Objective: To explore the network structure of eating behaviors with anxiety, depression and perceived stress in adolescents, so as to provide a basis for effective prevention and intervention of eating behavior problems and negative emotions in adolescents. Methods: Based on the Psychology and Behavior Investigation of Chinese Residents (2021) database, the study was conducted among 3 087 adolescents. Sakata Eating Behavior Scale Short From(EBS-SF) was used to investigate their eating behaviors. The Patient Health Questionnaire-9(PHQ-9), Generalized Anxiety Disorder Scale-7 Item(GAD-7), and Perceived Stress Questionnaire-3 Item (PSQ-3) were used to evaluate their depression, anxiety and perceived stress. Network analysis method was applied to construct a network of eating behaviors and negative emotional symptoms among adolescents, so as to evaluate the centrality, bridge strength, stability and accuracy of each item. Results: The total scores of eating behaviors, depression,anxiety and stress perception in adolescents were 17.41±4.53,6.95±6.08,4.86±5.03,9.34±3.80,respectively. The symptom with the highest intensity and expected impact was "I am only satisfied when I buy more food than I need", with a node intensity and expected impact value of 4.37. The nodes Depression and Anxiety were the most closely connected(weight=0.87). There were no statistically significant differences in the network structure( M =0.13,0.11) and network connection strength(female and male:4.16,4.06, s =0.10;urban and rural areas:4.08,4.07, s =0.01) between different sexes and residents ( P >0.05). Conclusion The negative impact of comorbidities such as anxiety, depression, perceived stress and eating behaviors among adolescents can be reduced through targeted prevention and intervention of core symptoms and bridging symptoms.

Objective To discuss the technical advantages of MRI image fusion technology in guiding percutaneous balloon compression(PBC)for trigeminal neuralgia(TN).Methods The clinical data of 13 patients with TN,who received MRI image fusion technology-guided PBC from November 2022 to July 2023,were retrospectively analyzed.The MRI images of the trigeminal nerve obtained one week before surgery were fused with the intraoperative DynaCT images of the skull base so as to simultaneously display the Meckel s cave and foramen ovale,and under the 3-D view the optimal puncture path was determined.The needle was positioned at the entry point of the skin,than the skin was cut open with a sharp surgical blade and the needle was inserted to the foramen ovale area to a predetermined depth.Lateral skull base fluoroscopy and DynaCT scan were used to check that the puncture needle tip was placed into the foramen ovale.Than the puncture needle was replaced by a fine guiding-needle and it was pushed into the Meckel's cave.Under the dual guidance of lateral fluoroscopy and fusion image,the balloon was push forward and was filled with iodine contrast media to compress the trigeminal ganglion within the Meckel's cave.After completion of the treatment,the balloon and puncture needle were removed and manual oppression was applied on the face to achieve hemostasis.Results Immediately after PBC,the pain was relieved in all patients.No permanent or serious complications occurred.One patient had a relapse 3 months after PBC and a second PBC procedure had to be carried out.No obvious pain recurrence was observed in the remaining patients during follow-up period.During the surgery,the mean number of foramen ovale puncturing was(1.31±0.46)times,the mean X-ray exposure time was(8.64±5.66)min,and the mean cumulative dose of X-ray was(570.29±257.15)mGy.After PBC,12 patients(92.31％)developed facial numbness and one patient(7.69％)developed facial pain,all of which were healed after treatment.Conclusion MRI image fusion technology can improve the visualization and accuracy of PBC procedure.It can also reduce the number of puncturing,decrease the radiation exposure dose,and improve the surgical ability of young doctors.Therefore,MRI image fusion technology should be further developed and applied in clinical practice.

