Objective To understand and analyze the epidemiological and pathogenic characteristics of foodborne diseases in Changzhou in the past five years, so as to provide evidence for prevention and control measures. Methods All foodborne disease surveillance information reported by Changzhou foodborne disease sentinel hospital from 2016 to 2020 was collected through the ^“Foodborne Disease Surveillance and Reporting System^”. The distribution of reported cases and etiological results was described, and the possible factors affecting pathogen detection results were analyzed. Results A total of 14 931 cases of foodborne diseases were reported, mainly distributed in summer and autumn, and peaked in July and August. The age group of reported cases was 25-34 years old, and the occupations were mainly workers, and farmers and migrant workers, accounting for 23.2% and 36.9%, respectively. Among the reported cases of 3 120 anal swabs were collected and tested for etiology , of which 291 specimens were positive, with a positive detection rate of 9.32%. Among the 291 positive results of 118 cases of norovirus were detected, with a detection rate of 6.03% . 66 cases of salmonella were detected, with a detection rate of 2.12% . 25 cases of vibrio parahaemolyticus were detected, with a detection rate of 0.80% . 7 cases of diarrhea-causing Escherichia coli was detected, with a detection rate of 0.22% ; and 5 cases of shigella was detected, with a detection rate of 0.16% . Single factor analysis of the results of pathogen detection showed that there were no statistical differences in the distribution of positive pathogen detection rate between males and females, and between different suspicious exposed foods (all P>0.05). There were statistical differences in different age groups, occupations, seasons and eating places (all P<0.05). Multivariate Logistic regression analysis showed that age and season were correlated with the detection rates of pathogenic microorganisms (all P<0.05) , and age was negatively correlated with the positive rate of pathogenic microorganisms (OR=0.863). The detection rates in the first and fourth quarters were higher than those in the second and third quarters. Conclusion Summer and autumn are the seasons with high incidence of foodborne diseases in Changzhou. Norovirus is the main pathogen. Age and season are closely related to the detection results of pathogenic microorganisms. Comprehensive prevention and control measures should be implemented for key population in summer and autumn to reduce the occurrence and outbreak of foodborne diseases.

Objective To understand the contamination status of common food-borne pathogens in foods sold in Changzhou, and to provide evidence for food safety risk assessment and prevention of food-borne diseases. Methods From 2010 to 2020 , 2 513 samples of 17 types of foods were collected in Changzhou area. The detection of pathogenic bacteria was carried out in accordance with the standard operation procedure specified in the ^“Workbook for Surveillance on Food Microorganisms and Pathogenic Factors in Jiangsu Province^”. Results A total of 260 positive samples of common food-borne pathogens were detected in all 2 513 samples with an overall detection rate of 10.30%. Single factor analysis showed that the detection rate of pathogenic bacteria in non-ready-to-eat samples was higher than that in ready-to-eat samples (χ²=148.875，P =0.000). The detection rate of pathogenic bacteria in bulk samples was higher than that in prepackaged ones (χ²=70.956，P=0.000). There is a difference in the detection rate of food-borne pathogens from different types of sampling sites (χ²=65.017，P=0.000). Logistic regression analysis showed that ready-to-eat food, packaging type, and sampling season were significantly correlated with the detection rate of food-borne pathogens. The detection rate of pathogenic bacteria in samples collected in the third or fourth quarters was higher than that in the first quarter. Conclusion The commercial foods sold in Changzhou have a relatively high level of contamination of food-borne pathogenic bacteria, and they should be fully heated and sterilized before consumption. The relevant departments should strengthen supervision and health education in summer and autumn.

Background With the increasing exposure to hazardous chemicals in the workplace and frequency of occupational injuries and occupational safety accidents, the acquisition of occupational exposure limits of hazardous chemicals is imminent. Objective To obtain more unknown immediately dangerous to life or health (IDLH) concentrations of hazardous chemicals in the workplace by exploring the application of quantitative structure-activity relationship (QSAR) prediction method to IDLH concentrations, and to provide a theoretical basis and technical support for the assessment and prevention of occupational injuries. Methods QSAR was used to correlate the IDLH values of 50 benzene and its derivatives with the molecular structures of target compounds. Firstly, affinity propagation algorithm was applied to cluster sample sets. Secondly, Dragon 2.1 software was used to calculate and pre-screen 537 molecular descriptors. Thirdly, the genetic algorithm was used to select six characteristic molecular descriptors as dependent variables and to construct a multiple linear regression model (MLR) and two nonlinear models using support vector machine (SVM) and artificial neural network (ANN) respectively. Finally, model performance was evaluated by internal and external validation and Williams diagram was drawn to determine the scopes of selected models. Results The ANN model results showed that \begin{document}$ {R}_{\mathrm{t}\mathrm{r}\mathrm{a}\mathrm{i}\mathrm{n}}^{2} $\end{document}=0.8526 and \begin{document}$ {R}_{\mathrm{t}\mathrm{e}\mathrm{s}\mathrm{t}}^{2} $\end{document}=0.8505 respectively, root mean square (RMSE) error=0.5243, mean absolute error (MAE)=0.4610, internal and external validation coefficients \begin{document}$ {Q}_{\mathrm{l}00}^{2} $\end{document}=0.8476 and \begin{document}$ {Q}_{\mathrm{e}\mathrm{x}\mathrm{t}}^{2} $\end{document}=0.8905 respectively. By comparison, the performance verification parameters of the ANN model were superior to the MLR and SVM models, and all substances were in the applicable domain. Conclusion At present, the ANN model has the best performance in fitting ability, stability, and prediction, and is suitable for predicting IDLH concentrations of benzene and its derivatives. Predicting the IDLH concentraitons of benzene and its derivatives by QSAR method is an effective method, and provides a theoretical basis and technical support for the development of occupational health and safety.

