Objective To evaluate the surgical characteristics and clinical effect of percutaneous reduction with kirachner wire assisted by a small lateral incision approach for poking reduction and allngraft bone transplantation in treating compressive intra-articular calcaneal fractures. Methods A retrospective analysis was performed among 17 patients with compressive intra-articular calcaneal fractures (Sanders Ⅱ to Ⅲ ) treated by percutaneous reduction with kirachner wire assisted by a small lateral incision approach for poking reduction and allograft bone transplanta-tion. Results All the patients were followed-up for an average time of 13.5 months. The wound of 15 feet achieved primary healing, the acute rejection was found in 2 patients. The Bohler's angle was (9.58±5.25)° and Gissane an-gle was (101.15±13.83)° preoperation and was (33.55±4.17)° and (113.25±12.17)° immediate postopera-tion, showing statistically significant differences pre-and postoperation(P < 0.05). By the lately follow-up, the Bohler angle was (31.65±7.72)° and Gissane angle was (111.15±8.68)°, also showing statistically significant differ-ences when compared to preoperation (P < 0.05), there was no statistically significant differences (P > 0.05) when compared with normal X-ray. Conclusion That percutaneous reduction with kirschner wire assisted by a small lateral incision approach for poking reduction and allograft bone transplantation in treating the compressive intra-articular cal-caneal fractures (Sanders Ⅱ to Ⅲ) is minimally invasive, less complication, and it enables satisfactory recoastruc-tion of bone defects and allows metanatomic reduction and functional recovery, also maintaining restoration of calcane-al height and anatomic reduction of the posterior facet.

Objective To investigate the distribution of interstitial cells of Cajal (ICCs) —the pacemaker cells of the gut in the different parts of guinea pig pyeloureteral tract and explore the effect on the contraction of smooth muscle. Methods The ureteropelvic junction, upper ureteral, middle ureteral, lower ureteral tissues harvested from 10 guinea pigs were performed KIT immunofluorescent staining in stretched preparations. Smooth muscle strips of 2 mm?6 mm were dissected from the sites for tone determination. The frequency and amplitude of the smooth muscle were compared among different sites of pyeloureteral tract. Results Cells with positive staining by KIT and with similar morphology to ICCs were found in the entire pyeloureteral tract of guinea pigs. The density of ICCs-like cells in the ureteropelvic junction, upper ureteral, middle ureteral, and lower ureteral tissues were (5.20?0.98), (3.90?0.98), (3.03?0.98) and (2.50?0.81) respectively. The contraction of strips in different sites varied according to the distribution of ICCs. The amplitude and frequency of strips from the ureteropelvic junction and upper ureteral were significantly higher than those from middle ureteral and lower ureteral (P

Objective To screen and analyze genes differentially expressed within dermal papillae cells(DPC)with aggregative behavior.Methods Total RNA was extracted from DPC with and without ag-gregative behavior,and double-stranded cDNA were synthesized by using SMART cDNA synthesis.The cD-NA fragments of differentially expressed genes in dermal papillae cells with aggregative behavior were isolat-ed by suppression subtractive hybridization,sequencing,and then subtracted library was set up.Positive clones were screened by PCR method and verified by cDNA dot blot and then analyzed through homologous retrieving.Results A subtractive cDNA library of DPC with aggregative behavior was successfully construct-ed.The results of screening and cloning of the library showed that DPC with aggregative behavior could ex-press genes related to homologous aggregation,regnlation of growth,differentiation and development,and sig-nal transduction proliferation and cycle control,which included known genes(capping protein,paladin,vas-cular endothelial growth factor),hematopoietic stem/progenitor cells(HSPC)related genes(HSPC011and HSPC016)and a new gene.Conclusions The construction of subtractive library of DPC lays solid founda-tion for screening and cloning new and specific genes related to aggregative behavior of DPC.Several genes may cooperatively involve in homologous aggregation,and regnlation of growth of DPC.Among these genes,capping protein and palladin may be closely related to aggregative behavior of DPC,and VEGF and HSPC re-lated clones may be responsible for the status of higher proliferation of DPC.

