Objective: To construct a scientific and perfect evaluation index system of infectious disease prevention and control ability in colleges and universities, so as to provide reference tools for colleges and universities to effectively respond to infectious disease. Methods: The initial framework of the evaluation index system of infectious disease prevention and control ability in colleges and universities was constructed by using literature analysis method. Experts familiar with infectious disease prevention and control or school health work were selected to conduct two rounds( n =16，18) of Delphi expert consultation for determining the evaluation index system. Analytical hierarchy process was used to calculate the index weights and combined weights. About 198 prevention and control personnel were conveniently selected from 3 universities in Inner Mongolia Autonomous Region to comprehensively evaluate the evaluation indicators by using fuzzy comprehensive evaluation method. Results: After two rounds of Delphi consultation questionnaire, the effective recovery rates were 80.0% and 90.0%, the expert authority levels were 0.89 and 0.86, the expert harmony coefficients for Kendall W were 0.166 and 0.310, and the variation coefficient of each index was <0.25. Finally, the evaluation index system of infectious disease prevention and control ability of colleges and universities included 4 first level indicators, 14 second level indicators and 75 third level indicators. The weights of prevention and monitoring and early warning, organizational system guarantee, emergency management, rehabilitation and summary were 0.176, 0.476, 0.268 and 0.080, respectively. The top 3 weights of the secondary indexes were 0.623 for infectious disease surveillance and early warning, 0.595 for loss assessment and 0.370 for emergency response. The score of fuzzy comprehensive evaluation of the index system of infectious disease prevention and control ability in colleges and universities was 79.148, suggesting a high level. Conclusion The established evaluation index system of infectious disease prevention and control ability in colleges and universities is scientific and reasonable, which is conducive to provide tool reference for the evaluation of infectious disease prevention and control ability in colleges and universities.

To investigate the awareness of cognitive impairment disorders among residents of the Xizang Autonomous Region and its influencing factors, thereby providing a basis for targeted prevention and treatment efforts.

Morita therapy has been bom for more than 100 years.Inpatient Morita therapy is highly oper-able and easy to master.It can improve many refractory neuroses through four-stage treatment.But more neuroses are treated in outpatient clinics,and Morita therapy cannot be used in hospitalized patients.Therefore,the formula-tion of expert opinions on outpatient operations is particularly important.This paper is based on domestic and for-eign references,and after many discussions by domestic Morita therapy experts,and then drew up the first version of the expert opinions on operation of outpatient Morita therapy.Meanwhile the operation rule of Morita therapy in three stages of outpatient treatment was formulated:in the etiological analysis stage,under the theoretical guidance of Morita therapy,analyze the pathogenic factors,to improve treatment compliance and reduce resistance;during the operating stage,guide patients to engage in constructive and meaningful actions,realizing the achievement of letting nature take its course principle;in the cultivating character and enriching life stage,pay attention to positive infor-mation,expanding the scope and content of actions,improving the ability to adapt to complex life,and preventing recurrence caused by insufficient abilities.It will lay a foundation for the promotion of Morita therapy in domestic outpatient clinics,so that more patients with neurosis and other psychological diseases could receive characteristic Morita therapy treatment in outpatient clinics.

Objective To evaluate the potential risk of transmission of angiostrongyliasis by common freshwater snails in Dali Bai Autonomous Prefecture, Yunnan Province, so as to provide insights into local surveillance of angiostrongyliasis. Methods Common freshwater snails were collected from Dali Bai Autonomous Prefecture, Yunnan Province from March to April, 2020, and identified and bred in laboratory. SD rats were infected with third-stage larvae of Angiostrongylus cantonensis that were isolated from commercially available Pomacea canaliculata snails in Dali Bai Autonomous Prefecture, and freshwater snails were infected with the first-stage larvae of A. cantonensis that were isolated from the feces of SD rats 39 days post-infection at room temperature. The developmental process and morphological characteristics of worms in hosts were observed, and the percentages of A. cantonensis infections in different species of freshwater snails were calculated. Then, SD rats were infected with the third-stage larvae of A. cantonensis that were isolated from A. cantonensis-infected freshwater snails, and the larval development and reproduction was observed. Results More than 3 000 freshwater snail samples were collected from farmlands, ditches and wetlands around Erhai Lake in Dali Bai Autonomous Prefecture, and Cipangopaludina chinensis, P. canaliculata, Parafossarulus striatulus, Oncomelania hupensis robertsoni, Galba pervia, Physa acuta, Radix swinhoei, Assiminea spp., Tricula spp. and Bellamya spp. were morphologically identified. A total of 105 commercially available P. canaliculata snails were tested for A. cantonensis infections, and 2 P. canaliculata snails were found to be infected with A. cantonensis, in which the third-stage larvae of A. cantonensis were isolated. Ten species of freshwater snails were artificially infected with the third-stage larvae of A. cantonensis, and all 10 species of freshwater snails were found to be infected with A. cantonensis, with the highest positive rate of A. cantonensis infections in Bellamya spp. (62.3%, 137/204), and the lowest in C. chinensis (35.5%, 11/31). After SD rats were infected with the third-stage larvae of A. cantonensis isolated from different species of freshwater snails, mature adult worms of A. cantonensis were yielded. Conclusions Multiple species of freshwater snails may serve as intermediate hosts of A. cantonensis under laboratory conditions in Dali Bai Autonomous Prefecture of Yunnan Province. Further investigations on natural infection of A. cantonensis in wild snails in Dali Bai Autonomous Prefecture seem justified.

