Objective: To evaluate the effectiveness for the construction of "mosquito-free village" in Xuejia Village, Pujiang County, Zhejiang Province, so as to provide the guidance for the construction of "mosquito-free village" in other rural areas. Methods: Density of adult mosquitoes in Xuejia Village was investigated using light trap method and density of larval mosquitoes was investigated using larval straw method from April to November each year. Totally 30 households of villagers were randomly selected, and their awareness rates of mosquito control knowledge, mosquito control behavior forming rates and satisfaction rates were surveyed through questionnaires. Investment during construction (from August 2016 to December 2018) and maintenance period (from 2019 to 2023) of "mosquito-free village" were investigated through data review and interviews. Long-term effects of "mosquito-free village" construction in Xuejia Village were evaluated in terms of mosquito density from 2016 to 2023, effectiveness of health education for villagers, satisfaction and investment. Results: Compared with the year 2016, the densities of adult and larval mosquitoes in Xuejia Village were significantly decreased from 2017 to 2023. The average monthly density of adult mosquitoes in 2023 decreased by 98.34%, and the average monthly 100 household index of larval mosquitoes decreased by 98.45% compared to 2016. The average monthly density of adult mosquitoes from 2019 to 2023 was less than or equal to one mosquito per light trap in a night, and the average monthly 100 household index of larval mosquitoes was less than or equal to five places per 100 households. The awareness rate of mosquito control knowledge was 93.33%, the behavior forming rate was 86.67%, and the satisfaction rate was 90.00%. By December 2023, the total investment during construction and maintenance period was 450 thousand Yuan, with an average annual investment of 60.7 thousand Yuan and average annual investment of 206.61 Yuan per household. The average annual investment during maintenance period was 36.2 thousand Yuan, and the average annual investment per household was 109.70 Yuan. Conclusion The mosquito density, effectiveness of health education for villagers and satisfaction of "mosquito-free village" in Xuejia Village all meet the evaluation criteria of "mosquito-free village", and the investment is reasonable, making it suitable for promotion to other rural areas.

Objective:To investigate the value of systemic inflammatory response syndrome (SIRS), pediatric sequential organ failure assessment (pSOFA) and pediatric critical illness score (PCIS) in predicting mortality of pediatric sepsis in pediatric intensive care units (PICU) from Southwest China.Methods:This was a prospective multicenter observational study. A total of 447 children with sepsis admitted to 12 PICU in Southwest China from April 2022 to March 2023 were enrolled. Based on the prognosis, the patients were divided into survival group and non-survival group. The physiological parameters of SIRS, pSOFA and PCIS were recorded and scored within 24 h after PICU admission. The general clinical data and some laboratory results were recorded. The area under the curve (AUC) of the receiver operating characteristic curve was used to compare the predictive value of SIRS, pSOFA and PCIS in mortality of pediatric sepsis.Results:Amongst 447 children with sepsis, 260 patients were male and 187 patients were female, aged 2.5 (0.8, 7.0) years, 405 patients were in the survival group and 42 patients were in the non-survival group. 418 patients (93.5%) met the criteria of SIRS, and 440 patients (98.4%) met the criteria of pSOFA≥2. There was no significant difference in the number of items meeting the SIRS criteria between the survival group and the non-survival group (3(2, 4) vs. 3(3, 4) points, Z=1.30, P=0.192). The pSOFA score of the non-survival group was significantly higher than that of the survival group (9(6, 12) vs. 4(3, 7) points, Z=6.56, P<0.001), and the PCIS score was significantly lower than that of the survival group (72(68, 81) vs. 82(76, 88) points, Z=5.90, P<0.001). The predictive value of pSOFA (AUC=0.82) and PCIS (AUC=0.78) for sepsis mortality was significantly higher than that of SIRS (AUC=0.56) ( Z=6.59, 4.23, both P<0.001). There was no significant difference between pSOFA and PCIS ( Z=1.35, P=0.176). Platelet count, procalcitonin, lactic acid, albumin, creatinine, total bilirubin, activated partial thromboplastin time, prothrombin time and international normalized ratio were all able to predict mortality of sepsis to a certain degree (AUC=0.64, 0.68, 0.80, 0.64, 0.68, 0.60, 0.77, 0.75, 0.76, all P<0.05). Conclusion:Compared with SIRS, both pSOFA and PCIS had better predictive value in the mortality of pediatric sepsis in PICU.

