Objective To discuss the main pathological types and imaging characteristics of pulmonary nodules that are highly suspected to be malignant in clinical practice but are pathologically confirmed to be benign. Methods A retrospective analysis was performed on the clinical data of patients with pulmonary nodules who were initially highly suspected of malignancy but were subsequently pathologically confirmed to be benign. These patients were treated at the First Affiliated Hospital of Xiamen University from December 2020 to April 2023. Based on the outcomes of preoperative discussions, the patients were categorized into a benign group and a suspicious malignancy group. The clinical data and imaging characteristics of both groups were compared. Results A total of 232 patients were included in the study, comprising 112 males and 120 females, with a mean age of (50.7±12.0) years. Among these, 127 patients were classified into the benign group, while 105 patients were categorized into the suspicious malignancy group. No statistically significant differences were observed between the two groups regarding age, gender, symptoms, smoking history, or tumor history (P>0.05). However, significant differences were noted in nodule density, CT values, margins, shapes, and malignant signs (P＜0.05). Further analysis revealed that in the suspicious malignancy group, solid nodules were predominantly characterized by collagen nodules and fibrous tissue hyperplasia (33.3%), followed by tuberculosis (20.4%) and fungal infections (18.5%). In contrast, non-solid nodules were primarily composed of collagen nodules and fibrous tissue hyperplasia (41.2%) and atypical adenomatous hyperplasia (17.7%). Conclusion Benign pulmonary nodules that are suspected to be malignant are pathologically characterized by the presence of collagen nodules, fibrous tissue hyperplasia, tuberculosis, atypical adenomatous hyperplasia, and fungal infections. Radiologically, these nodules typically present as non-solid lesions and may exhibit features suggestive of malignancy, including spiculation, lobulation, cavitation, and pleural retraction.

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.

Objective: To analyze the epidemiological characteristics and trends of other infectious diarrhea among children under 18 years old in Guangzhou City from 2014 to 2020, and to explore the correlation between climatic factors and the incidence of the disease, so as to provide reference for the early prevention of infectious diseases. Methods: The data of cases of other infectious diarrhea and meteorological data of children under 18 years old in Guangzhou City from 2014 to 2020 were collected through the Chinese Infectious Disease Reporting System and the Guangzhou Meteorological Bureau. The correlation between meteorological factors and the incidence of other infectious diarrhea was analyzed using negative binomial regression. Results: A total of 104 566 cases of other infectious diarrhea among children under 18 years old were reported in Guangzhou City from 2014 to 2020, with a male to female ratio of 1.48∶1. The incidence rate was the highest in 2017 (980.83 per 100 000) and the lowest in 2020 (388.22 per 100 000). The peak of incidence occurred from October to March of the following year. Children under 5 years old accounted for 87.95% of all cases. The number of cases of other infectious diarrhea was negatively correlated with the temperature of the previous 6 days ( IRR = -0.07 ), and positively correlated with the temperature difference on the day of onset ( IRR =0.02) (both P <0.05). It was also positively correlated with the wind speed of the previous 7 days ( IRR=0.07, P <0.05), but there was no statistically significant correlation with the relative humidity on the day of onset ( IRR=-0.00, P >0.05). Conclusions Low temperature, large temperature difference, and high wind speed can increase the risk of other infectious diarrhea. It is necessary to strengthen the prediction and early warning in conjunction with meteorological changes, and warn kindergartens and schools to enhance preventive measures against the clustering of other infectious diarrhea cases.

