ObjectiveTo analyze the epidemiological characteristics of a local dengue fever cluster outbreak in Qingpu District of Shanghai in 2024, and to provide a reference for subsequent dengue fever prevention and control. MethodsSeven confirmed local dengue fever cases reported through the National Notifiable Infectious Diseases Surveillance System in Qingpu District of Shanghai in 2024 were selected as the research subjects. Descriptive epidemiological methods were used to conduct investigation and analysis from the aspects of onset, medical treatment and reporting, clinical symptoms, travel and contact history within 15 days before onset, and activity trajectories. ResultsA total of 7 cases were identified in this outbreak. None of the cases had a travel history to dengue-endemic areas within 15 days prior to onset, while all had shared exposure environments and mosquito bite histories, indicating a local clustered transmission pattern. The main clinical manifestations included fever (100.00%) and myalgia (42.86%). All 7 cases were positive for dengue virus serotype 2 (DENV-2) by nucleic acid testing. Genetic sequencing showed that the virus strains belonged to the Cosmopolitan genotype and were most closely related to the epidemic DENV strains circulating in southern China in recent years. ConclusionThis outbreak might be a local secondary infection caused by the short-term stay of dengue fever-infected individuals, and the possible source of importation was dengue fever endemic areas in southern China.

Objective:To investigate the clinical characteristics and genetic etiology of Duchenne muscular dystrophy (DMD) with myogenic tumors.Methods:The clinical data of 2 children with DMD combined with myogenic tumors diagnosed in Children′s Hospital Affiliated to Zhengzhou University in July 2021 and February 2022 were collected. The relevant literature was reviewed to summarize the clinical characteristics and explore the mechanism of the dystrophin ( DMD) gene in myogenic tumors. Results:A 6-year and 10-month-old boy with DMD (deletion of exon 45) and a 12-year-old boy with DMD (deletion of exon 51) were diagnosed with tumors. They were diagnosed with DMD for delayed motor development in the Department of Neurology of Children′s Hospital Affiliated to Zhengzhou University. They presented with painless masses in the waist. Postoperative pathological diagnosis: the pathology and immunohistochemistry of case 1 showed an alveolar rhabdomyosarcoma (ARMS) and both myogenin and myogenic differentiation 1 positive; the pathology and immunohistochemistry of case 2 showed an alveolar soft part sarcoma(ASPS) and transcription factor enhancer 3 positive; both cases were myogenic tumors. Literature review (including this paper) showed that there were in total 14 cases with DMD combined with myogenic tumors including 13 cases of rhabdomyosarcoma (RMS) and 1 case of ASPS. All of them are male, and the age of onset of the tumors was 4-17 years. Pathological subtypes were described in 6 cases of ARMS and 5 cases of embryonal RMS, and were not described in 2 cases. The 9 cases described all had large deletions in the DMD gene which can change the reading frame of the DMD gene, and all gene mutations did not exceed exon 62. Conclusions:DMD gene with deletion may increase the risk of having myogenic tumors, and RMS is more common, which is manifested as painless mass in early stage. All DMD gene deletions do not exceed exon 62 and lead to change of the gene reading frame with severe clinical phenotype and degenerative changes in muscle function.

