OBJECTIVE To explore the risk factors for serum COVID-19 antibodies in the population of Fuzhou to provide scientific basis for prevention and control strategies.METHODS The prospective study and the multi-stage stratified random sampling method were performed to select at least 200 subjects from each of the 12 counties(cit-ies)in Fuzhou.Questionnaires follow-ups and serum collections were conducted in Mar,Jun,Sep,and Dec.2024,respectively.The antibody levels in Dec.were divided into a high protective antibody group(IgG antibody≥50 AU/ml)and a low protective antibody group(IgG antibody≤20 AU/ml).The influencing factors of serum anti-body levels were analyzed by multivariate logistic regression model.RESULTS A total of 2816 subjects were en-rolled.In Mar,1454 subjects with high-protective antibodies were identified.After nine months of follow-up,of the 1454 subjects,344 had high protective antibodies and 369 had low protective antibodies in Dec..There were statistically significant differences in age,presence of typical symptoms after infection,underlying diseases,surgi-cal history,healing time,smoking and drinking histories between the high and low antibody groups(P<0.05).Multivariate logistic regression model showed that older age,underlying diseases,history of surgery,smoking and drinking were risk factors which could reduce antibody levels(P<0.05),while typical symptoms after infec-tion and longer recovery time were protective factors which could increase antibody levels(P<0.05).After the COVID-19 infection in spring of 2024,the serum antibody levels in Fuzhou residents showed the downward trend,especially after Sep.2024,with a more pronounced downward trend.CONCLUSIONS According to the risk factors of COVID-19 antibody levels,prevention and control efforts should be focused on the key population.It is necessa-ry to strengthen health education and carry out vaccination to maintain the levels of immunity to protect population from COVID-19 infection.

OBJECTIVE To explore the risk factors for severe influenza patients in Fuzhou,and to provide reference for the prevention and control of severe influenza.METHODS Information on 412 patients with severe influenza in Fuzhou City with onset dates from Jan.2023 to Jan.2025 was collected from the China Influenza Surveillance In-formation System and the China Disease Prevention and Control Information System.The severe patients were matched 1∶1 with non-severe patients based on gender and age±3 years of the severe patients.Basic infor-mation,vaccination history,clinical symptoms,types of infecting viruses and medical history of both groups of patients were collected to summarize the risk factors for severe illness progression in influenza patients.RESULTS The proportions of obesity,retired personnel,children or students,unemployed individuals and smokers in the se-vere group were all higher than those in the non-severe group,while the vaccination rate(6.07％)was lower than that of the non-severe group(16.50％)(P＜0.001).The proportions of typical symptoms of shortness of breath/dyspnea and altered mental status/convulsions in the severe group were 23.30％and 21.60％,respectively,which were higher than those in the non-severe group(P＜0.001).The proportions of individuals with a history of chro-nic respiratory diseases and cancer/tumors in the severe group were 26.70％and 19.90％,respectively,which were higher than those in the non-severe group(P＜0.001).The proportion of influenza A(H1 N1)in the severe group(58.50％)was higher than that in the non-severe group(39.32％)(P＜0.001).Retired personnel,children or students and unemployed individuals were high-risk groups for the severe influenza,while farmers were a low-risk group.Obesity(OR=1.966),unvaccination(OR=3.738),smoking(OR=1.787),typical symptoms of shortness of breath/dyspnea(OR=3.305),altered mental status/convulsions(OR=4.099),history of chronic respiratory diseases(OR=4.820)and history of cancer/tumors(OR=3.269)and infection with influenza A(H1N1)(OR=6.422)and influenza A(H3N2)(OR=4.441)were risk factors for the severe influenza(P＜0.05).The recovery time in the severe group was 21(6,33)days,which was longer than that in the non-severe group(P＜0.001).CONCLUSIONS Obesity,unvaccination,smoking,typical symptoms of shortness of breath/dyspnea,altered mental status/convulsions,history of chronic respiratory diseases and history of cancer/tumors and infection with influenza A(H1N1)and influenza A(H3N2)are risk factors for severe influenza patients.It is necessary to strengthen influenza prevention and control among the elderly and children,enhance health edu-cation,and continuously promote influenza vaccination among key populations.