Objective: To understand the current status of acquired immunodeficiency syndrome (AIDS) knowledge, attitudes, and practices of college students in Tianjin City and to further investigate the associated factors of high risk sexual behaviors, so as to provide a scientific and theoretical basis for accurate prevention and treatment of AIDS. Methods: A stratified cluster random sample of 64 697 students in 56 colleges and universities in Tianjin City in November to December 2022 was investigated about the current status of AIDS knowledge, attitudes and practices. Information was collected using online survey via Questionnaire Star. Descriptive analysis was used for the current status of AIDS knowledge, attitudes and practices among college students. Chi square test and multiple Logistic regression analysis were used to analyze the influencing factors of high risk sexual behavior among college students. Results: The AIDS awareness rate of college students in Tianjin City reached 87.33%. The sexual openness rate was 70.73 %. Among the 3 463 students who had sex during the past year, 42.13% of students reported high risk sexual behavior. Multivariate Logistic regression showed that female, having a romantic partner, having received sex education and prevention and treatment knowledge of AIDS were negatively associated with high risk sexual behavior ( OR =0.66, 0.59, 0.81, 0.59, P <0.05). Being in sophomore year, non heterosexuality (homosexuality, bisexuality, not knowing), prejudice against AIDS, and misunderstanding the testing methods for AIDS showed positive correlations with highrisk sexual behavior ( OR =1.22, 2.49, 2.30, 3.17, 1.43, 1.22 , P <0.05). Conclusions The awareness rate of AIDS in college students in Tianjin is high, but high risk sexual behaviors are still at a high level. Further targeted knowledge education and behavioral interventions are needed to scientifically prevent the spread of AIDS.

Objective:To understand the prevalence of psychoactive substance use and its related factors in young men who have sex with men (YMSM) in Tianjin.Methods:From September 2017 to December 2022, a face-to-face anonymous questionnaire survey was conducted in MSM aged 16-24 years selected by snowball sampling in Tianjin, the main demographic and behavioral information of the YMSM were collected, and blood samples were collected from them for HIV test. Multivariate logistic regression analysis was used to identify related factors of psychoactive substances use.Results:A total of 2 919 YMSM were included in the study, in whom 47.1% (1 374/2 919) had ever used psychoactive substances. The rate of psychoactive substance use in YMSM who were not students was 51.6% (853/1 653), which was higher than that (41.2%, 521/1 266) in YMSM who were students ( χ2=31.42, P<0.001). In the YMSM who were not students, multivariate analysis showed that the OR of psychoactive substance use was 1.49 times higher in smokers than in non-smokers (95% CI: 1.17-1.84), 4.14 times higher in those who had anal sex in the past six months than in those who had no anal sex (95% CI: 1.71-9.98), 1.65 times higher in those who had ≥3 anal intercourses in the last week than in those who had <3 anal intercourses (95% CI: 1.27-2.14), 1.99 times higher in those who had commercial sex in the past six months than in those who had no homosexual commercial sex (95% CI: 1.14-3.45), 2.37 times higher in those who had HIV test in the last year than in those who had no HIV test (95% CI: 1.90-2.94), 1.89 times higher in those who had STD diagnosis in the last year than in those who had no STD diagnosis (95% CI: 1.11-3.21), 0.66 times higher in those who had the first homosexual sex at age ≥20 years than in those who had the first homosexual sex at age <20 years (95% CI: 0.52-0.83), 0.48 times higher in those who were heterosexual or bisexual than in those who were homosexual (95% CI: 0.30-0.74) and 0.70 times higher in those who mainly searched sexual partners offline than in those who mainly searched sexual partners online (95% CI: 0.53-0.94). Meanwhile, in the YMSM who were students, multivariate analysis showed that the OR of psychoactive substance use was 1.31 times higher in local residents than in non-local residents (95% CI: 1.02-1.69), 1.61 times higher in smokers than in non-smokers (95% CI: 1.14-2.27), 1.52 times higher in those who had ≥3 anal intercourses in the last week than in those who had <3 anal intercourses (95% CI: 1.05-2.19), 3.31 times higher in those who had STD diagnosis in the last year than in those who had no STD diagnosis (95% CI: 1.68-6.50) and 0.53 times higher in those in Han ethnic group than in those in minor ethnic groups (95% CI: 0.30-0.94). Conclusions:The prevalence of psychoactive substance use was high in YMSM in Tianjin, and the influencing factors varied in different groups (students or not). It is necessary to conduct targeted interventions for different groups.