Objective To analyze the latent categories of traditional Chinese medicine(TCM)constitution of college students,and to explore the moderating effects of latent categories of TCM constitution on the the associations between self-efficacy and depression-anxiety symptoms.Methods An investigation was carried out in two universities of Guangdong Province with 30-item TCM constitution scale,General Self-Efficacy Scale(GSES)and Kessler Psychological Distress Scale,and then a total of 1 097 valid samples were obtained.Correlation analysis,latent profile analysis,and hierarchical regression analysis were used for statistical analysis.Results(1)Four latent categories of TCM constitution were obtained in the college students:generally-balanced type(32.0%),highly-balanced type(17.4%),generally-biased type(36.9%)and highly-biased type(13.7%).There were statistically significant differences in the subscale scores of TCM constitution scale among the college students with various latent categories of TCM constitution(all P＜0.001).(2)Hierarchical regression analysis showed that the self-efficacy negatively predicted the symptoms of depression and anxiety(β value being-0.268,-0.161 respectively,P＜0.001);with the generally-balanced type as reference,the generally-biased type and the highly-biased type positively predicted the symptoms of depression and anxiety,and the highly-balanced type negatively predicted the symptoms of depression and anxiety(all P＜0.001).(3)The latent categories of TCM constitution had moderating effects on the self-efficacy and depression-anxiety symptoms:the depression-anxiety symptoms were relieved with the increase of self-efficacy in the college students with the TCM constitution being generally-biased type,highly-biased type and generally-balanced type(all P＜0.01);in the college students with highly-balanced type,the symptoms of depression(β=0.005,P=0.907)and anxiety(β=0.007,P=0.878)did not change with the increase of self-efficacy.Conclusion Obvious heterogeneity of TCM constitution is presented in the population of college students.The measures of enhancement of self-efficacy and the correction of TCM to promote the psychological health of college students should be performed with reference to the characteristics of their TCM constitution types.

Objective To investigate the effectiveness of team-based learning(TBL)combined with research-based learning(RBL)in enhancing evidence-based nursing practice skills of undergraduate nursing interns.Methods A total of 114 undergraduate nursing students who interned in the operating room of a ⅢA hospital in Guangzhou from July 2021 to April 2022 were selected as study subjects.A randomized cluster sampling method based on a random number table was used to divide the students into a control group and a trial group.The control group received traditional teaching methods,while the trial group was taught using a combination of TBL and RBL.The two groups were compared in terms of evidence-based practice skills,critical thinking abilities,and their evaluations on the teaching methods.Results The differences in evidence-based practice skills and critical thinking abilities before and after the internship were significantly higher in the observation group compared to the control group(t=35.108,35.897;both P<0.05).Additionally,post-internship evaluation scores for the teaching methods in the trial group were significantly higher than those in the control group(t=-17.580,P<0.05).Conclusion TBL combined with RBL effectively enhances the evidence-based nursing practice skills and critical thinking abilities of undergraduate nursing interns.This approach also improves students'evaluations on the teaching methods and fosters the cultivation of excellent clinical evidence-based nursing professionals.

To clarify the structural characteristics of virus communities carried by primates in the Guangdong region,and evaluate the risk of the important zoonotic virus monkeypox virus(MPXV)being introduced into China through artificially do-mesticated primates,this study conducted metagenomic research on artificially domesticated primates and performed screening for MPXV.Primate samples were collected from 20 wildlife rescue centers or zoos in 14 prefecture level cities in Guangdong Province,and the structural characteristics of virus communities carried by artificially domesticated primates were identified through Illumina sequencing.Fluorescence quantitative PCR detection of MPXV excluded the risk of MPXV being introduced through artificially domesticated primates in Guangdong Prov-ince.A total of 489 oral and pharyngeal swabs and feces from primates were collected.High-throughput sequencing indicated that the viral group structure in the feces of artificially domesti-cated primates in the Guangdong region is complex and shows regional differences.Members of Alphaflexiviridae and Vir-gaviridae,followed by members of Parvoviridae and Genomo-viridae,had the highest abundance.Subsequently,fluorescence quantitative PCR results showed that all primates from wildlife rescue centers or zoos in Guangdong Province were MPXV neg-ative.This study provides the first description of the complex viral structure characteristics of artificially domesticated primates in the Guangdong region,and elucidates the differences in vi-ral communities among artificially domesticated primates in different regions.Our findings suggested that the risk of zoonotic diseases caused by artificially domesticated primates in Guangdong Province is extremely low,and the risk of MPXV being in-troduced into China through artificially domesticated primates in Guangdong Province is zero.

