ObjectiveTo investigate the imaging features of calcium salt deposition and serological markers in patients with alveolar echinococcosis through a retrospective analysis， as well as independent risk factors for the degree of calcium salt deposition in lesions， and to provide a basis for assessing disease process. MethodsA retrospective analysis was performed for the imaging and clinical data of 107 patients with alveolar echinococcosis who were admitted to The First Affiliated Hospital of Shihezi University from December 2023 to June 2025， and according to the volume of calcium salt deposition， they were divided into non-deposition group with 16 patients， mild deposition group with 52 patients， moderate deposition group with 16 patients， and severe deposition group with 23 patients. A one-way analysis of variance or the Kruskal-Wallis H test was used for comparison of continuous data between groups， and the χ² test or Fisher’s exact test was used for comparison of categorical data between groups. The four groups were further combined into the low deposition group （no/mild deposition） and the high deposition group （moderate/severe deposition）. A binary logistic regression analysis was used to investigate the independent influencing factors for calcium salt deposition， and a predictive model was established. The receiver operating characteristic （ROC） curve was used to assess the predictive performance of the model， and the Bootstrap method was used for internal validation. ResultsThere were significant differences between the four groups in sex distribution， involvement of other sites， white blood cell count， lymphocyte percentage， fibrinogen， uric acid， sodium ion， chloride ion， and calcium ion （all P<0.05）. The univariate analysis showed that there were significant differences between the four groups in sex， involvement of other sites， white blood cell count， lymphocyte percentage， fibrinogen， alanine aminotransferase， albumin， creatinine， uric acid， sodium ion， chloride ion， and calcium ion （all P<0.1）. The multi-collinearity diagnosis showed that the VIF values for all continuous variables ranged from 1.104 to 1.760， suggesting that collinearity did not affect modeling. An ordinal logistic regression model was established based on sex， involvement of other sites， calcium ion， lymphocyte percentage， and uric acid. The multivariate analysis showed that lymphocyte percentage （odds ratio ［OR］=1.106， 95% confidence interval ［CI］： 1.041 — 1.174， P=0.001） and blood calcium level （OR=0.005， 95%CI： 0.000 —0.230， P=0.007） were independent influencing factors for the degree of calcium salt deposition. The regression equation was established as Logit（P）=8.231 + 0.100 × lymphocyte percentage -5.344 × calcium ion. The ROC curve analysis showed that the model had an area under the ROC curve of 0.716， with a Youden index of 0.353， a sensitivity of 1.000， and a specificity of 0.353. The Hosmer-Lemeshow test showed that the model had poor calibration （χ²=20.688， P=0.008）. The Bootstrap method with 1000 repeated samples showed that the estimated values of lymphocyte percentage （OR=1.106， 95%CI： 1.049 — 1.186， P=0.002） and calcium ion （OR=0.005， 95%CI： 0.000 — 0.214， P=0.010） were consistent with the original model， and the confidence intervals did not include 1， which further supported the reliability of the model. ConclusionBoth lymphocyte percentage and blood calcium level are independent influencing factors for calcium salt deposition in alveolar echinococcosis， and the degree of calcium salt deposition in alveolar echinococcosis lesions increases with the reduction in blood calcium level and the increase in lymphocyte percentage.

