Objective:To understand the composition of infectious pathogens and the changes in the epidemic characteristics of inpatients with acute respiratory tract infections in Pudong New Area of Shanghai, from 2018 to 2023.Methods:Specimens of inpatients with acute respiratory infection cases were collected from 14 healthcare institutions in Pudong New Area, Shanghai, from 2018-2023 and tested for eight respiratory pathogens: influenza virus, adenovirus, rhinovirus, parainfluenza virus, respiratory syncytial virus, common coronavirus, metapneumovirus, and bocavirus. The groups were divided into three periods,2018-2019, 2020-2022 and 2023, and the chi-square or Kruskal-Wallis rank sum test was used to compare the group differences. The SPSS 22.0 software was used for statistical analysis.Results:Among the 3 023 inpatients with acute respiratory infection, the positive rate of any virus was 24.25% (733/3 023). The positive rates of any virus in 2018-2019, 2020-2022, and 2023 were 33.40% (336/1 006), 12.01% (116/966), and 26.74% (281/1 051), respectively, and the differences were statistically significant ( χ2=128.20, P<0.001). Among the age groups, in 2018-2019 and 2020-2022, the positive rate of any virus was the highest in the <5 years age group (46.20% and 14.64%), while in 2023, the 15-59 years age group had the highest positive rate (32.97%). The positive rate of any virus in winter was the highest in 2018-2019 (53.21%) and 2020-2022 (17.58%), and the highest in autumn was in 2023 (31.53%). The peak positive rate of respiratory syncytial virus was in winter of 2018-2019 and 2020-2022, as well as the summer of 2023.The positive rates of influenza virus in 2018-2019, 2020-2022 and 2023 were 9.84%, 1.55% and 9.71%, respectively. Conclusions:The pathogen epidemic characteristics of inpatients with acute respiratory infection in Pudong New Area from 2018 to 2023 have shown certain changes. It is necessary to strengthen monitoring. Targeted prevention and control strategies should be developed and implemented in a timely manner.

Objective To investigate the serum levels and significance of S100 calcium-binding protein β(S100β)and insulin-like growth factor 1 receptor(IGF-1R)in vascular cognitive impairment no dementia(VCIND)patients.Methods A total of fifty patients with VCIND due to cerebral infarction admitted to a hospital from June 2022 to June 2023 were selected as the VCIND group,50 cerebral infarction patients with no cognitive impairment(NCI)were selected as the NCI group,and 50 patients with no history of cerebrovas-cular disease admitted to a hospital during the same period were selected as the control group.Serum levels of S100β and IGF-1R were detected by enzyme-linked immunosorbent assay.Logistic regression analysis was used to evaluate whether serum S100β and IGF-1R levels were influential factors in the diagnosis of VCIND,and receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of serum S100β and IGF-1R level in VCIND.Results There were significant differences in proportion of hypertension and Hcy level among VCIND group,NCI group and control group(P<0.05).The serum S100β level in VCIND group was higher than that in NCI group and control group,and the difference was statistically significant(P<0.05).The serum IGF-1R level in VCIND group was lower than that in NCI group and control group,and the difference was statistically significant(P<0.05).Multivariate Logistic regression analysis showed that serum S100β≥1.26 μg/L and IGF-1R≤1.52 ng/mL were independent risk factors for VCIND(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of serum S100β level for VCIND di-agnosis was 0.734(95%CI:0.553-0.769),sensitivity was 75.8%,specificity was 67.3%,the AUC of serum IGF-1R level for diagnosis of VCIND was 0.806(95%CI:0.738-0.932),sensitivity was 69.5%,specificity was 72.2%.The diagnostic value of serum S100β and IGF-1R combined detection for VCIND was higher than that of single detection.Conclusion Serum S100β level increased and IGF-1R level decreased in patients with VCIND.The combined detection of serum S100β and IGF-1R has high diagnostic value for VCIND,and has the value of promotion and application in clinical practice.

