Objective To examine the impact of extreme temperature and drought stress on the survival of Bulinus globosus, so as to provide the theoretical evidence for the genomic research of Bulinus in absence of reference genes. Methods B. globosus snail samples were collected from Kiwani Shehia in Pemba Island, Zanzibar, Tanzania, and offspring snails were obtained through laboratory breeding and reproduction. A total of 120 10-week-old B. globosus snails from the same generation were selected and randomly assigned into four groups, including the high-temperature drought (HD) group, normal temperature drought (D) group, low-temperature drought (LD) group, and the control (C) group, of 30 snails in each group. Snails in HD, D, and LD groups were placed in beakers containing dry soil at the bottom and subsequently housed in climate chambers at 35, 26 ℃, and 10 ℃, respectively, while snails in Group C were maintained in 500 mL petri dishes containing dechlorinated tap water at 26 ℃. Following 3 days of breeding, living snails in each group were collected, and soft tissues were dissected and isolated. Total RNA was extracted from snail soft tissues for library construction, followed by high-throughput sequencing on the Illumina HiSeq 4000 sequencing system. De novo transcriptome assembly was performed using the Trinity software, and the longest transcripts were selected as unigenes. Gene functional annotations of unigenes were conducted using the Diamond software against Gene Ontology (GO) knowledgebase, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway database, NCBI non-redundant (NR) protein sequences database, Protein Family (Pfam) database, and UniProtKB/Swiss-Prot (Swiss-Prot) knowledgebase. GO and KEGG enrichment analyses of differentially expressed genes (DEGs) were performed using the topGO and clusterProfiler software, respectively. In addition, four relevant genes were selected for validation using a real-time quantitative PCR (qRT-PCR) assay to verify the reliability of transcriptome sequencing results. Results Following 3 days of breeding, there were 7, 20, 28, and 30 survival B. globosus snails in HD, LD, D, and C groups, with corresponding survival rates of 23.33% (7/30), 66.67% (20/30), 93.33% (28/30), and 100.00% (30/30), respectively (χ² = 52.72, P < 0.001). De novo transcriptome assembly generated 176 942 unigenes, with annotation rates of 0.98%, 13.49%, 26.46%, 12.48%, and 14.39% against GO knowledgebase, KEGG pathway database, NR protein sequences database, Pfam database, and Swiss-Prot knowledgebase, respectively. There were 33 up-regulated and 72 down-regulated genes in Group D, 483 up-regulated and 815 down-regulated genes in Group HD, and 245 up-regulated and 172 down-regulated genes in Group LD relative to in Group C. Following removal of overlapping genes across groups and unmatched genes, 11 candidate genes were identified. GO and KEGG analyses revealed 3 heat shock protein (HSP)-related DEGs in these 11 candidate genes, which were annotated as HSP12.2, HSP70, and HSP20 genes and were all significantly up-regulated in each treatment group. Three immune and nervous system-related DEGs were identified, and were all significantly down-regulated in each treatment group, which were involved in the neural cell adhesion molecule L1-like protein pathway, fibrinogen binding protein pathway, and leukocyte elastase inhibitor-like protein pathway. qRT-PCR assay quantified that the expression trends of four genes related to temperature and drought stress across different treatment groups were highly consistent with transcriptome sequencing data. Conclusion The survival rate of B. globosus significantly reduces under combined stresses of extreme temperature and drought, possibly due to an imbalance in its cellular homeostasis regulatory system.

