Objective: To analyze the characteristics of public health emergencies in schools in Jinhua City, Zhejiang Province from 2015 to 2024, so as to provide the evidence for public health risk management in schools. Methods: Data on public health emergencies in schools in Jinhua City from 2015 to 2024 were collected through the Emergency Public Health Management Information System of China Disease Prevention and Control Information System, including event name, reporting time, region, number of cases, and number of affected persons. A descriptive analysis was conducted on the classification, temporal distribution, regional distribution, school type distribution, and emergency response of public health emergencies in schools. Results: From 2015 to 2024, a total of 221 public health emergencies in schools were reported in Jinhua City, accounting for 73.67% of all public health emergencies. The cumulative number of cases was 9 399, with an attack rate of 3.70%. No deaths were reported. Infectious disease events predominated, accounting for 218 events (98.64%). The top three infectious disease events were other infectious diarrheal diseases, influenza, and varicella, with 110, 59, and 25 events, accounting for 50.46%, 27.06%, and 11.47%, respectively. The reporting peak occurred from November to December, with 56 and 38 events reported, accounting for 25.34% and 17.19%, with seasonal indices of 278.73% and 189.14%, respectively. A secondary peak occurred from March to May, with 25, 28, and 21 events reported, accounting for 11.31%, 12.67%, and 9.50%, with seasonal indices of 124.43%, 139.37%, and 104.52%, respectively. The top three regions by number of reported events were Yiwu City, Wucheng District, and Wuyi County, with 58, 48, and 29 events, accounting for 26.24%, 21.72%, and 13.12%, respectively. Primary schools and childcare centers reported a relatively high number of events, with 116 and 48 events, accounting for 52.49% and 21.72%, respectively. Spearman rank correlation analysis showed that the time from intervention to resolution was positively correlated with the duration of the event for other infectious diarrheal diseases, varicella, and hand, foot, and mouth disease (rS=0.695, 0.607, and 0.729, all P<0.05). Conclusions From 2015 to 2024, public health emergencies in schools in Jinhua City were mainly infectious disease events, with two peaks in winter and spring. They occurred predominantly in primary schools and childcare centers. Priority should be given to the prevention and control of other infectious diarrheal diseases, influenza, and varicella.

Objective To analyze the composition characteristics and biological functions of tumor cell subpopulations in glioblastoma(GBM)through multi-transcriptomics sequencing technology,and explore the hypoxia characteristics and spatial localization features of the mesenchymal-like(MES-like)tumor cell subpopulation in GBM and the influence on malignant biological behaviors.Methods Multi-transcriptomics sequencing data,including single-cell RNA sequencing(scRNA-seq)data(18 patients),bulk RNA sequencing(bulk RNA-seq)and spatial transcriptomics(ST)data of GBM,were employed to define cell subpopulations in GBM,and Gene Ontology(GO)and Gene Set Enrichment Analysis(GSEA)were utilized to analyze their functions.The proportions and locations of cell subpopulations in bulk RNA-seq data were evaluated with BayesPrism deconvolution.Immunofluorescence assay was conducted for verification on 12 paraffin samples of GBM from patients who visited the neurosurgical department of our hospital from 2015 to 2023 and met the pathological diagnostic criteria for GBM(10 males and 2 females,at an average age of 53.50 years and a median age of 54.50 years).pySCENIC was applied to predict specific transcription factors of tumor cell subpopulations.Results Tumor cells in GBM were highly heterogeneous,and could be mainly divided into 4 subpopulations:astrocyte-like(AC-like),neural progenitor-like(NPC-like),oligodendrocyte progenitor-like(OPC-like)and MES-like.Differential gene analysis found that the MES-like tumor cells highly expressed vascular endothelial growth factor A(VEGFA),adrenomedullin(ADM),N-myc downstream regulated 1(NDRG1),insulin like growth factor binding protein 5(IGFBP5),and A-kinase anchoring protein 12(AKAP12)(P<0.001).pySCENIC transcription factor prediction found that the high-active transcription factors of the MES-like tumor cells were AT-rich interaction domain 3A(ARID3A),FOS like 2,AP-1 transcription factor subunit(FOSL2),endothelial PAS domain protein 1(EPAS1),CCAAT enhancer binding protein delta(CEBPD),and CCAAT enhancer binding protein beta(CEBPB)(P<0.05).GO and GSEA enrichment analyses found that the MES-like tumor cells were enriched in hypoxia-related pathways,especially the pathway of cell responses to hypoxia levels(NES=2.437,P<0.001).BayesPrism deconvolution showed that the MES-like tumor cells mainly existed in PAN(Pseudopalisading cells around necrosis)and perinecrotic zone.Immunofluorescence assay confirmed CD44+(CD44 antigen)MES-like tumor cells were mainly located in hypoxia areas with highly expression of hypoxia inducible factor 1 subunit alpha(HIF1α)(P<0.01).Multivariate Cox regression analysis indicated that the MES-like tumor cells were significantly correlated with the adverse prognosis of GBM patients(HR=1.71,95%CI:1.38～2.11,P<0.001).Conclusion Tumor cells in GBM are of highly heterogeneity.They could be mainly divided into 4 subpopulations:AC-like,NPC-like,OPC-like and MES-like.MES-like tumor cells,mainly locating in PAN and perinecrotic zone,are characterized by hypoxia,which can promote the malignant progression of GBM.

