Objective: To establish a risk assessment index system for epidemic infectious diseases in primary and secondary schools, for early warning and prevention of school infectious diseases accurately and timely. Methods: Through literature review, the indicators pool was established by consulting relevant experts and referring to practical experience. Then two rounds of expert consultation using the Delphi method were conducted(13 experts of round 1, and 20 experts of round 2). The concentration of expert opinions (the average, the percentage of full marks) and the coordination of expert opinions (the coefficient of variation, the coordination coefficient W ) were calculated and analyzed. The coordination coefficient W was obtained by nonparametric Kendall s W test of multiple samples. According to the experts feedback, necessary addition, reduction and modification of the indicators were carried out to determine the evaluation index system, and the analytic hierarchy process (AHP) was used to calculate the weight of each indicator. Results: The expert authority coefficients of the two rounds of consultation were 0.89 and 0.88, respectively, and the form recovery rate was 100%. The range of the variation coefficient of each three level indicator was 0.07-0.31 and 0.06-0.19, and the coordination coefficient W was 0.25 and 0.47, respectively, indicating that the consistency and credibility of expert opinions were good. Finally, the risk assessment index system of infectious diseases in primary and secondary schools was established, which was composed of 5 first level indexes, 23 second level indexes and 86 third level indexes. The AHP was used to calculate the intra level weight of the index. The variation coefficient of five first level indicators of school health management and security system, school health personnel facilities, health monitoring and cognition level, severity and coping measures were 0.09, 0.06, 0.08, 0.12 and 0.06 , respectively, and the weight coefficients were 20.42%, 21.19%, 19.87%, 17.45% and 21.08%, respectively. Conclusion The risk assessment index system of school infectious diseases is applicable to primary and secondary schools. The initiative, coordination and authority of experts in this system are all high. It is of practical guiding significance for the early warning of infectious diseases in primary and secondary schools.

Osteoporotic vertebral compression fracture (OVCF) is the most common complication of spinal osteoporosis, mostly occurring in thoracolumbar segment, which can cause acute and chronic pain at the fracture site and loss of vertebral height, and can lead to progressive kyphosis. For kyphosis caused by old OVCF, open surgery such as anterior or posterior decompression and fusion, internal fixation and osteotomy can improve local sequence and achieve satisfactory kyphotic correction which is difficult to complete in percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP), and reconstruct the sagittal balance. Due to the older age of OVCF patients, some of them have poor general conditions. In addition, osteoporosis leads to increased vertebral fragility, which increases the risk of surgery and postoperative internal fixation failure. The anterior approach presents some problems including a complex approach and poor mechanical stability. At present, most studies focus on posterior surgery. Due to the limitation of kyphosis correction by decompression and fixation alone, osteotomy is often required to correct kyphosis. In cases of old OVCF with kyphosis, the screw holding capability decreases due to the decrease of bone mineral density. Additionally, once the screw loosens, the orthopedic effect is inevitably affected. To enhance pedicle screws, most studies have utilized bone cement to increase the axial pullout force of the vertebral body and improve screw stability. The selection from different osteotomy methods is a critical determinant in achieving favorable surgical outcomes for patients.