Objective To explore the value of preoperative detection of soluble fragments of cytokeratin-19 (CYFRA21-1), carcinoembryonic antigen (CEA), and postoperative detection of nuclear proliferation associated antigen Ki67 in prognostic evaluation of non-small cell lung cancer patients. Methods The clinicopathological data and follow-up results of patients with non-small cell lung cancer treated in the Department of Thoracic Surgery of the First Affiliated Hospital of Xiamen University in 2017 were collected. CYFRA21-1>3.39 ng/mL was defined as positive, and CEA>5 ng/mL was defined as positive. The receiver operating characteristic curve (ROC curve) of Ki67 expression level was drawn. The maximum area under the curve (AUC) was the cutoff value of Ki67 expression level, and the Ki67 expression level greater than its cutoff value was defined as positive. Cox regression analysis was used to determine the independent risk factors for poor prognosis in patients with non-small cell lung cancer. Results Finally 248 patients were collected, including 125 males and 123 females, with a median age of 61 years (ranging from 30 to 81 years) at the time of surgery. Univariate analysis showed that positive CYFRA21-1, high expression of Ki67, positive CEA, age≥60 years at operation, distant metastasis, lymph node metastasis, maximum tumor diameter>3 cm, and TNM stage Ⅲ were associated with poor prognosis in patients with non-small cell lung cancer. When combined detection of preoperative tumor markers and postoperative Ki67, the prognosis of all negative patients was the best, and that of all positive patients was the worst. Cox regression analysis showed that positive CEA+positive CYFRA21-1+high expression of Ki67 was an independent risk factor for poor prognosis in patients with non-small cell lung cancer (P<0.05). Conclusion The combined detection of preoperative serum CYFRA21-1, CEA, and postoperative Ki67 has important value in evaluating the prognosis of non-small cell lung cancer patients.

[Objective]To investigate the effect of salidroside on calcification of vascular smooth muscle cells (VSMCs) and explore its underlying mechanism.[Methods]VSMCs were cultured in high-phosphate media to induce vascular calcification and treated with different concentrations of salidroside. Cell calcification was tested by alizarin red staining and calcium content assay. qRT-PCR and western blotting were used to determine the expression levels of osteogenic proteins including runt-related transcription factor 2 (RUNX2) and bone morphogenetic protein 2 (BMP2),toll-like receptor 4 (TLR4),nuclear factor kappa-B p65 (NF-κB p65),phosphorylated nuclear factor kappa-B p65 (p-NF-κB p65),inflammatory factors including Interleukin-1 beta (IL-1β) and Interleukin-6 (IL-6). We transfected VSMCs with TLR4 small interfering RNA (si-TLR4) and examined whether TLR4 mediated the inhibitory effect of salidroside on calcification of VSMCs.[Results]Alizarin red staining and calcium content assay revealed that different concentrations of salidroside ameliorated high phosphate-induced calcification of human VSMCs (P<0.05). Salidroside at concentrations of 250 and 500 μmol/L decreased the expression levels of RUNX2,BMP2,TLR4,p-NF-κB p65,IL-1β and IL-6 (all P<0.05),but did not affect NF-κB p65 expression (P>0.05). The examination of VSMCs transfected with si-TLR4 showed that salidroside enhanced the inhibitory effect of TLR4 knockdown on calcification of VSMCs (P<0.05).[Conclusions]Salidroside attenuates high phosphate-induced calcification of VSMCs via inhibiting TLR4/NF-κB pathway.

Taking Kunming Medical University as an example, we explore the mechanism for the separation and coordination of supervision, management, and evaluation, establish and implement a course quality rating system, and strengthen the course quality evaluation. The course quality rating system mainly consists of merit evaluation for courses of grades A and B and admittance evaluation for courses of grades C and D. Through the course quality rating, courses are diagnosed and compared, with the aim to improve course connotation construction (labeling, setting an example, promoting excellent courses, and removing inferior courses), achieve "good pay for good courses", encourage the faculty to strengthen curriculum quality, and measure ourselves with our own ruler. We discussed the problems about the difference in evaluation indicators, the professionality of evaluators, and the incentive effect of evaluation results, and also proposed strategies for improving course quality rating in medical colleges from the perspectives of deepening the content of evaluation indices, ensuring the effectiveness after evaluation, and ascertaining the main body of course construction in daily work.