Objective To investigate the distribution characteristics of Oncomelania hupensis snails in Yunnan Province fol-lowing interruption of schistosomiasis transmission, so as to provide the evidence for assessing the risk of schistosomiasis transmission and scientifically formulating the schistosomiasis surveillance program. Methods According to the requirements of the National Schistosomiasis Surveillance Scheme (2020 Edition), O. hupensis snail surveillance data were collected from 18 schistosomiasis-endemic counties (cities, districts) in Yunnan Province from 2020 to 2024, including area of snail survey, area of snail habitats, area of re-emerging snail habitats, number of frames surveyed, number of frames with O. hupensis snails, number of O. hupensis snails captured, and number of living snails, and the occurrence of frames with snails and mean density of living snails were calculated. Changes in snail status over the 5-year period from 2020 to 2024 and the differences in snail distributions specified by epidemic intensity, environmental type, and vegetation type were analyzed. Results The areas of snail survey increased from 1 727.96 hm² in 2020 to 3 894.45 hm² in 2024 (peak) across 18 schistosomiasis-endemic counties (cities, districts) in Yunnan Province during the period from 2020 through 2024. The areas of snail habitats increased from 70.36 hm² in 2020 to a peak in 2023 (172.04 hm²), followed by a reduction to 132.36 hm² in 2024, and the areas of re-emerging snail habitats increased from 42.71 hm² in 2020 to a peak in 2022 (78.43 hm²), followed by a reduction to 40.21 hm² in 2024. The occurrence of frames with snails and mean density of living snails increased from 1.24% (3 025/244 404) and (0.033 2 ± 0.038 7) snails/0.1 m² in 2020 to peaks at 2.03% (6 231/307 563) and (0.066 9 ± 0.068 4) snails/0.1 m² in 2023, followed by reductions to 1.04% (5 829/559 941) and (0.032 6 ± 0.057 7) snails/0.1 m² in 2024, respectively. There was a significant difference in the occurrence of frames with snails over the 5-year study period (χ² = 1 962.95, P < 0.05), and the occurrence of frames with snails reduced by 48.71% in 2024 relative to in 2023 (χ² = 1 411.05, P < 0.005); however, there was no significant difference in the mean density of living snails over the 5 years (H = 5.310, P > 0.05). There were significant differences in the occurrence of frames with snails (χ² = 481.27, P < 0.05) and mean density of living snails (H = 6.872, P < 0.05) in schistosomiasis-endemic areas with different epidemic intensities. The occurrence of frames with snails (χ² = 25.32 and 38.70, both P values < 0.017) and mean density of living snails (Z = 28.55 and 49.96, both P values < 0.017) were higher in schistosomiasis transmission-interrupted and eliminated areas with snails than in schistosomiasis-eliminated areas without snails, and the occurrence of frames with snails (χ² = 453.54, P < 0.017) and mean density of living snails (Z = −56.97, P < 0.017) were higher in schistosomiasis-eliminated areas with snails than in schistosomiasis transmission-interrupted areas with snails. O. hupensis snails were mainly distributed in paddy fields, dry farmlands and ditches; however, the occurrence of frames with snails (13.40%, 424/3 164) and mean density of living snails [(0.252 8 ± 0.158 7) snails/0.1 m²] were higher in ponds/weirs than in other types of environments (both P values < 0.05). Rice, dry farmland crops and weeds were main vegetations in which O. hupensis snails were distributed, and the occurrence of frames with snails (2.29%, 7 111/310 140) and mean density of living snails [(0.072 3 ± 0.018 9) snails/0.1 m²] were higher in weeds than in other types of environments (both P values < 0.05). Conclusions O. hupensis snails have been effectively controlled in Yunnan Province following implementation of integrated schistosomiasis control measures; however, there are still risk factors for schistosomiasis transmission, including reduced attention to schistosomiasis control and snail re-emergence. Improved control efforts and surveillance system construction and timely identification of risk factors of snail status and timely management are recommended to ensure the achievement of the target of schistosomiasis elimination as scheduled.

