Objective: To investigate the spatio-temporal clustering characteristics of influenza in Shaoxing City, Zhejiang Province from 2015 to 2024, so as to provide the basis for formulating influenza prevention and control strategies. Methods: Influenza case data in Shaoxing City from 2015 to 2024 were collected through the Infectious Disease Surveillance Reporting System of the Chinese Disease Prevention and Control Information System. Descriptive epidemiological methods analyses were used to analyze the epidemiological characteristics of influenza. Spatial autocorrelation and spatio-temporal scanning were used to analyze the spatio-temporal clustering characteristics of influenza. Results: A total of 328 759 influenza cases were reported in Shaoxing City from 2015 to 2024, with an average annual reported incidence of 639.90/100 000, which showed an upward trend (AAPC=68.95%, P<0.05). The peak incidence period was from December to February of the following year, with 193 051 cases reported, accounting for 58.72%. There were 165 408 male cases and 163 351 female cases, with a male-to-female ratio of 1.01∶1. Children and adolescents aged 0-<15 years constituted the high-incidence population, while students represented the predominant occupational category, comprising 113 589 cases (34.55%). Keqiao District, Shengzhou City, and Yuecheng District had the top three average annual reported incidence of influenza, at 995.64/100 000, 734.66/100 000, and 687.44/100 000, respectively. Spatial autocorrelation analysis showed that, there were 155 high-high aggregation areas in Shaoxing City from 2015 to 2024, which gradually expanded from the local aggregation in the central part of Shengzhou City to Keqiao District and then spread to Yuecheng District. Spatio-temporal scanning analysis showed that, from November 2023 to February 2024, the strongest spatio-temporal clustering of influenza centered on Keqiao Street in Keqiao District, covering 11 towns (streets) in Yuecheng District and Keqiao District. From 2015 to 2018, the primary-type clustering of influenza was mainly concentrated in Xinchang County and Shengzhou City. After 2019, they gradually shifted to Yuecheng District and Keqiao District, with the main clustering period being from November to February of the following year. Conclusions The incidence of influenza in Shaoxing City from 2015 to 2024 showed an upward trend, with obvious spatio-temporal clustering. The clustering area expanded from Shengzhou City in the central region to Keqiao District and Yuecheng District in the northern region, mainly clustering from November to February of the following year.

Objective : To investigate the clinical and molecular epidemiological characteristics of 10 patients with enterovirus (EV)-D68 infections in the respiratory tract in Shaoxing City, Zhejiang Province, so as to provide insights into formulation of control interventions for EV-D68 infections. Methods: Clinical specimens were sampled from patients with acute respiratory tract infections (ARTIs) admitted to sentinel hospitals in Shaoxing City from 2021 to 2022, and EV-D68 was detected using real-time fluorescent PCR assay and sequencing of the VP1 region of enterovirus. The epidemiological and etiological characteristics of EV-D68 infected cases were descriptively analyzed. Results: A total of 3 009 specimens were sampled from patients with ARTIs from 2021 to 2022, and the detection of EV-D68 was 0.33%. Of all EV-D68-infected patients, there were 6 men and 4 women, and 5 cases under 18 years of age, 2 cases at ages of 18 to 60 years and 3 cases at ages of over 60 years. EV-D68 infection predominantly occurred in summer (5 cases detected between May and July) and autumn (5 cases detected between September and October). The main clinical symptoms included fever (10 cases), sore throat (9 cases) and cough (8 cases), and all 10 cases recovered well, with no deaths reported. Sequencing identified D3 subtype in all 10 specimens positive for EV-D68. Conclusions The ARTIs caused by EV-D68 occurred predominantly among children under 18 years of age in Shaoxing City, and was highly prevalent in summer and autumn. D3 was the predominant enterovirus subtype.

