Objective: To investigate the epidemiological and spatio-temporal characteristics of influenza in Jiaxing City, Zhejiang Province, so as to provide insights into perfecting the prevention and control strategies of influenza. Methods: Data of influenza in Jiaxing City from 2019 to 2023 were collected from the Chinese Disease Prevention and Control Information System. Population data of the same period were collected from the Zhejiang Health Information Network Reporting System. The epidemiological characteristics of influenza were analyzed using descriptive analysis. Vector map information was collected from the Open Street Map, and the spatio-temporal clustering characteristics of influenza were analyzed using spatial autocorrelation and spatio-temporal scanning. Results: A total of 181 501 cases of influenza were reported in Jiaxing City from 2019 to 2023, with an average annual reported incidence of 653.93/105. The majority of cases were aged 5 to <15 years (59 785 cases, 32.94%). The majority of the occupations were students (78 239 cases, 43.11%) and pre-school children (33 715 cases, 18.58%). The county (city, district) with the highest reported incidence was Haining City (1 451.70/105), and the town (street) with the highest reported incidence was Chang'an Town (1 932.78/105). Spatial autocorrelation analysis showed that the incidence of influenza in Jiaxing City from 2019 to 2023 had positive spatial correlations (all Moran's I>0, all P<0.05), with a high-high clustering in the southern region. Spatio-temporal scanning analysis showed that there was a spatio-temporal clustering of influenza in Jiaxing City from 2019 to 2023, with the southern region being the primary-type clustering area and the period between November and January of the following year being the clustering time. Conclusion There was a significant spatio-temporal clustering of influenza in Jiaxing City from 2019 to 2023, with winter being the peak season and the southern region being the primary area.

Objective: To investigate the epidemiological characteristics of pertussis in Jiaxing City from 2004 to 2023 and spatio-temporal clustering characteristics from 2022 to 2023, so as to provide insights into formulation of pertussis control measures. Methods: Data of pertussis cases in Jiaxing City from 2004 to 2023 were collected through the Infectious Disease Report Information System of Chinese Disease Prevention and Control Information System. The epidemiological characteristics of pertussis cases in Jiaxing City from 2004 to 2023 were descriptively analyzed, and the spatio-temporal clustering characteristics from 2022 to 2023 were analyzed using spatio-temporal scanning. Results: A total of 478 pertussis cases were reported in Jiaxing City from 2004 to 2023, with an average annual reported incidence of 0.53/105. The reported incidence showed an upward trend from 2004 to 2023 (P<0.05), with the highest in 2022 (3.17/105). Higher incidence of pertussis was reported in June to August (149 cases, 31.17%) and November to December (112 cases, 23.43%). There was no statistically significant difference in the reported incidence between males and females (0.56/105 vs. 0.50/105, P>0.05). The cases aged under one year accounted for the highest proportion, with 199 cases (41.63%). Haining City (0.68/105), Jiashan County (0.64/105) and Tongxiang City (0.60/105) ranked the top three in the reported incidence of pertussis. Spatio-temporal scanning analysis showed that from 2022 to 2023, the primary clustering area of pertussis was centered in Daqiao Town of Nanhu District, covering 27 towns (streets) in Nanhu District, Jiashan County, Xiuzhou District and Pinghu City, and the clustering time was from November to December, 2023. Conclusions The reported incidence of pertussis was at a low level in Jiaxing City, but showed an upward trend from 2004 to 2023. The incidence of pertussis was higher among infants under one year of age, peaked in June to August and November to December, and was concentrated in Nanhu District and its surrounding areas.

