AIM:To analyze the effect of conbercept treatment on different types of macular edema secondary to retinal vein occlusion(RVO-ME)using optical coherence tomography(OCT)images.METHODS: This retrospective study included patients who first received conbercept injections for RVO-ME at Yijishan Hospital of Wannan Medical College from December 1, 2017, to March 31, 2022. Data on disease duration, age, hypertension, OCT images, central macular thickness(CMT), and best-corrected visual acuity(BCVA)were collected before and at 4-6 wk after treatment. Patients were divided into 4 groups according to different types of macular edema: cystoid macular edema(CME), sponge-like diffuse retinal thickening(SDRT), serous retinal detachment(SRD), and mixed type(FULL). Changes in CMT and visual acuity before and after treatment were compared among the groups to analyze differences in the effect of conbercept treatment on different ME types, and the effect of baseline CMT and visual acuity on post-treatment visual acuity.RESULTS: Totally 139 patients(139 eyes)were classified as having macular edema, including 62 males(44.6%)and 77 females(55.4%), with a mean age of 58.9±10.9 years, and they were divided into 4 groups based on different types of macular edema, including 54 cases(54 eyes)(mean age 59.6±11.1 years)in the CME group, 23 cases(23 eyes; mean age 56.6±10.2 years)in the SDRT group, 22 cases(22 eyes; mean age 57.8±12.0 years)in the SDR group, and 40 cases(40 eyes; mean age 60.0±10.7 years)in the FULL group. There were no significant differences in the duration of disease or age between groups(P>0.05). There was a significant difference in preoperative CMT between groups(P=0.01, one-way ANOVA), with the CMT in the FULL group being significantly greater than that in the SDRT group(P=0.03). There were no significant differences in pre-treatment visual acuity between the four groups(P=0.26). After conbercept treatment, the macular central recess thickness was reduced and visual acuity was improved in all four groups, among which the CMT in the CME and FULL groups was reduced significantly compared with the other two groups(P<0.05), and the visual acuity in the CME and SRD groups was improved significantly compared with the other two groups(P<0.05). Postoperative visual acuity was negatively correlated with preoperative CMT(P=0.044)and positively correlated with preoperative visual acuity(P<0.01).CONCLUSION:The efficacy of intravitreal conbercept in the treatment of RVO and macular edema may be related to the type of edema observed on OCT images, in which the efficacy is best in patients with CME but poor in patients with SDRT.

Objective: To explore the impact of adverse childhood experiences (ACEs) on health risk behaviors (HRBs) among college students and the mediating role of psychological symptoms, so as to provide a basis for developing intervention strategies. Methods: From March to April 2023, a convenience cluster sample of 1 801 students from 12 universities in Nanning, Liuzhou, Guilin, Wuzhou of Guangxi completed an online survey. A self designed questionnaire, Adverse Childhood Experiences-International Questionnaire (ACE-IQ) and Symptom Checklist-90 (SCL-90) were used for evaluation tools. Binary Logistic regression, structural equation modeling (SEM) and Bootstrap methods were used to analyze the associations and mediating effects. Results: Overall, 71.2% of college students experienced at least one type of ACE, with emotional neglect (40.3%) and emotional abuse ( 25.2 %) having the highest detection rates. The top three HRBs were unhealthy diet (77.8%), physical inactivity (54.1%), and smoking/alcohol use (18.5%). Logistic regression showed that poor family functioning, abuse, and extra familial violence were each associated with an increased risk of smoking/alcohol use ( OR =1.14, 1.11, 1.18) and deliberate self harm ( OR =1.26, 1.19,1.30) (all P <0.05). Experience of abuse increased the risk of high risk sexual behavior and family dysfunction increaded the risk of physical inactivity, respectively ( OR = 1.07 , 1.04, both P <0.05). Mediation analysis revealed that anxiety ( β =0.20) and depression ( β = 0.09 ) partially mediated the pathway from poor family functioning to deliberate self harm; paranoia ( β =0.02) partially mediated the pathway from abuse to high risk sexual behavior; and obsessive-compulsive symptoms ( β =0.26) and depression ( β =0.10) partially mediated the pathway from extra familial violence to deliberate self harm (all P <0.05). Conclusion Psychological symptoms play a mediating role in the association between ACEs and HRBs, and mental health interventions may reduce the risk of HRBs among college students.