Objective: To analyze epidemiological characteristics of brucellosis in Shaoxing City, Zhejiang Province from 2005 to 2023, so as to provide the basis for developing targeted control measures. Methods: Data of brucellosis cases and epidemiological investigation in Shaoxing City from 2005 to 2023 were collected from the Monitoring and Reporting Management System of the Chinese Disease Prevention and Control Information System. The epidemiological characteristics of brucellosis were descriptively analyzed, the trend in incidence of brucellosis was analyzed using average annual percent change (AAPC). Results: A total of 270 cases of brucellosis were reported in Shaoxing City from 2005 to 2023, with an average annual incidence of 0.29/105. The AAPC was 0.812%, with no significant changing trend (P>0.05). The incidence of brucellosis peaked from February to March, with 80 cases (29.63%). The reported cases were mainly distributed in Shangyu District (139 cases, 51.48%) and Shengzhou City (74 cases, 27.41%). There were 188 male cases and 82 female cases, with a male-to-female ratio of 2.29∶1. The cases were primarily concentrated in the age group of 40 to <70 years, with 205 cases accounting for 75.93%. Among these, 86 cases were reported in the 50 to <60 years of age group, accounting for 41.95%. The majority of the cases were farmers, with 187 cases accounting for 69.26%. The median interval from onset to diagnosis was 22.73 (interquartile range, 39.97) days, with a delayed diagnosis rate of 62.96%. Infections through breeding, selling and transporting cattle and sheep resulted in 164 cases (60.74%), and through buying and slaughtering resulted in 36 cases (13.33%). An outbreak of brucellosis was reported in Xinchang County in 2018, with three confirmed cases. Conclusions The incidence of brucellosis in Shaoxing City had no significant change from 2005 to 2023. The peak period was from February to March. The cases were mainly distributed in Shangyu District and Shengzhou City. People aged 50 to <60 years, males, and farmers were the key groups for prevention and control.

The density and composition of lymphocytes infiltrating colon tumors serve as predictive factors for the clinical outcome of colon cancer.Our previous studies highlighted the potent anti-cancer properties of the principal compounds found in Garcinia yunnanensis(YTE-17),attributing these effects to the regu-lation of multiple signaling pathways.However,knowledge regarding the mechanism and effect of YTE-17 in the prevention of colorectal cancer is limited.In this study,we conducted isobaric tags for relative and absolute quantification(iTRAQ)analysis on intestinal epithelial cells(IECs)exposed YTE-17,both in vitro and in vivo,revealing a significant inhibition of the Wnt family member 5a(Wnt5a)/c-Jun N-terminal kinase(JNK)signaling pathway.Subsequently,we elucidated the influence and mechanism of YTE-17 on the tumor microenvironment(TME),specifically focusing on macrophage-mediated T helper 17(Th17)cell induction in a colitis-associated cancer(CAC)model with Wnt5a deletion.Additionally,we performed the single-cell RNA sequencing(scRNA-seq)on the colonic tissue from the Wnt5a-deleted CAC model to characterize the composition,lineage,and functional status of immune mesenchymal cells during different stages of colorectal cancer(CRC)progression.Remarkably,our findings demon-strate a significant reduction in M2 macrophage polarization and Th17 cell phenotype upon treatment with YTE-17,leading to the restoration of regulatory T(Treg)/Th17 cell balance in azoxymethane(AOM)/dextran sodium sulfate(DSS)model.Furthermore,we also confirmed that YTE-17 effectively inhibited the glycolysis of Th17 cells in both direct and indirect co-culture systems with M2 macrophages.Notably,our study shed light on potential mechanisms linking the non-canonical Wnt5a/JNK signaling pathway and well-established canonical β-catenin oncogenic pathway in vivo.Specifically,we proposed that Wnt5a/JNK signaling activity in IECs promotes the development of cancer stem cells with β-catenin activity within the TME,involving macrophages and T cells.In summary,our study undergoes the po-tential of YTE-17 as a preventive strategy against CRC development by addressing the imbalance with the immune microenvironment,thereby mitigating the risk of malignancies.

