Abstract:Diabetes of the exocrine pancreas (DEP) used to be called pancreatic diabetes, pancreatogenic diabetes or type 3c diabetes mellitus. Currently, the incidence of DEP is higher than that of type 1 diabetes mellitus. The pathogenesis and clinical manifestations of DEP are related to primary pancreatic diseases. In terms of management, we need to consider both pancreatic endocrine and exocrine functions, and comprehensively treat diabetes mellitus and primary pancreatic diseases. By now, there has been no guideline related to DEP; its diagnostic criteria, differentiation with type 2 diabetes mellitus, and selection of hypoglycemic programs are challenges in clinical practice. This article reviews the clinical studies related to DEP, and summarizes the evolution of its terminology, pathogenesis, clinical manifestations, complications, diagnosis, treatment and management.

Abstract:Objective To explore the mechanism by which cancer-associated fibroblasts (CAFs) regulate CD13-high expression neutrophil-like myeloid-derived suppressor cell (CD13^hi-nMDSC) migration in pancreatic ductal adenocarcinoma (PDAC), so as to provide potential molecular targets and experimental evidences for immunotherapy in patients. Methods CAFs were isolated and purified from pancreatic cancer tissues of 5 PDAC patients. The phenotype and purity of CAFs were identified by immunofluorescence and flow cytometry. The expression of related factors in CAF was detected by quantitative polymerase chain reaction (qPCR) and enzyme-linked immunosorbent assay (ELISA). CAF conditioned medium and myeloid-derived suppressor cell (MDSC) migration system were constructed by Transwell to observe the migration of MDSCs and to study the specific mechanisms by which the aforementioned cytokines participate in regulating the migration of MDSCs. Results The isolated primary CAFs expressed activation biomarkers fibroblast activation protein (FAP) and α-smooth muscle actin (α-SMA), while the human foreskin fibroblasts (HFFs) of control cells did not express FAP and α-SMA. qPCR results showed that the mRNA expression levels of interleukin 6 (IL-6), monocyte chemotactic protein 1 (MCP-1), and stromal cell-derived factor 1 (SDF-1) in CAFs were higher than those in HFFs (all P＜0.01). The contents of IL-6, MCP-1, and SDF-1 in the CAF culture supernatant were significantly higher than those in the HFF culture supernatant (all P＜ 0.01), and the secretion content increased with the prolongation of culture time. Compared with HFF conditioned medium and regular medium (RPMI 1640), CAF conditioned medium could recruit more total MDSCs and CD13^hi-nMDSCs (all P＜ 0.01). The addition of SDF-1 recombinant protein alone in the culture system could induce the migration of total MDSCs and CD13^hi-nMDSCs, and the addition of SDF-1 neutralizing antibodies or C-X-C motif chemokine receptor 4 (CXCR4) blocking antibodies could significantly reduce the migration of CD13^hi-nMDSCs induced by CAF conditioned medium (all P＜0.01). Although MCP-1 alone could also induce the migration of total MDSCs and CD13^hi-nMDSCs, the number of CD13^hi-nMDSCs migrating was significantly less than that of the SDF-1 experimental group. The IL-6 recombinant protein did not induce the migration of total MDSCs or CD13^hi-nMDSCs. Conclusion CAFs can mediate the migration of total MDSCs and CD13^hi-nMDSCs in PDAC through SDF-1/CXCR4 pathway.