Objective: To investigate the prevalence of comorbidity of myopia, and overweight and obesity among primary and middle school students in Yanqing District, Beijing Municipality, so as to provide the evidence for \prevention and control of comorbidity. Methods: In September from 2020 to 2024, a stratified cluster sampling method was adopted annually to select primary, junior high school, senior high school, and vocational high school students in Yanqing District as survey subjects. Myopia was screened based on Screening Protocol for Myopia in Children and Adolescents. Height an weight were measured, and overweight and obesity were determined using the Screening for overweight and Obesity in School-Age Children and Adolescents. Results: A total of 9 883 individuals were surveyed, including 5 219 primary school students (52.81%), 2 486 junior high school students (25.15%), and 2 178 senior high school / vocational high school students (22.04%). There were 5 154 boys (52.15%) and 4 729 girls (47.85%). From 2020 to 2024, the numbers of primary and middle school students in Yanqing District with myopia, overweight, and obesity were 4 426, 1 897, and 3 164, respectively, with detection rates of 44.78%, 19.19%, and 32.01%. The detection rates of myopia, overweight, and obesity showed an increasing trend with the elevation of school stage (all P<0.05). The detection rate of myopia was higher in girls than in boys, while the detection rate of obesity was lower in girls than in boys (all P<0.05). There were 2 588 individuals with both myopia and overweight/obesity, representing a detection rate of 26.19%, which showed an increasing trend (P<0.05), rising from 25.04% in 2020 to 34.41% in 2024. The detection rates of comorbidity of myopia, and overweight and obesity among primary school, junior high school, and senior high school / vocational high school students were 13.22%, 36.93%, and 45.00%, respectively, showing an increasing trend with the elevation of school stage (P<0.05). The difference between genders was not statistically significant (P>0.05). Conclusions The detection rates of comorbidity of myopia, and overweight and obesity among primary and middle school students in Yanqing District is relatively high and shows an upward trend, with students in higher school stage being the key target group for prevention and control. It is recommended to strengthen health education on the co-prevention of multiple health issues and implement differentiated interventions based on school stages.

Objective To explore factors associated with early postoperative hormonal remission in patients with prolactinoma and to develop prediction models based on clinical and radiological features. Methods Data from 107 patients with prolactinoma who underwent transsphenoidal surgery at The First People’s Hospital of Huai’an, Nanjing Medical University between January 2020 and December 2024 was collected, included general clinical characteristics, preoperative laboratory indicators, and imaging features. Based on whether early postoperative prolactin (PRL) levels normalized, patients were divided into a remission group (n=76) and a non-remission group (n=31). Univariate logistic regression was used for preliminary evaluation of candidate variables, followed by LASSO regression for feature selection. Multiple machine learning models were constructed, including logistic regression, random forest, support vector machine, K-nearest neighbors, naive Bayes, decision tree, neural network, and gradient boosting decision tree (GBDT). All models were trained and evaluated using ten-fold cross-validation, with comprehensive assessment of model performance based on the area under the ROC curve (AUC), accuracy, sensitivity, specificity, precision, and F1 score. Results The maximum diameter of tumors in the non remission group was larger than that in the remission group (P=0.019), and the incidence of tumor stroke and preoperative PRL levels were significantly higher than those in the remission group (P＜0.001). Univariate analysis showed that sex, maximum tumor diameter, tumor stroke, and preoperative PRL levels were influencing factors for early postoperative hormone response in patients with prolactinoma (P＜0.05). The comparison results of machine learning models show that the neural network model performs the best (AUC=0.921) and has good clinical application value, followed by the GBDT model (AUC=0.893) and the support vector machine model (AUC=0.884). Other models also show certain predictive ability. Conclusions Sex, preoperative PRL levels, maximum tumor diameter, Hounsfield unit value, and tumor stroke are important factors affecting early hormone response after prolactinoma surgery. The machine learning model constructed based on the above variables has good predictive performance, and performs the best and has good clinical application value.