Objective To investigate the application of targeted next-generation sequencing test(tNGS)in detecting patho-gens and drug resistance genes in the diagnosis and treatment of Mycoplasma pneumoniae pneumonia(MPP)in chil-dren.Methods The clinical data of children diagnosed with MPP and hospitalized in Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology from July 2022 to December 2023 were analyzed.The differences of MP se-quence detected by tNGS in children of different gender,age,course,and clinical features were compared.The performance of tNGS in detecting macrolides resistance genes was assessed.The optimal prediction cut-off value of MP resistance gene was ex-plored by ROC.Results A total of 497 cases were included,including 257(51.7％)male and 240(48.3％)female.The age dis-tribution was from 3 months to 13 years old[(6.08±2.68)years old in average],and the average durations of fever and cough were(6.04±3.42)and(7.46±5.54)days,respectively.MP was detected in all patients by tNGS method.There was no signifi-cant difference in different gender or age groups.The MP sequence count in patients with positive nucleic acid was significantly higher than that in patients with negative nucleic acid.The MP sequence count in lower respiratory specimens was significantly higher than that in upper respiratory specimens.MP sequence count in severe cases was significantly higher than that in non-se-vere cases,but there was no significant difference between patients with or without pulmonary complications and refractory or non-refractory cases.The overall diagnostic sensitivity of tNGS for detecting MP drug-resistant genes was 92.8％,specificity was 27.8％,PPV was 48.3％,NPV was 84.2％,and the mutation site was 23S rRNA:A2063G.The ratio of MP pathogenic se-quence to drug-resistant gene sequence was 6.83,which was the best cut-off value for predicting drug resistance.The negative predictive value was higher when the MP pathogenic sequence ratio was greater than 6.83.Conclusion tNGS has the value in early diagnosis of MPP.The MP sequence counts may have a guiding value in predicting disease severity.The negative predictive value is higher in drug-resistant gene detection.

With the acceleration of aging society in China, acute obstructive suppurative cholangitis (AOSC) in the extremely elderly (≥80 years) patients has become a common and frequent acute abdominal disease, which seriously threatens national strategy of "healthy aging" in China. Endoscopic retrograde cholangiopancreatography (ERCP) is currently the mainstream treatment for AOSC, but emergency ERCP treatment for elderly patients with AOSC is limited. In recent years, laparoscopic surgery targeting laparoscopic transcystic common bile duct exploration (LTCBDE) has been an ideal treatment method, but it has a high surgical risk. The authors′ team has conducted in-depth exploration into the advantages and disadvantages of ERCP treatment, strategies for repairing Oddi sphincter function, selection of laparoscopic surgical methods, and formulation of safety guarantee measures, and has carried out the technical improvements on LTCBDE, aiming to enhance the feasibility and safety of this surgical method in the treatment of AOSC in extremely elderly patients.

Enteric human adenovirus(HAdV),a common cause of acute viral gastroenteritis in children,frequently triggers spo-radic infections,nosocomial transmissions,and outbreaks in kindergarten settings.This study was aimed at investigating the molecular characteristics and genetic evolution of enteric HAdV among patients with acute gastroenteritis younger than 5 years in China,to pro-vide foundational data for disease prevention and control.A total of 8 074 stool samples were collected from hospitalized or outpatient children younger than 5 years with acute gastroenteritis in China during 2023.HAdV screening was conducted with real-time fluores-cence PCR.Positive samples were sequenced,then subjected to bioinformatics analysis including genotyping,homology assessment,and phylogenetic analysis with GenBank,BioAider,and MEGA11.0.A total of 370 samples(4.58%)tested positive for HAdV.Two enteric HAdV genotypes were identified:HAdV-F41(which predominated,at 98.09%)and HAdV-F40(1.90%).HAdV-F41 was the dominant genotype among patients with acute gastroenteritis younger than 5 years in China.Bioinformatics analysis indicated that the predominant HAdV lineages in China were lineage 1 and 2,whereas European lineage 3 showed no influence.Systematic and long-term surveillance of HAdV should help elucidate its diversity and evolutionary patterns in China,thereby providing scientific evi-dence for developing more effective prevention strategies.

This study investigated the full-genome molecular characteristics of a rotavirus vaccine-derived strain,G1P[8]geno-type A group rotavirus RVA/Human-wt/CHN/HN1140/2021/G1P[8](referred to as HN1140).The gene fragments of the HN1140 strain were amplified with reverse transcription-polymerase chain reaction(RT-PCR)combined with whole-genome primers to obtain the full genome sequence.Genotyping was performed with the online genotyping tool RotaC 2.0,and similarity and genetic evolution analyses for each gene segment were conducted in DNAstar5.1 and MEGA11.0 software.The genotype of the HN1140 strain was deter-mined to be G1-P[8]-I2-R2-C2-M2-A3-N2-T6-E2-H3.Phylogenetic analysis demonstrated that all 11 genomic segments clus-tered closely with the RotaTeq vaccine strains,sharing 99.7%-100%nucleotide sequence similarity.Notably,VP1,VP2,VP6,and NSP2-NSP5 segments showed 100%nucleotide identity with RotaTeq strains.Comparative genomic analysis identified 13 nucleotide and 8 amino acid substitutions between HN1140 and RotaTeq strains,localized within the VP7,VP4,VP1,VP2,VP3,and NSP1 segments.The HN1140 strain exhibited the genotype G1-P[8]-A3-T6-H3,which was consistent with the typical profile of a vaccine-derived reassortant.This strain demonstrated high genetic similarity to RotaTeq vaccine strains,with nucleotide sequence identity ranging from 99.7%to 100%.These findings suggested that HN1140 evolved from RotaTeq vaccine strains through genetic reassortment.