Abstract:Objective To explore the regulatory effect of corilagin (COR) on Nod-like receptor family pyrin domain-containing protein 3 (NLRP3) inflammasome activation and chondrocyte pyroptosis induced by lipopolysaccharide (LPS) combined with nigericin (NIG). Methods Primary chondrocytes isolated from C57BL/6J mice were cultured to passage 3 for experiments. Cells were divided into control group, LPS group, LPS＋NIG group, and LPS＋NIG＋ COR (low-, medium-, and high-dose) groups. The chondrocytes were pre-sensitized with LPS for 4 h. Then the cells were treated with COR at different concentrations (10, 20, and 40 μmol/L) for 30 min, and finally NIG (10 μmol/L) was supplemented for 1 h. Control cells were cultured in DMEM/F-12 medium supplemented with 1% FBS. Cell counting kit 8 (CCK-8) was used to detect the effect of COR at different concentrations (10, 20, 40 μmol/L) on chondrocyte viability. Propidium iodide (PI) and Hoechst 33342 staining and lactate dehydrogenase (LDH) release assay were used to analyze the effect of COR on chondrocyte death induced by LPS and NIG. Western blotting was used to detect the expression of the NLRP3 inflammasome activation marker cysteine aspartic acid specific protease 1 (caspase 1) p20 in the cell supernatant and NLRP3, apoptosis-associated speck-like protein (ASC), caspase 1, interleukin-1β precursor (pro-IL-1β), and pyroptosis execution protein gasdermin D (GSDMD) in the cell lysate. Enzyme-linked immunosorbent assay was used to detect the level of IL-1β in cell culture supernatant. Reactive oxygen species (ROS) fluorescent probe 2’,7’-dichlorodihydrofluorescein diacetate (H₂DCFDA) staining was used to observe the effect of COR on ROS production, and Western blotting was used to detect the expression of intracellular glycolysis-related proteins hexokinase 2 (HK2), glucose transporter 1 (GLUT1), and lactate dehydrogenase A (LDHA). Results COR exhibited slight effect on chondrocyte viability at the concentration ≤ 40 μmol/L. COR (10-40 μmol/L) reduced the proportion of PI-positive cells (all P＜0.05) and the release of LDH (all P＜ 0.01) stimulated by LPS and NIG, inhibited the expression of GSDMD N-terminus domain in chondrocytes, and reduced the release of caspase 1 p20 and IL-1β from chondrocytes (all P＜0.01). Furthermore, COR (40 μmol/L) reduced the production of ROS (compared with the control group, P＜0.01) and inhibited the expression of glycolysis-related proteins HK2, GLUT1, and LDHA (all P＜0.05). Conclusion COR can inhibit NIG-induced glycolysis/ROS/NLRP3 signaling, thereby preventing NLRP3 inflammasome activation and chondrocyte pyroptosis.

Abstract:Objective To investigate the influence of preoperative blood lipid levels on postoperative recovery in patients with acute Achilles tendon rupture (AATR). Methods The clinical data of 353 AATR patients treated in Department of Orthopaedics Trauma of our hospital from Jan. 2021 to Jan. 2024 were retrospectively analyzed, including general clinical information and preoperative fasting blood biochemistry indices. Patients’ Achilles tendon total rupture score (ATRS) and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score were recorded 6 months postoperatively. Postoperative recovery was categorized as favorable if ATRS≥80 and poor if ATRS＜80; similarly, recovery was considered favorable if AOFAS score ≥90 and poor if AOFAS score ＜90. Univariate and multivariate logistic regression analyses were done to investigate the influencing factors of patients’ postoperative recovery. Results When categorized by ATRS, patients in the favorable postoperative recovery group exhibited significantly lower serum levels of triglyceride (TG), total cholesterol (TC), and low-density lipoprotein (LDL) compared to the poor postoperative recovery group (all P＜0.05). Similarly, when categorized by AOFAS score, the favorable postoperative recovery group had lower serum TG and TC levels than the poor postoperative recovery group (both P＜0.05). Univariate logistic regression analysis demonstrated that in the ATRS grouping, elevated serum levels of TG, TC and LDL were significantly associated with an increased risk of poor postoperative recovery in AATR patients (all P＜0.05). Similarly, in the AOFAS score grouping, elevated serum levels of TG and TC were significantly correlated with an increased risk of poor postoperative recovery in AATR patients (both P＜0.05). Multivariate logistic regression analysis further identified that high serum LDL level was an independent predictor of poor postoperative recovery in AATR patients (P＜0.05). Conclusion High preoperative serum LDL level is associated with an increased risk of poor postoperative recovery in AATR patients. Therefore, preoperative blood lipid management in AATR patients may have positive effects on postoperative functional recovery.

