Objective: To retrospectively investigate the clinical efficacy, safety, and management experience of a patient diagnosed with polycythemia vera (PV) at the age of 3 who underwent regular erythrocytapheresis for 7 years starting at the age of 10. Methods: Treatment was initiated when the patient's hematocrit was≥50%. The goal was to reduce the hematocrit to below 40%; the removal volume was calculated as 10%-15% of the total red blood cell mass, and an equal volume of normal saline was supplemented during the procedure. Pre-treatment precautions included avoiding fasting and high-fat diets. Post-treatment measures included lying flat for 30 minutes, reducing strenuous exercise for 2–3 days, and rechecking complete blood count 2–5 days after the procedure. During the procedure, adverse reactions such as palpitations, dyspnea, hypotension, and convulsions were monitored. Follow-up was conducted after 3 days to assess any delayed adverse effects. Results: As of August 2025, the patient had undergone a total of 16 erythrocytapheresis sessions. The average volume ranged from 212 to 500 mL. The frequency was 1 to 4 times annually. Post-procedure, hemoglobin (Hb) and hematocrit (Hct) were effectively controlled. Conclusion: Continuous erythrocytapheresis can effectively control Hb and Hct levels in PV patients, preventing adverse effects from the primary disease. Erythrocytapheresis demonstrates efficacy with minimal adverse reactions and can be used as a routine therapeutic technique for PV patients.

Objective:To understand the epidemiological characteristics of injury deaths in local residents in Nanjing from 2009 to 2023, and provide evidence for the development of injury prevention and control strategies.Methods:The injury mortality data in Nanjing from 2009 to 2023 were analyzed based on the death cause surveillance system. In the recorded 33 542 injury death cases, 19 906 (59.35%) were men, and 13 636 (40.65%) were women. The crude mortality rate, age-standardized mortality rate, age-specific mortality rate, cause-eliminated life expectancy (CELE), potential gains in life expectancy (PGLEs) and life loss rate, were calculated. Joinpoint 5.0 software was used to estimate the average annual percentage change (AAPC) and its 95% CI to assess temporal trends of injury deaths. Results:In Nanjing, the crude injury mortality rate showed an upward trend (AAPC=2.11%), while the age-standardized mortality rate exhibited a downward trend (AAPC=-1.27%) from 2009 to 2023. The ranking of injury deaths in all causes of death declined from the 4 th in 2009 to the 6 th in 2023. The crude and age-standardized injury mortality rates in men were consistently higher than those in women. The primary cause of injury deaths was fall (31.42%). Drowning was the primary cause of injury deaths in age group 0-14 years (35.94%), while traffic accident was the primary cause in age group 15-64 years. For residents aged ≥65 years, fall was the primary cause of injury deaths. From 2009 to 2023, the CELE (AAPC=0.61%, 95% CI: 0.34%-0.89%, P<0.05) and the PGLEs (AAPC=1.73%, 95% CI: 0.21%-3.29%, P<0.05) showed increasing trends. The PGLEs and life loss rate due to injury were consistently higher in men than in women, but the AAPC of PGLEs and life loss rate was higher in women. Conclusions:From 2009 to 2023, the age-standardized injury mortality rate decreased, but the life loss due to injury deaths showed an upward trend in Nanjing, indicating that injury still has non-negligible negative impact on life expectancy.

Objective To clarify the risk factors of diaphragmatic dysfunction (DD) after cardiac surgery with extracorporeal circulation. Methods A retrospective analysis was conducted on the data of patients who underwent cardiac surgery with extracorporeal circulation in the Department of Cardiovascular Surgery of Peking University People's Hospital from January 2023 to March 2024. Patients were divided into two groups according to the results of bedside diaphragm ultrasound: a DD group and a control group. The preoperative, intraoperative, and postoperative indicators of the patients were compared and analyzed, and independent risk factors for DD were screened using multivariate logistic regression analysis. Results A total of 281 patients were included, with 32 patients in the DD group, including 23 males and 9 females, with an average age of (64.0±13.5) years. There were 249 patients in the control group, including 189 males and 60 females, with an average age of (58.0±11.2) years. The body mass index of the DD group was lower than that of the control group [(18.4±1.5) kg/m2 vs. (21.9±1.8) kg/m2, P=0.004], and the prevalence of hypertension, chronic obstructive pulmonary disease, heart failure, and renal insufficiency was higher in the DD group (P<0.05). There was no statistical difference in intraoperative indicators (operation method, extracorporeal circulation time, aortic clamping time, and intraoperative nasopharyngeal temperature) between the two groups (P>0.05). In terms of postoperative aspects, the peak postoperative blood glucose in the DD group was significantly higher than that in the control group (P=0.001), and the proportion of patients requiring continuous renal replacement therapy was significantly higher than that in the control group (P=0.001). The postoperative reintubation rate, tracheotomy rate, mechanical ventilation time, and intensive care unit stay time in the DD group were higher or longer than those in the control group (P<0.05). Multivariate logistic regression analysis showed that low body mass index [OR=0.72, 95%CI (0.41, 0.88), P=0.011], preoperative dialysis [OR=2.51, 95%CI (1.89, 4.14), P=0.027], low left ventricular ejection fraction [OR=0.88, 95%CI (0.71, 0.93), P=0.046], and postoperative hyperglycemia [OR=3.27, 95%CI (2.58, 5.32), P=0.009] were independent risk factors for DD. Conclusion The incidence of DD is relatively high after cardiac surgery, and low body mass index, preoperative renal insufficiency requiring dialysis, low left ventricular ejection fraction, and postoperative hyperglycemia are risk factors for DD.

