Objective: To explore parents knowledge, vaccination attitude, and willingness influencing factors of human papillomavirus (HPV) and its vaccine for male primary and secondary school students, so as to provide a scientific basis for formulating targeted health education strategies and promoting the popularization of boys HPV vaccination. Methods: From March 3 to 14, 2025, a stratified cluster random sampling method was used to select 912 parents of boys in primary and secondary school in Bao an District, Shenzhen for a questionnaire survey. Data on their demographic characteristics, HPV related knowledge and its vaccine, vaccination attitude, and willingness were collected. Univariate analysis was performed by using the χ 2 test or t-test, and binary Logistic regression model was used to analyze related factors of HPV vaccine vaccination willingness. Results: The total awareness rate of parents knowledge related to HPV and its vaccine was 35.75%, among which the awareness rates of boys vaccine types ( 6.36% ), optimal age (21.16%), and optimal vaccination period (31.25%) were the lowest. The scores of parents knowledge and attitude related to HPV and its vaccine were (4.31±2.66) and (3.82±0.63). About 64.25% of parents expressed willingness to have boys vaccinated against HPV. The scores of knowledge and attitude related to HPV and its vaccine of parents with vaccination willingness (4.86±2.55, 4.02±0.58) were higher than those of parents without vaccination willingness (3.34±2.57, 3.46±0.55), and the differences were statistically significant ( t =8.59,13.96, both P <0.01). Logistic analysis showed that parents without raising daughters had a lower willingness to vaccinate boys against HPV ( OR=0.49, 95%CI =0.35-0.70); for each 1 increase in parents knowledge score related to HPV and its vaccine, the vaccination willingness increased by 9.0% ( OR=1.09, 95%CI =1.01-1.17); parents who were worried about boys infection risk ( OR=1.50, 95%CI =1.08-2.08) and parents who had their children vaccinated against HPV even if their classmates were not vaccinated ( OR=3.68, 95%CI =2.73-4.94) had higher willingness to vaccinate boys against HPV(all P <0.05). Conclusions Parents of boys in primary and secondary schools of Bao an District, Shenzhen have low scores of knowledge related to HPV and its vaccine.While parents show strong willingness to vaccinate boys against HPV, limited knowledge may hinder both the sustained growth of vaccination intentions and the actual implementation of vaccination practices.

Objective To address the challenges of poor performance and lack of interpretability in existing models,the SHAP algorithm is used to develop an interpretable machine learning model that offers a novel approach to wound age estimation,Methods Based on the previous discovery of the expression of 35 wound age healing-related genes in contused skeletal muscle,the woun age estimaton model was constructed using four algorithms,namly,Multilayer Perceptron(MLP),Random Forest(RF),LightGBM(LGBM),and Support Vector Machine(SVM).The SHAP(Shapley Additive Explanation)algorithm was used to rank the importance of genetic features,eliminate redundant attributes,and optimize the model for accurate wound age estimation.the genetic features of the optimal model were analyzed using SHAP's local interpretation capabilities.Results The best results were obtained using model of MLP(area under the curve(AUC)=0.99)The wound ages were classified into four categories:4～12 h,16～24 h,28～36 h,and 40～48 h,using only 15 gene features.According to SHAP analysis,Fam210a was identified as the most relevant gene.Local analysis revealed that high expression of Fam210a contributed to an increase in the predicted probability of 4 h～12 h,while high expression of Rae1 contributed to an increase in the predicted probability of 16 h～24 h.Additionally,low expression of Tbx18 contributed to an increase in the predicted probability of 28 h～36 h,whereas high expression of Tbx18 contributed to an increase in the predicted probability of 40 h～48 h.Conclusions The combined MLP and SHAP model can be used to predict wound age.Using the SHAP interpreter can better understand the degree of contribution of feature genes to the model prediction,and lay the foundation for further in-depth study of wound age estimation.

Objective To construct and validate a risk prediction model for delayed healing of venous leg ulcer(VLU),so as to provide a reference basis for early identification of people at high risk of delayed healing.Methods Using a convenience sampling method,331 VLU patients attending vascular surgery departments in 2 tertiary A hospitals in Sichuan Province from January 2018 to December 2022 were selected as a modeling group and an internal validation group,and 112 patients admitted to another tertiary A hospital were selected as an external validation group.Risk factors for delayed healing in VLU patients were screened using univariate analysis,LASSO regression,and multivariate logistic regression analysis,and a risk prediction model was constructed using R software,and the predictive effects of the models were examined using the area under the receiver operating characteristic curve,the Hosmer-Lemeshow test,decision curve,and the bootstrap resampling for internal validation and spatial external validation were performed,respectively.Results The predictors that ultimately entered the prediction model were diabetes(OR=4.752),deep vein thrombosis(OR=4.104),lipodermatosclerosis(OR=5.405),ulcer recurrence(OR=3.239),and ankle mobility(OR=5.520).The model had good discrimination(AUC:0.819 for internal validation and 0.858 for external validation),calibration(Hosmer-Lemeshow test:χ2=13.517,P=0.095 for internal validation and χ2=3.375,P=0.909 for external validation)and clinical validity.Conclusion The model constructed in this study has good differentiation and calibration,and it can effectively predict people at high risk of delayed healing of VLU,which facilitates targeted clinical interventions to improve ulcer outcomes and reduce the risk of delayed ulcer healing.

