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 investigate the clinical features and prognosis of male with anti-melanoma differentiation-associated gene 5 (MDA5) autoantibody.Methods:The clinical data of 246 patients with DM and anti-MDA5 autoantibodies hospitalized by Jiangsu Myositis Cooperation Group from 2017 to 2020 were collected and retrospectively analyzed. Chi-square test was performed to compared between counting data groups; Quantitative data were expressed by M ( Q1, Q3), and rank sum test was used for comparison between groups; Single factor survival analysis was performed by Kaplan-Meier method and Log rank test; Cox regression analysis were used for multivariate survival analysis. Results:①The male group had a higher proportion of rash at the sun exposure area [67.1%(47/70) vs 52.8%(93/176), χ2=4.18, P=0.041] and V-sign [50.0%(35/70) vs 30.7%(54/176), χ2=8.09, P=0.004] than the female group. The male group had higher levels of creatine kinase [112(18, 981)U/L vs 57 (13.6, 1 433)U/L, Z=-3.50, P<0.001] and ferritin [1 500 (166, 32 716)ng/ml vs 569 (18, 14 839)ng/ml, Z=-5.85, P<0.001] than the female group. The proportion of ILD [40.0%(28/70) vs 59.7%(105/176), χ2=7.82, P=0.020] patients and the red blood cell sedimentation rate[31.0(4.0, 101.5)mm/1 h vs 43.4(5.0, 126.5)mm/1 h, Z=-2.22, P=0.026] in the male group was lower than that of the female group, but the proportion of rapidly progressive interstitial lung disease (PR-ILD) [47.1%(33/70) vs 31.3%(55/176), χ2=5.51, P=0.019] was higher than that of the female group. ②In male patients with positive anti-MDA5 antibodies,the death group had a shorter course of disease[1.0(1.0, 3.0) month vs 2.5(0.5,84) month, Z=-3.07, P=0.002], the incidence of arthritis [16.7%(4/24) vs 42.2%(19/45), χ2=4.60, P=0.032] were low than those in survival group,while aspartate aminotransferase (AST)[64(22.1, 565)U/L vs 51(14,601)U/L, Z=-2.42, P=0.016], lactate dehydrogenase (LDH) [485(24,1 464)U/L vs 352(170, 1 213)U/L, Z=-3.38, P=0.001], C-reactive protein (CRP) [11.6(2.9, 61.7) mg/L vs 4.95(0.6, 86.4) mg/L, Z=-1.96, P=0.050], and ferritin levels [2 000(681, 7 676) vs 1 125 (166, 32 716)ng/ml, Z=-3.18, P=0.001] were higher than those in the survival group, and RP-ILD [95.8%(23/24) vs 22.2%(10/45), χ2=33.99, P<0.001] occurred at a significantly higher rate. ③Cox regression analysis indicated that the course of disease LDH level, and RP-ILD were related factors for the prognosis of male anti-MDA5 antibodies [ HR (95% CI)=0.203(0.077, 0.534), P=0.001; HR (95% CI)=1.002(1.001, 1.004), P=0.003; HR (95% CI)=95.674 (10.872, 841.904), P<0.001]. Conclusion:The clinical manifestations of male anti-MDA5 antibody-positive patients are different from those of female. The incidence of ILD is low, but the proportion of PR-ILD is high. The course of disease, serum LDH level, and RP-ILD are prognostic factors of male anti-MDA5 antibody-positive patients.

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.

