ObjectiveTo retrospectively analyze the effect of modified Shugan Dingji Decoction （疏肝定悸汤） on the occurrence of endpoint events in patients with paroxysmal atrial fibrillation of liver constraint and qi stagnation. MethodsA retrospective cohort study was conducted using the electronic medical record database of Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine to screen and include patients with paroxysmal atrial fibrillation of liver constraint and qi stagnation from January 1st， 2018， to December 31th， 2021. The included patients were divided into an exposure group and a non-exposure group， each consisting of 100 cases， based on whether they received modified Shugan Dingji Decoction. General information of the patients including age， gender， body mass index， duration of illness and comorbidities， medication history， cardiac structure and function indicators such as left atrial diameter， left ventricular end-diastolic diameter， stroke volume and ejection fraction， and the occurrence of endpoint events assessed through 24-hour dynamic electrocardiography or electrocardiogram to determine the recurrence of paroxysmal atrial fibrillation were collected. Kaplan-Meier （K-M） curves and Log-Rank tests were used to conduct survival analysis on the occurrence of endpoint events in the two groups of patients. Univariate and multivariate Cox regression analyses were used to analyze the impact of various factors on entry into endpoint events. Additionally， a safety assessment was performed by comparing liver and kidney function indicators before and after treatment. ResultsIn the non-exposure group， a total of 49 cases （49.0%） experienced endpoint events， while in the exposure group， there were 26 cases （26.0%）. The Log-rank test indicated significant difference between the two groups （χ²=11.211， P=0.001）. Univariate Cox regression analysis showed that age， duration of illness， hypertension， diabetes， chronic heart failure， left atrial diameter， stroke volume， and the use of modified Shugan Dingji Decoction may be the influencing factors for the occurrence of endpoint events in patients with paroxysmal atrial fibrillation of liver constraint and qi stagnation （P＜0.05 or P＜0.01）. Multivariate Cox regression analysis showed that the risk of endpoint events in the exposure group was significantly lower than that in the non-exposure group （P＜0.01）. Patients with a duration of illness ＞12 months had a significantly higher risk of endpoint events compared to those with a duration of illness ≤12 months （P＜0.01）. Patients without concomitant hypertension had a lower risk of endpoint events compared to those with hypertension （P＜0.05）. Patients with left atrial diameter ＞40 mm had significantly higher risk of endpoint events than those with left atrial diameter ≤40 mm （P＜0.01）. There was no statistically significant difference in liver and kidney function indicators between the two groups before and after treatment （P＞0.05）. ConclusionThe use of modified Shugan Dingji Decoction is a protective factor for patients with paroxysmal atrial fibrillation of liver constraint and qi stagnation， which can help to reduce the recurrence and progression of atrial fibrillation. Long duration of illness， concomitant hypertension， and enlarged left atrial diameter are risk factors for patients to experience endpoint events.

Objective To investigate the clinical application of three-dimensional intracavitary/free-hand interstitial brachytherapy technique in radical radiotherapy for cervical cancer. Methods A retrospective study was conducted on the clinical data of patients with cervical cancer who underwent radical radiotherapy using CT-guided three-dimensional intracavitary/free-hand interstitial brachytherapy technique in The Affiliated Cancer Hospital of Nanjing Medical University from April 2019 to September 2021. The short-term efficacy and adverse reactions were analyzed, and the independent predictors affecting short-term efficacy were evaluated by logistic risk regression model. Results A total of 182 patients were included, and all patients successfully completed the treatment. Clinical efficacy assessment performed 3 months after treatment revealed an overall response rate of 90.65%; the incidence of grade 3 and 4 adverse reactions in the lower gastrointestinal tract was 4.4% during treatment. After reclassifying stage IIIC patients according to the International Federation of Gynecology and Obstetrics (FIGO) 2009 staging system and including factors affecting the stage, it was found that the tumor volume before brachytherapy was the main factor affecting the clinical efficacy of patients at this stage (P = 0.004). Conclusion As a key method in radical radiotherapy for cervical cancer, three-dimensional intracavitary/free-hand interstitial brachytherapy technique is safe and effective and can be quickly popularized in primary hospitals beyond regional cancer centers for cervical cancer brachytherapy.

