Objective To understand the antibody levels of diphtheria and tetanus among healthy population in Shanghai Pudong New Area, and to provide a scientific basis for improving the vaccine immunization strategy. Methods Random sampling was used to select healthy people of all ages in 16 communities in Shanghai Pudong New Area from 2018 to 2024, and serum samples were collected and tested for serum anti-diphtheria and tetanus toxin IgG antibodies by enzyme-linked immunosorbent assay (ELISA) method to analyze the antibody positivity rate (≥0.1 IU/ml) and the geometric mean concentration (GMC) of antibodies. Results A total of 3 312 serum samples were included, with a male-to-female ratio of 0.76:1, and 53.77% were local residents. The seropositivity rates and geometric mean concentrations (GMC) of both diphtheria and tetanus antibodies generally declined with increasing age, but exhibited a transient rebound in the 7y-. A total of 1 175 individuals (35.48%) were seropositive for diphtheria, with a GMC of 0.054 IU/mL. For tetanus, 988 individuals (29.83%) were seropositive, with a GMC of 0.033 IU/mL. Significant differences in seropositivity rates (χ²_diphtheria=950.005,χ²_tetanus=1 324.393) and GMC (H_diphtheria=1027.160,H_tetanus=1 142.007) were observed among different age groups (P<0.001). Significant differences in seropositivity rates (χ²_diphtheria=950.005,χ²_tetanus=1324.393) and GMC (H_diphtheria=1027.160,H_tetanus=1142.007) were also found across different years (P<0.001). Conclusion The prevalence of diphtheria and tetanus antibodies in the healthy population of Pudong New Area is relatively low, particularly among adults over 20 years of age with inadequate immunization. This underscores the need to reinforce the National Immunization Program (NIP) vaccine specifications for children under 6 years of age and implement an immunization strategy for adolescents or adults against diphtheria and tetanus.

Objective To compare the effects of nalbuphine combined with etomidate and nalbuphine combined with propofol in painless colonoscopy for elderly patients with hypertension. Methods Elderly patients with hypertension who underwent painless colonoscopy in the Department of Anesthesiology of Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University from August 2022 to February 2023 were selected and randomly divided into three groups: nalbuphine combined with etomidate group (E group), nalbuphine combined with propofol group (P group), and the nalbuphine combined with etomidate and propofol group (EP group). The primary endpoint was the incidence of hypotension during anesthesia. Secondary endpoints included mean arterial pressure (MAP), systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) at five time points: before anesthesia (T₀), before colonoscopy (T₁), 5 minutes after colonoscopy (T₂), at the end of the examination (T₃), upon leaving the post-anesthesia care unit (PACU, T₄). Additionally, examination time, awakening time, Ramsay score, and adverse reactions were compared among the three groups. Results A total of 180 patients were included in the analysis, with 60 cases in each group. The incidence of hypotension was 11.7%, 55.0%, and 33.3% in the E group, P group, and EP group, respectively. The incidence of hypotension in the E group was lower than that in the P and EP groups (P＜0.05). At T₁, T₂, T₃, and T₄, MAP, SBP, and DBP in the E group were significantly higher than those in the P and EP groups (P＜0.05). There were no statistically significant differences among the three groups in awakening time, Ramsay score, or incidence of adverse reactions. Conclusions Compared with nalbuphine combined with propofol, nalbuphine combined with etomidate for painless colonoscopy in elderly patients with hypertension resulted in a lower incidence of hypotension, less impact on hemodynamics, and higher safety.

