With the widespread adoption of low-dose CT screening and the extensive application of high-resolution CT, the detection rate of sub-centimeter lung nodules has significantly increased. How to scientifically manage these nodules while avoiding overtreatment and diagnostic delays has become an important clinical issue. Among them, lung nodules with a consolidation tumor ratio less than 0.25, dominated by ground-glass shadows, are particularly worthy of attention. The therapeutic challenge for this group is how to achieve precise and complete resection of nodules during surgery while maximizing the preservation of the patient's lung function. The "watershed topography map" is a new technology based on big data and artificial intelligence algorithms. This method uses Dicom data from conventional dose CT scans, combined with microscopic (22-24 levels) capillary network anatomical watershed features, to generate high-precision simulated natural segmentation planes of lung sub-segments through specific textures and forms. This technology forms fluorescent watershed boundaries on the lung surface, which highly fit the actual lung anatomical structure. By analyzing the adjacent relationship between the nodule and the watershed boundary, real-time, visually accurate positioning of the nodule can be achieved. This innovative technology provides a new solution for the intraoperative positioning and resection of lung nodules. This consensus was led by four major domestic societies, jointly with expert teams in related fields, oriented to clinical practical needs, referring to domestic and foreign guidelines and consensus, and finally formed after multiple rounds of consultation, discussion, and voting. The main content covers the theoretical basis of the "watershed topography map" technology, indications, operation procedures, surgical planning details, and postoperative evaluation standards, aiming to provide scientific guidance and exploration directions for clinical peers who are currently or plan to carry out lung nodule resection using the fluorescent microscope watershed analysis method.

This paper systematically summarizes the practical experience of the 2025 Dingri earthquake emergency medical rescue in Tibet. It analyzes the requirements for earthquake medical rescue under conditions of high-altitude hypoxia, low temperature, and low air pressure. The paper provides a detailed discussion on the strategic layout of earthquake medical rescue at the national level, local government level, and through social participation. It covers the construction of rescue organizational systems, technical systems, material support systems, and information systems. The importance of building rescue teams is emphasized. In high-altitude and cold conditions, rapid response, scientific decision-making, and multi-party collaboration are identified as key elements to enhance rescue efficiency. By optimizing rescue organizational structures, strengthening the development of new equipment, and promoting telemedicine technologies, the precision and effectiveness of medical rescue can be significantly improved, providing important references for future similar disaster rescues.

Objective To understand the HIV/AIDS burden and the disease burden attributed to various risk factors in four countries with different socio-demographic index (SDI) (China, United States, Russia, and Afghanistan) from 1990 to 2019, and to predict the HIV/AIDS attributable disease burden from 2020 to 2029. Methods The 2019 Global Burden of Disease Study data was used to describe and compare the incidence, prevalence, death, and DALYs of HIV/AIDS in the four countries. The standardized DALYs attributed to various risk factors in different age groups of HIV/AIDS in the four countries in 1990 and 2019 were compared. R4.3.0 was used to construct an autoregressive moving average mixed model to predict the attributable disease burden in each country over the next decade. Results Compared with 1990, in 2019, the standardized incidence rate, standardized prevalence rate, standardized mortality rate, and standardized DALYs rate in China and the other two countries, except the United States, showed an increase. People aged 10 to 49 years old were a key group for disease burden, and the main risk factors for disease burden varied among different countries and age groups. The autoregressive moving average mixed model predicted that the main risk factor for Russia in the next decade would be injecting drugs, while unsafe sexual behavior would occur in the other three countries. Conclusion There are differences in disease burden and risk factors among different genders and age groups globally and in the four different SDI countries. Therefore, differences should be fully considered to determine the focus of HIV/AIDS prevention and control and rationally allocate health resources.

