Objective To investigate the suitable habitats of Phlebotomus chinensis in Gansu Province, so as provide insights into effective management of mountain-type zoonotic visceral leishmaniasis (MT-ZVL). Methods The geographical coordinates of locations where MT-ZVL cases were reported were retrieved in Gansu Province from 2015 to 2023, and data pertaining to 26 environmental variables were captured, including 19 climatic variables (annual mean temperature, mean diurnal range, isothermality, temperature seasonality, maximum temperature of the warmest month, minimum temperature of the coldest month, temperature annual range, mean temperature of the wettest quarter, mean temperature of the driest quarter, mean temperature of the warmest quarter, mean temperature of the coldest quarter, annual precipitation, precipitation of the wettest month, precipitation of the driest month, precipitation seasonality, precipitation of the wettest quarter, precipitation of the driest quarter, precipitation of the warmest quarter, and precipitation of the coldest quarter), five geographical variables (elevation, annual normalized difference vegetation index, vegetation type, landform type and land use type), and two population and economic variables (population distribution and gross domestic product). Twelve species distribution models were built using the biomod2 package in R project, including surface range envelope (SRE) model, generalized linear model (GLM), generalized additive model (GAM), multivariate adaptive regression splines (MARS) model, generalized boosted model (GBM), classification tree analysis (CTA) model, flexible discriminant analysis (FDA) model, maximum entropy (MaxEnt) model, optimized maximum entropy (MAXNET) model, artificial neural network (ANN) model, random forest (RF) model, and extreme gradient boosting (XGBOOST) model. The performance of 12 models was evaluated using the area under the receiver operating characteristic curve (AUC), true skill statistics (TSS), and Kappa coefficient, and single models with high performance was selected to build the optimal ensemble models. Factors affecting the survival of Ph. chinensis were identified based on climatic, geographical, population and economic variables. In addition, the suitable distribution areas of Ph. chinensis were predicted in Gansu Province under shared socioeconomic pathway 126 (SSP126), SSP370 and SSP585 scenarios based on climatic data during the period from 1991 to 2020, from 2041 to 2060 (2050s), and from 2081 to 2100 (2090s) . Results A total of 11 species distribution models were successfully built for prediction of potential distribution areas of Ph. chinensis in Gansu Province, and the RF model had the highest predictive accuracy (AUC = 0.998). The ensemble model built based on the RF model, XGBOOST model, GLM, and MARS model had an increased predictive accuracy (AUC = 0.999) relative to single models. Among the 26 environmental factors, precipitation of the wettest quarter (12.00%), maximum temperature of the warmest month (11.58%), and annual normalized difference vegetation index (11.29%) had the greatest contributions to suitable habitats distribution of Ph. sinensis. Under the climatic conditions from 1991 to 2020, the potential suitable habitat area for Ph. chinensis in Gansu Province was approximately 5.80 × 10⁴ km², of which the highly suitable area was 1.42 × 10⁴ km², and primarily concentrated in the southernmost region of Gansu Province. By the 2050s, the unsuitable and lowly suitable areas for Ph. chinensis in Gansu Province had decreased by varying degrees compared to that of 1991 to 2020 period, while the moderately and highly suitable areas exhibited expansion and migration. By the 2090s, under the SSP126 scenario, the suitable habitat area for Ph. chinensis increased significantly, and under the SSP585 scenario, the highly suitable areas transformed into extremely suitable areas, also showing substantial growth. Future global warming is conducive to the survival and reproduction of Ph. chinensis. From the 2050s to the 2090s, the highly suitable areas for Ph. chinensis in Gansu Province will be projected to expand northward. Under the SSP126 scenario, the suitable habitat area for Ph. chinensis in Gansu Province is expected to increase by 194.75% and 204.79% in the 2050s and 2090s, respectively, compared to that of the 1991 to 2020 period. Under the SSP370 scenario, the moderately and highly suitable areas will be projected to increase by 164.40% and 209.03% in the 2050s and 2090s, respectively, while under the SSP585 scenario, they are expected to increase by 195.98% and 211.66%, respectively. Conclusions The distribution of potential suitable habitats of Ph. sinensis gradually shifts with climatic changes. Intensified surveillance and management of Ph. sinensis is recommended in central and eastern parts of Gansu Province to support early warning of MT-ZVL.

