Objective: To understand the changing trends and related factors of knowledge, attitude and practice (KAP) regarding the three major infectious diseases (acquired immunodeficiency syndrome, tuberculosis, hepatitis B) among freshmen in Jiangsu from 2019 to 2022, so as to provide a reference basis for the health education of infectious diseases in schools. Methods: From 2019 to 2022, a total of 33 944 freshmen from 20 universities in Jiangsu Province were randomly selected for four consecutive years to investigate their KAP levels online through self designed questionnaires on three major infectious diseases. The multiple linear regression model was used to analyze the changing trends of students KAP levels of the three major infectious diseases, and to explore the influencing factors of KAP. Results: From 2019 to 2022, the knowledge scores(18.0±3.1,18.4±3.2,18.7±3.2,18.8±3.2), related to the three major infectious diseases showed an upward trend ( F=436.50, P <0.01), and the positive attitude reporting rates were 81.77%, 81.46%, 82.68% and 81.74%, respectively. The reporting rates of positive practice were 80.11%, 79.25%, 79.08 % and 79.04%, respectively. Multiple linear regression showed that school type, parental education level, mother s occupation, average income per person in family and living arrangements during high school all had an impact on the knowledge ( β = -1.510 -0.559), attitudes ( β =-0.043-0.065) and practice ( β =-0.028-0.027) of the three major infectious diseases ( P < 0.05 ). The family residence areas only affected the reporting rate of positive attitude scores ( β =0.002-0.065), and whether only children or not affected the reporting rate of positive practice scores ( β =0.009)( P <0.05). The knowledge score showed an upward trend ( β= 0.297, P <0.01), the positive attitude reporting rate showed no statistically significant change ( β=0.001, P =0.22), and the positive practice reporting rate showed a downward trend ( β=-0.005, P <0.01). Conclusions Freshman in Jiangsu Province from 2019 to 2022 have shown a separation in KAP scores regarding the three major infectious diseases. Targeted measures should be taken to improve their health practice level.

Objective:To explore the assessment value of quantitative parameters of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)and tumor markers in assessing the curative effect of neoadjuvant chemotherapy for breast cancer.Methods:A total of 75 patients with breast cancer who received neoadjuvant chemotherapy combined with surgical intervention in Jining No.1 People's Hospital from May 2019 to May 2022 were selected,and they were divided into effective group(54 cases)and ineffective group(21 cases)according to the Response Evaluation Criteria In Solid Tumour(RECIST).The Ve,Kep and Ktrans of DCE-MRI quantitative parameters and CEA,CA125 and CA15-3 levels of tumor markers between two groups were compared before and after chemotherapy,and the receiver operating characteristics(ROC)curve was adopted to analyze the predictive efficiency of each diagnostic method.Results:After chemotherapy,the differences of the Ve,Kep and Ktrans of quantitative parameters between the two groups were significant(t=7.237,51.695,16.879,P<0.05),respectively.The differences of the CEA,CA125 and CA15-3 of tumor markers between two groups were significant(t=44.201,6.736,6.885,P<0.05),respectively.The AUC value of combined prediction of 6 indicators included Ve,Kep,Ktrans,CEA,CA125 and CA15-3 was 0.979 in predicting the curative effect of neoadjuvant chemotherapy for breast cancer,which was significantly higher than the AUC value of each alone indicator,and the differences of them were statistically significant(Z=2.993,2.679,2.510,2.731,3.215,3.071,P<0.05),respectively.Conclusion:The combination of tumor markers and DCE-MRI quantitative parameters can better predict the curative effect of neoadjuvant chemotherapy for breast cancer,which can indirectly assess the prognosis.

