ObjectiveTo analyze the epidemiological characteristics of patients with hepatitis C in Jinhua City, Zhejiang Province from 2005 to 2023, so as to provide a scientific basis for the prevention and control of hepatitis C. MethodsThe data on patients with hepatitis C, as well as whose current address is in Jinhua City, from 2005 to 2023 were collected from the infectious disease surveillance system of the China Disease Control and Prevention Information Management System. Descriptive epidemiological methods were used to analyze the temporal, spatial and demographic distribution characteristics of hepatitis C. ResultsA total of 2 326 cases of hepatitis C were reported in Jinhua from 2005 to 2023, including 2 death cases, with an average annual incidence rate of 2.19/100 000, showing a trend which rose first and then declined and then rose again. Hepatitis C was reported all the year round without significant seasonal pattern. In terms of the number of reported cases and the average annual incidence rate, Yiwu City ranked the first place. From 2005 to 2023, a total of 1 438 (61.82%) male cases and 888 (38.18%) female cases were reported, and the reported incidence rate was higher for males (2.62/100 000) than that for females (1.74/100 000), showing a statistically significant difference (χ²=92.937, P<0.001). Most cases aged between 30 to <50 years old (1 175, 50.52%), and the incidence rate of hepatitis C among the age group of 40‒<50, 50‒<60, 60‒<70 years old was showing an upward trend, with farmers (1 024, 44.02%) as the main occupation . ConclusionThe prevalence of hepatitis C in Jinhua City is generally at a low level, with an incidence rate of increasing and then decreasing, but rise up again after 2019. Therefore, epidemic surveillance and health education among the male, middle-aged and elderly people and farmers, as well as the key regions where the migrant workers flows in should be enhanced.

Abstract Childhood hypertension is becoming a substantial public health challenge with profound implications for children s quality of life and long term health. The study analyzes the global prevalence of childhood hypertension and the relationship between macroecological factors, meso environmental factors, and micro individual factors based on the perspective of life course and childhood hypertension. And it further summarizes existing prevention and control strategies: systematic prevention and control based on policy and social support, health promotion based on behavioral science theory, and dynamic monitoring and management based on individualized prevention and control, to provide a reference for promoting the advancement of childhood hypertension prevention and control strategies.

Objective: To investigate the epidemiological characteristics and spatial-temporal clustering characteristics of scarlet fever in Jinhua City, Zhejiang Province from 2005 to 2023, so as to provide a reference for improving the prevention and control strategy of scarlet fever. Methods: The data of scarlet fever cases in Jinhua City from 2005 to 2023 were collected from the China Information System for Disease Control and Prevention, and descriptive epidemiological method was used to analyze the epidemiological characteristics of scarlet fever. The average annual percent change (AAPC) was calculated to analyze the trend of scarlet fever incidence from 2005 to 2023. The spatial-temporal clustering of scarlet fever was identified using spatial autocorrelation analysis and space-time scanning analysis. Results: A total of 1 494 scarlet fever cases were reported in Jinhua City from 2005 to 2023, and the average annual reported incidence rate was 1.41/100 000, with no significant change trend (AAPC=1.706%, P>0.05). There were two incidence peaks, from April to June and from November to January of the next year. There were 937 males and 557 females, with a male to female ratio of 1.68∶1. The age was mainly <10 years (1 391 cases, 93.11%), of which 3-<7 years was the high incidence age group (936 cases, 62.65%). There were 1 466 cases of preschool children, students, and scattered children, accounting for 98.13%. The average annual reported incidence of scarlet fever in Dongyang City, Pujiang County, and Yongkang City was 4.58/100 000, 3.04/100 000, and 1.99/100 000, respectively. The spatial autocorrelation analysis showed that there was a positive spatial correlation between the incidence of scarlet fever in Jinhua City from 2005 to 2023 (Moran's I=0.579, P<0.05), and the high-high clustering areas were mainly distributed in Dongyang City and Pujiang County. The spatial-temporal scanning analysis showed that there were 8 spatial-temporal clustering areas of scarlet fever in Jinhua City from 2005 to 2023. The class Ⅰ clustering area was 9 towns in Dongyang City, and the clustering period was from August 2013 to December 2022. There were 7 class Ⅱ clusters, covering some streets in Pujiang County, Dongyang City, Yongkang City, Yiwu City, and Pan'an County. Conclusions From 2005 to 2023, the incidence of scarlet fever in Jinhua City was relatively low, and children aged 3-<7 years had a high incidence, and there was a spatiotemporal clustering. The peak incidence was from April to June and from November to January of the next year. Dongyang City, Pujiang County, and Yongkang City had high incidence areas.