Objective:To assess the effectiveness of a 6-month Ba Duan Jin exercise program in improving the balance of community-dwelling older adults.Methods:A two arms, parallel-group, cluster randomized controlled trial was conducted in 1 028 community residents aged 60-80 years in 40 communities in 5 provinces of China. Participants in the intervention group (20 communities, 523 people) received Ba Duan Jin exercise 5 days/week, 1 hour/day for 6 months, and three times of falls prevention health education, and the control group (20 communities, 505 people) received falls prevention health education same as the intervention group. The Berg balance scale (BBS) score was the leading outcome indicator, and the secondary outcome indicators included the length of time of standing on one foot (with eyes open and closed), standing in a tandem stance (with eyes open and closed), the closed circle test, and the timed up to test.Results:A total of 1 028 participants were included in the final analysis, including 731 women (71.11%) and 297 men (28.89%), and the age was (69.87±5.67) years. After the 3-month intervention, compared with the baseline data, the BBS score of the intervention group was significantly higher than the control group by 3.05 (95% CI: 2.23-3.88) points ( P<0.001). After the 6-month intervention, compared with the baseline data, the BBS score of the intervention group was significantly higher than the control group by 4.70 (95% CI: 4.03-5.37) points ( P<0.001). Ba Duan Jin showed significant improvement ( P<0.05) in all secondary outcomes after 6 months of exercise in the intervention group compared with the control group. Conclusions:This study showed that Ba Duan Jin exercise can improve balance in community-dwelling older adults aged 60-80. The longer the exercise time, the better the improvement.

Concurrent chemoradiotherapy (CCRT) refers to the simultaneous treatment of chemotherapy and radiotherapy, and the effect of radiotherapy is enhanced with low-dose chemotherapy, which can reduce tumor recurrence and metastasis and improve clinical prognosis of patients. At present, the main factors for the increase of radiosensitivity of concurrent chemotherapy is that concurrent chemotherapy prevents the repair of tumor cells, and chemotherapy and radiotherapy act on different cell cycles and have synergistic effects. However, even for patients with locally advanced cervical cancer (LACC) who have undergone CCRT, the 5-year survival rate is only 60%, which is still not ideal. In order to improve the efficacy, researchers have conducted a series of exploratory studies, which consist of the combination of targeted drugs and immunodrugs, and neoadjuvant regimens before CCRT, etc. Although targeted or immunologic drugs are effective treatment of LACC, in view of the lack of large-scale evidence-based medical evidence, multi-center prospective and randomized phase III clinical trials and high-level articles are needed to improve the level of evidence-based medicine. This consensus summarizes several key evidence-based medical studies published recently, especially the clinical research progress in targeted and immunological therapies, providing reference for domestic peers.

