Objective To analyze the epidemic characteristics of scarlet fever in Pudong New Area, Shanghai from 2010 to 2023, and to grasp the incidence of scarlet fever in time. Methods The information on the registration of scarlet fever in Pudong New Area, Shanghai from January 1, 2010 to December 31, 2023 was collected through the China Disease Prevention and Control Information System, and descriptive epidemiological methods and Joinpoint regression model were used for data analysis. Results From 2010 to 2023, a total of 5 669 cases of scarlet fever were reported in Pudong New Area, Shanghai, and no deaths were reported. The annual reported incidence rate was 7.2/100 000, and the overall trend was decreasing year by year. In terms of time distribution, the incidence peaks were in spring and winter. The incidence rate in males was higher than that in females, and it mainly affected children, especially those aged 2 to 10 years. Joinpoint regression model analysis showed that the annual percentage change (APC) and average annual percentage change (AAPC) of the reported incidence rate of scarlet fever from 2010 to 2023 showed that the incidence rate was fluctuating, and the incidence rate decreased significantly from 2019 to 2023 (APC was -53.7%). Conclusion The reported incidence rate of scarlet fever in Pudong New Area in Shanghai has decreased year by year from 2010 to 2023, and children remain the focus of prevention and control.

Objective To investigate the therapeutic effect of Huangkui capsules on targeted drug-related proteinuria in patients with hepatocellular carcinoma (HCC). Methods A retrospective analysis was conducted on clinical data of HCC patients with targeted drug-related proteinuria from June 2023 to December 2024 at Zhongshan Hospital, Fudan University. According to the treatment plan, patients were divided into the conventional treatment group and the Huangkui combination treatment group (Huangkui capsules combined with conventional treatment), and the clinical efficacy between the two groups was compared. The logistic regression analysis was used to identify the main factors affecting treatment efficacy. Results The Huangkui combination treatment group (n＝29) showed a significantly higher overall effective rate (79.3% vs 42.3%, P＝0.005), and an earlier proteinuria improvement (median time: 3 months vs 6 months, P＝0.008) than the conventional treatment group (n＝26) . The multivariate logistic regression analysis showed angiotensin-converting enzyme inhibitor (ACEI) or angiotensin Ⅱ receptor blocker (ARB) using (OR＝0.190, 95%CI 0.045-0.808, P＝0.025), targeted drug adjustment (OR＝0.132, 95%CI 0.030-0.581, P＝0.007), and Huangkui capsules using (OR＝0.168, 95%CI 0.039-0.730, P＝0.017) were protective factors for treatment efficacy of targeted drug-related proteinuria. Conclusions On the basis of conventional treatment, additive treatment with Huangkui capsules can alleviate targeted drug-related proteinuria faster and more effectively in HCC patients.

ObjectiveTo investigate the infection characteristics of respiratory syncytial virus (RSV) in children with acute respiratory tract infection (ARI) in Pudong New Area, Shanghai, from 2013 to 2023, so as to provide an evidence for the prevention and control of RSV in Shanghai. MethodsChildren who sought medical care at sentinel healthcare facilities in Pudong New Area, Shanghai, between January 2013 and December 2023 and met the case definition of ARI were included in the study. Nasopharyngeal swab samples were collected and tested for viral pathogens using real-time fluorescene PCR, and the clinical information of whom was collected simultaneously. ResultsA total of 4 980 children were included in the ARI surveillance, among whom 231 tested positive for RSV, with an overall detection rate of 4.64%. Of these, 106 cases were type A and 125 were type B. From 2013 to 2023, the detection rate of RSV in children showed an overall trend of initial increase followed by a decline, with higher detection rates in autumn and winter and lower rates in spring and summer. The RSV detection rate gradually decreased with age, with the highest rate observed in children <1 year old, accounting for 16.33% (80/490) of RSV-detection cases. Cough was the most common clinical symptom. Among the RSV-positive cases, 36 involved co-infection with another virus, 6 co-infected with three viruses, and 1 with mixed infection of four viruses. The most frequent co-infection was RSV and human coronavirus. ConclusionChildren under 1 year of age are more susceptible to RSV infection, with cough being the predominant symptom. RSV infection in Pudong New Area, Shanghai, mainly occurs in winter. Targeted prevention and control measures should be taken for children under 1 year old during the winter season to reduce the risk of both RSV infection and co-infection with human coronavirus and influenza virus.