OBJECTIVE To analyze the correlation between styloid process related parameters and symptoms in patients with styloid process syndrome.METHODS A retrospective study was conducted on the 3D reconstruction CT results of the styloid process in 68 patients diagnosed with styloid process syndrome who visited the Department of Otolaryngology Head and Neck Surgery,the Second Affiliated Hospital of Xi'an Jiaotong University from January 2010 to December 2024.The relationship between parameters such as styloid process length,angle,distance from styloid process tip to pharynx,and specific symptoms in patients with styloid process syndrome was analyzed.RESULTS Among 68 patients with styloid process syndrome,44 had unilateral symptoms and 24 had bilateral symptoms.The length of the styloid process on the symptomatic side of patients with unilateral symptoms(3.86±0.16)cm was significantly longer than that on the asymptomatic side(2.98±0.17)cm(Z=-2.191,P=0.028);The length of the styloid process on the side with severe symptoms in patients with bilateral symptoms(3.98±0.37)cm was also significantly longer than that in patients with mild symptoms(3.37±0.15)cm(t=2.448,P=0.024).Patients with styloid process syndrome mainly present with pharyngalgia(64.71%,44/68).There were no significant differences in the length,inclination angle,anteversion angle,and distance between the styloid process tip and the pharynx among those with unilateral pharyngalgia(n=29),bilateral pharyngalgia(n=15),and non pharyngalgia(n=24)(P>0.05).However,among the 68 patients with styloid syndrome,12 had calcification of the styloid hyoid ligament,while 56 did not.The incidence of unilateral pharyngalgia was significantly higher in patients with calcification of the styloid hyoid ligament than in patients without calcification(66.7%vs.35.7%,χ2=3.909,P=0.048).CONCLUSION The severity of symptoms in patients with styloid process syndrome is related to the length of the styloid process,and those with calcification of the styloid hyoid ligament are more likely to experience pharyngalgia.