Objective:To analyze the efficacy, safety and learning curve of Thulium laser enucleation of the prostate by laser controller(LC-THuLEP) anchored at six o'clock position of the bladder neck in the treatment of benign prostatic hyperplasia(BPH) with large gland.Methods:The clinical data of the 1st to 45th BPH cases with large gland(prostate volume> 80 ml) treated by a doctor with LC-THuLEP anchored at six o'clock position of bladder neck in Shanghai East Hospital from January to October 2022 were retrospectively analyzed. The patients were divided into groups A, B and C according to the order of operation time, with 15 cases in each group. There were no significant differences among the three groups( P>0.05) in age[(71.8±9.4)years old vs. (73.5±8.2) years old vs.(71.4±5.5)years old], prostate volume[88.3(84.8, 100.6)ml vs.91.5(86.1, 118.4)ml vs. 94.5(84.7, 101.8)ml], prostate specific antigen(PSA)[4.8(2.9, 8.5)ng/ml vs. 7.2(3.2, 11.2)ng/ml vs. 7.8(4.5, 12.7)ng/ml], postvoid residual volume[44.0(34.0, 67.0)ml vs. 60.0(40.0, 76.0)ml vs. 39.0(0, 59.0)ml], maximum urine flow rate(Q max)[8.4(7.6, 11.1)ml/s vs. 8.6(6.5, 10.6)ml/s vs. 10.4(7.8, 13.2)ml/s], international prostate symptom score(IPSS)[20(18, 21) vs. 20(20, 22) vs. 20(20, 25)]and quality of life(QOL)[4(4, 5) vs. 4(4, 4) vs. 4(3, 5)].The doctor had more than 100 cases of TURP surgery experience. LC-THuLEP anchored at six o'clock position of bladder neck was described as follows. The bladder neck at six o'clock position is reserved 0.5-1.0 cm as an "anchor" to fix the prostatic bladder neck when the gland was pushed directly by the laser controller, preventing the detached prostate gland from turning. Finally the bladder neck was cut off at six o'clock position, and the prostate was en-bloc removed. The effect of surgery and postoperative complications were compared. The enucleation efficiency was equal to the weight of prostate tissue removed divided by the time of enucleation. Results:The differences among the three groups in operation time [100.0(90.0, 110.0)min vs. 80.0(70.0, 90.0)min vs. 75.0(70.0, 90.0)min], enucleation time[89.0(72.0, 97.0)min vs. 67.0(64.0, 77.0)min vs. 64.0(60.0, 77.0)min] and the efficiency of enucleation [0.65(0.62, 0.68)g/min vs. 0.84(0.83, 0.94)g/min vs. 0.93(0.82, 1.00)g/min] were statistically significant( P<0.05). The operation time and enucleation time in groups B and C were significantly lower than those in group A, and the enucleation efficiency was significantly higher than that in group A( P<0.05), while there was no significant difference between group B and C. However, the difference of three groups in hemoglobin decrease [8.0(5.0, 11.0)g/L vs. 7.0(2.0, 10.0)g/L vs. 11.0(4.0, 16.0)g/L] and catheter indwelling duration[4.0(2.0, 6.0)d vs. 6.0(3.0, 7.0)d vs. 4.0(3.0, 6.0)d] were not statistically different( P>0.05). All patients were followed up for 6 months after surgery. In three groups, postoperative Q max were 23.2(21.0, 25.1)ml/s, 22.7(21.1, 26.1)ml/s and 22.9(21.5, 25.7)ml/s, IPSS were 6(5, 8), 7(6, 8) and 7(7, 8), QOL were 2(1, 2), 2(1, 2) and 2(1, 2), postvoid residual volume were 20.0(10.0, 25.0)ml, 22.0(15.0, 25.0)ml and 5.0(0, 25.0)ml, respectively, which were all significantly different from that of pre-operation( P<0.05).However, there were no statistically significant differences in the postoperative indicators among the three groups ( P>0.05). No statistical difference was found in postoperative complications among the three groups[26.7%(4/15) vs. 20.0%(3/15) vs. 20.0%(3/15), P>0.05]. Conclusions:LC-THuLEP anchored at six o'clock position of bladder neck was an effective operation in the treatment of BPH with large gland, and the learning curve could be reached after 15 cases.

