Objective:To explore the value of dual-layer spectral CT virtual monoenergetic images (VMI) in contrast-enhanced abdominal CT scans with reduced contrast medium volume in pediatric tumor patients.Methods:The study is a self-matched case-control study. From January to October 2024, pediatric patients admitted to Shandong Cancer Hospital with abdominal tumors who underwent low contrast dose spectral CT contrast-enhanced scans during follow-up were prospectively included. A total of 47 patients aged (6.2±2.2) years (4-14 years) were enrolled. Usual contrast dose enhanced CT served as the conventional-dose group, while the follow-up low-dose spectral CT scans employed a protocol with half the contrast agent dose (low-dose group). Images were reconstructed as conventional CT images and VMI at 45, 55, and 65 keV. Using muscle as the reference background, differences in CT values and contrast-to-noise ratio (CNR) in the aorta, kidneys, liver, and spleen were compared between the low-dose group and conventional-dose group. Multi-group comparisons were performed using the Friedman test. Post-hoc pairwise comparisons were conducted with Bonferroni correction for P-values. Results:CT values and CNRs for all measured regions progressively increased with decreasing keV levels in spectral CT VMI. Significant overall differences were found in CT values and CNRs for the aorta, kidneys, liver, and spleen among the low-dose group (all VMIs) and the conventional-dose group (all P<0.001). At 65 keV VMI in the low-dose group, both CT values and CNRs (except for the liver CNR) were significantly lower than those in the conventional-dose group (all adjusted P<0.05). At 55 keV VMI in the low-dose group, CT values and CNRs for all regions did not show statistically significant differences compared to the conventional-dose group (all adjusted P>0.05). At 45 keV VMI in the low-dose group, CT values for all structures and CNR for the spleen were significantly higher than those in the conventional-dose group (all adjusted P<0.05). However, no statistically significant difference was found in CNRs for the aorta, kidneys, and liver (adjusted P=1.000, 0.313, and 0.503, respectively). Conclusion:When the contrast dose is halved, spectral CT 45 keV VMI enhances CT attenuation values and CNR in the abdomen of pediatric tumor patients, while 55 keV VMI provides image quality comparable to that of conventional-dose CT.

Objective:The objective of this study was to understand the incidence, spatial and temporal distribution characteristics and trends of bacillary dysentery in China from 2005 to 2024 in order to identify the high-risk groups and reveal the potential risk factors and to provide a scientific basis for optimizing the allocation of preventive and control resources, formulating targeted intervention strategies and assessing the effectiveness of the measures.Methods:The nationally reported incidence data of bacillary dysentery was collected from 2005 to 2024 in the Chinese Center for Disease Control and Prevention National Notifiable Diseases Reporting Information System. Descriptive epidemiological methods were used to analyze the population characteristics of bacillary dysentery cases. A Joinpoint regression model was constructed to examine long-term trends in reported incidence rates and spatial dynamic window scanning statistics were applied to detect spatial clusters of bacillary dysentery cases.Results:Between 2005 and 2024, 3 520 247 cases of bacillary dysentery were reported across China, with an average incidence rate of 12.88 per 100 000 people, after which the rate of decline decreased. The incidence rate showed a general downward trend, featuring a significant inflection point in 2016. It exhibited marked seasonality, peaking from May to October (summer-autumn), which weakened over time. From 2005 to 2024, the most likely clusters were in Beijing and Tianjin. Males, infants, the elderly, farmers, and children not in daycare showed many cases.Conclusions:The results revealed that the peak incidence of bacillary dysentery in China from 2005 to 2024 was featured in the summer-autumn months. High-incidence areas were mainly Beijing and Tianjin. The key groups, including males, infants, the elderly, farmers and children not in daycare, were identified. Enhancing surveillance, targeted health education, and preventive measures, especially in these key populations and in regions where the disease shows a high incidence should be strengthened.

