The onset of cognitive dysfunction related to cerebral small vessel disease(CSVD)is often occult,with unclear pathogenesis and diverse clinical manifestations,which is difficulty to be early diagnosed.The changes of brain structure-function coupling and neurovascular coupling in CSVD patients play an important role in the occurrence of related cognitive dysfunction.The progresses of MRI researches on different dimension couplings of brain in patients with cognitive dysfunction related to CSVD were reviewed in this article.

This article introduces the development history of educational technology to better understand the role of current educational technology in medical education. These technologies include behaviorism and computer-assisted teaching as well as constructivism and virtual situational technique. The article also demonstrates the application status of key technologies in medical education such as online learning, artificial intelligence, learning behavior analysis, and virtual simulation. This shows how modern educational technologies promote the realization of new teaching concepts and the emergence of new learning paradigms. The article finally provides an outlook of medical education development with the emerging technologies and the directions of research in the application of educational technologies.

Objective:To investigate the clinical, pathological and CT characteristics of lung adenocarcinoma patients with epidermal growth factor receptor (EGFR) 19 and 21 exon mutations.Methods:Clinical, pathological and imaging data of 683 patients with lung adenocarcinoma in the First Affiliated Hospital of Chongqing Medical University from December 2012 to December 2020 were retrospectively analyzed. According to the gene mutation status, patients were divided into EGFR common loci mutation group (exons 19 or 21) with 382 cases (mutation group), including 19 exon mutation in 165 cases (exon 19 mutation subgroup) and 21 exon mutation in 217 cases (exon 21 mutation subgroup), and EGFR negative mutation group with 301 cases (negative mutation group). Independent sample t-test and χ 2 test were used to compare those features between mutation group and negative mutation group, exon 19 mutation subgroup and exon 21 mutation subgroup. The indicators with statistically significant differences in univariate analysis were included in binary logistic regression analysis to screen out independent predictors and establish the model. Receiver operating characteristic curve and area under curve (AUC) were used to evaluate the predictive performance of the model or index. Results:There were significant differences between mutation group and negative mutation group in gender distribution, smoking history, the proportion of solid-dominated growth pattern, peripheral distribution, tumor maximum diameter (3 cm as the cut-off point) distribution, spiculation, ground-glass opacity (GGO), air bronchogram, vascular convergence sign, pleural retraction, the number of lung metastases (10 as the cut-off point), pleural effusion, necrosis, and lymph node metastasis in lung adenocarcinoma patients ( P<0.05). The logistic regression showed that female (OR=5.230,95%CI 3.534-7.740, P<0.001), non-smoking history (OR=2.970, 95%CI 1.986-4.443, P<0.001), GGO (OR=3.092, 95%CI 1.746-5.477, P<0.001), absence of necrosis (OR=1.754, 95%CI 1.047-2.939, P=0.033), vascular convergence sign (OR=3.129, 95%CI 1.971-4.969, P<0.001), pleural retraction (OR=2.434, 95%CI 1.680-3.526, P<0.001), and the number of lung metastases≥10 (OR=2.242, 95%CI 1.284-3.915, P=0.005) were independent predictors of EGFR exon 19 and 21 mutations, and the AUC of the logistic model based on these predictors in predicting EGFR exon 21 and 19 mutations in lung adenocarcinoma was 0.804. There were significant differences between EGFR exon 19 mutation subgroup and EGFR 21 mutation subgroup in gender distribution, the proportion of acinar-dominated growth pattern, peripheral distribution, vascular convergence sign, pleural retraction ( P<0.05). The logistic regression showed that vascular convergence sign (OR=1.833, 95%CI 1.187-2.831, P=0.006) was independent predictor of EGFR exon 21, the AUC of vascular convergence sign for distinguishing EGFR exon 19 and EGFR 21 mutation was 0.604. Conclusions:There are some differences in the clinical, pathological, and CT features of patients between EGFR common loci mutation and EGFR negative mutations, EGFR exon 19 and exon 21 mutations in lung adenocarcinoma. Familiarity with these differences is helpful for the individualized treatment of patients with unknown gene mutation status of lung adenocarcinoma.

China has classified the Corona Virus Disease 2019(COVID-19) as a statutory category B infectious disease and managed it according to Category B since January 8, 2023.In view that Omicron variant is currently the main epidemic strain in China, in order to guide the treatment of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infection in children with the times, refer to the Diagnosis and Treatment Protocol for Novel Coronavirus Infection (Trial 10 th Edition), Expert Consensus on Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fourth Edition) and the Diagnosis and Treatment Strategy for Pediatric Related Viral Infections.The Expert Consensus on the Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fifth Edition) has been formulated and updated accordingly on related etiology, epidemiology, pathogenic mechanism, clinical manifestations, auxiliary examination, diagnosis and treatment, and added key points for the treatment of COVID-19 related encephalopathy, fulminating myocarditis and other serious complications for clinical reference.

