This paper introduces a real-world cohort research model for community-acquired pneumonia （CAP） based on the Jiangsu Traditional Chinese Medicine （TCM） Dominant Diseases Diagnosis and Treatment Data Platform. Firstly， data cleaning is performed by standardizing diagnosis， symptoms， treatment and imaging， intelligently extracting unstructured information， and cleaning and constructing a standardized database. Secondly， for cohort establishment， CAP patients across the province are screened in accordance with CAP diagnostic criteria to build a high-quality disease-specific cohort. Lastly， in terms of protocol design， the characteristics of TCM research and the CAP disease profile are considered to determine appropriate inclusion and exclusion criteria， estimate sample size， define interventions， outcomes and economic evaluations， providing a reference for real-world TCM research on CAP.

This paper introduces a real-world cohort research model for community-acquired pneumonia （CAP） based on the Jiangsu Traditional Chinese Medicine （TCM） Dominant Diseases Diagnosis and Treatment Data Platform. Firstly， data cleaning is performed by standardizing diagnosis， symptoms， treatment and imaging， intelligently extracting unstructured information， and cleaning and constructing a standardized database. Secondly， for cohort establishment， CAP patients across the province are screened in accordance with CAP diagnostic criteria to build a high-quality disease-specific cohort. Lastly， in terms of protocol design， the characteristics of TCM research and the CAP disease profile are considered to determine appropriate inclusion and exclusion criteria， estimate sample size， define interventions， outcomes and economic evaluations， providing a reference for real-world TCM research on CAP.

Objective To explore the application of plasma 7 microRNA (miR7) testing in the differential diagnosis of very early-stage hepatocellular carcinoma (HCC). Methods This study is a multicenter real-world study. Patients with single hepatic lesion (maximum diameter≤2 cm) who underwent plasma miR7 testing at Zhongshan Hospital, Fudan University, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Anhui Provincial Hospital, and Peking University People’s Hospital between January 2019 and December 2024 were retrospectively enrolled. Patients were divided into very early-stage HCC group and non-HCC group, and the clinical pathological characteristics of the two groups were compared. The value of plasma miR7 levels, alpha-fetoprotein (AFP), and des-gamma-carboxy prothrombin (DCP) in the differential diagnosis of very early-stage HCC was evaluated using receiver operating characteristic (ROC) curves and area under the curve (AUC). In patients with both negative AFP and DCP (AFP＜20 ng/mL, DCP＜40 mAU/mL), the diagnostic value of plasma miR7 for very early-stage HCC was analyzed. Results A total of 64 528 patients from 4 hospitals underwent miR7 testing, and 1 682 were finally included, of which 1 073 were diagnosed with very early-stage HCC and 609 were diagnosed with non-HCC. The positive rate of miR7 in HCC patients was significantly higher than that in non-HCC patients (67.9% vs 24.3%, P＜0.001). ROC curves showed that the AUCs for miR7, AFP, and DCP in distinguishing HCC patients from the non-HCC individuals were 0.718, 0.682, and 0.642, respectively. The sensitivities were 67.85%, 43.71%, and 44.45%, and the specificities were 75.70%, 92.78%, and 83.91%, respectively. The pairwise comparison of AUCs showed that the diagnostic efficacy of plasma miR7 detection was significantly better than that of AFP or DCP (P＜0.05). Although its specificity was slightly lower than AFP and DCP, the sensitivity was significantly higher. Among patients negative for both AFP and DCP, miR7 maintained an AUC of 0.728 for diagnosing very early-stage HCC, with 67.82% sensitivity and 77.73% specificity. Conclusions Plasma miR7 testing is a potential molecular marker with high sensitivity and specificity for the differential diagnosis of small hepatic nodules. In patients with very early-stage HCC lacking effective molecular markers (negative for both AFP and DCP), miR7 can serve as a novel and effective molecular marker to assist diagnosis.

