insomnia disorder(ID).Methods High-resolution MRI data were collected from 32 ID patients(ID group)and 30 healthy controls(HC)(HC group).The cortical thickness of both groups were analyzed using statistical parametric mapping 12(SPM12)software,while considering age,gender,and educational level as covariates.The cortical thickness in brain regions showed statistically significant differences was extracted for Pearson's correla-tion analyses with sleep and mood-related scales.Results Compared with the HC group,the ID group exhibited significantly decreased cortical thickness in brain regions such as the left insula,fusiform gyrus,orbitofrontal lobe,superior temporal gyrus,middle temporal gyrus,lateral occipital lobe and right caudal anterior cingulate gyrus[P＜0.05,family-wise error(FWE)correction].Furthermore,reduced cortical thickness of the cingulate gyrus was negatively correlated with the Pittsburgh sleep quality index(PSQI)score(r=-0.437,P=0.012).Conclusion The cortical thickness of several brain regions associated with sleep and mood are significantly reduced in patients with ID,providing potential neuroimaging evidence for understanding the pathophysiological mechanism of ID.

Cardiovascular surgery is still the preferred treatment for some congenital or acquired cardiovascular diseases.With the aging of China's population and the prevalence of unhealthy lifestyles brought about by the improvement of living standards,the burden of cardiovascular diseases is still steadily increasing and the volume of cardiovascular surgery continues to be at a high level,which puts forward a new demand for the prevention and treatment strategy of cardiovascular diseases and the allocation of medical resources.Cardiovascular surgery has many perioperative complications and high risk of mortality,a scientific surgical complexity scoring system can help clinicians fully assess the difficulty of surgery,stratify the risk of patient surgery,and formulate targeted and personalized diagnosis and treatment plans;meanwhile,it can help the health management department accurately grasp the overall diagnosis and treatment level of China's cardiovascular surgery,monitor the quality of medical care and provide a reference for the formulation and implementation of relevant medical policies.In this study,we systematically review the current status of evidence-based research on different cardiovascular surgical complexity assessment systems and summarize the application of machine learning in cardiovascular surgical assessment,with a view to contributing to the establishment of a cardiovascular surgical complexity assessment system applicable to the Chinese population.

ObjectiveTo analyze the application of International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) in China. MethodsResearches using ISNCSCI in the spinal cord injury were retrieved from CNKI, from January 1st, 2020 to December 31st, 2022. The authors and the keywords of the included literatures were analyzed using VOSviewer and CiteSpace to generate a collaboration network graph of authors and a theme distribution map of keywords. The objects, purposes, causes of spinal cord injury, distribution of researchers' departments, ISNCSCI version used, corresponding publication time and other information of the included studies were manual searched and analyzed. ResultsA total of 285 literatures were finally included, involving 1 279 authors, out of whom 111 published 97.19% of the total number of articles. The main keywords included spinal cord injury, spinal fractures, neurological function, thoracolumbar fractures and spinal tuberculosis, which classified in seven clusters, and the topics of spinal cord injury, efficacy, spinal fractures, quality of life and prognosis were the hotspots in the field. With manual searching, the main topic was spinal cord injury; the main object was traumatic spinal cord injury; the main purpose was to evaluate the surgical efficacy; the research institutions were mostly the comprehensive hospitals or specialized hospitals focusing on orthopedics (spinal surgery); the clinical departments that used ISNCSCI the most were orthopedics (including spinal surgery) and rehabilitation medicine, and nursing teams were paying more attention to ISNCSCI; the most commonly used versions of ISNCSCI were 2011 (7th edition) and 2000 (6th edition), however, for a large number of articles, the versions were not clear or earlier than 2000. ConclusionThe application of ISNCSCI in China should be improved in the standardization.

Hepatocellular carcinoma (HCC) has an insidious onset, and most patients are in the advanced stage when attending the hospital and thus lose the opportunity for radical surgical resection, which results in the poor prognosis of patients. With the development of clinical treatment, the treatment of advanced HCC has gradually transitioned from the relatively single and limited treatment options in the past to the new model of comprehensive treatment. In recent years, immunotherapy, represented by immune checkpoint inhibitors (ICIs), has become widely used in clinical practice. At present, a number of clinical studies have been conducted for immunotherapy combined with local and targeted antitumor therapy, and in particular, ICIs combined with targeted therapy have become a research hotspot in the field of HCC treatment. This article reviews the research advances in immunotherapy for the treatment of HCC.

Objective:To observe the efficacy and safety of single-port laparoscopy for giant ovariotubal cysts.Methods:38 patients with giant ovarian and fallopian tube cysts in Ruijin Hospital Affiliated to Shanghai Jiaotong University Hospital from January 2018 to June 2019 were retrospectively analyzed. They were divided into transumbilical single-port laparoscopy group (18 cases) and traditional laparoscopy group (20 cases). The perioperative related indexes such as operation time, intraoperative bleeding and the number of analgesic cases were compared between the two groups.Results:All 38 patients successfully completed the operation without conversion to laparotomy, and no auxiliary hole was added in the single-port laparoscopy group; There were no postoperative complications and no cystic fluid leakage. In the single-port laparoscopy group, 18 patients were satisfied with the concealment of umbilical scar. There was no statistically significant difference in operation time [(51.67±13.72)min vs (55.50±14.59)min], intraoperative blood loss [(52.22±24.38)ml vs (61.50±28.88)ml] and first postoperative anal exhaust time [(25.77±8.59)h vs (27.60±6.67)h] between single-port laparoscopy group and traditional laparoscopy group (all P>0.05); The number of cases requiring postoperative analgesia in the single-port laparoscopy group (2 cases vs 12 cases) was less than that in the traditional laparoscopy group ( P<0.05); The out of bed activity time [(20.95±3.65)h vs (26.95±5.43)h] and postoperative discharge time [(3.11±0.68)h vs (4.30±1.21)h] were shorter than those in the traditional laparoscopy group (all P<0.05). All 38 patients were followed up in the gynecological clinic for 6-24 months. The incision healed well without recurrence. Conclusions:Transumbilical single-port laparoscopic surgery for giant ovarian and fallopian tube cysts is reliable and safe when the possibility of malignant ovarian and fallopian tube tumors was excluded before operation.

