Objective:To investigate the clinical efficacy and safety of different combination therapies with aminolevulinic acid photodynamic therapy (ALA-PDT) in the treatment of facial basal cell carcinoma in the elderly.Methods:A retrospective analysis was conducted on 131 elderly patients with facial basal cell carcinoma who visited Shanghai Skin Disease Hospital from August 2020 to October 2023. According to the depth of the lesions, the patients were divided into 3 groups to receive intensive pretreatment with curettage (41 cases), CO 2 laser therapy (35 cases), and narrow-margin excision surgery without sutures (55 cases) respectively, all followed by ALA-PDT. During the follow-up period of 17.7 ± 9.0 months, the efficacy was evaluated and adverse reactions were recorded in each group. Results:The total remission rates were 100%, 100%, and 96.4% in the curettage + ALA-PDT group, CO 2 laser + ALA-PDT group, and narrow-margin excision surgery without sutures + ALA-PDT group, respectively. The patients experienced mild pain and local erythematous swelling during ALA-PDT treatment, which were temporary and fully tolerable, and no wound infections or difficulties in healing were observed. After treatment, scar formation was observed in 3 cases of basal cell carcinoma on the nose and nasolabial folds in the narrow-margin excision surgery without sutures + ALA-PDT group, but the rest of the patients retained a good facial appearance. Conclusions:In this preliminary exploration study on PDT for basal cell carcinoma of different depths, ALA-PDT combined with curettage, CO 2 laser or narrow-margin excision surgery without sutures all exhibited definite efficacy and minimal damage, providing effective treatment options for facial basal cell carcinoma in the elderly.

Objective:To investigate the application value of dermoscopy and reflectance confocal microscopy (RCM) in identifying field cancerization in actinic keratosis (AK) in the elderly.Methods:A retrospective analysis was conducted on clinical, dermoscopic, and RCM features of elderly (> 60 years old) patients, who were confirmedly diagnosed with AK and had complete medical records at Shanghai Skin Disease Hospital from January 2022 to December 2023.Results:A total of 132 elderly patients with AK were included. Dermoscopy showed brownish-gray pseudonetwork pigment patterns, follicular horn plugs, irregular branched vessels, and rosette signs in AK lesions. Histopathological examination in 51 patients revealed that 47 (92.16%) were confirmedly diagnosed with AK. Field cancerization was observed in 106 patients (80.3%), among whom 66 (62.26%) had irregular branched vessels, 88 (83.02%) predominantly exhibited brownish-gray pseudonetwork pigment patterns, and 83 (78.30%) showed scattered brown pigment networks/fingerprint-like patterns. Post-treatment follow-up of 63 patients showed varying degrees of changes in vascular and pigment structures by dermoscopy, with significant reductions in follicular horn plugs and superficial yellow-white scales or keratin masses. RCM examinations in 41 AK patients all showed disordered arrangements of keratinocytes presenting as atypical honeycomb patterns, with atypical cells in the AK lesions; in the field cancerization areas of 20 patients, RCM revealed keratinocytes disorderedly arranged in an irregular honeycomb pattern, with some keratinocytes exhibiting mild atypia. Thirty-four AK patients underwent dynamic RCM monitoring before and after 1, 3 and 6 months of ALA-PDT treatment, which showed gradual regularization of arrangements of keratinocytes and reduction of atypical cells, as well as reappearance of atypical keratinocytes upon recurrence.Conclusions:The incidence of field cancerization was relatively high in elderly AK patients. Dermoscopy and RCM are helpful for the early identification of AK and field cancerization, especially in patients with multiple lesions and with difficulties in multi-site biopsy.