Objective:To investigate the clinical characteristics of encephalocraniocutaneous lipomatosis (ECCL) in pediatric patients.Methods:A retrospective analysis was conducted on the clinical data of 2 ECCL cases admitted to Children′s Hospital Affiliated to Zhengzhou University between January 2024 and December 2024. Additionally, a review of relevant literature was performed to summarize the clinical features of this condition.Results:Case 1 is a male patient aged 2 years and 10 months, while case 2 is a female patient aged 8 months. Both patients presented with seizures and exhibited nevus psiloliparus on the scalp, non-scarring alopecia, nodular skin tags around the eyes, and ocular choristomas. Brain magnetic resonance imaging revealed leptomeningeal angiomatosis in both cases, with case 1 also demonstrating an intracranial lipoma and case 2 showing localized cerebral atrophy and an arachnoid cyst. Whole-exome sequencing of peripheral blood and copy number variation analysis in both cases did not identify any pathogenic variants. Additionally, no relevant pathogenic variants were detected in the scalp lesion tissue of case 2. A review of the literature revealed that, to date, there have been 5 reported domestic cases, 132 reported foreign cases in pediatric populations, totally 139 cases including 2 cases described in this article. Among these patients, 86 are male, 49 are female, and the gender of 4 cases remains unspecified. Clinical manifestations observed included seizures in 79.0% (64/81) of cases and developmental delay in 64.7% (57/88). Cutaneous lesions were characterized by non-scarring alopecia in 100% (97/97) of cases,non-hair-bearing fatty tissue nevi in 98.3% (58/59), nodular skin tags in 96.5% (56/58), and subcutaneous lipomas in 94.8% (73/77). Ocular lesions predominantly involved choristomas, occurring in 91.8% (90/98) of cases. Central nervous system abnormalities were identified as ventricular dilatation or hydrocephalus in 85.0% (68/80) of cases, intracranial lipomas in 82.1% (69/84), localized cerebral atrophy in 80.9% (34/42), intracranial vascular anomalies in 74.1% (23/31), and spinal lipomas in 66.6% (30/45).Conclusions:ECCL is an uncommon neurocutaneous disorder with the potential to impact various organ systems, notably the integumentary, ocular, and central nervous systems. Pediatric patients may exhibit symptoms such as seizures, developmental delays, and additional clinical manifestations, necessitating vigilant monitoring and management.

Objective To explore the challenges faced by online appointment nurses during nasogastric intubation and to provide a reference for improvement of the quality and safety of the services provided by online appointment nursing.Methods A purposive sampling was employed to select 13 online appointment nurses from our hospital who had previously provided home nasogastric intubation services for patients.Semi-structured interviews were conducted with the online appointment nurses.The results acquired from the interviews were analysed using Colaizzi's method.Results Two themes were identified.Theme 1 covered the increased risks of nasogastric intubation due to the patients themselves and home environment,which included 4 sub-themes of difficulties in identification and response due to complex conditions of patient,high risk of a sudden asphyxia with poor resuscitation facility,psychological stress from unfamiliar home environment,and more challenges in risk identification due to limited conditions for performing home-based intubation procedures;Theme 2 covered the coping strategies of online-scheduled nurses,which included the improvement of knowledge and skills in emergency nursing to improve comfidence and judge ability of intubation,the strengthening of nurse-patient communication to build a trust and cooperation,the conduct of thorough assessment to ensure procedural safety,and the use of alternative tools and collaboration with family members.Conclusion Online appointment nurses face challenges and risks from both of the procedures and patients themselves during home based nasogastric intubation.Hospitals and relevant management should actively implement corresponding strategies,provide training and guidance for online appointment nurses,develop relevant regulations,and improve the management mechanisms of the internet platform to ensure the safety of home based nasogastric intubation for online appointment nurses and improve the quality of the"Internet Plus Nursing Services."

Objective To explore the value of a clinical diagnostic model of heart failure(HF)based on disulfidptosis-related genes.Methods The differentially expressed disulfidetosis-related genes from the training set of Gene Expression Omnibus Series(GSE)57345 were obtained,and then analyzed with Gene Ontology(GO),Kyoto Encyclopedia of Genes and Genomes(KEGG)en-richment analysis,and Metascape disease enrichment analysis.Six male C57BL/6J mice were ran-domly divided into control group(intraperitoneal injection of normal saline)and HF group(intra-peritoneal injection of isoproterenol),with 3 mice in each group.Real-time quantitative PCR was applied to detect the expression levels of key genes.Results GO enrichment analysis revealed that the differentially expressed disulfidetosis-related genes were mainly involved in platelet aggrega-tion and other aspects.KEGG showed they were significantly enriched in tight junctions,vascular smooth muscle contraction and other signaling pathways.Metascape enrichment analysis indicated that these genes were mainly related to focal glomerulosclerosis,glomerular disease,platelet dis-ease,tumor infiltration,nephrotic syndrome and other diseases.The HF group had significantly higher heart weight-to-body weight ratio,and lower ejection fraction,fractional shortening,cardiac output and stroke volume than the control group(P＜0.05,P＜0.01).The cardiac mRNA levels of BNP and MYH10 were significantly higher[1.026±0.501 vs 0.686±0.187,P=0.038;1.469(1.782,2.670)vs 0.360(0.786,1.117),P=0.000],while those of MYL6 and TLN1 was obviously lower(0.575±0.105 vs 1.000±0.202,P=0.027;0.429±0.114 vs 1.000±0.109,P=0.000)in the HF group than the control group.Conclusion Our constructed HF diagnostic model has better di-agnostic performance.