Objective:To explore the effect of EAERI (E: environment; A: accompany; E: emotion; R: respect; I: information) support strategies in the application of nurse second victims in restoring the passage of a patient safety incident, and to provide support to nurse second victims experiencing a safety incident in restoring the incident and mitigating secondary victimization from the incident.Methods:The method of historical comparison was adopted. A convenience sampling method was used to select nurses who experienced patient safety events in Shanxi Bethune Hospital (Shanxi Academy of Medical Sciences) from January 2023 to February 2024 as the study subjects, which were divided into observation group and control group by the historical control grouping method. The observation group used the EAERI support strategy for patient safety incident reduction, and the control group used the conventional reduction method. The second victims of the nurses in both groups were assessed for their level of harm and support in the patient safety incident using the Second Victim Experience and Support Tool before and after the event reduction, respectively.Results:A total of 124 second victims completed the study. There were 63 cases in the control group, including 13 males and 50 females, with an age of (30.24 ± 4.91) years old. There were 20 males and 41 females in the observation group, with an age of (30.85 ± 5.50) years old. Before the restoration event, there was no significant differences in the total scores of victim experience and support, the degree of injury and the degree of support between the two groups (all P>0.05). The total scores of victim experience and support, the degree of injury and the degree of support were (89.35 ± 10.69), (44.57 ± 6.19), (44.78 ± 9.40) points in the control group, and (64.13 ± 9.36), (33.56 ± 8.84), (30.56 ± 3.17) points in the observation group. The differences were significant between the two groups ( t=14.02, 8.07, 11.29, all P<0.01). Conclusions:The EAERI support strategy is feasible and effective. The implementation of the EAERI support strategy can reduce the degree of injury when the second victim of the nurse restores the safety incident and improve the degree of support.

With the continuous development of imaging techniques such as magnetic resonance imaging,the detection rate of brain metastases is increasing.Although the incidence rate of cystic brain metastasis is far lower than that of solid brain metastasis,patients with cystic brain metastasis are in urgent condition and have obvious space occupying effect,which is an urgent clinical problem.Previous literature has reported that cystic brain metastasis is more common in breast cancer and lung adenocarcinoma,especially in lung cancer patients with positive driver gene.This article reports a case of small cell lung cancer with cystic brain metastasis,which started with neurological symptoms,and was clinically cured under a multidisciplinary diagnosis and treatment model.Through dynamic imaging evaluation and molecular residual lesion detection,the patient can avoid overtreatment and achieved a relatively higher quality of life on the basis of prolonging survival.

Naringenin (4,5,7-trihydroxyflavonoid) is a naturally occurring bioflavonoid found in citrus fruits, which plays an important role in metabolic syndrome, neurological disorders, and cardiovascular diseases. However, the pharmacological mechanism and biological function of naringenin on anti-angiogenesis and anti-tumor immunity have not yet been elucidated. Our study firstly demonstrates that naringenin inhibits the growth of hepatocellular carcinoma (HCC) cells both in vivo and in vitro. Naringenin diminishes the ability of HCC cells to induce tube formation and migration of human umbilical vein endothelial cells (HUVECs) and suppresses neovascularization in chicken chorioallantoic membrane (CAM) assays. Meanwhile, in vivo results demonstrate that naringenin can significantly upregulate level of CD8⁺ T cells, subsequently increasing the level of immune-related cytokines in the tumor immune microenvironment. Mechanistically, we found that naringenin facilitate the K48-linked ubiquitination and subsequent protein degradation of vascular endothelial growth factor A (VEGFA) and mesenchymal-epithelial transition factor (c-Met), which reduces the expression of programmed death ligand 1 (PD-L1). Importantly, combination therapy naringenin with PD-L1 antibody or bevacizumab provided better therapeutic effects in liver cancer. Our study reveals that naringenin can effectively inhibit angiogenesis and anti-tumor immunity in liver cancer by degradation of VEGFA and c-Met in a K48-linked ubiquitination manner. This work enlightens the potential effect of naringenin as a promising therapeutic strategy against anti-angiogenesis and anti-tumor immunity in HCC.