Abstract:Objective To explore the application value of ultrasound combined with elastography in grading inflammation in patients with chronic liver disease at S2 stage of liver fibrosis. Methods Totally 51 patients who were hospitalized at Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from Jan. 2022 to Mar. 2024 and underwent liver biopsy with pathological results indicating a stage of S2 liver fibrosis in chronic liver disease were enrolled. All patients underwent ultrasound-guided liver biopsy to obtain the stage of pathological liver fibrosis (S1 to S4) and the grade of liver inflammation (G0 to G4). In addition, all the patients were examined by ultrasound combined with elastography; and shear wave velocity (Vs), acoustic attenuation coefficient (ATT), liver fibrosis index (LFI), fibrosis-related index (F index), and inflammatory activity index (A index) were obtained. The correlation between ultrasound combined with elastography parameters and pathological inflammation grading was analyzed. Results According to the pathological inflammation grading, there were 15 cases in group G1, 28 cases in group G2, and 8 cases in group G3. There were significant differences in F index, A index, Vs and ATT among the 3 groups (all P＜0.05). Among them, F index, A index and Vs in group G1 were significantly lower than those in group G3 (P＝0.007, 0.006, 0.040), while ATT was significantly higher than that in group G3 (P＝0.005); and there was no significant difference in LFI among the 3 groups (P＝0.373). Vs, ATT, F index and A index were correlated with pathological inflammation grade (r＝0.404, －0.417, 0.379, 0.383; P＝0.003, 0.002, 0.006, 0.006). The mean plot showed that with the increase of pathological inflammation grade, the age of patients showed a linear upward trend, ATT showed a linear downward trend, and A index showed a linear upward trend. Vs was positively correlated with alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), γ-glutamyltransferase (GGT), total bilirubin, and direct bilirubin (DBil) (all P＜0.05). ATT was negatively correlated with ALT, AST, GGT, and DBil (all P＜0.05); and both F index and A index were positively correlated with ALT, AST, ALP, GGT, and DBil (all P＜0.05). Conclusion Ultrasound combined with elastography can be used to evaluate the degree of inflammation in patients with chronic liver disease at S2 stage of liver fibrosis.

Abstract:Objective To analyze the computed tomography (CT) imaging features of urachal carcinoma and evaluate its diagnostic value. Methods The clinical data of 20 patients with urachal carcinoma confirmed by surgery and pathology, who were admitted to The First Affiliated Hospital of Naval Medical University from Dec. 2012 to Dec. 2022, were collected. Seventeen of the 20 patients underwent enhanced CT urography and 3 underwent pelvic CT plain scan＋enhanced scan. After scanning, multiplanar reconstruction was performed on the post-processing workstation. The general data, clinical symptoms, CT imaging findings, pathological data, and prognosis of the patients were analyzed and summarized. Results The patients included 16 males and 4 females, aged 27 to 75 years old, with a median age of 61.50 (41.50, 71.25) years old. The tumors were all located in the anterior wall of the bladder, along the urachus, with a maximum diameter of 1.72-5.55 cm and a median maximum diameter of 3.34 (2.48, 3.71) cm. Fourteen cases had cystic-solid lesions and 6 had solid lesions. In the cystic-solid lesions, 9 cases showed the “upper cystic and lower solid” sign on the sagittal plane. Calcification was noted in 17 cases. After enhanced scanning, 18 cases showed progressive enhancement, and 2 cases showed “fast in and fast out” enhancement. Tumor invasion extended beyond the urachus and/or bladder muscle layer in 19 cases. At the end of follow-up, 3 cases had recurrence, 2 had metastasis, 5 had no recurrence after surgery, 3 died, and 7 were lost to follow-up. Conclusion Urachal carcinoma has certain characteristic manifestations on CT imaging. Reconstructing the sagittal plane with enhanced CT scanning and multiplanner reformation can help preoperative diagnosis and prognostic evaluation of urachal carcinoma.