Objective:To explore the influence of different scanning positions based on chest phantom of computed tomography(CT)scan on chest on image quality and radiation dose.Methods:A thermoluminescent dosimeter(TLD)was placed at the breast area of simulating anthropoid chest phantom.GE Revolution evo CT was used to conduct scan on the conventional supine position(supine group)and prone position(prone group)for chest phantom.Different noise indexes(NI=10-23)were adjusted to control ration doses,and other parameters were fixed,and each group collected 12 sequence images.The average value(AV),standard deviation(SD)of the CT scan at region of interest(ROI)under different scanning positions were recorded to calculate the signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)of the image.The radiation dose at the breast area was measured by TLD,and the volume CT dose index(CTDIvol)and dose-length product(DLP)were recorded.Results:Under different scanning positions,the radiation dose of breast organs in the prone group was lower than that in the supine group,there was a statistically significant difference between the two groups(t=6.57,P<0.05),while there were not statistically significant differences in CTDIvol and DLP between the two groups(P>0.05).There were not statistically significant differences in the CT values,SD,SNR,CNR of lung tissue,and the CT values of breast tissue between the two groups of images(P>0.05).The SD,SNR and CNR of breast tissue in the prone group were lower than those in the supine group,and the differences were statistically significant(t=-13.33,-10.59,6.70,P<0.05).There were no statistically significant differences in the subjective scores of the clarity of the edge of the tissue within lung,the layers of soft tissue of the breast,noise,and artifacts in the bone tissue between the two groups of images(P>0.05).Conclusion:When low-dose CT physical examination on chest is conducted in clinical practice,the scanning of prone position during undergoing CT scan on chest can obtain image quality that can meet the requirements in diagnosing lung,and reduce the radiation dose on the breast,and conform to the technical principle of optimal radiation protection.

Objective:To analyze the epidemiological characteristics and infection sources of cholera in China from 2005 to 2024.Methods:A total of 2 066 cholera cases were included in the study, which were obtained from the China Disease Control and Prevention Information System (CDPCIS) of China CDC. The information on cholera clusters was downloaded from the National Public Health Emergency Event Surveillance System (PHEESS) of China CDC. A total of 128 cholera clusters were included and analyzed in this study. The epidemiological characteristics and infection sources of cholera were analyzed. The Jointpoint model was applied to analyze the incidence trend, and annual percentage change (APC) was also quantified.Results:From 2005 to 2024, a total of 2 066 cholera cases were reported, with an average of 103 cases reported annually. Specifically, the incidence showed a marked downward trend from 2004 to 2015 ( APC=-26.78%, P=0.006). During 2015-2024, the disease remained at low endemic levels, with an average of 18 reported cases annually ( APC=-2.68%, P=0.807). Cholera peak season was from May to October. A total of 24 provinces reported cholera cases, which were mainly distributed in Zhejiang, Fujian, Beijing, Jiangsu, Anhui, Guangdong, and Hainan provinces, accounting for 78.03% of the total cases. Pathogen surveillance indicated an alternating prevalence of Vibrio cholerae serogroups O1 and O139 among laboratory-confirmed cases between 2005 and 2024. There was a disparity in the dominant serogroup of Vibrio cholerae by region. The results from 128 cholera clusters indicated that cholera outbreaks frequently occurred in rural banquets (64.84%), followed by regular restaurants (13.28%). Among these, 63 clusters (49.22%) with identified infection sources indicated that foodborne transmission (95.24%) was the primary mode of cholera transmission, which mainly through seafood and aquatic products, such as soft-shelled turtles, shrimp and shellfish. The characteristics of cholera clusters caused by Vibrio cholerae serogroups O1 and O139 showed statistically significant differences in scale, attack rate, place of residence, setting, and infection source ( P<0.05). Conclusion:Cholera incidence has remained consistently low since 2015 in China, mainly in sporadic cases. Rural gatherings (e.g., wedding banquets) are the main settings for cholera clusters. The main infection sources are predominantly caused by cross-contamination due to improper processing practices of aquatic products, such as soft-shelled turtles.