Objective:To investigate the effects of peritoneal dialysis combined with hemodialysis on improving cardiac and renal function, peritoneal function, and nutritional status, and reducing complications in patients with end-stage renal disease.Methods:A total of 90 patients with end-stage renal disease who received treatment at Lishui Municipal Central Hospital and Lishui People's Hospital from January 2019 to May 2022 were retrospectively included in this study. The patients were divided into a control group and an observation group, with 45 patients in each group, based on the treatment methods used. The control group received peritoneal dialysis treatment, while the observation group received a combination of peritoneal dialysis and hemodialysis treatment. The changes in cardiac and renal function, peritoneal function, nutritional status, and the occurrence of complications were observed in both groups.Results:After treatment, the observation group showed significantly lower values in the cardiothoracic ratio [(57.02 ± 3.35)%], brain natriuretic peptide [(8 849.34 ± 124.65) ng/L], left ventricular mass index [(181.32 ± 8.56) g/m2], blood urea nitrogen [(14.04 ± 1.94) mmol/L], and serum creatinine [(181.47 ± 27.06) μmol/L] compared with the control group [(58.92 ± 3.11)%, (15 126.39 ± 322.82) ng/L, (187.28 ± 8.95) g/m2, (18.49 ± 2.82) mmol/L, (196.56 ± 31.07) μmol/L, t = 2.79, 121.68, 3.23, 8.72, 2.46, all P < 0.05]. Additionally, the observation group had significantly higher levels of ejection fraction [(63.47 ± 5.23)%], albumin [(52.98 ± 6.37) g/L], and hemoglobin [(114.94 ± 13.61) g/L] compared with the control group [(60.46 ± 5.18)%, (47.01 ± 6.04) g/L, (98.04 ± 10.93) g/L, t = -2.74, -4.52, -6.49, all P < 0.05]. The observation group also exhibited a significantly lower dialysate/plasma creatinine ratio [(0.56 ± 0.09)] and a lower level of β 2-microglobulin [(18 032.29 ± 718.11) mg/L] compared with the control group [(0.61 ± 0.07), (18 424.42 ± 736.43) mg/L, t = 2.54, 2.06, both P < 0.05]. The incidence of complications in the observation group was 11.11% (5/45), which was significantly lower than that in the control group [31.11% (14/45), χ2 = 4.27, P < 0.05]. Conclusion:Peritoneal dialysis combined with hemodialysis can improve cardiac and renal function, peritoneal function, and nutritional status and decrease the incidence of complications in patients with end-stage renal disease. This approach deserves to be clinically promoted. The findings of this study are of significant innovation and scientific value.

Objective:To retrospectively analyze efficacy and safety of granulocyte colony-stimulating factor(G-CSF)in relapsed/refractory B cell acute lymphoblastic leukemia(R/R B-ALL)patients with neutropenia(NE)after receiving CAR-T cell therapy.Methods:From March 2017 to December 2022,99 patients with R/R B-ALL developed NE after receiving CAR-T cell therapy in Tianjin First Central Hospital were collected and divided into two groups according to using time of G-CSF.One was early G-CSF group(received G-CSF within 7 days,n=56),the other was control group(received G-CSF after 7 d,n=43),whose recovery of NE and occurrence of adverse reactions after G-CSF were compared.Results:Duration of NE in early G-CSF group was shorter than control group[4(2,5.7)vs 11(9,14),P<0.05],but there were no significant differences in the lowest absolute neutrophil count(ANC),degree of NE inhibition and incidence of infection(P=0.261,P=0.09,P=0.111).There was no significant difference between incidence and severity of cytokine release syndrome(CRS)between two groups,and CRS was controllable in all patients.Conclusion:Early application of G-CSF in R/R B-ALL patients after CAR-T cell therapy can shorten duration of NE,and has no significant effect on adverse reactions after CAR-T cells.

Objective:To investigate the predictive value of neutrophil percentage-to-albumin ratio (NPAR) on the outcome after intravenous thrombolysis (IVT) in elderly patients with acute ischemic stroke (AIS).Methods:Elderly patients with AIS who received IVT in Fuyang People's Hospital from October 2021 to September 2023 were retrospectively included. Clinical outcome were assessed by the modified Rankin Scale at 90 days after onset, with a score of >2 defined as poor outcome. Multivariate logistic regression analysis was used to determine the association between NPAR and poor clinical outcome after IVT in elderly AIS patients. Receiver operating characteristic (ROC) curves were used to evaluate the predictive value of NPAR for poor outcome. Results:A total of 148 patients were included, including 86 males (58.1%), aged (74.11±6.17) years. The median baseline National Institutes of Health Stroke Scale (NIHSS) score was 5 (interquartile range: 3-8), and the NPAR was 1.58±0.30. The neutrophil count, neutrophil percentage, NPAR, fasting blood glucose and baseline NIHSS score in the poor outcome group were significantly higher than those in the good outcome group (all P<0.05). Multivariate logistic regression analysis showed that higher baseline NPAR (odds ratio [ OR] 2.659, 95% confidence interval [ CI] 1.117-5.324; P<0.001), NIHSS score ( OR 1.191, 95% CI 1.083-1.309; P<0.001) and fasting blood glucose ( OR 1.224, 95% CI 1.013-1.479; P=0.037) were independent risk factors for poor outcome. ROC curve analysis showed that the area under the curve for NPAR to predict poor outcome was 0.712 (95% CI 0.613-0.812; P<0.001), the optimal cut-off value was 1.728, and the predictive sensitivity and specificity were 65.1% and 75.2%, respectively. Conclusion:Higher baseline NPAR may be a predictor of poor outcome after IVT in elderly AIS patients.