Objective To investigate the epidemiological characteristics of imported malaria cases in Shanghai Municipality from 2020 to 2024, so as to provide insights into dynamic adjustment of imported malaria control strategies. Methods All data pertaining to malaria cases reported in Shanghai Municipality from 2020 to 2024 were collected from Infectious Diseases Reporting Information Management System and Parasitic Diseases Prevention and Control Information Management System of Chinese Center for Disease Control and Prevention, and epidemiological investigation reports of malaria cases. The type of malaria cases, source of acquiring infections, temporal, spatial and population distributions of malaria cases, type of initial diagnosis institutions, accuracy of initial diagnosis, time interval from disease onset to initial diagnosis, and the time interval from initial diagnosis to diagnosis were statistically analyzed. The monthly distribution of malaria cases was analyzed using a circular distribution method. Results A total of 124 malaria cases were reported in Shanghai Municipality from 2020 to 2024, with 14, 52, 22, 8 and 28 cases annually, respectively, and all cases were overseas imported cases. Plasmodium falciparum malaria was the predominant type, accounting for 82.26% (102/124) of all malaria cases, while P. ovale, P. vivax and P. malariae malaria accounted for 8.06% (10/124), 7.26% (9/124) and 2.42% (3/124) of reported cases, respectively. Malaria cases acquired infections from 28 countries in 4 continents, with African countries as a major source of acquiring infections (96.77%, 120/124). Malaria cases were reported across all 16 districts in Shanghai Municipality. There were peaks in numbers of reported malaria cases in May 2021 (9 cases) and November 2021 (9 cases); however, there was no concentration trend in the reporting time of malaria cases from 2020 to 2024 (Z = 2.45, P > 0.05). The reported malaria cases included 116 males and 8 females, with a male-to-female ratio of 14.5∶1.0, and had a median age of 39 (17) years. Worker was the primary occupation of reported malaria cases, accounting for 48.39% (60/124) of all reported cases. City-level medical institutions were the predominant initial diagnosis institutions (75.81%, 94/124). The overall accuracy of initial diagnosis was 74.19% (92/124), and the median time interval from disease onset to initial diagnosis was 0 (2) day (healthcare seeking on the day of disease onset), with 72.58% (90/124) of malaria cases seeking healthcare services within one day. The median time interval from initial diagnosis to diagnosis was 2 (3) days, with 41.94% (52/124) of malaria cases that were definitively diagnosed within one day following initial diagnosis. There were significant differences in the accuracy of initial malaria diagnosis (χ² = 15.01, P < 0.05), the time interval from disease onset to initial diagnosis (H = 29.30, P < 0.001), and the time interval from initial diagnosis to diagnosis (H = 22.92, P < 0.001) among years from 2020 to 2024, and the time interval from disease onset to initial diagnosis (Z = -5.09, P < 0.001) and the time interval from initial diagnosis to diagnosis (Z = -4.14, P < 0.001) were both shorter during the period from 2020 to 2022 than those recorded from 2023 to 2024. In addition, a total of 2 malaria deaths were reported in Shanghai Municipality during the period from 2020 to 2024, both caused by P. falciparum malaria. Conclusions The numbers of malaria cases fluctuated continuously in Shanghai Municipality from 2020 to 2024. It is recommended to continuously strengthen surveillance and response measures, improve malaria diagnosis and treatment capabilities, and conduct targeted health education activities among high-risk populations, such as labors going to overseas malaria hyper-endemic areas, so as to prevent re-establishment of imported malaria.