Objective: To understand the trends and associated factors of tuberculosis knowledge and behavior among freshmen from Jiangsu Province, 2019 to 2022, so as to provide theoretical support for the popularization of tuberculosis knowledge and the prevention and control of tuberculosis in universities. Methods: From 2019 to 2022, a total of 33 944 freshmen from 20 universities in Jiangsu Province were selected by stratified random sampling, and tuberculosis knowledge and behavior were surveyed online using a selfdesigned questionnaire. Oneway variance trend test and multiple linear regression analysis were used to analyze the trend of knowledge and behavior levels, and a multiple linear regression model was used to analyze the influencing factors. Results: The overall awareness rate of tuberculosis among freshmen from Jiangsu Province was 90.6%, and the overall awareness rates from 2019 to 2022 were 88.4%, 90.4%, 91.7%, and 91.8%, respectively. The overall behavioral accuracy rate was 92.3%, with the annual rates from 2019 to 2022 being 91.8%, 92.3%, 92.7%, and 92.4%, respectively. Both the awareness rate and accuracy behavior rate increased annually (F=216.67, 11.75, P<0.01). The multiple linear regression analysis showed that school type, ethnicity, fathers educational level, mothers educational level, mothers occupation, family per capita monthly income, and living arrangement in high school affected both personal knowledge awareness rate and personal behavioral accuracy rate (β=-0.047-0.035, P<0.01), while region, gender, family residence, and being an only child only affected behavioral accuracy rate (β=-0.003-0.032, P<0.05). Conclusions The tuberculosis knowledge and behavior levels of freshmen from Jiangsu Province have been increasing by year. Targeted health education should be carried out based on the relevant influencing factors to further enhance the tuberculosis prevention and control literacy.

Clinicians need to focus on various points in the diagnosis and treatment of insomnia.This article prescribed the treatment protocol based on the unique features,such as insomnia in the elderly,women experiencing specific physiologi-cal periods,children insomnia,insomnia in sleep-breathing disorder patients,insomnia in patients with chronic liver and kidney dysfunction.It pro-vides some reference for clinicians while they make decision on diagnosis,differentiation and treat-ment methods.

Diabetes mellitus and its consequences have gained increased attention with the incidence rate rising.Diabetic cognitive impairment (DCI), a neurological consequence of diabetes mellitus, has shown a significant increase in recent years, and its related mechanisms need to be elucidated. Short-chain fatty acids (SCFAs), which are metabolites of dietary fiber fermented by gut microbiota and play a significant role in the "microbial-gut-brain axis", have become a popular research topic in recent years for their link to diabetes mellitus and brain function. Therefore, it is important to explore the relationship between SCFAs and DCI. This review summarized the changing characteristics of SCFAs in diabetes mellitus, cognitive impairment and DCI populations, as well as the mechanisms of SCFAs in DCI, which include glucose-lipid metabolism, pathological protein aggregation, inflammation, and mitochondrial autophagy.Future studies should address the common pathophysiological mechanisms of diabetes mellitus and cognitive impairment, in order to explore the effects of different types and doses of SCFAs in DCI and the underlying mechanisms, so as to provide a theoretical basis for the prevention and treatment of the disease in the context of the "co-morbidity model" .

Diabetes mellitus type 2 might cause mild cognitive impairment in its advanced stages,potentially progressing to dementia.Diabetic cognitive impairment(DCI)stands as a chronic complication of diabetes mellitus,with its underlying pathogenesis still remaining elusive.Research has revealed that gut microbiota dysbiosis influenced the central nervous system through the"microbiota-gut-brain axis",thereby contributing to the progression of cognitive impairment.Therefore,the regulation of gut microbiota emerges as a promising approach to the prevention and treatment of DCI.This article comprehensively reviews the mechanisms through which gut microbiota influences DCI.Furthermore,it delves into experimental studies exploring targeted therapies for gut microbiota,including probiotics,fecal microbiota transplantation,dietary and nutrient interventions,as well as traditional Chinese medicine.These studies not only address diabetes-related cognitive impairment but also consider aspects such as glycolipid metabolism and inflammation.The insights gleaned from these studies provide valuable guidance for the clinical application of gut microbiota-targeted intervention in DCI.