Objective To investigate the HPV vaccination status of children aged 9-14 years, parents’ vaccine-related cognition, willingness to vaccinate children and their influencing factors. Methods From January to April 2021, the convenience sampling method was used to collect data based on the online platform and the Department of Pediatrics and Adolescent Gynecology of the Children&#39;s Hospital of Zhejiang University School of Medicine. The data were analyzed by descriptive analysis, Chi-square test, and logistic regression. Results A total of 864 questionnaires were collected, and 846 valid questionnaires were obtained after screening, with an effective rate of 97.9%. 13.57% of mothers and 3.09% of girls were vaccinated, and the vaccine awareness rate was 68.43%. 87.22% of parents were willing to bring their children for vaccination. Risk perception (OR=4.79, 95% CI: 2.22-10.35), willingness to vaccinate themselves (OR =29.01, 95% CI: 12.62-66.69), awareness of sex education (OR =3.73, 95% CI: 1.08-12.83) and whether the vaccines were free (P<0.001) were related to whether parents were willing to vaccinate their children. Conclusion Parents of children aged 9-14 have high awareness of HPV and HPV vaccine and are willing to vaccinate their children with HPV vaccine , but the vaccination rate in children is low. Disease perception, willingness to vaccinate, awareness of sex education, and whether vaccines are free are all the factors influencing parents&#39; willingness to vaccinate children.

Objective : To discuss the effectiveness and mechanism for movement of maxillary buccally transposed canines by using a door-shaped individualized dental archwire mechanic and to provide a reference for clinicians. Methods: Eight patients with unilateral maxillary transposed canines were enrolled. All patients were treated with door-shaped individualized archwires. Before treatment (T1) and after the crowns of the transposed canines were moved to the right buccal positions in the dental arch during the treatment (T2), orthopantomograms were taken both at T1 and T2 to compare the linear changes (distance changes of the crown and root apex) and angular changes to study the mechanisms of tooth movement. The probing depth and buccal crown height were measured using a periodontal probe to compare periodontal changes before treatment (T1) and after treatment (T3) between the transposed canines and contralateral canines. Results: All eight transposed canines were successfully brought back to their normal dental arch position but were made more buccal by using the door-shaped individualized dental archwire, with a mean of (11.5 ± 2.7) months. The average overall duration was (28.3 ± 4.7) months. The crown distance changes of the canines from T1 to T2 (8.1 mm) were greater than those of the root apexes (1.5 mm) (P<0.05). The mean angulation changes of the long axes of the canines were 17.5°. There was no significant difference in the depth of periodontal measurement and buccal crown height measurement between T1 and T3 (P>0.05). Conclusion The buccal movement of maxillary transposed canines under a door-shaped individualized dental archwire was effective and feasible. The movement pattern under this mechanism was controlled tipping.

[摘 要] 目的：探讨鱼藤素通过调控miR-520a-3p表达对卵巢癌SKOV3细胞增殖和凋亡的影响。方法：将SKOV3细胞分为对照组（鱼藤素0 μmol/L）、鱼藤素低剂量（5 μmol/L）、中剂量（10 μmol/L）、高剂量（20 μmol/L）组，miR-NC组、过表达miR-520a-3p组，鱼藤素+anti-miR-NC组、鱼藤素+anti-miR-520a-3p组。CCK-8法、细胞集落形成实验、FCM以及qPCR法分别检测SKOV3细胞的增殖抑制率、细胞克隆形成数、凋亡率以及miR-520a-3p表达水平。结果：与对照组比较，鱼藤素（低、中、高剂量）组SKOV3细胞增殖抑制率、凋亡率、miR-520a-3p表达水平均显著升高（均P<0.05），细胞克隆形成数显著减少（P<0.05）。与miR-NC组比较，过表达miR-520a-3p组SKOV3细胞的增殖抑制率、凋亡率均显著升高（均P<0.05），细胞克隆形成数显著减少（P<0.05）。与鱼藤素+anti-miR-NC组比较，鱼藤素+anti-miR-520a-3p组SKOV3细胞的增殖抑制率、凋亡率均显著降低（均P<0.05），细胞克隆形成数显著增多（P<0.05）。结论：鱼藤素通过增加miR-520a-3p表达抑制卵巢癌SKOV3细胞的增殖能力，并诱导其凋亡。