Consumptive thirst is widely discussed in Huangdi Neijing and it is classified as a"strange disease"in Suwen·Strange Diseases Treatise,which reflects the intractable nature of consumptive thirst.This paper explores and analyzes consumptive thirst based on the core concept in Huangdi Neijing.First,this paper approaches the subject through the use of image thinking method from Huangdi Neijing,recognizing that consumptive thirst can lead to changes in the internal climate of the human body.Then,guided by the theories of essence and qi,yin and yang,and the five elements in Huangdi Neijing,it deconstructs and analyzes the causes of these changes and the laws of qi transformation.It points out that the changing climate of consumptive thirst is characterized by"heat symptoms".The main cause of"heat symptoms"is spleen deficiency and excessive dampness,and its qi transformation law is the heat transformation of Shaoyin.The intractable nature of consumptive thirst is mainly reflected in the uncontrolled"heat symptoms"caused by the imbalance of the five elements.Based on the understanding of the heat symptoms of consumptive thirst,this paper proposes a treatment strategy for preventing the disease by resolving dampness and regulating the spleen,harmonizing kidney qi to prevent progression,and balancing yin and yang to treat chronic and recalcitrant conditions.The aim is to provide a reference for optimizing the treatment of consumptive thirst.

Objective:To explore the value of whole exome sequencing for the inferential analysis of recessive genetic disease carrier status for couples with a child died of Primary immunodeficiency (PID).Methods:Clinical data was collected from four couples with a childbearing history of PID who had sought genetic counseling and undergone genetic testing at Henan Provincial People′s Hospital from February 2017 to December 2021. Whole exome sequencing (WES) was performed on both partners of each couple, and candidate variants were validated by Sanger sequencing and fluorescent quantitative PCR. Prenatal diagnosis was conducted on fetuses of these couples after confirming the variants.Results:A total of six variants were detected in four genes including IL2RG, BTK, CYBB, and DUOX2. Among these, the c.1265G>A and c.3329G>A variants of the DUOX2 gene and the c. 676C>T variant of the IL2RG gene were previously known as pathogenic variants. On the other hand, the Exon5_8del variant of the IL2RG gene, the c. 184_185delAC variant of the BTK gene, and the c. 472A>T variant of the CYBB gene were unreported previously. Based on the guidelines from the American College of Medical Genetics and Genomics, the IL2RG: Exon5_8del, BTK: c. 184_185delAC and CYBB: c. 472A>T variants were classified as likely pathogenic (PVS1+ PM2_Supporting+ PP4).Prenatal diagnosis was conducted for three couples during their subsequent pregnancies, and the results revealed that the fetuses had the wild-type genotypes at the c. 184_185 position of the BTK gene, the c. 472 position of the CYBB gene, and the c. 676 position of the IL2RG gene. Follow-up examinations one year after birth has found no abnormality in the infants. Conclusion:WES is an important tool to infer and analyze the carryier status for couples who had given births to children died of PID and improve the positive detection rate.

Idiopathic epiretinal membrane(IERM)is a kind of epiretinal membrane without any other known ocular conditions, which occurs mostly in the middle-aged and elderly people over the age of 50. As IERM worsens, the structure and function of the retina in the macular region are altered, leading to symptoms like reduced vision and metamorphopsia. The pathogenesis of IERM remains unclear, and surgery is the primary treatment option. However, there is no consensus on the best time to have surgery, and there are differences in how well patients recover their vision following surgery. Optical coherence tomography(OCT)and OCT angiography(OCTA), as non-invasive and rapid diagnostic tools to observe retinal microstructure and blood flow changes in the macula, have been extensively utilized in clinical settings. The use of OCT and OCTA parameters to predict postoperative visual acuity has emerged as a hot topic in IERM research. This article provides a comprehensive review of current research on the correlation between various OCT and OCTA parameters and the prediction of postoperative visual acuity in IERM, aiming to assist clinicians in determining the optimal timing for surgery and balancing the benefits and risks involved.

