Objective: To analyze the epidemiological characteristics and influencing factors of severe fever with thrombocytopenia syndrome (SFTS) in Zhejiang Province from 2019 to 2023, so as to provide the reference for strengthening SFTS prevention and control. Methods: Data on laboratory-confirmed SFTS cases in Zhejiang Province from 2019 to 2023 were collected through the Infectious Disease Reporting Information System of Chinese Disease Prevention and Control Information System. Meteorological data, geographic environment and socioeconomic factors during the same period were collected from the fifth-generation European Centre for Medium-Range Weather Forecasts, Geospatial Data Cloud, and Zhejiang Statistical Yearbook, respectively. Descriptive epidemiological methods were used to analyze the epidemiological characteristics of SFTS from 2019 to 2023, and a Bayesian spatio-temporal model was constructed to analyze the influencing factors of SFTS incidence. Results: A total of 578 SFTS cases were reported in Zhejiang Province from 2019 to 2023, with an annual average incidence of 0.23/105. The peak period was from May to July, accounting for 52.60%. There were 309 males and 269 females, with a male-to-female ratio of 1.15∶1. The cases were mainly aged 50-<80 years, farmers, and in rural areas, accounting for 82.53%, 77.34%, and 75.43%, respectively. Taizhou City and Shaoxing City reported more SFTS cases, while Shaoxing City and Zhoushan City had higher annual average incidences of SFTS. The Bayesian spatio-temporal interaction model showed good goodness of fit. The results showed that mean temperature (RR=1.626, 95%CI: 1.111-2.378) and mean wind speed (RR=1.814, 95%CI: 1.321-2.492) were positively correlated with SFTS risk, while altitude (RR=0.432, 95%CI: 0.230-0.829) and population density (RR=0.443, 95%CI: 0.207-0.964) were negatively correlated with SFTS risk. Conclusions SFTS in Zhejiang Province peaks from May to July. Middle-aged and elderly people and farmers are high-risk populations. Taizhou City, Shaoxing City, and Zhoushan City are high-incidence areas. Mean temperature, mean wind speed, altitude, and population density can all affect the risk of SFTS incidence.

Introduction: Malaysian adults consume an average of 2892 mg of sodium daily, exceeding the recommended <2000 mg/day. In response, Malaysia implemented mandatory sodium labelling in 2022; however, compliance with regulatory limits remains uncertain, as discrepancies between laboratory-analysed and label-declared sodium values have been reported internationally. Given the limited local evidence, this study examined sodium labelling compliance in selected processed and ultra-processed foods. Methods: A total of 52 products, including salted packaged nuts, commercially packaged biscuits, and canned fish, of which 8 bore the Healthier Choice Logo (HCL), were analysed. Sodium content was determined using flame atomic absorption spectroscopy, following dry ashing and nitric acid digestion. Compliance was assessed using the <120% regulatory tolerance criterion, primarily applied for enforcement purposes. Results: Only three out of the eight products (37.5%) met the regulatory tolerance criterion for sodium labelling compliance: almond (94.8 vs. 103.6 mg/100 g; label-declared vs. laboratory-analysed sodium), raisin biscuit (245.4 vs. 286.8 mg/100 g), and canned mackerel in tomato sauce (337.0 vs. 365.6 mg/100 g). The remaining products (62.5%) had higher laboratory-analysed sodium than declared. Sodium content did not differ significantly across categories. HCL products generally had lower sodium content than non-HCL products across all categories, although differences were not statistically significant for sweet cookies and canned fish. As HCL certification is voluntary, non-HCL products were also assessed against HCL nutrient criteria; none met all criteria. Conclusion: These findings highlight the need for more rigorous regulatory enforcement and periodic laboratory verification to ensure sodium labelling compliance in Malaysia.