ObjectiveTo investigate the epidemiological characteristics of human parainfluenza virus (HPIV) in Pudong New Area, Shanghai, and to provide a basis for the prevention and control of HPIV infections in this area. MethodsA total of 8 180 cases with acute respiratory infection (ARI)/influenza-like illness (ILI) attending the fever outpatient clinics, pediatric outpatient clinics, respiratory outpatient clinics, pediatric wards, emergency departments, respiratory wards, and intensive care units (ICUs) and other monitoring departments in 9 sentinel hospitals in Pudong New Area from 2017 to 2022 were selected as the research subjects, and their nasopharyngeal/ throat swabs were collected. Polymerase chain reaction (PCR) method was performed for testing the respiratory virus such as influenza virus, human adenovirus, human parainfluenza virus, respiratory syncytial virus (RSV), human enterovirus, rhinovirus, et al. HPIV serotypes were analyzed, and the detection rates of HPIV were compared between different times, seasons, and population groups. ResultsThe overall HPIV detection rate of ARI/ILI cases in Pudong New Area was 3.73% (305/8 180) in 2017‒2022, with HPIV-3 being the predominant serotype. The detection rate of HPIV decreased significantly in 2017‒2022, peaking at 7.66% (99/1 293) in 2017 and falling to 0.80% (13/1 617) in 2021. Statistically significant differences were observed in HPIV detection rates across different years (χ²_trend=80.037, P_trend<0.001). The detection rate was higher in 2017‒2019 than that in 2020‒2022 (χ²_trend=38.990, P_trend<0.001). HPIV exhibited seasonal patterns in 2017‒2019, with higher detection rates in summer and autumn and lower in spring and winter, whereas no seasonal patterns were observed in 2020‒2022. Children aged <6 years had the highest detection rate (7.07%, 139/1 967), followed by adults aged ≥60 years (4.78%, 85/1 779). Statistically significant differences were observed in the detection rates of HPIV among different age groups (χ²=111.210, P<0.001). Symptoms of HPIV infection were predominantly cough, fever, and runny nose in pre-school children, fever, cough, and sore throat in school-age children, and adults, and cough, expectoration, and fever in the elderly. ConclusionThe HPIV detection rate in Pudong New Area was low in 2017‒2022. The seasonal pattern of HPIV circulation in Pudong New Area disappeared in 2020‒2022 due to the influence of infectious disease epidemics. Young children and the elderly should be prioritized in HPIV prevention and control efforts.

Objective To construct a nursing consultation information system based on consultation process and information interaction needs and explore its application effect.Methods The nursing consultation process and information interaction needs were analyzed;the information process,content modules and information interaction interface were designed;the structured records for nursing consultation were developed.The system was officially applied in January 2024.The application effect was evaluated by comparing the completion time of nursing consultations,nursing consultation record quality score,nursing consultation evaluation completion rate,and satisfaction rate before(August 2023 to October 2023)and after(January 2024 to March 2024)the application of the information system.Results After the application of the nursing consultation information system,the implementation rate of nursing consultation for inpatients increased from 1.27％ before the application of the system to 1.47％(P=0.019).The completion time of nursing consultation in the whole hospital reduced from 351(225,421)minutes before the application of the system to 310(156,402)minutes(P＜0.001),and there was a statistically significant difference in the completion time of nursing consultation among the 3 specialties of intravenous therapy,blood purification,and diabetes nursing(P＜0.05).The quality score of nursing consultation records increased from 90.5(82.0,100)points to 95.5(92.0,100)points(P＜0.001).The completion rate of nursing consultation evaluation was higher than those before the system application,with statistical significance(21.6％ vs 78.4％,P＜0.001).Conclusion Nursing consultation information system based on information interaction needs can improve the implementation of nursing consultation for inpatients,shorten the completion time of nursing consultations,improve the writing quality of nursing consultation records and the completion rate of nursing consultation evaluation,and it succeeded in real-time quality monitoring.

