Objective To explore the effectiveness of the cumulative sum (CUSUM) and the exponentially weighted moving average (EWMA) for early warning of influenza epidemic using two datasets of reported influenza cases and influenza-like illness (ILI) cases. Methods Using the reported cases of influenza and ILI in Daxing District, Beijing, from week 23 of 2018 to week 22 of 2024 as data sets, the CUSUM and EWMA models were established, respectively. The positive rate of influenza etiology was used as the ^“gold standard^”, and the Youden index was used as the evaluation index to compare the early warning effect of the two models under different data sets and different parameters. Results In CUSUM, the optimal Youden indices of the reported influenza cases set and the ILI cases set were 0.751 and 0.635, respectively. In EWMA, the optimal Youden indices of the reported influenza cases set and the ILI cases set were 0.544 and 0.464, respectively. The optimal EWMA and CUSUM models could both issue early warning signals in advance of the ^“gold standard^”. Conclusion In the influenza epidemic early warning in Daxing District, Beijing, the CUSUM model established with the reported cases of influenza can achieve good early warning effects, but the model parameters need to be dynamically adjusted according to the local epidemic characteristics.

Objective: To statistically analyze the association between blood donation intervals and the incidence of adverse reactions to blood donation based on blood donor data from Shenzhen. Methods: Basic data and records of adverse reactions to blood donation among voluntary whole blood donors in Shenzhen from January 2017 to June 2025 were extracted. A total of 795 404 whole blood donations were recorded, including 502 743 from males and 292 661 from females, with 1 088 and 751 cases of adverse reactions, respectively. Analyses were performed using R software, including restricted cubic spline (RCS), binary logistic regression, and generalized estimating equations (GEE) to evaluate the correlation between donation intervals and adverse reactions. Results: A total of 1 839 cases of adverse reactions were recorded, accounting for 0.23% of the total donations. Both binary logistic regression analysis and the generalized estimating equations (GEE) model showed that there was no significant difference in the incidence of adverse reactions between male and female donors with an interval of ≥6 months compared to those with an interval of ≥3 months but<6 months. Furthermore, using the 3-5 month interval group as the reference, the analysis indicated that the incidence of adverse reactions significantly increased in males with a 9-12 month interval, while no statistically significant differences were observed across any of the female subgroups. Conclusion: There was no significant correlation between adverse reactions to blood donation and the donation interval. Compared with a donation interval of ≥6 months, an interval of<6 months does not lead to an increase in the incidence of adverse reactions among male or female donors. The findings of this study may help enhance the willingness of blood donors to participate.

Objective: To statistically analyze the association between blood donor age and the incidence of adverse reactions based on whole blood donor data from Shenzhen. Methods: Data on basic characteristics and records of adverse donation reactions among voluntary whole blood donors in Shenzhen from January 2017 to June 2025 were extracted. A total of 795 404 whole blood donations were recorded, including 502 743 from males and 292 661 from females, with 1 088 and 751 cases of adverse reactions, respectively. Analyses were performed using R software, including restricted cubic spline (RCS) analysis, binary logistic regression, and generalized estimating equations (GEE) to evaluate the correlation between donor age and adverse reactions. Results: A total of 1 839 cases of adverse reactions were recorded, accounting for 0.23% of the total donations. Both binary logistic regression and GEE model revealed that, compared with the≤55 years age group, the incidence of adverse reactions was reduced in both male and female donors in the >55 years age group, with the difference being statistically significant in males. Using the <23 years age group as a reference, the incidence of adverse reactions significantly decreased in both male and female donors across the 23-30, 31-40, 41-50, and 51-60 age groups, with the differences being statistically significant. Conclusion: There is a negative correlation between the rate of adverse donation reactions and age, with the incidence of such reactions among whole blood donors over 55 years old being no higher than that among donors aged 55 years or younger. These findings carry positive significance for safeguarding the donation rights of older donors and meeting clinical blood demand.

