Objective To compare five time series models and predict the monthly incidence of bacillary dysentery in Qinghai Province in 2024,and provide reference for the prevention and control.Methods The epidemic charac-teristics of bacterial dysentery in Qinghai Province from 2014 to 2023 were analyzed.R4.3.1 software was used for establishing seasonal autoregressive integrated moving average(SARIMA)model,Holt-Winters triple exponential smoothing(Holt Winters)model,exponential smoothing(ETS)model,neural network autoregression(NNAR)model,and trigonometric seasonality,Box-Cox transformation,ARMA errors,trend and seasonal components(TBATS)model.Fitting effect of the models was analyzed and accuracy was compared.Results From 2014 to 2023,a total of 5 833 cases of bacterial dysentery were reported in Qinghai Province,without deaths,male to fe-male ratio being 1.23∶1.The highest incidence was reported in 2016(15.45 per 100 000 people),and the lowest in-cidence was reported in 2023(3.68 per 100 000 people).Incidence increased from 2014 to 2016,then decreased,showing an obvious overall downward trend.Case number in＜5 years age group was the highest,accounting for 29.76％of the total cases(n=1 736).Regarding population distribution,the top three were children in childcare institutions and scattered children(35.56％),farmers(24.65％),and students(12.62％).Except the additive Holt-Winters model,the predicted trends of the other four models were consistent with actuality.The ETS model had the best fitting effect,with a relatively balanced overall performance(training set:MAE=0.13,RMSE=0.21,MAPE=19.55％;testing set:MAE=0.11,RMSE=0.16,MAPE=28.66％).It is recommended to pre-dict the incidence of bacillary dysentery in Qinghai Province based on ETS model.Conclusion From 2014 to 2023,bacterial dysentery in Qinghai Province showed a downward trend,with the peak of the epidemic from June to Au-gust.Preschool and scattered children were high-risk groups.Among the five prediction models,ETS model has the best fitting effect,and can be used to predict the incidence of bacillary dysentery.

Objective To compare five time series models and predict the monthly incidence of bacillary dysentery in Qinghai Province in 2024,and provide reference for the prevention and control.Methods The epidemic charac-teristics of bacterial dysentery in Qinghai Province from 2014 to 2023 were analyzed.R4.3.1 software was used for establishing seasonal autoregressive integrated moving average(SARIMA)model,Holt-Winters triple exponential smoothing(Holt Winters)model,exponential smoothing(ETS)model,neural network autoregression(NNAR)model,and trigonometric seasonality,Box-Cox transformation,ARMA errors,trend and seasonal components(TBATS)model.Fitting effect of the models was analyzed and accuracy was compared.Results From 2014 to 2023,a total of 5 833 cases of bacterial dysentery were reported in Qinghai Province,without deaths,male to fe-male ratio being 1.23∶1.The highest incidence was reported in 2016(15.45 per 100 000 people),and the lowest in-cidence was reported in 2023(3.68 per 100 000 people).Incidence increased from 2014 to 2016,then decreased,showing an obvious overall downward trend.Case number in＜5 years age group was the highest,accounting for 29.76％of the total cases(n=1 736).Regarding population distribution,the top three were children in childcare institutions and scattered children(35.56％),farmers(24.65％),and students(12.62％).Except the additive Holt-Winters model,the predicted trends of the other four models were consistent with actuality.The ETS model had the best fitting effect,with a relatively balanced overall performance(training set:MAE=0.13,RMSE=0.21,MAPE=19.55％;testing set:MAE=0.11,RMSE=0.16,MAPE=28.66％).It is recommended to pre-dict the incidence of bacillary dysentery in Qinghai Province based on ETS model.Conclusion From 2014 to 2023,bacterial dysentery in Qinghai Province showed a downward trend,with the peak of the epidemic from June to Au-gust.Preschool and scattered children were high-risk groups.Among the five prediction models,ETS model has the best fitting effect,and can be used to predict the incidence of bacillary dysentery.