ObjectiveTo retrospectively analyze the association between novel coronavirus (“SARS-CoV-2”) infection and clinical symptoms in inpatients with severe acute respiratory infection (SARI) in Pudong New Area, Shanghai, so as to provide evidence for improving clinical diagnostic ability. MethodsFrom January 13 to March 2, 2023, respiratory tract specimens of 456 inpatients with SARI were collected from 8 sentinel institutions, SARS-CoV-2 was detected by real-time fluorescence quantitative PCR. Whole genome sequencing and sequence analyses were performed to samples with a cycle threshold (Ct) value of <35. At the same time, demographic information, clinical characteristics and underlying disease condition of the cases were collected, and the association between age, symptoms and nucleic acid positive rates was evaluated by χ² test and Spearman correlation analysis. ResultsA total of 456 cases were included, the median (P₂₅, P₇₅) age was 70 (69, 85) years old, of which 200 cases were novel coronavirus nucleic acid positive for SARS-CoV-2, with a positive rate of 43.86%. The positive rate was the highest in the 80-year-old group (56.82%), and the positive rate increased significantly with age (r=0.15, P=0.002). The proportion of oppression in chest, sore throat and expectoration in novel coronavirus nucleic acid positive cases was significantly higher than that in negative cases (all P<0.05). The 33 viruses sequenced successfully were all Omicron subvariants, with BF.7 (51.52%) and BA.5.2 (42.42%) being the predominant ones. ConclusionA positive correlation was observed between advanced age and the risk of SARS-CoV-2 positivity in patients with SARI. The symptoms of expectoration, oppression in chest and sore throat are more common in positive cases, which can be used as a prompt indicator for key screening and clinical identification of elderly SARI cases.

Objective:To understand the composition of infectious pathogens and the changes in the epidemic characteristics of inpatients with acute respiratory tract infections in Pudong New Area of Shanghai, from 2018 to 2023.Methods:Specimens of inpatients with acute respiratory infection cases were collected from 14 healthcare institutions in Pudong New Area, Shanghai, from 2018-2023 and tested for eight respiratory pathogens: influenza virus, adenovirus, rhinovirus, parainfluenza virus, respiratory syncytial virus, common coronavirus, metapneumovirus, and bocavirus. The groups were divided into three periods,2018-2019, 2020-2022 and 2023, and the chi-square or Kruskal-Wallis rank sum test was used to compare the group differences. The SPSS 22.0 software was used for statistical analysis.Results:Among the 3 023 inpatients with acute respiratory infection, the positive rate of any virus was 24.25% (733/3 023). The positive rates of any virus in 2018-2019, 2020-2022, and 2023 were 33.40% (336/1 006), 12.01% (116/966), and 26.74% (281/1 051), respectively, and the differences were statistically significant ( χ2=128.20, P<0.001). Among the age groups, in 2018-2019 and 2020-2022, the positive rate of any virus was the highest in the <5 years age group (46.20% and 14.64%), while in 2023, the 15-59 years age group had the highest positive rate (32.97%). The positive rate of any virus in winter was the highest in 2018-2019 (53.21%) and 2020-2022 (17.58%), and the highest in autumn was in 2023 (31.53%). The peak positive rate of respiratory syncytial virus was in winter of 2018-2019 and 2020-2022, as well as the summer of 2023.The positive rates of influenza virus in 2018-2019, 2020-2022 and 2023 were 9.84%, 1.55% and 9.71%, respectively. Conclusions:The pathogen epidemic characteristics of inpatients with acute respiratory infection in Pudong New Area from 2018 to 2023 have shown certain changes. It is necessary to strengthen monitoring. Targeted prevention and control strategies should be developed and implemented in a timely manner.

Objective To evaluate the effectiveness of different thermal insulation measures on intervention of perioperative hypothermia in patients undergoing abdominal surgery,through a network Meta-analysis.Methods A systematic search through online databases was conducted from the inception of the databases to August 2023.Databases of CNKI,VIP,Wan Fang Data,SinoMed,PubMed,the Cochrane Library,Web of Science and Embase were searched to retrieve randomly controlled trials(RCTs)in the effectiveness of different thermal insulation measures on perioperative hypothermia in patients undergoing abdominal surgery.According to the inclusion and exclusion criteria,two researchers independently screened the retrieved literatures,extracted data and evaluated the quality of acquired data.Revman 5.4,R 4.3.1 and Stata17.0 were used for the network meta-analysis of the acquired data.Results A total of 26 RCTs were included,involving 9 thermal insulation measures that involved with 2 414 patients.Meta-analysis showed that an inflatable blanket combined with warmed intravenous infusion achieved the best effectiveness in maintaining the perioperative core temperature of the patients with abdominal surgery.An inflatable blanket combined with warmed peritoneal lavage fluid achieved the best effectiveness in reduction of the incidence of perioperative hypothermia and shivering.Conclusion This study shows that a combination of inflatable blanket with warmed peritoneal lavage fluid/warmed intravenous infusion can achieve the best effectiveness on intervention of perioperative hypothermia in patients undergoing abdominal surgery.