ObjectiveTo conduct a meta-analysis of the prevalent characteristics of the injury-related behaviors among adolescents in China based on Chinese literature, so as to inform the prevention and control of injury-related behaviors of this population. MethodsA cross-sectional study on the prevalent characteristics of adolescent injury-related behaviors was conducted with the data collected from CNKI, VIP, Wanfang Data, CBM, PubMed, and Web of Science. The review included publications from the inception of the databases to November 2023. Meta-analysis was performed with Stata 15.1 software. ResultsA total of 40 articles were included in this study, and the meta-analysis results showed that cycling violation rate was 38% (95%CI: 32%‒43%), walking violation rate was 29% (95%CI: 22%‒36%), rate of unsafe swimming was 13% (95%CI: 11%‒14%), suicidal ideation rate was 13% (95%CI: 12%‒15%) and the prevalence of fighting was 19% (95%CI: 17%‒22%). Subgroup analysis showed that the cycling violation rate was (44%) for boys and 34% (95%CI: 28%‒40%) for girls. Adolescents in Northeast, East, and Southwest of China had the highest rate of cycling violation (44%), of which junior high school students had the highest rate of violation [42% (95%CI: 36%‒49%)]. As for the walking violation rate, male students [29% (95%CI: 21%‒37%)] was higher than that of female students [22% (95%CI: 15%‒30%)]. Adolescents in North of China had the highest rate of walking violation [54% (95%CI: 30%‒76%)], of which vocational school students accounted for 38% (95%CI:21%‒56%) of the total violation. In terms of the detection rate of unsafe swimming, male students [18% (95%CI: 14%‒24%)] was higher than that of female students [8% (95%CI: 6%‒10%)]. Adolescents in Central South China had the highest rate of unsafe swimming [15% (95%CI: 12%‒18%)], of which, vocational school students accounted for the highest [15% (95%CI: 10%‒19%)]. When it comes to the prevalence of suicidal ideation, female students [16% (95%CI: 13%‒19%)] was higher than that of male students [13% (95%CI: 11%‒15%)]. Adolescents in Southwest of China had the highest rate of suicidal ideation [17% (95%CI: 10%‒25%)], of which high school students accounted for the highest [15% (95%CI: 12%‒18%)]. Finally, the detection rate of fights was 30% (95%CI: 26%‒34%) for boys and 11% (95%CI: 10%‒14%) for girls. Adolescents from Southwest of China had the highest rate [29% (95%CI: 24%‒34%)] for fights, and junior high school students accounted for the highest [26% (95%CI: 22%‒31%)]. ConclusionThe prevalence of harmful behaviors among adolescents in China is notably high, with statistical differences across gender, region, and school stages. These behaviors pose a risk to adolescent health, underscoring the need for targeted interventions by health and educational authorities.

