Objective: To investigate the epidemiological characteristics and influencing factors for hand, foot, and mouth disease (HFMD) incidence in Binzhou City, Shandong Province, so as to provide the evidence for developing HFMD prevention and control strategies. Methods: Data on HFMD cases in Binzhou City from 2017 to 2023 were collected through the Infectious Disease Reporting Information System of Chinese Disease Prevention and Control Information System. Meteorological data during the same period were collected from the fifth-generation European Centre for Medium-Range Weather Forecasts. The incidence of HFMD was calculated, and the temporal, population, and regional distribution characteristics of HFMD were analyzed descriptively. Bayesian spatiotemporal model was used to analyze the influencing factors for HFMD incidence Results: From 2017 to 2023, a total of 17 314 HFMD cases were reported in Binzhou City, with an annual average reported incidence of 62.57/105. The incidence peak was from June to September, and a secondary peak appeared from October to November in some years. The annual average reported incidences were higher in Bincheng District and Yangxin County, which were 107.41/105 and 72.95/105, respectively. There were 10 461 males and 6 853 females, with a male-to-female ratio of 1.53∶1. The age was mainly 1-3 years, with 11 713 cases accounting for 67.65%. Bayesian spatiotemporal model analysis showed that the risk of HFMD incidence had obvious seasonality and regionality. From 2017 to 2019 and in 2021, the peaks occurred in weeks 24-27 and 44-47 each year, with RR values of 1.771-6.747. From 2022 to 2023, it showed a single peak distribution. The RR values were all >1 in Bincheng District, Yangxin County, and Huimin County. Average temperature (RR=1.092, 95%CI: 1.080-1.105) and average relative humidity (RR=1.015, 95%CI: 1.008-1.022) were positively correlated with the risk of HFMD incidence, while average wind speed (RR=0.749, 95%CI: 0.655-0.856) was negatively correlated with the risk of HFMD incidence. Conclusions HFMD in Binzhou City mainly occurs in summer and in central areas. Males and children aged 1-3 years are high-risk populations. The risk of HFMD incidence increases with the increase of average temperature and average relative humidity, and decreases with the increase of average wind speed.

Objective To establish a method for simultaneous determination of trace levels of microcystins,cylindrospermopsin,anatoxin,and nodularin in lake water based on liquid chromatography-tandem mass spectrometry(LC-MS/MS).Methods After being adjusted to alkaline conditions and mixed with six internal standards,the water samples were enriched using dual HLB and ENVI-Carb cartridges.The eluates were then evaporated under nitrogen,reconstituted,and subjected to instrumental analysis.Both water and acetonitrile containing 0.1%formic acid were used as mobile phases.An ACQUITY UPLC? BEH C18 column(150 mm×2.1 mm,1.7 μm)was selected to separate the target cyanotoxins.Multiple reaction monitoring was applied for data acquisition,and quantification was accomplished using internal standard methods.Results Within certain concentration ranges,all 14 cyanotoxins examined in the study showed good linearity,with all correlation coefficients greater than 0.998.When the water volume was 100 mL,the limits of detection and quantification for the 14 cyanotoxins were 0.1-0.9 ng/L and 0.3-2.9 ng/L,respectively,and spiked recoveries and relative standard deviations were 81.7%-132.9%and 1.2%-14.9%,respectively.In the 10 lake water samples analyzed,cylindrospermopsin,anatoxin-α,and multiple microcystins were detected.Conclusion The method developed in the study has high-throughput capacity,as well as high sensitivity,accuracy,and reliability.The method can be applied in the simultaneous detection of microcystins,cylindrospermopsin,anatoxin,and nodularin in lake water.

This study delves into the pivotal factors influencing the consensus process within traditional Chinese medicine guideline development, with the objective of augmenting the quality of this process through methodological recommendations aimed at elevating standardization.