Objective:To explore the differences in sociodemographic and clinical characteristics between pa-tients with unipolar depression bipolar depression and to establish a nomogram for identifying bipolar depression.Methods:Using data from the China Mental Disorders Cohort Study,the sociodemographic and clinical characteristics of 2 643 patients with unipolar depression and 250 patients with bipolar depression diagnosed accord-ing to the criteria of the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5)were includ-ed to compare their sociodemographic and clinical characteristics.These characteristics included general demograph-ic information,disease-related information,clinical examination results,and the severity of the disease assessed with the Global Assessment of Functioning(GAF)and Hamilton Depression Rating Scale.Logistic regression analysis was employed to identify factors influencing bipolar depression,and a nomogram was constructed for its identifica-tion.Results:The risk factors for bipolar depression included being male(OR=1.48),being employed(OR=1.38),having non-melancholic features during episodes(OR=2.33),a Body Mass Index ranging from normal to obese(OR=2.48,2.49,4.65),psychotic features(OR=2.14),mixed episode(OR=9.36),comorbid physical diseases(OR=2.47),four or more depressive episodes(OR=1.67),earlier age of onset(OR=0.95),longer ill-ness duration(OR=1.03),and higher GAF scores(OR=1.02).The nomogram model achieved an AUC of 0.81(95％CI:0.78-0.84).The Hosmer-Lemeshow test result was x2=6.96(P＞0.05),indicating good model fit.The calibration curve showed good performance.The decision curve analysis revealed that the nomogram pro-vides significant clinical benefit when the risk of bipolar depression was within the range of 0 to 0.9.Conclusion:The nomogram established based on the identified sociodemographic and clinical factors can accurately assess the risk of bipolar depression,providing a useful tool for early identification and intervention.

Objective:To describe the time trend of suicide rate in China from 2016 to 2021,and to identify key populations and regions for targeted prevention.Methods:The crude suicide rates were obtained from China Health Statistical Yearbook,and the standardized suicide rate was calculated based on Population Census of China as the standard population.Poisson regression model was used to test the time trend of the average annual rate of sui-cide rate.The average suicide rates(average annual percentage change,AAPC)were calculated to describe suicide rates and trend in China.Results:From 2016 to 2021,the crude suicide rate(AAPC=-1.4％,95％CI:-3.6％-0.8％)and the standardized suicide rate(AAPC=-0.7％,95％CI:-2.5％-1.2％)showed a decreasing trend,but no statistically significance was found.Crude suicide rate in urban residents was lower than that in rural resi-dents.Crude suicide rate of the male was higher than that of the female in both urban and rural regions.The suicide rate of adolescents(AAPC=7.7％-25.2％),urban men aged 35-39 years(AAPC=3.4％)and men aged55-59 years(AAPC=2.1％-2.2％)in urban and rural regions had significantly increasing trends.The average annu-al suicide rate from 2016 to 2021 was 6.03/100 000,with a trend of increasing with age.Rural residents and men had higher average annual suicide rate.Conclusion:While overall suicide rates showed declining trends from 2016 to 2021,rising rates among adolescents and middle-aged men warrant targeted intervention.Continued efforts are needed to prevent suicide in rural areas and in old population.

Objective:To investigate the self-perceived cognitive decline status in the community population,and to explore the association between different dietary habits and self-perceived cognitive decline.Methods:A cross-sectional study was carried out in 11 879 community residents in the three regions of Weifang,Jining,and Zoucheng in Shandong Province.The Ascertain Dementia-8 and dietary habits information questionnaire were used to assess self-perceived cognitive decline and dietary habits,and their association were analyzed using single factor and multivariate logistic regression.Results:The detection rate of self-perceived cognitive decline was 21.4％.Lo-gistic regression showed that smoking in the past was positively associated with self-perceived cognitive decline(OR=1.40,95％CI:1.14-1.73).However,intake of fruits(often,OR=0.70,95％CI:0.52-0.94;everyday,OR=0.60,95％CI:0.44-0.81),nuts(daily,OR=0.62,95％CI:0.44-0.88),mushrooms(often,OR=0.74,95％CI:0.57-0.92)and high tryptophan foods(sometimes,OR=0.79,95％CI:0.68-0.91;everyday,OR=0.54,95％CI:0.34-0.87)were negatively associated with self-perceived cognitive decline.Conclusion:Smoking history might be a risk factor for self-perceived cognitive decline,and high frequency intake of fruits,nuts,mush-rooms,and high tryptophan foods might protective factors for it.