Objective:To investigate the differences in complications after transcatheter aortic valve replacement (TAVR) between patients with pure aortic regurgitation (PAR) and aortic valve stenosis (AS), and to explore the risk factors for the occurrence of major complications.Methods:Totally 124 patients who underwent TAVR at the First Affiliated Hospital of Wannan Medical College between October 2021 and January 2024 were retrospectively included. Patients were divided into the PAR group (64 cases) and AS group (60 cases) based on preoperative echocardiography findings. Preoperative clinical data, echocardiography, CT imaging data,and postoperative complications were collected. The differences between the two groups in postoperative complications and preoperative clinical data, imaging data were compared. Multivariate logistic regression analysis was used to assess the risk factors for major complications in the two groups, receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive efficacy of major risk factors for common postoperative complications in both groups.Results:The major complication in the PAR group was conduction disturbance (CD, 33 cases); the major complication in the AS group was perivalvular leakage (PVL, 41 cases). Comparison of preoperative data showed that in the PAR group, there were statistically significant differences in the shortest diameter of the membranous septum (MS) and the ratio of the shortest to longest MS diameter between patients with and without postoperative CD (both P<0.05). In the AS group, there were statistically significant differences in the long diameter of the aortic annulus, annular area, annular perimeter, and calcification score of the anchoring zone between patients with and without postoperative PVL (all P<0.05). Multivariate logistic regression analysis revealed that the shortest diameter of the MS was an independent risk factor for postoperative CD in PAR patients ( OR=0.628,95% CI 0.437-0.902, P=0.012), and the area under the ROC curve was 0.751 (95% CI 0.630-0.872, P=0.001). Meanwhile, the calcification score of the anchoring zone was an independent risk factor for postoperative PVL in AS patients ( OR=1.454,95% CI 1.055-2.003, P=0.022), and the area under the ROC curve was 0.740 (95% CI 0.601-0.879, P=0.003). Conclusions:After TAVR, complications differ between PAR and AS patients. CD is the major complication in PAR patients, with the shortest diameter of the MS being a risk factor. Conversely, PVL is the major complication in AS patients, with the calcification score of the anchoring zone identified as a risk factor.

Objective To establish a method for the simultaneous determination of peimine,peiminine,and hupehenine in Juhong pills,to investigate the raw material usage of Fritillaria thunbergii Miq.,and to preliminarily develop a detection approach for identifying adulteration with Fritillaria hupehensis Hsiao et K.C.Hsia.Methods The high-performance liquid chromatography-triple quadruple mass spectrometry(HPLC-MS/MS)was performed on an Agilent Poroshell 120 SB C18 column(2.1 mm×100 mm,2.7 μm)with a mobile phase consisting of acetonitrile-methanol(1∶1)and 0.1%formic acid under gradient elution.The flow rate was set at 0.3 mL·min-1.The column temperature was maintained at 35℃,and the injection volume was 2 μL.Electrospray ionization(ESI)in positive ion mode and multiple reaction monitoring were employed to quantify the three components in 170 batches of Juhong pills.Simulated positive samples with varying adulteration ratios of Fritillaria hupehensis Hsiao et K.C.Hsia were prepared to establish a simple yet efficient detection limit for adulteration.Results Three components showed good linear correlation within their ranges(r≥0.997 5),and the averaged recoveries ranged from 92.0%-106.2%.A total of 61 batches were suspected of Fritillaria thunbergii Miq.adulteration with Fritillaria hupehensis Hsiao et K.C.Hsia in raw material inputs,with the peimine to peiminine ratio below 1.15.Among these samples,27 batches were large honey-bound pills with hupehenine levels of 2.636-9.939 μg·g-1;34 batches were water-honeyed pills showing significantly higher hupehenine contamination at 6.752-48.137 μg·g-1.Conclusion The established method is simple,reliable,and accurate for the quality control of Fritillaria thunbergii Miq.adulteration in Juhong pills without imposing significant additional costs.