Objective:To evaluate the efficacy and prognostic factors of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with secondary acute myeloid leukemia (sAML) .Methods:In this multicenter, retrospective clinical study, adult patients aged ≥18 years who underwent allo-HSCT for sAML at four centers of the Zhejiang Hematopoietic Stem Cell Transplantation Collaborative Group from January 2014 to November 2022 were included, and the efficacy and prognostic factors of allo-HSCT were analyzed.Results:A total of 95 patients were enrolled; 66 (69.5%) had myelodysplastic syndrome-acute myeloid leukemia (MDS-AML) , 4 (4.2%) had MDS/MPN-AML, and 25 (26.3%) had therapy-related AML (tAML) . The 3-year CIR, LFS, and overall survival (OS) rates were 18.6% (95% CI 10.2%-27.0%) , 70.6% (95% CI 60.8%-80.4%) , and 73.3% (95% CI 63.9%-82.7%) , respectively. The 3-year CIRs of the M-AML group (including MDS-AML and MDS/MPN-AML) and the tAML group were 20.0% and 16.4%, respectively ( P=0.430) . The 3-year LFSs were 68.3% and 75.4%, respectively ( P=0.176) . The 3-year OS rates were 69.7% and 75.4%, respectively ( P=0.233) . The 3-year CIRs of the groups with and without TP53 mutations were 60.0% and 13.7%, respectively ( P=0.003) ; the 3-year LFSs were 20.0% and 76.5%, respectively ( P=0.002) ; and the 3-year OS rates were 40.0% and 77.6%, respectively ( P=0.002) . According to European LeukmiaNet 2022 (ELN2022) risk stratification, the 3-year CIRs of patients in the low-, intermediate-, and high-risk groups were 8.3%, 17.8%, and 22.6%, respectively ( P=0.639) . The three-year LFSs were 91.7%, 69.5%, and 65.6%, respectively ( P=0.268) . The 3-year OS rates were 91.7%, 71.4%, and 70.1%, respectively ( P=0.314) . Multivariate analysis revealed that advanced disease at allo-HSCT and TP53 mutations were independent risk factors for CIR, LFS, and OS. Conclusion:There was no significant difference in the prognosis of patients who underwent allo-HSCT among the MDS-AML, MDS/MPN-AML, and tAML groups. Advanced disease at transplantation and TP53 mutations were poor prognostic factors. ELN2022 risk stratification had limited value for predicting the prognosis of patients with sAML following allo-HSCT.

Objective:To evaluate the safety and efficacy of domestically produced magnetic sphincter augmentation (MSA) for gastroesophageal reflux disease.Method:This study is a prospective cohort study. Patients with typical heartburn and reflux symptoms (at least partial response to proton pump inhibitors), abnormal esophageal acid exposure and normal esophageal peristalsis were included, prospectively in the Department of Gastroesophageal Surgery, Rocket Force Characteristic Medical Center from June 2019 to September 2022. Patients with hiatal hernia >2 cm and severe esophagitis were excluded. The MSA was wrapped around the distal esophagus after esophageal hiatus repair by laparoscopy. A postoperative questionnaire survey was conducted to assess the relief of symptom, complications, the discontinuation rate of proton pump inhibitor, and surgical satisfaction. Gastroscopy, high-resolution esophageal pressure measurement, and pH value impedance monitoring were also reviewed. The pre- and postoperative rates were compared using the McNeinar χ2 test. Result:Currently, 23 patients with gastroesophageal reflux disease were enrolled and underwent MSA surgery. There were 20 males and 3 females, aged ( M (IQR)) 48 (14) years (range: 25 to 64 years). All cases were successfully implanted with MSA. Subjective indicators were followed for 17 (18) months (range: 14 to 53 months), while objective indicators were followed for 17 (1) months (range: 12 to 23 months). The postoperative gastrointestinal and extraesophageal symptom scores showed a significant decrease compared to preoperative levels as follows: the degree of subjective relief of overall digestive symptoms was 90 (20)% (range:0~100%), the degree of subjective relief of overall respiratory symptoms was 100(10)% (range: 10%~100%), the overall satisfaction rate was 83% (19/23), the proton pump inhibitor discontinuation rate was 70% (16/23). The proportion of esophagitis has decreased from 44% (10/23) to 9% (2/23) ( κ=0.169, P=0.039), The Hill grade of gastroesophageal valve morphology improved from 1 case of grade Ⅰ, 5 cases of grade Ⅱ, 10 cases of grade Ⅲ, and 7 cases of grade Ⅲ preoperative to 22, 1, 0, and 0 cases postoperative. The proportion of lower esophageal sphincter pressure below normal has decreased from 70% (16/23) to 35% (8/23) ( κ=0.170, P=0.012). There were 21 patients who restored normal esophageal acid exposure. Eleven patients had mild long-term dysphagia, but it didn′t affect their daily life. No postoperative device migration, erosion, or secondary surgical removal occurred. Conclusions:Laparoscopic implantation of the MSA device was safe and well tolerated. It can effectively control the symptoms of gastroesophageal reflux disease, reduce medication, restore normal cardia morphology and function, and esophageal acid exposure. The main postoperative complication was dysphagia, but it was relatively mild.