Objective:To investigate the influencing factors and regularity of inferior mediastinal lymph node metastasis in Siewert type Ⅱ and Ⅲ adenocarcinoma of esophagogastric junction (AEG).Methods:The retrospective case-control study was conducted. The clinicopatho-logical data of 185 Siewert type Ⅱ and Ⅲ AEG patients in two medical centers (113 cases in Changzhi People's Hospital Affiliated to Changzhi Medical College and 72 cases in Heji Hospital Affiliated to Changzhi Medical College) from January 2017 to January 2022 were collected. There were 143 males and 42 females, aged (64±8)years. Patients underwent radical resection of AEG combined with inferior mediastinal lymph node dissection. Observation indicators: (1) clinicopathological charac-teristics of Siewert type Ⅱ and Ⅲ AEG patients; (2) analysis of influencing factors for inferior mediastinal lymph node metastasis in Siewert type Ⅱ and Ⅲ AEG; (3) regularity of inferior mediastinal lymph node metastasis in Siewert type Ⅱ and Ⅲ AEG. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the t test. Measurement data with skewed distribution were represented as M(range), and comparison between groups was analyzed using the Mann-Whitney U test. Count data were represented as absolute numbers or percentages, and comparsion between groups was analyzed using the chi-square test or Fisher exact probability. Comparison of ordinal data was analyzed using the rank sum test. Univariate and multivariate analyses were conducted using the Logistic regression model. Results:(1) Clinicopathological characteristics of Siewert type Ⅱ and Ⅲ AEG patients. Pathologic staging as stage Ⅰ, Ⅱ, Ⅲ and Ⅳ, degree of tumor invasion as stage T1, T2, T3 and T4, length of esophageal invasion ≤1 cm, >1 cm and ≤2 cm, >2 cm and ≤3 cm, >3 cm and ≤4 cm were found in 30, 61, 75, 7, 3, 41, 79, 50, 101, 46, 18, 8 cases of the Siewert type Ⅱ and Ⅲ AEG patients without inferior mediastinal lymph node metastasis, respectively, versus 0, 2, 10, 0, 0, 0, 5, 7, 4, 3, 2, 3 cases of the Siewert type Ⅱ and Ⅲ AEG patients with inferior mediastinal lymph node metastasis, showing a significant differences between them ( Z=?2.21, ?2.49, ?2.22, P<0.05). (2) Analysis of influencing factors for inferior mediastinal lymph node metastasis in Siewert type Ⅱ and Ⅲ AEG. Results of univariate analysis showed that pathological staging, depth of tumor invasion and length of esophageal invasion were related factors affecting inferior mediastinal lymph node metastasis in Siewert type Ⅱ and Ⅲ AEG ( odds ratio=2.48, 3.26, 2.03, 95% confidence intervals as 1.02?6.01, 1.21?8.80, 1.18?3.51, P<0.05). Results of multivariate analysis showed that depth of tumor invasion and length of esophageal invasion were independent influening factors affecting inferior mediastinal lymph node metastasis in Siewert type Ⅱ and Ⅲ AEG ( odds ratio=4.01, 2.26, 95% confidence interval as 1.35?11.96, 1.26?4.06, P<0.05). The inferior mediastinal lymph node metastasis probability of AEG patients with the length of esophageal invasion >3 cm and ≤4 cm was 9.47 times that of AEG patients with the length of esophageal invasion ≤1 cm. (3) Regularity of inferior mediastinal lymph node metastasis in Siewert type Ⅱ and Ⅲ AEG. The number of inferior mediastinal lymph nodes including No.110, No.111 and No.112 dissected in 185 patients of Siewert type Ⅱ and Ⅲ AEG were 127, 50 and 27. The number of lymph nodes dissected and the number of metastatic lymph nodes in No.110 and No.111 of patients with length of esophageal invasion ≤1 cm, >1 cm and ≤2 cm, >2 cm and ≤3 cm, >3 cm and ≤4 cm were 69, 4, 42, 4, 4, 1, 12, 4 and 23, 0, 17, 0, 7, 2, 3, 0, respectively. There were significant differences in metastatic lymph nodes in No.110 and No.111 of patients with length of esophageal invasion ≤1 cm, >1 cm and ≤2 cm, >2 cm and ≤3 cm, >3 cm and ≤4 cm ( χ2=8.45, 7.30, P<0.05). Of the 185 patients of Siewert type Ⅱ and Ⅲ AEG, the ratio of cases with inferior mediastinal lymph nodes metastasis was 6.49%(12/185). The ratio of inferior mediastinal lymph nodes metastasis in cases with length of esophageal invasion ≤1 cm, >1 cm and ≤2 cm, >2 cm and ≤3 cm, >3 cm and ≤4 cm were 3.81%(4/105), 6.12%(3/49), 10.00%(2/20), 27.27%(3/11), respectively. The ratio of No.110 lymph nodes metastasis in cases with length of esophageal invasion ≤1 cm, >1 cm and ≤2 cm, >2 cm and ≤3 cm, >3 cm and ≤4 cm were 2.86%(3/105), 6.12%(3/49), 5.00%(1/20), 27.27%(3/11), respectively, showing a significant difference among them ( χ2=8.26, P<0.05). Conclusions:Depth of tumor invasion and length of esophageal invasion are independent influening factors affecting inferior mediastinal lymph node metastasis in Siewert type Ⅱ and Ⅲ AEG. The rate of inferior mediastinal lymph node metastasis increases with the increase of the length of esophageal invasion.