Objective To analyze the distribution characteristics of 9 hypertension drug related gene polymorphisms in the population of essential hypertension(EH)in Xi'an area,providing an objective basis for personalized treatment.Methods A total of 306 EH patients who visited the Shaanxi Provincial Armed Police Force Hospital from January 2022 to December 2023 were selected as the research subjects.The PCR melting curve method was used to detect 9 hypertension drug related gene polymorphisms,their genotype and allele distribution frequency were analyzed,and the correlations of gene polymorphism among patients of different genders,ages,and hypertension grading groups were compared.Results Among 306 patients,the distribution frequencies of each gene were consistent with Hardy Weinberg equilibrium(x2=0.153～2.941,all P＞0.05).Mutation rates of various gene were as follows:SLCO1B1 c.388A＞G,ADRB1 c.1165G＞C,MTHFR C677T,ADD1 c.1378G＞T,CYP2D6 c.100C＞T,ACE I/D,CYP3A5 c.806-4288C＞T,SLCO1B1 c.521T＞C,AGTR1 c.1166A＞C and CYP2C9 c.1075A＞C were 77.29％,73.20％,56.54％,48.37％,50.82％,35.13％,29.41％,11.76％,7.68％and 3.43％,respectively,and CYP2C9 c.403C＞T had no mutation.Comparing with patients of different genders,the mutation rate of SLCO1B1 c.388A＞G genotype and allele mutations in male group were higher than those in the female group(x2=5.221,8.237),the mutation rate of CYP2D6 c.100C＞T genotype and allele in the female group were higher than those in the male group(x2=5.093,9.661),the mutation rate of ACE I/D allele in the male group was higher than that in the female group(x2=6.118,8.032),with significant differences(all P＜0.05).The mutation rates of CYP2C9 c.1075A＞C,SLCO1B1 c.388A＞G,CYP2D6 c.100C＞T genotypes and alleles in the middle-aged and young age group were higher than those in the elderly group,and the differences were statistically significant(x2=11.683,10.243;9.003,9.803;10.617,9.931,all P＜0.05).There was no significant difference in the comparison of other genotypes and alleles among different gender and age groups and in the frequency of genotype and allele mutations among different hypertension grading groups(x2=1.321～7.733,1.031～5.198,all P＞0.05).Conclusion The distribution of gene polymorphisms related to antihypertensive drugs in the Xi'an area was related to the gender and age of EH patients.Thus,the genotype testing of antihypertensive drugs may have important guiding significance for personalized medication treatment of EH patients.

Objective:To explore the potential categories and influencing factors of family resilience of breast cancer patients based on potential profile analysis to provide reference for targeted intervention.Methods:Cross-sectional investigation was used. From January 2022 to June 2023, 268 breast cancer patients revisited in the outpatient department or ward of the Second Affiliated Hospital of Guilin Medical College and Nanxishan Hospital of Guangxi Zhuang Autonomous Region were selected as the study objects. The subjects were investigated by general data questionnaire, Family Resilience Assessment Scale, Medical Coping Style Questionnaire and Perceptive Social Support Scale. Potential profile analysis was used to identify the potential categories of family resilience in breast cancer patients, and ordered multiple Logistic regression analysis was used to determine the influencing factors of family resilience.Results:Totally 268 cases of breast cancer, aged 30-65 (49.51 ± 3.23) years old; the total score of family resilience was (81.78 ± 13.71) points. The family toughness of breast cancer patients could be divided into three potential profiles: low toughness and low coping difficulty group (23.1%), medium toughness and medium coping difficulty group (33.2%), high toughness and high coping difficulty group (43.7%). The results of ordered multiple Logistic regression analysis showed that residence, per capita monthly household income, medical coping style and perceived social support had an impact on the potential categories of family resilience in breast cancer patients (all P<0.05). Conclusions:There is group heterogeneity in family resilience of breast cancer patients. Medical staff should pay attention to the classification of patients in different places of residence and family per capita monthly income, and formulate personalized and precise interventions from the aspects of coping styles and social support to improve family resilience.

Objective:To explore the current situation of fear of progression among parents of school-age children with asthma, and to analyze the latent profile categories and influencing factors, so as to provide the reference for the formulation of prevention and intervention.Methods:Using convenient sampling method, school-age children with asthma and their parents treated in the Affiliated Children's Hospital of Xiangya School of Medicine, Central South University from March to August 2023 were selected as the study objects. The General Data Questionnaire, Parent Fear of Progression Scale, Childhood Asthma Control Test, and Social Support Rating Scale were used to investigate school-age children with asthma and their parents. Latent profile analysis was performed on the fear of disease progression among parents of school-age children with asthma, and χ2 test and binary Logistic regression were used to explore the influencing factors. Results:A total of 210 parents of the children were included with 51 fathers and 159 mothers.The age distribution was 20-30 years old with 42 parents, 31-40 years old with 112 parents, 41-50 years old with 56 parents. In 210 children with asthma, there were 123 males and 87 females, with 141 cases aged<10 years old and 69 cases aged ≥10 years old. The fear of progression among parents of school-age children with asthma could be divided into two potential profile categories: "psychological dysfunction group (46.7%, 98/210)" and "psychological health good group (53.3%, 112/210)". The results of binary Logistic regression analysis showed that asthma family history, combined allergic rhinitis, child-parent relationship, marital status, asthma symptom control level, and social support level were the influencing factors of fear of progression among parents of school-age children with asthma( OR values were 0.925-10.010, all P<0.05). Conclusions:The fear of progression among parents of school-age children with asthma is at a moderate level, and there are obvious different classification characteristics. In the future, targeted and precise prevention and intervention should be implemented according to the category characteristics of fear of progression among parents of school-age children with asthma.

