ObjectiveTo observe the clinical efficacy of Tangshen Dihuang decoction in treating diabetic kidney disease （DKD） with liver-kidney Yin deficiency and blood stasis syndrome and its impact on gut microbiota. MethodsA randomized controlled clinical trial was conducted， in which 102 DKD patients with liver-kidney Yin deficiency and blood stasis syndrome were randomly assigned to the Tangshen Dihuang decoction group and the control group. Each group consisted of 51 cases， and the treatment period was 3 months. The primary efficacy indicators included urinary albumin-to-creatinine ratio （UACR）， fasting blood glucose （FBG）， 2-hour postprandial blood glucose （2 hPBG）， glycated hemoglobin （HbA₁C）， serum creatinine （SCr）， blood urea nitrogen （BUN）， angiotensinⅡ （AngⅡ）， serum cystatin C （Cys-C）， urinary N-acetyl-β-D-glucosaminidase （NAG）， urinary β₂-microglobulin （Uβ₂-MB）， traditional Chinese medicine （TCM） symptom scores， and gut microbiota. ResultsAfter treatment， the total response rate in the Tangshen Dihuang decoction was 87.23% （41/47）， which was higher than that （69.57%， 32/46） in the control group （Z=4.30， P<0.05）. After treatment， the TCM symptom scores decreased in both groups （P<0.01） and were lower in the Tangshen Dihuang decoction group than in the control group （P<0.01）. After treatment， the control group showed decreases in UACR， Uβ₂-MG， AngⅡ， and FBG （P<0.05） as well as 2 hPBG and HbA₁C （P<0.01）， and no significant differences in BUN， Cys-C， eGFR， SCr， and NAG. The Tangshen Dihuang decoction group showed increased eGFR （P<0.05）， declined levels of UACR， BUN， Cys-C， Uβ₂-MB， AngⅡ， FBG， 2 hPBG， NAG， and HbA₁C （P<0.01）， and no significant difference in SCr. The Tangshen Dihuang decoction group had lower BUN （P<0.05）， Cys-C （P<0.05）， AngⅡ （P<0.05）， 2 hPBG （P<0.05）， Uβ₂-MG （P<0.01）， and NAG （P<0.01） and higher eGFR level （P<0.05） than the control group. After treatment， the control group showed declines in Shannon， Observed_species， and Chao1 indices （P<0.05）. The samples from both groups showed statistically significant differences in the principal coordinates analysis （PCoA） plot based on Anosim analysis （P<0.05）. After treatment， the Tangshen Dihuang decoction group showed decreased relative abundance of Actinobacteria （P<0.05）. Moreover， the relative abundance of Actinobacteria was significantly lower in the Tangshen Dihuang decoction group than in the control group （P<0.05）. At the genus level， the control group showed decreased relative abundance of Bifidobacterium （P<0.05）， and the Tangshen Dihuang decoction group presented increased relative abundance of Bifidobacterium and Blautia_A （P<0.05）. After treatment， the Tangshen Dihuang decoction group had higher relative abundance of Bifidobacterium than the control group （P<0.01）. ConclusionTangshen Dihuang decoction has a significant therapeutic effect on DKD patients with liver-kidney Yin deficiency and blood stasis syndrome. It can markedly relieve clinical symptoms and reduce proteinuria and postprandial blood glucose by antagonizing the local renin-angiotensin system （RAS） and alleviating gut microbiota dysbiosis.