ObjectiveTo elucidate the critical role of rehabilitation medical records (including electronic records) in rehabilitation medicine's clinical practice and management, comprehensively analyzed the structure, core content and data standards of rehabilitation medical records, to develop a standardized medical record data architecture and core dataset suitable for rehabilitation medicine and to explore the application of rehabilitation data in performance evaluation and payment. MethodsBased on the regulatory documents Basic Specifications for Medical Record Writing and Basic Specifications for Electronic Medical Records (Trial) issued by National Health Commission of China, and referencing the World Health Organization (WHO) Family of International Classifications (WHO-FICs) classifications, International Classification of Diseases (ICD-10/ICD-11), International Classification of Functioning, Disability and Health (ICF), and International Classification of Health Interventions (ICHI Beta-3), this study constructed the data architecture, core content and data standards for rehabilitation medical records. Furthermore, it explored the application of rehabilitation record summary sheets (home page) data in rehabilitation medical statistics and payment methods, including Diagnosis-related Groups (DRG), Diagnosis-Intervention Packet (DIP) and Case Mix Index. ResultsThis study proposed a systematic standard framework for rehabilitation medical records, covering key components such as patient demographics, rehabilitation diagnosis, functional assessment, rehabilitation treatment prescriptions, progress evaluations and discharge summaries. The research analyzed the systematic application methods and data standards of ICD-10/ICD-11, ICF and ICHI Beta-3 in the fields of medical record terminology, coding and assessment. Constructing a standardized data structure and data standards for rehabilitation medical records can significantly improve the quality of data reporting based on the medical record summary sheet, thereby enhancing the quality control of rehabilitation services, effectively supporting the optimization of rehabilitation medical insurance payment mechanisms, and contributing to the establishment of rehabilitation medical performance evaluation and payment based on DRG and DIP. ConclusionStructured rehabilitation records and data standardization are crucial tools for quality control in rehabilitation. Systematically applying the three reference classifications of the WHO-FICs, and aligning with national medical record and electronic health record specifications, facilitate the development of a standardized rehabilitation record architecture and core dataset. Standardizing rehabilitation care pathways based on the ICF methodology, and developing ICF- and ICD-11-based rehabilitation assessment tools, auxiliary diagnostic and therapeutic systems, and supporting terminology and coding systems, can effectively enhance the quality of rehabilitation records and enable interoperability and sharing of rehabilitation data with other medical data, ultimately improving the quality and safety of rehabilitation services.

ObjectiveTo systematically analyze the global policy framework, standard systems and application technology models of digital rehabilitation within the framework of the World Health Organization (WHO) Global Digital Health Strategy and propose policy recommendations for the future development of digital rehabilitation. MethodsBased on the policies on digital health and rehabilitation development issued by the WHO, focusing on the Global Digital Health Strategy, Rehabilitation 2030 Initiative, Rehabilitation in Health Systems, Rehabilitation in Health Systems: A Guide for Action, and World Report on Disability, a systematic review was conducted, to explore the policy architecture and core content of digital rehabilitation, the standard system for digitalizing rehabilitation, and key technological models for the development of digital rehabilitation. ResultsIn the context of global health and digital transformation, the development of digital rehabilitation services was an essential component of the global digital health strategy. Building a comprehensive policy framework and content system for digital rehabilitation was critical for strengthening rehabilitation data governance, enhancing data utilization efficiency, and ensuring data privacy and security. Empowering rehabilitation with digital technology was vital for improving the standardization, effectiveness, coverage, quality and safety of rehabilitation services. International digital rehabilitation policies primarily involved the following areas: policy and governance, digital standard systems, data privacy, security and ethics, digital talent cultivation and capacity building, and monitoring, evaluation and continuous improvement of digitally empowered rehabilitation services. The standard system for rehabilitation digitization covered the three major reference classifications of the WHO Family of International Classifications, including International Classification of Diseases Eleventh Revision (ICD-11), International Classification of Functioning, Disability and Health (ICF), and International Classification of Health Interventions (ICHI), especially ICF. It also included international data interoperability standards, data security and privacy protection standards, data quality and certification standards, and health information standards, etc. The application technology models of digital rehabilitation primarily included data-driven service models, artificial intelligence -enabled models, and remote rehabilitation models combined with virtual reality, augmented reality technologies, and Internet of Things support. ConclusionThe establishment and implementation of comprehensive policies, standards and technological models for digital rehabilitation are crucial for driving the digital transformation and development of global rehabilitation services. Under the framework of the WHO Global Digital Health Strategy, it is necessary to build adaptive digital rehabilitation policy frameworks, and enhance digital governance capabilities and levels, establishing and improving digital rehabilitation standard systems, and promoting the interoperability and integration of rehabilitation data with other health big data. Meanwhile, it is essential to actively develop data-driven technological models for rehabilitation services to comprehensively improve the accessibility, availability, quality and safety of rehabilitation services.