Objective: To explore the intervention effect of group counseling integrating teadrinking on depression, social avoidance and distress, coping styles and selfesteem among college students, so as to provide references for promoting the psychological health of students. Methods: From March to June 2021, a convenience sampling method was used to recruit 46 college students from a university in Nanjing for intervention project. There were 23 students in intervention group and control group, respectively. The intervention was conducted for 2.5 hours per week across a 6 week period. The intervention group received two sessions of group counseling that incorporated teadrinking experience, and the sessions involved tea knowledge explanation, observation and learning, embodied experience, emotional expression, interpersonal assistance and emotional support, cultural customs and life integration. After the intervention was completed, the control group received onetime group counseling that integrated teadrinking. The Wilcoxon difference test and Mann-Whitney U test were performed to compare the scores of each scale within and between the groups, and the χ2 test was used to compare the detection rates. Results: There were no statistically significant differences in the scores of positive coping, negative coping, selfesteem, social avoidance and distress between the intervention group and the control group (Z=-1.20, -0.33, -0.35, 1.31,P>0.05). There were statistically significant differences in positive coping styles, selfesteem, social avoidance and distress between the intervention group and the control group after the intervention(27.70±5.60，22.05±4.30；30.52±3.63，28.27±4.06；7.43±7.38，13.64±6.79) (Z=-3.31, -2.10, 3.22, P<0.05). The intervention group showed statistically significant differences in social avoidance and distress scores before and after the intervention(11.96±7.47,7.43±7.38) (Z=-2.88), and the depression detection rate decreased(60.9%，30.4%) (χ2=4.29) (P<0.05). There were no statistically significant differences in positive coping, negative coping, selfesteem, social avoidance and distress scores, and depression detection rate between the control group before and after the intervention (Z/χ2=-0.28, -0.42, -1.24, -1.25；1.39, P>0.05). The followup results 1year later showed that there was a statistically significant difference in social avoidance and distress(6.57±6.21,14.16±9.22), and in the detection rates of depression(21.7%,52.2%) between the intervention group and the control group (Z/χ2=2.70,4.57,P<0.05). Conclusions Group counseling integrating teadrinking could improve interpersonal relationships, emotional states, selfesteem levels and coping strategies among college students. Group psychological counseling that incorporates teadrinking can be adopted to improve the mental health status of college students.

ObjectiveTo explore the influencing factors of occupational hand-arm vibration disease (OHAVD) caused by handheld workpiece polishing. Methods A total of 222 OHAVD patients (case group), 275 hand-transmitted vibration-exposed workers (exposed group) and 243 healthy workers without hand-transmitted vibration exposure (control group) in a sports equipment manufacturing enterprise were selected as the study subjects using the convenience sampling method. Worksite survey of occupational health was conducted on these three groups, and the human vibration measurement equipment was used to measure the vibration exposure level of handheld vibration among the study subjects. The 8-hour energy equivalent frequency-weighted vibrating acceleration ［A(8)］ and cumulative vibration exposure level (CVEL) were calculated. Results The prevalence of coldness, numbness, tingling fingers, and vibration-induced white finger was higher in the exposed group and the case group compared with the control group (all P<0.05). The prevalence of the above-mentioned hand symptoms was higher in the case group compared with the exposed group (all P<0.05). The A(8) and CVEL levels of the study subjects in the case group were higher than those in the exposed group (all P<0.05). Binary logistic analysis result showed that age and CVEL were both influencing factors of OHAVD (all P<0.05). According to the restricted cubic spline models, CVEL of the study subjects in the exposed group had a positive nonlinear dose-response relationship with the risk of OHAVD (overall trend P<0.01, nonlinear P<0.01), indicating an increasing risk of OHAVD with increasing CVEL. Conclusion Hand-transmitted vibration exposure is a risk factor for OHAVD. Early intervention should be carried out for hand-transmitted vibration-exposed individuals to reduce vibration-exposed levels and control vibration exposure time.