Objective To evaluate the effect of low-dose ¹⁸F-fluorodeoxyglucose (FDG) injection on image quality in pediatric patients, calculate the whole-body effective dose and absorbed doses to critical organs, and provide a reference for clinical protection in pediatric low-dose positron emission tomography/computed tomography (PET/CT) examination. Methods A total of 67 pediatric patients aged 4-14 years who underwent ¹⁸F-FDG whole-body PET/CT imaging in the Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University between January 2024 and December 2025 were enrolled in a retrospective study. According to the injected ¹⁸F-FDG dose, patients were divided into a full-dose group (37 cases, 2.96-3.7 MBq/kg, PET acquisition duration of 10 min) and a low-dose group (30 cases, 1.85-2.4 MBq/kg, PET acquisition duration of 15 min). All scans were performed using a uEXPLORER PET/CT scanner. The standardized uptake value, standard deviation, and signal-to-noise ratio were measured for the liver and mediastinal blood pool. Image quality was compared between the two groups. The PET effective dose was calculated based on body mass index, and the total effective dose was obtained by combining PET effective dose with CT effective dose. The doses to critical organs were calculated according to ICRP Publication 128. Statistical analysis was performed using SPSS 26.0 and Prism 9.0 software. Differences were compared between groups. Results There were no significant differences in age, sex, weight, height, or body mass index between the two groups (P>0.05), while the injected dose showed a significant difference (P<0.001). In terms of image quality, there were no significant differences in standardized uptake value, standard deviation, and signal-to-noise ratio between the two groups. In terms of radiation dose, compared with the full-dose group, the low-dose group showed a 35.13% reduction in PET effective dose and a 15.22% reduction in total effective dose (P<0.05), whereas the CT effective dose was reduced by 2.4% and the difference was not significant (P=0.0892). The doses to critical organs (gonads, breasts, thyroid, red bone marrow, lungs) in the low-dose group were significantly lower than those in the full-dose group (P<0.01). Conclusion Under the premise of meeting clinical diagnostic requirements, low-dose ¹⁸F-FDG whole-body PET/CT imaging in pediatric patients can reduce the overall radiation exposure by 15%, and decrease the doses to critical organs, including the gonads, by more than 20%.

ObjectiveTo investigate whether there exists an independent association beyond shared risk factors between colorectal space-occupying lesions and metabolic associated fatty liver disease （MAFLD）， and to provide new ideas for early identification of colorectal space-occupying lesions in the MAFLD population. MethodsA retrospective analysis was performed for 12 252 patients who were hospitalized in The First Affiliated Hospital of Shandong First Medical University （Shandong Provincial Qianfoshan Hospital） and underwent both colonoscopy and abdominal imaging （abdominal ultrasound， magnetic resonance imaging， or computed tomography） from September 1， 2018 to August 31， 2023. According to colonoscopy findings， the patients were divided into colorectal space-occupying lesion group with 6 545 patients and non-colorectal space-occupying lesion group with 5 707 patients. Baseline data were compared between the two groups. The univariate and multivariate Logistic regression analyses were used to identify influencing factors for colorectal space-occupying lesions， and further analysis was performed to investigate the association of MAFLD and liver fibrosis （assessed by fibrosis-4 ［FIB-4］， nonalcoholic fatty liver disease fibrosis score ［NFS］， and aspartate aminotransferase-to-platelet ratio index） with colorectal space-occupying lesions. The Mann-Whitney U test was used for comparison of continuous data with skewed distribution between groups， and the chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups. ResultsThe univariate analysis showed that compared with the non-colorectal space-occupying lesion group， the colorectal space-occupying lesion group had significantly higher age （Z=-95.628， P<0.001）， proportion of male patients （χ²=406.910， P<0.001）， body weight （Z=-24.928， P<0.001）， body mass index （BMI） （Z=-21.367， P<0.001）， diastolic blood pressure （Z=-15.527， P<0.001）， systolic blood pressure （Z=-16.965， P<0.001）， proportion of patients with history of coronary heart disease （χ²=28.112， P<0.001）/hypertension （χ²=152.993， P<0.001）/diabetes （χ²=52.175， P<0.001）/cerebral infarction （χ²=14.097， P<0.001）， white blood cell