Debates persist regarding the efficacy and safety of azvudine, particularly its real-world outcomes. This study involved patients aged ≥60 years who were admitted to 25 hospitals in mainland China with confirmed SARS-CoV-2 infection between December 1, 2022, and February 28, 2023. Efficacy outcomes were all-cause mortality during hospitalization, the proportion of patients discharged with recovery, time to nucleic acid-negative conversion (T _NANC), time to symptom improvement (T _SI), and time of hospital stay (T _HS). Safety was also assessed. Among the 5884 participants identified, 1999 received azvudine, and 1999 matched controls were included after exclusion and propensity score matching. Azvudine recipients exhibited lower all-cause mortality compared with controls in the overall population (13.3% vs. 17.1%, RR, 0.78; 95% CI, 0.67-0.90; P = 0.001) and in the severe subgroup (25.7% vs. 33.7%; RR, 0.76; 95% CI, 0.66-0.88; P < 0.001). A higher proportion of patients discharged with recovery, and a shorter T _NANC were associated with azvudine recipients, especially in the severe subgroup. The incidence of adverse events in azvudine recipients was comparable to that in the control group (2.3% vs. 1.7%, P = 0.170). In conclusion, azvudine showed efficacy and safety in older patients hospitalized with COVID-19 during the SARS-CoV-2 omicron wave in China.

The novel coronavirus(severe acute respiratory syndrome coronavirus 2,SARS-CoV-2),classified as a single-stranded RNA virus,replicates and transcribes its genome through the action of an RNA-dependent RNA polymerase,which is itself comprised of numerous non-structural pro-teins(non-structural proteins,Nsps).The present study delineates the development of a detection system founded on a bicistronic reporter plasmid in conjunction with an array of Nsp plasmids,ai-ming to investigate the influence of SARS-CoV-2 Nsps on the virus's replication and expression profiles.Specifically,a bicistronic reporter gene plasmid along with twelve distinct Nsp plasmids(encompassing Nsp3C-Flag,Nsp4,Nsp6-Nsp10,Nsp12-Nsp16)were meticulously constructed via molecular cloning techniques.The successful expression of these Nsps was subsequently confirmed through Western blot analysis.Initially,the activity of the RNA-dependent RNA polymerase was assessed by co-transfection of the reporter plasmid with Nsp12,in the presence of its auxiliary fac-tors Nsp7 and Nsp8,with careful regulation of the co-transfection ratio,culturing temperature,and the timing of activity determination for the triad of Nsp plasmids.The normalized NLuc fluorescein value,in reference to the FLuc fluorescein value of the housekeeping gene,served as a metric for determining the polymerase activity.Building upon this foundation,the co-transfection concentra-tions of Nsp9-16 were fine-tuned,followed by the incremental addition of varying doses of Nsp3C,Nsp4,and Nsp6,to further elucidate the activity of RNA-dependent RNA polymerase(RdRp).The findings indicated that upon transfection with varying ratios of Nsp7,Nsp8,and Nsp12 at a propor-tion of 1∶8∶24,the polymerase activity was markedly elevated compared to the control group,with a statistical significance level(P＜0.001).Furthermore,in the absence of Nsp3,Nsp4,and Nsp6,the inclusion of Nsp10-16 substantially augmented the activity of the RdRp,particularly in scenarios where Nsp9 was not introduced,achieving statistical significance(P＜0.001).In the pres-ence of Nsp3 and Nsp4,the RdRp activity was augmented further upon the addition of Nsp9,reac-hing a level of significance(P＜0.05).The data imply that Nsp9 is capable of enhancing the RdRp activity of SARS-CoV-2 exclusively in the context of Nsp3 and Nsp4 coexistence,suggesting that the stimulatory influence of Nsp9 on viral replication may be contingent upon the formation of double-membrane vesicles.

