Objective To analyze the clinical features and risk factors for mortality of patients with severe fever with thrombocytopenia syndrome (SFTS) in Zhoushan, the eastern coastal of China with high incidence of severe fever with thrambocytopenia syndrome bunyavirus infection, to provide reference for reducing the mortality rate of SFTS.Methods Clinical data of 107 cases of SFTS from Zhoushan Hospital during June 2011 to June 2016 were retrospectively analyzed.According to the prognosis, patients were divided into survival group and death group.The clinical features and the laboratory results were analyzed with a case-control method to analyze the prognostic factors.Normal distribution data were compared with the independent t test.Kolmogorov-Smirnov Z test were used in data with skewness distribution.Categorical data were analyze by chi-square test.The related risk factors were analyzed with the receiver-operating characteristic (ROC) curve and multivariate unconditioned logistics regression analysis.Results Seventeen cases among 107 STFs patients died, yielding the mortality rate of 15.9%.The proportion of patients suffering from two or more underlying diseases, with disorders of consciousness, activated partial thromboplastin time (APTT), the level of creatine kinase (CK), lactate dehydrogenase (LDH) as well as sepsis-related or sequential organ failure assessment (SOFA) score in death group were all significantly higher than those in the survival group (all P<0.05).The Ca2+ level and fibrinogen level in death group were significantly lower than those in the survival group (both P<0.05).Indexes mentioned above were analyzed by ROC curve, and the calculated cut-off value was set as the optimal diagnostic thresholds.These data were then included into the multivariate logistic regression analysis.It turned out that Ca2+<1.625 mmol/L, APTT >73.45 s, SOFA scores >9 were the independent risk factors for mortality of SFTS (OR=6.947, 8.459 and 11.770, respectively, all P<0.05).Conclusion Ca2+, APTT and SOFA score are the independent risk factors for prognosis of SFTS, which provide reference for prognostic evaluation of SFTS.

Purpose: Drug resistance is one of the main causes of chemotherapy failure in patients with small cell lung cancer (SCLC), and extensive biological studies into chemotherapy drug resistance are required. Materials and Methods: In this study, we performed lncRNA microarray, in vitro functional assays, in vivo models and cDNA microarray to evaluate the impact of lncRNA in SCLC chemoresistance. Results: The results showed that KCNQ1OT1 expression was upregulated in SCLC tissues and was a poor prognostic factor for patients with SCLC. Knockdown of KCNQ1OT1 inhibited cell proliferation, migration, chemoresistance and promoted apoptosis of SCLC cells. Mechanistic investigation showed that KCNQ1OT1 can activate transforming growth factor-β1 mediated epithelial-to-mesenchymal transition in SCLC cells. Conclusion Taken together, our study revealed the role of KCNQ1OT1 in the progression and chemoresistance of SCLC, and suggested KCNQ1OT1 as a potential diagnostic and prognostic biomarker in SCLC clinical management.

Objective:To investigate the status and the influencing factors of influenza vaccination during the COVID-19 pandemic among community-dwelling elderly in Shanghai.Methods:A questionnaire survey on influenza vaccination among community-dwelling elderly was conducted in Shanghai Taikang elderly community in November 2020. The information on demographic characteristics, reasons for refusal of vaccination, and measures for increasing vaccination rates were collected. Multiple logistic regression was used to analyze the correlation between influenza vaccination and sociodemographic and health-related characteristics.Results:Among 520 respondents, the vaccination rate was 30.58% (159/520). Compared with unvaccinated group, elderly in vaccinated group was older ( t=16.04, P=0.003)and more educated(χ2=8.16, P=0.043). The elderly with comorbid heart disease, chronic obstructive pulmonary disease, tumor, asthma, Parkinson′s disease were likely to have vaccination ( OR=1.45, 2.16, 1.23, 1.64, 5.83; all P<0.05).The reasons for the elderly not to be vaccinated were concerns of side effects (46.26%, 167/361), lack of doctors′ recommendations (24.10%, 87/361), and unnecessary for people with good health conditions (19.39%, 70/361). The independent factors of influenza vaccine awareness rate were healthcare providers′ recommendations ( OR=9.18, 95% CI:5.47-16.32), vaccination at home( OR=11.79, 95% CI:6.87-21.66),vaccination available in community( OR=8.08, 95% CI:8.08-15.45),the mandatory requirement ( OR=4.61,95% CI:4.61-10.11),free of charge( OR=7.48, 95% CI:4.08-15.12). Conclusion:Influenza vaccination coverage among the elderly in Shanghai is still low even during the COVID-19 pandemic. Policy interventions, awareness education and strengthening the primary healthcare resources may contribute to achieving a high influenza vaccine coverage rate in the community-dwelling elderly