Objective: To investigate the epidemiological and etiological characteristics of viral diarrhea among children under 5 years of age in Shaoxing City, Zhejiang Province, so as to provide insights into management of viral diarrhea. Methods: The surveillance data on viral diarrhea among children under 5 years of age in Shaoxing City from 2019 to 2022 were collected, including demographics and stool testing results. The epidemiological and etiological characteristics of viral diarrhea were analyzed using a descriptive epidemiological method. Results: A total of 763 diarrheal children under 5 years of age were reported in Shaoxing City from 2019 to 2022, and 236 children were tested positive for virus (30.93%). The detection of virus was 49.01%, 31.61%, 20.43% and 21.89% from 2019 to 2022, which appeared an overall tendency towards a decline (P<0.05). The incidence of viral diarrhea peaked from November to March of the next year and from May to July, and the detection of virus was lower among children with diarrhea living in urban areas (Yuecheng District, Keqiao District and Shangyu District) than among those in suburb areas (Zhuji City, Shengzhou City and Xinchang County) (30.22% vs. 52.00%, P<0.05). There were 206 children tested positive for a single virus, and the detection rates of rotavirus (RV), enteric adenovirus (EAdV), norovirus (NoV), and sapovirus (SaV) were 9.57%, 8.91%, 8.39%, and 0.13%, respectively. There were 25 children with virus co-infections, and the positive rates of EAdV and NoV, RV and EAdV and RV and NoV co-infections were 1.31%, 1.18% and 0.79%, respectively. There were 5 children with triple infections of RV, EAdV and NoV (0.66%). The highest detection of EAdV was seen in April, the highest detection of RV and NoV was seen in January, while SaV was only detected in April. Conclusion The incidence of viral diarrhea among children under 5 years of age peaked in winter and spring in Shaoxing City from 2019 to 2022, and the cases predominantly occurred in urban areas. The detection of virus appeared an overall tendency towards a decline, with high detection of RV, EAdV and NoV.

Objective: To investigate the epidemiological characteristics of hemorrhagic fever with renal syndrome (HFRS) in Shaoxing City from 2006 to 2022, so as provide insights into improvements of the HFRS control strategy. Methods: Data pertaining to HFRS cases in Shaoxing City from 2006 to 2022 were captured from the Surveillance System of China Information System for Disease Control and Prevention. The temporal, population and regional distributions of HFRS were analyzed using the descriptive epidemiological method, and the trends in incidence of HFRS were evaluated using annual percent change (APC). Results: Totally 1 022 HFRS cases were reported in Shaoxing City from 2006 to 2022, with annual average incidence of 1.22/105 and three deaths. The incidence of HFRS appeared a tendency towards a decline in Shaoxing City from 2006 to 2022 (APC=-11.101%, t=-9.930, P<0.001), and the incidence of HFRS peaked from May to June and from November to January of the next year. A higher incidence of HFRS was seen in men than in women (1.76/105 vs. 0.68/105; χ2=201.361, P<0.001). There were 714 HFRS cases at ages of 30 to 59 years (69.86%), and farmers were the predominant occupation (78.18%). The three counties with the largest number of HFRS cases included Zhuji (366 cases), Xinchang (263 cases) and Shengzhou (134 cases). The incidence of HFRS was lower in urban districts (Yuecheng, Keqiao and Shangyu) than in counties (Zhuji, Shengzhou and Xinchang) (0.58/105 vs. 1.96/105; χ2=326.880, P<0.001). Conclusion The incidence of HFRS appeared a tendency towards a decline in Shaoxing City from 2006 to 2022, and the incidence was high in late spring, early summer and winter. The HFRS cases were mainly males, young and middle-aged people, and farmers, and predominantly distributed in counties. Targeted control measures are needed.