Objective: To analyze the occupational health literacy (OHL) level and its influencing factors among key populations in the tertiary industry in Lu'an City, Anhui Province, so as to provide a basis for developing targeted health interventions and improving regional occupational health policies. Methods: A stratified cluster random sampling method was employed to select five categories of key populations from the tertiary industry in Lu'an City as study subjects from August to September 2024. Data on gender, age, education level, and OHL were collected through the National OHL Monitoring Questionnaire for Key Populations. The OHL levels were analyzed, and influencing factors of OHL levels among key populations were analyzed using a multivariable logistic regression model. Results: A total of 1 243 individuals were surveyed, comprising 700 (56.32%) males and 543 (43.68%) females. The median age was 42.00 (interquartile range, 17.00) years. There were 609 individuals with OHL, and the OHL level was 48.99%. The OHL levels in fundamental knowledge of occupational health protection, healthy work styles and behaviors, knowledge of occupational health laws, and basic skills for occupational health protection were 84.71%, 60.34%, 43.93%, and 37.09%, respectively. Multivariable logistic regression analysis showed that educational level (primary school and below, OR=0.149, 95%CI: 0.064-0.344; junior high school, OR=0.340, 95%CI: 0.184-0.629; high school, OR=0.408, 95%CI: 0.230-0.723), average monthly personal income (3 000-<5 000 yuan, OR=1.655, 95%CI: 1.092-2.508; 5 000-<7 000 yuan, OR=2.195, 95%CI: 1.302-3.699; ≥7 000 yuan, OR=2.062, 95%CI: 1.016-4.183), employer nature (private enterprises, OR=2.992, 95%CI: 1.569-5.443), and industry category (education, OR=3.423, 95%CI: 1.407-8.327; courier / food delivery services, OR=0.459, 95%CI: 0.268-0.787; healthcare, OR=7.539, 95%CI: 3.255-17.461) were statistically associated with the OHL level among key population. Conclusion The OHL level among key population in the tertiary industry of Lu'an City can be further enhanced, with educational level, average monthly personal income, employer nature, and industry category identified as the primary influencing factors.

The novel coronavirus(severe acute respiratory syndrome coronavirus 2,SARS-CoV-2),classified as a single-stranded RNA virus,replicates and transcribes its genome through the action of an RNA-dependent RNA polymerase,which is itself comprised of numerous non-structural pro-teins(non-structural proteins,Nsps).The present study delineates the development of a detection system founded on a bicistronic reporter plasmid in conjunction with an array of Nsp plasmids,ai-ming to investigate the influence of SARS-CoV-2 Nsps on the virus's replication and expression profiles.Specifically,a bicistronic reporter gene plasmid along with twelve distinct Nsp plasmids(encompassing Nsp3C-Flag,Nsp4,Nsp6-Nsp10,Nsp12-Nsp16)were meticulously constructed via molecular cloning techniques.The successful expression of these Nsps was subsequently confirmed through Western blot analysis.Initially,the activity of the RNA-dependent RNA polymerase was assessed by co-transfection of the reporter plasmid with Nsp12,in the presence of its auxiliary fac-tors Nsp7 and Nsp8,with careful regulation of the co-transfection ratio,culturing temperature,and the timing of activity determination for the triad of Nsp plasmids.The normalized NLuc fluorescein value,in reference to the FLuc fluorescein value of the housekeeping gene,served as a metric for determining the polymerase activity.Building upon this foundation,the co-transfection concentra-tions of Nsp9-16 were fine-tuned,followed by the incremental addition of varying doses of Nsp3C,Nsp4,and Nsp6,to further elucidate the activity of RNA-dependent RNA polymerase(RdRp).The findings indicated that upon transfection with varying ratios of Nsp7,Nsp8,and Nsp12 at a propor-tion of 1∶8∶24,the polymerase activity was markedly elevated compared to the control group,with a statistical significance level(P＜0.001).Furthermore,in the absence of Nsp3,Nsp4,and Nsp6,the inclusion of Nsp10-16 substantially augmented the activity of the RdRp,particularly in scenarios where Nsp9 was not introduced,achieving statistical significance(P＜0.001).In the pres-ence of Nsp3 and Nsp4,the RdRp activity was augmented further upon the addition of Nsp9,reac-hing a level of significance(P＜0.05).The data imply that Nsp9 is capable of enhancing the RdRp activity of SARS-CoV-2 exclusively in the context of Nsp3 and Nsp4 coexistence,suggesting that the stimulatory influence of Nsp9 on viral replication may be contingent upon the formation of double-membrane vesicles.