Objective To investigate the value of polar residual network(PResNet)model for assisting evaluation on rat myocardial infarction(MI)segment in myocardial contrast echocardiography(MCE).Methods Twenty-five male SD rats were randomly divided into MI group(n=15)and sham operation group(n=10).MI models were established in MI group through ligation of the left anterior descending coronary artery using atraumatic suture,while no intervention was given to those in sham operation group after thoracotomy.MCE images of both basal and papillary muscle levels on the short axis section of left ventricles were acquired after 1 week,which were assessed independently by 2 junior and 2 senior ultrasound physicians.The evaluating efficacy of MI segment,the mean interpretation time and the consistency were compared whether under the assistance of PResNet model or not.Results No significant difference of efficacy of evaluation on MI segment was found for senior physicians with or without assistance of PResNet model(both P＞0.05).Under the assistance of PResNet model,the efficacy of junior physicians for diagnosing MI segment was significantly improved compared with that without the assistance of PResNet model(both P＜0.01),and was comparable to that of senior physicians.Under the assistance of PResNet model,the mean interpretation time of each physician was significantly shorter than that without assistance(all P＜0.001),and the consistency between junior physicians and among junior and senior physicians were both moderate(Kappa=0.692,0.542),which became better under the assistance(Kappa=0.763,0.749).Conclusion PResNet could improve the efficacy of junior physicians for evaluation on rat MI segment in MCE images,shorten interpretation time with different aptitudes,also improve the consistency to some extent.

Objective To grasp the main environmental factors affecting the growth of Astragalus membranaceus(Fisch.)Bge.var.mongholicus(Bge.)Hsiao;To predict the distribution of suitable areas of Astragalus membranaceus(Fisch.)Bge.var.mongholicus(Bge.)Hsiao in Shanxi Province;To provide references for the rational distribution of the resources in Shanxi Province.Methods This study utilized the sample point longitude and latitude information collected in the"Fourth Survey of Chinese Materia Medica Resources"database in Shanxi Province.The data were supplemented by searching the China Digital Herbarium and retrieving related literature records.347 sample points distribution data and environmental factors were added to the MaxEnt model.The main environmental factors and contribution rates affecting the geographical distribution of Astragalus membranaceus(Fisch.)Bge.var.mongholicus(Bge.)Hsiao were screened out.The ArcGIS software was used to divide the ecological suitable area of Astragalus membranaceus(Fisch.)Bge.var.mongholicus(Bge.)Hsiao in Shanxi Province.Results The area under the ROC curve of the established MaxEnt model was 0.909,indicating that the model prediction results were accurate.The model screened 19 environmental factors.Among them,climate factor was the most important environmental factor,followed by biological factor and topographic factor,and soil factor had the least influence.The potential suitable areas of Astragalus membranaceus(Fisch.)Bge.var.mongholicus(Bge.)Hsiao in Shanxi Province were mainly distributed in the northern mountainous areas,presenting a trend of gradually decreasing suitability levels from north to south.Under the current climate conditions,the most suitable area for Astragalus membranaceus(Fisch.)Bge.var.mongholicus(Bge.)Hsiao in Shanxi Province was 15 424 km2,the suitable area was 19 856 km2,the sub suitable area was 59 436 km2,and the unsuitable area was 61 894 km2.Conclusion Based on MaxEnt model and ArcGIS software,this study predicts the distribution of suitable areas of Astragalus membranaceus(Fisch.)Bge.var.mongholicus(Bge.)Hsiao in Shanxi Province,which has certain reference value for the protection and rational distribution of Astragalus membranaceus(Fisch.)Bge.var.mongholicus(Bge.)Hsiao resources in Shanxi Province.