Objective: To analyze the surveillance data of schistosomiasis and snail status in Jiaxing City, Zhejiang Province from 2001 to 2024, so as to provide the reference for prevention and control of schistosomiasis in jiaxing City. Methods: Data on schistosomiasis and snail surveillance in Jiaxing City from 2001 to 2024 were collected through schistosomiasis control work reports and the Zhejiang Provincial Schistosomiasis (Parasitic Diseases) Control Information Management System. These data included serological testing results, stool etiological examination (stool examination) results, area surveyed for snails, snail-infested areas, number of snail-positive frames, and number of live snails. Indicators, including the positive rate of serological testing, the positive rate of stool examinations, the rate of snail-positive frames, and the density of live snails were analyzed. The Prophet time series model was employed to forecast the schistosomiasis epidemic in Jiaxing City from 2025 to 2029. Results: A total of 636 493 serological testing were conducted in Jiaxing City from 2001 to 2024, with a positive rate of 1.532%, showing a decreasing trend (P<0.05). Among 7 582 stool examinations, positive cases were all imported, resulting in a positivity rate of 0.066%. During the same period, snail surveys covered a cumulative area of 30 545.999 hm2, with snail-infested areas totaling 69.355 hm2; no significant trend was observed (P>0.05). All snail habitats were identified as recurrent foci within hydrographic network regions, primarily distributed across Xiuzhou District, Nanhu District, Pinghu City, Jiashan County, and Tongxiang City, with snail-infested areas of 39.588, 12.538, 10.728, 4.315, and 2.186 hm2, respectively. From 2009 to 2024, a total of 35 692 134 frames of snails were surveyed, of which 16 543 were snail-positive, yielding a snail-positive frame rate of 0.046%. A total of 33 175 live snails were collected, with a mean density of 0.000 98 snails per frame. No infected Oncomelania snails were detected. The projection results indicated that from 2025 to 2029, the positive rate of serological testing rate in Jiaxing City would range between 0.253% to 0.389%, the snail-infested areas would range from 0.025 to 1.818 hm2, and the density of live snails would vary from 0.001 56 to 0.001 66 snails per frame. None of these indicators showed a significant trend (all P>0.05). Conclusions From 2001 to 2024, the positive rate of serological testing rate of schistosomiasis in Jiaxing City showed a declining trend, with no new autochthonous cases or infected Oncomelania snails detected. However, imported cases were still reported. All identified snail habitats were recurrent foci within hydrographic network regions. It is recommended to enhance schistosomiasis and snail status surveillance in high-risk areas.

Objective:To discuss the promotive effect of nerve growth factor(NGF),which is highly expressed in the adipose-derived stem cell(ADSC)-induced Schwann-like cells(SCLCs),on the growth of dorsal root ganglion(DRG)cell processes in the rats,and to clarify its mechanism.Methods:The ADSCs were extracted from the epididymal adipose tissue of the SD rats,and their multidirectional differentiation potential was identified through osteogenic,adipogenic,and chondrogenic induction.The ADSCs were induced to differentiate into the SCLCs,and the expression levels of glial fibrillary acidic protein(GFAP)and S100 calcium-binding protein β(S100β)protein in the ADSCs and SCLCs were detected by immunofluorescence staining and Western blotting methods.The DRG cells were isolated and cultured,and immunofluorescence staining was used to detect the βⅢ-tubulin expression in the DRG cells for identification.The SCLCs were co-cultured with the DRG cells(co-culture group),the single-culture DRG cells were regared as DRG group and toluidine blue staining was used to observe and measure the length of DRG cell processes under the optical microscope in co-culture group and DRG group.Small interfering RNA(siRNA)transfection was used to knock down NGF,and plasmid transfection was used to over-express NGF.Real-time fluorescence quantitative PCR(RT-qPCR)method was used to detect the NGF mRNA expression levels in the cells in various groups;enzyme-linked immunosorbent assay(ELISA)method was used to detect the NGF protein levels in the cell supernatants.The transfected SCLCs were co-cultured with DRG cells and divided into control group,siNC/vector group,NGF knockdown group(si-NGF group),and NGF over-expression group(oe-NGF group).The lengths of DRG cell processes in various groups were observed.Results:The primary ADSCs adhered within 24 h after seeding,with a small number of lipid droplets remaining.After 3 d of culture,the cells were mostly short spindle-shaped,fusiform,or polygonal,growing rapidly in a vortex pattern.After passaging,the cells exhibited a uniform morphology,appearing as long spindles arranged in a fish-school pattern.After 14 d of adipogenic induction,the cell morphology changed from spindle-shaped to flat-round,with translucent lipid droplets forming in the cytoplasm,which were stained red by Oil Red O.After 28 d of osteogenic induction,the cells appeared sand-like with blurred morphology,and calcified nodules were observed,which were stained red by Alizarin Red and deposited in the extracellular matrix.After 28 d of chondrogenic induction in a 3D culture system,millet-sized chondrogenic spheres formed.Frozen sections of the spheres were stained with Alcian Blue,and acidic mucopolysaccharides in the cartilage tissue were stained blue under the microscope.Under the fluorescence microscope,the third-passage purified ADSCs showed positive expression of CD29[fluorescein isothiocy anate(FITC)-labeled green fluorescence]and CD44(Cy3-labeled red fluorescence).The immunofluorescence staining results showed that GFAP was labeled with FITC(green fluorescence),and S100β was labeled with Cy3(red fluorescence).The Western blotting results showed that compared with ADSCs,the expression levels of S100β and GFAP proteins in the SCLCs were increased(P<0.05).The primary DRG cells began to adhere 6 h after conventional culture,and after 3 d,the cell bodies appeared round and bright,with two linear processes extending from them.Under fluorescence microscope,the cells positively expressed the neuron-specific marker βⅢ-tubulin,confirming that the isolated cells were DRG cells.Compared with the ADSCs,the NGF protein expression level in the SCLCs was increased(P<0.05).Compared with DRG group,the length of DRG cell processes in co-culture group was the highest when DRG cells and SCLCs were co-cultured at a 1∶2 ratio(P<0.05).The RT-qPCR results showed that compared with si-NC group,the expression levels of NGF mRNA in the cell supernatant in si-NGF-1,si-NGF-2,and si-NGF-3 groups were significantly decreased(P<0.05),with si-NGF-1 showing the highest knockdown efficiency,which was selected for subsequent experiments.The ELISA results showed that compared with si-NC group,the NGF levels in the cell supernatant of si-NGF-1,si-NGF-2,and si-NGF-3 groups were decreased(P<0.05).Compared with Vector group,the expression level of NGF mRNA and NGF protein level in the supernatant in oe-NGF group were increased(P<0.05).Compared with control group and siNC/vector group,the length of DRG cell processes in si-NGF group was decreased(P<0.05),while the length of DRG cell processes in oe-NGF group was increased(P<0.05).Conclusion:ADSCs can be directionally differentiated into SCLCs,and the differentiated cells highly express NGF.Knockdown or overexpression of NGF can affect the growth of DRG cell processes.