【Objective】 To estimate the prevalence, associated factors and patterns of multimorbidity of non-communicable diseases among adults in Shaanxi Province so as to provide evidence for the prevention and control of non-communicable diseases. 【Methods】 We used the data of adults aged 18 years and older collected in the baseline survey of Shaanxi Project in the Regional Ethnic Cohort Study in Northwest China. Multinomial logistic regression was used to explore the associated factors for multimorbidity. Exploratory factor analysis was used to extract patterns of multimorbidity. 【Results】 The prevalence of multimorbidity was 10.7% among the 44 442 participants. Age increase, being males, urban residence, and being overweight or obesity were positively associated with multimorbidity. Compared with women, men had a higher risk of multimorbidity. The OR and 95% CI was 1.25 (1.12-1.39). The risk of multimorbidity increased with age among adults. Compared with participants aged 18.0-34.9 years, the ORs and 95% CIs of those aged 35.0-44.9, 45.0-54.9, 55.0-64.9, and ≥65.0 years were 4.73 (3.47-6.46), 15.61 (11.60-21.00), 41.39 (30.76-55.70) and 90.04 (66.58-121.77), respectively. The primary multimorbidity patterns among adults in Shaanxi were cardiovascular-metabolic multimorbidity (5.4%), viscero-articular multimorbidity (1.0%), and respiratory multimorbidity (0.3%). 【Conclusion】 More than one in ten adults in Shaanxi Province had multimorbidity, and the predominant pattern of multimorbidity was cardiovascular-metabolic multimorbidity. The prevention and control of non-communicable diseases should be reinforced in middle-aged and older people, males, people living in the urban, and overweight or obese people. More attention should be paid to the prevention and control of cardiovascular-metabolic diseases.

Monkeypox is a zoonotic disease.Previous studies have shown that children are vulnerable to monkeypox and are also at high risk for severe disease or complications.In order to improve pediatricians′ understanding of monkeypox and achieve early detection, early diagnosis, early treatment and early disposal, the committee composed of more than 40 experts in the related fields of infectious diseases, pediatrics, infection control and public health formulate this expert consensus, on the basis of the latest clinical management and infection prevention and control for monkeypox released by the World Health Organization (WHO), the guidelines for diagnosis and treatment of monkeypox (version 2022) issued by National Health Commission of the People′s Republic of China and other relevant documents.During the development of this consensus, multidisciplinary experts have repeatedly demonstrated the etiology, epidemiology, transmission, clinical manifestations, laboratory examinations, diagnosis and differential diagnosis, treatment, discharge criteria, prevention, case management process and key points of prevention and control about monkeypox.

Since December 2019, severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infections have raged globally for more than 2 years.China has always adopted scientific and effective prevention and control measures to achieved some success.However, with the continuous variation of SARS-CoV-2 cases and imported cases from abroad, the prevention and control work has become more difficult and complex.With the variation of the mutant strain, the number of cases in children changed, and some new special symptoms and complications were found, which proposed a new topic for the prevention and treatment of SARS-CoV-2 infection in children in China.Based on the third edition, the present consensus according to the characteristics of the new strain, expounded the etiology, pathology, pathogenesis, and according to the clinical characteristics and experience of children′s cases, and puts forward recommendations on the diagnostic criteria, laboratory examination, treatment, prevention and control of children′s cases for providing reference for further guidance of effective prevention and treatment of SARS-CoV-2 infection in children in China.

In 2012, Chongqing Medical University was approved to be the first batch of pilot universities in China for excellent doctor education and training program, which started the exploration of "early clinical, multi-clinical and repeated clinical" for medical students, and put it into practice in clinical medicine of Batch 2015 ("5+3" integrated specialty). This paper applies the methods of literature research, questionnaire survey and empirical research to understand the needs and suggestions of students for clinical practice. It is suggested that the concept of "early clinical practice" should be integrated into the theoretical teaching, the teaching method of "case introduction" should be adopted in the course of integrated medicine education, the course of Clinical Skills should be reformed, the clinical practice activities such as "early admission to the ward" should be carried out, and the evaluation system of clinical practice should be rebuilt, hoping to provide references for the exploration of "early clinical, multi-clinical and repeated clinical" in medical education of other colleges and universities.

2019 novel coronavirus(2019-nCoV) outbreak is one of the public health emergency of international concern.Since the 2019-nCoV outbreak, China has been adopting strict prevention and control measures, and has achieved remarkable results in the initial stage of prevention and control.However, some imported cases and sporadic regional cases have been found, and even short-term regional epidemics have occurred, indicating that the preventing and control against the epidemic remains grim.With the change of the incidence proportion and the number of cases in children under 18 years old, some new special symptoms and complications have appeared in children patients.In addition, with the occurrence of virus mutation, it has not only attracted attention from all parties, but also proposed a new topic for the prevention and treatment of 2019-nCoV infection in children of China.Based on the second edition, the present consensus further summarizes the clinical characteristics and experience of children′s cases, and puts forward recommendations on the diagnostic criteria, laboratory examination, treatment, prevention and control of children′s cases for providing reference for further guidance of treatment of 2019-nCoV infection in children.

At present, severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)infection is still rampant worldwide.As of September 10, 2021, there were about 222 million confirmed cases of corona virus disease 2019(COVID-19)and more than 4.6 million deaths worldwide.With the development of COVID-19 vaccines and the gradual vaccination worldwide, the increasing number of cases in children and unvaccinated young people has drawn attention.According to World Health Organization surveillance data, the proportion of COVID-19 infection cases in children gradually increased, and the proportion of cases in the age groups of under 5 years and 5-14 years increased from 1.0% and 2.5% in January 2020 to 2.0% and 8.7% in July 2021, respectively.At present, billions of adults have been vaccinated with various COVID-19 vaccines worldwide, and their protective effects including reducing infection and transmission, reducing severe disease and hospitalization, and reducing death, as well as high safety have been confirmed.Canada, the United States, Europe and other countries have approved the emergency COVID-19 vaccination in children and adolescents aged 12 to 17 years, and China has also approved the phased vaccination of COVID-19 vaccination in children and adolescents aged 3 to 17 years. For smooth advancement and implementation of COVID-19 vaccination in children, academic institutions, including National Clinical Research Center for Respiratory Diseases, National Center for Children′s Health, and The Society of Pediatrics, Chinese Medical Association organized relevant experts to reach this consensus on COVID-19 vaccination in children.