Objective:To explore whether there is a mediating role of emotional intelligence between perceived stress and burnout in ICU nurses. Praide a basis for ICU nurses managers to develop corresponding intervention plans.Methods:Using a convenience sampling method, 683 nurses in 15 class A tertiary hospitals were conducted a cross-sectional surrey from January to April 2023 using general information, the Chinese version of the Perceived Stress Scale, the Emotional Intelligence Scale, and the Burnout Scale.Results:Chinese version of the Perceptual Stress Scale Score (45.59 ± 6.70), Emotional Intelligence Scale score (57.06 ± 9.22), Burnout Scale score (54.50 ± 11.63); pearson correlation analysis showed a positive correlation between perceptual stress and burnout ( r = 0.543, P<0.01); emotional intelligence was a negative correlation ( r = -0.465, P<0.01). A negative correlation was found between perceived stress and emotional intelligence ( r = -0.585, P<0.01); emotional intelligence mediated the effect between perceived stress and burnout, accounting for 24.2% of the total effect. Conclusions:Emotional intelligence is a mediating variable between perceived stress and burnout among nurses in ICU. Nursing managers should pay attention to their perceived stress and emotional intelligence levels, regularly assess them, and target take timely interventions to improve emotional management ability and develop resilience to cope with stress, so as to reduce the burnout level of nurses in ICU.

Objective:To explore any effect of transcranial direct current stimulation (tDCS) on neurons, behavior, cerebral blood flow (CBF), vascular regeneration, and the expression of vascular endothelial growth factor (VEGF) and CD34 protein in rats modeling cerebral infarction.Methods:Thirty-two adult male Sprague-Dawley rats were randomly divided into a sham surgery group (Sham group), a model group (modeled with middle cerebral artery occlusion, MCAO group), an anode transcranial direct current stimulation group (A-tDCS group), and a cathode transcranial direct current stimulation group (C-tDCS group), each of 8. MCAO models were established in the rats of the MCAO, A-tDCS and C-tDCS groups using thread fixation. Twenty-four hours after successful modeling, both the Sham and MCAO groups were connected with electrodes without current stimulation, while the A-tDCS and C-tDCS groups were given 20 minutes of 200μA anodic or cathodic electrical stimulation daily, 5 days a week for 12 days. Before and 24 hours after the modeling, and then after the 12 days of treatment, the four groups received Longa neurobehavioral scoring. Moreover, three days after the modeling as well as after the 12 days of treatment, changes in CBF were observed using MRI. Any blood vessel regeneration was observed using immunofluorescence methods, and the expression of VEGF and CD34 proteins were detected using western blotting.Results:The rats in the MCAO, A-tDCS and C-tDCS groups exhibited various degrees of neurological deficit after the modeling. After the 12 days of treatment the average neurobehavioral scores of the A-tDCS and C-tDCS groups were significantly lower than that of the MCAO group, with the A-tDCS group′s average significantly lower than that of the C-tDCS group. Three days after the modeling, 3D-arterial spin labeling scanning showed a significant decrease in CBF around the ischemic lesion in the MCAO, A-tDCS and C-tDCS groups, but that had increased to varying degrees after 12 days of treatment. The changes in the A-tDCS and C-tDCS groups were significantly larger than in the MCAO group on average, with the former group improving significantly more than the latter. After the 12 days of treatment, new vascularization and the expression of VEGF and CD34 proteins were significantly higher in the A-tDCS and C-tDCS groups than in the MCAO group, with the change in the former group again significantly greater than in the latter.Conclusions:tDCS can relieve the symptoms of neurological deficits in rats with cerebral infarction, promote vascular regeneration, CBF, and expression of VEGF and CD34 proteins. Anodic is superior to cathodic stimulation.