Objective To study the spatial distribution of the incidence of pulmonary tuberculosis in Hubei Province and its influencing factors, so as to improve the theoretical basis for scientific development of tuberculosis prevention and control measures in the future. Methods The data of reported incidence of tuberculosis and related influencing factors in various counties and districts of Hubei Province in 2020 were collected. Global Moran's I index, hotspot analysis and geographically weighted regression (GWR) model analysis were used to calculate the spatial autocorrelation of the incidence of tuberculosis, and to analyze the influencing factors affecting the incidence rate of tuberculosis. Results There were obvious regional differences in the space distribution of the incidence rate of tuberculosis. Hot spot analysis showed positive spatial correlation and obvious clustering. The GWR model (AICc=784.251) in this study had higher AICc value compared to the ordinary least squares regression (OLS) model (AICc=804.2585). The GWR model showed that the increase in the proportion of the population aged 65 and above and the proportion of the ethnic minority population had a significant promoting effect on the increase of the incidence rate of tuberculosis, and there was significant spatial heterogeneity. The effect of PM_2.5 concentration on the incidence rate of pulmonary tuberculosis varied in different regions, and the degree of effect was also different. Conclusion The proportion of people aged 65 and above and the proportion of ethnic minorities may significantly influence the incidence of pulmonary tuberculosis. The effect of PM_2.5 concentration varies in different regions, so targeted measures should be formulated according to the situation in different regions.

Aim To systematically investigate the ac-tive components,targets,and regulatory pathways of Po-lygonum capitatum in intervening atherosclerosis(AS)through network pharmacology,molecular docking and animal experiments.Methods Active components of Polygonum capitatum and AS-related targets were screened and identified through database searches.Protein-protein interaction(PPI)network analysis was performed using the STRING database,followed by GO and KEGG enrichment analyses via the David plat-form.Molecular docking validation was conducted with AutoDock.An AS model was established in Syrian golden hamsters fed a high-fat diet.Predicted pathways and targets were validated using qPCR,ELISA,and histopathological assessment of aortic and hepatic tis-sues via HE staining.Results Network pharmacology identified 27 potential active components of Polygonum capitatum(primarily flavonoids such as quercetin and luteolin)and 110 drug-disease intersection targets,in-cluding core targets MMP-9,ALB,and AKT1.GO and KEGG analyses enriched 593 and 125 pathways,re-spectively,with the NF-κB inflammatory pathway,TNF signaling pathway and lipid metabolism/atherosclerosis pathways highlighted as key mechanisms.Animal ex-periments demonstrated that Polygonum capitatum im-proved serum lipid profiles(reduced TC,TG,LDL-C)in AS hamsters,suppressed the MMP-9/NF-κB signa-ling pathway(downregulated MMP-9,p65 phosphoryla-tion,TNF-α,and IL-6),and inhibited VSMC synthetic phenotypic transformation(upregulated α-SMA and myocardin)by downregulating MCPIP1.Additionally,Polygonum capitatum ameliorated aortic lesions and he-patic lipid deposition in AS hamsters.Conclusions Polygonum capitatum alleviates AS by synergistically regulating the MMP-9/NF-κB/MCPIP1 axis through flavonoid components,suppressing vascular inflammato-ry cascades and maintaining VSMC contractile pheno-types.This reflects Polygonum capitatum's multi-com-ponent,multi-pathway,and multi-target characteristics in combating AS.

