Objective: To identify research priorities on physical and mental comorbidity among children and adolescents in Zhejiang Province, so as to provide a theoretical base for improving their physical and mental health. Methods: In May 2025, 77 experts in the fields of health and education from 11 cities in Zhejiang Province were selected by convenient sampling method to participate in the first round of expert consultation. In June, 2025, snowball sampling was used to expand to 194 experts for the second round of consultation, and it was convenient to select 21 students from primary schools to high schools in Zhejiang Province and 29 parents to empower the evaluation criteria. It applied the Child Health and Nutrition Research Initiative (CHNRI) method in a structured process, which encompassed the definition of the research field, generation of research ideas, scoring, and quantitative ranking of priorities. Research ideas were evaluated against 6 predefined criteria: effectiveness, safety, answerability, feasibility, sustainability, and scientific significance. Results: After 2 rounds of structured consultations, 81 research ideas on physical and mental comorbidity among children and adolescents were established and classified into 7 subthemes: epidemiological characteristics and influencing factors, optimization of primary service systems and policies, comprehensive intervention strategies for physical and mental comorbidity, biological mechanisms and clinical research, the impact of education and environment on physical and mental health, special populations and social support, and digital and technology driven disease prevention and intervention. The top 10 research priorities primarily centered on the subdomain of "epidemiological characteristics and influencing factors" (5 items). The top 3 research priorities were "the association between outdoor activity duration and the incidence of common diseases (including mental disorders) among children and adolescents" "the impact of outdoor activity duration on the physical and mental health of adolescents" "comprehensive intervention strategies for myopia, obesity, and their comorbidities among children and adolescents". Conclusion The framework of priority issues in the field of psychosomatic comorbidity of children and adolescents in Zhejiang Province based on CHNRI method provides a reference for optimizing the allocation of provincial research resources.

Objective To isolate the Japanese encephalitis virus carried by Culex tritaeniorhynchus in Dongchuan District of Yunnan Province and analyze its molecular characteristics, so as to provide insights into the prevention and control of Japanese encephalitis in Yunnan Province. Methods Mosquito specimens were collected using mosquito-trapping lamps from pig farms in Batang Village and Xiaoxin Village, Dongchuan District, Kunming City, Yunnan Province in July 2016, and the mosquito species was identified according to the mosquito morphology. Then, 60 to 100 mosquitoes of each species served as a group and were ground. Baby hamster kidney-21 (BHK-21) cells and Aedes albopictus clone C6/36 cells were used for virus isolation, and positive isolates were identified using flavivirus primers. The positive isolates were amplified using reverse transcription polymerase chain reaction (RT-PCR) assay with 15 pairs of specific primers covering the full length of the genotype I Japanese encephalitis virus, and DNA sequence assembly was performed using the software SeqMan in the DNASTAR package. The obtained sequences were aligned with the complete sequences of 38 Japanese encephalitis virus downloaded from the GenBank with the software MegAlign, and the nucleotide and amino acid homology analyses of the obtained sequences were performed. The difference in amino acid sites was analyzed with the software GeneDoc, and phylogenetic trees were created based on the sequences of the coding region and E protein of the isolated Japanese encephalitis virus with the software Mega X. In addition, the secondary and tertiary structures of the E protein of the Japanese encephalitis virus were predicted using the online tool SOPMA and the software Swiss-Model. Results A total of 5 820 mosquitoes were collected and 3 843 Cx. tritaeniorhynchus (66.03%) were identified according to the mosquito morphology. A positive virus isolate, termed YNDC55-33, was isolated from Cx. tritaeniorhynchoides following batches of virus isolation from mosquito specimens, and cytopathic effect was observed following inoculation into BHK-21 and C6/36 cells. The YNDC55-33 virus isolate was successfully amplified with the flavivirus primes, and a long sequence containing 300 nucleotides was obtained. Following sequence alignment using the BLAST tool, the sequence of the YNDC55-33 virus isolate had high homology with that of the genotype I Japanese encephalitis virus. A long sequence with 10 845 nucleotides in length, which encoded 3 432 amino acids, was obtained by splicing the full sequence of the YNDC55-33 virus isolate. Phylogenetic analysis based on the whole-genome sequence and E gene sequence of the YNDC55-33 virus isolate showed that the new YNDC55-33 virus isolate was most closely related to the genotype I Guizhou isolate (GenBank accession number: HM366552), with nucleotide homology of 98.5% and amino acid homology of 99.4%, and the YNDC55-33 virus isolate shared 97.96% ± 0.33% nucleotide homology and 99.35% ± 0.08% amino acid homology with other genotype I Japanese encephalitis virus isolates, and < 90% nucleotide homology and < 98% amino acid homology with other genotypes of Japanese encephalitis virus. The YNDC55-33 virus isolate and the live attenuated virus vaccine candidate SA14-14-2 isolate differed at 16 amino acid sites on E gene, and 7 out of 8 key amino acid sites related to neurovirulence. The secondary and tertiary structures of the E protein of the YNDC55-33 virus isolate were predicted to be characterized by random coils. Conclusions A genotype I Japanese encephalitis virus was isolated from Cx. tritaeniorhynchus in Dongchuan District, Kunming City. This virus isolate and the live attenuated virus vaccine candidate SA14-14-2 isolate does not differ at antigenic epitopes-related key amino acid sites, and the major protein structure of the virus isolate is random coils. This study adds new data for the epidemiological distribution of Japanese encephalitis virus in Yunnan Province, which may provide insights into the prevention and control of Japanese encephalitis in the province.

