Objective:To investigate the change of peptidylarginine deiminase 4 (PAD4) expression in the neutrophils of peripheral blood of patients with anti-neutrophil cytoplasmic myeloperoxidase antibody-associated vasculitis (MPO-AAV), and to analyze the relationship between the change and disease activity.Methods:Thirty-nine untreated patients with active MPO-AAV (patient group) and thirty-nine healthy volunteers (control group) were enrolled into this study. The PAD4 expressed on neutrophils was detected by flow cytometry (FCM). The serum neutrophil extracellular traps (NETs), fragments from the activated complement C5 (C5a) and anti-neutrophil cytoplasmic myeloperoxidase antibody (MPO-ANCA) were measured by enzyme-linked immuno sorbent assay (ELISA). Their disease activity was evaluated by Birmingham vasculitis activity score (BVAS). All the detected results were compared between the 2 groups by t test, Spearman correlation analysis and multivariate linear regression analysis were employed to analyze the relationship between BVAS and the Lab test results in patient group. Results:The proportion of neutrophil expressing PAD4, the mean fluorescence intensity (MIF) of PAD4, the levels of NETs and C5a in patient group were significantly higher than those in the control group [(71±11)% vs (26±6)%, t=22.456, P<0.01; (33±4) vs (14±4), t=18.668, P<0.01; (0.62±0.22) vs (0.26±0.15), t=8.466, P<0.01 and (4.6±1.0) vs (2.9±1.0), t=7.697, P<0.01, respectively]. In patient group, BVAS was positively associated with the proportion of PAD4 + neutrophil, MFI of PAD4, the serum level of NETs, C5a and MPO-ANCA ( r=0.843, P<0.01; r=0.821, P<0.01; r=0.411 1, P<0.01; r=0.613, P<0.01 and P=0.790, P<0.01, respectively), however, the results of multiple linear regression analysis showed only the percentage of PAD4 + neutrophils and the level of MPO-ANCA were independent influencing factors on BVAS ( β=0.324 6, P<0.01 and β=0.796, P<0.01, respectively). Conclusion:The percentage of neutrophils expressed PAD4 in the peripheral blood of patient with active MPO-AAV is significantly increased, and it is an independent factor affecting the disease activity. Intervention on this expression might be a potential new pathway for MPO-AAV treatment.

Objective:To analyze and explore the possible mechanism of anti-tumor metastasis of Notoginseng Radix et Rhizoma using Internet pharmacology. Methods:The active components and targets of Notoginseng Radix et Rhizoma were screened by retrieving Chinese Medicine System Pharmacology Database and Analysis Platform (TCMSP). GeneCards database was used to screen the anti-tumor metastasis-related targets, and compounds and disease targets were under mapping analysis. Key targets of Notoginseng Radix et Rhizoma for anti-tumor metastasis were screened through Venn map. With the help of Cytoscape 3.7.2 software, a compound-disease network diagram was constructed. String platform was used to build a PPI network. Bioconductor was used to enrich the target genes for KEGG signaling pathway and GO biological process analysis. Results:Totally 119 active components were selected from Notoginseng Radix et Rhizoma. There were 8 eligible active components, corresponding to 162 related targets, 121 targets related to anti-tumor metastasis, and 30 key targets screened by PPI network, including AKT1, MAPK1, JUN, RELA, IL6, etc. GO enrichment analysis mainly involved biological processes such as cytokine receptor binding, heme binding, RNA polymerase Ⅱ transcription factor binding, ubiquitin protein ligase binding, and steroid hormone receptor activity. 149 signal pathways related to Notoginseng Radix et Rhizoma anti-tumor metastasis were obtained by KEGG enrichment analysis, mainly involving multiple signal pathways, such as AGE-RAGE and PI3K-Akt, and hepatitis B, Kaposi's sarcoma-associated herpes virus infection, human cytomegalovirus infection and other viral infections and various tumors. Conclusion:Notoginseng Radix et Rhizoma can pass multiple active components, such as ginsenoside f2, ginsenoside rh2 β-, sitosterol, stigmasterol and quercetin, and multiple targets, such as AKT1, MAPK1, JUN, RELA and IL6, acting on multiple pathways such as PI3K-Akt, thereby playing the role of anti-tumor metastasis.

