Objective:To analyze the infection status of HBV among the healthy population in Tongchuan city in 2023, and compare it against the data from 2006, 2014, and 2020, thereby elucidating epidemiological trends and providing reference for optimizing hepatitis B prevention and control strategies in Tongchuan city.Methods:By using the method of multi-stage stratified random sampling, healthy people aged 1-59 from eight villages/communities in the four districts and counties of Tongchuan city were selected for on-site investigation and blood sample collection. ELISA was used to detect the five hepatitis B markers of the survey respondents, including HBsAg and HBsAb, and the seroprevalence rates of the populations with different characteristics were analyzed. Statistical analysis was performed using Chi-square test.Results:In 2023, a total of 1 926 healthy people were surveyed. After standardization, the positive rates of HBsAg, HBsAb, and HBV, and the rate of all five hepatitis B markers being negative were 0.56%, 54.57%, 26.77%, and 33.05%, respectively. Children aged 1-4 had the lowest positive rates of HBsAg, HBcAb, HBeAb, and HBV, as well as the lowest rate of all five hepatitis B markers being negative, while they had the highest positive rate of HBsAb. In the population aged 1-29, the positive rates of HBsAg and HBV, and the rate of all five hepatitis B markers being negative showed an upward trend with increasing age, while the positive rate of HBsAb showed a downward trend. In particular, the positive rate of HBsAb dropped sharply in the 5-14 age group. In 2023, the positive rate of HBV in the population aged 1-29 was 10.93% (111/1 016), and the rate of all five hepatitis B markers being negative was 38.39% (390/1 016), both lower than the results of the previous three surveys. The positive rate of HBsAb was 56.69% (576/1 016) in people aged 1-29 in 2023, which was higher than the results of the previous three surveys.Conclusions:Although certain achievements have been made in the prevention and control of hepatitis B in Tongchuan city in 2023, with more than one-third of the population showing all negative results in the five hepatitis B tests, the positive rate of HBsAb in the 5-14 age group has dropped sharply. Further actions required for hepatitis B prevention and control in Tongchuan city include optimizing the childhood immunization schedule for national immunization program vaccines, implementing booster programs for adolescents, and developing tailored immunization strategies for adults.

Background Accurate T-staging is critical for esophageal cancer therapy,but CT-based assessment has significant limitations.Large vision models(LVMs)hold promise,yet their zero-shot clinical diagnostic capability without fine-tuning remains unvalidated.Methods A retrospective analysis was conducted on the chest CT images from 98 esophageal cancer patients and 50 normal controls.Using radiologist-consensus as the gold standard,the zero-shot T-staging performance of 3 LVMs(GPT-5,Gemini,and MedGemma)was evaluated with prompts of varying complexity.Results GPT-5 exhibited the highest accuracy and stability.Significant biases were observed among models:Gemini tended to over-stage,while MedGemma showed a tendency to under-stage.All models faced challenges in identifying early-stage tumors,but structured prompts improved diagnostic performance for mid-to-late stage lesions.Conclusion LVMs have potential for zero-shot T-staging,but their performance highly depends on model choice and prompt design.The generic model GPT-5 show superior zero-shot generalization.However,current model performance is not yet clinically viable,especially for early diagnosis.Future work should focus on fine-tuning with high-quality clinical data and developing standardized prompt frameworks.