Nuclear medicine plays an indispensable role in the diagnosis,treatment,and prognosis of a wide range of diseases.Nuclear medicine using radionuclides for diagnosis has the advantages of accuracy,speed,high sensitivity and high resolution.Currently,several radionuclides play pivotal roles in disease diagnosis.This article primarily examines the clinical application and research of diagnostic radionuclides,including 18 F,89 Zr,68 Ga,99m Tc,131 I,123 I,and 11 C.The objective is to offer valuable insights for disease diagnosis and staging of diseases.

Objective To analyze the differences in the initial stability of an acetabular cup with a Voronoi polyhedral porous structure and a solid acetabular cup and to explore the impact of the Voronoi polyhedral porous layer on the initial stability of the acetabular cup,as well as its role in preventing loosening and dislocation.Methods Voronoi polyhedral porous scaffold structures with 60％and 70％porosities were designed using the Grasshopper software.Specimens of porous acetabular cups with 60％and 70％porosities and solid acetabular cups were manufactured using selective laser melting technology.Lever tests on the acetabular cups were conducted using polyurethane block models under identical conditions,and the maximum lever-out moment,angular displacement,and interface stiffness of the three groups of specimens were analyzed and compared.Results Under the condition of no significant differences in the compression force,for porous acetabular cups with porosities of 60％and 70％,the maximum lever-out moment increased by 278.82％and 320.56％,the angular displacement increased by 194.04％and 269.23％,respectively,and the interface stiffness increased by 18.58％and 7.88％,respectively,compared with that of solid acetabular cups.After the lever-out tests were completed,significant wear was observed within the polyurethane block hemisphere cavity using the porous acetabular cups.Conclusions The initial stability indicators of acetabular cups with a Voronoi polyhedral porous structure were higher than those of solid acetabular cups,indicating that the Voronoi polyhedral porous layer can enhance the initial stability of the acetabular cup.These results provide a reference for designing and selecting acetabular components.

Objective To analyze the risk factors for lung injury and pulmonary arterial hypertension in patients with chronic obstructive pulmonary disease(COPD),and the predictive value of serum SDF-1 and sRAGE for lung injury and pulmonary arterial hypertension.Methods A total of 200 patients with COPD admitted to our hospital from January 2021 to January 2023 were selected as research objects,23 of whom occurred lung injury and the rest 177 had no lung injury,and 31 developed pulmonary hypertension and the remaining 169 had no pulmonary hypertension.The predictive value of serum SDF-1 and sRAGE for pulmonary injury and pulmonary hypertension was analyzed.Results Multi-factor logistic regression analysis showed that D-D,PCT,CRP,RDW,MPV,PLT,NLR,SDF-1,sRAGE,pulmonary hypertension,arterial blood oxygen partial pressure,FVC and FEV1 were the main factors affecting lung injury in patients with COPD.D-D,PCT,CRP,RDW,MPV,PLT,NLR,SDF-1,sRAGE,arterial partial oxygen pressure,FVC,FEV1 and CT angiographic pulmonary artery volume were the main factors affecting the occurrence of pulmonary hypertension in those patients(P<0.05).Serum SDF-1 and sRAGE were positively correlated with lung injury and pulmonary hypertension in patients with COPD(P<0.05).The sensitivity and accuracy of SDF-1 and sRAGE for predicting lung injury and pulmonary hyperten-sion in patients with COPD were higher than those of SDF-1 and SRage alone(P<0.05).Conclusions Pulmonary injury in patients with COPD is associated with D-D,PCT,CRP,RDW,MPV,PLT,NLR,SDF-1,sRAGE,pulmonary hypertension,arterial blood oxygen partial pressure,FVC,FEV1.The occurrence of pulmonary hyper-tension is related to D-D,PCT,CRP,RDW,MPV,PLT,NLR,SDF-1,sRAGE,arterial partial pressure of oxy-gen,FVC,FEV1 and CT angiography of pulmonary artery volume.Combined detection of SDF-1 and sRAGE has a higher predictive value for lung injury and pulmonary hypertension.