Objective:To investigate the short-term efficacy of the intelligent robot-assisted fracture reduction system (RAFR) in the treatment of Tile-type C1-2 pelvic fractures.Methods:A retrospective study was conducted to analyze the clinical data of the 15 patients who had been treated for Tile-type C pelvic fractures at Department of Orthopedic Trauma, Foshan Hospital of Traditional Chinese Medicine between June 2022 and November 2023. The cohort were 7 males and 8 females, with an age of (51.6±22.1) years and a body mass index of (22.35±2.14) kg/m 2. According to the Tile classification, there were 9 cases of type C1 and 6 cases of type C2. The interval from injury to surgery was (11.3±3.9) days. Minimally invasive closed reduction and internal fixation of pelvic fractures were performed with the assistance of RAFR system. The anterior pelvic ring was fixed with percutaneous hollow screws from the pubic branch, and the posterior pelvic ring fixed with percutaneous hollow screws from the sacroiliac joint. If necessary, external fixation brackets and internal stent fixation technique for the anterior pelvic ring were used to enhance the stability of the pelvic ring. The frequency and time of intraoperative fluoroscopy, reduction time, surgical time, intraoperative bleeding volume, fracture reduction quality, follow-up time, fracture healing time, pelvic function recovery at the last follow-up, and incidence of complications were recorded. Results:With the assistance of RAFR system, 15 patients were all successfully treated with minimally invasive closed reduction and internal fixation for pelvic fractures. For this cohort, intraoperative fluoroscopy frequency was 31 (20, 55) times, fluoroscopy time 25.8 (18.0, 33.0) seconds, reduction time (57.7±3.5) minutes, surgical time 205 (200, 210) minutes, intraoperative bleeding volume 100 (100, 200) mL, and residual displacement (7.55±3.51) mm. According to the Matta scoring, the postoperative quality of fracture reduction was evaluated as excellent in 4 cases, as good in 8 cases, and as fair in 3 cases. Fourteen patients were followed up for 15.0 (10.8, 18.0) months after surgery, and 1 patient was lost to the follow-up. The fracture healing time for the 14 patients was 3.6 (3.2, 4.7) months. The Majeed functional score at the last follow-up was (83.4±6.4) points, giving 4 excellent and 10 good cases.Conclusion:The RAFR system can facilitate precise and minimally invasive closed reduction for the majority of patients with Tile-type C1-2 pelvic fracture, achieving satisfactory fracture reduction quality and short-term efficacy.

Objective: To explore the efficacy and safety of clonidine adhesive patch in Tourette syndrome (TS) patients with comorbid attentiondeficit/hyperactivity disorder (ADHD). Methods: This study was conducted on a sample of children and adolescents with TS who had comorbid ADHD between May 2012 and March 2015. The patients were diagnosed according to Diagnostic and Statistical Manual of Mental Disorders Fourth Edition, and were randomly assigned to four different dose groups: 1.0 mg/week, 1.5 mg/week, 2.0 mg/week and placebo group, and the symptom was evaluated by Swanson, Nolan, and Pelham Rating Scale, Version IV (SNAP-IV) and Yale Global Tic Severity Scale scales every 2 weeks. The primary outcome was tic disorders (TD) effective rate at week 8. Results: One hundred and twenty-seven TS patients with comorbid ADHD in 2.0 mg/week (n=35), 1.5 mg/week (n=27), 1.0 mg/week (n=36) and placebo groups (n=29) were included in this subgroup analysis. The TD effective rate of the 2.0 mg, 1.5 mg, and 1.0 mg groups at week 8 were significantly better than that in placebo group (85.7%, 81.5%, and 86.1% vs. 20.7%, all p<0.0001). All groups demonstrated significant improvements in SNAP-IV total scale scores compared to baseline (p=0.0004), with treatment groups showing only a trend for better performance compared to placebo group at week 8, without statistical differences (22.1±15.41, 21.3±11.96, and 21.2±12.48 vs. 26.0±13.37, p=0.3385). A total of 9 adverse reactions occurred, all recovered spontaneously without additional medication. Conclusion Clonidine adhesive patch could safely and effectively reduce the tic symptoms of TS patients with comorbid ADHD, and might be potentially helpful in the ADHD symptoms control.