OBJECTIVE To explore the risk factors for severe influenza patients in Fuzhou,and to provide reference for the prevention and control of severe influenza.METHODS Information on 412 patients with severe influenza in Fuzhou City with onset dates from Jan.2023 to Jan.2025 was collected from the China Influenza Surveillance In-formation System and the China Disease Prevention and Control Information System.The severe patients were matched 1∶1 with non-severe patients based on gender and age±3 years of the severe patients.Basic infor-mation,vaccination history,clinical symptoms,types of infecting viruses and medical history of both groups of patients were collected to summarize the risk factors for severe illness progression in influenza patients.RESULTS The proportions of obesity,retired personnel,children or students,unemployed individuals and smokers in the se-vere group were all higher than those in the non-severe group,while the vaccination rate(6.07％)was lower than that of the non-severe group(16.50％)(P＜0.001).The proportions of typical symptoms of shortness of breath/dyspnea and altered mental status/convulsions in the severe group were 23.30％and 21.60％,respectively,which were higher than those in the non-severe group(P＜0.001).The proportions of individuals with a history of chro-nic respiratory diseases and cancer/tumors in the severe group were 26.70％and 19.90％,respectively,which were higher than those in the non-severe group(P＜0.001).The proportion of influenza A(H1 N1)in the severe group(58.50％)was higher than that in the non-severe group(39.32％)(P＜0.001).Retired personnel,children or students and unemployed individuals were high-risk groups for the severe influenza,while farmers were a low-risk group.Obesity(OR=1.966),unvaccination(OR=3.738),smoking(OR=1.787),typical symptoms of shortness of breath/dyspnea(OR=3.305),altered mental status/convulsions(OR=4.099),history of chronic respiratory diseases(OR=4.820)and history of cancer/tumors(OR=3.269)and infection with influenza A(H1N1)(OR=6.422)and influenza A(H3N2)(OR=4.441)were risk factors for the severe influenza(P＜0.05).The recovery time in the severe group was 21(6,33)days,which was longer than that in the non-severe group(P＜0.001).CONCLUSIONS Obesity,unvaccination,smoking,typical symptoms of shortness of breath/dyspnea,altered mental status/convulsions,history of chronic respiratory diseases and history of cancer/tumors and infection with influenza A(H1N1)and influenza A(H3N2)are risk factors for severe influenza patients.It is necessary to strengthen influenza prevention and control among the elderly and children,enhance health edu-cation,and continuously promote influenza vaccination among key populations.

Objective To establish a method for the simultaneous determination of peimine,peiminine,and hupehenine in Juhong pills,to investigate the raw material usage of Fritillaria thunbergii Miq.,and to preliminarily develop a detection approach for identifying adulteration with Fritillaria hupehensis Hsiao et K.C.Hsia.Methods The high-performance liquid chromatography-triple quadruple mass spectrometry(HPLC-MS/MS)was performed on an Agilent Poroshell 120 SB C18 column(2.1 mm×100 mm,2.7 μm)with a mobile phase consisting of acetonitrile-methanol(1∶1)and 0.1%formic acid under gradient elution.The flow rate was set at 0.3 mL·min-1.The column temperature was maintained at 35℃,and the injection volume was 2 μL.Electrospray ionization(ESI)in positive ion mode and multiple reaction monitoring were employed to quantify the three components in 170 batches of Juhong pills.Simulated positive samples with varying adulteration ratios of Fritillaria hupehensis Hsiao et K.C.Hsia were prepared to establish a simple yet efficient detection limit for adulteration.Results Three components showed good linear correlation within their ranges(r≥0.997 5),and the averaged recoveries ranged from 92.0%-106.2%.A total of 61 batches were suspected of Fritillaria thunbergii Miq.adulteration with Fritillaria hupehensis Hsiao et K.C.Hsia in raw material inputs,with the peimine to peiminine ratio below 1.15.Among these samples,27 batches were large honey-bound pills with hupehenine levels of 2.636-9.939 μg·g-1;34 batches were water-honeyed pills showing significantly higher hupehenine contamination at 6.752-48.137 μg·g-1.Conclusion The established method is simple,reliable,and accurate for the quality control of Fritillaria thunbergii Miq.adulteration in Juhong pills without imposing significant additional costs.