Objective: To investigate the effect of dopamine (DA) on the glutamate (Glu) uptake ability of neural cells, as well as its effect on cognitive impairment in rats with minimal hepatic encephalopathy (MHE) via related pathways. Methods: A total of 45 Sprague-Dawley rats were randomly divided into control group, MHE model group, and DA intervention model group, with 15 rats in each group. The rats in the MHE model group were given intraperitoneal injection of thioacetamide (TAA), those in DA intervention model group were given intraventricular injection of DA, and those in the control group were given intraperitoneal injection of physiological saline, with a frequency of twice a week for 8 weeks. Cerebral microdialysis was used to measure the change in the content of Glu in the brain in MHE rats and rats with DA intervention; RT-PCR and Western blotting were used to measure the relative mRNA and protein expression of trace amine-associated receptor 1 (TAAR1) and excitatory amino acid transporter 2 (EAAT2); the changes in the expression of EAAT2 and extracellular Glu level were measured after intracerebroventricular injection of TAAR1 siRNA and TAAR1 plasmid in MHE rats and rats with DA intervention. One- way analyses of variance for comparison among different groups were performed, categorical data between groups were compared using nonparametric tests. Results: Compared with the control group, the MHE model group had significant increases in the content of DA in liver tissue, plasma, and brain tissue (4.90 ± 0.13 ng/g vs 1.20 ± 0.13 ng/g, P < 0.05; 16.32 ± 1.01 pmol/ml vs 5.50 ± 0.82 pmol/ml, P < 0.05; 732.45 ± 78.85 ng/g vs 387.00 ± 23.36 ng/g, P < 0.05). There was a significant increase in the extracellular Glu level within 40-120 minutes after intracerebral injection of DA in the DA intervention model group. Compared with the control group, the MHE model group and the DA intervention model group had a significant increase in the relative protein expression of TAAR1 (3.72 ± 0.50/4.18 ± 0.43 vs 0.96 ± 0.40, both P < 0.05) and a significant reduction in the expression of EAAT2 (0.46 ± 0.16/0.51 ± 0.20 vs 0.92 ± 0.11, P = 0.013 and 0.036). Compared with the model group treated with empty vector, the MHE model group and the DA intervention model group had a significant increase in the relative protein expression of EAAT2 after TAAR1 siRNA intervention (0.86±0.142 vs 0.56 ± 0.060, P = 0.028; 0.99 ± 0.056 vs 0.43 ± 0.098, P = 0.0010) and a significant reduction in the extracellular Glu level in the brain at 60-120 minutes after injection, while after TAAR1 plasmid intervention, the MHE model group and the DA intervention model group had a significant reduction in the relative protein expression of EAAT2 (0.20 ± 0.040 vs 0.48 ± 0.08, P = 0.006; 0.24 ± 0.05 vs 0.54 ± 0.07, P = 0.004) and a significant increase in the extracellular Glu level in brain at 60-100 minutes after injection. Conclusion DA interacts with TAAR1 in brain tissue to induce extracellular accumulation of Glu, thus leading to the disorder of the TAAR1-EAAT2 signaling pathway in brain tissue and ultimately injuring the cognitive function of MHE rats.

Objective:To compare the imaging quality and metabolic quantitative parameters of pulmonary nodules between Q. Flex whole information five-dimensional (5D) and conventional three-dimensional (3D) PET/CT imaging for clinical evaluation.Methods:Fifty-four patients (30 males, 24 females, age: 60(42, 75) years; 78 solid pulmonary nodules (maximum diameter≤3 cm) with abnormal uptake of 18F-FDG) from Tianjin Cancer Hospital Airport Hospital between June 2022 and August 2022 were enrolled in this retrospective study. All patients underwent 5D scanning and 3D, 5D reconstruction. Image quality scores, signal-to-noise ratio (SNR), SUV max, SUV mean and metabolic tumor volume (MTV) of pulmonary nodules of 5D group and 3D group were evaluated and compared with χ2 test and Wilcoxon signed rank test. Correlation of quantitative parameters between 2 groups were analyzed by using Spearman rank correlation analysis. Results:Thirty-five of 78(45%) pulmonary nodules with image quality score≥4 were found in 5D group, which were more than those in 3D group (22/78(28%); χ2=4.67, P=0.031). Meanwhile, SNR, SUV max, SUV mean, and MTV were significantly positively correlated between the 2 groups ( rs values: 0.86, 0.86, 0.85, and 0.95, all P<0.001). SNR, SUV max and SUV mean of pulmonary nodules in 5D group were significantly higher than those in 3D group, which were 37.46(18.42, 62.00) vs 32.72(16.97, 54.76) ( z=-4.07, P<0.001), 9.71(5.48, 13.82) vs 8.96(4.82, 12.63) ( z=-3.05, P<0.001) and 6.30(3.39, 8.94) vs 5.61(2.99, 7.63)( z=-4.07, P<0.001) respectively. MTV of pulmonary nodules in 5D group was significantly lower than that in 3D group, which was 1.72(0.66, 2.74) cm 3vs 1.98(1.06, 4.63) cm 3 ( z=-7.13, P<0.001). Quantitative parameters of lower lung field and nodules with maximum diameters of >10 mm and ≤20 mm based on 5D scanning changed most significantly compared with those based on 3D scanning ( z values: from -5.23 to -2.48, all P<0.05). Conclusion:Q. Flex 5D PET significantly improves the quantitative accuracy of SUV and MTV of pulmonary nodules, and the improvement of image quality is substantial without increasing the radiation dose, which has clinical practical value.