Objective Based on mosq-ovitrap monitoring method of Aedes albopictus， to determine the spatial and temporal distribution of Aedes albopictus in Songjiang District and provide scientific evidence for prevention and control of mosquito-borne diseases. Methods From May to October， 2018‒2020， density of Aedes albopictus was monitored by using the mosq-ovitrap method. Sub-districts and towns were used as the monitoring units and the difference in mosquito ovitrap index （MOI） was compared by seasons， years and habitats. Results The total number of positive mosquito ovitraps was 1049 in 2018‒2020， and the average MOI was 8.10. Four sub-districts/towns in the urban area and the northern area had the relatively high MOIs. Moreover， MOIs in residential and external environments were higher than other habitats. In addition， MOI of Aedes albopictus decreased over years from 2018 to 2020. Conclusion Aedes albopictus is widely distributed in Songjiang District. Although the number of mosquito decreased over years after the implementation of mosquito control measures， reproduction of mosquito remains excessive in some areas and seasons. It is necessary to perform targeted control measures based on comprehensive monitoring methods.

ObjectiveTo characterize the prevalence and epidemic situation of imported malaria cases in Songjiang District of Shanghai from 2013 to 2022， and to provide evidence for malaria prevention and control. MethodsRelated data were collected and analyzed， including malaria cases， blood testing of febrile patients， and mosquito surveillance in Songjiang from 2013 to 2022. ResultsA total of 13 002 febrile patients in Songjiang were tested for plasmodium parasites from 2013 to 2022， among which 18 malaria cases were confirmed， including 17 cases of falciparum malaria and 1 case of ovale malaria. Moreover， a total of 36 malaria cases were notified in Songjiang through the National Notifiable Disease Reporting System from 2013 to 2022， including cases reported from Songjiang District and other districts or provinces with physical addresses in Songjiang. Of them， there were 31 cases of falciparum malaria， 2 cases of vivax malaria， 2 cases of ovale malaria and 1 case of quartan malaria. The gender ratio of male to female cases was 17∶1， and the majority was young and middle aged. In addition， 35 cases were imported from Africa and 1 case from southeast Asia； 34 cases were migrant workers， and 2 cases were travellers abroad； 17 cases were found and reported in Songjiang， 15 cases were reported from other districts of Shanghai， and 4 cases were reported from other provinces； 27 cases were treated in Shanghai， 3 cases were treated in other provinces and 6 cases were treated with self-provided antimalarial drugs. Mosquito surveillance in Songjiang showed that density of Anopheles sinensis was extremely low. ConclusionNo indigenous malaria case has been notified in Songjiang since 2008. Malaria surveillance on migrant workers remains the focus of malaria prevention and control. Furthermore， achievement of malaria elimination in Songjiang should be continually enhanced to avoid potential further transmission of imported malaria.

Objective:To explore the sensitivity and specificity of fetal intelligent navigation echocardiography(FINE, 5D Heart) in the prenatal detection of congenital heart defect(CHD), and to compare its diagnostic performance with spatiotemporal image correlation(STIC) loop (STICloop).Methods:A total of 250 pregnant women having a singleton pregnancy in the second and third trimesters from April 2018 to May 2019 in Sir Run Run Shaw Hospital, Zhejiang University College of Medicine were enrolled in this prospective study. 2D ultrasound diagnosis has been made before acquiring STIC volume data set. After the appropriateness of each volume data set was preliminarily determined, all identifying informations were concealed and the appropriate volumes were randomly distributed to less experienced sonographer for analysis using 5D Heart software. The sensitivity and specificity, positive and negative likelihood ratios, as well as area under the receiver operating characteristic curve (AUC) of the two methods were determined respectively, and the differences between the two methods were statistically analyzed.Results:The diagnostic performance of 5D Heart for the prenatal detection of CHD was: sensitivity of 95.45% (105/110), specificity of 94.29% (132/140), positive likelihood ratio of 16.72, negative likelihood ratio of 0.05, and AUC of 0.95, respectively. Among cases with confirmed CHD, the 5D Heart diagnosis completely matched the final diagnosis in 77.27% (85/110). The diagnostic performance of STICloop for the prenatal detection of CHD was: sensitivity of 90.91% (100/110), specificity of 92.86% (130/140), positive likelihood ratio of 12.73, negative likelihood ratio of 0.10, and AUC of 0.92. The sensitivity and secificity of 5D Heart in diagnosing CHD were both higher than 90%, and it could successfully detect a broad spectrum of severe fetal CHD. Among cases with confirmed CHD, even the STICloop diagnosis completely matched the final diagnosis in 61.81%(68/110), its diagnostic accuracy was relatively lower than 5D Heart ( P=0.013). However, there were no statistical differences between the two methods in sensitivity and specificity(all P>0.05). Conclusions:The sesitivity and specifity of 5D Heart in diagnosis CHD were both higher than 90%, and it could successfully detect a broad spectrum of severe fetal CHD. STICloop could be used for preliminary screening of CHD, as it has the same high sensitivity and specificity as 5D Heart. Further examination may be recommended when fetal heart abnormalities are suspected.