Objectives To construct a cDNA subtractive library of dermal papilla cells (DPCs) in anagen with suppression subtractive hybridization (SSH) and clone differentially expressed genes related to DPCs in anagen. Methods Total RNA was isolated from DPC of anagen and telogen follicles. Then ds cDNAs were synthesized in turn using SMART cDNA synthesis technique. After cDNAs from anagen and telogen follicle DPCs were hybridized with each other twice and underwent two rounds of nested PCR, PCR products were ligated with arms of T/A plasmid vectors to set up the subtractive library. Selected clones were verified by reverse Nothern blot and DNA sequencing, and the acquired sequences were analyzed for homology based on Genbank nucleotide database. Results cDNA subtractive library of DPCs in anagen follicle was set up successfully with high subtractive efficiency. Thirty-five genes were identified with 22 known functional genes and 13 unknown functional genes. Conclusions These results demonstrate the effectiveness and sensitivity of SSH in detecting differentially expressed genes from a small amount of clinical samples. Information about such alterations in gene expression might be useful for elucidating the genetic events in hair follicle growth regulation.

Objective: To analyze the HIV detection results through different detection routes in Jiading District, Shanghai Municipality from 2009 to 2023, so as to provide the reference for improving HIV detection measures. Methods: Data pertaining to HIV detection in Jiading District from 2009 to 2023 was collected through the HIV/AIDS Comprehensive Control System of Chinese Disease Prevention and Control Information System. The number of HIV detection and HIV positive rates through detection routes including voluntary counseling and testing (VCT) clinics, sexually transmitted disease (STD) clinics, pre-operation and blood transfusion (products), premarital and antenatal periods, other clinical outpatients and other populations were described. Results: A total of 1 729 347 HIV tests were conducted in Jiading District from 2009 to 2023, with an average annual growth rate of 7.55%. A total of 1 125 HIV positive cases were confirmed, with an HIV positive rate of 6.51/104. The number of HIV detection conducted in VCT clinics, STD clinics, pre-operation and blood transfusion (products), premarital and antenatal periods, other clinical outpatients and other populations were 11 516, 112 880, 692 609, 635 770, 196 315 and 80 257, respectively. The main detection routes were pre-operation and blood transfusion (products) as well as premarital and antenatal periods, accounting for 40.05% and 36.76%, respectively. The HIV positive rates in VCT clinics, STD clinics, pre-operation and blood transfusion (products), premarital and antenatal periods, other clinical outpatients and other populations were 336.05/104, 21.79/104, 2.93/104, 0.35/104, 10.95/104 and 6.48/104, respectively. The HIV positive rate in VCT clinics was higher than that in other detection routes (all P<0.001). Conclusions From 2009 to 2023, the number of HIV tests increased in Jiading District, mainly through pre-operation and blood transfusion (products) as well as premarital and antenatal periods. The HIV positive rate was the highest in VCT clinics.

Objective To investigate the molecular mechanism of colistin resistance mediated by mcr-1and pmrAB genes in clinical Escherichia coli ( E. coli) isolates. Methods A total of 1988 clinical E. coli isolates were collected from the First People′s Hospital of Shangqiu from 2010 to 2017 and screened for colistin-resistant isolates using agar dilution method. The minimum inhibitory concentrations ( MICs) of nine common clinical antibiotics were determined using broth microdilution method. PCR and sequencing analysis were performed to detect the colistin resistance genes of mcr-1 and pmrAB. Conjugation experiments were used to test the transferability of the plasmid carrying mcr-1 gene. S1-PFGE and Southern blot were used to locate the plasmid carrying mcr-1. All colistin-resistant E. coli isolates were typed by multilocus se-quence typing ( MLST) . Results Six colistin-resistant E. coli isolates were obtained by agar dilution meth-od. The results of susceptibility testing showed that all of the six isolates were multidrug resistant. PCR and sequencing analysis revealed that four out of the six strains carried mcr-1 gene, and the other two isolates both had an amino acid substitution (L167P) caused by pmrB gene mutation. The results of conjugation ex-periments, S1-PFGE and Southern hybridization analysis showed that the plasmids of four mcr-1 gene-posi-tive E. coli strains were located on a conjugative plasmid about 60 kb in length. MLST analysis classified the six isolates into six distinct sequence types ( STs) . Conclusion This study suggested that mcr-1 gene and mutations in pmrAB gene were the main mechanisms mediating the resistance of E. coli to colistin. In clinical practice, the occurrence and spread of colistin-resistant E. coli should be further monitored, and the rational use of antibiotics should be promoted to prevent the spread of colistin-resistant strains.