count （WBC） （Z=-12.801， P<0.001）， hemoglobin （HGB） （Z=-19.258， P<0.001）， aspartate aminotransferase （Z=-6.673， P=0.001）， alanine aminotransferase （Z=-10.375， P<0.001）， alkaline phosphatase （Z=-10.496， P<0.001）， gamma-glutamyl transpeptidase （GGT） （Z=-18.893， P<0.001）， blood urea nitrogen （Z=-13.291， P<0.001）， creatinine （Z=-16.798， P<0.001）， uric acid （Z=-16.822， P<0.001）， triglyceride （Z=-10.186， P<0.001）， and fasting blood glucose （Z=-15.761， P<0.001）. The multivariate Logistic regression analysis showed that age （odds ratio ［OR］=1.052， 95% confidence interval ［CI］： 1.045 — 1.057， P<0.001）， sex （OR=0.523， 95%CI： 0.466 — 0.587， P<0.001）， BMI （OR=1.031， 95%CI： 1.018 — 1.046， P<0.001）， history of hypertension （OR=1.140， 95%CI： 1.019 — 1.276， P=0.022）， WBC （OR=1.057， 95%CI： 1.028 — 1.087， P<0.001）， GGT （OR=1.001， 95%CI： 1.000 — 1.002， P=0.021）， Alb （OR=0.982， 95%CI： 0.969 — 0.995， P=0.008）， and HGB （OR=1.004， 95%CI： 1.001 — 1.008， P=0.019） were independent influencing factors for colorectal space-occupying lesions. In the MAFLD population， after adjustment for age， sex， BMI， history of hypertension， WBC， HGB， GGT， and Alb， intermediate-to-high risk of advanced liver fibrosis assessed by FIB-4 and NFS was still an influencing factor for colorectal space-occupying lesions （FIB-4： OR=1.457， 95%CI： 1.176 — 1.810， P<0.05； NFS： OR=1.499， 95%CI： 1.244 — 1.809， P<0.05）. Liver fibrosis degree based on FIB-4 was not significantly associated with the pathological type， location， size， or number of colorectal space-occupying lesions （all P>0.05）. While intermediate-to-high risk of advanced liver fibrosis based on NFS was not associated with pathological type， location， or size， it might be associated with the number of lesions （χ²=9.770， P<0.05）. ConclusionAge， sex， BMI， history of hypertension， WBC， HGB， GGT， and Alb are independent influencing factors for colorectal space-occupying lesions. Intermediate-to-high risk of advanced liver fibrosis assessed by FIB-4 or NFS is independently associated with colorectal space-occupying lesions， and liver fibrosis assessed by NFS might be associated with the increase in the number of lesions.

Objective To evaluate the effect of low-dose ¹⁸F-fluorodeoxyglucose (FDG) injection on image quality in pediatric patients, calculate the whole-body effective dose and absorbed doses to critical organs, and provide a reference for clinical protection in pediatric low-dose positron emission tomography/computed tomography (PET/CT) examination. Methods A total of 67 pediatric patients aged 4-14 years who underwent ¹⁸F-FDG whole-body PET/CT imaging in the Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University between January 2024 and December 2025 were enrolled in a retrospective study. According to the injected ¹⁸F-FDG dose, patients were divided into a full-dose group (37 cases, 2.96-3.7 MBq/kg, PET acquisition duration of 10 min) and a low-dose group (30 cases, 1.85-2.4 MBq/kg, PET acquisition duration of 15 min). All scans were performed using a uEXPLORER PET/CT scanner. The standardized uptake value, standard deviation, and signal-to-noise ratio were measured for the liver and mediastinal blood pool. Image quality was compared between the two groups. The PET effective dose was calculated based on body mass index, and the total effective dose was obtained by combining PET effective dose with CT effective dose. The doses to critical organs were calculated according to ICRP Publication 128. Statistical analysis was performed using SPSS 26.0 and Prism 9.0 software. Differences were compared between groups. Results There were no significant differences in age, sex, weight, height, or body mass index between the two groups (P>0.05), while the injected dose showed a significant difference (P<0.001). In terms of image quality, there were no significant differences in standardized uptake value, standard deviation, and signal-to-noise ratio between the two groups. In terms of radiation dose, compared with the full-dose group, the low-dose group showed a 35.13% reduction in PET effective dose and a 15.22% reduction in total effective dose (P<0.05), whereas the CT effective dose was reduced by 2.4% and the difference was not significant (P=0.0892). The doses to critical organs (gonads, breasts, thyroid, red bone marrow, lungs) in the low-dose group were significantly lower than those in the full-dose group (P<0.01). Conclusion Under the premise of meeting clinical diagnostic requirements, low-dose ¹⁸F-FDG whole-body PET/CT imaging in pediatric patients can reduce the overall radiation exposure by 15%, and decrease the doses to critical organs, including the gonads, by more than 20%.