Objective:To compare the positioning errors of the clavicular,cervical,and humeral regions during radiotherapy between a 3D-printed breast bracket and common head-occipital pillow in patients with breast cancer and to assess patients with brachial plexus damage to determine whether 3D-printed breast brackets can reduce radiation-induced brachial plexopathy(RIBP).Methods:A total of 58 patients admitted to Sichuan Provincial People's Hospital from January 2022 to October 2022 were randomly assigned into four groups:breast-con-serving patients with 3D-printed breast bracket,breast-conserving patients with common head pillow,postoperative patients with 3D-prin-ted breast bracket,and postoperative patients with common head pillow.The positioning error data were obtained for the clavicular,cer-vical,and humeral regions,and the errors in the elevating direction(vrt),head and foot direction(lng),and left and right direction(lat)were analyzed.At the same time,100 patients treated at Sichuan Provincial People's Hospital from January 2022 to November 2022 were ran-domly assigned into the above four groups,and their brachial plexus damage was assessed and classified.Results:In postoperative patients with 3D-printed breast bracket,the vrt,lng,and lat positioning errors in the clavicle,cervical,and humeral regions were(0.95±0.70)mm,(0.90±0.61)mm,(1.50±0.077)mm,(1.50±1.16)mm,(1.16±0.87)mm,(1.45±1.21)mm,(1.31±0.82)mm,(1.10±0.87)mm,and(1.64±1.04)mm,respectively.In breast-conserving patients,the positioning errors were(1.68±0.67)mm,(2.92±1.20)mm,(2.37±1.07)mm,(2.60±1.22)mm,(2.81±1.19)mm,(2.34±1.09)mm,(2.66±1.17)mm,(3.11±1.20)mm,and(2.52±1.21)mm,respectively.There was significant difference in the positioning error between the two groups(P<0.05).The return visit for brachial plexus damage showed that grade 0 was 24%higher in the 3D-printed breast bracket groups than in the ordinary headrest groups,grade 1 was 22%lower,and there were no significant differences in the other grades.Conclusions:The positioning error of the 3D-printed breast bracket in the three areas was smaller than that of the ordin-ary headrest.Brachial plexus damage in the 3D-printed breast bracket group was also better than that in the ordinary head pillow group.

Objective To develop a pulmonary rehabilitation training system based on scenario simulation for children with bronchiolitis obliterans,and to explore its application effect.Methods A pulmonary rehabilitation training program for children with bronchiolitis obliterans was constructed,and on the basis of this program,a pul-monary rehabilitation training system based on scenario simulation was developed for children with bronchiolitis obliterans,with real-time monitoring of relevant data.44 children with bronchiolitis obliterans who were hospitalized in the Department of Respiratory Medicine of a tertiary A children's specialized hospital in Hunan Province from January to December 2022 were selected by convenience sampling method,and the subjects were divided into an experimental group and a control group with 22 cases in each group.The experimental group adopted a pulmonary rehabilitation training program based on scenario simulation,and the control group implemented pulmonary rehabili-tation through nurse demonstration and guidance.At pre-intervention,4 weeks,and 12 weeks of intervention,the 2 groups were compared in terms of clinical symptom severity,pulmonary function,adherence to pulmonary rehabilita-tion,and the occurrence of pulmonary rehabilitation-related adverse events.Results There were no shedding cases in the experimental group and a case in the control group,and 22 cases were finally included in the experimental group and 21 cases in the control group.The results of repeated measures ANOVA showed that the comparison of clinical symptom severity and pulmonary function between the 2 groups at different time points was statistically sig-nificant in terms of time,between groups and interaction(P＜0.05).Simple effect analysis showed that after 4 and 12 weeks of intervention,the severity of clinical symptoms in the experimental group was lighter than that in the control group,and the difference was statistically significant(P＜0.001).At 12 weeks of intervention,pulmonary func-tion indexes,such as exertional expiratory volume in the first second,exertional lung volume,and maximum expiratory flow rate,were higher in the experimental group than those in the control group,and the difference was statistically significant(P＜0.001).At 4 and 12 weeks of intervention,the compliance of pulmonary rehabilitation in the experi-mental group was higher than that of the control group,and the difference was statistically significant(P＜0.05).At 12 weeks of intervention,the occurrence of adverse events related to pulmonary rehabilitation in the experimental group was less than that in the control group,and the difference was statistically significant(P=0.026).Conclusion The use of a scenario simulation-based pulmonary rehabilitation training system for children with bronchiolitis obliterans can effectively alleviate the clinical symptoms of children,improve their pulmonary function,increase compliance,and reduce the occurrence of pulmonary rehabilitation-related adverse events.

