ObjectiveTo understand the seropositivity of neutralizing antibodies (NAb) and low-level NAb against SARS-CoV-2 infection in the community residents, and to explore the impact of COVID-19 vaccination and SARS-CoV-2 infection on the levels of NAb in human serum. MethodsOn the ground of surveillance cohort for acute infectious diseases in community populations in Shanghai, a proportional stratified sampling method was used to enroll the subjects at a 20% proportion for each age group (0‒14, 15‒24, 25‒59, and ≥60 years old). Blood samples collection and serum SARS-CoV-2 NAb concentration testing were conducted from March to April 2023. Low-level NAb were defined as below the 25^th percentile of NAb. ResultsA total of 2 230 participants were included, the positive rate of NAb was 97.58%, and the proportion of low-level NAb was 25.02% (558/2 230). Multivariate logistic regression analysis indicated that age, infection history and vaccination status were correlated with low-level NAb (all P<0.05). Individuals aged 60 years and above had the highest risk of low-level NAb. There was a statistically significant interaction between booster vaccination and one single infection (aOR=0.38, 95%CI: 0.19‒0.77). Compared to individuals without vaccination, among individuals infected with SARS-CoV-2 once, both primary immunization (aOR=0.23, 95%CI: 0.16‒0.35) and booster immunization (aOR=0.12, 95%CI: 0.08‒0.17) significantly reduced the risk of low-level NAb; among individuals without infections, only booster immunization (aOR=0.28, 95%CI: 0.14‒0.52) showed a negative correlation with the risk of low-level NAb. ConclusionsThe population aged 60 and above had the highest risk of low-level NAb. Regardless of infection history, a booster immunization could reduce the risk of low-level NAb. It is recommended that eligible individuals , especially the elderly, should get vaccinated in a timely manner to exert the protective role of NAb.

ObjectiveTo analyze the evolutionary characteristics and genetic variations of the HA (hemagglutinin) and NA (neuraminidase) genes of influenza A(H1N1) viruses in Shanghai during 2024, to investigate their transmission patterns, and to evaluate their potential impact on vaccine effectiveness. MethodsFrom January to October 2024, throat swab specimens were collected from influenza like illness (ILI) patients at 4 hospitals in Shanghai. Real-time fluorescence ploymerase chain reaction (RT-PCR) was used for virus detection and isolation of H1N1 influenza viruses. Forty influenza A(H1N1) virus strains were sequenced using Illumina NovaSeq 6000 platform, followed by phylogenetic analyses, genetic distance analysis, and amino acid variation analyses of HA and NA genes. ResultsPhylogenetic tree of the HA and NA genes revealed that the 40 influenza A(H1N1) virus strains circulating in Shanghai in 2024 exhibited no significant geographic clustering, with a broad origin of strains and complex transmission chains. Genetic distance analyses demonstrated that the average intra-group genetic distances of HA and NA genes among the Shanghai strains were 0.005 1±0.000 6 and 0.004 6±0.000 6, respectively, which were comparable to or higher than those observed in global surveillance strains. Both HA and NA genes displayed frequent mutations. Compared to the 2023‒2024 and 2024‒2025 Northern Hemisphere A(H1N1) vaccine strains (WHO-recommended), the HA proteins of 40 Shanghai strains exhibited amino acid substitutions at positions 120, 137, 142, 169, 216, 223, 260, 277, 356 and 451, with critical mutations at positions 137 and 142 located within the Ca2 antigenic determinant. Furthermore, mutations in the NA protein were observed at positions 13, 50, 200, 257, 264, 339 and 382. ConclusionThe genetic background of the 2024 Shanghai influenza A(H1N1) virus strains is complex and diverse, and antigenic variation may affect vaccine effectiveness. Therefore, it is recommended to enhance genomic surveillance of influenza viruses, evaluate vaccine suitability, and implement more targeted prevention and control strategies against imported influenza viruses.