Objective To investigate the therapeutic efficacy of dandelion extract on intracerebral hemorrhage(ICH)rats and its effect on nuclear factor erythroid 2 related factor 2(Nrf2)/heme oxygenase-1(HO-1)signaling pathway.Methods Stereotaxic intracranial injection of type Ⅳ col-lagenase was used to establish rat ICH model.Then 48 ICH rats were randomly divided into mod-el group,dandelion extract group,Nrf2 inhibitor(ML385)group and dandelion extract+ML385 group,with 12 rats in each group.Another 12 rats served as sham operation group.After treat-ment,neurological deficits was evaluated and scored for all groups of rats.Blood-brain barrier(BBB)function,neuronal apoptotic rate in the hippocampus,serum levels of COX-2,IL-6 and iNOS,cerebral contents of CAT,GSH-Px,ROS and MAD,and protein levels of Nrf2/HO-1 signal pathway were detected.Results Compared with sham operation group,the neurological deficit score,Evans blue exudation,appptotic rate of hippocampal neurons,serum COX-2,IL-6,iNOS levels,brain tissue reactive oxygen species(ROS)and malondialdehyde level in the model group were significantly increased(P＜0.05),and the expression levels of CAT,GSH-Px,Nrf2 and HO-1 proteins were significantly decreased(P＜0.05).Compared with dandelion extract group,combination of dandelion extract and ML385 significantly increased the neurological deficit score(2.54±0.23 vs 1.43±0.19),Evans blue exudation[(22.15±3.61)ng/mg vs(6.54±1.24)ng/mg],apoptotic rate[(31.97±5.26)％vs(3.51±0.94)％],serum COX-2[(5.82±1.16)ng/ml vs(1.34±0.42)ng/ml],IL-6[(1.47±0.31)ng/ml vs(0.43±0.14)ng/ml]and iNOS levels[(59.91±10.36)U/ml vs(13.94±3.78)U/ml],brain tissue ROS[(4.70±0.45)U/kg vs(1.70± 0.51)U/kg]and MDA levels[(3.72±0.52)nmol/mg vs(1.17±0.34)nmol/mg],and decreased expression levels of CAT[(2.54±0.59)U/mg vs(5.68±1.04)U/mg],GSH-Px[(8.01±0.86)U/mg vs(16.97±3.03)U/mg],Nrf2(0.67±0.13 vs 1.07±0.19)and HO-1(0.55±0.07 vs 0.86± 0.10,P＜0.05).Conclusion Dandelion extract can enhance the antioxidant activity in ICH rats by activating Nrf2/HO-1 signaling pathway,prevent the progression of inflammation and oxida-tive stress,inhibit neuronal apoptosis in hippocampus,repair blood-brain barrier function,and thus improve nerve function.

Objective To explore the relationship between baseline clinical characteristics and hematological parameters of patients undergoing radical resection for pancreatic ductal adenocarcinoma(PDAC)and their prognosis,and to provide references for stratifying the patients'clinical risks.Methods We retrospectively collected clinical data from 445 patients who underwent radical surgical treatment for PDAC at West China Hospital,Sichuan University between January 2010 and February 2019.Then,we conducted retrospective clinical analysis with the collected data.Data on patients'basic clinical characteristics,routine blood test results,and tumor indicators were collected to explore their effects on the postoperative overall survival(OS)of PDAC patients.Cox proportional hazards regression was used to identify factors affecting OS.Statistical analysis was performed using the SPSS 23.0 software package.Results The postoperative median overall survival(mOS)was 17.0 months(95% CI:15.0-19.0).The 1,2,3,4,and 5-year survival rates of the patients included in the study were 60.6%,33.4%,19.1%,12.7%,and 9.6%,respectively.The multivariate Cox proportional hazards model analysis demonstrated that a number of factors independently affect postoperative survival in PDAC patients.These factors include tumor location(hazards ratio[HR]=1.574,95% CI:1.233-2.011),degree of tumor cell differentiation(HR=0.687,95% CI:0.542-0.870),presence of neural invasion(HR=0.686,95% CI:0.538-0.876),TNM staging(HR=1.572,95% CI:1.252-1.974),postoperative adjuvant therapy(HR=1.799,95% CI:1.390-2.328),preoperative drinking history(HR=0.744,95% CI:0.588-0.943),and high serum CA199 levels prior to the surgery(HR=0.742,95% CI:0.563-0.977).Conclusion In PDAC patients,having tumors located in the head of the pancreas,moderate and high degrees of differentiated,being free from local neurovascular invasion,being in TNM stage Ⅰ,undergoing postoperative adjuvant therapy,no history of alcohol consumption prior to the surgery,and preoperative serum CA199 being less than or equal to 37 U/mL are significantly associated with a better prognosis.