Abstract:Objective To analyze the characteristics of influenza incidence and the changes of innate immune cells among children who visited the pediatric outpatient or emergency department of a hospital in Shanghai from Jan. 2019 to Dec. 2023, so as to provide references for the prevention of influenza in children. Methods Influenza-like illness (ILI) children who first visited the pediatric outpatient or emergency department of The First Affiliated Hospital of Naval Medical University from Jan. 2019 to Dec. 2023, and underwent influenza virus antigen or nucleic acid testing were enrolled. Their clinical and laboratory data were collected for retrospective analysis. With a month as the basic monitoring unit, a line chart was used to describe the changes in the number of influenza cases and the positive rate. Then, these cases were assigned to pre-coronavirus disease 2019 (COVID-19) group (Jan. 2019 to Dec. 2019), mid-COVID-19 group (Jan. 2020 to Dec. 2022), or post-COVID-19 group (Jan. 2023 to Dec. 2023), and the influenza positive rates among these groups were compared. To further observe the changes of the innate immune cells of children with influenza A after non-pharmacological intervention (NPI) measures, considering the development characteristics of children’s white blood cells, children with influenza A were assigned to 2 subgroups according to age: 0-6 years or 7-16 years. Within each subgroup, they were assigned to pre-NPI group or post-NPI group according to time. A ratio of 1∶1 matching was carried out according to gender and age using propensity score matching, and the blood routine parameters were compared between the 2 groups. Results A total of 41 028 ILI children were enrolled. During the COVID-19 period from Jan. 2020 to Dec. 2022, the influenza positive rates decreased significantly (P＜0.001), and almost no influenza virus was detected. The peak of influenza reappeared in Mar. 2023, with a lag in the peak period, but higher than previous years’ peak, and the speed of reaching the peak was faster. In each subgroup, the white blood cell count and lymphocyte ratio of children with influenza A in the post-NPI group were lower than those in the pre-NPI group (all P＜0.001), and the monocyte ratio was higher than that in the pre-NPI group (both P＜0.001). Conclusion The implementation of NPI measures during COVID-19 leads to disruption of influenza transmission route and changes in the epidemic trend of influenza. The influenza virus causes serious public health problems after COVID-19 period, and children with influenza A experience more serious immune response. It is recommended to strengthen the vaccination of influenza vaccine before the flu season.

Abstract:Objective To understand the clinical distribution characteristics and drug-resistance genotypes of carbapenem-resistant Pseudomonas aeruginosa (CRPA) in a tertiary hospital in Shanghai, so as to guide the rational use of antibiotics, reduce bacterial resistance and control nosocomial infections. Methods A total of 94 consecutive and non-redundant CRPA strains isolated from clinical specimens were collected in The First Affiliated Hospital of Naval Medical University between Jan. 1, and Dec. 31, 2019. The distribution of CRPA across departments and sample sources were analyzed. Antimicrobial susceptibility testing against 13 antibiotics was determined using the VITEK 2 Compact automated microbiology analyzer and the Kirby-Bauer disk diffusion method. Polymerase chain reaction (PCR) was employed to detect genes encoding extended-spectrum β-lactamase resistance gene, carbapenemase resistance gene, and porin resistance gene. Homology analysis of selected isolates was performed using kSNP3, a k-mer-based software, for single nucleotide polymorphism (SNP) analysis. An evolutionary tree was constructed to assess genetic relationships. Additionally, multilocus sequence typing (MLST) was performed using the Pseudomonas aeruginosa typing scheme from the PubMLST database. Results Among the 94 CRPA isolates, high resistance rates were observed for carbapenems, including imipenem (92.6%, 87 strains) and meropenem (87.2%, 82 strains). In contrast, low resistance rates were detected for aminoglycosides, such as amikacin (10.6%, 10 strains), gentamicin (20.2%, 19 strains), and tobramycin (20.2%, 19 strains). The top 3 departments in terms of isolate distribution were the Emergency Intensive Care Unit (9.6%, 9 strains), Department of Cerebrovascular Surgery (8.5%, 8 strains), and Department of Respiratory Medicine (8.5%, 8 strains). PCR analysis of 94 CRPA strains detected outer membrane protein D2 (OprD2) gene deletion in 47 (50.0%) strains, 13 (13.8%) strains were positive for bla_KPC, 4 (4.3%) strains for bla_VIM, 2 (2.1%) strains for bla_IMP, 1 (1.1%) strain for bla_NDM, 12 (12.8%) strains for bla_TEM, 4 (4.3%) strains for bla_PER, and 2 (2.1%) strains for bla_GES, while bla_OXA-48, bla_BIC, bla_SIM, bla_VEB, and bla_SHV were not detected. MLST identified 36 different sequence types (STs), with ST463 and ST274 being the most common, and 2 new ST (ST4023 and ST4024) were identified for the first time. Conclusion CRPA strains carry multiple resistance genes and exhibit concurrent resistance to several commonly used clinical antibiotics. The resistance is primarily associated with the presence of bla_KPC, bla_VIM and bla_TEM genes and the deletion of OprD2 gene. Clinical monitoring of CRPA should be strengthened, and rational use of antimicrobial agents is essential to control its spread within the hospital.