Objective:To explore the current status of intrinsic capacity in elderly patients with hospitalization-associated disability (HAD) and explore its influencing factors.Methods:From November 2023 to January 2024, convenience sampling was used to select 203 elderly patients with HAD at Xuanwu Hospital of Capital Medical University as the study subjects. A survey was conducted on elderly patients using the General Information Questionnaire, Fried Frailty Phenotype, Barthel Index, Social Support Rating Scale, and Intrinsic Capacity Assessment Tool. Binomial Logistic regression was used to analyze the influencing factors of intrinsic capacity in elderly patients with HAD.Results:A total of 203 questionnaires were distributed, and 199 valid questionnaires were collected, with a valid response rate of 98.03% (199/203). The total score of intrinsic capacity in 199 elderly patients with HAD was 5.00 (4.00, 6.00), with scores for cognitive dimension, psychological dimension, motor dimension, vitality dimension, and sensory dimension being 1.00 (1.00, 2.00), 2.00 (1.00, 2.00), 0 (0, 1.00), 1.00 (1.00, 1.00) and 1.00 (1.00, 1.00), respectively. The binomial Logistic regression showed that department of medicine and surgery, self-rating health status, social support, serum albumin, and Barthel Index were the influencing factors of intrinsic capacity in elderly patients with HAD ( P<0.05) . Conclusions:The intrinsic capacity of elderly patients with HAD is at medium to low level, with the most severe impairment in the motor dimension. Medical and nursing staff should develop personalized rehabilitation measures for elderly HAD patients based on the influencing factors of their intrinsic capacity, enhance their intrinsic capacity, and reduce the burden of care on families and society.

Objective:To analyze the etiology and risk factors of Zang nationality cerebral infarction patients of different ages in Xizang Autonomous Region, so as to provide basis for more targeted diagnosis, treatment and prevention of cerebral infarction in this region.Methods:The clinical data of 500 Zang nationality cerebral infarction patients hospitalized in Xizang Autonomous Region People′s Hospital from January 2019 to December 2023 were retrospectively analyzed. According to age, they were divided into young and middle-aged group (18-59 years old) and elderly group (60-75 years old). Baseline data, laboratory data and imaging results of patients in each group were collected and retrospectively analyzed.Results:The proportion of males in the young and middle-aged group ( n=267) [188 (70.41%)] was higher than that in the elderly group ( n=233) [130 (55.79%), χ 2=11.485, P=0.001]. The proportion of smokers [131 (49.06%) vs 74 (31.76%), χ 2=15.401], drinkers [121 (45.32%) vs 84 (36.05%), χ 2=4.417], high altitude polycythemia (HAPC)[ 51 (19.10%) vs 23 (9.87%), χ 2=8.406], hyperuricemia (HUA)[ 61 (28.90%) vs 34 (19.32%), χ 2=4.766], increased hemoglobin [152 (56.93%) vs 97 (41.63%), χ 2=6.677], hypertriglyceridemia [47 (17.60%) vs 18 (7.73%), χ 2=10.734], hypercholesterolemia [12 (4.94%) vs 3 (1.29%), χ 2=4.397], hyperlipidemia [79 (29.59%) vs 43 (18.45%), χ 2=8.360] in the young and middle-aged group was higher than that in the elderly group (all P<0.05). The proportion of hypertension [108 (40.44%) vs 158 (67.81%), χ 2=37.413], atrial fibrillation [5 (1.87%) vs 20 (8.58%), χ 2=11.797], hyperhomocysteinemia (HHcy)[159 (59.55%) vs 168 (72.10%), χ 2=8.664], abnormal creatinine [18 (6.74%) vs 29 (12.45%), χ 2=4.755], atherosclerosis [113 (42.32%) vs 145 (62.23%), χ 2=19.748], heart disease [135 (50.56%) vs 150 (64.38%), χ 2=9.690] in the young and middle-aged group was lower than that in the elderly group (all P<0.05). Multivariate Logistic regression analysis showed that hypertension ( OR=2.865, 95% CI 1.742-4.710) and HHcy ( OR=1.968, 95% CI 1.177-3.290) were risk factors of cerebral infarction in the elderly group. Smoking ( OR=1.848, 95% CI 1.017-3.360), HAPC ( OR=1.993, 95% CI 1.991-4.011), HUA ( OR=1.863, 95% CI 1.015-3.419) and living at the extremely high altitude ( OR=2.405, 95% CI 1.207-4.791) were risk factors of cerebral infarction in the young and middle-aged group. According to the TOAST etiological classification, the causes of stroke of other determined etiology and stroke of other undetermined etiology were complex and diverse, which were more common in the young and middle-aged group, while cardiac embolism was more common in the elderly group. Conclusions:There are significant differences in the risk factors and etiology of cerebral infarction in different age groups in Xizang Autonomous Region. The occurrence of cerebral infarction in elderly patients is significantly related to hypertension and HHcy, while the occurrence of cerebral infarction in young and middle-aged patients is significantly related to smoking, HAPC, HUA, and living in extremely high altitude areas. In clinical practice, diagnosis and treatment of cerebral infarction patients in different age groups should have different focuses.