Objective A joint Poisson-logistic model in a Bayesian framework is proposed to constructed using tuberculosis(TB)reporting data from 14 prefectures in Xinjiang from 2014 to 2020 in combination with relevant social,economic,and environmental factors affecting the reported incidence rate of TB to explore potential underreporting areas of the TB reporting data,and to provide a strong evidence－based support for the subsequent decision－making on the precision prevention and control of TB.Methods Relevant factors affecting the reporting process and disease process of TB were collected,and important covariates were screened for inclusion in the model using the factor detector in the Geo-detector method,and the reported incidence model of TB and the expected incidence model of TB in Xinjiang were constructed separately,which together constituted a hybrid model of underreporting of TB(Poisson-logistic joint model).The mixed model was used to estimate the risk of TB underreporting in each prefecture of Xinjiang,and to explore the regional distribution of the potential risk of TB underreporting.Results Factor detector result pairs showed that GDP per capita was associated with the largest contribution to the risk of TB underreporting(0.5481);goodness－of－fit test showed that the data were well fitted(Bayesian P－value<0.001),and the Bayesian Poisson-logistic joint model could be applied to the study of the risk of underreporting of TB reporting data in Xinjiang from 2014 to 2020.The results showed that the risk of underreporting of TB The risk of underreporting of reported data was concentrated in the four southern Xinjiang prefectures,with the greatest risk of underreporting of TB reported data in Kashgar 0.1426(0.1403,0.1445).The lower risk of underreporting was concentrated in the eastern and central parts of Xinjiang,with the lowest risk of underreporting in the city of Karamay[0.1017(0.9983,0.1034)].In a joint Bayesian Poisson-logistic model,it was found that population density(IRR＝1.0060,95%CI:1.0059~1.0061)and average annual temperature(IRR＝1.0087,95%CI:1.0086~1.0088)were risk factors for underreporting of TB,and GDP per capita(IRR＝0.9385,95%CI:0.9365~0.9394)and an increase in the number of registered nurses(IRR＝0.9916,95%CI:0.9913 to 0.9920)reduced the risk of TB underreporting.Conclusion The Bayesian Poisson-logistic joint model estimated the potential incidence of TB in Xinjiang Uygur Autonomous Region and revealed significant discrepancies between reported and true TB incidence rates.It identified underreporting trends and localized potential underreporting risk areas,providing a theoretical basis for tailored and precise TB prevention and control strategies in Xinjiang.

Objective A joint Poisson-logistic model in a Bayesian framework is proposed to constructed using tuberculosis(TB)reporting data from 14 prefectures in Xinjiang from 2014 to 2020 in combination with relevant social,economic,and environmental factors affecting the reported incidence rate of TB to explore potential underreporting areas of the TB reporting data,and to provide a strong evidence－based support for the subsequent decision－making on the precision prevention and control of TB.Methods Relevant factors affecting the reporting process and disease process of TB were collected,and important covariates were screened for inclusion in the model using the factor detector in the Geo-detector method,and the reported incidence model of TB and the expected incidence model of TB in Xinjiang were constructed separately,which together constituted a hybrid model of underreporting of TB(Poisson-logistic joint model).The mixed model was used to estimate the risk of TB underreporting in each prefecture of Xinjiang,and to explore the regional distribution of the potential risk of TB underreporting.Results Factor detector result pairs showed that GDP per capita was associated with the largest contribution to the risk of TB underreporting(0.5481);goodness－of－fit test showed that the data were well fitted(Bayesian P－value<0.001),and the Bayesian Poisson-logistic joint model could be applied to the study of the risk of underreporting of TB reporting data in Xinjiang from 2014 to 2020.The results showed that the risk of underreporting of TB The risk of underreporting of reported data was concentrated in the four southern Xinjiang prefectures,with the greatest risk of underreporting of TB reported data in Kashgar 0.1426(0.1403,0.1445).The lower risk of underreporting was concentrated in the eastern and central parts of Xinjiang,with the lowest risk of underreporting in the city of Karamay[0.1017(0.9983,0.1034)].In a joint Bayesian Poisson-logistic model,it was found that population density(IRR＝1.0060,95%CI:1.0059~1.0061)and average annual temperature(IRR＝1.0087,95%CI:1.0086~1.0088)were risk factors for underreporting of TB,and GDP per capita(IRR＝0.9385,95%CI:0.9365~0.9394)and an increase in the number of registered nurses(IRR＝0.9916,95%CI:0.9913 to 0.9920)reduced the risk of TB underreporting.Conclusion The Bayesian Poisson-logistic joint model estimated the potential incidence of TB in Xinjiang Uygur Autonomous Region and revealed significant discrepancies between reported and true TB incidence rates.It identified underreporting trends and localized potential underreporting risk areas,providing a theoretical basis for tailored and precise TB prevention and control strategies in Xinjiang.