Objective: To analyze the epidemiological characteristics of leptospirosis in Jinhua City, Zhejiang Province, from 2007 to 2024, so as to provide a basis for improving the prevention and control strategies of leptospirosis. Methods: Data pertaining to leptospirosis cases in Jinhua City from 2007 to 2024 were collected through the Monitoring and Reporting Management System of the Chinese Disease Prevention and Control Information System. Descriptive epidemiological methods were used to analyze the distribution characteristics of leptospirosis in terms of time, region, population, interval from the onset of the disease to diagnosis and the outbreak of the epidemic. Results: A total of 81 cases of leptospirosis were reported in Jinhua City from 2007 to 2024, with an average annual reported incidence of 0.08/100 000. The peak incidence occurred from August to September, with 57 cases accounting for 70.37%. Leptospirosis cases were reported in 9 counties (cities, districts) in Jinhua City. Pan'an County reported the most cases, with 52 cases accounting for 64.20%. There were 54 male cases and 27 female cases, with a male-to-female ratio of 2∶1. The majority of cases were aged over 40 years, with 73 cases accounting for 90.12%. The average reported incidence of leptospirosis showed an upward trend with the increase of age (P<0.05), and the highest incidence of leptospirosis was at the 60-<80 age group (0.21/100 000). The majority of patients were farmers, with 77 cases accounting for 95.06%. The median interval from onset to diagnosis was 4.00 (interquartile range, 6.00) days. There were significant differences in the interval from onset to diagnosis among cases in Dongyang City compared with Pan'an County, Wuyi County, and Wucheng District, between Pan'an County and Jindong District, Wucheng District, and between Wuyi County and Wucheng District (all P<0.05). In 2007, one outbreak of leptospirosis was reported, which occurred in Jiuhe Township, Pan'an County, with 36 reported cases. Conclusions The reported incidence of leptospirosis in Jinhua City from 2007 to 2024 is generally low. The high-incidence period is from August to September, and Pan'an County is the high-incidence area. Males over 40 years and farmers are the key populations for prevention and control. It is recommended to strengthen epidemic surveillance and health education for high-risk populations.

Aim To explore the molecular mechanism of luteolin against acute lung injury by network phar-macology and molecular docking technology,and to conduct experimental verification.Methods The re-lated targets of luteolin were predicted by PubChem and Swiss Target Prediction databases.Acute lung in-jury-related targets were collected through the Gene-Cards database.Venny 2.1 was used to draw the Venn diagram,and the common targets of drug and disease were obtained.The protein interaction network(PPI)was established by String online platform,and the core targets were screened by Cytoscape 3.8.2 software.The functional enrichment analysis of Gene Ontology(GO)and pathway enrichment analysis of Kyoto Ency-clopedia of Gene and Genome(KEGG)were per-formed on the common targets using the DAVID data-base,and the results were visualized.Finally,molecu-lar docking was performed by Auto Dock software,and the molecular results were visualized by Pymol.The mouse acute lung injury model was constructed.HE staining was used to detect histopathology,and Western blot was used to detect lung tissue related proteins.Results After screening,85 common targets were ob-tained.Among them,the core targets were AKT1,EG-FR,SRC,MMP9,ESR1,PTGS2,etc.GO enrichment analysis obtained 265 biological processes,including signal transduction,protein phosphorylation,and nega-tive regulation of apoptosis.There were 48 cells,main-ly including plasma membrane,cell solute,cytoplasm,etc.There are 107 molecular functions,mainly inclu-ding ATP binding,protein serine/threonine/tyrosine ki-nase activity,protein kinase activity and so on.A total of 92 signaling pathway were obtained by KEGG path-way enrichment analysis,which mainly acted on PI3 K-AKT signaling pathway,ErbB signaling pathway,VEGF signaling pathway,etc.Molecular docking results showed that luteolin had good docking activity with core targets AKT1,EGFR,SRC,MMP9,ESR1,PTGS2,MMP2,GSK3 B,KDR and PARP1.The binding ener-gy of ERS1,GSK3B and MMP2 was lower than-5.0 kal·mol-1,and the affinity with luteolin was stronger.The pathological results of lung tissue showed that lute-olin could inhibit inflammatory infiltration and had a strong anti-inflammatory effect in LPS-induced acute lung injury model in mice.Western blot experiments showed that luteolin might alleviate the inflammatory response by inhibiting the phosphorylation of AKT.Conclusions Luteolin can play an anti-acute lung in-jury role through multi-target and multi-channel mecha-nisms,which may be closely related to the inhibition of AKT phosphorylation.