Objective:To compare the effects of robotic and laparoscopic radical gastrectomy on short-term clinical outcomes and long-term prognosis in obese patients with gastric cancer.Methods:Clinical data from 231 obese gastric cancer patients undergoing laparoscopic or robotic radical gastrectomy at the Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University between Jan 2015 and Dec 2022 was analyzed. After propensity score matching, the patients were divided into robotic surgery group ( n=79) and laparoscopic surgery group ( n=79). The short-term clinical outcomes and long-term prognosis were compared. Results:Compared with the laparoscopic group, the robotic group had a significantly greater number of dissected lymph nodes [(32±13) vs. (26±11), t=2.797, P=0.006], shorter operation time [(245±65) min vs. (272±62) min, t=-2.669, P=0.008], less intraoperative blood loss[(84±69) vs. (119±56) ml, t=-3.502, P=0.001], shorter postoperative hospital stay [(8.2±3.5) vs. (9.6±4.2) d, t=-2.363, P=0.019], and higher hospitalization cost [(102,139±18,303) vs. (77,857±18,325) yuan, t=8.333, P<0.001]. The 5-year overall survival and disease-free survival rates were comparable between the robotic and laparoscopic groups (77.2% vs. 74.7%, P=0.684; and 73.4% vs. 68.4%, P=0.491, respectively). Conclusions:Robotic radical gastrectomy is a safe and feasible alternative for obese gastric cancer patients in experienced hands. It offers advantages in short-term clinical outcomes, however, it fails to provide a significant long-term survival benefit.

Objective:To compare the effects of robotic and laparoscopic radical gastrectomy on short-term clinical outcomes and long-term prognosis in obese patients with gastric cancer.Methods:Clinical data from 231 obese gastric cancer patients undergoing laparoscopic or robotic radical gastrectomy at the Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University between Jan 2015 and Dec 2022 was analyzed. After propensity score matching, the patients were divided into robotic surgery group ( n=79) and laparoscopic surgery group ( n=79). The short-term clinical outcomes and long-term prognosis were compared. Results:Compared with the laparoscopic group, the robotic group had a significantly greater number of dissected lymph nodes [(32±13) vs. (26±11), t=2.797, P=0.006], shorter operation time [(245±65) min vs. (272±62) min, t=-2.669, P=0.008], less intraoperative blood loss[(84±69) vs. (119±56) ml, t=-3.502, P=0.001], shorter postoperative hospital stay [(8.2±3.5) vs. (9.6±4.2) d, t=-2.363, P=0.019], and higher hospitalization cost [(102,139±18,303) vs. (77,857±18,325) yuan, t=8.333, P<0.001]. The 5-year overall survival and disease-free survival rates were comparable between the robotic and laparoscopic groups (77.2% vs. 74.7%, P=0.684; and 73.4% vs. 68.4%, P=0.491, respectively). Conclusions:Robotic radical gastrectomy is a safe and feasible alternative for obese gastric cancer patients in experienced hands. It offers advantages in short-term clinical outcomes, however, it fails to provide a significant long-term survival benefit.

Brucellosis is a zoonotic disease caused by Brucella. Its typical clinical manifestations include fever, chills, fatigue, bone and muscle pain, etc. Brucellosis can affect multiple organs and tissues, of which spine is the most common affected part, forming Brucella spondylitis. Due to the clinical manifestations and imaging characteristics of infected individuals being similar to other spinal diseases, it is easy to cause misdiagnosis, missed diagnosis, and mistreatment. This article reviews the latest research progress in clinical manifestations, imaging examination, diagnosis, differential diagnosis, and treatment of Brucella spondylitis both domestically and internationally, in order to provide reference for the diagnosis and treatment of Brucella spondylitis.