Objective:To analyze epidemiological characteristics and spatiotemporal clustering of hepatitis A in China from 2005 to 2023.Methods:The incidence data of hepatitis A in China during 2005-2023 were collected from the China Disease Control and Prevention Information System .Results:From 2005 to 2023, a total of 605 509 cases of hepatitis A were reported in China. The average annual reported incidence rate was 2.32/100 000, the incidence was 2.85/100 000 in men and 1.81/100 000 in women, and the incidence was 3.25/100 000 in age group 0-14 years, 2.10/100 000 in age group 15-64 years and 2.49/100 000 in age group ≥65 years , respectively. The case count in farmers was highest (40.57%, 245 639/605 509). The proportion of the cases in jobless or the unemployed increased most obviously (347.32%), and the proportion of the cases in students decreased most significantly (90.27%). The average annual reported incidence rate in the western China was highest (4.45/100 000), followed by that in northeastern China (2.02/100 000), central China (1.89/100 000) and eastern China (1.16/100 000). From 2020 to 2023, the incidence of hepatitis A showed no spatial clustering. From 2005 to 2019, the obvious hot spots and high-high clustering areas mainly distributed in provinces, such as, Sichuan, Qinghai, Xinjiang, Xizang and Gansu. The low-low clustering areas were mainly distributed in Beijing, Tianjin, Hebei, Shandong, Jiangsu, Shanghai, Zhejiang, Fujian, Henan, Anhui, Jiangxi, Jilin and Liaoning. An independent high-low clustering was found in Shanxi during 2014-2019. A total of 5 high incidence clustering areas were detected through spatiotemporal scanning analysis.Conclusions:The incidence rate of hepatitis A in China declined significantly from 2005 to 2023. The reported incidence rate in the elderly showed no obvious decrease, and the reported cases accounted for the highest proportion in the whole population. Before 2020, the reported incidence rate of hepatitis A showed high-high clustering in western China, the spatiotemporal clustering disappeared from 2020 to 2023, but the reported incidence rate of hepatitis A in western China was still high. It is suggested to pay attention to the prevention and control of hepatitis A in populations at high risk and areas with high incidence of hepatitis A.

Objective:To explore the efficacy, safety, and feasibility of single port laparoscopic liver resection via umbilical cord, and summarize its surgical experience.Method:A retrospective analysis was conducted on 39 patients who underwent liver resection surgery at the Department of Hepatobiliary and Pancreatic Surgery, the Affiliated Hospital of Qingdao University from February 2022 to September 2023. There were 19 patients in the transumbilical single-port laparoscopic group, including 5 males and 14 females, aged (49.6±2.5) years. There were 20 patients in the multi-port laparoscopic group, including 7 males and 13 females, aged (49.9±3.1) years. The intraoperative blood loss, operation time, intestinal recovery time, postoperative hospital stay and postoperative complications were compared between the single-port group and multi-port group.Results:All 39 patients successfully completed the surgery without any additional foramen or conversion to open surgery. The operation time of the single hole group (166.3±59.0) min was longer than that of the multi-port group (123.2±48.0) min, and the difference was statistically significant ( t=2.50, P=0.020). There were no statistically significant differences in intraoperative blood loss, intestinal recovery time, postoperative hospital stay, and postoperative complications between these two groups (all P>0.05). All patients had no postoperative complications such as bleeding, infection, or bile leakage. Follow up for 3~21 months showed no recurrence of primary diseases such as hepatic hemangioma, hepatic adenoma, and intrahepatic bile duct stones. The aesthetic effect of the umbilical incision in the single orifice group was significant, and patient satisfaction was 100%. Conclusion:Umbilical single-port laparoscopic liver resection surgery is safe and feasible, with significant minimally invasive and aesthetic effects.

Objective:To observe the efficacy and safety of letermovir in preventing cytomegalovirus (CMV) reactivation after allogeneic hematopoietic stem cell transplantation (allo-HSCT) .Method:From September 2022 to September 2023, retrospective analysis was conducted for the relevant clinical data of 50 recipients of allo-HSCT at First Affiliated Hospital of Zhengzhou University Hospital. Letermovir prophylaxis was offered for preventing cytomegalovirus (CMV) reactivation post-transplantation. They were historically compared with previous patients at the same center without letermovir prophylaxis. The incidence of CMV reactivation, overall survival rate, engraftment status and other adverse events within 100 days post-transplant were compared between two groups. Propensity score matching (PSM) was utilized for controlling confounding factors. Univariate analyses were performed with t and chi-square tests while survival analysis conducted with Kaplan-Meier method.Result:In letermovir group, CMV reactivation was detected in 3 cases (6%) versus 23 cases (46%) in control group. Letermovir significantly reduced the incidence of post-transplant CMV reactivation ( P<0.01). Within Day 100 post-transplant, there was one death in letermovir group with an overall survival rate of 98%. In control group, three deaths occurred with an overall survival rate of 94%. The median survival time of deceased cases was 64 (58-81) day. No statistically significant inter-group difference existed in overall survival rate ( P=0.617). In letermovir group, secondary implantation failure was observed in 3 cases (6%) and it was lower than 12 cases (24%) in control group. Statistically significant inter-group difference existed in secondary implantation failure rate ( P=0.023). However, regarding timing of neutrophil engraftment ( P=0.054) and platelet engraftment ( P=0.649), there were no significant inter-group statistical differences. Hemorrhagic cystitis (HC) occurred in letermovir group (17 cses, 34%) and control group (27cases, 54%). The incidence of HC was significantly lower in letermovir group than that in control group ( P=0.044). However, no statistically significant inter-group difference existed in the incidence of post-transplant EBV infection or acute graft-versus-host disease. Conclusion:Letermovir may significantly lower the incidence of cytomegalovirus (CMV) reactivation after allo-HSCT. It is both effective and safe for preventing CMV disease and improving early outcomes.