Objective:To investigate the efficacy and safety of modified endoscopic submucosal multi-tunnel dissection (ESMTD) for superficial circumferential esophageal cancer with an axial length of more than 8 cm.Methods:Data of 79 patients with superficial circumferential esophageal cancer with lesion length of more than 8 cm who were treated in the First Affiliated Hospital of Nanjing Medical University from January 2018 to December 2021 were retrospectively analyzed. Patients were divided into modified ESMTD group (32 cases) and surgery group (47 cases) according to the treatment. The en bloc resection rate, complete resection rate, operation time, hospitalization time, medical expenses, incidence of procedure-related complications of the two groups were compared.Results:The en bloc resection rate in the modified ESMTD group and the surgery group were both 100.0% ( χ2=0.000, P=1.000), and the complete resection rate were 96.9% (31/32) and 97.9% (46/47) ( χ2=0.000, P=1.000), respectively. The operation time in the modified ESMTD group was shorter than that in the surgery group (150.5±17.2 min VS 185.8±15.2 min, t=9.527, P<0.001). The incidence of delayed bleeding [3.1% (1/32) VS 10.6% (5/47), χ2=0.648, P=0.421] and delayed perforation [3.1% (1/32) VS 4.3% (2/47), χ2=0.000, P=1.000] in the two groups were not statistically different. Postoperative C-reactive protein (64.3±6.9 mg/L VS 89.2±7.4 mg/L, t=15.634, P<0.001) and neutrophil levels [(10.1±1.4)×10 9/L VS (13.1±1.2)×10 9/L, t=15.083, P<0.001] were lower in the modified ESMTD group than those in the surgery group. The hospital stay of the modified ESMTD group was shorter than that of the other group (9.2±1.2 d VS 11.5±1.2 d, t=8.363, P<0.001), and the medical expense was less than that of the surgery group (32±3 thousand yuan VS 59±6 thousand yuan, t=26.384, P<0.001). Conclusion:Compared with traditional surgery, modified ESMTD for the treatment of superficial circumferential esophageal cancer with an axial length >8 cm has definite curative effect, safety, short hospital stay, and low medical costs, and can preserve the integrity of the esophagus and improve the quality of life of patients. It has good clinical application value.

Objective:To explore the association between nighttime sleep duration and semen quality.Methods:By using a cross-sectional study, 3357 men were investigated by questionnaire for nighttime sleep duration, the time of falling asleep and falling asleep duration in the Reproductive Center of Shenzhen People's Hospital from August 2017 to August 2018. Semen quality parameters were obtained by computer-aided semen analysis system (CASA). Multiple linear regression was used to analyze the relationship between nighttime sleep duration and semen quality parameters. According to age and body mass index (BMI) stratification, the relationship between nighttime sleep duration and semen quality parameters was further discussed.Results:Compared with males with nighttime sleep duration between 6-8 h, the sperm progressive motility and total motility were 49.15% and 59.49%, respectively, which were significantly lower in the males with nighttime sleep duration≥8 h after adjusting for age, BMI, abstinence time, exercise, drinking and smoking, with regression coefficients, β=-3.16, 95% confidence interval ( CI)=-5.77--0.55 and β=-3.22, 95% CI=-5.93--0.51, respectively. Compared with the shortest duration of falling asleep group (<10 min), the increase of falling asleep duration was related to the decrease of sperm progressive motility ( P=0.045). The total sperm motility of falling asleep duration between 31-60 min group was also significantly lower than that of the shortest falling asleep duration group （ β=-3.80, 95% CI=-6.54--1.06, P=0.007）. Further stratification analysis showed that among the subjects aged 35 to 39 years, the sperm progressive motility of men with nighttime sleep duration less than 6 h was lower than that of 6-8 h group ( β=-4.01, 95% CI=-7.84-0.18, P=0.04). And among the subjects aged more than 40 years, the total sperm number of the men who slept ≥8 h at night was lower than that of the men with nighttime sleep duration between 6-8 h （percentage changes: -47.84%, 95% CI=-72.29%--2.19%, P=0.04）. The progressive and total sperm motility of men with BMI≥24 kg/m 2 and nighttime sleep duration ≥8 h were lower than those with BMI≥24 kg/m 2 in 6-8 h nighttime sleep duration group, and the corresponding regression coefficients were β=-5.75, 95% CI=-10.40--1.10, P=0.02 and β=-6.85, 95% CI=-11.69--2.00, P=0.01. Conclusion:In men ≥40 years old or BMI≥24 kg/m 2, the nighttime sleep duration ≥8 h were associated with the decreased sperm progressive motility and total motility.