Enteric human adenovirus(HAdV),a common cause of acute viral gastroenteritis in children,frequently triggers spo-radic infections,nosocomial transmissions,and outbreaks in kindergarten settings.This study was aimed at investigating the molecular characteristics and genetic evolution of enteric HAdV among patients with acute gastroenteritis younger than 5 years in China,to pro-vide foundational data for disease prevention and control.A total of 8 074 stool samples were collected from hospitalized or outpatient children younger than 5 years with acute gastroenteritis in China during 2023.HAdV screening was conducted with real-time fluores-cence PCR.Positive samples were sequenced,then subjected to bioinformatics analysis including genotyping,homology assessment,and phylogenetic analysis with GenBank,BioAider,and MEGA11.0.A total of 370 samples(4.58%)tested positive for HAdV.Two enteric HAdV genotypes were identified:HAdV-F41(which predominated,at 98.09%)and HAdV-F40(1.90%).HAdV-F41 was the dominant genotype among patients with acute gastroenteritis younger than 5 years in China.Bioinformatics analysis indicated that the predominant HAdV lineages in China were lineage 1 and 2,whereas European lineage 3 showed no influence.Systematic and long-term surveillance of HAdV should help elucidate its diversity and evolutionary patterns in China,thereby providing scientific evi-dence for developing more effective prevention strategies.

This study investigated the full-genome molecular characteristics of a rotavirus vaccine-derived strain,G1P[8]geno-type A group rotavirus RVA/Human-wt/CHN/HN1140/2021/G1P[8](referred to as HN1140).The gene fragments of the HN1140 strain were amplified with reverse transcription-polymerase chain reaction(RT-PCR)combined with whole-genome primers to obtain the full genome sequence.Genotyping was performed with the online genotyping tool RotaC 2.0,and similarity and genetic evolution analyses for each gene segment were conducted in DNAstar5.1 and MEGA11.0 software.The genotype of the HN1140 strain was deter-mined to be G1-P[8]-I2-R2-C2-M2-A3-N2-T6-E2-H3.Phylogenetic analysis demonstrated that all 11 genomic segments clus-tered closely with the RotaTeq vaccine strains,sharing 99.7%-100%nucleotide sequence similarity.Notably,VP1,VP2,VP6,and NSP2-NSP5 segments showed 100%nucleotide identity with RotaTeq strains.Comparative genomic analysis identified 13 nucleotide and 8 amino acid substitutions between HN1140 and RotaTeq strains,localized within the VP7,VP4,VP1,VP2,VP3,and NSP1 segments.The HN1140 strain exhibited the genotype G1-P[8]-A3-T6-H3,which was consistent with the typical profile of a vaccine-derived reassortant.This strain demonstrated high genetic similarity to RotaTeq vaccine strains,with nucleotide sequence identity ranging from 99.7%to 100%.These findings suggested that HN1140 evolved from RotaTeq vaccine strains through genetic reassortment.

Respiratory syncytial virus (RSV) is the most common respiratory pathogen in infants and young children, which can lead to severe pneumonia and even death. Early diagnosis and intervention are crucial for reducing complications and sequelae and improving prognosis. This study presents the complete diagonsis and treatment process of a typical severe RSV pneumonia patient. For high-risk children, the condition can progress rapidly after RSV infection, and may present with respiratory failure and multiple extrapulmonary complications, such as heart failure, liver and kidney function impairment, coagulation dysfunction. After active symptomatic and supportive treatment, the prognosis is generally good. RSV infection will not lead to long-lasting immunity, but as the child grows older and their immune function gradually improves, the condition of a secondary infection is generally relatively mild. Currently, there are no specific antiviral drugs or safe and effective vaccines for RSV. Long-acting monoclonal antibodies are one of the effective means to prevent RSV infection in infants and young children and have been approved for use in China.

Objective To explore the influence of general medicine combined with family motivation management on the prognosis of cardiovascular and cerebrovascular disease patients.Methods A total of 120 cardiovascular and cerebrovascular diseases patients who received medical care at the First People's Hospital ofFuyang District from October 2023 to October 2024 were selected as subjects.They were divided into control group(n=60)and study group(n=60)by using a random number table method.Control group received standard nursing interventions,while study group underwent combined general medicine and family motivation management.Psychological status was assessed using the self-rating anxiety scale(SAS)and self-rating depression scale(SDS),with quality of life and self-management ability evaluated using the World Health Organization quality of life brief scale(WHOQOL-BREF)and exercise of self-care agency scale(ESCA).The triglycerides(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C)and low density lipoprotein cholesterol(LDL-C),readmission rate and average length of stay before and after intervention were compared between two groups.Results After intervention,both groups showed decreased SAS and SDS scores,while WHOQOL-BREF scores and ESCA levels increased.Score of study group were statistically significant better than that of control group(P＜0.05).After intervention,HDL-C levels rose in both groups,whereas LDL-C,TG,and TC levels decreased.The improvement of each index in study group was better than that in control group(P＜0.05).The rehospitalization rate and average length of stay in study group were significantly lower than those in control group(P＜0.05).Conclusion The combination of general medicine and family motivation management can effectively optimize the prognosis of cardiovascular and cerebrovascular disease patients.