Objective:To investigate the current situation and changing trends of coal-burning-borne endemic fluorosis (coal-burning-borne fluorosis) areas in Henan Province, and evaluate the effectiveness of prevention and control measures.Methods:From 2019 to 2021, monitoring was carried out in all villages affected by coal-burning-borne fluorosis in Henan Province. A simple random sampling method was used to select 30 households in each affected village each year to investigate the use of stoves and the formation of related healthy living behaviors. According to the criteria of "Diagnosis of Dental Fluorosis" (WS/T 208-2011), all children aged 8 to 12 in the affected villages were examined for dental fluorosis. The evaluation for control and elimination of the disease areas was carried out in accordance with the "Evaluation Approach for Control and Elimination of Priority Endemic Diseases (2019 Edition)".Results:From 2019 to 2021, a total of 7 472 households were monitored, the rate of qualified improved stoves were all ≥99.80%, the correct use rate of qualified improved stoves and correct drying of corn and pepper were reached 100%. From 2019 to 2021, the prevalence of dental fluorosis in children was 5.38% (237/4 405), 5.18% (232/4 477), and 3.68% (145/3 937), respectively, showing a declining trend (χ 2trend = 12.73, P < 0.001). The prevalence of dental fluorosis among children in affected villages was less than 15%. From 2019 to 2021, all affected villages in coal-burning-borne fluorosis in Henan Province had met the elimination criteria. Conclusion:Coal-burning-borne fluorosis areas in Henan Province have been continuously eliminated, with significant prevention and control effects, and the disease has been effectively controlled.

Objective:To develop and evaluate the reliability and validity of the Unmet Needs Scale for Middle-aged and Young Women with Gynecological Cancer after Hysterectomy.Methods:Based on the Existence-Relatedness-Growth (ERG) theory, the initial version of the scale was developed through literature review, Delphi expert consultation, and a pilot survey. A total of 684 middle-aged and young women with gynecological cancer who underwent hysterectomy were selected using convenience sampling from three Class ⅢGrade A hospitals in Hebei Province between April and October 2024 for item analysis and psychometric testing.Results:The item-level content validity index ( I- CVI) of the scale ranged from 0.833 to 1.000, and the scale-level content validity index ( S- CVI) was 0.911. Exploratory factor analysis extracted seven common factors, explaining a cumulative variance of 71.083%. Confirmatory factor analysis showed good model fit. The final scale consisted of 45 items across seven dimensions: life needs, emotional needs, disease information needs, economic and medical care needs, needs for love and respect, self-actualization needs, and inner peace needs. Conclusions:The Unmet Needs Scale for Middle-aged and Young Women with Gynecological Cancer after Hysterectomy constructed based on ERG theory demonstrated good reliability and validity, and can serve as a useful tool for clinical assessment of unmet needs in this patient population.

Objective To investigate the prevalence of specific IgE antibodies against Alternaria alternata and Aspergillus fumigatus in serum samples from clinical allergy patients across selected provinces in China.Methods Data on specific IgE antibodies for Alternaria A.and Aspergillus F.were collected from 20 hospital laboratories in 17 cities spanning 11 provinces.The study analyzed the levels of specific IgE and their variations across different provinces and seasons.Results A total of 27 471 cases of Alternaria A.and 32 843 cases of Aspergillus F.specific IgE data were included.The national average positive rate of Alternaria A.IgE was 10.40%,with the highest rate of 22.68%in Jiangsu and the lowest rate of 2.06%in Guangxi.For Aspergillus F.specific IgE,the average positive rate was 4.24%,with Hubei province having the highest rate(7.25%)and Hunan province the lowest(1.23%).The difference in IgE levels for both Alternaria A.and Aspergillus F.among provinces were statistically significant(H=9 955,16 993,all P<0.0001).Among patients,5.85%had Alternaria A.specific IgE levels at grade 3 or above,while only 0.57%had Aspergillus F.specific IgE levels at this level.When examining seasonal variations using data from Liaoning,Hunan and Anhui provinces,significant seasonal changes were observed for both Alternaria A.and Aspergillus F.IgE antibodies(HAlternaria A=347.6,338.0,401.3,HAspergillus F=196.6,133.7,231.7,all P<0.0001).Conclusion The sensitization to Alternaria A.and Aspergillus F.exhibits distinct geographical characteristics and vary significantly with seasons.Given the relatively high IgE levels associated with Alternaria A.,it should be given adequate clinical attention.