Abstract:Objective To construct and validate a prediction model for urosepsis in patients after upper urinary tract stone surgery using various machine learning algorithms. Methods A total of 7 464 upper urinary tract stone patients who underwent surgery at the Sixth Affiliated Hospital of Guangxi Medical University from Jun. 2018 to Jun. 2023 were enrolled and randomly assigned to training (5 224 cases) or validation sets (2 240 cases) at a ratio of 7∶3. Among them, 622 (8.33%) cases developed urosepsis postoperatively. Six machine learning algorithms, including extreme gradient boosting (XGBoost), logistic regression, light gradient boosting machine (LightGBM), random forest (RF), adaptive boosting (AdaBoost), and gradient boosting decision tree (GBDT), were used to construct prediction models for postoperative urosepsis. The model’s predictive ability and clinical benefits were evaluated using receiver operating characteristic (ROC) curves, Shapley additive explanation (SHAP) analysis, calibration curves, and decision curve analysis (DCA). Results The clinical features included body mass index (BMI), number of surgeries, heart rate, Barthel index, venous thrombo embolism (VTE) risk assessment, gender, American Society of Anesthesiologists (ASA) grade, urinary nitrite, and urinary leukocyte in the models. In the training set, the XGBoost, LightGBM, and RF models performed excellently, with area under curve (AUC) values of ROC curves reaching 1.00. In the validation set, the logistic regression model performed the best, with an AUC value of ROC curve of 0.76, showing good predictive stability and calibration. The AdaBoost and GBDT models followed with AUC values of 0.74 and 0.75, respectively, while the AUC values of the LightGBM, XGBoost, and RF models were 0.71, 0.70, and 0.68. In terms of model interpretability, SHAP analysis showed the contribution of variables in a descending order as: heart rate, urinary leukocytes, gender, BMI, Barthel index, VTE risk assessment, urinary nitrite, number of surgeries, and ASA grade. Conclusion A logistic regression model for early risk prediction of postoperative urosepsis in upper urinary tract stone patients has been successfully constructed. This model has good predictive performance and calibration, and can effectively assist clinical diagnosis.

Abstract:Objective To explore the effects of single-session table tennis exercise with different intensities on working memory and the associated cognitive neural processing mechanisms in college students with depressive symptoms by using event-related potential (ERP) technology. Methods A convenience sampling approach was employed to recruit 100 college students with depressive symptoms from a university. Participants were randomly assigned at a 1∶1 ∶1 ∶1 ratio to low-intensity exercise group, moderate-intensity exercise group, high-intensity exercise group, or control group. The exercise groups participated in a single 30-min table tennis intervention at intensities corresponding to 57%-64% of maximum heart rate (HRmax) and rate of perceived exertion (RPE) scores ranging from 9-11, 65%-75% HRmax and RPE scores 12-13, and 76%-95% HRmax and RPE scores of 14-17 (5-min warm-up, 20-min monitored exercise, 5-min cool-down). The control group did not receive any exercise intervention. Pre- and post-intervention assessments of verbal working memory (VWM) and spatial working memory (SWM) were performed, alongside the recording of ERP components, including the amplitude and latency of N2 and P3, during the tasks. Results A total of 91 participants (20 in the low-intensity exercise group, 25 in the moderate-intensity exercise group, 23 in the high-intensity exercise group, and 23 in the control group) were enrolled for analysis. In the VWM task, the main effect of time on accuracy was found to be significant (F_(1,89)＝5.942, P＝0.017, partial η²＝0.064). Post-intervention, accuracy was significantly improved in the moderate-intensity and high-intensity exercise groups (change＝0.027, 95% confidence interval ［CI］ 0.001-0.053, P＝0.037; change＝0.029, 95% CI 0.002-0.055, P＝0.040). The main effect of time on reaction time was also significant (F_(1,89)＝7.244, P＝0.009, partial η²＝0.077). The interaction between group and time was also significant (F_(3,87)＝2.844, P＝0.042, partial η²＝0.089). After the intervention, the reaction time was reduced in the low-intensity and moderate-intensity exercise groups (change＝－0.095, 95% CI －0.183-－0.007, P＝0.035; change＝ －0.079, 95% CI －0.158-0, P＝0.049). The interaction between time and electrode location in the P3 latency in ERP components was significant (F_(3,87)＝5.785, P＜0.001, partial η²＝0.062), while the interactions for other ERP measures were not significant (all P＞0.05). In the SWM task, the main effect of time on accuracy was significant (F_(1,89)＝5.092, P＝0.027, partial η²＝0.055), while the interaction between group and time was not significant (F_(3,87)＝0.799, P＝0.498, partial η²＝0.027). After the intervention, accuracy was improved in the moderate-intensity exercise group (change＝0.019, 95% CI 0-0.037, P＝0.046). The main effect of time on reaction time was significant (F_(1,89)＝14.322, P＜0.001, partial η²＝0.141). The interaction between group and time was not significant (F_(3,87)＝1.521, P＝0.215, partial η²＝0.050). After the intervention, reaction time was shortened in the moderate-intensity and high-intensity exercise groups (change＝－0.082, 95% CI －0.136-－0.027, P＝0.004; change＝－0.075, 95% CI －0.131-－0.018, P＝0.029). The interaction between time and electrode location in the P3 amplitude in ERP components was significant (F_(3,87)＝5.475, P＝0.001, partial η²＝0.059), while the interactions for other ERP measures were not significant (all P＞0.05). Conclusion Single-session table tennis exercise with different intensities has a positive effect on working memory in college students with depressive symptoms. Moderate- to high-intensity exercise can enhance VWM accuracy, while low- to moderate-intensity exercise can reduce VWM reaction time. Furthermore, moderate-intensity exercise can improve SWM accuracy, and moderate- to high-intensity exercise can shorten SWM reaction time. Additionally, high-intensity exercise can lead to greater activation of ERP components.