In the treatment of persistent atrial fibrillation with radiofrequency ablation,it is often necessary to add the ablation of external trigger foci of pulmonary vein on the basis of annular pulmonary vein isolation,including linear ablation,BOX ablation and fragmentation potential ablation.The isthmus of mitral valve is the most important component of linear ablation,but it is difficult to reach the isthmus of mitral valve for complete blockade by conventional radiofrequency ablation.The guide catheter was transported through the inferior vena cava to the coronary sinus,and the injection of Marshall vein anhydrous ethanol for ablation could achieve epicardial and myocardial block in the mitral isthmus,and the ablation combined with the endocardial patch ablation in the mitral isthmus could significantly improve the ablation effect,but there were disadvantages such as Marshall vein and coronary vein injury,high surgical cost and long time.This paper reports a case of persistent atrial fibrillation treated by self-made perforated balloon with Marshall intravenous anhydrous ethanol combined with individualized ablation strategy.No major adverse cardiovascular events or recurrence of atrial fibrillation occurred during 6 months of follow-up after discharge.

To evaluate the effectiveness and safety of implantable D-shant atrial shunt device in patients with severe pulmonary arterial hypertension(PAH)and right heart failure.A 53-year-old female patient diagnosed with severe idiopathic PAH and right heart failure,her WHO FC grade was Ⅳ.The right heart catheter and implantation of D-shant atrial shunt device were performed under local anesthesia on November 30,2021.A 6 mm×4 cm peripheral artery balloon was selected to dilate the atrial septum and a D-shant atrial shunt device with a fixed 4 mm diameter orifice was implanted into the heart.The clinical symptoms and hemodynamics of the patient was improved after the intervention.Implantation of atrial shunt device as a palliative therapy to established a right to left shunt is another strategy for treating patients with severe PAH in late period,which has good effectiveness and safety.It could be the last replacement therapy to improve symptoms and prolonged lives to drug resistant and severe PAH patients.

Objective:To investigate the effects of Longmu Anshen prescription on microglia(MG)polarization in the medial prefrontal cortex(mPFC)and anxiety behavior of chronic restraint stress(CRS)mice.Methods:Forty-eight healthy male KM mice were randomly divided into normal group,paroxetine hydrochloride group and Longmu Anshen prescription high,middle and low dose groups.From the 15th day,after 30 minutes of CRS every day,the normal group and the model were given distilled water by gavage,the paroxetine hydrochloride group was given paroxetine hydrochloride(2.6 mg/kg)by gavage,and the traditional Chinese medicine group was given Longmu Anshen prescription at high,medium and low doses(4.16,2.08,1.04 g/kg)by gavage for 21 days.The changes of anxiety behavior in mice were evaluated by light-dark boxes experiment and elevated plus maze;ELISA was used to detect IL-1β,IL-6,TNF-α and IL-10 levels;protein expression of inducible nitric oxide synthase(iNOS)and arginase-1(Arg-1)in mice mPFC tissue were detected by Western blot;mRNA expression of ionized calcium binding adaptor molecule-1(Iba-1),iNOS and Arg-1 in mice mPFC tissue were detected by RT-PCR;the protein expression of Iba-1 in mice hippocampal tissue was detected by immuno-histochemistry(IHC).Results:Compared with normal group,the residence time in the light boxes,the number of times of shuttle between the light-dark boxes,the percentage of times of entering the open arm(OE%)and the percentage of time spent in the open arm(OT%)of mice in model group were significantly reduced(P<0.01);moreover,in the mPFC tissue of the model group mice,the protein and mRNA expressions of Iba-1 and iNOS were significantly increased(P<0.01),and the levels of IL-1β,IL-6 and TNF-α were significantly increased(P<0.01),while the protein and mRNA expressions of Arg-1 were significantly decreased(P<0.01),and the level of IL-10 was significantly decreased(P<0.01).Compared with model group,the residence time in the light boxes,the number of shuttles between the light-dark boxes,the OE%and OT%of mice in the paroxetine hydrochloride group and the high and medium dose groups of Longmu Anshen prescription were significantly increased(P<0.01);the expression levels of Iba-1 and iNOS protein and mRNA in mPFC tissue were significantly decreased(P<0.05,P<0.01),and the levels of IL-1β,IL-6 and TNF-α were significantly decreased(P<0.01),while the expression levels of Arg-1 protein and mRNA were significantly increased(P<0.01).IL-10 level was significantly increased(P<0.01).Conclusion:Longmu Anshen prescription can inhibit the activation of MG in mPFC tissues of CRS mice and may reduce nerve inflammation and increase the level of anti-inflammatory cytokines by regulating the polarization phenotype of M1/M2,thereby ameliorate CRS-induced anxiety behavior.