Objective To investigate the prevalence of Schistosoma japonicum infections in wild murines in schistosomiasisendemic areas of Yunnan Province, so as to provide the evidence for improving the schistosomiasis surveillance and early warning capability and implementing precise interventions in the province. Methods A total of 56 natural villages were sampled from 14 schistosomiasis-endemic counties (cities, districts) in Yunnan Province as surveillance sites from 2024 to 2025. Wild murines were captured using traps at night and characterized for species. Liver samples were collected from wild murines, S. japonicum eggs and miracidia were simultaneously detected using liver tissue compression microscopy, liver tissue homogenate microscopy, and liver tissue homogenate hatching. In addition, stool samples were collected from wild murine rectum, with S. japonicum eggs detected using a modified Kato-Katz thick smear technique and S. japonicum miracidia detected using the hatching test with nylon gauzes. Results A total of 15 577 valid murine traps were recovered, and 891 wild murines belonging to 16 species were captured, with a capture rate of 5.72%(891/15 577). The captured wild murines were predominantly districted in paddy fields, dry lands, ditches, ponds and marshlands, with Apodemus chevrieri, Rattus norvegicus, Crocidura attenuata, R. rattus sladeni, R. flavipectus, and Eothenomys miletus as dominant species. No S. japonicum eggs or miradicia were in laboratory; however, other parasites were identified in 25 wild murines. The prevalence rates of Schistosoma sinensis, Capillaria hepatica and Hymenolepis nana were 2.24% (20/891), 0.90% (8/891) and 0.56% (5/891), and the prevalence of S. sinensis and C. hepatica co-infection was 0.90% (8/891), respectively. Conclusions S. sinensis, C. hepatica and H. nana are predominant parasite species in wild murines in schistosomiasis-endemic areas of Yunan Province. No S. japonicum infection was detected during the study period; however, there is still a risk of wild murines as a potential source of infection for schistosomiasis transmission. Continuous intensified surveillance of S. japonicum infections in wild murines is a critical programme in schistosomiasis surveillance and early warning in Yunnan Province.

Objective To systematically explore the psychological decision-making pathways influencing influenza vaccination intentions among Chinese residents, and to identify the key driving factors in the transformation process from cognition and belief to final intention. Methods This study employed a cross-sectional survey design and surveyed 303 Chinese residents via an online questionnaire. Three independent multiple linear regression analyses were conducted to sequentially test the path models of ^“Knowledge → Beliefs^”(Stage 1), ^“Beliefs → Attitude^”(Stage 2), and ^“Attitude → Intention^” (Stage 3). The role of demographic variables in each stage was also analyzed. Results In Stage 1, influenza knowledge was a significant predictor of forming key beliefs, significantly positively predicting the social responsibility belief of ^“being responsible for family^” (B=0.242, P < 0.001), and significantly negatively predicting ^“doubt about vaccine effectiveness^” (B=−0.210, P < 0.001). In Stage 2, the public's vaccine-supportive attitude was significantly influenced by ^“social responsibility^” (B=0.234, P < 0.001), ^“doubt about vaccine effectiveness^” (B=−0.153, P=0.002), traditional media reports (B=0.233, P=0.002), and place of residence (B=−0.265, P=0.005). In Stage 3, vaccine-supportive attitude was the core predictor of future vaccination intention (B=0.597, P< 0.001), confirming its key mediating role. Additionally, previous vaccination history (B=0.143, P=0.001) and recommendations from friends and family (B=0.184, P=0.018) were two independent driving factors for vaccination intention. Specific occupations also showed significant influence in this final decision-making stage. Conclusion The public's decision-making process for influenza vaccination is a hierarchical transformation process from ^“Knowledge-Beliefs^” to ^“Attitude" and then to ^“Intention.^” Public health intervention strategies should implement targeted interventions based on the status of key driving factors at different stages..

Tumor microenvironment(TME)is the cellular environment for tumor development,growth,and metastasis.Adenosine(ADO)is an immunosuppressive metabolic product that is continuously upregulated in TME,with various types and wide distribution of receptors.The complex and dynamic interactions between ADO and tumor cells constantly influence tumor progression.ADO can di-rectly or indirectly promote tumor development and progression by promoting tumor generation and metastasis,mediating the immune escape of tumor,and modulating tumor-infiltrating immune cells.Based on the characteristics of ADOs in TME,this article reviews the latest advances in the dynamic alterations of ADO in TME,in order to provide insights into tumor treatment targeting the ADO pathway.

