Objective: To investigate the epidemiological characteristics of epidemic encephalitis B in Huzhou City, Zhejiang Province from 2007 to 2023, so as to provide the evidence for formulating prevention and control measures for epidemic encephalitis B. Methods: Epidemic encephalitis B case data in Huzhou City from 2007 to 2023 were collected through the National Notifiable Disease Reporting System of the Chinese Disease Prevention and Control Information System. The temporal, regional and population distribution characteristics of laboratory-confirmed epidemic encephalitis B cases were analyzed using the descriptively epidemiological method. Results: A total of 49 laboratory-confirmed epidemic encephalitis B cases were reported in Huzhou City from 2007 to 2023, and the average annual incidence was 0.10/105, showing a significant downward trend (P<0.05). The epidemic encephalitis B cases were concentrated from July to August, and July was the peak month, with 40 cases accounting for 81.63%. There was a statistically significant difference in the average annual incidences of epidemic encephalitis B among counties (districts) (P<0.05). Nanxun District had the highest reported incidence, with an average annual incidence of 0.23/105. There were 30 male cases and 19 female cases, with a male-to-female ratio of 1.58∶1. The youngest case was 5 months old, and the oldest was 49 years old. The children under 15 years were in the majority, with 42 cases accounting for 85.71%. Most of the cases were scattered children, with 25 cases accounting for 51.02%. There were 22 cases with no vaccination history and 21 cases with an unknown vaccination history, accounting for 44.90% and 42.86% respectively. All cases presented with fever. Other main clinical symptoms included listlessness, drowsiness, vomiting and headache, with 47, 40, 33 and 29 cases respectively, accounting for 95.92%, 81.63%, 67.35% and 59.18%, respectively. Conclusions The incidence of epidemic encephalitis B in Huzhou City remained at a relatively low level from 2007 to 2023, with Nanxun District being the high-risk area and July being the peak month for disease incidence. Fever and listlessness were the predominant clinical manifestations. Strengthening vaccination for children under 15 years should be prioritized.

Objective: To investigate the epidemiological characteristics of hand, foot, and mouth disease (HFMD) in Huzhou City, Zhejiang Province from 2013 to 2023, so as to provide the basis for improving HFMD prevention and control measures. Methods: Data on HFMD cases in Huzhou City from 2013 to 2023 were collected through the Infectious Disease Reporting Information System of Chinese Disease Prevention and Control Information System. The epidemiological and etiological characteristics of HFMD cases were described. Results: A total of 61 093 HFMD cases were reported in Huzhou City from 2013 to 2023, with an average annual reported incidence of 181.89/100 000, showing no significant trend (AAPC=1.855%, P>0.05). The peak incidence of HFMD was reported from May to July, with a second peak from October to December. The average annual reported incidence of HFMD in males was higher than in females (206.93/100 000 vs. 155.74/100 000, P<0.05). The majority of cases were children aged under 5 years, with 48 936 cases (80.10%). The highest average annual reported incidence was observed in the children aged 1 year (5 767.62/100 000). The majority of cases were scattered children, with 33 508 cases (54.85%). Anji County and Wuxing District had relatively high average annual reported incidences of HFMD, at 211.68/100 000 and 210.43/100 000, respectively. Among the 2 791 laboratory-confirmed HFMD cases, 246, 600, and 1 945 cases tested positive for enterovirus 71 (EV71), Coxsackievirus A16, and other enteroviruses, respectively. Children aged under 5 years accounted for 87.39%, 75.67%, and 82.57% of the cases positive for the corresponding virus types, respectively. From 2013 to 2023, other enteroviruses had a relatively high positive proportion, while the positive proportion of EV71 decreased after 2014. Conclusions The reported incidence of HFMD in Huzhou City remained relatively stable. The peak incidence occurred from May to July. Males, children aged under 5 years, and scattered children were the key populations for prevention and control. Anji County and Wuxing District were high-incidence areas, and other enteroviruses were the predominant pathogens.