Objective: To analyze the epidemiological characteristics of leptospirosis in Jinhua City, Zhejiang Province, from 2007 to 2024, so as to provide a basis for improving the prevention and control strategies of leptospirosis. Methods: Data pertaining to leptospirosis cases in Jinhua City from 2007 to 2024 were collected through the Monitoring and Reporting Management System of the Chinese Disease Prevention and Control Information System. Descriptive epidemiological methods were used to analyze the distribution characteristics of leptospirosis in terms of time, region, population, interval from the onset of the disease to diagnosis and the outbreak of the epidemic. Results: A total of 81 cases of leptospirosis were reported in Jinhua City from 2007 to 2024, with an average annual reported incidence of 0.08/100 000. The peak incidence occurred from August to September, with 57 cases accounting for 70.37%. Leptospirosis cases were reported in 9 counties (cities, districts) in Jinhua City. Pan'an County reported the most cases, with 52 cases accounting for 64.20%. There were 54 male cases and 27 female cases, with a male-to-female ratio of 2∶1. The majority of cases were aged over 40 years, with 73 cases accounting for 90.12%. The average reported incidence of leptospirosis showed an upward trend with the increase of age (P<0.05), and the highest incidence of leptospirosis was at the 60-<80 age group (0.21/100 000). The majority of patients were farmers, with 77 cases accounting for 95.06%. The median interval from onset to diagnosis was 4.00 (interquartile range, 6.00) days. There were significant differences in the interval from onset to diagnosis among cases in Dongyang City compared with Pan'an County, Wuyi County, and Wucheng District, between Pan'an County and Jindong District, Wucheng District, and between Wuyi County and Wucheng District (all P<0.05). In 2007, one outbreak of leptospirosis was reported, which occurred in Jiuhe Township, Pan'an County, with 36 reported cases. Conclusions The reported incidence of leptospirosis in Jinhua City from 2007 to 2024 is generally low. The high-incidence period is from August to September, and Pan'an County is the high-incidence area. Males over 40 years and farmers are the key populations for prevention and control. It is recommended to strengthen epidemic surveillance and health education for high-risk populations.

Pfeiffer syndrome，an extremely rare autosomal dominant disorder in prenatal settings，is caused by pathogenic variants in Fibroblast Growth Factor Receptor 1（ FGFR1）or Fibroblast Growth Factor Receptor 2（ FGFR2）. In this article，a 33-year-old pregnant woman whose fetus was diagnosed with Pfeiffer syndrome type Ⅱ was reported. Initial ultrasound at 23 +1 weeks revealed temporal skull depression and spinal alignment abnormalities. By 29 +3 weeks，subsequent ultrasound identified additional findings：a cloverleaf-shaped skull，midface hypoplasia，elbow joint fusion，and broad thumb/toe deformities. Fetal MRI confirmed cranial deformities and sacral kyphosis. Postpartum，a CT 3D reconstruction demonstrated craniosynostosis and humeroulnar fusion. Whole exome sequencing（WES）identified an FGFR2 pathogenic variant. This case dynamically illustrates the phenotypic evolution of Pfeiffer syndrome type Ⅱ from subtle to classic triads during gestation，highlighting that multimodal imaging combined with WES enables precise diagnosis and facilitates genetic counseling.

"Clinical microbiology testing technology" is one of the core courses of medical laboratory science (MLS). Clinical microbiology testing enables quick and accurate identification of pathogens causing infectious diseases and provides guidance to the rational use of medications, thereby playing a key role in the diagnosis and treatment of infectious diseases. To address the evolving needs for intelligent testing and to nurture proficient microbiology technologists with self-learning abilities and advanced critical thinking skills, this course has undergone a series of reforms, focusing on content structure, method diversification, and the establishment of a skill-based assessment system. After three years of exploration and practice, an online-offline hybrid teaching mode aimed at improving students' thinking skills was developed. This teaching mode enhanced students' learning and logical thinking abilities and strengthened their professional training, serving as a reference for the reform of MLS courses.

"Clinical microbiology testing technology" is one of the core courses of medical laboratory science (MLS). Clinical microbiology testing enables quick and accurate identification of pathogens causing infectious diseases and provides guidance to the rational use of medications, thereby playing a key role in the diagnosis and treatment of infectious diseases. To address the evolving needs for intelligent testing and to nurture proficient microbiology technologists with self-learning abilities and advanced critical thinking skills, this course has undergone a series of reforms, focusing on content structure, method diversification, and the establishment of a skill-based assessment system. After three years of exploration and practice, an online-offline hybrid teaching mode aimed at improving students' thinking skills was developed. This teaching mode enhanced students' learning and logical thinking abilities and strengthened their professional training, serving as a reference for the reform of MLS courses.