Objective To evaluate the effect of low-dose ¹⁸F-fluorodeoxyglucose (FDG) injection on image quality in pediatric patients, calculate the whole-body effective dose and absorbed doses to critical organs, and provide a reference for clinical protection in pediatric low-dose positron emission tomography/computed tomography (PET/CT) examination. Methods A total of 67 pediatric patients aged 4-14 years who underwent ¹⁸F-FDG whole-body PET/CT imaging in the Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University between January 2024 and December 2025 were enrolled in a retrospective study. According to the injected ¹⁸F-FDG dose, patients were divided into a full-dose group (37 cases, 2.96-3.7 MBq/kg, PET acquisition duration of 10 min) and a low-dose group (30 cases, 1.85-2.4 MBq/kg, PET acquisition duration of 15 min). All scans were performed using a uEXPLORER PET/CT scanner. The standardized uptake value, standard deviation, and signal-to-noise ratio were measured for the liver and mediastinal blood pool. Image quality was compared between the two groups. The PET effective dose was calculated based on body mass index, and the total effective dose was obtained by combining PET effective dose with CT effective dose. The doses to critical organs were calculated according to ICRP Publication 128. Statistical analysis was performed using SPSS 26.0 and Prism 9.0 software. Differences were compared between groups. Results There were no significant differences in age, sex, weight, height, or body mass index between the two groups (P>0.05), while the injected dose showed a significant difference (P<0.001). In terms of image quality, there were no significant differences in standardized uptake value, standard deviation, and signal-to-noise ratio between the two groups. In terms of radiation dose, compared with the full-dose group, the low-dose group showed a 35.13% reduction in PET effective dose and a 15.22% reduction in total effective dose (P<0.05), whereas the CT effective dose was reduced by 2.4% and the difference was not significant (P=0.0892). The doses to critical organs (gonads, breasts, thyroid, red bone marrow, lungs) in the low-dose group were significantly lower than those in the full-dose group (P<0.01). Conclusion Under the premise of meeting clinical diagnostic requirements, low-dose ¹⁸F-FDG whole-body PET/CT imaging in pediatric patients can reduce the overall radiation exposure by 15%, and decrease the doses to critical organs, including the gonads, by more than 20%.

Objective To investigate the epidemiological characteristics of respiratory syncytial virus (RSV) infection in elderly patients at a hospital in Hengshui and its correlation with climatic and environmental factors. Methods A retrospective study was conducted on 826 elderly patients with RSV infection who were hospitalized in the Department of Respiratory and Critical Care Medicine Department of Hengshui People's Hospital from June 2022 to May 2024. Clinical data of the patients were collected. Based on the climatic and environmental data of the Hengshui region during the same period, the epidemiological characteristics of RSV in the elderly population were analyzed. Pearson analysis was used to examine the correlation between RSV incidence and climatic and environmental factors. Results Among the 826 elderly RSV infected patients, males (54.24%) had a higher incidence than females (45.76%). The age of onset was highest in elderly people aged ≥ 80 (39.47%), followed by the age group of 70-79 (32.08%). Cough (89.95%) and sputum (71.19%) were the main clinical symptoms of elderly RSV infected patients. 28.57% of the elderly patients with RSV infection had basic diseases, of which the patients with diabetes accounted for the highest proportion (12.35%), followed by cardiovascular diseases (10.41%). The proportion of patients with mixed infections reached 4.60%, and the proportion of patients with other systemic complications reached 1.69%. From the perspective of the season of onset, the number of elderly RSV cases was highest in spring and winter, accounting for 39.47% and 47.09%, respectively. The correlation analysis results showed that the number of elderly RSV cases was negatively correlated with average wind speed (r=-0.196), average temperature (r=-0.731), and average humidity (r=-0.729), and weakly positively correlated with average atmospheric pressure (r=0.085) (all P<0.05). Conclusion In the elderly population, RSV infection is more prevalent among males and the very old, with a higher incidence during the winter and spring seasons, and is closely related to climate changes in the Hengshui region.