BACKGROUND/OBJECTIVES: Sanghuangporus sanghuang (SS) has various medicinal effects, including anti-inflammation and anticancer activities. Despite the extensive research on SS, its molecular mechanisms of action on lung cancer are unclear. This study examined the impact of an SS alcohol extract (SAE) on lung cancer using in vitro and in vivo models.MATERIALS/METHODS: Different concentrations of SAE were used to culture lung cancer cells (A549 and H1650). A cell counting kit-8 assay was used to detect the survival ability of A549 and H1650 cells. A scratch assay and transwell cell invasion assay were used to detect the migration rate and invasive ability of SAE. Western blot analysis was used to detect the expression of B-cell lymphoma-2 (Bcl-2), Bcl2-associated X (Bax), cyclin D1, cyclin-dependent kinases 4 (CDK4), signal transducer and activator of transcription 3 (STAT3), and phosphorylated STAT3 (p-STAT3). Lung cancer xenograft mice were used to detect the inhibiting ability of SAE in vivo.Hematoxylin and eosin staining and immunohistochemistry were used to detect the effect of SAE on the structural changes to the tumor and the expression of Bcl-2, Bax, cyclin D1, CDK4, STAT3, and p-STAT3 in lung cancer xenograft mice. RESULTS: SAE could inhibit lung cancer proliferation significantly in vitro and in vivo without cytotoxicity. SAE suppressed the viability, migration, and invasion of lung cancer cells in a dose and time-dependent manner. The SAE treatment significantly decreased the proapoptotic Bcl-2/Bax ratio and the expression of pro-proliferative proteins Cyclin D1 and CDK4 in vitro and in vivo. Furthermore, SAE also inhibited STAT3 expression. CONCLUSIONS SAE reduced the cell viability and suppressed cell migration and invasion in human lung cancer cells. Moreover, SAE also exhibited anti-proliferation effects in vivo. Therefore, SAE may have benefits in cancer therapy.

Objective: To investigate the genotypes of enteroviruses causing hand, foot and mouth disease ( HFMD ) in Shaoxing City, so as to provide insights into HFMD control. Methods: The anal and pharyngeal swab specimens were collected from HFMD cases under 14 years of age reported by sentinel hospitals of HFMD in Shaoxing City from 2018 to 2020. The enterovirus genotypes were determined by quantitative real-time PCR (qPCR) assay and sequenced by BLAST, and the constitution and temporal distribution of enterovirus genotypes were descriptively analyzed. Results: A total of 1 267 anal and pharyngeal swab specimens were collected from children with HFMD, and 661 specimens were positive for enteroviruses, with a positive rate of 52.17%. Among the 661 enterovirus-positive specimens, 70 specimens were tested positive for EV71 ( 5.52% ), 208 specimens tested positive for CoxA16 ( 16.42% ), 239 specimens tested positive for CoxA6 ( 18.86% ); 23 specimens tested positive for CoxA10 (1.82%), and 121 specimens tested positive for other 10 genotypes, including CoxA2, CoxA4, and CoxA5. The prevalence rates of EV71 were 14.08%, 0.72% and 1.84% from 2018 to 2020, and the detection of EV71 peaked during the period between April and July, 2018. The prevalence rates of CoxA16 were 10.98%, 26.57% and 11.98 from 2018 to 2020, and the detection of CoxA16 peaked during the period between April and August, and between November and December, 2019. The prevalence rates of CoxA6 were 10.50%, 14.73% and 30.88% from 2018 to 2020, and the detection of CoxA6 peaked during the period between May and December, 2020. Conclusions EV71, CoxA16 and CoxA6 were predominant enterovirus genotypes causing HFMD in Shaoxing City from 2018 to 2020, and the detection of CoxA6 appeared a tendency towards a rise.