The composition of serum is extremely complex,which complicates the discovery of new pharmaco-dynamic biomarkers via serum proteome for disease prediction and diagnosis.Recently,nanoparticles have been reported to efficiently reduce the proportion of high-abundance proteins and enrich low-abundance proteins in serum.Here,we synthesized a silica-coated iron oxide nanoparticle and devel-oped a highly efficient and reproducible protein corona(PC)-based proteomic analysis strategy to improve the range of serum proteomic analysis.We identified 1,070 proteins with a median coefficient of variation of 12.56％using PC-based proteomic analysis,which was twice the number of proteins iden-tified by direct digestion.There were also more biological processes enriched with these proteins.We applied this strategy to identify more pharmacodynamic biomarkers on collagen-induced arthritis(CIA)rat model treated with methotrexate(MTX).The bioinformatic results indicated that 485 differentially expressed proteins(DEPs)were found in CIA rats,of which 323 DEPs recovered to near normal levels after treatment with MTX.This strategy can not only help enhance our understanding of the mechanisms of disease and drug action through serum proteomics studies,but also provide more pharmacodynamic biomarkers for disease prediction,diagnosis,and treatment.

Objective:To develop and apply the optimal evidence-based practice plan for enteral nutrition management in severe acute pancreatitis (SAP) patients.Methods:We combined the best evidence and scenario analysis to form the optimal evidence-based practice plan for enteral nutrition management in patients with severe acute pancreatitis, and integrated the plan into clinical practice. According to the procedure of evidence-based practice of the JBI Evidence-based Center, 18 nurses in the intensive care unit (ICU) were trained, and 30 SAP patients were subjected to a baseline review of the implementation of nutritional support care, with obstacles addressed and analyzed. The nutritional support quality were re-examined in another 30 SAP patients after the current plan was practiced.Results:Compared with the results of the baseline review, after the implementation of this plan, the implementation rate of the reviewed indicators was significantly improved; the ICU nurses showed a significant increase in the knowledge of SAP enteral nutrition (88.9% vs 33.3%, P<0.05. Except for the correct rate of catheter selection (100.0% vs 100.0%), the correct rate of implementation of the other 8 indicators (enteral nutrition timing selection, pre-catheterization evaluation, preparation, patients′ position, nutrition preparation selection, perfusion rate regalation, energy calculation, infusion method) was significantly improved (all P value <0.05). Furthermore, both the tolerance and satisfaction of SAP patients for enteral nutrition were significantly improved (all P value <0.05). Conclusions:The application of the optimal evidence-based practice plan for enteral nutrition management of SAP patients was beneficial to standardize the practice of ICU nurses, improve the quality of clinical care and improve the tolerance and satisfaction of enteral nutrition care of SAP patients.

Haining City and Jiashan County in Zhejiang Province are the first areas to carry out colorectal cancer screening in China, which started in the early 1970s and has been going on for more than 40 years. Meanwhile, Haining and Jiashan have also become the first batch of National Demonstration Bases for Early Diagnosis and Treatment of Colorectal Cancer. In the past 40 years, owing to Professor Zheng Shu who is brave and innovative, with an indomitable spirit, as well as the unremitting efforts and active exploration of all the team members, colorectal cancer screening which was unknown by the public and implemented with difficulties, has gradually been widely accepted and benefited the population. Today, remarkable achievements have been fulfilled in the colorectal cancer screening of Haining and Jiashan which has become the pioneer power in promoting the progress of colorectal cancer prevention and control in China and has certain influence both on China and the world. Meanwhile, a set of colorectal cancer screening strategies suitable for China has been explored and further promoted to be used nationwide, which is of great significance to the prevention and control of colorectal cancer in China. Looking forward to the future, the prevention and control of colorectal cancer in China is still difficult. We will continue to give full play to our existing advantages, not forget our original intention, move forward, explore innovation, and create greater glories!
China/epidemiology* ; Colonic Neoplasms/diagnosis* ; Colorectal Neoplasms/diagnosis* ; Early Detection of Cancer/statistics & numerical data* ; History, 20th Century ; Humans ; Mass Screening/methods* ; Rural Population/statistics & numerical data*

Objective To investigate the pshcyological status and influencing factors of patients with acute pancreatitis. Methods Acute pancreatitis patients admitted in Changhai Affiliated Hospital of Navy Medical University from December 2018 to February 2019 were enrolled, and 120 patients were selected using random number table method. Self-made general questionnaire, self-rating depressing scale, self-rating anxiety scale and coping style questionnaire were used for investigation and patients′ psychological status was evaluated. Results In this survey, 109 questionnaires were collected and eligible for final analysis. The incidence of depression in patients with acute pancreatitis was 44. 0％, and the incidence of anxiety was 20. 2％. Male patients had significantly lower anxiety and depression than women. The levels of anxiety and depression in the 31-50 age group were significantly lower than those in other age groups. The level of anxiety in patients with pancreatitis with children was significantly lower than in patients without children. The coping style of "solving problem" was significantly negatively correlated with depression and anxiety level. The"self-blame" coping style was significantly positively correlated with depression and anxiety level. The"rationalized"coping style was positively correlated with the level of depression. Conclusions The mental health status of patients with acute pancreatitis was not optimistic. Different coping styles were important factors affecting the level of anxiety and depression.