Abstract:Bronchial asthma (hereinafter referred to as asthma) is a common chronic respiratory disease with significant gender differences. Epidemiologic surveys show that both the incidence and severity of asthma are significantly higher in adult females than in males. It is now believed that gender differences in asthma may be related to sex hormones, and the airway effects of estrogen and progesterone on asthma pathophysiology have been extensively studied. However, the mechanism of androgens in asthma is not clear. In recent years, some new studies have found that androgens and androgen receptors can exert anti-inflammatory effects in asthma through immune cells; moreover, they can also decrease airway hyperresponsiveness, relax airway smooth muscle, and improve lung function. This article reviews the progress of androgens and androgen receptors in asthma to deepen our understanding of the relationship between sex hormones and asthma, providing more options for future asthma treatment.

Abstract:Intensive care unit acquired weakness (ICU-AW) is common in clinical practice, especially muscle weakness and muscle dysfunction caused by delayed weaning from mechanical ventilation, which requires timely and effective imaging evaluation. Ultrasound, as a non-radiation, non-invasive, real-time and repeatable imaging technology, can serve as a preferred method for assessing muscle structure and function, and has important clinical value in the diagnosis and monitoring of ICU-AW. This review summarizes the clinical application and research progress of ultrasound examination in the non-invasive quantitative evaluation of ICU-AW.

Abstract:Mental health inequality is a major manifestation of health inequality in the psychological dimension, and it has become a realistic problem to challenge common social progress. The aim of this study is to review the domestic and international research on the measurement and decomposition of mental health inequality. The authors mainly discussed 3 aspects: socio-economic and demographic inequalities in mental health, and the impact of acute major infectious diseases on mental health inequality. They also summarized the commonly used indicators and research methods. This paper reviews the selection of data indicators, research subjects, and research perspectives, so as to provide evidence for further research on mental health inequality in China.

Abstract:Objective To investigate the detection rate and related influencing factors of gastrointestinal diseases in grass-roots personnel. Methods A total of 481 grass-roots personnel were enrolled and examined by magnetic-controlled capsule endoscopy (MCCE). Multivariate logistic regression were used to analyze the influencing factors of gastrointestinal diseases detected by MCCE. Results All personnel completed MCCE, and gastrointestinal diseases were detected in 154 (32.0%) cases, including 106 cases of erosive gastritis, 25 cases of chronic atrophic gastritis, 17 cases of digestive tract polyp, 16 cases of gastric ulcer, 5 cases of reflux esophagitis, 4 cases of cardia, 1 case of duodenitis, and 1 case of enteritis. Gastrointestinal diseases was correlated with special operation posts, long-term tasks within recent 6 months, abdominal distension, belching, nausea and vomiting, diarrhea and other symptoms (all P＜0.05). Multivariate logistic regression analysis showed that the risk factors of gastrointestinal diseases were working in special operation posts, performing long tasks within 6 months, belching, nausea and vomiting symptoms (all P＜0.05). Conclusion The overall detection rate of gastrointestinal diseases (mainly acid related diseases) is relatively high, and its incidence is closely related to working in special operation posts and performing long-term tasks within recent 6 months. Personnel working in special operation posts should be more alert to gastrointestinal diseases. Gastrointestinal symptoms have reference value for the prediction of lesions, but more attention should be paid to the identification of functional gastrointestinal diseases with endoscopy.