OBJECTIVE: To explore the genetic etiology of a child featuring global developmental and mental retardation. METHODS: Chromosome G-banding karyotype analysis, copy number variation sequencing (CNV-seq) and high-resolution chromosome banding were used to screen the genomic variant in the child and his parents. RESULTS: Both the child and his father were found to have a karyotype of 46,XY,del(18)(q21.1q21.3), whilst his mother was 46,XX. CNV-seq analysis showed that the child was arr[19]18q21.2-q21.32(chr18:48 422 190-58 039 582)×1, with a 10.58 Mb deletion which encompassed the TCF4 gene. The same deletion was found in neither parent. High-resolution banding revealed that the father has a fragment of 18q21.1q21.3 inserted into 5p13.1. CONCLUSION The child was diagnosed with Pitt-Hopkins syndrome due to the 18q21.2q21.32 deletion. Chromosome karyotyping and CNV-seq can effectively identify submicroscopic chromosome anomalies.
Child ; Chromosome Banding ; Chromosome Deletion ; DNA Copy Number Variations ; Facies ; Humans ; Hyperventilation ; Intellectual Disability/genetics*

OBJECTIVE：To investigate the effects of gypenosides （GPs）on gene expression of major urinary proteins （Mups） in liver tissue of hypercholesterolemia model mice. METHODS ：C57BL/6J mice were divided into control （ND）group，model （HFD）group and GPs therapy （GP）group according to body weight （BW），with 11 mice in each group. Except for ND group ， other groups were given high-lipid diet to induce hypercholesterolemia model. From the 17th week of feeding ，ND group and HFD group were given constant volume of 0.1％CMC-Na solution intragastrically ；GP group were given GPs suspension （250 mg/kg） intragastrically，once a day ，for consecutive 22 weeks. BW ，the levels of blood glucose （BG）and blood lipid （TC，LDL-C）were detected in each group. Total RNA of liver tissue was extracted ，and reverse transcription library was constructed and RNA-seq sequencing was performed. The differentially expressed genes were screened by PCA ，volcano map and scatter plot. RT-qPCR was used for verification for differentially expressed genes. The correlation between the expression of differentially expressed genes and the above pharmacodynamic indexes was analyzed by bivariate analysis. RESULTS ：Compared with ND group ，BW，the levels of BG，TC and LDL-C in HFD group were increased significantly （P＜0.05）. Compared with HFD group ，above indexes of GP group were decreased significantly except for BW （P＜0.05）. PCA showed that the data of ND group and HFD group distributed in different quadrants ，and the data distribution of GP group was between above two groups. mRNA of Mup4，Mup5，Mup11，Mup15 and Mup21 in liver tissue of mice were increased significantly after treated with high-fat diet （P＜0.05）. mRNA of Mup3，Mup4， Mup5，Mup8，Mup12 and Mup21 were decreased significantly after treated with GPs （P＜0.05）. In ND group vs. HFD group and HFD group vs. GP group ，mRNA of Mup4，Mup5 and Mup21 genes changed significantly and the trend was opposite. Results of RT-qPCR verification showed that compared with ND group ，relative mRNA expression of Mup4，Mup5 and Mup21 gene were increased significantly in HFD group （P＜0.05）. Correlation analysis revealed that mRNA expression of Mup5 was positively correlated with the levels of TC and BG （r＝0.727 1，0.670 6，P＜0.05），mRNA expression of Mup4 and Mup21 were positively correlated with the level of BG （r＝0.737 8，0.721 5，P＜0.05）. CONCLUSIONS ：GPs can regulate the expression of Mups genes in liver tissue of hypercholesterolemia model mice ， and reduce glucose and lipid level through regulating the mRNA over-expression of Mup4，Mup5 and Mup21.