Background Accurate T-staging is critical for esophageal cancer therapy,but CT-based assessment has significant limitations.Large vision models(LVMs)hold promise,yet their zero-shot clinical diagnostic capability without fine-tuning remains unvalidated.Methods A retrospective analysis was conducted on the chest CT images from 98 esophageal cancer patients and 50 normal controls.Using radiologist-consensus as the gold standard,the zero-shot T-staging performance of 3 LVMs(GPT-5,Gemini,and MedGemma)was evaluated with prompts of varying complexity.Results GPT-5 exhibited the highest accuracy and stability.Significant biases were observed among models:Gemini tended to over-stage,while MedGemma showed a tendency to under-stage.All models faced challenges in identifying early-stage tumors,but structured prompts improved diagnostic performance for mid-to-late stage lesions.Conclusion LVMs have potential for zero-shot T-staging,but their performance highly depends on model choice and prompt design.The generic model GPT-5 show superior zero-shot generalization.However,current model performance is not yet clinically viable,especially for early diagnosis.Future work should focus on fine-tuning with high-quality clinical data and developing standardized prompt frameworks.

Objective:To analyze the infection status of HBV among the healthy population in Tongchuan city in 2023, and compare it against the data from 2006, 2014, and 2020, thereby elucidating epidemiological trends and providing reference for optimizing hepatitis B prevention and control strategies in Tongchuan city.Methods:By using the method of multi-stage stratified random sampling, healthy people aged 1-59 from eight villages/communities in the four districts and counties of Tongchuan city were selected for on-site investigation and blood sample collection. ELISA was used to detect the five hepatitis B markers of the survey respondents, including HBsAg and HBsAb, and the seroprevalence rates of the populations with different characteristics were analyzed. Statistical analysis was performed using Chi-square test.Results:In 2023, a total of 1 926 healthy people were surveyed. After standardization, the positive rates of HBsAg, HBsAb, and HBV, and the rate of all five hepatitis B markers being negative were 0.56%, 54.57%, 26.77%, and 33.05%, respectively. Children aged 1-4 had the lowest positive rates of HBsAg, HBcAb, HBeAb, and HBV, as well as the lowest rate of all five hepatitis B markers being negative, while they had the highest positive rate of HBsAb. In the population aged 1-29, the positive rates of HBsAg and HBV, and the rate of all five hepatitis B markers being negative showed an upward trend with increasing age, while the positive rate of HBsAb showed a downward trend. In particular, the positive rate of HBsAb dropped sharply in the 5-14 age group. In 2023, the positive rate of HBV in the population aged 1-29 was 10.93% (111/1 016), and the rate of all five hepatitis B markers being negative was 38.39% (390/1 016), both lower than the results of the previous three surveys. The positive rate of HBsAb was 56.69% (576/1 016) in people aged 1-29 in 2023, which was higher than the results of the previous three surveys.Conclusions:Although certain achievements have been made in the prevention and control of hepatitis B in Tongchuan city in 2023, with more than one-third of the population showing all negative results in the five hepatitis B tests, the positive rate of HBsAb in the 5-14 age group has dropped sharply. Further actions required for hepatitis B prevention and control in Tongchuan city include optimizing the childhood immunization schedule for national immunization program vaccines, implementing booster programs for adolescents, and developing tailored immunization strategies for adults.

Objective:This study aimed to assess the effects of Peer Balint-style group on the empathy ability of third-year long-term medical students and to provide a theoretical and practical reference for effectively improving their humanistic quality.Methods:Ninety third-year Chinese long-term medicine students participated. Volunteers received either ten sessions of 1.5-h Peer Balint-style group which were led by specially trained peers from June 2019 to August 2019. The College Students' Empathy Ability Questionnaire was used before the experiment and the second day after the experiment. The total score of the scale from the pre-test and post-test and the scores of each dimension conformed to a normal distribution, with equal variance, describing in the form of ( x± s). Paired t-tests were performed to compare the total score and each dimension score before and after the intervention, using SPSS 22.0. Semi-structured interviews were conducted with 7 peer-group leaders and group members after the clinical practice period. The interview materials were analyzed by traditional content analysis. The content of the qualitative research was open-coded to obtain 10 categories, suggesting the role and inadequacy of Peer Balint-style groups. Results:A total of 63 valid samples were obtained. There was no significant difference of ( t=-0.44, P=0.661, P>0.05) between the total score of the post-test (118.00±11.98) and the total score of the pre-test (117.38±12.36). In each dimension, the reverse comprehension score of post-test (9.06±1.97) was significantly different ( t=-2.08, P=0.041, P>0.05) from the pre-test's (8.57±2.15), which increased compared to the pre-test score. Conclusions:Peer Balint-style group had a positive effect on improving empathy among medical students. Compared with the traditional Balint group, it has wider coverage, higher affinity and greater mobility. However, the design of the Peer Balint-style group still needs to be further improved.