Abstract:Objective To establish a management scheme for the prevention and control of sudden respiratory infectious diseases on hospital ships and to evaluate its application. Methods The clinical practice, guidelines, expert consensus and systematic evaluation on the prevention and control of sudden respiratory infectious diseases at home and abroad were systematically retrieved. At the same time, the research team proposed a preliminary draft of the management scheme for the prevention and control of sudden respiratory infectious diseases on hospital ships by referring to the literatures on the management of major epidemics at home and abroad in recent years. After 2 rounds of discussion and amendment suggested by expert demonstration meetings, the management scheme for the prevention and control of sudden respiratory infectious diseases on hospital ships was finally formed, and preliminary verification was carried out in “Mission Harmony-2022”. Results The hospital ship management scheme for the prevention and control of sudden respiratory infectious diseases included 6 first-level items, 22 second-level items, and 40 third-level items (including 34 level-A recommended indicators and 6 level-B recommended indicators). The scheme was applied in “Mission Harmony-2022” and the task was successfully completed. Conclusion The management scheme for the prevention and control of sudden respiratory infectious diseases on hospital ships is systematic, comprehensive, rigorous, practical and scientific, and can provide a guiding reference for the rescue task of sudden respiratory infectious diseases on hospital ships.

Abstract:Objective To compare the application value of different nutritional assessment tools for peritoneal dialysis patients. Methods A total of 147 patients who were hospitalized for peritoneal dialysis in The Second Affiliated Hospital of Naval Medical University between Oct. 2022 and Oct. 2023 were enrolled by convenience sampling method. The nutritional assessment was carried out by using 3 assessment tools, including 7-point subjective global assessment (7-SGA), malnutrition inflammation score (MIS) and controlling nutritional status (CONUT). Correlation analyses were conducted between the nutritional assessment results and anthropometric measurements and blood biochemical indexes. Results The incidence of malnutrition assessed by 7-SGA, MIS, and CONUT were 53.74% (79/147), 48.30% (71/147), and 76.19% (112/147), respectively. Both 7-SGA and MIS assessment revealed that the incidence of malnutrition in peritoneal dialysis patients ＞ 60 years old was significantly higher than that in patients ≤60 years old (both P＜0.01). Grouped by 7-SGA results, the body mass index (BMI), skeletal muscle mass, skeletal muscle mass index, phase angle, grip strength, upper arm circumference, upper arm muscle circumference, skinfold thickness, albumin and prealbumin levels in malnourished peritoneal dialysis patients were significantly lower than those in well-nourished peritoneal dialysis patients (all P＜0.05). The 7-SGA score was negatively correlated with age (P＜0.05), and was positively correlated with BMI, skeletal muscle mass, skeletal muscle mass index, phase angle, grip strength, upper arm circumference, upper arm muscle circumference, skinfold thickness, albumin, prealbumin, total protein, creatinine, and hemoglobin (all P＜0.05). Conclusion The incidence of malnutrition in peritoneal dialysis patients varies with the assessment tools used. 7-SGA score has high correlation with anthropometric and blood biochemical indexes, and is effective, reliable, and practical. It is a good tool for nutritional assessment in patients undergoing peritoneal dialysis.

Abstract:Objective To examine the relationship between stigma and post-traumatic stress disorder (PTSD) symptoms among college students. Methods With cluster random sampling method, 1 312 college students were surveyed from various types of higher education institutions. Propensity score matching was employed to control potential confounding variables such as gender, age, and education level. Stigma were compared between the PTSD and non-PTSD groups. Results After matching, the students in the PTSD group (n＝139) exhibited significantly higher levels of stigma compared to the non-PTSD group (n＝139, P＜0.01). Further analysis revealed that stigma significantly affected all PTSD symptom clusters, with the strongest association found for hyperarousal and reactivity symptoms. Conclusion Individuals with PTSD may experience more severe stigma, which in turn may exacerbate their PTSD symptoms. Greater attention should be given to the potential impact of stigma on PTSD symptoms in college students, and effective interventions are needed to address this issue.

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