Background Animal farming may affect the structure and diversity of gut microbiota of farm workers, but it needs more studies to provide solid evidence. Objective To analyze the diversity characteristics of gut microbiota in dairy farm workers, dairy cows, and the control population (non-animal contact occupational group), and to assess the impact of dairy farming on the gut microbiota of workers. Methods The 16S rRNA full-length amplicon sequencing technology was used to sequence 60 fecal samples from dairy farm workers, 89 from dairy cows, and 50 from the general population. The gut microbiota structure characteristics, including operational taxonomic units (OTUs), alpha diversity, beta diversity, and the composition of species at the phylum, family, and genus levels were analyzed. The differences in gut microbiota among the three groups of samples were compared to explore the impact of occupational exposure on the gut microbiota structure of dairy farm workers. Results A total of 50478 OTUs were identified in the gut microbiota of farm workers, dairy cows, and the general population, with 23613, 42723, and 16592 OTUs, respectively. The number of shared OTUs between the dairy cows and the general population was 12674 (27.17%), between the general population and the farm workers was 10099 (33.54%), and between the dairy cows and the farm workers was 17690 (36.36%). Compared with the general population, the farm workers and dairy cows showed more shared gut microbiota (P<0.01). The abundance of Firmicutes in the gut of the farm workers was higher than that of the general population (P<0.01), while Actinobacteriota and Proteobacteria were the opposite (P<0.01). The alpha diversity of gut microbiota in the farm workers was different from that of the general population. The ACE index of the farm workers was slightly lower than that of the general population and much lower than that of dairy cows (P<0.05), while their Shannon index was higher than that of the general population but lower than that of dairy cows (P<0.01). The linear discriminant analysis effect size (LefSe) showed that the abundances of Lachnospiraceae and Ruminococcaceae in the gut microbiota of the farm workers were significantly higher than those of the general population, while Streptococcaceae, Lactobacillaceae, Bifidobacteriaceae, Enterobacteriaceae, and Erysipelatoclostridiaceae were lower than those of the general population. Conclusion The dairy farm workers shares a certain proportion of common bacterial communities with dairy cows. Dairy farming operations can affect the structure and diversity of the gut microbiota of workers by increasing the abundances of Lachnospiraceae and Ruminococcaceae, while decreasing the abundances of Streptococcaceae, Lactobacillaceae, Bifidobacteriaceae, Enterobacteriaceae, and Erysipelatoclostridiaceae. The study results provide reference data for further exploring the cross-host transmission of pathogens related to occupational exposure in dairy farming.

Objective: To analyze the epidemiological characteristics of influenza in Huzhou City, Zhejiang Province from 2014 to 2023, so as to provide a reference for the improvement of influenza prevention and control measures. Methods: The data of influenza cases in Huzhou City from 2014 to 2023 were collected from the China Disease Prevention and Control Information System. Descriptive epidemiological methods were used to analyze the population and regional distribution characteristics of influenza. Annual percent change (APC) and average annual percent change (AAPC) were used to analyze the trend of influenza incidence in Huzhou City from 2014 to 2023. Results: A total of 83 277 influenza cases were reported in Huzhou City from 2014 to 2023, with an average annual reported incidence of 268.68/105. From 2014 to 2023, the reported incidence of influenza in Huzhou City showed an upward trend (AAPC=68.748%, P<0.05), with a slow upward trend from 2014 to 2021 (APC=31.055%, P<0.05) and a sharp upward trend from 2021 to 2023 (APC=308.782%, P<0.05). The average annual reported incidence of influenza was 270.72/105 in males and 266.54/105 in females, and the difference was not statistically significant (P>0.05). The average annual reported incidence of influenza in children aged 5-<15 years was 1 502.77/100 000. The reported incidences of influenza in Deqing county, Changxing county, and Anji county were 551.44/100 000, 370.47/100 000, and 175.31/100 000, respectively. From 2014 to 2023, the trends of reported influenza incidence in males, females, residents aged 5-<15 years, and 15-<25 years were consistent with the whole population. The reported influenza incidence in each district (county) from 2021 to 2023 was consistent with Huzhou City from 2021 to 2023. Conclusions The reported incidence of influenza in Huzhou City showed an overall upward trend from 2014 to 2023, especially from 2021 to 2023. There was no significant gender difference. The majority of the cases were aged 5-<15 years, and the high incidence areas were Deqing County.