ObjectiveTo analyze the epidemiological characteristics of clustered vomiting and diarrhea outbreaks in Minhang District of Shanghai, to identify the influencing factors of outbreak scale and duration of epidemic, and to provide scientific evidence for further strengthening surveillance early-warning efforts in key settings and for optimizing prevention and control measures. MethodsThe data for describing epidemiological characteristics of clustered vomitting and diarrhea outbreaks in Minhang District from 2018 to 2023 were collected, multivariable logistic regression models were applied to analyze the influencing factors for epidemic scale,and Spearman rank correlation analyses were applied to analyze the factors duration. ResultsA total of 136 clustered vomiting and diarrhea outbreaks were reported in Minhang District from 2018 to 2023, all occurring in school settings, with an overall attack rate of 0.90%. The outbreaks exhibited distinct seasonality, predominantly occurring from October to December (43.38%) and March to May (32.35%). The primary settings were preschools (45.59%) and elementary schools (44.12%), with students accounted for the majority of cases (99.48%). The predominant clinical manifestation was vomiting (90.44%), with person-to-person contact being the primary transmission route (98.53%). Norovirus genogroup Ⅱ was identified as the main pathogen (71.32%). Standardized terminal disinfection of outbreak sites (OR=0.39, 95%CI=0.20‒0.74) and effective isolation of affected classes (OR=0.23, 95%CI=0.09‒0.57) were significant protective factors for reducing outbreak scale. Both response time (r=0.64, P<0.001) and the number of case generations (r=0.71, P<0.001) showed positive correlations with outbreak duration. ConclusionSchools are the key settings for the prevention and control of clustered vomiting and diarrhea outbreaks in Minhang District, with peak occurring in autumn and spring. Early detection, timely reporting, and prompt response to outbreaks are crucial. Strengthening school-based surveillance systems and standardizing outbreak management protocols are of particular importance.

Artemisia argyi is the leaves of compositae plants of A. argyi Lévl. et Vant.， which is a traditional Chinese medicine commonly used in China. The analysis was carried out by consulting traditional medical classics， modern standard norms and literature， and using Cytoscape software to sort out and visualize the evolution of the processing and the efficacy of processed products. The processing of A. argyi was first made in the Han dynasty and was popular in the Song and Ming dynasties. There were many processing methods in ancient times， including net processing， cutting， frying， processing with auxiliary material （vinegar， wine， salt， charcoal， rice water， sulfur， medicinal juice， jujube mud processing） and other processing methods （baking， winching， making herbs into wool）. Modern common processing methods included purification， vinegar processing， charcoal processing and making herbs into wool， which are relatively simple compared with ancient processing methods. There were obvious differences in the efficacy and application of raw and processed products of A. argyi. Although the processing effects of A. argyi in ancient and modern times were mainly to reduce toxic side effects and enhance the effects of warming meridians and hemostasis， only the purified A. argyi， vinegar-processed A. argyi and vinegar-processed A. argyi charcoal could be seen in the present studies， other processed products had not been inherited and studied， and the processing mechanism was still unclear. It is suggested that in the later exploration and research， researchers can establish a multi-dimensional standard research system based on the characteristics of the medicinal plant A. argyi and the processing characteristics of A. argyi decoction pieces in order to systematically explore the transformation rules before and after processing， and clearly explain the scientific connotation.