ObjectiveTo investigate the epidemiological characteristics of human brucellosis (hereinafter referred to as brucellosis) in Baoshan City, Yunnan Province, and to provide scientific evidence for adjusting prevention and control strategies. MethodsBased on the surveillance data of reported brucellosis cases in Baoshan City from 2020 to 2023 and the information collected through individual epidemiological questionnaire surveys, the epidemic status and clinical characteristics of brucellosis in Baoshan City were analyzed using descriptive epidemiological methods. ResultsA total of 85 brucellosis cases were reported in Baoshan City from 2020 to 2023, and detailed individual information was obtained for 83 of them. Brucellosis in Baoshan City showed a clear seasonal pattern, with peak incidence from May to September. The average annual incidence rate was 0.80/100 000, with a male-to-female ratio of 7.5∶1. And 82.35% of the cases aged 30 to 60 years, with farmers being the predominant affected group. The main clinical manifestations of the cases were myalgia and arthralgia. Regarding transmission routes, 87.95% of the cases had a contact history with cattle, with livestock rearing and grazing being the main exposure modes. Most infections occurred at home. ConclusionFrom 2020 to 2023, the incidence of brucellosis in Baoshan City exhibited a fluctuating upward trend, with a peak period from May to September. Males and farmers were identified as the primary affected populations. It is recommended to strengthen livestock surveillance and control, and to enhance both awareness and self-protection capacity among high-risk groups.

This paper summarizes professor ZHU Shengliang's academic idea and clinical experience in treating gastroesophageal reflux disease （GERD） with qi constraint and phlegm obstruction syndrome. It is believed that the core pathogenesis of GERD is the dysfunction of the liver， gallbladder， spleen and stomach， with binding of phlegm and stasis. The basic pathogenesis is the liver and gallbladder failing to dredge and disperse， the stomach failing to harmonize and descend， and the stomach qi counterflowing upward. In clinical practice， the treatment principle of regulating qi as the priority， resolving phlegm as the key， and activating blood as the assistant is applied， with harmonizing the stomach and directing counterflow downward throughout the whole process. A self-made Shugan Hewei Huatan Formula （疏肝和胃化痰方） is employed with the function of soothing the liver and rectifying qi， opening constraint and dissipating knot， dissolving phlegm and dispelling stasis， harmonizing stomach and directing counterflow downward， with an emphasis on flexible modification according to the syndrome as well as careful protection of stomach qi.

ObjectiveTo analyze the incidence and spatiotemporal distribution of typhus fever in Baoshan City, Yunnan Province from 2005 to 2023, to identify high-risk populations and regions, so as to provide a scientific basis for optimizing the allocation of local prevention and control resources and developing targeted intervention measures. MethodsData of typhus fever cases in Baoshan City from 2005 to 2023 were obtained from the Infectious Disease Information Management System of the Chinese Center for Disease Control and Prevention. Descriptive epidemiological methods were used to analyze the temporal, spatial and demographic distribution of typhus fever cases. Spatial clustering was assessed using spatial dynamic window scan statistics (circular and elliptical windows), flexible spatial scan statistics, and local spatial autocorrelation methods (including local Moran’s I, local Geary’s C, and Getis-Ord G_i*). Retrospective spatiotemporal scan statistics were employed to detect spatiotemporal clusters. ResultsA total of 1 099 typhus fever cases were reported in Baoshan City from 2005 to 2023. The incidence rate peaked at 6.31/ 100 000 in 2007, followed by a decline until reaching its lowest level at 0.21/100 000 in 2015 , and subsequently rebounded during 2016‒2023. The highest proportion of cases was among children under 10 years of age (31.12%), and the top three occupations of cases were farmers, students, and children, accounting for 88.62% of all cases. Cases occurred predominantly between June and September each year. The incidence was relatively high in Jiucheng Town (62.58/100 000), Yaoguan Town (57.15/100 000), and Dianyang Town (46.81/100 000) of Shidian County. Spatial clustering analyses indicated that high-risk areas were mainly located in the southern part of Baoshan City, showing a south-to-north trend. Spatiotemporal scan analyses identified five clusters, with the most likely cluster centered around Yaoguan Town, covering ten towns (subdistricts) during the period 2007‒2010. ConclusionThe incidence of typhus fever in Baoshan City exhibits a clear seasonal and spatial clustering pattern, with peak incidence occurring in summer and autumn. Spatially, cases are primarily distributed in the southern part of Baoshan City, and high-risk clusters exhibit a south-to-north trend. Farmers, students, and children are the high-risk groups.