Mycophenolic acid (MPA), the active moiety of both mycophenolate mofetil (MMF) and enteric-coated mycophenolate sodium (EC-MPS), serves as a primary immunosuppressant for maintaining solid organ transplants. Therapeutic drug monitoring (TDM) enhances treatment outcomes through tailored approaches. This study aimed to develop an evidence-based guideline for MPA TDM, facilitating its rational application in clinical settings. The guideline plan was drawn from the Institute of Medicine and World Health Organization (WHO) guidelines. Using the Delphi method, clinical questions and outcome indicators were generated. Systematic reviews, Grading of Recommendations Assessment, Development, and Evaluation (GRADE) evidence quality evaluations, expert opinions, and patient values guided evidence-based suggestions for the guideline. External reviews further refined the recommendations. The guideline for the TDM of MPA (IPGRP-2020CN099) consists of four sections and 16 recommendations encompassing target populations, monitoring strategies, dosage regimens, and influencing factors. High-risk populations, timing of TDM, area under the curve (AUC) versus trough concentration (C₀), target concentration ranges, monitoring frequency, and analytical methods are addressed. Formulation-specific recommendations, initial dosage regimens, populations with unique considerations, pharmacokinetic-informed dosing, body weight factors, pharmacogenetics, and drug‍-‍drug interactions are covered. The evidence-based guideline offers a comprehensive recommendation for solid organ transplant recipients undergoing MPA therapy, promoting standardization of MPA TDM, and enhancing treatment efficacy and safety.
Mycophenolic Acid/administration & dosage* ; Drug Monitoring/methods* ; Humans ; Organ Transplantation ; Immunosuppressive Agents/administration & dosage* ; Delphi Technique

Objective To explore the application value of preoperative nebulized inhalation of esket-amine in pediatric snoring surgery under general anesthesia.Methods A total of 145 children who were sched-uled to undergo elective pediatric snoring surgery in this hospital from January to December 2023 were select-ed and divided into the control group,the NC group and the ES group by random number table method,with 48,49,48 cases in each group,respectively.The control group was given routine preoperative preparations,the NC group was nebulized and inhaled normal saline before the operation,and the ES group was nebulized and inhaled esketamine solution before the operation.The awakening time,extubation time,post-anesthesia care u-nit(PACU)stay time,direct care time,choking cough score after awakening,visual analogue scale(VAS)for pain,restlessness score,incidence of restlessness and occurrence of adverse reactions were compared among the three groups of children.Results Compared with the control group and the NC group,the recovery time,ex-tubation time,PACU stay time,direct care time,choking cough score after awaking,VAS,restlessness score and the incidence of restlessness in the ES group were significantly decreased(P＜0.05).There was no statis-tically significant difference in the above indicators between the NC group and the control group(P＞0.05).No adverse reactions occurred in any of the three groups of children during the recovery period from general anesthesia.Conclusion Preoperative nebulized inhalation of esketamine can effectively accelerate the recovery and extubation time of children undergoing general anesthesia for snoring surgery,alleviate choking,pain and restlessness reactions,and reduce direct care time.