OBJECTIVE To optimize the clinical drug list of diagnosis-related group （DRG）， reduce the drug cost of patients， and increase the DRG settlement rate. METHODS By selecting BR23 disease group in the department of neurology of a hospital as the research object， data mining technology was used to explore the medication rule of the disease group， and the key monitored drugs were scored by comprehensive evaluation of drugs， thus optimizing the clinical drug list of disease groups. The hospitalization information of patients enrolled in the disease group in December 2022 was selected as the pre-optimization data， and the hospitalization information of patients enrolled in the disease group in September 2023 was selected as the post-optimization data. The implementation effect of the optimized list was evaluated by comparing the medical quality and drug cost data between the two groups. RESULTS After optimizing the clinical drug list， the settlement rate of this disease group increased from 84.36% before optimization to 104.70%； there was significant reduction in hospitalization drug cost and total hospitalization cost （P＜ 0.05）； the consumption of key monitored drugs significantly decreased. CONCLUSIONS Data mining technology helps explore the clinical medication rules of disease groups， which can be used by pharmacists to improve the settlement rate of DRG through effective pharmaceutical intervention.

Objective To evaluate the clinical significance of transvaginal color Doppler ultrasound for the differential diagnosis of benign and malignant ovarian cysts. Methods Patients who were diagnosed with clinically suspected or palpable adnexal masses and underwent gray-scale ultrasonography, transvaginal color Doppler ultrasonography, and ultrasound-guided fine-needle aspiration cytology (FNAC) during the period from 2018 to 2021 were enrolled in this study. The pulsatility index (PI) and resistance index (RI) were estimated, and an ovarian cyst with the lowest PI value of < 1.0 or the lowest RI value of < 0.4 was considered as malignant. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of gray-scale ultrasound and transvaginal color Doppler ultrasound for the differential diagnosis of benign and malignant ovarian cysts were estimated with FNAC as the gold standard. Results A total of 180 patients with ovarian cysts were recruited, and FNAC revealed that 81 of them had malignant lesions and 99 of them had benign lesions. The transvaginal color Doppler ultrasonograms showed that 75 patients (92.59%) with malignant lesions had blood-flow signals in their cysts and 42 patients (42.24%) with benign lesions had blood-flow signals in their cysts, with a significant difference in the proportion between the two groups (χ² = 49.29, P < 0.01). Among the 75 patients with blood-flow signals in malignant ovarian cysts, 75 had PI < 1.0 and 24 had RI < 0.4; among the 42 patients with blood-flow signals in benign ovarian cysts, 15 had PI < 1.0 and no one had RI < 0.4; there were significant differences in the proportions of PI < 1.0 and RI < 0.4 between the two groups (χ² = 62.68, P < 0.01; χ² = 16.91, P < 0.01). In addition, compared with the combination of gray-scale ultrasound and transvaginal color Doppler ultrasound, gray-scale ultrasound alone had significantly lower sensitivity (51.85% vs 81.48%; χ² = 16.00, P < 0.01), specificity (75.76% vs 93.94%; χ² = 12.73, P < 0.01), PPV (63.64% vs 91.67%; χ² = 15.90, P < 0.01), and NPV (65.79% vs 86.11%; χ² = 12.44, P < 0.01) for the differential diagnosis of benign and malignant ovarian cysts. Conclusion Gray-scale ultrasound is effective for diagnosing ovarian cysts; however, gray-scale ultrasound combined with transvaginal color Doppler ultrasound can improve the differential diagnosis of benign and malignant ovarian cysts.

Objective To understand the water quality and sanitation of swimming pools in Changzhou City, provide a basis for the sanitation supervision of swimming places by the sanitation supervision department, and protect the health of swimmers. Methods The water samples (pool water and foot immersion water) of Changzhou swimming pool from June to August of 2018-2020 were randomly collected and tested according to the Examination Methods for Public Places-Part 6: Technical Specifications of Health Monitoring (GB/T 18204.6-2013). The evaluation of test result was based on the Hygienic Standard for Swimming Place (GB 9667-1996) and Hygienic Indicators and Limits for Public Places (GB 37488-2019). SPSS19.0 statistical software was used, and the data was analyzed by chi-square test. Results Total 94 swimming places and 178 water samples were tested from 2018 to 2020. 40 samples achieved standard (22.47%). There was no statistically significant difference in water qualified rates quality qualification rate between 2018, 2019 and 2020 (χ²=5.42, P=0.07). The main unqualified items were free residual chlorine (46.63%), followed by urea (76.40%) and total bacteria count (78.09%). Conclusion The water quality of swimming pools in Changzhou is still poor, and the daily supervision of swimming pools should continue to be strengthened.