Objective To systematically evaluate the efficacy and safety of hydroxychloroquine(HCQ)in obstetric antiphospholipid syndrome(OAPS).Methods PubMed,Embase,Cochrane Library,Web of Science,SinoMed,Wanfang Data,CNKI,and VIP databases were searched electronically to collect clinical research on HCQ treatment for OAPS from inception to January 31,2023.Two researchers independently screened the literature,extracted data,and assessed the risk of bias of the included studies,Meta-analysis and GRADE evaluation were performed using RevMan 5.4 software and GRADE Profile 3.6 softwares.Results Five cohort studies and three randomized controlled trias(RCTs)were included,with a total of 644 OAPS patients(732 pregnancies).The results of Meta-analysis showed that compared with conventional treatment,HCQ supplementation significantly increased the live birth rate of OAPS(RR=1.29,95％CI 1.10 to 1.51,P=0.001),the negative conversion rate of lupus anticoagulant(RR=1.29,95％CI 1.13 to 1.47,P＜0.001),the anticardiolipin antibody negative conversion rate(RR=1.27,95％CI 1.12 to 1.45,P＜0.001)and the anti-β2 glycoprotein I antibody negative conversion rate(RR=1.31,95％CI 1.12 to 1.52,P＜0.001),the rate of early abortion(＜10 weeks)was significantly reduced(RR=0.31,95％CI 0.10 to 0.93,P=0.04).However,there was no significant difference between the two groups in reducing the rate of premature birth,late abortion(＞10 weeks)and the incidence of preeclampsia(P＞0.05).In terms of safety analysis,two studies described HCQ adverse effects including skin reactions and dry eyes,symptoms are mild.Three RCTs were used to compare the incidence of adverse reactions between the two groups,the incidence of adverse reaction of HCQ group was lower than that of control group(RR=0.40,95％CI 0.25 to 0.66,P＜0.001),and no serious adverse reactions occurred in both groups.The sensitivity analysis results were robust and reliable.The results of GRADE evaluation showed that the quality of index evidence included in this study were low or very low,with weak recommendations.Conclusion HCQ can significantly improve the live birth rate of OAPS and the negative conversion rate of antiphospholipid antibody,and reduce the fetal abortion rate before 10 weeks with fewer adverse reactions,but there is insufficient evidence to reduce the incidence of premature birth,fetal abortion after 10 weeks and preeclampsia.Due to the limited number and quality of included studies,the above conclusions need to be confirmed by more high-quality studies.

Objective To understand the distribution and changing resistance profiles of clinical isolates of Enterococcus in hospitals across China from 2015 to 2021.Methods Antimicrobial susceptibility testing was conducted for the clinical isolates of Enterococcus according to the unified protocol of CHINET program by automated systems,Kirby-Bauer method,or E-test strip.The results were interpreted according to the Clinical & Laboratory Standards Institute(CLSI)breakpoints in 2021.WHONET 5.6 software was used for statistical analysis.Results A total of 124 565 strains of Enterococcus were isolated during the 7-year period,mainly including Enterococcus faecalis(50.7％)and Enterococcus faecalis(41.5％).The strains were mainly isolated from urinary tract specimens(46.9％±2.6％),and primarily from the patients in the department of internal medicine,surgery and ICU.E.faecium and E.faecalis strains showed low level resistance rate to vancomycin,teicoplanin and linezolid(≤3.6％).The prevalence of vancomycin-resistant E.faecalis and E.faecium was 0.1％and 1.3％,respectively.The prevalence of linezolid-resistant E.faecalis increased from 0.7％in 2015 to 3.4％in 2021,while the prevalence of linezolid-resistant E.faecium was 0.3％.Conclusions The clinical isolates of Enterococcus were still highly susceptible to vancomycin,teicoplanin,and linezolid,evidenced by a low resistance rate.However,the prevalence of linezolid-resistant E.faecalis was increasing during the 7-year period.It is necessary to strengthen antimicrobial resistance surveillance to effectively identify the emergence of antibiotic-resistant bacteria and curb the spread of resistant pathogens.