Objective:To evaluate the efficacy and safety of cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment of pseudomyxoma peritonei (PMP).Methods:In this descriptive case series study, we retrospective analyzed the records of PMP patients treated with CRS and HIPEC between January 2013 and June 2023 at Affiliated Cancer Hospital and Institute of Guangzhou Medical University. The inclusion criteria were as follows: (1) Aged 18 to 75 years and nonpregnant women. (2) Histologically confirmed diagnosis of pseudomyxoma peritonei. (3) Karnofsky Performance Scale (KPS)>70. (4) The functions of major organs such as the heart, liver, lungs, and kidneys can tolerate major surgery for long periods of time. (5) No evidence of extra-abdominal metastasis. Patients with extensive intra-abdominal adhesions or severe infectious diseases were excluded. The main outcomes were overall survival (OS) and postoperative major complications. The postoperative major complications were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (version 5.0). We used the peritoneal cancer index (PCI) score to quantitatively assess the peritoneal metastases and the completeness of cytoreduction (CCR) score at the end of surgery (CCR-0 and CCR-1 considered to be complete CRS).Results:A total of the 186 PMP patients with a median age of 56 (interquartile range extremes (IQRE), 48-64) years were included, 65 (34.9%) males and 121 (65.1%) females. The median peritoneal cancer index (PCI) score was 28 (20-34). Appendiceal origin accounted for 91.4%. Histological types were low grade in 99 patients (53.2%), high grade in 57 patients (30.6%), and 55 patients (29.6%) received complete cytoreduction (CCR-0/1). The median operative duration was 300 (211-430) minutes for all patients. Treatment-related 30-day mortality was 2.7%; 90-day mortality 4.3%; reoperation 1.6%; and severe morbidity 43.0%. Within the entire series, anemia(27.4%), electrolyte disturbance(11.6%), and hypoalbuminemia(7.5%) were the most frequent major complications (grade 3-4). The incidences of gastrointestinal anastomotic leakage, abdominal bleeding, and abdominal infection were 2.2%, 2.2%, and 4.3%, respectively. After a median follow-up of 38.1 (95%CI:31.2-45.1) months, the 5-year OS was 50.3% (95%CI: 40.7%-59.9%) with a median survival time of 66.1 (95%CI: 43.1-89.1) months. The survival analysis showed that patients with pathological low grade, low PCI, and low CCR score had better survival with statistically significant differences (all P<0.05). Further stratified into complete and incomplete CRS subgroups, the 5-year OS of the CCR-0 and CCR-1 subgroups was 88.9% (95%CI: 68.3%-100.0%) and 77.6% (95%CI: 62.7%-92.5%), respectively; and 42.0% (95%CI: 29.5%-54.5%) in the CCR-2/3 subgroup. Conclusions:CRS and HIPEC may result in a long-term survival benefit for PMP patients with acceptable perioperative morbidity and mortality. This strategy, when complete CRS is possible, could significantly prolong survival for strictly selected patients at experienced centers.