Objective:To evaluate the safety and efficacy of domestically produced magnetic sphincter augmentation (MSA) for gastroesophageal reflux disease.Method:This study is a prospective cohort study. Patients with typical heartburn and reflux symptoms (at least partial response to proton pump inhibitors), abnormal esophageal acid exposure and normal esophageal peristalsis were included, prospectively in the Department of Gastroesophageal Surgery, Rocket Force Characteristic Medical Center from June 2019 to September 2022. Patients with hiatal hernia >2 cm and severe esophagitis were excluded. The MSA was wrapped around the distal esophagus after esophageal hiatus repair by laparoscopy. A postoperative questionnaire survey was conducted to assess the relief of symptom, complications, the discontinuation rate of proton pump inhibitor, and surgical satisfaction. Gastroscopy, high-resolution esophageal pressure measurement, and pH value impedance monitoring were also reviewed. The pre- and postoperative rates were compared using the McNeinar χ2 test. Result:Currently, 23 patients with gastroesophageal reflux disease were enrolled and underwent MSA surgery. There were 20 males and 3 females, aged ( M (IQR)) 48 (14) years (range: 25 to 64 years). All cases were successfully implanted with MSA. Subjective indicators were followed for 17 (18) months (range: 14 to 53 months), while objective indicators were followed for 17 (1) months (range: 12 to 23 months). The postoperative gastrointestinal and extraesophageal symptom scores showed a significant decrease compared to preoperative levels as follows: the degree of subjective relief of overall digestive symptoms was 90 (20)% (range:0~100%), the degree of subjective relief of overall respiratory symptoms was 100(10)% (range: 10%~100%), the overall satisfaction rate was 83% (19/23), the proton pump inhibitor discontinuation rate was 70% (16/23). The proportion of esophagitis has decreased from 44% (10/23) to 9% (2/23) ( κ=0.169, P=0.039), The Hill grade of gastroesophageal valve morphology improved from 1 case of grade Ⅰ, 5 cases of grade Ⅱ, 10 cases of grade Ⅲ, and 7 cases of grade Ⅲ preoperative to 22, 1, 0, and 0 cases postoperative. The proportion of lower esophageal sphincter pressure below normal has decreased from 70% (16/23) to 35% (8/23) ( κ=0.170, P=0.012). There were 21 patients who restored normal esophageal acid exposure. Eleven patients had mild long-term dysphagia, but it didn′t affect their daily life. No postoperative device migration, erosion, or secondary surgical removal occurred. Conclusions:Laparoscopic implantation of the MSA device was safe and well tolerated. It can effectively control the symptoms of gastroesophageal reflux disease, reduce medication, restore normal cardia morphology and function, and esophageal acid exposure. The main postoperative complication was dysphagia, but it was relatively mild.