Objective: To analyze the effects of maternal gestational weight gain and pre pregnancy body mass index (BMI) on the weight of preschool children,so as to provide scientific basis for prevention and treatment of overweight and obesity in children. Methods: Based on Jiangmen maternal and child health information platform, annual physical examination data of 3-6 years old preschool children from all nurseries and kindergartens in Jiangmen were collected from January to December 2024. A unique identification was made according to the mother s ID number and delivery date, and retrospective data collection was conducted on the platform to obtain pre pregnancy and pregnancy related information for 46 481 mothers. The Chi-square test,two way ordered variable analysis and Logistic regression analysis were used to compare the effects of maternal pre pregnancy BMI and gestational weight gain on overweight and obesity among preschool children. Results: A total of 5 168 (11.12%) children were overweight and obese, and the proportion of overweight and obesity in the 6 year old group was the highest (12.86%). There were significant differences in the detection rates of overweight and obesity between boys and girls ( χ 2=155.38), and there were also significant gender differences in the age groups of 4, 5 and 6 years ( χ 2=17.08, 96.97, 66.27)(all P <0.01). Through trend χ 2 test, the overall detection rates of overweight and obesity, as well as those for boys, increased with age ( χ 2 trend =49.36,60.54, both P <0.01). The BMI group of preschool children was correlated with the BMI group of their mothers before pregnancy and the weight gain group during pregnancy （χ 2= 1 250.64, 157.01, both P <0.01) and the proportion of children with higher BMI levels showed an upward trend with the improvement of their mothers pre-pregnancy BMI levels or gestational weight gain levels ( Gamma =0.13, 0.10, both P <0.01). Multiple Logistic regression analysis showed that pre pregnancy BMI groups as overweight ( OR =1.590, 1.922), obesity ( OR =2.100, 2.921 ), and male gender of the children ( OR =1.213, 1.763)，and newborns excessive birth weight( OR =1.001，1.001) increased the risks of overweight and obesity in preschool children; maternal gestational weight gain insufficiency ( OR =1.374) and advanced maternal age at the first prenatal visit ( OR =1.012) increased the risks of obesity in preschool children; maternal gestational weight gain deficiency or excess ( OR =1.324,1.118) increased the risk of overweight in preschool children (all P <0.01). Conclusions Maternal pre-pregnancy overweight and obesity and insufficient or excessive gestational weight gain increase the risk of overweight and obesity in preschool children. It is necessary to strengthen weight management before and during pregnancy to reduce the occurrence of childhood overweight and obesity.

Objective To investigate the dynamic balance ability of healthy young adults under different obstacle-crossing strategies,thereby providing a theoretical basis for fall prevention training and public facility design.Methods Twenty healthy young adults participated in the experiment using F-scan plantar pressure analysis insoles.The subjects were required to cross three obstacles with different combinations of height and width.With their dominant foot serving as the leading foot and the non-dominant foot as the trailing foot,the subjects performed both lateral and forward crossing maneuvers,and their plantar pressure data were collected.Results Different crossing strategies significantly affected the adjustment speed of the leading foot's center of pressure in the medial-lateral direction(COP_ML),the area of the 95％confidence circle,ML amplitude,and anterior-posterior(AP)amplitude(P＜0.05).These strategies also significantly impacted the trailing foot's COP_ML adjustment speed,the area of the 95％confidence circle,and the range between the maximum and minimum swings(P＜0.05).For the leading foot,during lateral and forward crossing,the balance parameter values under different heights and widths were statistically significant(P＜0.05),increasing as the height and width increased.For the trailing foot,during forward crossing,the balance parameter values under different heights were statistically significant(P＜0.05),increasing with height,while during lateral crossing,the differences in balance parameter values were not statistically significant(P＞0.05).Conclusions Healthy young adults demonstrate better balance ability with the leading foot during forward obstacle crossing,which aligns with the movement habits of the dominant foot and daily activity patterns.The trailing foot exhibits a more stable plantar pressure distribution during lateral obstacle crossing,likely due to a larger contact area and more even center of gravity distribution.

