Objective:To explore the construction of a competency-oriented off-campus practice training system for master of public health (MPH).Methods:Through literature review and analysis on domestic and foreign MPH degree training models, a comprehensive and feasible MPH off-campus practice training system was designed innovatively.Results:The construction of a "4+N+Comprehensive Evaluation" practice system for MPH programs with a practice duration of more than 2 years has been explored by high-level public health talent training demonstration base of Sun Yat-sen University-Guangzhou CDC. "4" represents practice-based teaching, professional practice, participation in public health project management, and research for the training of MPH in terms of theory, practice, management and research anility of public health. "N" represents expanded practice to train MPH with comprehensive competence and professional spirit," and comprehensive evaluation is used to assess the training effect.Conclusion:A competency MPH off-campus practice system of "4+N+Comprehensive Evaluation" has been established for the training of high-level public health professionals in new era.

Objective To understand the mental health status and influencing factors of adolescent idiopathic scoliosis AIS patients,and to provide a more comprehensive reference basis for clinical intervention.Methods A total of 381 patients were enrolled after screening according to the study criteria,and questionnaires were administered to the patients after informed consent was obtained from the patients and their guardians.Results Of the 381 AIS patients,182 patients,or 47.77%,were screened for mental health problems.Multiple linear regression analysis showed that eight factors,namely,the parents'education level,visual acuity,sleep duration,exercise intensity,self-consciousness,whether or not they were an only child,the nature of the school,and the sleeping position,were the main factors influencing the mental health status of the patients with AIS(P<0.05).Conclusion The high detection rate of mental health problems in AIS patients requires more attention in the 5 factors of parents'education,patients'visual acuity,sleep duration,exercise intensity,and self-consciousness,and correction for the corresponding risk factors to reduce the emergence of mental health problems in patients.

In recent years,the"One Hospital with Multiple Campuses"model has emerged in major public hospitals across China,providing intrinsic impetus and vitality for the expansion and balanced distribution of high-quality medical re-sources.This paper analyzed the current situation and challenges of the multiple campuses development in public hospitals within China,adopting a problem-oriented approach to explore optimized path to a unified management system.The aim was to establish a collaborative management model across campuses based predicated on the homogenization of systems,management,supervi-sion,professionals,and performance.Taking the Third Affiliated Hospital of Sun Yat-sen University as a case in this study,the paper reviewed and summarized management strategies and practical experience from the aspects of management model,resource allocation,information-orientation,homogenized management,and cultural development.Additionally,the article suggested to u-tilize 5G technology to empower homogenization across campuses.In this way,the hospital's overall operational efficiency can be improved,optimize resource allocation optimized,homogenized medical services ensured,and core competitiveness enhanced.These efforts will provide a reference for the high-quality development of multi-campus public hospitals.

Objective:To analyze the optical coherence tomography (OCT) imaging characteristics in patients with Coats disease and their value in predicting macular fibrosis.Methods:A nested case-control study was performed.A total of 43 patients (43 eyes) diagnosed with Coats disease through color fundus photography, ocular B-scan ultrasonography, fundus fluorescein angiography, and spectral-domain OCT examination were enrolled from January 2008 to October 2021 at the Xijing Hospital.Among them, there were 40 males and 3 females, aged from 2 to 60 years old, with a median age of 13 years.Macular fibrosis was used as an indicator of poor prognosis, and patients were divided into two groups based on whether macular fibrosis occurred at the end of follow-up.The differences in OCT characteristics between two groups were compared and logistic regression analysis was used to identify the risk factors for macular fibrosis.This study adhered to the Declaration of Helsinki and was approved by the Ethics Committee of Xijing Hospital of Fourth Military Medical University (No.KY20202009-C-1).Results:The OCT clinical features of 43 cases of Coats disease included intraretinal hard exudates in 43 eyes (100%), subretinal fluid in 21 eyes (48.8%), macular cysts in 17 eyes (27.9%), subretinal exudates in 9 eyes (20.9%), anterior retinal hyperreflective dots in 7 eyes (16.3%), epiretinal membrane in 21 eyes (48.8%), and intraretinal fluid in 22 eyes (51.2%).In color fundus photos of 41 eyes, 38 eyes (93.0%) had hard exudates distributed in the posterior pole and 27 eyes (65.9%) had the mid-peripheral region.OCT examination showed that hard exudates were distributed in the inner nuclear layer in 35 eyes (81.4%) and the outer nuclear layer in 33 eyes (76.7%).Among 21 eyes with exudative retinal detachment detected by OCT, 9 eyes (42.9%) were detected by fundus photography and 18 eyes (85.7%) were detected by B-scan ultrasonography.The proportions of eyes with subretinal fluid and subretinal exudates were higher in the macular fibrosis group than in the non-macular fibrosis group, and the differences were statistically significant ( χ2=20.755, P<0.001; χ2=6.133, P=0.013).Logistic regression analysis showed that the presence of subretinal fluid was a risk factor for macular fibrosis (odds ratio=48.345, 95% confidence interval: 4.272-547.066, P=0.002). Conclusions:OCT examination can detect subretinal fluid, subretinal exudates, macular cysts, macular exudates, and hyperreflective spots in the retina of patients with Coats disease.Subretinal fluid is a risk factor for macular fibrosis.