OBJECTIVE To establish a UPLC detection method for simultaneous determination of mycophenolic acid(MPA) and its glucuronide(MPAG) in plasma of rats, and to investigate gender-related pharmacokinetic characteristics of mycophenolic acid. METHODS Twelve SD rats(half male and half female) were intragastrically administrated with 90 mg·kg-1·d-1mycophenolate acetate, and blood was collected from periorbital vein at different time points after administration. Plasma samples were extracted by liquid-liquid extraction and drug concentrations of MPA and metabolite MPAG in plasma were determined using UPLC. The method was developed using Waters BEH C18 column. The gradient elution was performed at a flow rate of 0.35 mL·min-1 with the mobile phase acetonitrile solution (A)-0.1% formic acid aqueous solution(B). The detection wavelength was at 266 nm and column oven temperature was maintained at 40 ℃. The pharmacokinetic parameters were calculated by using DAS 2.0 software. RESULTS The linear relationship between peak area and concentrations of MPA and MPAG were good in the ranges of 0.31-160 µg·mL-1(R2=0.999 8) and 0.62-320 µg·mL-1(R2=0.999 4), respectively. Analytical methods of MPA and MPAG all met the requirements of the methodology. Pharmacokinetic parameters AUC0-t and Cmax of MPA and MPAG in female rats were higher than that in male rats(P<0.05 or P<0.01). In addition, the metabolic rate of genistein[UDP-glucuronosyltransferases(UGT)s substrate] and MPA in male rat liver microsomes were significantly faster than that in female rat liver microsomes. CONCLUSION This developed UPLC method is sensitive, accurate and specific, which is suitable to detect the concentrations of MPA and MPAG in the plasma. The pharmacokinetics of MPA and MPAG in rats are gender different, which may be related to the sex difference of UGTs metabolic enzyme activity.

Objective To study the characteristics of hepatitis B before and after hepatitis B vaccine was included in the immunization program in Haidong area, and to provide basis for the prevention and control strategy of hepatitis B. Methods The annual incidence of hepatitis B before (2000 -2002) and after (2018 -2020) hepatitis B vaccine was analyzed by descriptive epidemiological method from the hepatitis B cases reported by the notifiable infectious diseases reporting system and hepatitis B surveillance system in Haidong region. After the hepatitis B vaccine was included in the immunization program, the experimental group was used to analyze the characteristics of hepatitis B disease before and after the hepatitis B vaccine was included in the immunization program, including age, sex, region, occupation and season of onset. A certain number of people were randomly selected to compare the vaccination rate of hepatitis B vaccine before and after inclusion in the immunization program. Results The incidence of hepatitis B increased year by year before hepatitis B vaccine was included in the immunization program, but decreased year by year after hepatitis B vaccine was included in the immunization program, and the difference between the two groups was statistically significant (P<0.05). There was no significant difference between the two groups ( P>0.05). Before and after the introduction of hepatitis B vaccine into the immunization program, the incidence of hepatitis B mainly concentrated in 20 to 60 years old, 0 to 19 years old, the lowest incidence, there was no statistical significance between the two groups (P>0.05). The incidence of hepatitis B vaccine in males was higher than that in females before and after hepatitis B vaccine was included in the immunization program, and there was no statistical significance between the two groups (P>0.05). The incidence of hepatitis B in urban areas was higher than that in rural areas before hepatitis B vaccine was included in the immunization program, and the incidence of hepatitis B in rural areas was higher than that in urban areas after hepatitis B vaccine was included in the immunization program, with statistical significance (P<0.05). Before the introduction of hepatitis B vaccine into the immunization program, the incidence of hepatitis B mainly concentrated in farmers, the proportion of farmers increased from 50.99% to 53.31%, the proportion of students decreased from 5.38% to 2.56%, and the difference was statistically significant (P<0.05). After hepatitis B vaccine was included in the immunization program, the vaccination rate of hepatitis B vaccine increased from (93.61%) to (98.18%), and the difference between the two groups was statistically significant (P<0.05). Conclusion The hepatitis B vaccine in Haidong area has achieved remarkable effect and effectively controlled the incidence of hepatitis B.