Objective:To describe the distribution of fat-free mass (FFM) and fat-free mass index (FFMI) in children aged 3-17 years in China.Methods:Data were collected from National Nutrition and Health Systematic Survey in 0-18 years old children in China. By using multi-stage stratified randomized cluster sampling method, the project was conducted in 28 survey points in urban and rural areas in 14 provinces (autonomous regions and municipalities) in 7 regions in China from 2019 to 2021. FFM was measured using bioelectrical impedance meter. Finally, the body composition data of 70 853 children were included in the analysis. M ( Q1, Q3) was used to describe the gender and age specific FFM and FFMI of the children in different regions. Kruskal-Wallis H rank sum test was used to compare FFM and FFMI of boys and girls in same age group, boys in different age groups, girls in different age groups, as well as boys in same age group and girls in same age group in different regions. DSCF method was used for pairwise comparisons. Results:After the age of 11 years, the difference of FFMI between boys and girls increased year by year. The FFMI was 14.2 kg/m 2 in boys and 13.8 kg/m 2 in girls at 11 years old, the difference was significant ( χ2=135.86, P<0.001). The difference of FFMI between boys and girls exceed 1.0 kg/m 2 from 12 years old, and FFMI was 15.3 kg/m 2 in boys and 14.2 kg/m 2 in girls at 12 year old, the difference was significant ( χ2=597.27, P<0.001). The FFMI was 17.5 kg/m 2 in boys and 14.7 kg/m 2 in girls at 16 years old, the difference was significant ( χ2=2 543.60, P<0.001). The FFMI was higher in boys in northeast China, while the FFMI was lower in both boys and girls in northwest China. Conclusions:Gender specific difference was observed in the increase of FFMI with age. The FFMI was significantly higher in boys than in girls after 11 years old. It is necessary to pay attention to the problem of FFM in children in northeastern and northwestern China.

Objective:To investigate the distribution characteristics of body height, body weight and body mass index (BMI) in children aged 3-17 years in China.Methods:Data were obtained from the National Nutrition and Health Systematic Survey in 0-18 years old children in China. The study selected 70 853 children aged 3-17 years from 28 urban and rural survey sites in 14 provinces (autonomous regions and municipalities) in 7 regions of China with multi-stage stratified cluster random sampling. M ( Q1, Q3) was used to describe the region, age and gender specific body height, body weight and BMI in the children aged 3-17 years. Wilcoxon rank sum test was used to compare the body height, body weight, and BMI between boys and girls in same age group. Kruskal-Wallis H rank sum test was used to compare the body height, body weight and BMI among boys in different age groups and among girls in different age groups, as well as among boys in same age group and among girls in same age group from different regions, and DSCF method was used for further pairwise comparisons. Results:In this study, the median body height and body weight were 172.0 cm and 62.9 kg in 17-year-old boys and 160.0 cm and 53.7 kg in 17-year-old girls. The median for children's body height, body weight, and BMI in most age groups were higher in northeastern and northern China than in southern China, and the differences could be observed until age 17 years. The differences in body weight and BMI in children in northeastern and northern China were greater in Q3 than in Q1 compared with southern China. Conclusions:The body height of children aged 3-17 years continues to increase in China. Northeastern and northern China have more children with higher bodyweight, showing an obvious body weight increase trend, to which close attention needs to be paid.