Objective:To investigate the fundus fluorescein angiography (FFA) characteristics of spontaneous regression in retinopathy of prematurity (ROP) and the range of retinal vascularization.Methods:A clinical retrospective study. A total of 82 eyes of 41 infants with ROP, who underwent FFA from January 2019 to December 2021 in Department of Ophthalmology of Xijing Hospital after completion of ROP regression, were included. There were 25 males (50 eyes) and 16 females (32 eyes). ROP was diagnosed in Zone Ⅱ in 44 eyes, with 38 eyes in stage 2 and 6 eyes in stage 3, and in zone Ⅲ in 38 eyes of stage 2. All patients underwent FFA examination under general anesthesia, at postmenstrual age of 70.70±12.25 weeks, after the natural regression of ROP was completed. Focus on the retinal vascular development, as well as choroid circulation and macular abnormalities, and compare and observe the differences between zone Ⅱ and Ⅲ after spontaneous regression. The extent of retinal vascularization was determined by the ratio between the distance of the center of the disc to the border of the vascularized zone (DB) and the center of the disc to the fovea distance (DF). The width of avascular area, recorded as the distance from the ora serrata to the vascular termination, was counted by disc diameters (DD). The measurement data between zone Ⅱ and zone Ⅲ ROP were compared by the independent sample t-test, and the count data were compared by χ2 test or Fisher exact probability test. Results:The linear choroidal pattern was present in 9 eyes (21.95%, 9/41), and the tortuous arteries in the posterior retina were detected in 32 eyes (39.02%, 32/82). It was noted that increased branching of vessels presented in 45 eyes (54.88%, 45/82), straight shape of vessels shown in 27 eyes (32.93%, 27/82), circumferential vessels arisen in 45 eyes (54.88%, 45/82), arteriovenous shunt appeared in 18 eyes (21.95%, 18/82), and capillary bed lost in 46 eyes (56.10%, 46/82) in areas from initial ridge to vascular termini. Punctate or linear dye leakage was observed in 23 eyes (28.05%, 23/82) during the late phase of FFA. Macular abnormalities, such as the absence of foveal avascular zone and hypoperfusion, were observed in 28 eyes (34.15%, 28/82), of which the macular ectopia presented in 1 eye. The mean DB/DF ratio of all the 82 eyes on the temporal side was 4.63±0.29 and 3.77±0.23 in the nasal. The mean avascular area on the temporal retina was 1.74±1.00 DD. Compared with ROP in zone Ⅲ, increased branching of vessels and dye leakage were more common ( χ2=9.303, 10.774; P=0.002, 0.001), the extent of temporal retinal vascularization was smaller ( t=-2.285, P=0.026), and the avascular area of the retina was more significant ( t=5.491, P<0.001) in zone Ⅱ ROP. Conclusions:Even after completion of spontaneous regression in ROP, incomplete retinal vascularization and vascular abnormalities may exist permanently in FFA, including those such as the tortuous arteries in the posterior retina, increased branching and straight shape of vessels, circumferential vessels, capillary bed lost and macular abnormality. Further appropriate follow-up is needed for long-term safety.