AIM:To observe the changes of atrial fibrillation susceptibility,and the remodeling of atrial myo-cyte action potential,ultrarapid activation delayed rectifier potassium current(IKur)and transient outward potassium cur-rent(Ito)in elderly mice,and to explore the mechanism of atrial fibrillation from the single cell electrophysiological level.METHODS:The C57BL/6J mice were divided into old group(20 months old)and young group(4 months old).Atrial fi-brillation was induced by esophageal atrial pacing.The atrial myocytes were isolated,and action potential and ion currents were recorded with patch-clamp technique.The associated proteins were detected by Western blot technique.RE-SULTS:(1)Compared with young mice,the total incidence of atrial fibrillation was significantly increased in old mice(20.0%at 4 months old vs 60.0%at 20 months old,P<0.01).(2)The action potential duration of atrial myocytes in aged mice was shortened,and more significantly after stimulation.(3)The density of Ito and IKur in atrial myocytes of aged mice increased significantly,from(12.6±1.4)pA/pF to(21.7±1.1)pA/pF,and from(7.5±1.5)pA/pF to(13.3±2.1)pA/pF,respectively(P<0.01).After stimulation,the current increased more significantly,especially in older atrial cells.Compared with the young mice,the steady-state activation curve of Ito in the atrial myocytes of the aged mice shifted towards the depolarization,suggesting that activation of Ito channels in the aged mice increased at the same voltage stimula-tion.(4)Compared with young group,the expression of KV4.2(generating Ito)and KV1.5(generating IKur)proteins in the atrial tissue of the mice in old group was significantly increased,and the expression of caveolin-3 and end-binding protein 1(EB1)was up-regulated,suggesting that the increases in KV4.2 and KV1.5 total channel proteins and effective proteins in the cell membrane might contribute to the increase in the remodeling of potassium currents in the elderly atrial myo-cytes.CONCLUSION:The incidence of atrial fibrillation in elderly mice is significantly augmented,which may be related to the increases in Ito and IKur in atrial myocytes.The remodeling of potassium currents in elderly atrial myocytes is one of the electrophysiological bases leading to the shortening of action potential duration and the occurrence of atrial fibrillation.

Objective To investigate the characteristics of attentional bias towards cancer-related stimuli in breast cancer patients with fear of cancer recurrence(FCR)under subthreshold and suprathreshold stimulus conditions.Methods A total of 94 female breast cancer patients admitted in First Affiliated Hospital of Army Medical University from September 2022 to March 2023 were recruited to complete the Fear of Cancer Recurrence Inventory-Short Form(FCRI-SF)and the dot-probe task.According to the FCRI-SF cut-off score of 13,they were divided into clinical and non-clinical FCR groups,with 47 cases in each group.One-sample t-test and repeated-measures ANOVA were used to statistically analyze the subjects in the 2 groups in terms of attentional bias score,attentional orienting score and attentional disengagement difficulty score.Results The patients in the clinical FCR group showed a significant attentional bias toward cancer-related negative words(P<0.05).Under the subthreshold stimulus condition,its main component was attentional orienting to cancer-related negative words(P<0.05).In the suprathreshold stimulus condition,the main components were attentional orienting to neutral words matched by cancer-related negative words and difficulty in attentional disengagement from cancer-related negative words as well as attentional avoidance for cancer-related positive words(P<0.05).Conclusion Breast cancer patients with clinical FCR have an attentional bias toward cancer-related negative stimuli.Reducing their attention to cancer-related negative stimuli may be an effective measure to reduce FCR level in the patients.