Objective:To discuss the effect of exosome(Exo)microRNA-761(miR-761)on the epithelial-mesenchymal transition(EMT)process of the osteosarcoma(OS)cells by regulating tumor-associated macrophage(TAM)polarization,and to clarify its related mechanism.Methods:The miR-761 plasmid and negative control(miR-NC)plasmid were transfected into the HEK293 cells,and the non-transfected cells were regarded as control group.The transfection efficiency was detected using real-time fluorescence quantitative PCR(RT-qPCR)method.The Exo containing miR-761 was isolated,and the morphology of Exo was observed by transmission electron microscope.The concentration and size distribution of Exo samples were detected by nanoparticle analyzer,and the expression of Exo surface marker protein was detected by Western blotting method.The human monocyte leukemia THP-1 cells were stimulated with phorbol 12-myristate 13-acetate(PMA)to become the M0 macrophages,which were then treated with Exo containing miR-761 and co-cultured with the OS MG63 cells to establish the co-culture system.The experiment was divided into M0 group,TAM group,miR-761 NC group,and miR-761 Exo group.The M0 macrophages were collected from various groups,and the positive rates of M1 macrophage marker CD86 and M2 macrophage marker CD206 in various groups were detected by flow cytometry;the protein expression levels of M1 macrophage secreted factors interleukin-1β(IL-1β)and tumor necrosis factor-α(TNF-α)and M2 macrophage secreted factors interleukin-10(IL-10)and transforming growth factor-β1(TGF-β1)in various groups were detected by Western blotting method.The M0 macrophages were treated with Exo containing miR-761 and co-cultured with MG63 cells to establish the co-culture system.The experiment was divided into control group,TAM group,miR-NC Exo+TAM group,and miR-761 Exo+TAM group.The MG63 cells in various groups were collected,and the fluorescence intensities of E-cadherin and Vimentin in the MG63 cells in various groups were observed by immunofluorescence staining;the expression levels of E-cadherin,Vimentin,and EMT regulation-related transcription factors Twist1,Snail,and Slug proteins in the cells in various groups were detected by Western blotting method;the numbers of invasion and migration cells in various groups were detected by Transwell chamber assay.Results:The HEK293 cells containing miR-761 were successfully obtained by transfection experiments,and the Exo was isolated.Compared with M0 group,the positive rate of CD86 of the macrophages in TAM group was decreased(P＜0.05),while the positive rate of CD206 was increased(P＜0.05),the expression levels of IL-1β and TNF-α proteins were decreased(P＜0.05),while the expression levels of IL-10 and TGF-β1 proteins were increased(P＜0.05).Compared with TAM group,the positive rate of CD86 of the macrophages in miR-761 Exo group was increased(P＜0.05),while the positive rate of CD206 was decreased(P＜0.05),the expression levels of IL-1β and TNF-α proteins were increased(P＜0.05),while the expression levels of IL-10 and TGF-β1 proteins were decreased(P＜0.05).Compared with control group,the fluorescence intensity of E-cadherin in the MG63 cells in TAM group was decreased,while the fluorescence intensity of Vimentin was increased,the expression level of E-cadherin protein was decreased(P＜0.05),while the expression levels of Vimentin,Twist1,Snail,and Slug proteins were increased(P＜0.05),and the numbers of invasion and migration cells were increased(P＜0.05).Compared with TAM group,the fluorescence intensity of E-cadherin in the MG63 cells in miR-761 Exo+TAM group was increased,while the fluorescence intensity of Vimentin was decreased,the expression level of E-cadherin protein was increased(P＜0.05),while the expression levels of Vimentin,Twist1,Snail,and Slug proteins were decreased(P＜0.05),and the numbers of invasion and migration cells were decreased(P＜0.05).Conclusion:The exo-delivered miR-761 can inhibit the EMT process of the OS cells,thereby inhibiting the cell migration and cell invasion;its mechanism may be related to regulating TAM polarization.

Humans ; Neoplasms, Second Primary/epidemiology* ; Neoplasms/epidemiology* ; Risk Factors ; Prognosis