Objective:To investigate the ocular clinical manifestations in pediatric patients with incontinentia pigmenti (IP).Methods:A case series study was carried out and a retrospective analysis was performed.Clinical data of 13 pediatric patients with IP treated from January 2013 to December 2019 in Xijing Hospital were collected.All the patients underwent regular ophthalmologic examination.Three patients accepted fundus fluorescein angiography and six eyes of five patients were treated with retinal photocoagulation or anti-vascular endothelial growth factor (VEGF) intravitreal injection according to severity of the condition.The follow-up period ranged from 6 months to 6 years.The medical history, family history, systemic manifestations, ocular characteristics, diagnosis, treatment as well as ocular and systemic changes during follow-up were recorded and analyzed.This study followed the Declaration of Helsinki and the study protocol was approved by the Ethics Committee of Xijing Hospital, Fourth Military Medical University (No.KY20203287-1).Results:All the 13 patients were female aged from 5 days to 42 months at first visit, with the average age of 2.0 (1.0, 8.5) months.As for the main skin lesions at first visit, there were 4 cases in erythematous vesicle stage, 3 cases in verrucous exanthema stage, and 6 cases in hyperpigmented stage.There were 7 cases in shrinkage stage during follow-up.Among the 26 eyes of 13 patients, 18 eyes of 10 patients showed ocular anomalies, accounting for 76.9% of total patients (69.2% of total eyes). Among the 13 patients, 8 patients presented bilateral ocular involvement, 2 patients showed unilateral anomalies, and 3 patients had no ocular lesions.The retina was involved in all patients with ocular manifestations.The typical retinal lesions included avascular zone of peripheral retina in 13 eyes, tortuous and dilated retinal vessels in 10 eyes, increased vascular branch in 7 eyes, white linear retinal arteries and partial vascular occlusion in 4 eyes, retinal neovascularization in 3 eyes, total retinal detachment in 2 eyes, and retinal fold with macular lamellar hole in 1 eye.In addition, there was retinal hemorrhage in 11 eyes, retinal pigment changes in 4 eyes, grey ridge lesions in 3 eyes, macular dysplasia in 2 eyes, choroidal atrophy in 1 eye, optic gliosis in 1 eye and yellowish-white retinal exudate in 1 eye.There were also 4 patients with other ocular manifestations, such as strabismus and eyeball atrophy.Retinal photocoagulation was performed in 4 eyes of 3 patients and anti-VEGF intravitreal injection in 2 eyes of 2 patients.The retinal lesions regressed and the condition of patients kept stable during follow-up.Conclusions:The ocular clinical manifestations in patients with IP are usually typical and diverse, and the retinal vascular lesion is the main type.Early diagnosis and timely treatment are of great significance.

Objective:To analyze the morphological changes and features of meibomian gland in patients with meibomian gland cyst under in vivo confocal microscope (IVCM). Methods:A cross-sectional study was performed.A total of 34 patients (34 eyes) with meibomian gland cysts and 18 control subjects (18 eyes) in the outpatient department without meibomian gland cysts treated in Shantou International Eye Center from September 2018 to April 2019 were included into the meibomian gland cyst group and control group accordingly.All the subjects underwent routine ophthalmologic examination and IVCM examination.IVCM test indicators included the opening area of meibomian gland, the longest diameter and the shortest diameter of meibomian gland opening, the morphology of glandular tube and acinus adjacent to the meibomian gland opening.The measurement indexes of the meibomian gland cyst group and the control group were compared and analyzed.This study followed the Declaration of Helsinki and was approved by the Ethics Committee of Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong (No.EC20171103[6]-P01). Written informed consent was obtained from each patient before examination.Results:The opening of the meibomian glands of the 34 subjects in the meibomian gland cyst group were all enlarged irregularly with smooth boundaries, and emboli in the openings were observed in 70.59% (24/34) of patients.The longest diameter, the shortest diameter and the area of meibomian gland openings were (148.12±70.16)μm, (114.77±52.38)μm and 9 239.11(5 506.96, 24 111.36)μm 2 in the meibomian gland cyst group, respectively, while (59.35±16.78)μm, (41.98±11.77)μm and 2 094.19 (1 432.28, 2 945.65)μm 2 in the control group, respectively.Compared with the control group, the longest diameter and shortest diameter in the meibomian cyst group were longer, and the area of meibomian gland openings in the meibomian cyst group was larger, and the differences were statistically significant (all at P<0.01). Adjacent to the opening, there was cystic dilation of glandular tube containing accumulated secretion of different characteristics detected in the 61.76% (21/34) of patients in the meibomian gland cyst group, and the dilated glandular tubes were with flat edges.The boundaries between the dilated glandular tubes and surrounding acini were clear. Conclusions:In vivo confocal microscope can detect the morphological changes of meibomian glands in patients with meibomian gland cyst, including enlarged opening with embolus, cystic dilation of glandular tube with clear boundary and accumulated secretion.