Objective:The epidemiological and host animal pathogen data of leptospirosis in the population of Zhejiang Province in 2023 were analyzed, providing scientific basis for formulating prevention and control strategies of leptospirosis.Methods:The data of human leptospirosis in the population were collected from the China Information System for Disease Control and Prevention, and analyzed using descriptive epidemiological methods. The data on isolation, culture, and nucleic acid testing of Leptospira pathogens from mouse kidneys, frog kidneys, pig kidneys, and duck kidneys as well as duck serum antibody data were collected from Zhejiang Provincial Center for Disease Control and Prevention "Leptospirosis Surveillance Project of Zhejiang Province". The carrying and changing status of Leptospira epidemic microbiota in populations and host animals were analyzed. Results:In 2023, a total of 83 cases of leptospirosis were reported in Zhejiang Province, with a incidence rate of 0.126 2/ 100 000, aged (62.66 ± 11.31) years, including 68 males and 15 females. Leptospirosis cases were reported in 11 cities, mainly concentrated in the southern cities of Wenzhou City, Lishui City and Taizhou City(a total of 68 cases), accounting for 81.93% of the total number of cases. August to October were high incidence months for leptospirosis (a total of 70 cases), accounting for 84.34% of the total number cases. The male to female ratio of patients was 4.53 ∶ 1.00, and all were adults ≥20 years old, the middle and old people aged 45 - 79 years were the high-risk population (a total of 77 cases), accounting for 92.77% of the total number of cases. The patient's occupation was mainly farmers, with a total of 54 cases, accounting for 65.06% of the total number cases. The shortest time from onset to initial diagnosis for patients with leptospirosis was 0 day, and the longest was 13 days. The shortest time from initial diagnosis to confirmed diagnosis was 0 day, and the longest was 16 days. The 72.29% of the leptospirosis cases (60 cases) had a history of field labor or suspected contact with contaminated water within one month before the onset of the disease, and 18.07% of the leptospirosis cases (15 cases) had a history of contact with animals such as mice, frogs, pigs, cows, dogs, fish or ducks, or their excreta within one month before the onset of the disease. The average nucleic acid positive rate of host animals with leptospirosis was 5.92% (31/524) in mouse kidney, 6.74% (36/534) in frog kidney, and 0.66% (1/151) in pig kidney. The isolation and culture of leptospirosis from duck kidney, nucleic acid detection, and antibody detection in duck blood were all negative. The leptospirosis bacteria detected in human population were serogroup Icterohaemorrhagiae (3 samples) and Hebdomadis (4 samples), and the bacteria group detected in host animals was serogroup Icterohaemorrhagiae (3 samples). Conclusions:The outbreak of leptospirosis in Zhejiang Province mainly occurs in the summer and autumn, with the affected areas mainly concentrated in the southern region of Zhejiang Province. The affected population is mainly middle-aged and elderly males, and the population carrying Leptospira is still mainly composed of the serogroup Icterohaemorrhagiae and the Hebdomadis, with the host animal being the serogroup Icterohaemorrhagiae.

Purpose: We aimed to evaluate the effects of baked egg and milk diets on the prognosis of immunoglobulin E (IgE)-mediated food allergy in young children. Methods: In this retrospective study, we enrolled children under 36 months of age who were diagnosed with egg or milk allergy between January 2020 and July 2023. The consumption group underwent oral food challenges with baked egg or milk, and was instructed to include baked eggs and milk in their diet for at least 6 months. The control group, matched for age and specific IgE (sIgE) levels, restricted these foods. We compared the age at which tolerance was achieved, and analyzed changes in total IgE and sIgE levels against egg white (EW), ovomucoid (OM), and cow’s milk (CM) in both groups. Results: Data were collected from 24 children in both the consumption and control groups. The consumption group demonstrated a significantly earlier acquisition of tolerance to egg and milk allergies compared to the control group (median: 24 vs. 31 months, P= 0.045). In the consumption group, total IgE and CM-sIgE levels showed no significant changes (P= 0.073 and P= 0.118, respectively), while EW- and OM-sIgE levels significantly decreased (P < 0.001 and P = 0.016, respectively). In the control group, total IgE and CM-sIgE levels significantly increased from baseline (P = 0.038 and P < 0.001, respectively), whereas there were no significant changes in EW- and OM-sIgE levels (P = 0.054 and P = 0.190, respectively). Between the consumption and control groups, no significant differences were observed in the changes in total IgE or specific IgE to EW, OM, and CM before and after the observation period (P = 0.404, P = 0.238, P = 0.531, and P = 0.167, respectively). Conclusion These findings suggest that diets of baked eggs and milk may accelerate the development of tolerance in children with egg or milk allergies.