Objective: To explore the impact mechanism of psychological health work in colleges on the psychological health status of college students, in order to provide a basis and practical guidance for optimizing the psychological health service system in colleges and formulating scientific and effective psychological capital intervention strategies. Methods: Through stratified cluster random sampling, 1 148 colleges students were selected from 7 colleges in Shanghai from October to November 2024. A survey was conducted using the Satisfaction Questionnaire for Psychological Health Work in colleges, Psychological Capital Questionnaire (PCQ) and Symptom Checklist-90 (SCL-90). Spearman correlation analysis, multiple Logistic regression analysis and structural equation model pathway analysis were conducted to analyze the relationship of psychological health work in colleges and psychological capital with psychological health status of college students. Results: The scores of satisfaction with college psychological health work, PCQ, and SCL-90 were [2.78(2.55,3.02),3.08(2.85,3.32),1.56(1.42,1.78)]. Spearman correlation analysis results showed that the four dimensions scores of satisfaction with psychological health work in colleges (satisfaction with psychological health course teaching, satisfaction with practical activities, satisfaction with psychological counseling services and satisfaction with crisis intervention and management) were negatively correlated with SCL-90 score of college students ( r =-0.26, -0.31, -0.24, -0.21 ); the four dimensions scores of psychological capital (self confidence, optimism, resilience, and hope) of college students were negatively correlated with SCL-90 score ( r =-0.29, -0.34, -0.28, -0.29) (all P <0.05). The results of multiple Logistic regression analysis showed that after adjusting for confounding factors such as gender, grade level, parents highest education level, major type, and physical health status, compared with college students who were "very satisfied" with their psychological health work, those who were "very dissatisfied" and "dissatisfied" with their psychological health work had a higher proportion of poor psychological health status ( OR =2.15, 1.68); compared to college students with higher level of psychological capital, those with lower level of psychological capital had a higher proportion of poor psychological health status ( OR =2.73, 2.05) (all P <0.05). The results of structural equation modeling path analysis showed that the satisfaction of psychological health work in colleges indirectly reduced psychological health risks by increasing psychological capital among colleges ( β=0.12, P <0.05), with mediation effect accounting for 60% of the total effect. Conclusion The satisfaction with psychological health work in colleges is positively correlated with both psychological health status and psychological capital among college students; and psychological capital, as an intermediary bridge, further amplifies and transmits the positive impact of satisfaction with psychological health work in colleges on psychological health among college students.

Objective:To investigate the clinical efficacy and safety of different combination therapies with aminolevulinic acid photodynamic therapy (ALA-PDT) in the treatment of facial basal cell carcinoma in the elderly.Methods:A retrospective analysis was conducted on 131 elderly patients with facial basal cell carcinoma who visited Shanghai Skin Disease Hospital from August 2020 to October 2023. According to the depth of the lesions, the patients were divided into 3 groups to receive intensive pretreatment with curettage (41 cases), CO 2 laser therapy (35 cases), and narrow-margin excision surgery without sutures (55 cases) respectively, all followed by ALA-PDT. During the follow-up period of 17.7 ± 9.0 months, the efficacy was evaluated and adverse reactions were recorded in each group. Results:The total remission rates were 100%, 100%, and 96.4% in the curettage + ALA-PDT group, CO 2 laser + ALA-PDT group, and narrow-margin excision surgery without sutures + ALA-PDT group, respectively. The patients experienced mild pain and local erythematous swelling during ALA-PDT treatment, which were temporary and fully tolerable, and no wound infections or difficulties in healing were observed. After treatment, scar formation was observed in 3 cases of basal cell carcinoma on the nose and nasolabial folds in the narrow-margin excision surgery without sutures + ALA-PDT group, but the rest of the patients retained a good facial appearance. Conclusions:In this preliminary exploration study on PDT for basal cell carcinoma of different depths, ALA-PDT combined with curettage, CO 2 laser or narrow-margin excision surgery without sutures all exhibited definite efficacy and minimal damage, providing effective treatment options for facial basal cell carcinoma in the elderly.

Objective:To investigate the application value of dermoscopy and reflectance confocal microscopy (RCM) in identifying field cancerization in actinic keratosis (AK) in the elderly.Methods:A retrospective analysis was conducted on clinical, dermoscopic, and RCM features of elderly (> 60 years old) patients, who were confirmedly diagnosed with AK and had complete medical records at Shanghai Skin Disease Hospital from January 2022 to December 2023.Results:A total of 132 elderly patients with AK were included. Dermoscopy showed brownish-gray pseudonetwork pigment patterns, follicular horn plugs, irregular branched vessels, and rosette signs in AK lesions. Histopathological examination in 51 patients revealed that 47 (92.16%) were confirmedly diagnosed with AK. Field cancerization was observed in 106 patients (80.3%), among whom 66 (62.26%) had irregular branched vessels, 88 (83.02%) predominantly exhibited brownish-gray pseudonetwork pigment patterns, and 83 (78.30%) showed scattered brown pigment networks/fingerprint-like patterns. Post-treatment follow-up of 63 patients showed varying degrees of changes in vascular and pigment structures by dermoscopy, with significant reductions in follicular horn plugs and superficial yellow-white scales or keratin masses. RCM examinations in 41 AK patients all showed disordered arrangements of keratinocytes presenting as atypical honeycomb patterns, with atypical cells in the AK lesions; in the field cancerization areas of 20 patients, RCM revealed keratinocytes disorderedly arranged in an irregular honeycomb pattern, with some keratinocytes exhibiting mild atypia. Thirty-four AK patients underwent dynamic RCM monitoring before and after 1, 3 and 6 months of ALA-PDT treatment, which showed gradual regularization of arrangements of keratinocytes and reduction of atypical cells, as well as reappearance of atypical keratinocytes upon recurrence.Conclusions:The incidence of field cancerization was relatively high in elderly AK patients. Dermoscopy and RCM are helpful for the early identification of AK and field cancerization, especially in patients with multiple lesions and with difficulties in multi-site biopsy.