Objective To assess the association between early adiposity rebound (AR) and indices of obesity and metabolic risk in 5-year-old children. Methods Based on Ma’anshan Birth Cohort Study (MABC), single live births born in Ma&#39;anshan of Anhui province from October 2013 to April 2015 were followed for up to 5 years consecutively. As of August 2019, 720 children with continuous measurements (≥8 times) and metabolic indicators were obtained. Physical examination and laboratory tests were used to obtain information on the birth status, length/height, weight, waist circumference, body composition and metabolic indicators of children. The 2 test, F test, t-test, non-parametric test, general linear model and logistic regression model were used for statistical analysis. Results 43.5% of the children had AR≤4 years. After controlling for gender, it was found that earlier AR was associated with overweight/obesity (OR=2.71, 95%CI: 1.81~4.05), larger waist circumference (OR=1.88, 95%CI: 1.25~2.82), and body fat percentage ≥90th percentile (OR=2.09, 95%CI: 1.26~3.48). In the earlier AR group, the insulin resistance and metabolic score were higher, but the difference was not statistically significant. At 5 years of age, the prevalence of obesity and overweight was 6.0% and 12.8%, respectively. Children with overweight/obesity, larger waist circumference, higher waist-to-weight ratio and body fat percentage ≥ 90th percentile were associated with higher insulin resistance and metabolic score, and all the differences were statistically significant (all P<0.001). Conclusion Earlier AR increased the risk of overweight/obesity, larger waist circumference, and body fat percentage ≥90th percentile at age of 5 years. Each index of the commonly used measures of childhood obesity was closely related with insulin resistance and metabolic risk factors at 5 years old.

Objective: To explore the effect of miR-141-3p on the proliferation, invasion and apoptosis of ovarian cancer cells via targeting PTEN and regulating PI3K/Akt pathway. Methods: Collecting twenty-eight cases pairs of ovarian cancerovarian cancer patients with tumor tissues and adjacent tissues were collected from patients, who from April 2014 to October 2017 were treated in the Department of Obstetrics and Gynecology. qPCR was applied to detect the expression of miR-141-3p in ovarian cancer tissues and cell lines. The relationship between miR-141-3p and PTEN was verified by dual-luciferase reporter gene assay. After over-expression or knockdown of miR-141 and PTEN genes, the cell viability, invasion and apoptosis of ovarian cancer A2780 cells were examined by CCK-8 assay, Transwell assay and Annexin V-FITC/PI double staining flow cytometry assay, respectively. Furthermore, the effect of miR-1413p on PTEN-PI3K/Akt signaling pathway was measured by WB. Results: miR-141-3p is was highly expressed in ovarian cancer tissues and cell lines (P<0.05 or P<0.01). The dual luciferase reporter gene assay confirmed that miR-141-3p targets PTEN was a target of miR-141-3p and downregulates its expression level was down-regulated (P<0.01). Compared with the control group, after knockdown of miR-141-3p, the proliferation ofA2780 cells was significantly inhibited after knockdown of miR-141-3p (at 48 h, 0.36±0.04 vs 0.82± 0.06, P<0.05), and the invasive ability of A2780 cells was significantly reduced (number of transmembrane cells: 215.32±16.04 vs 45.14±7.88, P<0.01), while the apoptotic rate was significantly increased ([1.85±0.26]% vs [9.29±0.65]%, P<0.01). Over-expression of PTEN significantly inhibited the expression of p-Akt and cell proliferation and invasion in A2780 cells (all P<0.01), inhibited cell proliferation and invasion (all P<0.01) and significantly promoted apoptosis (all P<0.01). However, simultaneous over-expression of miR141-3p or addition of IGF-1 wile over-expressing PTEN can offset the above effects. Conclusion: miR-141-3p facilitates the proliferation, invasion and decreases apoptosis of A2780 cells. The mechanism may be related to targeted regulation of PTEN and activation of PI3K/Akt pathway.