ObjectiveTo analyze the epidemiological characteristics of scarlet fever in Minhang District， Shanghai from 2005 to 2020， and to provide scientific basis for the investigation and prevention of scarlet fever. MethodsWe collected the scarlet fever incidence data through the China Information System for Disease Control and Prevention； used SPSS 17.0 to conduct descriptive epidemiological analysis； and used EpiInfo to analyze and compare the differences in incidence rates between different regions. ResultsA total of 12 012 scarlet fever cases were reported in Minhang District， Shanghai from 2005 to 2020. There were more cases in 2011， 2015 and 2017， and the difference in annual incidence was statistically significant （χ²=6 023.977， P<0.001）. Scarlet fever could occur throughout the year， but the peak incidence was from April to June and November to January of the following year. The gender ratio between men and women is 1.57：1， and the patients were concentrated in 4-6 years old. The incidence rate difference in 13 neighborhoods was statistically significant （χ²=2 455.516， P<0.001）. The four communities with the highest average annual incidence rate were Xinzhuang Town， Zhuanqiao Town， Maqiao Town， and Gumei Street. ConclusionFrom 2005 to 2020， the incidence of scarlet fever in Minhang District， Shanghai presents a double peak， which matches well the student semesters， and scarlet fever patients are mainly students. Attention should be paid to infection source management and epidemic surveillance in schools and other collective units， implementation of morning inspections and daily disinfection， and other prevention and control measures.

ObjectiveTo investigate the current status and influencing factors of hand hygiene practices among primary healthcare workers， and to provide a reference for improving hand hygiene behavior in primary healthcare institutions. MethodsA self-designed questionnaire was used to conduct a survey among medical staff of seven community health service centers in Jiading District， Shanghai， using a cluster random sampling method. The data collected were subjected to descriptive statistics， reliability and validity tests， correlation analysis， and structural equation model fitting. ResultsA statistical difference in hand hygiene compliance was found among medical staff with varying occupational types and educational levels （P<0.05）， and medical staff in clinical departments exhibited higher levels of hand hygiene compliance （P<0.05）. In the health belief model， among the core variables， healthcare workers’ perceived benefits， perceived barriers， and self-efficacy had a direct impact on hand hygiene behavior， with direct effect values of 0.341， -0.152， and 0.234， respectively. Meanwhile， cues to action and perceived severity of COVID-19 infection indirectly affected hand hygiene behavior， with an indirect effect value of 0.066 and 0.062， respectively. ConclusionHealthcare workers generally exhibit a high degree of hand hygiene compliance， but there are variations in hand hygiene scores among healthcare workers with different characteristics. Enhancing healthcare worders’ perception of benefits， action cues， and self-efficacy while reducing perceived barriers can effectively improve their hand hygiene behavior.

With the widespread adoption of low-dose CT screening and the extensive application of high-resolution CT, the detection rate of sub-centimeter lung nodules has significantly increased. How to scientifically manage these nodules while avoiding overtreatment and diagnostic delays has become an important clinical issue. Among them, lung nodules with a consolidation tumor ratio less than 0.25, dominated by ground-glass shadows, are particularly worthy of attention. The therapeutic challenge for this group is how to achieve precise and complete resection of nodules during surgery while maximizing the preservation of the patient's lung function. The "watershed topography map" is a new technology based on big data and artificial intelligence algorithms. This method uses Dicom data from conventional dose CT scans, combined with microscopic (22-24 levels) capillary network anatomical watershed features, to generate high-precision simulated natural segmentation planes of lung sub-segments through specific textures and forms. This technology forms fluorescent watershed boundaries on the lung surface, which highly fit the actual lung anatomical structure. By analyzing the adjacent relationship between the nodule and the watershed boundary, real-time, visually accurate positioning of the nodule can be achieved. This innovative technology provides a new solution for the intraoperative positioning and resection of lung nodules. This consensus was led by four major domestic societies, jointly with expert teams in related fields, oriented to clinical practical needs, referring to domestic and foreign guidelines and consensus, and finally formed after multiple rounds of consultation, discussion, and voting. The main content covers the theoretical basis of the "watershed topography map" technology, indications, operation procedures, surgical planning details, and postoperative evaluation standards, aiming to provide scientific guidance and exploration directions for clinical peers who are currently or plan to carry out lung nodule resection using the fluorescent microscope watershed analysis method.