Objective:To develop an evidence-based nursing practice program based on the Stetler model to extend the lifespan of arteriovenous fistulas (AVF) in maintenance hemodialysis (MHD) patients and evaluate its effectiveness.Methods:An evidence-based nursing practice program was constructed based on the best evidence for extending AVF lifespan in MHD patients. Expert group discussions were held to determine review indicators. A baseline survey was conducted among 100 MHD patients and 42 nurses using covenience sompling at the Blood Purification Center of Wuxi People's Hospital from January to December 2023, to identify barriers and facilitators. In the following year, from January to December 2024, the evidence-based practice was implemented at the same hospital, and the AVF surgical intervention rate and AVF self-management levels of MHD patients were compared before and after the practice.Results:No statistically significant difference was found in the AVF surgery rates before and after the evidence-based practice ( P>0.05) . However, after implementing the evidence-based practice, MHD patients' scores on the AVF self-management scale significantly improved, and the difference was statistically significant ( P<0.01) . Conclusions:The evidence-based practice based on the Stetler model is beneficial for standardizing the clinical management of AVF, reducing the need for surgical interventions, and improving MHD patients' ability to self-manage their AVF.

Objective This study aims to explore the impact of changes in psychological status on non-suicidal self-inju-ry(NSSI)among junior high school students,in order to provide a theoretical basis for promoting their mental health development and to formulate more effective prevention and intervention measures.Methods A longitudinal study design was employed.Baseline data were collected in 2021(T1)from 652 first-year junior high school students selected through stratified cluster ran-dom sampling from two middle schools in a city.In 2023(T2),585 valid follow-up cases were obtained(effective response rate:89.72％).Chi-square tests,binary logistic regression,and ROC curve analysis were used to examine the effects of dynamic changes in psychological stress,internet addiction,depression,anxiety,and insomnia on NSSI(significance level α=0.05).Results ① Univariate analysis showed that the detection rate of NSSI significantly decreased from 22.05％(129/585)at T1 to 8.55％(50/585)at T2(x2=41.164,P＜0.001),with an average annual decline of 6.75％.Gender differences:the detec-tion rate decreased from 14.68％(43/293)to 5.80％(17/293)in boys(x2=18.577,P＜0.001),and from 29.45％(86/292)to 11.30％(33/292)in girls(x2=5.658,P=0.017),with a narrowing gender gap(T1:14.77％→ T2:5.70％).The NSSI detection rates between boys and girls were statistically significant at both time points(x2=18.577,5.658).② Com-parison between the persistent group and the NSSI-remission group showed that both decreased insomnia severity(OR=3.525,95％CI:1.230-10.105)and increased insomnia severity(OR=5.431,95％CI:1.895-15.570)were associated with an in-creased risk of NSSI persistence or onset(P＜0.01).③ Predictive efficacy:When scores of GAD-7+PHQ-9+ISI all in-creased by≥2 points,AUC=0.709,with a sensitivity of 44.0％-67.7％for predicting NSSI.When PHQ-9+ISI scores both increased by≥2 points,AUC=0.705,with a sensitivity of 50.2％-67.8％.Conclusion This study reveals a high natural re-mission rate of NSSI(82.17％,106/129 in the remission group)during junior high school,but also identifies gender heteroge-neity and persistent risks.Accumulated psychological stress,aggravated internet addiction,and worsened emotional disorders(anxiety/depression)are factors associated with NSSI persistence or onset.Clinical interventions should focus on monitoring dy-namic psychological indicators and early threshold identification.Although these results provide valuable insights,future research is needed to further explore the interaction mechanisms among these factors and how to effectively translate these findings into practical prevention and intervention measures.

Creutzfeldt-Jakob disease(CJD)is a rapidly progressive and fatal neurodegenerative disorder caused by prions,with certain infectivity and iatrogenic transmission risks.With the rapid progress and application of new dia-gnostic biomarkers and detection methods,as well as the construction and improvement of surveillance and reporting systems,the detection of CJD in patients domestically and internationally has shown an increasing trend year by year.Due to its long incubation period and heterogeneity of early symptoms,early identification and diagnosis of the disease is difficult,increasing the risk of transmission within medical institutions.Currently,there is a lack of con-sensus on the infection prevention and control of CJD.In order to timely identify and diagnose CJD as well as effec-tively block its transmission in medical institutions,this consensus summarizes 15 clinical concerns and formulates 24 specific recommendations based on the latest domestic and international research findings and clinical evidence,as well as combines with clinical practice,aiming to standardize healthcare-associated infection prevention and control measures for CJD and reduce its transmission risk in medical institutions.