Objective:To investigate the symptom network structure of subjective cognitive decline(SCD)and its associated factors in middle-aged and older adults.Methods:A cross-sectional study was conducted among 8,262 community residents aged 45 years and over in Shandong Province(Jining,Weifang,and Zoucheng).SCD was assessed using the 8-item Ascertain Dementia(AD8)questionnaire,while mental health status was evaluated with Patient Health Questionnaire-9 and General Anxiety Disorder-7.SPSS and R were applied to construct the SCD symptom network model and examine its association with psychological factors.Results:The prevalence of SCD was 24.53％."Difficulty using household appliances"emerged as the core symptom,with the strongest connections to"forgetting appointments"(edge=2.13)and"declining daily memory and thinking ability".Additionally,"poor self-rated mental health"was most strongly linked to"loss of interest,change in hobbies and reduced activities"(edge=0.38).Conclusion:SCD symptoms in middle-aged and older adults exhibits strong interconnections and are closely linked to the individual's mental health condition.

Objective:To identify competency evaluation indicators for psychological hotline professionals,provi-ding scientific reference for their training and assessment.Methods:Through literature review,initial competency evalua-tion indicators were selected,followed by Delphi consultation with sixteen experts across China.The analytic hierarchy process(AHP)was used to assign weights to each indicators.Results:The response rate of expert consultation question-naire was 100％,and the expert authority coefficients for the two rounds of consultation were 0.92 and 0.90 respective-ly.After two rounds of expert consultation,a competency evaluation index system for professional counselors of psycho-logical aids hotline was constructed,including four first-level indexes,nine second-level indexes,and 34 third-level inde-xes.The weight of each index was determined using the AHP.The Kendall coefficient of concordance of all level's inde-xes in the two rounds of consultation were 0.16-0.18 and 0.16-0.25,respectively.Conclusion:The expert consensus developed in this study serves as an reference for evaluating the competency of psychological hotline professionals,sup-porting their training and assessment.

Objective To investigate the clinical application value of the combined detection of fecal syndecan 2(SDC2)and tissue factor pathway inhibitor 2(TFPI2)gene methylation in the diagnosis of colorectal cancer and advanced adenoma.Methods 124 pa-tients with colorectal lesions,including 43 colorectal cancer,52 advanced adenoma,and 29 non-advanced adenoma,and 46 patients with other gastrointestinal diseases such as colorectal inflammatory diseases,ulcers,etc.,who visited 5 hospitals in Zhengzhou from 2020 to 2023 were enrolled as the disease group.In addition,78 healthy individuals who underwent physical examinations in the same period were selected as the healthy control group.Their fecal samples were collected before undergoing colonoscopy,and the methyla-tion levels of SDC2 and TFPI2 genes were detected using the quantitative methylation-specific PCR(qMSP).Results The positive rates of the combined detection of SDC2 and TFPI2 gene methylation in the colorectal cancer group and advanced adenoma group(95.34％and 88.46％)were significantly higher than those in the non-advanced adenoma group(48.27％,x2=18.75/13.63,P＜0.05)and healthy controls(3.84％,x2=96.38/91.54,P＜0.05).In the colorectal cancer group,the postoperative positive rate of the combined detection in 34 patients with positive methylation of SDC2 and TFPI2(5.88％)was significantly lower than the preoperative positive rate(95.34％,x2=54.74,P＜0.05).Moreover,the mean Ct values of methylation of SDC2 and TFPI2 genes(32.38±3.72 and 31.85±3.21)in the colorectal cancer group were significantly lower than that in the advanced adenoma group(35.07±3.09 and 34.96±2.78,t=3.84 and 5.05,P＜0.05).The analysis results of the ROC curve showed that the sensitivities of SDC2,TFPI2,and their combination detection in the diagnosis of colorectal cancer were 86.40％,88.37％,and 89.35％,respectively,while in differenti-ating advanced adenoma they were 73.52％,66.73％,and 80.15％,respectively.The combined detection of SDC2 and TFPI2 in differ-entiating colorectal cancer and advanced adenoma achieved the highest diagnostic efficacy(AUCROC=0.889 and 0.738,respectively).Conclusion The combined detection of methylation of SDC2 and TFPI2 genes in fecal samples has high diagnostic value for colorectal cancer and advanced adenomas,and also has certain clinical application value for the progression and postoperative monitoring of the disease.