Objective:To understand the current situation and problems of general practitioners′ participation in family doctor services in the general hospitals of the tight county medical community (county medical community).Methods:This study was a qualitative study. From February to May 2024, the participants were selected by convenient sampling method from the experimental units of county medical community during the 9th General Practitioner Training Summit Forum organized by the Chinese Medical Doctor Association. The participants included general practitioners from the family doctor service teams of primary healthcare institutions within these county medical community, as well as general practitioners from the county medical community. We conducted semi-structured interviews with the respondents, and finally a total of 22 respondents were selected according to the principle of information saturation. The interview outline was developed based on the problems and needs of general practitioners in the county medical community general hospitals, and the data were analyzed using thematic framework analysis.Results:Twenty-two respondents came from 12 provinces/municipalities and 20 county medical community, including 6 from primary hospitals and 16 from general hospitals. A total of 6 themes and 23 sub-themes were extracted. The six topics are the construction of county medical communities, the establishment of general practice departments, the participation of general practice departments in the signing of family doctors at the grassroots level, the role of general practice departments in county medical communities, the factors influencing general practitioners in county-level general hospitals to perform family doctor signing services at the grassroots level, and the mechanisms that need to be established to promote the development of this work. The majority of the county medical community had been identified and surveyed. All the county general hospitals in this study had independently set up general practice departments, but they faced issues such as staffing shortages, unclear positioning, and insufficient role play, and the majority of them (13/16) did not participate in the family doctor services. General practitioners in general hospitals (5/16) are willing to participate in the primary contracted family doctor services, although the numbers are often insufficient. Restraining reasons include a lack of staff, inadequate capability, not supported by the hospital, poor effect, not demanded from residents, under management from primary healthcare institutions to large-scale medical institutions, and an incomplete assessment. The motivation of general practitioners in county-level general hospitals to participate in the primary contracted family doctor services can be enhanced by establishing relevant working mechanism, guarantee mechanism and incentive mechanisms.Conclusions:At present, the participation of general practitioners in county-level medical community general hospitals in family doctor contract services is seriously inadequate, with problems such as staff shortages, insufficient ability, and lack of hospital support.

Objective:To analyze the healthcare-seeking behavior of patients with knee osteoarthritis (KOA) in the community and its influencing factors.Methods:This was a cross-sectional study. Convenience sampling was used to select KOA patients who visited Fengtai Community Health Service Center from August to December 2022. A self-designed questionnaire was used to collect data on KOA patients and the characteristics of their healthcare-seeking behavior (healthcare-seeking intention and choice of first-contact medical institutions). Factors influencing their healthcare-seeking behavior were analyzed.Results:A total of 222 KOA patients were included, with a mean age of (67.35±9.82) years, and 40.5% (90/222) were male. Sixty-eight patients (30.6%) sought medical care immediately after symptoms appeared, and 154 patients (69.3%) did not. The main reasons for not seeking care immediately were considering the symptoms not serious (40.9%, 63/154) and self-treatment (35.7%, 55/154). Patients aged ≥65 years ( OR=2.413, 95% CI: 1.159-5.024), with a college degree or higher ( OR=3.285, 95% CI: 1.623-6.649), and with good medication adherence ( OR=2.122, 95% CI: 1.088-4.141) were more likely to seek medical treatment promptly after symptoms appeared (all P<0.05). Fifty patients (22.5%) chose primary medical institutions as their first contact. The main factors considered when choosing the first medical institution were the doctor′s competence (57.7%, 128/222) and equipment/facility conditions (55.4%, 123/222). Patients under 65 years old ( OR=0.512, 95% CI: 0.264-0.994), with agricultural household registration ( OR=1.954, 95% CI: 1.017-3.754), and those who had signed up for a family doctor ( OR=2.181, 95% CI: 1.101-4.320) were more inclined to choose primary medical institutions (all P<0.05). Conclusions:KOA patients in the community exhibit different healthcare-seeking behaviors based on their characteristics. The concepts of timely medical consultation and utilizing primary care facilities for initial contact need strengthening. Physicians′ competence and equipment/facility conditions significantly influence patients′ choice of medical institutions.