Objective:To explore the association between nighttime sleep duration and semen quality.Methods:By using a cross-sectional study, 3357 men were investigated by questionnaire for nighttime sleep duration, the time of falling asleep and falling asleep duration in the Reproductive Center of Shenzhen People's Hospital from August 2017 to August 2018. Semen quality parameters were obtained by computer-aided semen analysis system (CASA). Multiple linear regression was used to analyze the relationship between nighttime sleep duration and semen quality parameters. According to age and body mass index (BMI) stratification, the relationship between nighttime sleep duration and semen quality parameters was further discussed.Results:Compared with males with nighttime sleep duration between 6-8 h, the sperm progressive motility and total motility were 49.15% and 59.49%, respectively, which were significantly lower in the males with nighttime sleep duration≥8 h after adjusting for age, BMI, abstinence time, exercise, drinking and smoking, with regression coefficients, β=-3.16, 95% confidence interval ( CI)=-5.77--0.55 and β=-3.22, 95% CI=-5.93--0.51, respectively. Compared with the shortest duration of falling asleep group (<10 min), the increase of falling asleep duration was related to the decrease of sperm progressive motility ( P=0.045). The total sperm motility of falling asleep duration between 31-60 min group was also significantly lower than that of the shortest falling asleep duration group （ β=-3.80, 95% CI=-6.54--1.06, P=0.007）. Further stratification analysis showed that among the subjects aged 35 to 39 years, the sperm progressive motility of men with nighttime sleep duration less than 6 h was lower than that of 6-8 h group ( β=-4.01, 95% CI=-7.84-0.18, P=0.04). And among the subjects aged more than 40 years, the total sperm number of the men who slept ≥8 h at night was lower than that of the men with nighttime sleep duration between 6-8 h （percentage changes: -47.84%, 95% CI=-72.29%--2.19%, P=0.04）. The progressive and total sperm motility of men with BMI≥24 kg/m 2 and nighttime sleep duration ≥8 h were lower than those with BMI≥24 kg/m 2 in 6-8 h nighttime sleep duration group, and the corresponding regression coefficients were β=-5.75, 95% CI=-10.40--1.10, P=0.02 and β=-6.85, 95% CI=-11.69--2.00, P=0.01. Conclusion:In men ≥40 years old or BMI≥24 kg/m 2, the nighttime sleep duration ≥8 h were associated with the decreased sperm progressive motility and total motility.

Objective To explore the new operation method and clinical effect of treating degloving injuries of the whole thumb.Methods Nine cases of the whole thumb degloving injury caused by machine were treated with free wrap-around flap from the big toe and the flap from the opposite foot.The phalanges,joints and tendons of all injured thumbs were integral relatively,except that the interphalangeal joints in 3 cases were destroyed and the flexor and extensor pollicis longus were ruptured.The size of the dorsal tissue defects varied from 4.8 cm × 2.9 cm to 6.2 cm × 3.4 cm,and the volar tissue defects ranged from 4.7 cm × 3.2 cm to 6.1 cm × 4.0 cm.The area of the wraparound flap from the big toe harvested was from 5.0 cm × 3.2 cm to 6.7 cm × 3.9 cm.The flap from the opposite foot was tibial flap with dorsalis pedis flap from the opposite second toe,and the area of the flap was from 5.0 cm × 3.5 cm to 6.6 cm × 4.5 cm.Results All 9 combined flaps survived.The wound healed primarily.Skin grafts in the donor sites of the foot also survived.Postoperative follow-up ranged from 6 to 20 months,with an everage of 9 months.The pulp of the thumb was well-stacked.Sensory recovery ranged from S3 to S3 +.Thumb nail grew well.Thumbs performed good functions as grabbing,grasping and nipping.The range of motion of the MP joints of the reconstructed thumb was normal.The motion of interphalangeal joints were acceptable in 6 cases,but worse than the normal thumb.The interphalangeal joint in 3 cases destroyed was fused.There was no obvious influence on the function of the foot.Conclusion Applying combined wrap-around flap from the big toe with the tibial flap and dorsalis pedis flap from the opposite foot in treating degloving injuries of the whole thumb is a new operation method,which could achieve good appearance and function,but have a small influence on the donor site.It is worthy being used widely in clinical.