Objective:To explore the inconsistent and consistent classifications for lesions ≤2 cm by contrast-enhanced ultrasound(CEUS) Liver Imaging Reporting and Data System(LI-RADS) v2017 and contrast-enhanced computed tomography/contrast-enhanced magnetic resonance imaging(CECT/MRI) LI-RADS v2018.Methods:The focal liver lesions ≤2 cm underwent CEUS and CECT/MRI within 1 month were enrolled in this retrospective study.Each nodule was categorized according to the CEUS LI-RADS v2017 and CECT/MRI LI-RADS v2018. Intermodality agreement between the CEUS LI-RADS and CECT/MRI LI-RADS for each lesion was assessed with Cohen′s Kappa. Lesions with inconsistent classification for CEUS LI-RADS and CECT/MRI were analyzed.Results:A total of 145 lesions with a size of (1.65±0.33)cm in 145 patients were included. The numbers of lesions in LR-3, 4, 5 and M were 16, 23, 90 and 16 on CEUS LI-RADS, 25, 31, 87 and 2 on CECT/MRI, respectively. And 73.1% lesions were classified as LR-5 or M on CEUS, while 61.4% lesions were classified as LR-5 or M on CECT/MRI ( P=0.033). The incidences of HCC in LR-3, 4 and 5 were 37.5%, 52.2% and 97.8% on CEUS LI-RADS, 56.0%, 64.5% and 96.6% on CECT/MRI LI-RADS respectively. Among the 145 lesions, 56 lesions had inconsistent classifications of CEUS and CECT/MRI LI-RADS. Twenty-eight lesions in CECT/MRI LR-3 and 4 were escalated to LR-4 and 5 by CEUS and 82.1% of them were found to be HCC. Fourteen lesions on CEUS LR-3 and 4 were escalated to LR-4 and 5 by CECT/MRI and 85.7% of them were found to be HCC. Conclusions:The LR-5 of the CEUS and CECT/EOB-MRI LI-RADS has a comparable incidence of HCC. However, the inter-modality agreement of the LI-RADS category between CEUS and CECT/EOB-MRI is poor. The proportion of lesions in CEUS LR-5 and M is much higher than that in CECT/MRI LR-5 and M, while the proportion of lesions in CECT/MRI LR-3 and 4 is high than that in CEUS LR-3 and 4.

Objective:To investigate the application value of baseline MRI multi-parametric imaging radiomics in prediction of neoadjuvant chemoradiotherapy (NCR) efficacy of rectal mucinous adenocarcinoma (RMAC).Methods:Retrospective analysis was performed in the Sixth Affiliated Hospital of Sun Yat-sen University from August 2012 to October 2018. A total of 79 patients were included in this study, including 52 males and 27 females, aged 20-78 years (median age 52 years). According to the classification criteria of pathological regression, all patients were divided into NCR responsiveness group ( n=31) and nonresponsiveness group ( n=48). And 701 imaging features of T 2WI, diffusion weighted imaging (DWI) and enhanced T 1WI images of baseline MRI were extracted, and feature subsets were selected by repeatability analysis and feature dimensionality reduction to construct the radiomics prediction model. The tumor features from baseline MRI between the NCR responsiveness group and the nonresponsiveness group were compared, and the features of P<0.05 were combined with the radiomics to construct a model. Using pathology as the gold standard, the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficiency of the prediction model, and the area under the curve (AUC), 95% confidence interval, sensitivity and specificity were calculated, and the DeLong test was used to compare the diagnostic efficacy of different prediction models. Results:By comparing the conventional tumor imaging characteristics of the NCR responsiveness group and the nonresponsiveness group, the differences in lymph node stage and mucinous nodule status between the two groups were statistically significant (χ2 =6.040, 5.870, P<0.05). The AUC of ROC curves based on T 2WI, DWI, and enhanced T 1WI radiomics were 0.816, 0.821, and 0.819, respectively, which were higher than those of conventional tumor characteristics (lymph node staging, mucinous nodule status) (AUC=0.607), and the differences were statistically significant ( Z=-2.391, -2.580 and -2.717, P<0.05). Among the joint prediction models of T 2WI, DWI and contrast-enhanced T 1WI radiomics and conventional tumor features, the DWI combined model had the largest AUC (0.843), and there was no statistically significant difference between the three combined models (all P>0.05). Conclusion:The baseline T 2WI, DWI, and contrast-enhanced T 1WI radiomics model can be used to predict the NCR efficacy of RMAC, which is better than the predictive efficacy of conventional features, and the combination with conventional features can further improve the predictive efficacy.