OBJECTIVE To explore the risk factors for serum COVID-19 antibodies in the population of Fuzhou to provide scientific basis for prevention and control strategies.METHODS The prospective study and the multi-stage stratified random sampling method were performed to select at least 200 subjects from each of the 12 counties(cit-ies)in Fuzhou.Questionnaires follow-ups and serum collections were conducted in Mar,Jun,Sep,and Dec.2024,respectively.The antibody levels in Dec.were divided into a high protective antibody group(IgG antibody≥50 AU/ml)and a low protective antibody group(IgG antibody≤20 AU/ml).The influencing factors of serum anti-body levels were analyzed by multivariate logistic regression model.RESULTS A total of 2816 subjects were en-rolled.In Mar,1454 subjects with high-protective antibodies were identified.After nine months of follow-up,of the 1454 subjects,344 had high protective antibodies and 369 had low protective antibodies in Dec..There were statistically significant differences in age,presence of typical symptoms after infection,underlying diseases,surgi-cal history,healing time,smoking and drinking histories between the high and low antibody groups(P<0.05).Multivariate logistic regression model showed that older age,underlying diseases,history of surgery,smoking and drinking were risk factors which could reduce antibody levels(P<0.05),while typical symptoms after infec-tion and longer recovery time were protective factors which could increase antibody levels(P<0.05).After the COVID-19 infection in spring of 2024,the serum antibody levels in Fuzhou residents showed the downward trend,especially after Sep.2024,with a more pronounced downward trend.CONCLUSIONS According to the risk factors of COVID-19 antibody levels,prevention and control efforts should be focused on the key population.It is necessa-ry to strengthen health education and carry out vaccination to maintain the levels of immunity to protect population from COVID-19 infection.

Objective:To investigate the differences in complications after transcatheter aortic valve replacement (TAVR) between patients with pure aortic regurgitation (PAR) and aortic valve stenosis (AS), and to explore the risk factors for the occurrence of major complications.Methods:Totally 124 patients who underwent TAVR at the First Affiliated Hospital of Wannan Medical College between October 2021 and January 2024 were retrospectively included. Patients were divided into the PAR group (64 cases) and AS group (60 cases) based on preoperative echocardiography findings. Preoperative clinical data, echocardiography, CT imaging data,and postoperative complications were collected. The differences between the two groups in postoperative complications and preoperative clinical data, imaging data were compared. Multivariate logistic regression analysis was used to assess the risk factors for major complications in the two groups, receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive efficacy of major risk factors for common postoperative complications in both groups.Results:The major complication in the PAR group was conduction disturbance (CD, 33 cases); the major complication in the AS group was perivalvular leakage (PVL, 41 cases). Comparison of preoperative data showed that in the PAR group, there were statistically significant differences in the shortest diameter of the membranous septum (MS) and the ratio of the shortest to longest MS diameter between patients with and without postoperative CD (both P<0.05). In the AS group, there were statistically significant differences in the long diameter of the aortic annulus, annular area, annular perimeter, and calcification score of the anchoring zone between patients with and without postoperative PVL (all P<0.05). Multivariate logistic regression analysis revealed that the shortest diameter of the MS was an independent risk factor for postoperative CD in PAR patients ( OR=0.628,95% CI 0.437-0.902, P=0.012), and the area under the ROC curve was 0.751 (95% CI 0.630-0.872, P=0.001). Meanwhile, the calcification score of the anchoring zone was an independent risk factor for postoperative PVL in AS patients ( OR=1.454,95% CI 1.055-2.003, P=0.022), and the area under the ROC curve was 0.740 (95% CI 0.601-0.879, P=0.003). Conclusions:After TAVR, complications differ between PAR and AS patients. CD is the major complication in PAR patients, with the shortest diameter of the MS being a risk factor. Conversely, PVL is the major complication in AS patients, with the calcification score of the anchoring zone identified as a risk factor.