Objective To evaluate the efficacy of non-ablative vaginal erbium-doped yttrium aluminum garnet(Er:YAG)laser therapy in improving symptoms in women with mild-to-moderate stress urinary incontinence(SUI).Methods A prospective,multicenter,randomized controlled trial was conducted.A total of 126 female SUI patients were enrolled and randomized in a 2∶1 ratio to the treatment group(n=84,receiving Er:YAG laser therapy)and the sham control group(n=42,undergoing non-energized laser device with shielded beam).Efficacy outcomes were compared between the two groups,including the International Consultation on Incontinence Questionnaire-Short Form(ICI-Q-SF)scores at baseline and 1,3,6 months after treatment,response rate 3 month after treatment,urine leakage volume,daily incontinence episodes and visual analog scale(VAS).Results One month and 3 months after treatment,the ICI-Q-SF scores in the treatment group(8.07±3.33 and 7.04±3.04,respectively)were significantly lower than those in the control group(9.57±4.03 and 9.65±3.27,respectively;both P＜0.05).The 3-month response rate was significantly higher in the treatment group(71.43％)compared to the control group(35.71％,P＜0.05).Improvements in urine leakage volume 1 and 3 months after treatment were significantly greater in the treatment group versus the control group(both P＜0.05).A statistically significant reduction in daily incontinence episodes was observed in the treatment group 1 month after treatment compared to the control group[2(0,5)times vs.4(2,8)times,P＜0.05].VAS score in the treatment group markedly decreased 1 month after treatment,comparable to the level observed in the control group[0(0,2.45)vs.0(0,0),P＜0.05].Conclusion Non-ablative vaginal Er:YAG laser therapy significantly alleviates symptoms in women with mild-to-moderate SUI and represents a viable treatment option for this condition.

Objective: To investigate the regional differences in the incidence of urothelial carcinoma among kidney transplant recipients between northern and southern China，so as to provide reference for early diagnosis of this disease. Methods: A comprehensive search was conducted across multiple databases，including CNKI，Wanfang，CBM，and PubMed，using the keywords “kidney transplantation” and “tumor” to collect clinical data from qualified kidney transplant centers.The latest and most complete literature data published by 17 transplant centers in northern China and 14 in southern China were included.Statistical analyses were performed to compare the incidence of post-transplant urothelial carcinoma and non-urothelial malignancies. Results: A total of 37 475 kidney transplant recipients were included，among whom 837 (2.23%) developed post-transplant malignancies，including urothelial carcinoma (366/837，43.73%)，non-urothelial carcinoma (444/837，53.05%)，and malignancies with unspecified pathology (27/837，3.23%).The incidence of malignancies was significantly higher in northern China than in southern China [(2.82±1.39)% vs. (1.67±0.83)%，P=0.011]，with a particularly pronounced difference in the incidence of urothelial carcinoma [(1.68±1.12)% vs. (0.32±0.32)%，P<0.001].No significant difference was observed in the incidence of non-urothelial carcinoma between the two regions [(1.11±0.56)% vs. (1.35±0.65)%，P=0.279].Additionally，female transplant recipients exhibited a higher incidence of malignancies than males in both regions (southern China：2.38% vs. 1.80%; northern China：8.93% vs. 2.52%). Conclusion: The incidence of urothelial carcinoma following kidney transplantation is significantly higher in northern China than in southern China，underscoring the importance of implementing regular tumor screening for kidney transplant recipients，particularly for female patients in northern China，to facilitate early diagnosis and timely intervention.

Interleukin-17 (IL-17) and its receptor family members are involved in a variety of pathophysiological processes.Studies have shown that the IL-17 family may be closely related to the occurrence and development of interstitial cystitis/ bladder pain syndrome (IC/BPS).This paper explores the relationship between the IL-17 family and IC/BPS, introduces the members and structures of the IL-17 family, their value in inflammatory diseases, and discusses in depth the IL-17 pathways in IC/BPS and the latest research progress.Research has found that the IL-17 family is upregulated in IC/BPS, related to the exacerbation of pathological inflammatory reactions, and responsible for maintaining the chronic inflammatory state of IC/BPS patients.In addition, IL-17 is also associated with neuroinflammation, pain, and other biological effects in IC/BPS.This review aims to deepen the understanding of the mechanisms underlying IC/BPS and to provide references for the development of new therapeutic strategies.