Objective: To investigate the association between parenting style and sleep problems among school aged children with autism spectrum disorder (ASD). Methods: A total of 98 children with ASD aged 6-10 years old and 98 age and gender matched typically developing (TD) children from mainstream schools were recruited. Parenting style and sleep problems were measured via Parent Behavior Inventory (PBI) and Children s Sleep Habits Questionnaire(CSHQ), respectively. The symptom severity and intelligence level were also evaluated. Generalized linear model was used to analyze the relationship between parenting style and sleep problems. Results: There was no statistically significant difference in the parenting style of the two groups of children( P > 0.05 ); weekend sleep time of children with ASD was significantly shorter than that of the TD group [(9.1±0.7)(9.5±0.8)h, P < 0.01 ], and the score of sleep onset delay was significantly higher than that of the TD group[(1.8±0.7)(1.5±0.7), P <0.01]. However, there was no statistically significant difference in the incidence of total sleep problems and various problems between the two groups of children( P >0.05). The parental support/engagement of children with ASD was negatively associated with the total score of sleep problems( β=-2.68, 95%CI =-4.88--0.47), bedtime resistance ( β=-1.65, 95%CI =-2.54--0.77) and sleep anxiety( β=-1.01, 95%CI =-1.70--0.32). The parental hostility/coercion was positively correlated with score of daytime sleepiness( β=1.41, 95%CI =0.53-2.29)( P <0.05). Conclusion Parenting style of support/engagement is associated with lower sleep problems in children with ASD, while hostile/coercion is associated with higher sleep problems. It should be improve parental style to reduce the sleep problems in children with ASD.

ObjectiveTo investigate the population and chigger mite infection of rodents in Pudong District， Shanghai， so as to provide the scientific basis for the prevention and control of rodents and chigger transmitted diseases. MethodsThe monitoring work was conducted in four points including Xuanqiao， Hangtou， Laogang and Nanhui New Town with night trapping method from 2020 to 2022. Habitats as farmland， wasteland， rural residential areas， and parks were selected. The rodent species were identified and rodent density was calculated. All chigger mites were collected from the earlaps and auricular fossae of the rodents. The species of chigger mites were identified and the chigger mite index was calculated. ResultsA total of 222 rodents were captured. They belonged to 5 species， 4 genera， 2 families and 2 orders， including 4 species， 3 genera， and 1 family of Rodentia and 1 species of Insectivora. M. musculus was the dominant species， with a composition ratio of 54.05%. Total 80 chigger mites were captured， with a detection rate of 36.03%. The total chigger index was 0.36 and Rattus tanezumi held the highest （6.00）， followed by M. musculus （0.48）. There were 3 species of chigger mites， L.deliense， L.scutellare， and L.gaohuense. L.deliense was the dominant specie， accounting for 55.00%. ConclusionThere is a risk of chigger-borne disease transmission in Pudong New Area with M. musculus as the dominant host and L. deliense as the dominant species.