Objective:To compare the efficacy and safety of transurethral thulium laser enucleation of prostate for benign prostatic hyperplasia (BPH) with laser controller and sheath.Methods:The clinical data of 128 BPH patients who underwent transurethral thulium laser enucleation of prostate (THuLEP) in our hospital from January to June 2020 were retrospectively analyzed. Prostatic enucleation by laser controller was performed in 66 patients (LC-THuLEP group). The prostatic urethral mucosa was cut into Ω shape at 0.5 cm in front of the verumontanum to expose the prostate capsule, and then the fiber was retracted into the laser controller. Push the gland directly between the prostate gland and the prostate surgical capsule and expand along the capsule by the laser controller. In case of bleeding or prostate adhesive cord, the fiber was extended to coagulate or cut off, and the prostate was eventually en bloc removed. THuLEP by sheath was performed in 62 cases (THuLEP group). The ages of patients in LC-THuLEP group and THuLEP group were (71.00±8.72) years and (70.32±7.80) years, respectively. The prostate volumes were (74.80±40.88) ml and (73.14±36.31) ml, respectively. Prostate specific antigen (PSA) was (4.67±4.99) ng/ml and (4.89±4.59) ng/ml, International Prostate Symptom Score (IPSS) was (19.48±5.30) points and (18.50±5.05) points, respectively. The quality of life (QOL) scores were (4.17 ± 0.78) points and (4.18± 0.67) points, the maximum urine flow rate (Q max) was (9.82± 2.58) ml /s and (9.98± 2.91) ml/s, respectively. Postvoid residual (PVR) was (60.20±39.19) ml and (61.11±52.83) ml, respectively. The international index of erectile function (IIEF-5) score was (5.58±4.50) and (5.60±4.16), respectively.There was no significant difference in preoperative baseline data between 2 groups ( P>0.05). The operation time, the reduced level of hemoglobin, the weight of removed tissue, The time to postoperative bladder irrigation, the time to indwelling catheter and complications were compared between the two groups. IPSS, QOL score, Q max, PVR, and complications were compared between the two groups at 1, 3 and 6 months after surgery, while IIEF-5 score were compared only at 6 months after surgery. Results:The operative time of LC-THuLEP group and THuLEP group was (71.85±25.68) min and (80.65±29.64) min, respectively, and the decrease of postoperative hemoglobin was (6.42±9.89) g/L and (9.47±10.79) g/L, respectively, the weight of the removed tissue was (56.73±31.21) g and (48.11±24.50) g, respectively, and the time to postoperative bladder irrigation was (14.73±2.71) h and (16.06±2.71) h, respectively, the time to indwelling catheter was (4.41±1.92)d and (4.31±1.66)d, respectively, with no statistically significant differences between the two groups. IPSS scores of LC-THuLEP group were (6.52±2.46) points, (5.83±2.43) points and (5.30±2.49) points at 1, 3 and 6 months after surgery, respectively. QOL scores were (2.36±0.85) points, (2.27±1.02) points and (1.98±0.77) points, Q max were (22.89±2.41) ml/s, (23.61±2.62) ml/s and (23.83±3.53) ml/s, respectively. In THuLEP group, IPSS were (7.60±1.89) points, (6.86±1.81) points and (6.44±1.78) points at 1, 3 and 6 months after surgery, and QOL scores were (2.68±0.67) points, (2.74±1.01) points and (2.35±0.68) points, respectively. Q max were (21.31±2.52) ml/s, (22.13±2.51) ml/s and (22.11±2.49) ml/s, respectively. Those indexes (except Qmax at 6 months)were better in LC-ThuLEP group than THuLEP group, and the differences were statistically significant ( P<0.05). PVR of LC-THuLEP group were (15.95±12.31) ml, (14.83±12.19) ml and (13.67±15.03) ml, respectively, PVR of THuLEP group were (21.89±21.14) ml, (20.03±21.51) ml and (19.69±21.19) ml, respectively, and there were no significant differences. There was no bladder injury, severe bleeding, blood transfusion or secondary operation. The incidence of urinary incontinence 1 month after surgery was 6.1% (4/66) in the LC-THuLEP group and 19.4% (12/62) in the THuLEP group, the difference was statistically significant ( P<0.05). There was no significant difference at 3 months (3/66 vs. 4/62) and 6 months (1/66 vs. 2/62) after surgery ( P>0.05). There were no significant differences in the incidence of epididymitis, urethral stricture and bladder neck contracture between the two groups ( P>0.05). Conclusion:Compared by sheath, THuLEP by laser controller could be a safe and effective surgical method with better curative effect and lower complication rate.