Objective To investigate the effect of interaction between serum neutrophil gelatinase-associat-ed lipid carrier protein(NGAL)and complications after percutaneous coronary intervention(PCI)on poor prognosis in patients with ST-segment elevation myocardial infarction(STEMI),and to provide reference for improving prognosis.Methods From January 2017 to January 2020,a total of 400 STEMI patients admitted to this hospital were selected and divided into good prognosis group(n=378)and poor prognosis group(n=22)according to their 2-year prognosis.Logistic regression equations were used to analyze the prognostic fac-tors of STEMI patients,and multiplicative and additive effects were established to analyze the effect of the in-teraction between serum NGAL and post-PCI complications on poor prognosis.Results Gender,age,heart rate,Gensini score,number of lesions ≥2,Killip grade,complications after PCI and NGAL level after PCI were associated with poor prognosis in STEMI patients(P＜0.05).Gender(female),age,heart rate,Gensini score,number of lesions ≥2,Killip grade,complications after PCI and NGAL level after PCI were all inde-pendent influencing factors of poor prognosis in STEMI patients(P＜0.05).There was interaction between serum NGAL after PCI and complications after PCI,both of which had an adverse effect on the prognosis of STEMI patients(P＜0.05).There was no multiplicative interaction between serum NGAL and complications after PCI(P＞0.05).When serum NGAL and complications after PCI were exposed at the same time,the risk of poor prognosis in STEMI patients was higher than the sum of the two exposures alone,and the interaction was 2.611 times the sum of the effects of the two exposures alone.Conclusion Serum NGAL and postopera-tive complications after PCI are independent factors influencing poor prognosis in STEMI patients.There is a additive interaction between the two factors,and exposure can increase the risk of poor prognosis.

Objective To compare the efficacy and safety of vedolizumab(VDZ)and infliximab(IFX)for moderate to severe ulcerative colitis(UC)patients through a multicenter retrospective cohort study.Methods All patients with moderate to severe UC who were naive to biologic agents and treated with IFX or VDZ for at least 14 weeks at 3 hospitals in Southwest China between January 2021 and January 2023 were retrospectively enrolled.The efficacy evaluation indicators,including steroid-free clinical remission rates,clinical remission rates and endoscopic remission rates at weeks 14 and 52 were compared between the 2 groups.The occurrence of adverse events during treatment were recorded.Taking whether mucosal healing could be achieved after 14 and 52 weeks of treatment as the dependent variable,firstly,univariate analysis was performed to analyze the risk factors affecting mucosal healing at weeks 14 and 52,and then multivariate logistic regression analysis was applied to identify the independent risk factors of mucosal healing at the 2 time points.Results A total of 151 patients with moderate to severe UC were included,after propensity score matching(PSM),each group included 57 patients.There were no significant differences in the steroid-free clinical remission rate and clinical remission rate between the 2 groups at weeks 14 and 52(P＞0.05).The endoscopic remission rate at week 14 was significantly higher in the VDZ group than the IFX group[40.4％(23/57)vs 22.8％(13/57),P=0.044],but no such difference was observed at week 52[64.5％(20/31)vs 59.5％(22/37),P=0.669].Multivariate logistic regression analysis showed that left-sided disease(E2)[vs pancolitis(E3)](OR=0.46,95％CI:0.21～0.98,P=0.045)was independent risk factor for mucosal healing at week 14 and a disease duration ≥36 months(OR=0.25,95％CI:0.09～0.66,P=0.005)was independent risk factor for mucosal healing at week 52.No statistical difference was observed in the incidence of adverse events between the 2 groups(1.8％vs 7.0％,P=0.360).Conclusion VDZ and IFX have similar efficacy and safety,and both can be used as first-line options for patients with moderate to severe UC.