ObjectiveTo retrospectively analyze the correlation among serotypes, antimicrobial resistance phenotypes, and resistance genotypes of Salmonella isolates from diarrheal cases in Baoshan District of Shanghai from 2023 to 2024, and to provide a reference for the prevention and control of Salmonella infections and the rational use of antibiotics in clinical practice. MethodsSalmonella isolates collected from diarrheal cases under surveillance in Baoshan District from 2023 to 2024 were serotyped. Antimicrobial resistance phenotypes were determined using the broth microdilution method, and whole-genome sequencing was performed to identify resistance genes. Positive predictive value and Kappa were calculated to evaluate the agreement between phenotypic and genotypic resistance profiles of Salmonella. ResultsA total of 64 Salmonella isolates belonged to 17 serotypes, with the predominant ones being Salmonella Typhimurium (25.00%) and Salmonella Enteritidis (18.75%). The tested strains exhibited high resistance rates to ampicillin (60.94%), streptomycin (59.38%), and ampicillin/sulbactam (45.31%). All isolates remained susceptible to ceftiofur and ceftazidime/avibactam. Forty different resistance profiles were identified, and 39 isolates accounting for 60.94%, were multidrug-resistant. Overall, 80 resistance genes belonging to 13 categories were detected, with the most prevalent being bla_TEM-1 (57.81%), aac(6')⁃Iy (54.69%), and aph(6)⁃Id (46.88%). No carbapenem or polymyxin resistance genes were found. The types and numbers of resistance genes varied significantly across serotypes. A high concordance was observed between genotype and phenotype for penicillins (positive predictive value: 94.59%, Kappa: 0.81), cephalosporins (90.91%, 0.46), cephamycins (100.00%, 0.65), macrolides (77.78%, 0.86), tetracyclines (100.00%, 0.93), and chloramphenicol (95.83%, 0.93). ConclusionSalmonella isolates from diarrheal diseases in Baoshan District exhibit high antimicrobial resistance. Whole-genome sequencing provides valuable support for resistance surveillance, however, it still needs to be integrated with phenotypic susceptibility testing for comprehensive assessment. Further studies are warranted to elucidate the mechanisms and transmission patterns of resistance in Salmonella.

Objective To investigate the changes in the density of Aedes albopictus across different regions and different breeding habitats in Baoshan District, Shanghai Municipality from 2018 to 2024, so as to inform evidence-based control strategies for mosquito-borne infectious diseases in Shanghai Municipality. Methods Ae. albopictus surveillance sites were deployed in 12 subdistricts (towns) of Baoshan District, Shanghai Municipality from 2018 to 2024, and the surveillance on the density of Ae. albopictus was performed in each surveillance site once weekly during the peak activity period of Aedes mosquitoes from May to October each year from 2018 to 2024. Mosquito ovitraps were deployed in various breeding habitats in each surveillance site according to geographical locations, including residential areas, schools, government institutions, hospitals, recycling stations, and construction sites, and regularly collected, and the mosquito ovitrap index (MOI) was calculated. The changes in the Ae. albopictus density were analyzed based on MOI across years, regions, and breeding habitats. Additionally, from May to October each year between 2018 and 2024, monthly risk assessments of Aedes albopictus density were conducted in every subdistrict (town) of Baoshan District, Shanghai. Results The annual mean MOI values of Ae. albopictus were 5.88 ± 2.29, 8.19 ± 4.46, 7.43 ± 3.40, 5.44 ± 2.52, 3.97 ± 2.72, 3.82 ± 1.57, and 2.56 ± 1.11 in Baoshan District from 2018 to 2024, respectively (F = 75.886, P < 0.05), and the MOI appeared a rise followed by a reduction each year and peaked during the period between June and August. There was a significant difference in the 7-year mean MOI of Ae. albopictus across the 12 subdistricts/towns (F = 26.558, P < 0.05), and there were 6 subdistricts/towns with a 7-year mean MOI of over 5, including Songnan Town (8.44 ± 4.68), Dachang Town (7.71 ± 5.28), Gucun Town (7.13 ± 3.57), Yuepu Town (5.74 ± 1.69), Gaojing Town (5.51 ± 3.44), and Wusong Subdistrict (5.41 ± 2.04). There was a significant difference in the MOI of Ae. albopictus across breeding habitats (F = 3.843, P < 0.05), with the highest MOI seen in recycling stations (9.86 ± 4.61), which was significantly higher than in other habitats (P < 0.05), and the lowest seen in construction sites (4.90 ± 2.95), which was significantly lower than in other habitats (P < 0.05). The proportion of frequency with Ae. albopictus density transmission risk decreased from 54.17% in 2018 to 11.11% in 2024 in all subdistricts (towns) of Baoshan District, and the frequency of outbreak risks peaked in 2019 (18 instances) and declined substantially in 2021 (6 instances), with no records of outbreak or transmission risk documented across the district in 2024. Conclusions There were substantial seasonal variations in the Ae. albopictus density in Baoshan District, Shanghai Municipality from 2018 to 2024. The Ae. albopictus density peaked during the period between June and August in Baoshan District each year from 2018 to 2024, with a relatively higher density in Songnan Town and Dachang Town, and in recycling stations. Precision control measures and intensified seasonal interventions are recommended in high-risk settings in Baoshan District to reduce the transmission risk of Aedes-borne infectious diseases.