Objective To assess the state of schistosomiasis elimination in 6 districts of Changzhou City, Jiangsu Province, so as to provide the evidence for the formulation of consolidation measures. Methods Three towns (streets) were selected according to the schistosomiasis epidemic degree in each district, and one village was sampled from each town. The on-site assessment was carried out between 2016 and 2017, including Oncomelania hupensis snail survey, population investigation and domestic animal investigation. In addition, the related data and materials were evaluated and the monitoring ability was assessed. Results In the history, there were 54 endemic towns, 368 endemic villages in Changzhou City, with a total area of 3 934.79 hm² of historic snail spots, and 114 990 schistosomiasis cases so far. In the field assessment in 6 districts, a total of 26 environments were surveyed, with the surveyed area of 36.23 hm², and there were no living snails captured in each village. A total of 18 199 people were examined for schistosome infection, 255 were blood test positive, and the sero-positive rate was 1.40%. The stool examination was done in 255 sero-positive cases, and no cases were stool-positive. A total of 779 domestic animals were investigated, including 200 cattle, 179 sheep and 400 pigs, and no infections were detected. The files regarding the snail status and schistosomiasis epidemic situation, and the monitoring data were complete and accurate in 6 districts. The annual investment funds for schistosomiasis prevention were 3 120 000 Yuan in Changzhou City, and the number of staff working for schistosomiasis prevention was 86 totally, which could meet the requirements of high quality monitoring. Conclusions All 6 districts of Changzhou City have met the requirements of schistosomiasis elimination.

Post traumatic epilepsy （PTE） refers to the epileptic seizures after traumatic brain injury. Organic damage can be found by imaging examination, and abnormal electroencephalogram can be detected via electroencephalogram examination which has the similar location of the brain injury. PTE has the characteristics of low incidence, absence of case reports, and easy to exaggerate the state of illness, which add difficulties to the forensic identification. This paper reviews the status of epidemiology, pathogenesis, clinical treatment and forensic identification for PTE.
Brain Injuries, Traumatic/physiopathology* ; Electroencephalography ; Epilepsy ; Epilepsy, Post-Traumatic/pathology* ; Forensic Pathology ; Humans ; Incidence

To investigate the protective effect of salvianolic acid B(SAB)on the intestinal tract of rats after intestinal ischemia-reperfusion injury(IIRI). Forty-eight healthy male SD rats were equally randomized into IIRI group,SAB+IIRI group,sham control group,and SAB+sham control group. The malonyldialdehyde(MDA)level and superoxide dismutase(SOD)activity in the ileum were measured in each group according to the kit instructions,the transcription levels of inflammatory factors in the ileum of rats were detected by real-time fluorescence quantitative RT-PCR,the secretion level of inflammatory factors was detected by ELISA,and the effects of intestinal ischemia-reperfusion on intestinal permeability and histological lesions were measured by histopathology. The MDA level in IIRI group was significantly higher than those in negative control group(=0.005)and SAB+IIRI group(=0.012). SOD activity of IIRI group was significantly lower than those of negative control group(=0.006)and SAB+IIRI group(=0.017). The optical densities of tumor necrosis factor-α(TNF-α)(=0.003,=0.009),interleukin(IL)-1β(=0.026,=0.005),IL-6(=0.015,=0.003),and nuclear factor kappa-B(NF-κB)(=0.007,=0.015)in IIRI group were significantly higher than those in sham control group and SAB+IIRI group. The TNF-α(=0.002,=0.006),IL-1β(=0.002,=0.006),IL-6(=0.008,=0.002),and NF-κB(=0.026,=0.005)levels in IIRI group were significantly higher than those in sham control group and SAB+IIRI group. The inulin level in IIRI group was significantly lower than that in negative control group(=0.015)and significantly higher than that in SAB+IIRI group(=0.011). The dextran level in IIRI group was significantly lower than those in sham control group(=0.011)and SAB+IIRI group(=0.012). The dextran gel level in IIRI group was significantly higher than those in sham control group(=0.031)and SAB+IIRI group(=0.020). SAB pretreatment remarkably improved the edema,necrosis,and villus stripping of the intestinal mucosa in the ileum of rats. The Chiu score was significantly higher in SAB+sham control group than in sham control group(=0.001)and was significantly lower in SAB+IIRI group than in IIRI group(=0.001). SAB pretreatment can alleviate IIRI in rat models,and this protective effect may be achieved by alleviating oxidative stress and inflammation in the intestinal tract.