Objective:To evaluate the efficacy and safety of cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment of pseudomyxoma peritonei (PMP).Methods:In this descriptive case series study, we retrospective analyzed the records of PMP patients treated with CRS and HIPEC between January 2013 and June 2023 at Affiliated Cancer Hospital and Institute of Guangzhou Medical University. The inclusion criteria were as follows: (1) Aged 18 to 75 years and nonpregnant women. (2) Histologically confirmed diagnosis of pseudomyxoma peritonei. (3) Karnofsky Performance Scale (KPS)>70. (4) The functions of major organs such as the heart, liver, lungs, and kidneys can tolerate major surgery for long periods of time. (5) No evidence of extra-abdominal metastasis. Patients with extensive intra-abdominal adhesions or severe infectious diseases were excluded. The main outcomes were overall survival (OS) and postoperative major complications. The postoperative major complications were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (version 5.0). We used the peritoneal cancer index (PCI) score to quantitatively assess the peritoneal metastases and the completeness of cytoreduction (CCR) score at the end of surgery (CCR-0 and CCR-1 considered to be complete CRS).Results:A total of the 186 PMP patients with a median age of 56 (interquartile range extremes (IQRE), 48-64) years were included, 65 (34.9%) males and 121 (65.1%) females. The median peritoneal cancer index (PCI) score was 28 (20-34). Appendiceal origin accounted for 91.4%. Histological types were low grade in 99 patients (53.2%), high grade in 57 patients (30.6%), and 55 patients (29.6%) received complete cytoreduction (CCR-0/1). The median operative duration was 300 (211-430) minutes for all patients. Treatment-related 30-day mortality was 2.7%; 90-day mortality 4.3%; reoperation 1.6%; and severe morbidity 43.0%. Within the entire series, anemia(27.4%), electrolyte disturbance(11.6%), and hypoalbuminemia(7.5%) were the most frequent major complications (grade 3-4). The incidences of gastrointestinal anastomotic leakage, abdominal bleeding, and abdominal infection were 2.2%, 2.2%, and 4.3%, respectively. After a median follow-up of 38.1 (95%CI:31.2-45.1) months, the 5-year OS was 50.3% (95%CI: 40.7%-59.9%) with a median survival time of 66.1 (95%CI: 43.1-89.1) months. The survival analysis showed that patients with pathological low grade, low PCI, and low CCR score had better survival with statistically significant differences (all P<0.05). Further stratified into complete and incomplete CRS subgroups, the 5-year OS of the CCR-0 and CCR-1 subgroups was 88.9% (95%CI: 68.3%-100.0%) and 77.6% (95%CI: 62.7%-92.5%), respectively; and 42.0% (95%CI: 29.5%-54.5%) in the CCR-2/3 subgroup. Conclusions:CRS and HIPEC may result in a long-term survival benefit for PMP patients with acceptable perioperative morbidity and mortality. This strategy, when complete CRS is possible, could significantly prolong survival for strictly selected patients at experienced centers.

Objective:To investigate the predictive value of uterine artery hemodynamic parameter monitoring in the first trimester on pregnancy outcomes in patients with recurrent pregnancy loss (RPL).Methods:The RPL patients were selected from the Department of Reproductive and Immunology of Shanghai First Maternal and Infant Hospital between November 2012 and May 2018. RPL patients were divided into live birth group and miscarriage group according to their pregnancy outcome. Case-control studies were designed to compare the two groups in hemodynamic parameters of transvaginal ultrasonography-uterine artery during first trimester.Results:Totally 348 cases in the live birth group and 312 cases in the miscarriage group were enrolled. As the gestational week increases, peak uterine artery systolic/end-diastolic velocity (S/D), pulsatility index (PI), and blood flow resistance index (RI) increased in both groups; compared with miscarriage group, uterine artery S/D, PI, and RI of live birth group decreased by 3.462 1 (95% CI=-6.483 5-0.440 8, P=0.025 2), 0.474 2 (95% CI=-1.000 5-0.052 1, P=0.078 1), and 0.054 6 (95% CI=-0.111 5-0.002 4, P=0.060 9), respectively. Uterine artery S/D, PI, RI slope rates in live birth group were 0.064 5 (95% CI=0.013 6-0.115 9, P=0.014 5), 0.009 4 (95% CI=0.000 5-0.018 4, P=0.039 4), and 0.001 1 (95% CI=0.000 1-0.002 0, P=0.032 2) higher than those in miscarriage group during early pregnancy. Conclusion:The slope rate of uterine arterial blood flow parameters in live birth group is faster than that in miscarriage group. Monitoring of uterine arterial blood flow during the first trimester may have a predictive value for pregnancy outcomes in RPL patients.