Objective:To investigate alterations in brain function among elderly patients with interstitial cystitis/bladder pain syndrome(IC/BPS)during the resting state.Methods:We prospectively recruited seven elderly patients with IC/BPS admitted to the Urology Department of Beijing Hospital from December 2023 to May 2024 as the experimental group, and concurrently selected twelve elderly healthy individuals as the control group.After enrollment, all participants underwent resting-state functional magnetic resonance imaging(rs-fMRI)scans.General clinical data, including age and gender, as well as standardized assessment scores from the Interstitial Cystitis Symptom Index(ICSI), Interstitial Cystitis Problem Index(ICPI), Visual Analogue Scale(VAS), Self-Rating Anxiety Scale(SAS), and Self-Rating Depression Scale(SDS), were collected.The data were processed using Matlab.This study employed a paired sample t-test to analyze the differences in gray matter volume between the two groups.The functional activities of the subjects' brains were analyzed using regional homogeneity(ReHo)and low-frequency amplitude(ALFF)algorithms.Based on the identified abnormal brain regions, further functional connectivity(FC)analysis was conducted to explore the connectivity patterns among the functional brain regions.Results:No significant differences were observed in age( t=-0.68, P=0.536)or gender( χ2=0.019, P=0.891)between the experimental group and the control group.The scores of SAS and SDS in the experimental group were significantly higher than those in the control group( P<0.001).No significant difference was observed in cerebral gray matter volume between the two subject groups.In contrast to the control group, the ALFF value of the left superior parietal lobe(MNI: x, y, z=-21, -66, 60; t=12.530 5)was elevated in elderly patients with IC/BPS, and the ReHo value of the left precuneus(MNI: x, y, z=-9, -54, 63; t=9.410 3)was also increased.Through FC analysis, it was revealed that elderly IC/BPS patients exhibited significantly lower FC values between the left superior parietal lobule and the central sulcus(MNI: x, y, z=21, 15, 3; t=-27.835 6), as well as between the left anterior cingulate and the left posterior cingulate gyrus(MNI: x, y, z=-12, 0, 42; t=-8.738 9)in comparison with the control group. Conclusions:In contrast to normal individuals, elderly IC/BPS patients demonstrate functional aberrations in the left superior parietal lobule and the left precuneus.Moreover, a decrease in functional connectivity is observed between the left superior parietal lobule and the central sulcus, as well as between the left precuneus and the left posterior cingulate gyrus.These abnormal functional alterations in the brain may be implicated in the maintenance and development of symptoms in IC/BPS patients.This study conducted research from the perspective of central nervous system regulation, presenting possible directions for further exploration of the pathophysiological mechanisms of IC/BPS.

Objective To evaluate the efficacy of non-ablative vaginal erbium-doped yttrium aluminum garnet(Er:YAG)laser therapy in improving symptoms in women with mild-to-moderate stress urinary incontinence(SUI).Methods A prospective,multicenter,randomized controlled trial was conducted.A total of 126 female SUI patients were enrolled and randomized in a 2∶1 ratio to the treatment group(n=84,receiving Er:YAG laser therapy)and the sham control group(n=42,undergoing non-energized laser device with shielded beam).Efficacy outcomes were compared between the two groups,including the International Consultation on Incontinence Questionnaire-Short Form(ICI-Q-SF)scores at baseline and 1,3,6 months after treatment,response rate 3 month after treatment,urine leakage volume,daily incontinence episodes and visual analog scale(VAS).Results One month and 3 months after treatment,the ICI-Q-SF scores in the treatment group(8.07±3.33 and 7.04±3.04,respectively)were significantly lower than those in the control group(9.57±4.03 and 9.65±3.27,respectively;both P＜0.05).The 3-month response rate was significantly higher in the treatment group(71.43％)compared to the control group(35.71％,P＜0.05).Improvements in urine leakage volume 1 and 3 months after treatment were significantly greater in the treatment group versus the control group(both P＜0.05).A statistically significant reduction in daily incontinence episodes was observed in the treatment group 1 month after treatment compared to the control group[2(0,5)times vs.4(2,8)times,P＜0.05].VAS score in the treatment group markedly decreased 1 month after treatment,comparable to the level observed in the control group[0(0,2.45)vs.0(0,0),P＜0.05].Conclusion Non-ablative vaginal Er:YAG laser therapy significantly alleviates symptoms in women with mild-to-moderate SUI and represents a viable treatment option for this condition.

