ObjectiveTo analyze the evolutionary characteristics and genetic variations of the HA (hemagglutinin) and NA (neuraminidase) genes of influenza A(H1N1) viruses in Shanghai during 2024, to investigate their transmission patterns, and to evaluate their potential impact on vaccine effectiveness. MethodsFrom January to October 2024, throat swab specimens were collected from influenza like illness (ILI) patients at 4 hospitals in Shanghai. Real-time fluorescence ploymerase chain reaction (RT-PCR) was used for virus detection and isolation of H1N1 influenza viruses. Forty influenza A(H1N1) virus strains were sequenced using Illumina NovaSeq 6000 platform, followed by phylogenetic analyses, genetic distance analysis, and amino acid variation analyses of HA and NA genes. ResultsPhylogenetic tree of the HA and NA genes revealed that the 40 influenza A(H1N1) virus strains circulating in Shanghai in 2024 exhibited no significant geographic clustering, with a broad origin of strains and complex transmission chains. Genetic distance analyses demonstrated that the average intra-group genetic distances of HA and NA genes among the Shanghai strains were 0.005 1±0.000 6 and 0.004 6±0.000 6, respectively, which were comparable to or higher than those observed in global surveillance strains. Both HA and NA genes displayed frequent mutations. Compared to the 2023‒2024 and 2024‒2025 Northern Hemisphere A(H1N1) vaccine strains (WHO-recommended), the HA proteins of 40 Shanghai strains exhibited amino acid substitutions at positions 120, 137, 142, 169, 216, 223, 260, 277, 356 and 451, with critical mutations at positions 137 and 142 located within the Ca2 antigenic determinant. Furthermore, mutations in the NA protein were observed at positions 13, 50, 200, 257, 264, 339 and 382. ConclusionThe genetic background of the 2024 Shanghai influenza A(H1N1) virus strains is complex and diverse, and antigenic variation may affect vaccine effectiveness. Therefore, it is recommended to enhance genomic surveillance of influenza viruses, evaluate vaccine suitability, and implement more targeted prevention and control strategies against imported influenza viruses.

Objective To retrieve,evaluate and summarize the best pertinent evidence on the placement and management of peripheral arterial catheters in critically ill children at home and abroad for clinical references.Methods A systematic search was conducted in related databases on the evidence of the placement and management of peripheral arterial catheters in critically ill children.The spectrum of eligible documents included clinical decisions,guidelines,evidence summaries,systematic reviews,expert consensuses,and norms.The search period was from the establishment of the databases to April 30,2023.The included literature was limited to English and Chinese languages.The quality of the literature was independently evaluated by evidence-based trained investigators and combined with professional judgment to extract information from the literature that met the quality standards.Results A total of 18 articles were included,including 3 guidelines,3 clinical decisions,8 evidence summaries,3 systematic reviews and 1 expert consensus.The best evidence included a total of 27 pieces of evidence in 4 areas,namely the assessment of indwelling peripheral arterial catheters,placement of peripheral arterial catheters,maintenance during the duration of indwelling peripheral arterial catheters,and removal.Conclusion This study summarized the most robust evidence pertaining to the management of peripheral arterial catheters in critically ill children,and provided an evidence-based basis for the standardized placement and management of peripheral arterial catheters in critically ill children.Nursing staff should carefully select and apply evidence according to the actual clinical situation,the wishes of children and parents.

Objective:To document any impact of the timing of rehabilitation interventions on the recovery of motor function among children after a traumatic brain injury (TBI).Methods:Seventy-one children with a TBI were randomly divided into a control group ( n=36) and an observation group ( n=35). All received comprehensive rehabilitation-15 to 30 days after admission for those in the control group and 2 to 14 days after admission for the observation group. It included joint range-of-motion training, multi-sensory stimulation training, low-frequency electrical stimulation, and acupuncture. Before the experiment and 4, 12 and 24 weeks afterward, everyone′s motor functioning, muscle tone, and functional independence were quantified using the Fugl-Meyer Assessment (FMA), the Modified Ashworth Scale (MAS), and the WeeFIM pediatric functional independence measure. Results:Four weeks after the intervention the average FMA and WeeFIM scores of both groups had already increased significantly. At 12 and 24 weeks the average FMA and WeeFIM scores of the observation group were significantly higher than the control group′s averages. Muscle tone was then also significantly better on average. There was no significant difference in the incidence of rehabilitation interruptions between the two groups.Conclusion:Early comprehensive rehabilitation intervention within 2 to 14 days of admission can effectively better the motor functioning and functional independence of pediatric TBI patients.