Tyrosine kinase inhibitors (TKIs) have revolutionized the treatment landscape for chronic myeloid leukemia (CML). However, TKI resistance poses a significant challenge, leading to treatment failure and disease progression. Resistance mechanisms include both BCR::ABL1-dependent and BCR::ABL1-independent pathways. The mechanisms underlying BCR::ABL1 independence remain incompletely understood, with CML cells potentially activating alternative signaling pathways, including the AKT/mTOR and JAK2/STAT5 pathways, to compensate for the loss of BCR::ABL1 kinase activity. This study explored tumoral VISTA (encoded by VSIR) as a contributing factor to TKI resistance in CML patients and identified elevated tumoral VISTA levels as a marker of resistance and poor survival. Through in vitro and in vivo analyses, we demonstrated that VSIR knockdown and the application of NSC-622608, a novel VISTA inhibitor, significantly impeded CML cell proliferation and induced apoptosis by attenuating the AKT/ mTOR and JAK2/STAT5 pathways, which are crucial for CML cell survival independent of BCR::ABL1 kinase activity. Moreover, VSIR overexpression promoted TKI resistance in CML cells. Importantly, the synergistic effect of NSC-622608 with TKIs offers a potent therapeutic avenue against both imatinib-sensitive and imatinib-resistant CML cells, including those harboring the challenging T315I mutation. Our findings highlight the role of tumoral VISTA in mediating TKI resistance in CML, suggesting that inhibition of VISTA, particularly in combination with TKIs, is an innovative approach to enhancing treatment outcomes in CML patients, irrespective of BCR::ABL1 mutation status. This study not only identified a new pathway contributing to TKI resistance but also revealed the possibility of targeting tumoral VISTA as a means of overcoming this significant clinical challenge.

Background In the context of improving urban environment for healthy aging, it is necessary to rationally plan and provide community living space and public service facilities suitable for the elderly, and constantly optimize the built environment towards an age-friendly city. Objective To understand the relationship between community built environment and obesity in the elderly in Longgang City, and to provide a reference basis for improving the health of the elderly. Methods Elderly adults aged 60-90 years (n=6527) who completed a physical examination during the period from October 2020 to January 2021 in Longgang City were surveyed, and data on height and weight, waist circumference (WC), and other sociological demographic characteristics were obtained. Overweight was determined by 24 kg·m⁻² ≤ body mass index (BMI) < 28 kg·m⁻² and obesity by BMI ≥ 28 kg·m⁻². Men with WC ≥ 85 cm and women with WC ≥ 80 cm were considered central obesity. Based on the participants' residential addresses, geocoding was performed using a geographic information system, and built environment indicators such as restaurants, convenience stores, and basic medical facilities were obtained using Gaode Map. A binary logistic regression model with adjusted individual-level covariates was used to evaluate the relationship between obesity and built environment indicators among elderly adults by gender and age. Results Among the 6527 community elderly, 46.93% were male and 53.07% were female, with a mean age of (73.69±0.07) years, a mean BMI of (24.32±2.84) kg·m⁻², and 51.92% of the elderly were overweight or obese. The regression results showed that for elderly men, the more convenience stores and the higher mixed land use in residential areas, the higher risk of central obesity; however, the increases in street connectivity and accessibility to parks and recreational areas were associated a decreased risk of central obesity. The prevalence of overweight/obesity was higher among elderly women with more convenience stores in residential areas, while increased street connectivity was associated with a lower prevalence of central obesity among elderly women. Accessibility to primary health care facilities was negatively associated with the risk of central obesity among the 60- to 70-year-olds. For elderly residents aged 71−80 years, higher mixed land use and better accessibility to transit stations were associated with a higher prevalence of overweight/obesity, while street connectivity was negatively associated with the central obesity. Proximity to parks and recreational areas was associated with a reduced risk of overweight/obesity among the 81- to 90-year-olds. Conclusion Among the variables of a 500-m neighborhood built environment, the number of convenience stores, mixed land use, street connectivity, accessibility to primary health care facilities, accessibility to public transit stations, and accessibility to parks and recreational areas are correlated with obesity among elderly residents, and the degree of influence varies by gender and age.