Objective To investigate the effect and mechanism of dabrafenib （DAB） combined with tremelimumab （TREM） on melanoma. Methods The effects of DAB combined with TREM on cell viability, cytotoxicity and cell migration of A375 cells were evaluated by Cell Counting Kit-8 （CCK-8） method, lactate dehydrogenase （LDH） method and scratch assay. The levels of reactive oxygen species （ROS）, adenosine triphosphate （ATP）, malondialdehyde （MDA）, and superoxide dismutase （SOD） were detected to evaluate the effects of combined drugs on oxidative stress and energy metabolism. In addition, A375 tumor-bearing nude mice model was used to evaluate the inhibitory effect of the combined treatment on tumor growth in vivo, and the degree of cell apoptosis and cell proliferation in tumor tissues were analyzed by terminal deoxynucleotidyl transferase-mediated dutP Nick end labeling （TUNEL） and proliferating cell nuclear antigen （PCNA） immunohistochemical staining. Results The combined treatment significantly inhibited the survival rate and migration ability of A375 cells and enhanced the cytotoxicity. The combined intervention also significantly increased ROS level, decreased ATP, SOD and MDA levels. It effectively inhibited tumor growth in tumor-bearing nude mice, increased the apoptosis rate of tumor cells and inhibited cell proliferation. Conclusion DAB combined with TREM may improve the therapeutic effect of melanoma by enhancing oxidative stress, inhibiting energy metabolism, and promoting cell apoptosis. This combination therapy may provide a new therapeutic strategy to overcome the limitations of singledrug therapy.

ObjectiveTo analyze the etiological characteristics of two strains of Escherichia albertii first identified in Baoshan District, Shanghai, in 2024, to explore their antibiotic resistance characteristics, virulence characteristics, and multilocus sequence typing (MLST) to elucidate their genetic evolutionary relationships, so as to provide a scientific basis for the surveillance and control of Escherichia albertii in the local area. MethodsA total of 457 anal swabs were collected from patients with diarrhea in 2024, from which two suspected Escherichia albertii strains were isolated. The isolated strains were identified through mass spectrograph analysis, biochemical identification, and polymerase chain reaction (PCR) test. Microdilution broth method was used for the antimicrobial susceptibility testing, and whole-genome sequencing was performed for molecular characteristic analysis. ResultsMass spectrograph analysis and PCR test initially identified the two strains as Escherichia coli (E. coli), but their biochemical profiles were inconsistent with those of E. coli. Genomic sequencing identified the strains as Escherichia albertii, and which were named as S1 and S2, respectively. The antimicrobial susceptibility test showed that both strains were susceptible to β‑lactam antibiotics and moderately susceptible to polypeptide antibiotics. S1 was resistant to chloramphenicol (CHL), streptomycin (STR), tetracyclin (TET), florfenicol (FFC) and nalidixic acid (NAL), and carried five resistance genes including APH（6），APH（3）， gyrA， tet and flor, whereas S2 was susceptible to the five antibiotics mentioned above. Neither of the two strains contained the stx virulence gene, but S2 harbored the astA virulence gene. The two Escherichia albertii strains had the MLST types of ST4638 and ST4606, respectively. The genome size of the two strains was 4.5 Mb, and the closest relative strain was GTC14781 (Escherichia albertii). The average nucleotide identity (ANI) values to the reference genome of E. coli were both below 90%. S1 did not have the H serotype defined in the current database. S1 and S2 differed by 28 267 single-nucleotide polymorphisms (SNPs), and no homologous strains were found in comparison with the data in the GeneBank database. ConclusionTwo strains of Escherichia albertii are initially identified in Baoshan District of Shanghai. Strain S1 shows strong multidrug resistance, while strain S2 carries diarrheagenic virulence genes. The two strains have a distant genetic relationship and exhibits a pattern of sporadic occurrence. It is recommended to utilize whole-genome sequencing technology to enhance the epidemiological surveillance and laboratory detection of Escherichia albertii.