Objective To investigate the expression and clinical significance of serum cystatin SA(Cystatin SA)and long non-coding RNA(lncRNA)promoter of CDKN1A antisense DNA damage activated RNA(PANDAR)in patients with type 2 dia-betic kidney disease(T2DN).Method A total of 142 patients with type 2 diabetes mellitus(T2DM)admitted to Shanghai Jiao Tong University School of Medicine Suzhou Jiulong Hospital from February 2021 to October 2023 were selected.According to whether they had nephropathy,they were divided into T2DN group(n=82)and non-T2DN group(n=60).60 healthy people who underwent physical examination during the same period were used as the control group.Serum Cystatin SA levels were detected by enzyme-linked immunosorbent assay(ELISA).Serum lncRNA PANDAR level was detected by real-time fluorescence quanti-tative PCR.Pearson correlation analysis was used to analyze the correlation between serum Cystatin SA,lncRNA PANDAR and clinical parameters in T2DN patients.Logistic regression analysis was used to analyze the influencing factors of T2 DN.The re-ceiver operating characteristic(ROC)curve was used to analyze the value of serum Cystatin SA and lncRNA PANDAR in the evaluation of T2DN.Results Serum Cystatin SA(236.28±44.63 ng/L)and serum lncRNA PANDAR(3.21±0.34)in the T2DM group were higher than those in the control group(91.25±22.33 ng/L,1.06±0.23),and the differences were statistically significant(t=23.127,42.379,all P<0.001).Serum Cystatin SA(275.08±46.83 ng/L)and lncRNA PANDAR(3.64±0.38)in T2DN group were higher than those in non-T2DN group(183.25±40.88 ng/L,2.62±0.30),and the differences were statistically significant(t=12.169,17.226,all P<0.001).Serum Cystatin SA and lncRNA PANDAR in T2DN patients were positively correlat-ed with diabetes duration,serum creatinine(sCr),blood urea nitrogen(BUN)and UACR(r=0.562～0.750,all P<0.001),and neg-atively correlated with eGFR(r=-0.656,-0.634,all P<0.001).Serum Cystatin SA,lncRNA PANDAR,duration of diabetes,UACR,sCr were risk factors for T2DN,eGFR was a protective factor(Wald χ2=4.257～12.360,all P<0.001).The area under the curve(AUC)of serum Cystatin SA combined with lncRNA PANDAR in predicting T2DN was 0.920(0.899～0.960),which was greater than that of single index[0.847(0.791～0.887),0.851(0.803～0.896)],and the differences were statistically significant(Z=4.522,4.319,all P<0.05).Conclusion Serum Cystatin SA and lncRNA PANDAR are elevated in patients with T2DN,which are related to renal function indexes and are risk factors affecting the occurrence of T2DN.The combination of the two can effec-tively evaluate the occurrence of T2DN.

Objective To provide valuable references and insights for improving the excipient standard system of the Chinese Pharmacopeia and promoting its harmonization with ICH Q3D.By analyzing the harmonization strategies and implementation of excipient standards in the pharmacopoeias of Europe,the United States,and Japan.Methods Through a combination of literature review and case study analysis,this paper introduces the policies and strategies adopted by the pharmacopoeias of three major regions(Europe,the United States,and Japan)in implementing the ICH Q3D guidelines in the field of pharmaceutical excipients.Additionally,it reviews the updates on excipient standards in these regions and analyzes the characteristics of their alignment with ICH Q3D.Results The strategies for implementing ICH Q3D in pharmacopeial excipient standards vary across different regions,with each following distinct approaches and progressing at different rates.Notably,there are significant differences in the establishment of standards for elemental impurities.Conclusion Promoting the harmonization of pharmacopeial excipient standards with ICH Q3D is a challenging and long-term endeavor.It is essential to develop a harmonization strategy that is tailored to China's national context.