Objective:To analyze the epidemic characteristics and infection modes of human brucellosis in Jiaxing City, and provide a basis for refining brucellosis prevention and control strategies.Methods:Data on brucellosis epidemic reported in Jiaxing City from January 2021 to December 2023 were collected, and statistical analysis was conducted using descriptive epidemiology method.Results:A total of 122 cases of brucellosis were reported in Jiaxing City from 2021 to 2023, with an average annual incidence rate of 0.74/100 000. Specifically, the incidence rates from 2021 to 2023 were 0.43/100 000, 1.03/100 000 and 0.77/100 000, respectively, showing an upward trend(χ 2trend = 4.38, P = 0.036). The onset time was mainly from March to August(88 cases). The cases of brucellosis were mainly distributed in Tongxiang City (102 cases). The incidence rate of male (2.98/100 000) was higher than that of female (1.41/100 000, χ 2 = 15.00, P < 0.001). The age of onset was concentrated in 40 - 69 years old (100 cases), the incidence rate of 60 - 69 years old was higher (5.50/100 000). The main modes of infection among occupational population (72 cases) were slaughtering sheep and handling sheep scraps, accounting for 18.03% (22/122) and 17.21% (21/122), respectively. The main modes of infection for non-occupational population (46 cases) were cleaning and cooking of infected lambs and exposure to contaminated environments from diseased sheep, both accounting for 18.03% (22/122). Among them, the proportion of patients with the disease through cleaning and cooking infected lambs showed an increasing trend year by year (χ 2trend = 9.44, P = 0.002). The average time interval between the onset and diagnosis of brucellosis in patients was 20 (10, 40) d. The positive detection rate of standard tube agglutination test (SAT) in Brucella serological test was 67.88% (93/137), and the identification results of all case strains through pathogenic test were Brucella melitensis. Conclusions:The incidence rate of human brucellosis in Jiaxing City from 2021 to 2023 has shown an upward trend. The main population affected by the disease is occupational, but the proportion of non-occupational patients is increasing. Currently. It is suggested that targeted measures should be formulated for non-occupational population while implementing the prevention and control measures for occupational population.

OBJECTIVE To evaluate the innovation and sustainable development ability of traditional Chinese medicine(TCM) preparation in medical institutions, and to provide reference for the decision-making of administrative departments and the sustainable development of TCM preparation in hospitals. METHODS Based on the information data of 133 medical institutions in Zhejiang Province, analytic hierarchy process was used to construct the evaluation system of innovation and sustainable development ability of TCM preparation of medical institutions, and the prediction model of evaluation system of TCM preparation room/center was built by back propagation neural network. RESULTS The evaluation index system for innovation and sustainable development of TCM preparations in medical institutions included 4 second-level indexes and 19 third-level indexes. Among them, the number of varieties developed, the number of over one million varieties, the number of registered varieties, the way of research and development, and the area of preparation room had higher weight values, which were 0.15758, 0.12928,0.09343, 0.07879 and 0.07458, respectively. The entropy weight method and analytic hierarchy process index weights were used to construct the back propagation neural network. The overall correlation coefficients of the training models of the Levenberg-Marquardt algorithm and the Scaled Conjugate Gradient algorithm were 0.98983 and 0.93480, respectively. CONCLUSION This study establishes a scientific and effective comprehensive evaluation system for the innovation and sustainable development ability of TCM preparations in medical institutions, which can realize the prediction and evaluation of the comprehensive ability of TCM preparations in medical institutions.