ObjectiveTo analyze the epidemiological characteristics of senile dementia death in Jing’an District from 2016 to 2020， as well as the trends of mortality， standardized mortality， years of life lost （YLL） due to early death， years lived with disability （YLD）， and disability-adjusted life year （DALY）， and to provide scientific basis for the prevention and control of senile dementia. MethodsThe distribution of senile dementia in terms of gender， age， marital status and education level was investigated in the senile dementia death cases from 2016 to 2020 in Jing’an District. The YLL， YLD， DALY and their rates of the residents of Jing’an District from 2016 to 2020 were calculated by using Global Burden of Disease （GBD 2019） research method and results in combination with the corresponding population data. ResultsCompared to those without dementia， deaths with dementia were more likely to be female， more likely to be over 80 years old， less likely to be married， and more likely to have education level under middle school. Among the deaths with dementia， only 27.70% of the primary cause of death was dementia， and the other main causes were cerebrovascular disease， coronary heart disease and diabetes mellitus， which accounted for 25.54%， 17.81% and 7.28%， respectively. There was a significant gender difference in the burden of disease on senile dementia in Jing’an District. Mortality， standardized mortality， YLL， YLD and DALY rates of females were higher than those of males. The burden of disease on senile dementia increased with age. The change trend of mortality and YLL rate from 2016 to 2020 was not statistically significant， while the YLD rate and DALY rate showed an upward trend， which was statistically significant. ConclusionAs the life span of residents in Jing’an District increases and the population aging deepens， the burden of disease on senile dementia is still heavy. This requires extensive attention of the whole society， and active exploration of prevention and control strategies and measures for senile dementia， so as to improve the life quality of patients and reduce the burden of disease.

Objective To characterize the distribution and assess the exposure to phthalic acid esters （PAEs） in the indoor dust of Shanghai City. Methods Samples were collected from 33 sampling sites， including homes， hotels， offices and public places， in Shanghai in 2018， 2019， and 2020. The samples were pretreated by 100 sieves， extracted and concentrated， and then analyzed by gas chromatography-mass spectrometry in selected ion mode （SIM）. Results Results on the characteristics of PAEs in indoor dust in different places showed that concentrations of PAEs were in a range of <0.01-2 464 mg·kg^-1.The average concentration of 16 PAEs was 613 mg·kg^-1. Bis（2-ethylhexyl） phthalate （DEHP）， di-iso-butyl phthalate （DiBP）， di-n-butyl phthalate （DBP） and di-n-octyl phthalate （DnOP） were the main components of PAEs in indoor dust， accounting for approximately 99.5% of 16 PAEs. The intake of DEHP， DBP， DEP and BBP was lower than the tolerable daily intake （TDI） and reference doses （RfD） set by EU CSTEE and U.S. EPA. Conclusion Average daily dose （ADD） via indoor dust is estimated， and the order of intake through different pathways is hand-oral intake>skin contact>respiratory inhalation. Exposure risk of PAEs in children is greater than that in adults.

Background Diabetes mellitus is a major public health issue at present. Previous studies have shown that ambient air pollution is a risk factor for diabetes. Objective This study aims to explore the acute effects of ambient air pollution on diabetes related death in Shanghai Jing’an District. Methods Daily air pollution data, meteorological data, and diabetes related mortality data in 2013−2019 in Shanghai Jing’an District were collected. A generalized additive model (GAM) was established to conduct time-series analysis on the short-term effect of ambient air pollution on diabetes related mortality, and gender- and age-stratified analysis on susceptibility of various groups to ambient air pollution exposures. Results For every 10 μg·m⁻³ increase of the concentrations of PM_2.5, PM₁₀, SO₂, and NO₂, the diabetes related mortality increased by 2.47% (95%CI: 1.56%−3.38%), 2.02% (95%CI: 1.29%−2.75%), 5.75% (95%CI: 2.99%−8.58%), and 3.93% (95%CI: 2.49%−5.39%) at lag05 respectively (P<0.05). In the stratified analysis, exposures to increased concentrations of PM_2.5, PM₁₀, SO₂, and NO₂ raised the mortality risks from diabetes in male, female, and ≥65 years oldgroups (P<0.05). However, the differences in mortality risks from diabetes due to air pollution within gender and age groups were statistically insignificant. Conclusion In Shanghai Jing'an District, the elevated levels of ambient air pollutants, including PM_2.5, PM₁₀, SO₂, and NO₂, are significantly associated with the increase of diabetes related mortality, and there are lag effects and cumulative effects. The ≥65 years olds are more susceptible to the impact of air pollution on diabetes related deaths.