Objective:To investigate alterations in brain function among elderly patients with interstitial cystitis/bladder pain syndrome(IC/BPS)during the resting state.Methods:We prospectively recruited seven elderly patients with IC/BPS admitted to the Urology Department of Beijing Hospital from December 2023 to May 2024 as the experimental group, and concurrently selected twelve elderly healthy individuals as the control group.After enrollment, all participants underwent resting-state functional magnetic resonance imaging(rs-fMRI)scans.General clinical data, including age and gender, as well as standardized assessment scores from the Interstitial Cystitis Symptom Index(ICSI), Interstitial Cystitis Problem Index(ICPI), Visual Analogue Scale(VAS), Self-Rating Anxiety Scale(SAS), and Self-Rating Depression Scale(SDS), were collected.The data were processed using Matlab.This study employed a paired sample t-test to analyze the differences in gray matter volume between the two groups.The functional activities of the subjects' brains were analyzed using regional homogeneity(ReHo)and low-frequency amplitude(ALFF)algorithms.Based on the identified abnormal brain regions, further functional connectivity(FC)analysis was conducted to explore the connectivity patterns among the functional brain regions.Results:No significant differences were observed in age( t=-0.68, P=0.536)or gender( χ2=0.019, P=0.891)between the experimental group and the control group.The scores of SAS and SDS in the experimental group were significantly higher than those in the control group( P<0.001).No significant difference was observed in cerebral gray matter volume between the two subject groups.In contrast to the control group, the ALFF value of the left superior parietal lobe(MNI: x, y, z=-21, -66, 60; t=12.530 5)was elevated in elderly patients with IC/BPS, and the ReHo value of the left precuneus(MNI: x, y, z=-9, -54, 63; t=9.410 3)was also increased.Through FC analysis, it was revealed that elderly IC/BPS patients exhibited significantly lower FC values between the left superior parietal lobule and the central sulcus(MNI: x, y, z=21, 15, 3; t=-27.835 6), as well as between the left anterior cingulate and the left posterior cingulate gyrus(MNI: x, y, z=-12, 0, 42; t=-8.738 9)in comparison with the control group. Conclusions:In contrast to normal individuals, elderly IC/BPS patients demonstrate functional aberrations in the left superior parietal lobule and the left precuneus.Moreover, a decrease in functional connectivity is observed between the left superior parietal lobule and the central sulcus, as well as between the left precuneus and the left posterior cingulate gyrus.These abnormal functional alterations in the brain may be implicated in the maintenance and development of symptoms in IC/BPS patients.This study conducted research from the perspective of central nervous system regulation, presenting possible directions for further exploration of the pathophysiological mechanisms of IC/BPS.

Objective:To investigate the association between hyperuricemia and the risk for stroke occurrence, as well as the mediating effect of hypertension on this association.Methods:In this study, the China Chronic Diseases and Nutrition Surveillance system in 2015 was used as baseline data. We identified hospital admissions for stroke using the electronic homepage of inpatient medical records from 2013-2020, and death data were obtained from the 2015-2020 National Mortality Surveillance System. A retrospective cohort was established after matching and linking the database. The Cox proportional hazard regression model was used to analyze the relationship between hyperuricemia and the risk of stroke and its subtypes. Restricted cubic spline analysis was conducted to examine the dose-response relationship between serum uric acid levels and the risk for stroke. Mediation analysis was performed to investigate the mediating effect of hypertension on the association between hyperuricemia and the risk for stroke and its subtypes. Subgroup analyses were conducted based on gender and age groups.Results:A total of 124 352 study subjects were included, with an accumulative follow-up time of 612 911.36 person-years. During the follow-up period, 4 638 cases of stroke were found, including 3 919 cases of ischemic stroke and 689 cases of hemorrhagic stroke. The incidence density of stroke was 756.72 per 100 000 person-years, 641.37 per 100 000 person-years for ischemic stroke, and 114.60 per 100 000 person-years for hemorrhagic stroke. Multivariable Cox proportional hazards regression models showed that after adjusting for covariates, compared to those without hyperuricemia, individuals with hyperuricemia had a 16% higher risk for stroke [hazard ratio ( HR)=1.16, 95% CI: 1.06-1.27], a 12% higher risk of ischemic stroke ( HR=1.12, 95% CI: 1.01-1.24), and a 39% higher risk of hemorrhagic stroke ( HR=1.39, 95% CI: 1.11-1.75). Mediation analysis showed that hypertension partially mediated the associations between hyperuricemia and the risk for stroke, ischemic stroke, and hemorrhagic stroke, with mediation proportions of 36.07%, 39.98%, and 25.34%, respectively. The mediating effect is pronounced in the male population and individuals below 65. Conclusion:Hyperuricemia is a risk factor for stroke, and hypertension partially mediates the effect of hyperuricemia on stroke.