Objective This study aims to explore the impact of changes in psychological status on non-suicidal self-inju-ry(NSSI)among junior high school students,in order to provide a theoretical basis for promoting their mental health development and to formulate more effective prevention and intervention measures.Methods A longitudinal study design was employed.Baseline data were collected in 2021(T1)from 652 first-year junior high school students selected through stratified cluster ran-dom sampling from two middle schools in a city.In 2023(T2),585 valid follow-up cases were obtained(effective response rate:89.72％).Chi-square tests,binary logistic regression,and ROC curve analysis were used to examine the effects of dynamic changes in psychological stress,internet addiction,depression,anxiety,and insomnia on NSSI(significance level α=0.05).Results ① Univariate analysis showed that the detection rate of NSSI significantly decreased from 22.05％(129/585)at T1 to 8.55％(50/585)at T2(x2=41.164,P＜0.001),with an average annual decline of 6.75％.Gender differences:the detec-tion rate decreased from 14.68％(43/293)to 5.80％(17/293)in boys(x2=18.577,P＜0.001),and from 29.45％(86/292)to 11.30％(33/292)in girls(x2=5.658,P=0.017),with a narrowing gender gap(T1:14.77％→ T2:5.70％).The NSSI detection rates between boys and girls were statistically significant at both time points(x2=18.577,5.658).② Com-parison between the persistent group and the NSSI-remission group showed that both decreased insomnia severity(OR=3.525,95％CI:1.230-10.105)and increased insomnia severity(OR=5.431,95％CI:1.895-15.570)were associated with an in-creased risk of NSSI persistence or onset(P＜0.01).③ Predictive efficacy:When scores of GAD-7+PHQ-9+ISI all in-creased by≥2 points,AUC=0.709,with a sensitivity of 44.0％-67.7％for predicting NSSI.When PHQ-9+ISI scores both increased by≥2 points,AUC=0.705,with a sensitivity of 50.2％-67.8％.Conclusion This study reveals a high natural re-mission rate of NSSI(82.17％,106/129 in the remission group)during junior high school,but also identifies gender heteroge-neity and persistent risks.Accumulated psychological stress,aggravated internet addiction,and worsened emotional disorders(anxiety/depression)are factors associated with NSSI persistence or onset.Clinical interventions should focus on monitoring dy-namic psychological indicators and early threshold identification.Although these results provide valuable insights,future research is needed to further explore the interaction mechanisms among these factors and how to effectively translate these findings into practical prevention and intervention measures.

The aim of this study is to explore a new path of empowering ideological and political educa-tion in courses with digital intelligence technology,therefore to improve the teaching quality of biology courses in universities,promote the comprehensive implementation of the fundamental task of cultivating morality and talents,and continuously improve the level of"three pronged education".By using the biol-ogy course"Immunology"as a practical carrier,we have constructed a dual-driven framework of"ideo-logical and political guidance+digital intelligence empowerment"utilizing digital tools to further highlight pedagogical feature enhancement,curricular optimization,innovative teaching models,multidimensional assessment,and enhanced teaching refinement.The empowerment of digital intelligence in the ideological and political construction of the course"Immunology"has achieved notable progress.Students' profes-sional abilities and ideological and political literacy have significantly improved,and the proportion of students with excellent grades has been increasing year by year(81.93％of students with good grades or above in 2024),demonstrating outstanding performance in various social practice activities;The course exhibits excellent demonstration and radiation effects on campus,and the teaching results have been sup-ported by the Ministry of Education and provincial-level education reform projects.This study serves as a practical example for the digital transformation of ideological and political education in higher education courses,providing reference and innovative insights for implementing ideological and political elements in other courses of biology majors.