Objective To investigate the diagnostic value and safety of medical thoracoscopy in unexplained exudative pleural effusion.Methods A retrospective analysis was conducted using the clinical data of 70 routine medical thoracoscopy examinations of unexplained exudative pleural effusion in patients.The lesions were examined pathologically under direct vision.Results White military nodules were observed under endoscopy,with multiple pro-truding nodules,focal irregular thickening of the pleura,pleural congestion,edema and adhesion.The diagnostic accu-racy of thoracoscopy was 95.7%.Among the diagnosed cases,there were 35 cases of tuberculous pleurisy,20 cases of malignant pleural effusion,8 cases of parapneumonic effusion,4 cases of pleural effusion from congestive heart failure and 3 cases of idiopathic pleural effusion,with no serious complications.Conclusion Medical thoracoscopy is a safe and accurate method in the diagnosis of unexplained exudative pleural effusion.Medical thoracoscopy is beneficial in the establishment of treatment method quickly and allows observation of the pleural lesions in pleural effusion patients using the naked eye.

OBJECTIVETo investigate the diagnostic value of thoracoscopy on idiopathic coalworker's pneumoconiosis with pleural effusion in general medicine.

METHODRoutine (general medicine) thoracoscopyof patients suffering from iIdiopathiccoalworker's pneumoconiosis with pleural effusion, pathological examination of lesions obtained (direct vision).

RESULTPathological examination revealed grayish-white miliary nodules with multiple protruding nodules, irregular focal pleura thickening, pulmonary congestion, edema, fibrous adhesion. Thorascopy produced a diagnostic rate of 93.3%. Confirmed cases includes 13 cases of tuberculous pleurisy, 11 cases of malignant pleural effusion, 4 cases of cardiac insufficiency with pleural effusion and 2 cases of idiopathic pleural effusion, with no serious complications.

CONCLUSIONThoracoscopy of idiopathic coalworker's pneumoconiosis with pleural effusion is a safe, accurate diagnostic methodin general medicine, and could benefit the establishment of a treatment method quickly, visual observation of the lesions of patients suffering from coalworker's pneumoconiosis with pleural effusion using thoracoscopy, and at the same time offer preliminary investigationof the correlation between the intensity and compactibilityof coal macule distribution and clinical stages of coalworker's Pneumoconiosis.

Anthracosis ; diagnosis ; Heart Failure ; diagnosis ; Humans ; Lung ; pathology ; Pleural Effusion ; diagnosis ; Pleural Effusion, Malignant ; diagnosis ; Pulmonary Edema ; diagnosis ; Thoracoscopy ; Tuberculosis, Pleural ; diagnosis

OBJECTIVETo observe the effect of Jinmaitong capsule (JMT), a compound traditional Chinese medicine, on expressions of inducible nitric oxide synthase (iNOS) and nitro tyrosine (NT) protein in streptozocin-induced diabetic (STZ-DM) rats.