Isatis indigotica Fort. (Ban-Lan-Gen) is an herbal medicine prescribed for influenza treatment. However, its active components and mode of action remain mostly unknown. In the present study, erucic acid was isolated from Isatis indigotica Fort., and subsequently its underlying mechanism against influenza A virus (IAV) infection was investigated in vitro and in vivo. Our results demonstrated that erucic acid exhibited broad-spectrum antiviral activity against IAV resulting from reduction of viral polymerase transcription activity. Erucic acid was found to exert inhibitory effects on IAV or viral (v) RNA-induced pro-inflam-matory mediators as well as interferons (IFNs). The molecular mechanism by which erucic acid with antiviral and anti-inflammatory properties was attributed to inactivation of NF-kB and p38 MAPK signaling. Furthermore, the NF-kB and p38 MAPK inhibitory effect of erucic acid led to diminishing the transcriptional activity of interferon-stimulated gene factor 3 (ISGF-3), and thereby reducing IAV-triggered pro-inflammatory response amplification in IFN-β-sensitized cells. Additionally, IAV- or vRNA-triggered apoptosis of alveolar epithelial A549 cells was prevented by erucic acid. In vivo, erucic acid administration consistently displayed decreased lung viral load and viral antigens expression. Meanwhile, erucic acid markedly reduced CD8+cytotoxic T lymphocyte (CTL) recruitment, pro-apoptotic signaling, hyperactivity of multiple signaling pathways, and exacerbated immune inflammation in the lung, which resulted in decreased lung injury and mortality in mice with a mouse-adapted A/FM/1/47-MA(H1N1) strain infection. Our findings provided a mechanistic basis for the action of erucic acid against IAV-mediated inflammation and injury, suggesting that erucic acid may have a therapeutic potential in the treatment of influenza.

Objective To investigate the incidence of cognitive dysfunction in postpartum women who underwent epidural or non-drug labor analgesia and the influence factors.Methods A prospective cohort study was performed in 1 618 uneventful singleton pregnancies in International Peace Maternity and Child Health Hospital from January 2017 to January 2018.Women who received epidural labor analgesia were assigned to the epidural group (n=803),and those who received Doula technique non-drug labor analgesia rather than labor analgesia to the control group (n=815).Cognitive function was assessed using symbol digit modalities test (SDMT90) and Montreal cognitive assessment (MoCA) 1 d and 42 d after delivery.Incidence of maternal cognitive dysfunction,SDMT90 scores and pain intensity measured by visual analogue score (VAS) at the cervical dilatation of 3,6 and 10 cm between the two groups were compared using independent sample t-test,Chi-square test or logistic regression analysis.Results MoCA and SDMT90 scores of the epidural group were significantly higher than those of the control group 1 d after delivery (27.1 ± 1.5 vs 26.2± 1.8,49.1 ±2.4 vs 42.5 ± 3.6;t=3.775 and 16.956,both P＜0.05),but the incidence of postoperative cognitive dysfunction (POCD) in the epidural group was remarkably lower comparing to the control group [13.9％ (112/803) vs 21.2％ (173/815),x2=14.769,P=0.002].The VAS scores of the epidural group at the cervical dilatation of 3,6 and 10 cm were all lower than those of the control group (2.3 ± 0.6 vs 6.9± 1.3,3.3 ± 0.9 vs 8.7± 0.9,5.7± 0.9 vs 9.7± 0.4;t=0.013,0.011 and 0.015;all P＜0.001).Logistic regression analysis indicated that VAS scores ≤ 3 at the cervical dilatation of 3,6 and 10 cm were protective factors against the incidence ofPOCD 1 d after delivery [OR(95％CI):0.238 (0.198-0.287),0.180 (0.145-0.222) and 0.112 (0.088-0.142),all P＜0.001],while the absence of epidural labor analgesia was a risk factor (OR=4.698,95％CI:1.812-11.321,P＜0.001).Conclusions Epidural labor analgesia can reduce the incidence of postpartum cognitive dysfunction in women 1 d after delivery.The incidence of POCD has close relationship with the VAS scores at the cervical dilatation of 3,6 and 10 cm and epidural labor analgesia.

Viral infection is the main death cause of infectious diseases in China. The establishment of an animal model to mimic the progression of viral infectious diseases in humans is of great significance to the study of pathogenesis and prevention of viral infectious diseases. As a new animal model established and developed in recent years, tree shrew has showed obvious advantages and potentials compared with other non-human primates and mice which are commonly used as virus-infected animal models. In this paper, the biological advantages of tree shrew as a novel animal model of viral infectious diseases are summarized, including taxonomy, physiology and immunology. In addition, the latest application of tree shrew in the research of many viral infectious diseases such as hepatitis virus, herpes simplex virus, influenza virus and enterovirus infections are compared and summarized.