Objective:To understand the epidemiological characteristics of injury deaths in local residents in Nanjing from 2009 to 2023, and provide evidence for the development of injury prevention and control strategies.Methods:The injury mortality data in Nanjing from 2009 to 2023 were analyzed based on the death cause surveillance system. In the recorded 33 542 injury death cases, 19 906 (59.35%) were men, and 13 636 (40.65%) were women. The crude mortality rate, age-standardized mortality rate, age-specific mortality rate, cause-eliminated life expectancy (CELE), potential gains in life expectancy (PGLEs) and life loss rate, were calculated. Joinpoint 5.0 software was used to estimate the average annual percentage change (AAPC) and its 95% CI to assess temporal trends of injury deaths. Results:In Nanjing, the crude injury mortality rate showed an upward trend (AAPC=2.11%), while the age-standardized mortality rate exhibited a downward trend (AAPC=-1.27%) from 2009 to 2023. The ranking of injury deaths in all causes of death declined from the 4 th in 2009 to the 6 th in 2023. The crude and age-standardized injury mortality rates in men were consistently higher than those in women. The primary cause of injury deaths was fall (31.42%). Drowning was the primary cause of injury deaths in age group 0-14 years (35.94%), while traffic accident was the primary cause in age group 15-64 years. For residents aged ≥65 years, fall was the primary cause of injury deaths. From 2009 to 2023, the CELE (AAPC=0.61%, 95% CI: 0.34%-0.89%, P<0.05) and the PGLEs (AAPC=1.73%, 95% CI: 0.21%-3.29%, P<0.05) showed increasing trends. The PGLEs and life loss rate due to injury were consistently higher in men than in women, but the AAPC of PGLEs and life loss rate was higher in women. Conclusions:From 2009 to 2023, the age-standardized injury mortality rate decreased, but the life loss due to injury deaths showed an upward trend in Nanjing, indicating that injury still has non-negligible negative impact on life expectancy.

Objective This study aims to explore the associations between threat and deprivation childhood traumas and dysfunctional attitudes among patients with major depressive episode,based on the dimensional model of adversity and psychopathology(DMAP).Methods Data from 970 patients with major depressive episode were collected and categorized based on the childhood trauma questionnaire-short form(CTQ-SF)scores into no trauma(426),threat-only(86),deprivation-only(210),and mixed groups(248).Cognitive distortions were assessed using the dysfunctional attitudes scale(DAS),with scores above the upper quartile indicating significant distortions.Multifactorial logistic regression analysis was employed to examine the association between threat and deprivation and dysfunctional attitudes.Results There were significant differences in the proportion of cognitive distortions among the no trauma,threat-only,deprivation-only,and mixed groups(19.25% vs.30.23% vs.20.00% vs.35.89%,P<0.001),with differences across all dimensions(P≤0.001).Multifactorial logistic regression revealed a positive correlation between threat and overall cognitive distortions(OR=2.031,P<0.001),and specific positive correlations with dimensions such as vulnerability(OR=1.709,P<0.001),appeal and repulsion(OR=2.088,P<0.001),perfectionism(OR=2.321,P<0.001),compulsivity(OR=1.765,P=0.001),approval seeking(OR=1.837,P<0.001),dependency(OR=1.554,P=0.006),and autonomous attitudes(OR=1.864,P<0.001).In contrast,deprivation was only positively correlated with the cognitive philosophy dimension(OR=1.495,P=0.015).Conclusion Childhood trauma is closely associated with dysfunctional attitudes in patients with major depressive episode.Threat correlates positively with cognitive distortions in all dimensions except cognitive philosophy,whereas deprivation correlates only with the cognitive philosophy dimension.

Objective To study the identification methods and traits of the Chinese medicinal materials Inonotus obliquus.Methods Samples were collected from the origin of northeast China,and source identification,molecular biology identification,trait identification,microscopic identification and HPLC assay were used to study the Inonotus obliquus,its non-pure fungous part,and counterfeit.Results Inonotus obliquus had a nodular shape,the microstructure was closely interconnected with mycelia,and the medicinal part was the sclerotium,not the"fruiting body"as stipulated in the current standards of traditional Chinese medicinal materials.Occasionally,a very small amount of tubule and subiculum could be seen in Inonotus obliquus.Tubule hole shape was circular,with a diameter of 130-190 μm,and ruptured.The pipe wall structure was special,which was composed of longitudinal arranged small compartment with diameter of 2-5-8 μm.Non-pure fungous part was the decayed host xylem infiltrated by mycelia.The contents of trametenolic acid and ergosterol in this part were significantly lower than the pure sclerotium(P<0.05).The microstructure and HPLC fingerprints of Inonotus obliquus and the counterfeit burl were clearly distinguishable from each other.Conclusion The method used is able to identify the authenticity of Inonotus obliquus and the quality of the medicinal materials.