Objective To explore the lipid-lowering effect of Qige Decoction before and after compatibility through the combination of pharmacodynamics and liver metabolomics,and to provide new research strategies for exploring the scientific notation of traditional Chinese medicine compatibility.Methods According to the pharmacodynamic strategy,three groups of drug administration were set up as Qige Decoction group,Astragali Radix-Puerariae Radix group,and Pericarpium Citri Tangerinae group.Four indices of blood lipids,serum biochemical indicators,and liver morphology and pathology were used to evaluate the intervention effect of Qige Decoction on hyperlipidemic rats.Liver metabolomics technology was used to analyze the effects of Qige Decoction on metabolites before and after compatibility,and multivariate statistical analysis was used to evaluate the differences between groups in terms of differential metabolites and metabolic pathways.Results Compared with the model group,the callback abilities of four indices of blood lipid in the Qige Decoction group were higher than those in Astragali Radix-Puerariae Radix group and Pericarpium Citri Tangerinae group,among which the total cholesterol(TC)and triglyceride(TG)levels in the Qige Decoction group decreased(P＜0.05).A total of 86 potential biomarkers were identified by liver metabolomics,with 23,13,and 7 metabolites being significantly different in the Qige Decoction group,Astragali Radix-Puerariae Radix group,and Pericarpium Citri Tangerinae group,respectively(P＜0.05).Metabolic pathway analysis of 29 specific biomarkers with significant callback effects showed that they were related to glycerophospholipid metabolism,linoleic acid metabolism,α-linolenic acid metabolism,sphingolipid metabolism,arachidonic acid metabolism,and unsaturated fatty acid biosynthesis.Qige Decoction mainly regulates glycerophospholipid and linoleic acid metabolism,and uniquely acts on sphingolipid metabolism.Conclusion Qige Decoction has more lipid-lowering targets after compatibility,with better lipid-lowering effects than the Astragali Radix-Puerariae Radix group and Pericarpium Citri Tangerinae group.This study provides experimental evidence and research strategies for further revealing the scientific notation of traditional Chinese medicine compatibility.

Alzheimer's disease(AD)is an irreversible neurodegenerative disorder,making early screening and diagno-sis pivotal for its effective treatment.The complexity of diagnosing AD,however,poses significant challenges for primary-level screening.As an extension of the central nervous system,the retina exhibits changes closely linked to AD,offering a new pathway for non-invasive early detection of AD.In recent years,deep learning(DL)has achieved notable advance-ments in the medical field,especially in image recognition and analysis.The synergy between DL and retinal imaging has unveiled substantial potential in diagnosing and treating AD.This article reviews the advancements in applying DL to ana-lyze retinal images related to AD,encompassing the diagnosis,prediction of progression,and long-term management of AD,as well as the current shortcomings in clinical practice,providing a reference for further research into the application of DL in retinal imaging for AD.