OBJECTIVE To investigate the effect and mechanism of gracillin from Reineckia carnea on autophagy in non- small cell lung cancer A549 cells. METHODS Using A549 cells as subjects， the effects of different concentrations of gracillin （0.25， 0.5， 1， 2， 4 μmol/L） on the proliferation of cells were detected by CCK-8 after being treated for different time （12， 24， 48 h）. Compared with the control group without medication， the effect of gracillin （2 μmol/L） on the formation of autophagosomes in cells was observed by transmission electron microscope after 24 h of exposure. The aggregation of GFP-LC3 on autophagosome membrane was detected by GFP-LC3 plasmid transfection after being treated with gracillin （0.25， 0.5， 1， 2 μmol/L） for 24 h. Quantitative real-time PCR and Western blot assay were used to detect the mRNA and protein expressions of family with sequence similarity 102 member A（FAM102A）， the expressions of autophagy-related proteins [p62， Beclin-1， microtubule-associated protein 1 light chain 3B （LC3B）]， and the expressions of phosphoinositide 3-kinase （PI3K）/protein kinase B （Akt） signaling pathway-related proteins in A549 cells after being treated with gracillin （0.25， 0.5， 1 and 2 μmol/L） for 24 h. RESULTS Gracillin significantly inhibited the proliferation of A549 cells in a concentration- and time-dependent manner. The IC50 was 2.55 μmol/L at 24 h. After 24 h of gracillin treatment， autophagosomes with bilayer membrane structure were found in the cell cytoplasm， and GFP-LC3 green fluorescent spots on autophagosome membrane were obvious， representing an increasing trend as drug concentration. Compared with the control group， mRNA and protein expressions of FAM102A （0.5， 1， 2 μmol/L groups）， protein expression of Beclin-1 （1， 2 μmol/L groups） and LC3B-Ⅱ/LC3B-Ⅰ ratio （2 μmol/L group） were significantly increased in different concentrations of gracillin groups， while the protein expression of p62 （1， 2 μmol/L groups）， and the protein phosphorylations of Akt （1， 2 μmol/L groups） and PI3K （2 μmol/L group） were all decreased significantly （P＜0.05 or P＜0.01）. CONCLUSIONS Gracillin can promote excessive autophagy in A549 cells by up-regulating mRNA and protein expressions of FAM102A and inhibiting PI3K/Akt signaling pathway， thus inhibiting cell proliferation.

Objective:To establish a predictive model of the first cesarean delivery in multiparous women based on the situation of two consecutive pregnancies.Methods:The data of patients with two consecutive deliv-eries of single live birth and the previous delivery was vaginal delivery in the First Affiliated Hospital of Soochow U-niversity during the second delivery time range from January 1,2018 to December 31,2021 were retrospectively analyzed.According to whether the second pregnancy occurred cesarean section,the patients were divided into two groups(vaginal delivery group and cesarean section group).Univariate,stepwise,and multiple Logistic re-gression analyses were used to screen the influencing factors of multipara's first cesarean section delivery,and the prediction model was established.R language was used to build the model's nomogram and calibration curve.The bootstrap resampling method was used for internal verification.After establishing the model,clinical data of patients with two consecutive births of single live birth between January 1,2022 and April 1,2023 were retrospec-tively collected for external verification of the model.Results:①A total of 2709 patients were included in this study for modeling,of which 6.31％(171/2709)underwent cesarean section for the first time.603 cases were included for external verification.②According to univariate,stepwise and multivariate Logistic regression analysis,all the variables affecting the first delivery by cesarean section were screened out,including:abnormal labor in previous labor,age of current delivery,assisted reproductive technology,hypertension disorder complicating pregnancy,pregnancy with thrombocytopenia,oligohydramnios,excessive amniotic fluid,macrosomia,fetal growth restriction,abnormal fetal position,fetal distress,all of the above variables P＜0.05 and incorporated into the final prediction model.③The AUC of this model was 0.949(95％CI 0.928-0.969),and the calibration curve showed that the model intercept was 0 and the slope was 1.Hosmer-Lemeshow test had a P＞0.05,indicating that the model had a high accuracy.④The AUC of external validation was 0.958,the slope of the calibration curve was 0.972,and the Hosmer-Lemeshow test had a P of 0.49.Conclusions:The prediction model of the first delivery by cesarean section during the second pregnancy has been established.The prediction efficiency of the model is good,and it can provide a tool for the individualized evaluation of menstrual women in clinical work.