ObjectiveTo understand the internet media information of COVID-19 in Shanghai in 2022， to provide evidence for health administration departments to respond to public health emergencies， and to establish a comprehensive public health media surveillance system. MethodsData on internet media information and the local COVID-19 epidemic data in Shanghai from January 1 to June 30， 2022 were collected and analyzed. ResultsA total of 90.197 3 million pieces of internet media information were monitored. The top four sources of the information were Weibo （36.84%）， short videos （26.19%）， internet media （14.47%）， and forums （13.31%）. The variation trend of daily internet media surveillance information was identified with the number of newly reported cases per day， and a correlation was found （r＝0.770. After the seven-day moving average，r＝0.796）. Frequent keywords included Shanghai， cheer up， nucleic acid， new cases， local， asymptomatic， prevention and control， gratitude， isolation， epidemic prevention， supplies， pandemic response， patient， seeking help， and clearing the cases. Within the information on Weibo， in addition to netizens in Shanghai （7 823 100） who were highly concerned about the pandemic， netizens from Beijing （2 749 100）， Guangdong Province （2 352 300）， Jiangsu Province （2 189 100） and Zhejiang Province（1 532 100） also posted a relatively high amount of information related to COVID-19 in Shanghai. ConclusionThe outbreak of major infectious diseases triggers significant online activity， and platforms such as Weibo and short video platforms play crucial roles in disseminating internet media information. Weibo， short videos etc. are important platforms for current internet media information. Strengthening media information monitoring and analysis， paying close attention to hot events， taking timely response measures and actively engaging in risk communication contribute to the response and management of public health emergencies.

OBJECTIVETo establish an emergency response capability assessment indexes for disease control and prevention institutions.

METHODSHealth emergency response capability assessment indexes of Shanghai Centers for Disease Control and Prevention(CDCs) was drafted based upon documentary analysis, expert consultation and focus group discussion according to duties and features of emergency work of CDCs. The assessment indexes were determined by applying Delphi method (18 experts), and the weights of indexes were determined using analytic hierarchy process and proportional distribution method. And then the established index system was used to assess the emergency response capability of CDCs in Shanghai.

RESULTSTwo rounds of expert consultations were conducted. Kendall's coefficient of concordance was 0.420 and 0.495 at the first and second round of expert consultations respectively. After two rounds of consultations, the expert authority score was above 0.7. There were 7 primary indexes, 24 secondary indexes and 84 third-level indexes. The seven primary indexes included emergency management system, emergency response team, surveillance and early-warning ability, emergency response capacity, emergent supply capability, communication and cooperation, scientific research and exchange, with systematic weights of 0.2123, 0.1754, 0.1334, 0.1916, 0.1281, 0.0962 and 0.0630,respectively. According to the investigation, Shanghai Municipal Center for Disease Control and Prevention ranked first in the total score of emergency response capability evaluation.

CONCLUSIONSThe indexes identified in this study have good reliability and feasibility, and can be used in assessment of emergency response capability in disease prevention and control institutions.

Liver fibrosis is a dynamic wound-healing response characterized by the agglutination of the extracellular matrix (ECM). Si-Wu-Tang (SWT), a traditional Chinese medicine (TCM) formula, is known for treating gynecological diseases and liver fibrosis. Our previous studies demonstrated that long non-coding RNA H19 (H19) was markedly upregulated in fibrotic livers while its deficiency markedly reversed fibrogenesis. However, the mechanisms by which SWT influences H19 remain unclear. Thus, we established a bile duct ligation (BDL)-induced liver fibrosis model to evaluate the hepatoprotective effects of SWT on various cells in the liver. Our results showed that SWT markedly improved ECM deposition and bile duct reactions in the liver. Notably, SWT relieved liver fibrosis by regulating the transcription of genes involved in the cytoskeleton remodeling, primarily in hepatic stellate cells (HSCs), and influencing cytoskeleton-related angiogenesis and hepatocellular injury. This modulation collectively led to reduced ECM deposition. Through extensive bioinformatics analyses, we determined that H19 acted as a miRNA sponge and mainly inhibited miR-200, miR-211, and let7b, thereby regulating the above cellular regulatory pathways. Meanwhile, SWT reversed H19-related miRNAs and signaling pathways, diminishing ECM deposition and liver fibrosis. However, these protective effects of SWT were diminished with the overexpression of H19 in vivo. In conclusion, our study elucidates the underlying mechanisms of SWT from the perspective of H19-related signal networks and proposes a potential SWT-based therapeutic strategy for the treatment of liver fibrosis.
Humans ; RNA, Long Noncoding/genetics* ; Liver Cirrhosis/genetics* ; Liver/metabolism* ; Hepatic Stellate Cells/pathology* ; MicroRNAs/metabolism* ; Extracellular Matrix/metabolism* ; Drugs, Chinese Herbal