Objective:To investigate Helicobactor pylori (H. pylori) infection status and interfamilial transmission pattern in Zhengzhou area. Methods:A cross-sectional study was conducted from September 2020 to march 2021, among 731 individual from 266 families randomly selected from 9 communities of Zhengzhou area. H. pylori infection status was determined by serum antibody tests, and 13C-urea breath test was performed in the previously eradicated population to clarify the current infection status. The individual and familial infection rate, infection status for couples and children and adolescent were analyzed. Results:Among 731 individuals from 266 families, 397 of them were H. pylori positive. The individual infection rate was 54.31% (397/731); among infected individuals 77.83% (307/397) were infected with type Ⅰ strain, 22.67% (90/397) were infected by type Ⅱ strain. Annual household income ( χ2=0.419, 0.410, 0.213, all P>0.05), smoking history (χ 2=0.071, P>0.05), drinking history ( χ2=0.071, P>0.05), dining place ( χ2=0.009, P>0.05), gastrointestinal symptoms ( χ2=0.047, P>0.05), family history of gastric disease ( χ2=0.069, P>0.05), and history of gastric cancer ( χ2=0.004, P>0.05) had no significant differences between H. pylori-positive and -negative groups, but the infection rate in individuals with higher education level was lower ( χ2=4.449, P<0.05). The infection rate was significantly higher in≥18 age groups compared with<18 age groups ( χ2=6.531, 23.362, 20.671, 24.244, 37.948, 14.597 and 5.170, all P<0.05). The familial H. pylori infection rate was 87.59% (233/266), and in 61 families all member were infected (26.18%, 61/233). The positive rate was 23.08% (6/26) in 50 families with children under 18 years when both parents were infected. Among 231 coupled families, both couples were infected in 78 families (33.76%), one couple was infected in 113 families (48.92%), and both couples were not infected in 40 (17.32%). With the increase of marriage time, the infection rate of both spouses increased significantly ( χ2=7.775, 12.662, 15.487, all P<0.05). Conclusions:The distribution of H. pylori infection presents a family cluster pattern, and intrafamilial infection is an important transmission rout of H. pylori. The type I strain of H. pylori is the dominate strain in this area.

Group A Streptococcus (GAS) is a very important pathogen, especially for children.On a global scale, GAS is an important cause of morbidity and mortality.But the burden of disease caused by GAS is still unknown in China and also has not obtained enough attention.For this purpose, the expert consensus is comprehensively described in diagnosis, treatment and prevention of GAS diseases in children, covering related aspects of pneumology, infectiology, immunology, microbiology, cardiology, nephrology, critical care medicine and preventive medicine.Accordingly, the consensus document was intended to improve management strategies of GAS disease in Chinese children.

Objective:To investigate the knowledge, attitudes, and practices (KAP) of pulse oximetry among pediatric healthcare providers in China and analyze the factor influencing the KAP.Methods:A self-developed questionnaire was used for an online research on the KAP of 11 849 pediatric healthcare providers from 31 provinces, autonomous regions, and municipalities of China from March 11 to 14, 2022.The factors influencing the KAP of pulse oximetry among pediatric healthcare providers were examined by Logistic regression. Results:The scores of KAP, of pulse oximetry were 5.57±0.96, 11.24±1.25 and 11.19±4.54, respectively.The corresponding scoring rates were 69.61%, 74.95%, and 55.99%, respectively. Logistic regression results showed that the gender and working years of pediatric healthcare providers, the region they were located, and whether their medical institution was equipped with pulse oximeters were the main factors affecting the knowledge score (all P<0.05). Main factors influencing the attitude score of pediatric healthcare providers included their knowledge score, gender, educational background, working years, region, medical institution level, and whether the medical institution was equipped with pulse oximeters (all P<0.05). For the practice score, the main influencing factors were the knowledge score, gender, age, and whether the medi-cal institution was equipped with pulse oximeters (all P<0.05). Conclusions:Chinese pediatric healthcare providers need to further improve their knowledge about and attitudes towards pulse oximetry.Pulse oximeters are evidently under-used.It is urgent to formulate policies or guidelines, strengthen education and training, improve knowledge and attitudes, equip more institutions with pulse oximeters, and popularize their application in medical institutions.