METHODIntraperitoneal injection of streptozocin in rats to establish a model. STZ-DM rats were randomly divided into the model control group (distilled water), the small-dose JMT group (JMT at dose of 0.45 g x kg(-1) x d(-1)), the medium-dose JMT group (JMT at dose of 0.88 g x kg(-1) x d(-1)), the large-dose JMT group (JMT at dose of 1.75 g x kg(-1) x d(-1)) and Vitamin C group (VC at dose of 0.05 g x kg(-1) x d(-1)). Ten normal rats with matching weight and age were selected as the normal control group (distilled water). After intragastric administration for 16 weeks, the expressions of iNOS and NT in sciatic nerve were detected by the immunohistochemistry method.

RESULTThe expression levels of iNOS and NT protein in diabetic rats were higher than those in normal rats (P<0.05, P<0.01). Compared with the model group, the levels of iNOS and NT protein in JMT and VC groups were significantly decreased (P<0.05, P<0.01). Particularly, the medium-dose JMT group showed a better effect than the VC group (P<0.05, P<0.01).

CONCLUSIONJMT could down-regulate the expressions of iNOS and NT protein of sciatic nerve in diabetic rats.

Animals ; Blood Glucose ; Body Weight ; drug effects ; Capsules ; Diabetes Mellitus, Experimental ; drug therapy ; metabolism ; pathology ; Diabetic Neuropathies ; drug therapy ; metabolism ; pathology ; Drugs, Chinese Herbal ; administration & dosage ; pharmacology ; Enzyme Activation ; drug effects ; Male ; Nitric Oxide Synthase Type II ; metabolism ; Rats ; Rats, Sprague-Dawley ; Sciatic Nerve ; drug effects ; metabolism ; pathology ; Tyrosine ; analogs & derivatives ; metabolism

Objective We studied the clinical features and its significance of coal worker's pneumoconiosis combined with sleep apnea Methods In 40 patients with coal worker's pneumoconiosis combined with sleep apnea hospitalized from February 2006 to December 2009, polysomnography ( PSG) , blood routine, urine routine, blood pressure and biochemical indicators were measured and analyzed. Results Patients with coal worker' s pneumoconiosis combined with sleep apnea manifested mainly as duplicate hypoxemia and multi-organ dysfunction: high blood pressure, dysfunction of heart, lung and kidney, increase of serum glucose, blood lipids, blood uric acid and finally led a vicious cycle to aggravate the above mentioned damage. Conclusions In clinical, multiple-organ dysfunction resulted from severe hypoxemia and hypercapnia caused by coal worker's pneumoconiosis combined with sleep apnea, should be fully aware and give ational and effective treatment early to reverse or delay the further function damages of multiple organs, and therefore significantly improve the prognosis.

OBJECTIVE: To investigate the stimulation effect of several bacterial inhibitors of eye drops on eyes.METHODS: Stimulation effect of several bacterial inhibitors on rabbits eyes were observed with the contrast on the same body.The scores were counted according to the score standard of eyes stimulation response in order to evaluate the stimulation effect of bacterial inhibitors.RESULTS: After giving single dose of inhibitors,the average scores of stimulation reaction induced by 0.002% thiomersal,0.01% benzalkonium chloride,0.01% benzalkonium bromide,0.01% chlorhexidin acetas,0.5% chlorobutanol,0.03% ethylparaben,2% boric acid were 0.20,0.32,0.36,0.60,1.20,3.88,6.32,mild stimulation reaction was induced by 2% boric acid and 0.03% ethylparaben and others inhibitors caused no stimulation response.After giving multiple doses of inhibitors,the average scores of above inhibitors were 0.49,0.79,0.84,3.83,3.91,6.51,10.84,the medium stimulation reaction was induced by 2% boric acid,mild stimulation reaction were induced by 0.03% ethylparaben,0.01% chlorhexidin acetas and 0.5% chlorobutanol;0.002% thiomersal,0.01% benzalkonium chloride,0.01% benzalkonium bromide caused no stimulation reaction.CONCLUSION: The best inhibitors of eye drops are thiomersal,benzalkonium chloride,benzalkonium bromide,followed by chlorhexidin acetas,ethylparaben,chlorobutanol.