Pfeiffer syndrome，an extremely rare autosomal dominant disorder in prenatal settings，is caused by pathogenic variants in Fibroblast Growth Factor Receptor 1（ FGFR1）or Fibroblast Growth Factor Receptor 2（ FGFR2）. In this article，a 33-year-old pregnant woman whose fetus was diagnosed with Pfeiffer syndrome type Ⅱ was reported. Initial ultrasound at 23 +1 weeks revealed temporal skull depression and spinal alignment abnormalities. By 29 +3 weeks，subsequent ultrasound identified additional findings：a cloverleaf-shaped skull，midface hypoplasia，elbow joint fusion，and broad thumb/toe deformities. Fetal MRI confirmed cranial deformities and sacral kyphosis. Postpartum，a CT 3D reconstruction demonstrated craniosynostosis and humeroulnar fusion. Whole exome sequencing（WES）identified an FGFR2 pathogenic variant. This case dynamically illustrates the phenotypic evolution of Pfeiffer syndrome type Ⅱ from subtle to classic triads during gestation，highlighting that multimodal imaging combined with WES enables precise diagnosis and facilitates genetic counseling.

AIM:To determine the link between infliximab,adalimumab,vedolizumab,ustekinumab and risk of lymphoma in order to provide reference for the safety of clinical application.METHODS:Dis-proportionality analysis and Bayesian analysis were used in data mining to screen the suspected lym-phoma after the use of four biological agents based on the FAERS data from October 2012 to June 2023.The fatality and hospitalization rates of this four biological agents associated lymphoma were also investigated.RESULTS:Totally 705 cases of four biological agents associated lymphoma were collected.Four biological agents associated lymphoma appeared to influent more young pa-tients and middle-aged patients than elderly pa-tients(25.11％vs.22.41％vs.12.2％).There were slightly more male than females(42.84％vs.35.60％).Infliximab has the highest reporting odds ratio[ROR3.40,95％CI=(3.03,3.82)],proportional ratio[PRR3.38,95％CI=(3.01,3.79)],information component(IC1.14,IC-2SD=1.02)and empirical Bayes geometric mean(EBGM2.21,EBGM05=2.01).Significant difference in the fatality rate and hospi-talization rate among four biological agents were not found.CONCLUSION:Infliximab showed a strongest lymphoma association than the other three biological agents.Lymphoma risk should be vigilant when using infliximab.

Objective:To establish a method for the determination of triclocarban (TCC) and triclosan (TCS) in urine by ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) after purification by QuEChERS.Methods:In May 2022, urine samples were extracted by acetonitrile, purified by QuEChERS, separated by Waters Acquity UPLC BEH C18 column (100 mm×2.1 mm, 1.7 μm), and eluated with water-acetonitrile as mobile phase gradient at a flow rate of 0.3 ml/min. The detection was conducted in negative ion mode (ESI -) and multiple reaction monitoring (MRM) scanning, it was quantified with a internal standard method, and the methodology was verified. Results:The linear ranges of TCC and TCS were 0.5-100.0 μg/L and 1.0-100.0 μg/L, and the correlation coefficients were 0.9997 and 0.9991, respectively. The limits of detection and quantitation of TCC and TCS were 0.17 and 0.33 μg/L, and 0.5 and 1.0 μg/L, respectively. The recoveries of TCC and TCS were 100.1%-102.8% and 96.7%-108.6%, and the relative standard deviations were 4.9%-6.7% and 4.1%-8.3%, respectively, at 2.0, 10.0 and 80.0 μg/L.Conclusion:QuEChERS-UPLC-MS/MS method is simple, rapid, sensitive and reproducible, and can be used for rapid and accurate simultaneous detection of TCC and TCS exposure levels in occupational population.