Objective To investigate the longitudinal changes in left ventricular(LV)structure and function after bariatric surgery in obese individuals and their relationship with preoperative left ventricular ejection fraction(LVEF)by cardiac magnetic resonance(CMR)imaging.Methods We prospectively enrolled 75 obese subjects scheduled for laparoscopic sleeve gastrectomy and 46 age and sex-matched healthy controls(the control group).All subjects underwent CMR examination to obtain LV structural parameters,LVEF,and strain parameters.According to their preoperative LVEF,the obese subjects were divided into two obesity groups,including the group of patients with LVEF≥60％(n=43)and the group of patients with 50％≤LVEF＜60％(n=32).LV structural and functional differences between the control group and the two obesity groups were compared.Eventually,38 obese subjects completed the CMR follow-up at 1 month and 12 months after bariatric surgery.The longitudinal changes in LV structure and function after surgery in the LVEF ≥ 60％(n=20)group and the 50％≤LVEF＜60％group(n=18)were compared.Results Before bariatric surgery,the global longitudinal strain was significantly lower in the LVEF ≥ 60％group than that in the control group([-18.36±1.86]％vs.[-19.50±1.53]％,P＜0.05).The global radial([27.70±3.52]％vs.[34.44±4.11]％,P＜0.05),circumferential([-17.35±1.46]％vs.[-19.85±1.42]％,P＜0.05),and longitudinal([-16.22±1.81]％vs.[-19.50±1.53]％,P＜0.05)strain in the 50％≤ LVEF＜60％group was significantly lower than that in the control group.At 12 months after bariatric surgery,the global radial([32.52±7.84]％vs.[30.92±4.27]％,P＞0.05),circumferential([-19.02±2.42]％vs.[-18.63±1.49]％,P＞0.05),and longitudinal([-18.18±2.06]％vs.[-17.78±1.66]％,P＞0.05)strain in the LVEF≥60％group showed no significant difference compared with the baseline findings.In the 50％≤ LVEF＜60％group,the global radial([32.73±5.86]％vs.[26.83±4.85]％,P＜0.05)and circumferential([-19.10±2.00]％vs.[-16.91±2.09]％,P＜0.05)strain was significantly higher than that before surgery.Conclusion LV remodeling is reversed after bariatric surgery in obese subjects,and the longitudinal changes in LV structure and function vary with the preoperative LVEF.

Rheumatoid arthritis(RA)is an autoimmune disease with the basic pathological manifestation of synovial inflammation.Symmetric poly-articular pain and swelling are the main symptoms in clinical practice,and even extra-articular manifestations and comorbidities such as interstitial fibrosis and coronary artery disease are triggered,which seriously affect the quality of life of patients.Traditional Chinese medicine(TCM)has achieved good clinical efficacy in the prevention and treatment of RA with the advantages of multi-pathway,multi-target,multi-component,and less toxic side effects,and plays an important role in the treatment of RA.Recently,many studies have demonstrated that Chinese medicine monomers and Chinese herbal compound can control inflammation,reduce angiogenesis,induce apoptosis of synovial fibroblasts,and inhibit their proliferation,invasion and migration by regulating the PI3K/Akt signaling pathway,so as to play a key role in the treatment of RA.For this reason,the article summarizes current knowledge regarding the PI3K/Akt signaling pathway and its role in RA,as well as summarizes the current research progress of TCM in the treatment of RA by regulating the PI3K/Akt signaling pathway.The aim of this review is to provide theoretical bases for the prevention and treatment of RA and the development of new drugs.