Objective To analyze the relationship between soluble α-Klotho(SKL)levels and continuous glucose monitoring(CGMS)-derived measures of glycemic management in diabetic kidney disease(DKD)patients.Methods A total of 140 T2DM patients admitted to the Department of General Medicine Affiliated Hospital of Yan'an University from May 2020 to May 2022 were selected and divided into two groups according to the levels of UACR:T2DM group(UACR<30 mg/g,n=60),DKD group(UACR≥30 mg/g,n=80)and 45 healthy persons(NC group)who received physical examination in the hospital during the same period were the NC group.Results The SKL level of DKD group was lower than that of T2DM group and NC group(P<0.05).Spearman correlation analysis showed that SKL was positively correlated with eGRF and TIR(P<0.01),and negatively correlated with Scr,UACR,CysC,β2-MG,FPG,HbA1c,MG,TAR and GMI(P<0.01).Multiple linear regression analysis showed that HbA1c and GMI were the influencing factors of SKL.Conclusion The level of SKL in DKD patients is correlated with HbA1c and GMI.

Background: Benzo(a)pyrene (BaP) is a carcinogenic compound in contaminated foodstuffs.The effect of oral intake of the environmental carcinogen BaP under low doses and frequent exposure on a digestive system has not been thoroughly verified. Methods: In this regard, this study was conducted to prove the toxicity effects of BaP on the stomach and colon tissue after exposure to C57BL/6 mouse (3 and 6 µg/kg) following daily oral administration for 60 days. This study investigated acute gastric mucosal injury, severe gastric edema, cell infiltration, and mononuclear cells, multifocal cells, and tumoral inflammatory cells. Results: The results of ELISA showed that the expression of serum interleukin (IL)-6 and tumor necrosis factor-α in the BaP exposure group were significantly increased, and a high level of DNA adduct distribution in their stomach and colon. Moreover, this study has confirmed the expression of early carcinogenesis markers: nuclear factor (NF)-κB, p53, IL-6, superoxide dismutase 1 (SOD1), mucin (MUC1 and MUC2), and β-catenin in the stomach and colon, and showed that there was a significant increase in IL-6, NF-κB, SOD1, β-catenin, and MUC1 (P< 0.05). At the same time, there was a significant decrease in MUC2 and p53 (P < 0.05). Thus, even in low doses, oral intake of BaP can induce DNA damage, increasing the potential risk of gastrointestinal cancer. Conclusion This study will provide a scientific basis for researching environmental contaminated food and intestinal health following daily oral administration of BaP.

Life education aims at avoiding the consequent self-suicides of college students.Rich resources can be provided from traditional culture.Possible ways of life education from the perspective of traditional culture include educate through the curriculum teaching of Chinese Language and Culture,through the studying of the ancient Chinese classicals and through properly increasing the ratio of the training of traditional Chinese Wushu in current PE classes for college students.

Case teaching has evident characteristics compared with traditional theory teaching. This article expound the purpose,significance,teaching process and the noticeable problems of case teaching in medicaI ethics teaching.

Undergraduate is an important part of modern society, their psychology is becoming concerned hotspot of society gradually.In allusion to suicidal events happened on campus, it briefly analyzes cause, and describes actuality, concept, content of life education.

Through analyzing medical personnel's duty under Bio-psycho-social Medical Mode, this paper states that medical personnel's duty should be emphasized not only on preventing and curing diseases, but also on solving patients' psychological problems.Therefore it states that death education, first, to medical professionals themselves,second,to the patients and their family,is very important,at last it also inquires into the mode of death education.