Objective:To investigate the early predictive value of ECG PR interval for the risk of coronary heart disease(CHD) in patients with T2DM.Methods:A total of 7 886 participants from Guiyang who enrolled in the REACTION study between May and August 2011 were included. Baseline data were collected, and participants were followed for 10 years to monitor the occurrence of CHD. Logistic regression was used to identify risk factors for CHD, and a Cox proportional hazards model was employed to assess the predictive value of the PR interval for CHD incidence. Results:Over 10 years of follow-up, the overall incidence of CHD was 4.22%(245/5 812). The incidence was significantly higher in the T2DM group(7.57%, 96/1 268) than in the non-T2DM(3.28%, 149/4 544), and the shortened PR group(3.19%, 36/1 130; all P<0.05). Multiple logistic regression analysis identified both T2DM and prolonged PR interval as significant risk factors for CHD, with HR(95% CI) of 1.98(1.64-2.42) and 1.07(1.04-1.10), respectively(both P<0.01). The Cox proportional hazards model further revealed that the risk of CHD was significantly higher in the prolonged PR group than in the normal PR group, with an HR of 2.82(95% CI 2.34-3.12, P<0.01). Subgroup analysis showed that the risk of CHD was elevated in the non-T2DM with prolonged PR group, T2DM with normal PR group, and T2DM with prolonged PR group compared to the non-T2DM with normal PR group, with HRs(95% CI) of 1.43(1.14-1.82), 2.16(1.78-2.56), and 5.24(3.12-7.94), respectively. A significant interaction was observed between T2DM status and PR prolongation in predicting CHD risk(all P<0.01). Conclusions:Both T2DM and prolonged PR interval are independent risk factors for 10-year CHD incidence. Moreover, an interaction exists between T2DM and prolonged PR interval in predicting CHD risk. The PR interval may serve as an early predictor of CHD risk in patients with T2DM.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective:To investigate the 10-year incidence of reproductive system malignancies and their associated risk factors among overweight and obese women with different metabolic phenotypes aged 40 years and older in Guiyang City.Methods:A total of 6 444 female residents in Yunyan District, Guiyang City were included from the 2011 " Epidemiological Study on the Risk of Malignancy in Chinese Patients with Type 2 Diabetes Mellitus(REACTION)". Based on body mass index(BMI) and the presence or absence of metabolic syndrome(MetS), participants were categorized into four groups: metabolically healthy normal weight(MHNW, n=2 373), metabolically unhealthy normal weight(MUNW, n=1 098), metabolically healthy overweight/obese(MHO, n=2 229), and metabolically unhealthy overweight/obese(MUO, n=744). Baseline data were collected, and participants were followed up for 10 years to document the incidence of female reproductive system malignancies, including breast cancer, ovarian cancer, cervical cancer, and endometrial cancer. Logistic regression models were used to evaluate the association between metabolic phenotype and the 10-year risk of developing reproductive system malignancies. Results:Over a mean follow-up period of (9.89±0.77) years, the overall incidence of reproductive system malignancies was 1.15%(74/6, 444). Baseline characteristics such as age, BMI, high-density lipoprotein-cholesterol(HDL-C), and triglycerides(TG) differed significantly among the groups( P<0.05). The cumulative incidence of reproductive system malignancies in each group was: MHNW 0.93%(22/2 373), MUNW 0.73%(8/1 098), MHO 1.57%(35/2 229), and MUO 1.21%(9/744). There were no statistically significant differences in incidence across the four groups( P>0.05). However, multivariable logistic regression analysis revealed that, compared with the MHNW group, the adjusted HR (95% CI) were: MUNW 0.787(0.349-1.774, P>0.05), MHO 4.835(1.708-13.688, P<0.05), and MUO 3.719(1.144-12.089, P<0.05). Conclusion:Overweight and obesity are significant risk factors for reproductive system malignancies in women aged 40 and above. The presence of metabolic abnormalities in overweight or obese women further increases the risk of developing such malignancies.

OBJECTIVE To explore the time windows for postoperative pneumonia in patients undergoing different surgeries,providing evidence-based references for optimizing infection monitoring and prevention and control strategies.METHODS Sociodemographic characteristics,clinical information and surgical details of 263 patients with postoperative pneumonia from four different types of medical institutions between Jan.2019 and Dec.2024 were retrospectively collected.The time windows for postoperative pneumonia in patients undergoing different surgeries were analyzed.RESULTS There were no statistically significant differences in the time windows for post-operative pneumonia among groups in terms of sociodemographic factors and underlying diseases.However,sta-tistically significant differences were observed in the time windows for postoperative pneumonia based on surgery type,incision type,surgical approach and surgery duration(P＜0.05).The average time for the onset of postop-erative pneumonia in 263 patients was 2.00(1.00,7.00)days.The postoperative time windows varied for sur-geries involving different systems.The peak incidence occurred on day 0(16 cases)and day 1(17 cases)af-ter neurological surgery,while the peak incidence for digestive system and orthopedic surgeries was on day 1.The time span for the onset of pneumonia after skin surgeries was wider(0-53 days postoperatively)without a clear peak.In addition,33.33％of cardiovascular system surgery cases developed pneumonia 10 days postoperatively.There were also significant time differences in the diagnostic elements of postoperative pneumonia,with fever and abnormal white blood cell counts appearing earlier(median appearance time length:4.00 days)than lung imaging changes(median appearance time length:7.00 days).CONCLUSIONS This study demonstrates significant time differences in the on-set of postoperative pneumonia and confirms the significant spatiotemporal heterogeneity in the diagnostic elements of postoperative pneumonia.These findings provide a quantitative basis for developing dynamic,surgery-type-spe-cific monitoring protocols and prevention and control measures for postoperative pneumonia.