Objective To explore the correlation between the expression level of serum fibrinogen-like protein 1(FGL1)and the indexes of metabolism and renal function in patients with diabetic nephropathy(DN)and diabetes mellitus(DM),and provide reference for clinical diagnosis and treatment.Methods From January 2017 to April 2023,30 patients with DM and treated in Jiangsu Province Hospital of Chinese Medicine were selected as the DM group,68 patients with DN were selected as the DN group,and 36 healthy subjects were selected as the control group.The DN group was further divided into the early DN(DN-E)group(n=38)and the late DN(DN-A)group(n=30)according to whether there was a large amount of proteinuria and the severity.Clinical data such as serum albumin(ALB),estimated glomerular filtration rate(eGFR)and albumin-to-creatinine ratio(ACR)were collected.Serum FGL1 level was detected by enzyme-linked immunosorbent assay(ELISA).Pearson linear correlation was used for correlation,the diagnostic value was analyzed by ROC curve.Results Compared with the control group,the levels of ACR,FGL1 in patients with DM group increased,the levels of eGFR decreased,and the differences were statistically significant(t=5.686,4.336,-4.683,all P<0.05).Compated with the DM group,the levels of ACR,FGL1 in patients with DN-E group was increased,and the level of eGFR was decreased,and the differences were statistically significant(t=5.275,3.454,-4.969,all P<0.05).Compared with the DN-E group,the levels of ACR,FGL1 in the DN-A group were increased,the levels of eGFR were decreased,and the differences were statistically significant(t=7.881,7.051,-5.596,all P<0.05).Serum FGL1 level was negatively correlated with ALB and eGFR(r=-0.638,-0.547,all P<0.05),and positively correlated with ACR(r=0.691,P<0.05).The AUC(95%CI),specificity and sensitivity of serum FGL1 level in the diagnosis of DN were 0.947(0.908～0.987),100%and 82.4%,respectively.Conclusion The level of serum FGL1 in DN and DM patients is high,and the level of serum FGL1 is closely related to the common metabolic indexes such as ALB,eGFR and ACR in the diagnosis of DN,which may have certain clinical diagnostic value.

Idiopathic pulmonary fibrosis (IPF), a chronic interstitial lung disease, is characterized by aberrant wound healing, excessive scarring and the formation of myofibroblastic foci. Although the role of alternative splicing (AS) in the pathogenesis of organ fibrosis has garnered increasing attention, its specific contribution to pulmonary fibrosis remains incompletely understood. In this study, we identified an up-regulation of serine/arginine-rich splicing factor 7 (SRSF7) in lung fibroblasts derived from IPF patients and a bleomycin (BLM)-induced mouse model, and further characterized its functional role in both human fetal lung fibroblasts and mice. We demonstrated that enhanced expression of Srsf7 in mice spontaneously induced alveolar collagen accumulation. Mechanistically, we investigated alternative splicing events and revealed that SRSF7 modulates the alternative splicing of pyruvate kinase (PKM), leading to metabolic dysregulation and fibroblast activation. In vivo studies showed that fibroblast-specific knockout of Srsf7 in conditional knockout mice conferred resistance to bleomycin-induced pulmonary fibrosis. Importantly, through drug screening, we identified lomitapide as a novel modulator of SRSF7, which effectively mitigated experimental pulmonary fibrosis. Collectively, our findings elucidate a molecular pathway by which SRSF7 drives fibroblast metabolic dysregulation and propose a potential therapeutic strategy for pulmonary fibrosis.