Objective To investigate the incidence of motoric cognitive risk(MCR)syndrome and declines in both motor and cognitive functions in elderly patients with enlarged perivascular spaces(EPVS).Methods A total of 113 patients(≥60 years old)with EPVS identified by head MRI admitted to our department from March 1 to November 30,2023 were consecutively recrui-ted,and according to having MCR syndrome or not,they were divided into MCR group(44 cases)and non-MCR group(69 cases).Cognitive function and motor function were assessed with aid of Montreal Cognitive Scale(MoCA),Simple Mental State Examination Scale(MMSE),trail making test,and motor function assessments,including Tinetti Balance and Gait Scale,Short Physical Performance Battery(SPPB),8-meter walk,Timed up and Go test(TUGT),walking and contin-uous subtraction task(WSS),walking and semantic fluency task(WSF),and TUGT and serial subtraction task(TUGSS).The motor and cognitive functions were compared between the two groups,and the risk factors related to MCR syndrome in EPVS patients were analyzed by multi-variate logistic regression.Results Compared with the non-MCR group,the MCR group had low-er MoCA score,total SPPB score,8-meter walk speed,and longer times of TMT-A,TMT-B,WSS,WSF and TUGSS(P＜0.05,P＜0.01).Multivariate logistic regression analysis showed that in Model 1(including variables with differences in univariate analysis),MoCA score,8-meter walk speed,and TUGSS time were independent risk factors for MCR syndrome in EPVS patients(P＜0.05,P＜0.01);in Model 2(adjusting for age,sex,education level,and comorbidities),MoCA score(OR=0.621,95％CI:0.432-0.929,P=0.010),8-meter walk speed(OR=1.332,95％CI:1.115-1.591,P=0.002),and TUGSS time(OR=0.393,95％CI:0.232-0.665,P=0.001)re-mained independent risk factors for MCR syndrome in EPVS patients.Conclusion Among elderly EPVS patients,those with MCR syndrome show significantly worse cognitive and motor function compared to those without.MoCA score,8-meter walk speed,and TUGSS time are related factors for MCR occurrence in EPVS patients.

In the era of informatization, virtual teaching labs have emerged as a pivotal exploration in the construction of new teaching organizations at the primary level. Virtual labs of teaching research and reform require faculty members to collaboratively conduct teaching reform research and practice, thereby fostering new paradigms and achievements for teaching reforms. It serves as a vital foundation for supporting comprehensive reforms in curriculum teaching and specialty construction. This paper delves into the logical framework of virtual teaching research and reform labs from four dimensions (value orientation, construction principles, organizational structure, and operational safeguards), and elaborates on lab construction pathways from four aspects (technological platforms, behavioral relationships, knowledge management, and spiritual culture). Taking virtual teaching labs for medical education as an example, the paper summarizes practical experience in the innovative exploration of reform-oriented virtual teaching labs. Finally, we discuss the most constraining factors in the current construction of virtual teaching labs, and propose that research on virtual teaching labs should pay more attention to solving practical problems in major and curriculum reforms to promote the integration of medical education and practice, ultimately contributing to the realization of the Healthy China initiative.

OBJECTIVE To analyze the MSCT and MRI imaging manifestations of patients with duplication of the internal auditory canal(DIAC),improve understanding of the deformity,to provide preoperative basis for cochlear implantation.METHODS Retrospective observation of 20 cases(24 ears)of DIAC inner ear multi-spiral CT(MSCT)and MRI data,measurement and analysis of the width of the internal auditory canal(IAC)and cochlear nerve canal in the lesion group and the control group.RESULTS All DIACs had stenosis of the IAC cambined with other temporal bone malformations.MSCT shows that the 21 ears IAC,while MRI hydrography shows the 16 ears IAC divided into double tubes by bone.MRI hydrography shows a slender vestibulocochlear nerve.There were statistically significant differences(P<0.001)in the width of IAC and cochlear nerve canal between the lesion group and the control group.Six cases(8 ears)had varying degrees of hearing recovery after cochlear implant surgery.CONCLUSION DIAC shows stenosis of the IAC;The bone septa shown on MSCT are its characteristic fertures;MRI hydrography shows underdeveloped vestibular and cochlear nerves;The combination of two imaging examination methods can provide objective reference for the diagnosis of this disease and artificial auditory implantation.

Influenza imposes a significant disease burden on society and individuals annually, and influenza vaccination is considered a significant public health measure to prevent influenza and reduce influenza-related severe disease and death. The low influenza vaccination rate in China is partly due to certain factors affecting the willingness and behavior of individuals to receive them. Scientific research and targeted interventions on these factors can effectively improve the vaccination situation. Commonly used individual-level theoretical models for influenza vaccination behavior include the health belief model, protection motivation theory, and theory of planned behavior. This study reviews theoretical models commonly employed in researching influenza vaccination willingness and behavior. An overview of these practical applications and challenges models is presented to provide references for relevant research and intervention programs in China.