ObjectiveTo investigate the seroprevalence of Japanese encephalitis virus (JEV) IgG antibodies among the healthy individuals in Huzhou City, Zhejiang Province, so as to provide a scientific basis for the development of prevention and control strategies for Japanese B encephalitis (JE). MethodsA cross-sectional study was conducted from 2023 to 2024. Serum samples were collected from healthy individuals across 12 age groups (<8 months, 8 months‒<2 years, 2‒<4 years, 4‒<6 years, 6‒<8 years, 8‒<10 years, 10‒<15 years, 15‒<20 years, 20‒<30 years, 30‒<40 years, 40‒<50 years, 50‒ years) and tested for JEV IgG antibody to determine positivity rates. ResultsThe overall JEV IgG antibody seroprevalence rate was 57.75 % among the healthy individuals in Huzhou City. The positivity rates for the age groups of <8 months, 8 months‒<2 years, 2‒<4 years, 4‒<6 years, 6‒<8 years, 8‒<10 years, 10‒<15 years, 15‒<20 years, 20‒<30 years, 30‒<40 years, 40‒<50 years, and 50‒ years were 10.14%, 23.76%, 77.31%, 66.88%, 73.87%, 58.33%, 41.67%, 55.06%, 47.00%, 61.00%, 62.00%, and 92.00%, respectively, with a statistically significant difference observed in different age groups (χ²=243.996, P<0.001). Seroprevalence rates also differed significantly between males and females (χ²=9.999, P=0.002). Among subjects vaccinated with 0,1 or 2 doses of live attenuated Japanese encephalitis virus vaccine (JEV-L), the IgG antibody seroprevalence rate was 4.76%, 27.27% and 72.33%, respectively (χ²=108.568, P<0.001). Within the 2 doses group, the IgG antibody seroprevalence rate at <1 year, 1 year, 2 years and 3‒5 years after immunization were 80.85%, 77.36%, 66.67% and 65.45%, respectively, indicating a declining trend with time increased since vaccination (Z=-2.024, P=0.043). ConclusionAdults aged 50‒ years maintain high antibody levels, whereas levels are lower among the age groups of <2 years and 8‒<30 years and wane with time since vaccination in Huzhou City. It is recommended to maintain the routine JE vaccination schedule while exploring booster vaccination strategies for the age groups of 8‒<30 years, in order to enhance population immunity against JEV.

Objective: To investigate the trends in incidence and epidemiological characteristics of notifiable infectious diseases in Huzhou City, Zhejiang Province from 2005 to 2023, so as to provide insights into optimizing infectious disease surveillance and control. Methods: Data of notifiable infectious disease cases in Huzhou City from 2005 to 2023 were collected from the Infectious Disease Report Information System of Chinese Disease Prevention and Control Information System. Trends in incidence were analyzed using annual percent change (APC) and average annual percent change (AAPC). The population distribution and seasonal characteristics were descriptively analyzed. Results: From 2005 to 2023, a total of 504 283 cases of notifiable infectious diseases were reported in Huzhou City, with an annual crude incidence rate of 892.65/105 and a standardized incidence rate of 989.21/105. The incidence rate of notifiable infectious diseases in Huzhou City showed an upward trend (AAPC=8.886%, P<0.05), of which there was an obvious upward trend from 2021 to 2023 (APC=95.996%, P<0.05). After the removal of COVID-19 incidence, the incidence trend was basically unchanged (AAPC=7.970%, P<0.05). From 2005 to 2023, the incidence rate of class A and B notifiable infectious diseases showed no obvious trend (P>0.05), and the incidence rate of class A and B respiratory infectious diseases showed an upward trend (AAPC=6.958%, P<0.05). After the removal of COVID-19 incidence, the two showed a downward trend (AAPC=-7.680% and -8.660%, both P<0.05). The incidence rate of class A and class B intestinal infectious diseases, blood-borne and sexually transmitted infectious diseases showed a downward trend (AAPC=-14.849% and -5.977%, both P<0.05), while the incidence rates of natural and insect-borne infectious diseases did not show a significant trend (P>0.05). The overall incidence rate of class C infectious diseases showed an upward trend (AAPC=13.058%, P<0.05). The incidence rate ratio (IRR) of notifiable infectious diseases between males and females was 1.26 (95%CI: 1.25-1.27). A total of 204 043 cases under 10 years were reported, accounting for 40.46%. The peak incidence of class A and B respiratory infectious diseases was in January, May and June, while that of class A and B intestinal infectious diseases was from June to October. The peak incidence of class C respiratory infectious diseases was in January, March, April and December, while that of class C intestinal infectious diseases was from May to August and from November to December. Conclusions The incidence rate of notifiable infectious diseases in Huzhou City showed an upward trend from 2005 to 2023, which was more obvious from 2021 to 2023. Men and children under 10 years were the high-risk population. The incidence of respiratory and intestinal infectious diseases had obvious seasonal characteristics.