Objective Based on the theory of Information-Knowledge-Attitude-Practice(IKAP),the reliability and validity of the discharge preparation scale for patients with diabetic foot(DF)was developed and tested,which is in accordance with the national conditions and disease characteristics of our country.Methods Based on the IKAP theoretical framework,articles were identified through literature analysis,qualitative interviews and Delphi method.After pre-investigation,a total of 483 patients with DF were selected from 3 general hospitals in Jiangxi province from June 2023 to February 2024.The items were screened by item analysis,and the reliability and validity were tested.Results The discharge preparation scale for patients with DF included 4 dimensions and 29 items.The Cronbach's α coefficient was 0.934;the scores of each dimension Cronbach's α coefficient ranged from 0.889 to 0.947;the overall split-half reliability was 0.966,and the split-half reliability of each dimension ranged from 0.901 to 0.952.A total of 4 common factors were extracted by exploratory factor analysis,and the cumulative contribution rate of variance was 68.074％.The x2/df value of confirmatory factor analysis was 1.906.The fitting fit of the model is suitable.The content validity was 0.973 at scale level and 0.875～1.000 at item level.Conclusion The reliability and validity of the discharge preparation scale for patients with DF are good,and it can be used as a tool to evaluate the discharge preparation for patients with DF.

Objective:To evaluate the short-term efficacy and safety of a preoperative combination of programmed cell death protein-1 (PD-1) inhibitor with either oxaliplatin + capecitabine (CapeOx) or oxaliplatin + tegafur gimeracil oteracil potassium (SOX) in the treatment of locally advanced immunotherapy-sensitive gastric cancer (LAGC) or adenocarcinoma of the esophagogastric junction (AEG).Methods:The cohort of this retrospective descriptive case series comprised patients with LAGC or AEG whose cancers had been determined to be immunotherapy- sensitive by endoscopic biopsy before treatment in the Gastrointestinal Cancer Center, Unit III, Peking University Cancer Hospital and Institute from 1 August 1 2021 to 31 January 2024. Patients with any one of the following three characteristics were immunotherapy-sensitive: (i) PD-L1 combined positive score (CPS) ≥5; (ii) microsatellite instability-high (MSI-H) / mismatch repair deficiency (dMMR); or (iii) Epstein-Barr virus-encoded RNA (EBER) positivity. All study patients received PD-1 inhibitors combined with CapeOx or SOX as a neoadjuvant or conversion treatment strategy before surgery. Patients with immune system diseases, distant metastases, or human epidermal growth factor receptor 2 positivity were excluded. Factors analyzed included pathological complete response, clinical complete response, major pathological response, R0 resection rate, surgical conversion rate, and safety of the treatment, including immune-related adverse events (irAEs) and surgical complications.Results:The study cohort comprised 39 patients (28 men and 11 women) of median age 62 (range 44–79) years. After the above-described preoperative treatment, radical resection of the 14 tumors that were initially considered unresectable was achieved (surgical conversion rate: 14/14). Twenty-three of the remaining 25 patients underwent radical resection. The last two patients achieved clinical complete responses and opted for a "non-surgical strategy" (watch and wait). Overall, 37 patients (94.9%) underwent radical resection, with an R0 resection rate of 100% (37/37), pathological complete response rate of 48.6% (18/37), and major pathological response rate of 62.2% (23/37). Of the 24 patients with CPS ≥ 5 (non-MSI-H/dMMR and non-EBER positive), 11 achieved pathological complete responses and one with CPS=95 achieved a clinical complete response. Of the eight patients with MSI-H/dMMR, six achieved pathological complete responses and one a clinical complete response. Of the seven patients with EBER positivity, one achieved a pathological complete response. After excluding patients with major pathological complete responses, there was a statistically significant difference in CPS scores between preoperative biopsy specimens and postoperative surgical specimens in 13 patients (7.769±5.570 vs. 15.538±16.870, t=2.287, P=0.041). All patients tolerated preoperative immunotherapy well; nine patients (9/39, 23.1%) had Grade I–II irAEs. There were no Grade III–IV irAEs. The five patients with pyloric obstruction before treatment tolerated normal diets after treatment. The incidence of postoperative complications among all patients who underwent surgery was 18.9% (7/37), including one case of Grade IIIA anastomotic leakage, one of Grade IIIA intestinal obstruction, one of Grade II abdominal hemorrhage, two of Grade II abdominal infection, one of Grade I intestinal obstruction. Additionally, one patient developed COVID-19 postoperatively. All patients recovered with symptomatic treatment. Conclusion:We found that preoperative treatment of patients with LAGC or AEG of one of three types (CPS≥5, dMMR+MSI-H, and EBER positivity) with a PD-1 inhibitor combined with CapeOx or SOX chemotherapy achieved promising effectiveness and safety, with high surgical conversion, R0 resection, and complete response rates.