Objective To explore the role of clinical pharmacists involved in the case of a patient with acute myeloid leukemia whose QTc interval prolongation was induced by gilteritinib,and to provide reference for drug treatment and monitoring of those patients.Methods The abnormal electrocardiogram(ECG)of a patient with acute myeloid leukemia was found in time by clinical pharmacists,who participated in clinical diagnosis and treatment by analyzing the patient's underlying diseases,diagnosis and treatment process,therapeutic drugs and their potential interactions.Results Clinical pharmacists suspected that the prolonged QTc interval was likely to be an adverse reaction caused by gilteritinib,and recommended immediate discontinuation of the drug and re-examination of the electrocardiogram.The physician took the suggestion to stop the suspected drug therapy with gilteritinib promptly,and ECG was rechecked 3 d later,and the QTc value returned to the normal range.Conclusion Clinical pharmacists participating in clinical diagnosis and treatment could provide better pharmaceutical care for patients.

Objective To investigate the effects of denosumab(DEN)and alendronate(AL)on bone mineral density(BMD)around the prosthesis after total hip arthroplasty(THA).Methods A retrospective analysis was conducted on the clinical data of primary osteoporosis(POP)patients who underwent THA at the Affiliated Jinhua Hospital of Zhejiang University School of Medicine from March 2022 to March 2023,the patients were divided into the DEN group and the AL group according to the postoperative protocols.The main observation index was the bone density around the implant(Gruen zone:1st and 7th zones;time points:postoperative day 5(T1),6 months(T2),and 12 months(T3);detection method:dual-energy X-ray absorptiometry).The secondary observation index was the bone metabolism index(bone calcitonin(OC),β-collagen special sequence(β-Crosslaps),and type 1 procollagen N-terminal peptide(P1NP);time points:preoperative(T4),6 months(T2),and 12 months(T3);detection method:enzyme-linked immunosorbent assay).Results A total of 120 patients were included in the study,with 59 in the DEN group and 61 in the AL group.At baseline,there was no statistically significant difference in serum OC,β-Crosslaps and P1NP levels between the two groups(P＞0.05).Periprosthetic BMD showed a decreasing trend in both groups,and periprosthetic BMD was higher in the DEN group than in the AL group in both Gruen zone 1 and Gruen zone 7 at the T2 and T3 time points(P＜0.05).In terms of bone transformation markers,serum OC,β-Crosslaps and P1NP levels showed decreasing trends with prolonged treatment time in both groups(P＜0.05).In addition,serum OC,β-Crosslaps and P1NP levels were significantly lower in the DEN group than in the AL group at T2 and T3 time points(P＜0.05).Conclusion Compared with AL,DEN is more effective in preventing periprosthetic bone loss of the proximal femur and has a better safety profile.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective To investigate the protective effect and mechanism of glutathione peroxidase 3-(GPx3)modified mesenchymal stem cells(MSC)against radiation-induced lung injury(RILI).Methods GPx3-modified MSCs were injected into the tail vein of mice whose lungs were irradiated with 20 Gy.Lung tissues were collected and sections were stained to observe pathological changes.The expression levels of inflammation-related factors were detected by real time quantitative PCR(qPCR),while the levels of malondialdehyde(MDA),H2O2,and 8-hydroxyguanine(8-OHG)were detected via biochemical experiments.Additionally,RNA damage was assessed by reverse transcription blocking combining with double primer PCR.Results GPx3-modified MSCs significantly improved the pathological damage in post-radiation lung tissues and inhibited the fibrosis process and inflammatory response.GPx3-modified MSCs were able to scavenge reactive oxygen species(ROS)more effectively,resulting in a reduction of lipid peroxidation products such as MDA and oxidative damage to RNA formation of 8-OHG.Conclusion By decreasing ROS accumulation,GPx3-modified MSCs can potentially reduce oxidative damage and attenuate RILI.GPx3-modified MSCs can improve the therapeutic efficacy against RILI.