Objective:To investigate and analyze the predictive value of inhibin A (INHA), galectin-13 (Gal-13), leucine rich alpha-2-glycoprotein 1 (LRG1) in serum for adverse pregnancy outcomes in pregnant women with gestational diabetes mellitus (GDM) .Methods:From Jan. 2022 to Dec. 2023, 87 GDM pregnant women admitted to Obstetrics Department of Shanxi Children’s Hospital were included as the study group, and were assigned into a good outcome group ( n=54) and an adverse outcome group ( n=33) based on pregnancy outcomes. Meantime, another 87 healthy pregnant women who underwent normal prenatal examinations at our hospital and had no complications were selected as the control group. ELISA method was applied to detect serum levels of INHA, LRG1, and Gal-13. Multiple factor Logistic regression model was constructed to analyze the factors affecting adverse pregnancy outcomes in GDM pregnant women. Receiver operating characteristic (ROC) curves were applied to evaluate the efficacy of the three methods in predicting adverse pregnancy outcomes in GDM pregnant women. Results:Compared with the control group, the levels of INHA and LRG1 in the serum of pregnant women in the study group were obviously higher, and the level of Gal-13 in the serum was obviously lower ( P<0.05). Compared with the good outcome group, the adverse outcome group showed an increase in serum INHA and LRG1 levels and a decrease in serum Gal-13 level ( P<0.05). Elevated levels of serum INHA and LRG1 were risk factors for adverse pregnancy outcomes in GDM pregnant women, while elevated level of serum Gal-13 was a protective factor ( P<0.05). The AUC values for predicting adverse pregnancy outcomes in GDM pregnant women based solely on serum INHA, Gal-13, and LRG1 levels were 0.859, 0.850, and 0.841, respectively. The AUC predicted by the combination of the three factors was 0.978, which was better than the individual predictions of serum INHA, Gal-13, and LRG1 ( Zcombination-HA=2.378, Z combination-Gal-13=3.193, Zcombination-LRG1=3.050, P=0.017, 0.001, 0.002) . Conclusions:Serum levels of INHA and LRG1 are elevated in GDM pregnant women, while serum level of Gal-13 is decreased. All three are potential factors that affect the pregnancy outcomes of GDM pregnant women, and the combination of the three shows higher efficacy in predicting adverse pregnancy outcomes in GDM pregnant women.

Objective:To analyze the symptoms,diagnosis and treatment of upper urinary tract calculi patients combined with mild and moderate benign prostatic hyperplasia(BPH)after ureteral stent implantation.Methods:One hundred and six BPH pa-tients who were hospitalized for upper urinary tract calculi and had ureteral stents retained from January 2019 to December 2022 were selected and divided into 2 weeks group and 4 weeks group according to the time of removal of ureteral stents after surgery.Their gener-al clinical data were analyzed and compared.International Prostatic Symptom Scale(IPSS),postoperative ureteral Stent Symptom Questionnaire(USSQ),and incidence of adverse events after ureteral stent removal were recorded before and after removal.Results:The scores of IPSS were significantly increased in all patients,and symptoms in urinary tract had improved significantly after discharge(P＜0.05).Compared with the 2 weeks group,the USSQ score of the 4 weeks group was significantly increased(P＜0.05).And no significant adverse event was observed in the 2 weeks group after the removal of ureteral sten.Conclusion:IPSS score and USSQ score increased significantly during stent implantation in BPH patients with lithiasis.And complications increased sig-nificantly over time.Following thorough clinical assessment,early ureteral stent removal demonstrates both safety and efficacy,repre-senting an optimal therapeutic approach in selected cases.