Objective:To investigate the epidemiological and clinical characteristics of patients with psittacosis, in order to provide a basis for early diagnosis and prevention of the disease.Methods:Clinical data of psittacosis cases reported in 2023 from China Disease Prevention and Control Information System in Daxing District, Beijing were collected, and the patients' general information, epidemiological characteristics, clinical characteristics, imaging examination results, laboratory test results, treatment and prognosis were retrospectively analyzed.Results:A total of 7 cases of psittacosis were reported in Daxing District in 2023, with no clustered infection in households or workplaces. There were 4 males and 3 females, with a median age of 66 years old, and a range of 52 to 82 years old. Epidemiological investigation revealed that 6 patients had a clear history of contact with poultry (4 had first contact with parrots or pigeons, and 2 had long-term exposure to pigeons, parrots or wild birds). The onset time was concentrated in April and May. The primary clinical manifestations included high fever (6 cases), fatigue (4 cases), and chills (3 cases). The imaging examination results showed that inflammatory changes occurred in the unilateral lung of 6 patients, and both lungs were affected in 1 patients. Laboratory test results indicated elevated neutrophill percentage in 6 patients, decreased white blood cell counts in 2 patients, elevated white blood cell counts in 2 patients, and elevated C-reactive protein levels in 7 patients. Metagenomic next-generation sequencing test showed that all seven patients were positive for Chlamydia psittaci. All 7 patients were treated with quinolone or tetracycline antibiotics, with 6 cured and discharged, and 1 died. Conclusion:Psittacosis is usually manifested clinically as high fever, fatigue, and unilateral lung inflammation, often associated with poultry exposure.

Objective:The aim of this study is to analyse the clinical characteristics of Special clinical types of lung cancer nodules with "small tumors and big metastases" .Methods:From Jan. 2019 to Nov. 2024, patients with stage T1 solid lung cancer who were pathologically confirmed in the First Affiliated Hospital of Chongqing Medical University were prospectively collected and divided into lung cancer nodule with metastasis group (study group) and stage Ia lung cancer group (control group). The differences in clinical, imaging, pathological and molecular features between the two groups were compared, and the differences in the distribution of metastases in the study group and in patients with or without bone metastasis were analyzed.Results:A total of 827 patients with an average age of 62.65±11.01 years were included, including 425 in the study group and 402 in the control group. The proportion of males, number of smokers, nodule size and EGFR mutation rate in the study group were significantly higher than those in the control group (all P<0.05). Stage IV patients accounted for 63.76% in the study group, among which bone metastasis patients accounted for the highest proportion (51.66%), and alkaline phosphatase, calcium and phosphorus were significantly increased. Conclusions:Patients with smoking, male and solid lung cancer nodules are more likely to have "small tumor and large metastasis", and bone metastasis is the most common distant metastatic site. The increase of alkaline phosphatase, calcium and phosphorus is helpful for early identification of bone metastases.

Objective:To explore the mediating effect of job embeddedness and job satisfaction on psycholog-ical capital and organizational silence in clinical nurses.Methods:Totally 412 clinical nurses(145 males and 267 females)were selected and assessed with the Nurse Organizational Silence Assessment Questionnaire(NOSAQ),Psychological Capital Questionnaire-24(PCQ-24),Job Embedding Scale(JES)and Nurses Job Satisfaction Scale(NJSS).SPSS macro program PROCESS and Bootstrap method were used to explore the role of mediation.Results:The NOSAQ scores were negatively correlated with the scores of PCQ-24,JES and NJSS(r=-0.55,-0.59,-0.51,Ps＜0.01).Job embeddedness and job satisfaction played a chain mediating role between psychological capital and organizational silence of clinical nurses(95％CI:-0.26--0.04),and the mediating effect accounted for 14.7％of the total effect.Conclusion:It suggests that organizational silence is closely related to psychological capital,job embeddedness and job satisfaction in clinical nurses.