ObjectiveTo investigate the current status of ethical sensitivity among clinical nursing interns in the context of artificial intelligence （AI） and analyze its influencing factors. MethodsAdopting mixed research methods and convenience sampling， a total of 237 nursing interns from a tertiary A hospital in Xi’an were selected as research subjects. Data were collected using a general information questionnaire and the Nursing Students’ Ethical Sensitivity Scale， and semi-structured interviews were conducted with 8 nursing interns. ResultsThe total score of ethical sensitivity among nursing interns was （33.98±6.32）， which was at a moderate level. Multiple linear regression analysis revealed that academic degree （undergraduate： β=0.147， P<0.05； postgraduate： β=0.139， P<0.05）， affinity for the nursing profession （β=0.118， P<0.05）， whether they had taken nursing ethics courses （β=-0.124， P<0.05）， and familiarity with artificial intelligence （β=-0.159，P<0.05） were influencing factors of ethical sensitivity among nursing interns. Four themes were extracted from semi-structured interviews， namely， the incomplete mastery of nursing ethics-related knowledge among nursing interns， weakened ethical sensitivity in the AI teaching scenario of nursing interns， insufficient professional identity affecting the development of nursing interns’ ethical sensitivity， and technological dependence leading to the lack of humanistic care among nursing interns. ConclusionEthical sensitivity of nursing interns represents a moderate level， primarily influenced by educational background， degree of fondness for the nursing profession， learning experience of nursing ethics courses， and familiarity with AI. Nursing educators and clinical administrators urgently need to establish a sustainable school-hospital collaborative model of nursing ethics education， attach importance to the cultivation of ethical awareness and value guidance for nursing interns， and strengthen the intensity and depth of nursing ethics education among nursing interns， thereby improving their level of ethical sensitivity in the context of AI.

Objective To compare the efficacy of five Blastocystis staining method for staining cells with different morphologies and in different developmental stages to select appropriate staining techniques for specific scenarios and experimental purposes. Methods Blastocystis was stained using Wright-Giemsa, periodic acid-Schiff (PAS), Oil Red O, Nile Red, and Lugol's iodine solution respectively. The staining effects of the five method on Blastocystis were compared. Results Wright-Giemsa staining colored the cytoplasm and nucleus of Blastocystis bluish-purple, with other parts lightly stained; PAS staining rendered Blastocystis cells red; Oil Red O staining showed different structures within Blastocystis in varying intensities of orange-red; Nile Red enabled Blastocystis to fluoresce orange-yellow under a fluorescence microscope; Lugol's iodine solution stained the cytoplasm and nucleus a dark brownish-yellow. Conclusions Wright-Giemsa staining is recommended for clinical diagnosis. For metabolic studies, a combination of periodic acid-Schiff (PAS) staining and Oil Red O staining is suggested; PAS + Oil Red O staining can provide comprehensive morphological evidence for cell metabolism research. Nile Red staining is recommended for dynamic observation of live Blastocystis. Lugol's iodine staining is suitable for preliminary screening of large-scale samples.