ObjectiveTo investigate the epidemiological characteristics of hand, foot, and mouth disease (HFMD) in Baoshan District of Shanghai from 2008 to 2023, and to provide scientific evidence for surveillance and standardized management of HFMD. MethodsCase data for HFMD reported in the China Disease Control and Prevention Information System from 2008 to 2023 were collected. Descriptive epidemiological methods were used to analyze the population characteristics, and the Joinpoint regression models were applied to assess the temporal trends of HFMD in Baoshan District. ResultsA total of 43 853 HFMD cases were reported from 2008 to 2023 in Baoshan District, with a male-to-female ratio of 1.50∶1. The majority of cases were children, among which scattered children and preschool children accounted for 54.67% and 36.58%, respectively, with 88.00% occurring in children under 5 years old. The average annual incidence rate was147.22/100 000 individuals. The pathogen detection rate in 2018 was 58.60% (109/186). Prior to 2020, CoxA16 was the predominant strain, while EV71 was not detected after 2019. ConclusionThe incidence of HFMD in Baoshan District of Shanghai was influenced by multiple factors including the inclusion in the notifiable infectious disease surveillance system, the introduction of EV71 vaccination, and the COVID-19 pandemic timeline. Populations characterized by highly mobility and frequent external contacts were at high risk for HFMD in Baoshan District. The predominant circulating strains had shifted sequentially from EV71 and CoxA16 to CoxA6.

Objective:To investigate the effect of applying the analog of miR-145(agomiR-145)to target a disintegrin and metallopro-tease 17(ADAM17)on the growth of triple-negative breast cancer(TNBC)xenograft tumors in nude mice and the underlying mecha-nism.Methods:A subcutaneous xenograft tumor model was established in nude mice with MDA-MB-231 cells(n=30).The 30 nude mice were randomly divided into agomiR group,agomiR-NC group,and control group to receive intratumoral injection of 100 μL of agomiR-145(0.33 g/L),agomiR-NC(0.33 g/L),and normal saline,respectively.We examined tumor tissue morphology with HE stain-ing;measured the expression of miR-145,ADAM17,and epidermal growth factor receptor(EGFR)in tumor tissues by real-time poly-merase chain reaction(RT-PCR);and determined the protein expression of ADAM17,EGFR,and p-EGFR in tumor tissues by immu-nohistochemistry and Western blot.Results:The tumor growth in the agomiR group was slow,with a significantly smaller tumor volume than those in the control group and the agomiR-NC group(P<0.05).The results of HE staining showed more severe necrosis and hem-orrhage within tumor tissues in the control group and the agomiR-NC group than in the agomiR group.RT-PCR results showed that the expression level of miR-145 in the agomiR group was significantly higher than those in the agomiR-NC and control groups(P<0.001);the agomiR group had a significantly lower mRNA expression level of ADAM17 than the other two groups(P<0.05);and there was no significant difference in EGFR mRNA expression between the three groups(P>0.05).Immunohistochemistry and Western blot detected significantly lower protein expression levels of ADAM17 and EGFR in the agomiR group than in the agomiR-NC group and the control group(P<0.05).Conclusion:AgomiR-145 inhibits the growth of TNBC xenografts in nude mice by targeted suppression of ADAM17-EGFR activity.