Objective To investigate the immunomodulatory effect of albumin-bound Paclitaxel combined with Sintilimab on advanced esophageal cancer,and to analyze the survival benefit.Methods A total of 126 patients with advanced esophageal cancer admitted to Rugao People's Hospital from March 2020 to March 2023 were selected,and divided into the observation group(n=63)and the control group(n=63)using a random number table method.The control group was given albumin-bound Paclitaxel,while the observation group was given albumin-bound Paclitaxel combined with Sintilimab.The clinical efficacy,tumor markers[cytokeratin 19 fragment(CYFRA21-1),squamous cell carcinoma antigen(SCC-Ag),carbohydrate antigen 125(CA125),carcinoembryonic antigen(CEA)],immune function indicators(Th1/Th2,Th17/Treg),PD-1/PD-L1 signaling pathway indicators,Karnofsky performance status(KPS)scores,overall survival,and toxic side effects were compared between the two groups.Results The objective remission rate[38.10%(24/63)]and disease control rate[87.30%(55/63)]of the observation group were higher than those of the control group[20.63%(13/63),71.43%(45/63)](P<0.05).After 2 and 4 cycles of treatment,the serum SCC-Ag,CYFRA21-1,CA125 and CEA in the observation group were lower than those in the control group(P<0.05);after 2 and 4 cycles of treatment,compared with the control group,the observation group showed higher Th1/Th2,and lower Th17/Treg,PD-1 and PD-L1(P<0.05).The improvement rate of quality of life,progression free survival and overall survival in the observation group were higher or longer than those in the control group(P<0.05).There was no significant difference in the incidence of abnormal liver dysfunction,nausea and vomiting,decreased hemoglobin and leucopenia between the two groups(P>0.05),but the incidence of rash in the observation group[57.14%(36/63)]was higher than that in the control group[34.92%(22/63)](P<0.05).Conclusion Combination therapy of Sintilimab and albumin-bound Paclitaxel shows significant efficacy in the treatment of advanced esophageal cancer.It can regulate serum tumor marker levels,improve immune function,reduce the activity of the PD-1/PD-L1 signaling pathway to inhibit disease progression,enhance survival benefits,and improve quality of life.However,attention should be paid to the observation of rash reactions during treatment.

Objective:To construct a humanistic care nursing program for adult ICU patients, providing guidance for the clinical practice of humanistic care in ICUs.Methods:Based on a literature review and clinical practice experience, a preliminary humanistic care nursing program for adult ICU patients was drafted. From August to September 2024, the Delphi method was used to conduct two rounds of expert consultation with 16 experts to revise the content of each item and the overall program, resulting in the final version of the humanistic care nursing program for ICU adult patients. The experts' engagement was measured by the effective response rate of the questionnaires, their authority by the expert authority coefficient, and the coordination of expert opinions by the Kendall's coefficient of concordance.Results:The effective response rate for the Delphi expert consultation questionnaires was 100.00% (16/16) in both rounds. The expert authority coefficients were 0.872 and 0.875, respectively. After the second round of consultation, the Kendall's coefficients for the importance, applicability, and feasibility of each level of item ranged from 0.119 to 0.313 ( P<0.05). The final humanistic care nursing program for adult ICU patients included three first-level items, 12 second-level items, and 55 third-level items. Conclusions:The humanistic care nursing program for adult ICU patients constructed in this study is scientific, targeted, and feasible, providing guidance for the clinical practice of humanistic care in ICU settings.

Objective This review aims to investigate the application of eye tracking(ET)in patients with speech impairment in the ICU.The review summarizes the current status and prospects of ET technology applications.Methods Following the scoping reviews framework,a systematic search was conducted across Web of Science,PubMed,Cochrane Library,Embase,CINAHL,CNKI,Wanfang Data,Chinese Medical Database,and Chinese biomedical database.The search covered publications from the inception of each database to October 29th,2024.The included studies were comprehensively analyzed.Results A total of 12 pieces of the literature were included,including 4 prospective cohort studies,4 experimental studies,3 prospective observational studies,and 1 randomized controlled trial.The application population of ET in the ICU mainly includes patients on mechanical ventilation,those at high risk of delirium,patients with spinal cord injury,etc.The types of integrated ET system equipment are mainly head-mounted and fixed;the types of ET involve gaze,blinking,etc.;the functions include standardized scale assessment,free interaction,and eye-movement model recognition.The main outcome indicators of the research are feasibility,physical symptoms and social-psychological status.Conclusion ET is applicable to a specific group of ICU patients with aphasia,and has shown good feasibility and effectiveness in the expression of patients'basic needs,self-assessment of symptoms and improvement of psychosocial status.