Objective:To describe the distribution of fat mass (FM), fat mass percentage (FMP), and fat mass index (FMI) in children aged 3-17 years in China.Methods:Data of this study were from the National Nutrition and Health Systematic Survey in 0-18 years old children in China. A total of 70 853 children aged 3-17 years old selected from seven regions of China were included in this analysis. Body composition were measured by using bioelectrical impedance meter. The region, gender and age specific FM, FMP and FMI of the subjects were described by using M ( Q1, Q3). Kruskal-Wallis H rank sum test was used for the comparison of intergroup differences. DSCF method was used for pairwise comparisons. Results:The medians of FM, FMP and FMI were 3.0 kg, 18.3% and 2.9 kg/m 2 in boys aged 3 years and 2.9 kg, 19.0% and 2.9 kg/m 2 in girls aged 3 years, respectively. The FM increased with age and the FMP and FMI decreased with age in both boys and girls aged 3-5 years. After 11 years old, the FM, FMP and FMI decreased first and then increased in boys. From 6-17 years old, the FM, FMP and FMI increased gradually in girls. The FM, FMP and FMI were higher in girls than in boys after 12 years old (all P<0.05). The FM, FMP and FMI were relatively higher in children at the age of 6-14 in northeastern and northern China than in other regions. Conclusions:The age specific FM, FMP and FMI had different changing characteristics in boys and girls aged 3-17 years in seven regions of China. The FM, FMP and FMI also differed with region.

Objective:To analyze the relationship between body mass index (BMI) and fat mass percentage (FMP) in children aged 3-17 years in China.Methods:The BMI and FMP data of children aged 3-17 years from the National Nutrition and Health Systematic Survey in 0-18 years old children in China was analyzed. BMI- Z score/BMI and FMP were used to classify the subjects, respectively. Spearman correlation was used to analyze the correlation between BMI and FMP. The consistency between BMI- Z score/BMI and FMP in classifying the subjects was measured using Kappa coefficient. Results:The FMP of malnutrition, normal and overweight/obesity in boys was higher in age group 10-13-year than in other age groups (all P<0.001). The FMP of all nutritional status in girls increased with age (all P<0.05). The BMI of boys in all the FMP levels increased with age (all P<0.05). When the FMP of girls was 25%- or ≥30%, BMI increased with age (all P<0.001). The relationship between BMI and FMP was strong ( r=0.705, P<0.001), with r of 0.618 in boys and 0.884 in girls. The consistency between BMI- Z score/BMI and FMP in classifying the subjects was found to be moderate (Kappa=0.574, P<0.001). Conclusions:There was a strong relationship between BMI and FMP. The consistency between BMI- Z score/BMI and FMP in classifying the subjects was moderate.

ObjectiveTo investigate the infection and genotypes of Wolbachia in Aedes albopictus. MethodsAdult and larval samples of Aedes albopictus were collected from different residential and wild areas from 2020 to 2021， Wolbachia surface protein （wsp） gene was amplified and genotyped for wAlbA and wAlbB by PCR， and sequenced for phylogenetic analysis. The difference of detection rate among different habitats， male and female adult mosquitoes， adult and larvae was compared by χ² analysis. ResultsThe detection rate of Wolbachia in adult and larvae of Aedes albopictus were 43.5% （77/177） and 70.4% （190/270）， respectively， with a statistically significant difference （χ²=32.086，P<0.001）， and wAlbA and wAlbB were mainly detected together. The detection rate of Wolbachia in female and male Aedes albopictus were 50.7% （76/150） and 3.7% （1/27）， respectively， with a statistically significant difference（χ²=20.533，P<0.001）. The detection rate of adult Aedes albopictus in Songjiang wild area， residential area and Hongkou residential area were 91.7% （55/60）， 18.8% （22/117） and 41.7% （30/72）， respectively， with a statistically significant difference （χ²=54.322，P<0.001）. Genotyping and phylogenetic analysis showed that adult and larvae of Aedes albopictus infected with Wolbachia were mainly wAlb A and wAlb B. In addition， some sequences formed clades independently， and the genetic distance from other sequences was relatively large. ConclusionInfection of Wolbachia in Aedes albopictus is relatively common in Songjiang District. The main genotypes are wAlb A and wAlb B and there may be other subtypes， which are worthy of further exploration and research.