Objective:To investigate the relationship between single nucleotide polymorphisms of transforming growth factor-β2 (TGFβ2) gene and Keshan disease (KD) in Han population of Shaanxi Province.Methods:KD region in Huangling County, Yan'an City, Shaanxi Province was selected as the investigation site in this study. Using the method of cluster random sampling, 52 families with KD in 6 administrative villages in Huangling County (Duanjiawan Village, Taoqu Village, Yaoping Village, Jianzhuang Village, Anjiao Village in Yaoping Town, and Houziping Village in Diantou Town) were selected for epidemiological investigation. According to the "Diagnosis of Keshan Disease" (WS/T 210-2011), 285 subjects were identified, including 79 patients with KD (case group) and 206 healthy controls (control group). Genomic DNA was extracted from the peripheral venous blood. The polymorphism of genetic variation of TGFβ2 gene rs6658835 was genotyped by matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF). Chi-square (χ 2) test and t-test were used to analyze the baseline data, and binary logistic regression model was used to analyze the influencing factors of KD, all samples were tested for Hardy-Weinberg equilibrium using goodness-of-fit χ 2 test, differences in genotype and allele frequencies between case and control groups were compared by χ 2 test, and logistic regression analysis was used to compare the genotype frequencies between two groups after adjusting for confounding factors. Results:Epidemiological investigation showed that there were significant differences in age and heart murmur between case group and control group ( t = 7.03, χ 2 = 9.66, P < 0.05). The analysis of binary logistic regression model showed that the influence of age on KD was statistically significant (χ 2 = 20.72, P < 0.001). The gene frequency distribution of TGFβ2 gene rs6658835 in case group and control group conformed to the Hardy-Weinberg equilibrium (χ 2 = 0.02, P = 0.900). Correlation analysis results: the difference of genotype frequency of TGFβ2 gene rs6658835 in case group (GG, GA, AA: 6.3%, 38.0%, 55.7%) and control group (GG, GA, AA: 10.7%, 43.7%, 45.6%) was not statistically significant (χ 2 = 2.78, P = 0.249). After adjustment by age, the difference of genotype frequency and dominant model of TGFβ2 gene rs6658835 in case group and control group was statistically significant (χ 2adj = 5.43, 4.86, P < 0.05), the difference of recessive model of TGFβ2 gene rs6658835 in case group and control group was not statistically significant (χ 2adj = 2.12, P = 0.145). Conclusion:TGFβ2 gene rs6658835 is associated with KD in Han population of Shaanxi Province.

Objective:To establish a model for predicting the mental health status of nurses based on machine learning algorithm.Methods:In February 2020, the nurses from Shantou Central Hospital and Cancer Hospital of Shantou University Medical College were recruited by convenience sampling, investigated using the Self-reporting Inventory, Coping Style Questionnaire, Social Support Rating Scale and Work Attitude Scale. Mental health status was treated as a dichotomous variable, and candidate predictors were screened out by univariate and multivariate Logistic regression analysis. The subjects were randomly divided into a training set (80%) and a test set (20%). Then five prediction models of nursing staff mental health status were constructed using the five machine learning methods (Logistic Regression, Artificial Neural Network, C5.0 Decision Tree, Bayesian Network and Support Vector Machine), verified and compared to screen out the model with the highest predictive efficiency.Results:A total of 415 nurses were enrolled, and the positive detection rate of mental health symptoms was 20.48%. According to univariate and multiple Logistic regression analysis, candidate predictors were work attitude ( OR=1.098, 95% CI 1.028-1.174), self-accusation ( OR=7.703, 95% CI 2.014-29.468), problem-solving( OR=0.131, 95% CI 0.025-0.686), the number of night shifts per month ( OR=0.204, 95% CI 0.073-0.573)and support availability ( OR=0.830, 95% CI 0.701-0.984). The accuracy of prediction of Logistic Regression, Artificial Neural Network, C5.0 Decision Tree, Bayesian Network and Support Vector Machine were 84.21%, 85.53%, 82.89%, 78.95%, 84.21%. The area under the ROC curve was 0.801, 0.825, 0.777, 0.583, 0.774. Artificial Neural Network was significantly more effective than Logistic regression, C5.0 Decision Tree, Bayesian Network and Support Vector Machine (DeLong test, P<0.05). Conclusions:The machine learning based predictive models for nursing staff mental health status has higher predictive value, which can be applied into nursing staff mental health screening decisions to accurately grasp its dynamic changes, early identification of high-risk mental health abnormalities and early intervention. Work attitude, self-accusation, problem-solving, the number of night shifts per month and support availability was predictors to construct predictive models.