Objective To explore the status quo of the core competence and its influencing factors in undergraduate nursing students, so as to provide references for enhancing nursing undergraduates' core competence. Methods From November to December 2016, a total of 600 undergraduate nursing students were selected by purposive sampling method. The demographic questionnaire, Core Ability of Nursing Students Scale, Nursing Students Professional Identity Scale and Professional Commitment of Nursing Students Scale were applied in the investigation. In this study, 600 questionnaires were distributed and 541 were recovered. Pearson correlation analysis was adopted to analyze the correlation between nursing students' core competence and professional identity and professional commitment. Multiple stepwise regression analysis was applied to analyze the factors influencing nursing students' core competence. Results The core ability score of the undergraduate nursing students was (3.674±0.577). There was a positive correlation between each dimension of nursing students' core competence and each dimension of professional identity and professional commitment (P< 0.01). The result of multiple stepwise regression analysis showed that the influence of professional commitment to the core competence was the largest (P< 0.05). Conclusions The core competence level of undergraduate nursing students needs to be further improved, and schools should take various measures to improve the level of professional identity and professional commitment for the students, thus improving the core competence of nursing students.

Objective By detecting vascular cysteine-rich 61(Cyr61) related factor,connective tissue growth factor (CTGF),vascular endothelial growth factor (VEGF) and CD105 markers of microvascular density (MVD) of muscle tissue in patients with PM/DM,the role and significance of the expression of Cyr61,CTGF,VEGF and CD105 in the process of vascular lesions of dermatomyosits (DM) and polymyosits (PM) were discussed.Methods The expression of Cyr61,CTGF,VEGF and CD105 markers of micro vascular density (MVD) were detected in 10 cases of DM,10 cases of PM and 20 controls by using immunohistochemical Envision two step method.Data were analyzed using Statistical Product and Service Solutions (SPSS) statistical software.Fisher's exact probability analysis and Spearman correlation analysis were conducted.Results Compared with the control group,Cyr61,CTGF,VEGF positive expression rate in muscle tissue of patients with DM and PM group were significantly different (P＜0.01),the positive expression rates of Cyr61,CTGF,VEGF in DM group and PM group were 90％,70％,90％,80％,80％,70％,and the control group (5％,10％,5％) respectively.In the muscle tissue of patients with DM and PM group,CD105 markers of capillaries could be seen,and MVD in DM and PM group were higher than that in the control group,the difference was statistically significant (F=8.103,P=0.001).Cyr61,CTGF and VEGF protein expression levels in muscle tissueof patients with DM and PM were positively correlated with MVD.Conclusion The muscle tissue of PM/DMpatients may have new blood vessels formation.Cyr61,CTGF,VEGF may be involved in the formation of newblood vessels in the PM/DM muscle tissue.The results of this study suggest that microvascular lesion plays animportant role in the immune pathogenesis of inflammatory myopathy such as PM/DM.

Purpose To investigate the expression of Periostin and VEGF protein in esophageal squamous cell carcinoma tissue and their significance. Methods Immunohistochemical staining (SP method) was used to detect Periostin and VEGF expression in 130 cases of esophageal squamous cell carcinoma and 130 cases of normal esophageal mucosa tissues. Results There was a significantly difference between esophageal squamous cell carcinoma and normal esophageal mucoma ( P<0. 05 ) . The expression of Periostin was related to the depth of invasion and the metastasis of lymph node (P<0. 05). A dramatic correlation has been found in the expression of VEGF to the degrees of differentiation, the depth of invasion and the metastasis of lymph node (P<0. 05). The expression of Peri-ostin was also positively correlated with the expression of VEGF (P<0. 05). Follow-up data was available in 66 cases with a range of 1 to 48 months. Kaplan-Meier survival curve showed survival rate of Periostin-positive group was significantly lower than that of Perios-tin-negative group (P<0. 05). The survival rate of VEGF-positive group was significantly lower than that of VEGF-negative group (P<0. 05). Conclusion The expression of Periostin has a close relationship with VEGF in the carcinogenesis, combined detection of both Periostin and VEGF can become an objective target to evaluate Potentials of invasion and lymph node metastasis of esophageal squamous cell carcinoma, which has a great significance to the judgment of prognosis in esophageal squamous cell carcinoma.