Purpose: We aimed to evaluate the effects of baked egg and milk diets on the prognosis of immunoglobulin E (IgE)-mediated food allergy in young children. Methods: In this retrospective study, we enrolled children under 36 months of age who were diagnosed with egg or milk allergy between January 2020 and July 2023. The consumption group underwent oral food challenges with baked egg or milk, and was instructed to include baked eggs and milk in their diet for at least 6 months. The control group, matched for age and specific IgE (sIgE) levels, restricted these foods. We compared the age at which tolerance was achieved, and analyzed changes in total IgE and sIgE levels against egg white (EW), ovomucoid (OM), and cow’s milk (CM) in both groups. Results: Data were collected from 24 children in both the consumption and control groups. The consumption group demonstrated a significantly earlier acquisition of tolerance to egg and milk allergies compared to the control group (median: 24 vs. 31 months, P= 0.045). In the consumption group, total IgE and CM-sIgE levels showed no significant changes (P= 0.073 and P= 0.118, respectively), while EW- and OM-sIgE levels significantly decreased (P < 0.001 and P = 0.016, respectively). In the control group, total IgE and CM-sIgE levels significantly increased from baseline (P = 0.038 and P < 0.001, respectively), whereas there were no significant changes in EW- and OM-sIgE levels (P = 0.054 and P = 0.190, respectively). Between the consumption and control groups, no significant differences were observed in the changes in total IgE or specific IgE to EW, OM, and CM before and after the observation period (P = 0.404, P = 0.238, P = 0.531, and P = 0.167, respectively). Conclusion These findings suggest that diets of baked eggs and milk may accelerate the development of tolerance in children with egg or milk allergies.

Purpose: We aimed to evaluate the effects of baked egg and milk diets on the prognosis of immunoglobulin E (IgE)-mediated food allergy in young children. Methods: In this retrospective study, we enrolled children under 36 months of age who were diagnosed with egg or milk allergy between January 2020 and July 2023. The consumption group underwent oral food challenges with baked egg or milk, and was instructed to include baked eggs and milk in their diet for at least 6 months. The control group, matched for age and specific IgE (sIgE) levels, restricted these foods. We compared the age at which tolerance was achieved, and analyzed changes in total IgE and sIgE levels against egg white (EW), ovomucoid (OM), and cow’s milk (CM) in both groups. Results: Data were collected from 24 children in both the consumption and control groups. The consumption group demonstrated a significantly earlier acquisition of tolerance to egg and milk allergies compared to the control group (median: 24 vs. 31 months, P= 0.045). In the consumption group, total IgE and CM-sIgE levels showed no significant changes (P= 0.073 and P= 0.118, respectively), while EW- and OM-sIgE levels significantly decreased (P < 0.001 and P = 0.016, respectively). In the control group, total IgE and CM-sIgE levels significantly increased from baseline (P = 0.038 and P < 0.001, respectively), whereas there were no significant changes in EW- and OM-sIgE levels (P = 0.054 and P = 0.190, respectively). Between the consumption and control groups, no significant differences were observed in the changes in total IgE or specific IgE to EW, OM, and CM before and after the observation period (P = 0.404, P = 0.238, P = 0.531, and P = 0.167, respectively). Conclusion These findings suggest that diets of baked eggs and milk may accelerate the development of tolerance in children with egg or milk allergies.

Purpose: We aimed to evaluate the effects of baked egg and milk diets on the prognosis of immunoglobulin E (IgE)-mediated food allergy in young children. Methods: In this retrospective study, we enrolled children under 36 months of age who were diagnosed with egg or milk allergy between January 2020 and July 2023. The consumption group underwent oral food challenges with baked egg or milk, and was instructed to include baked eggs and milk in their diet for at least 6 months. The control group, matched for age and specific IgE (sIgE) levels, restricted these foods. We compared the age at which tolerance was achieved, and analyzed changes in total IgE and sIgE levels against egg white (EW), ovomucoid (OM), and cow’s milk (CM) in both groups. Results: Data were collected from 24 children in both the consumption and control groups. The consumption group demonstrated a significantly earlier acquisition of tolerance to egg and milk allergies compared to the control group (median: 24 vs. 31 months, P= 0.045). In the consumption group, total IgE and CM-sIgE levels showed no significant changes (P= 0.073 and P= 0.118, respectively), while EW- and OM-sIgE levels significantly decreased (P < 0.001 and P = 0.016, respectively). In the control group, total IgE and CM-sIgE levels significantly increased from baseline (P = 0.038 and P < 0.001, respectively), whereas there were no significant changes in EW- and OM-sIgE levels (P = 0.054 and P = 0.190, respectively). Between the consumption and control groups, no significant differences were observed in the changes in total IgE or specific IgE to EW, OM, and CM before and after the observation period (P = 0.404, P = 0.238, P = 0.531, and P = 0.167, respectively). Conclusion These findings suggest that diets of baked eggs and milk may accelerate the development of tolerance in children with egg or milk allergies.