Objective:To investigate the effect of penehyclidine hydrochloride on respiratory mechanics, arterial blood gas, and inflammatory factors in patients undergoing one-lung ventilation during thoracoscopic lobectomy.Methods:A total of 100 patients who underwent thoracoscopic lobectomy with one-lung ventilation at Jinhua Central Hospital from January to November 2022 were included in this randomized controlled study. They were divided into groups A and B ( n = 50 per group) using a random digital number table. Patients in group A received an intravenous infusion of 0.02 mg/kg of pentylenethyclidine hydrochloride 30 minutes before surgery, while patients in group B received an equal amount of 0.9% sodium chloride injection 30 minutes before surgery. Clinical indicators, respiratory mechanical indicators (peak airway pressure, lung compliance), arterial blood gas analysis indicators (blood oxygen saturation, arterial pressure of oxygen, oxygenation index), inflammatory factor levels (interleukin-6, interleukin-8, tumor necrosis factor level-α), and pulmonary complications were compared between the two groups. Results:There were no significant differences in mechanical ventilation time or total infusion volume between the two groups (both P > 0.05). At the end of surgery (T1) and 1 day after surgery (T2), peak airway pressure in group A was (17.43 ± 2.69) cm H 2O and (16.81 ± 2.28) cm H 2O (1 cm H 2O = 0.098 kPa), respectively, which were significantly lower than (19.23 ± 3.40) cm H 2O and (18.29 ± 2.06) cm H 2O in group B, respectively ( t = 2.94, 3.41, P = 0.002, < 0.001). At T1 and T2, lung compliance in group A was (34.67 ± 2.93) cm H 2O and (36.26 ± 3.11) cm H 2O, respectively, which were significantly higher than (32.23 ± 2.85) cm H 2O and (33.84 ± 2.87) cm H 2O in group B, respectively ( t = 4.22, 4.04, P = 0.000, < 0.001). At T1 and T2, blood oxygen saturation, arterial partial pressure of oxygen, and oxygenation index in group A were significantly higher than those in group B ( t = 8.12, 3.07, 10.47, 3.16, 3.81, 4.15, all P < 0.05). At T1 and T2, interleukin-6, interleukin-8, and tumor necrosis factor-α levels in group A were significantly lower than those in group B ( t = 11.67, 13.55, 9.60, 15.71, 6.13, 11.50, all P < 0.001). The incidence of complications in group A was 4% (2/50), which was significantly lower than 16% (8/50) in group B ( χ2 = 4.00, P < 0.05). Conclusion:Penehyclidine hydrochloride has a good effect on respiratory mechanics, arterial blood gas, and inflammatory factors in patients undergoing thoracoscopic lobectomy with one-lung ventilation and thereby deserves clinical promotion.

Objective: To assess the efficacy of supraclavicular artery island flap (SCAIF) for the reconstruction of hypopharynx and upper esophagus. Methods: The SCAIF procedure on was used in 10 patients, including 8 with hypopharygeal carcinomas, 1 with esophageal carcinoma and neck skin invasion and 1 with hypopharyngeal leiomyosarcoma, at the Otorhinolaryngology Hospital, the First Affiliated Hospital, Sun Yatsen University between December 2015 and June 2017. The sizes of the flaps were measured in (4-8) cm×(5-12) cm. Clinical indexes such as harvesting time and survival were recorded. Results: Harvesting time for SCAIF ranged from 20 to 30 minutes, averaging 26 minutes. Nine flaps survived, one flap had partially necrosis. Functional outcomes were excellent and the donor sites were direct closed without complications. Conclusions SCAIF is a versatile, reliable, and easily harvested flap, with good cosmetic and functional outcomes for reconstructing the defects of hypopharynx and upper esophagus.