Objective:To investigate the predictive value of uterine artery hemodynamic parameter monitoring in the first trimester on pregnancy outcomes in patients with recurrent pregnancy loss (RPL).Methods:The RPL patients were selected from the Department of Reproductive and Immunology of Shanghai First Maternal and Infant Hospital between November 2012 and May 2018. RPL patients were divided into live birth group and miscarriage group according to their pregnancy outcome. Case-control studies were designed to compare the two groups in hemodynamic parameters of transvaginal ultrasonography-uterine artery during first trimester.Results:Totally 348 cases in the live birth group and 312 cases in the miscarriage group were enrolled. As the gestational week increases, peak uterine artery systolic/end-diastolic velocity (S/D), pulsatility index (PI), and blood flow resistance index (RI) increased in both groups; compared with miscarriage group, uterine artery S/D, PI, and RI of live birth group decreased by 3.462 1 (95% CI=-6.483 5-0.440 8, P=0.025 2), 0.474 2 (95% CI=-1.000 5-0.052 1, P=0.078 1), and 0.054 6 (95% CI=-0.111 5-0.002 4, P=0.060 9), respectively. Uterine artery S/D, PI, RI slope rates in live birth group were 0.064 5 (95% CI=0.013 6-0.115 9, P=0.014 5), 0.009 4 (95% CI=0.000 5-0.018 4, P=0.039 4), and 0.001 1 (95% CI=0.000 1-0.002 0, P=0.032 2) higher than those in miscarriage group during early pregnancy. Conclusion:The slope rate of uterine arterial blood flow parameters in live birth group is faster than that in miscarriage group. Monitoring of uterine arterial blood flow during the first trimester may have a predictive value for pregnancy outcomes in RPL patients.

Objective:To understand the personal dose level of nuclear medical workers in a hospital, and to provide basis for health management of nuclear medicine occupational population.Methods:From January 2014 to December 2018, 147 radiation workers in a hospital were selected as the monitoring objects, and the individual dose monitoring data were analyzed. The correlation between individual dose and clinical workload was analyzed.Results:The average annual personal dose of 147 staff members was below the national dose limit. Compared with the radiation department, the average annual personal dose of nuclear medical staff was higher, and the difference was statistically significant ( P<0.05) . There was a positive correlation between the annual average personal dose and the corresponding injection workload (Rs=0.69, P<0.05) . Conclusion:The occupational exposure risk of nuclear medical technicians and nurses is high, and reasonable protective measures should be taken to reduce the radiation exposure dose. Conclusion The occupational exposure risk of nuclear medical technicians and nurses is high, and reasonable protective measures should be taken to reduce the radiation exposure dose.

Objective:To understand the personal dose level of nuclear medical workers in a hospital, and to provide basis for health management of nuclear medicine occupational population.Methods:From January 2014 to December 2018, 147 radiation workers in a hospital were selected as the monitoring objects, and the individual dose monitoring data were analyzed. The correlation between individual dose and clinical workload was analyzed.Results:The average annual personal dose of 147 staff members was below the national dose limit. Compared with the radiation department, the average annual personal dose of nuclear medical staff was higher, and the difference was statistically significant ( P<0.05) . There was a positive correlation between the annual average personal dose and the corresponding injection workload (Rs=0.69, P<0.05) . Conclusion:The occupational exposure risk of nuclear medical technicians and nurses is high, and reasonable protective measures should be taken to reduce the radiation exposure dose. Conclusion The occupational exposure risk of nuclear medical technicians and nurses is high, and reasonable protective measures should be taken to reduce the radiation exposure dose.

Retinal degeneration,associated with loss of photoreceptors,is the primary cause of permanent vision impairment,impacting millions of people worldwide.Age-related macular degeneration and retinitis pigmentosa are two common retinal diseases resulting in photoreceptor loss.Recently,many studies were working on the application of polymer scaffolds in retinal stem cell transplantation.The results showed that polymer scaffolds can delivery transplanted cells to the correct site and promote cell survival,integration,differentiation,thereby providing a good platform for cell transplantation.There are different transplantation cell types.Moreover,different materials have different advantages and disadvantages.The ideal scaffold should have the following characteristics:thin,biocompatible,biodegradable,certain mechanical strength and flexibility,and easy to bind.Surface modification of materials can improve their functioning.In addition to the cells,the scaffold can directional transport substances,such as drugs.Polymer scaffolds have a good prospect in the application of retinal cell transplantation.This paper summarized the findings of different scaffolds for cell delivery to the sub-retinal space-based transplant technology.

Learning modes based on the initiatives of students has become a new way in the development of medical students' quality.The second clinical medical college of Southern Medical University performed an improved teaching method:meliorated PBL based on TBL and taking clinical and scientific research ability as the core,which combined the advantages of PBL and TBL in view of the importance of clinical and scientific research ability for medical students.Practice proved that this teaching method was effective in improving comprehensive quality of medical students and cultivating more comprehensive talents for the society.