Objective To investigate the value of contrast-enhanced ultrasound(CEUS)guided fine needle aspiration(FNA)in diagnosing the nature of type 4 thyroid nodules by thyroid imaging re-porting and data system(TI-RADS).Methods A total of 120 patients with TI-RADS type 4 thyroid nodules were selected as subjects.Sixty patients underwent CEUS-guided FNA(CEUS group),while the other 60 patients underwent conventional ultrasound-guided FNA(conventional ultrasound group).Using pathological results as the gold standard,Kappa consistency tests were used to analyze the diagnostic consistency of conventional ultrasound-guided FNA and CEUS-guided FNA for TI-RADS type 4 thyroid nodules.Results Among 120 patients with TI-RADS type 4 thyroid nodules(138 nodules),85 malignant nodules and 53 benign nodules were confirmed by pathology.In the CEUS group,there were 28 benign nodules and 42 malignant nodules(40 papillary thyroid carcino-mas and 2 medullary carcinomas).In the conventional ultrasound group,there were 25 benign nod-ules and 43 malignant nodules(39 papillary thyroid carcinomas and 4 medullary carcinomas).The false positive rate and false negative rate of conventional ultrasound-guided FNA for diagnosing malignant TI-RADS type 4 thyroid nodules were 3.62％and 5.07％,respectively.For CEUS-guided FNA,the rates were 2.17％and 2.90％,respectively.The sensitivity,specificity and accuracy of con-ventional ultrasound-guided FNA for diagnosing the nature of TI-RADS type 4 thyroid nodules were 83.72％,80.00％and 82.35％,respectively,with Kappa value of 0.627.For CEUS-guided FNA,these values were 90.48％,89.29％and 90.00％,respectively,with Kappa value of 0.793.Based on pathological examination,the diagnostic agreement rates for malignant TI-RADS type 4 thyroid nodules were 79.07％for conventional ultrasound-guided FNA and 83.33％for CEUS-guided FNA,with Kappa values of 0.719 and 0.786,respectively.Conclusion CEUS-guided FNA can provide high-resolution,real-time dynamic imaging information,thereby improving the sensitivity and specificity of diagnosing the nature of TI-RADS type 4 thyroid nodules.

Objective To investigate the impact of hyperuricemia on risk of deep vein thrombo-sis after joint replacement surgery.Methods A total of 953 patients undergoing joint replacement surgery were enrolled in this study.Among them,662 patients did not develop thrombosis postopera-tively(postoperative non-thrombosis group),while 291 patients developed thrombosis(postoperative thrombosis group).Data including gender,age,surgical procedure,body mass index,hypertension,coronary heart disease,diabetes,preoperative D-dimer positivity(≥0.5 mg/L),prothrombin time,prothrombin activity,international normalized ratio,activated partial thromboplastin time,fibrinogen,thrombin time,white blood cell count,red blood cell count,hemoglobin,hematocrit and platelet count were analyzed.Logistic regression analysis was used to identify independent risk factors for postoperative deep vein thrombosis.Results Univariate analysis showed that age,gender,surgical procedure(total knee arthroplasty),hypertension,diabetes,hyperuricemia,preoperative red blood cell count,preoperative hematocrit and preoperative D-dimer positivity were influencing factors for deep vein thrombosis after joint replacement surgery(P＜0.05).Logistic regression analysis re-vealedthat age(＞60 years),surgical procedure(total knee arthroplasty)and hyperuricemia were independent risk factors for postoperative deep vein thrombosis(P＜0.05).Conclusion Hyperuri-cemia is an independent risk factor for deep vein thrombosis after joint replacement surgery.