Objective:To analyze the changes in the epidemiological characteristics of scarlet fever cases in Shanghai City before and after the outbreak of coronavirus disease 2019 (COVID-19), and to provide a reference for scientific prevention and control of scarlet fever.Methods:The information of scarlet fever reported cases in Shanghai City from January 2016 to June 2021 in the information system of Chinese Disease Prevention and Control was collected, and the differences in time trend, regional distribution, age and gender distribution of cases before and after the outbreak of COVID-19 in Shanghai City were analyzed by descriptive epidemiologic method.Results:The incidence rate of scarlet fever reported in 2016-2019 was (0.22-4.02)/100 000 in each month, with a median of 1.13/100 000. During January 2020 (the outbreak began in Shanghai City) and June 2021, the incidence rate of scarlet fever was (0.01-1.64)/100 000, with a median of 0.14/100 000, which was 12.39% of that before the outbreak of COVID-19. During February and June 2020, the monthly reported incidence rate of scarlet fever was (0.18-0.58)/100 000, showing an upward trend compared with the same period in 2020 ((0.01-0.05)/100 000). From 2016 to 2019, the annual reported incidence rate of each district was (0.55-65.48)/100 000, with a median of 9.57/100 000; while in 2020, the annual reported incidence rate of each district was (0.29-9.85)/100 000, with a median of 2.18/100 000, which was 22.78% of that before the outbreak of COVID-19. The incidence of scarlet fever dropped significantly. The incidence rate in Minhang District was still the highest. The cases were mainly four to eight years old, and there was no substantial difference of the proportions before and after COVID-19 pandemic, with the incidence rate of six years old group the highest. The proportion of male was more than female in reported case, while the male ratio in reported cases was not significantly different before and after COVID-19 pandemic.Conclusions:The incidence rate of scarlet fever in Shanghai City has dropped sharply after COVID-19 pandemic. The main epidemiological characteristics of the regional and population distribution of cases remain unchanged.

To prepare RGD peptide modified perfluorohexane ( PFH ) polymer nanoparticles RGD‐PFH‐NPs and investigate its basic characteristics ,targeting ability and combine with low‐intensity focused ultrasound ( LIFU ) for ultrasonic imaging in vivo and vitro . Methods Targeted nanoparticles RGD‐PFH‐NPs were prepared by double emulsifying method and carbodiimide method . T heir morphology and distribution were observed . T he particle size ,zeta potential and connection probability were measured . T he phase‐changed properties and the LIFU‐induced imaging ability in contrast‐enhanced ultrasound mode of RGD‐PFH‐NPs were investigated in vivo and vitro . T he tagetability of nanoparticles to human gastric cancer cell line M GC803 and tumor‐bearing nude mouse were observed through targeting group and non‐targeting group . Results T he prepared sample was milky w hite suspension liquid . T he RGD‐PFH‐NPs were spherical uniform size ,good dispersion w hen observed through the optical microscope and transmission electron microscopy . T he particle size was ( 259 .3 ± 42 .6) nm and the Zeta potential was ( －17 .6+5 .4) mV . T he connection probability of RGD peptide was 89 .13% . With 70℃ water bath and LIFU stimulation RGD‐PFH‐NPs can remarkably change phase and show good imaging performance in both conventional ultrasound and contrast‐enhanced ultrasound mode in vivo and vitro . The connection probability to M GC803 cells in targeting group ( RGD‐PFH‐NPs ) and the non‐targeting group( PFH‐NPs) were 82 .59% and 2 .96% . T he accumulation of nanoparticles in the RGD‐PFH‐NPs group in tumor tissues was significantly higher than that in the non‐targeted PFH‐NPs group( P) . Conclusions The constructed nanoparticles RGD‐PFH‐NPs ,providing contrast‐enhanced ultrasonic imaging and excellent targeting ability to human gastric cancer cells M GC803 and gastric cancer tissue ,is expected to become a new type of gastric cancer targeted ultrasound contrast agent .

Objective To prepare RGD peptide modified perfluorohexane ( PFH ) polymer nanoparticles RGD-PFH-NPs and investigate its basic characteristics ,targeting ability and combine with low-intensity focused ultrasound ( LIFU ) for ultrasonic imaging in vivo and vitro . Methods Targeted nanoparticles RGD-PFH-NPs were prepared by double emulsifying method and carbodiimide method . Their morphology and distribution were observed . The particle size ,zeta potential and connection probability were measured . The phase-changed properties and the LIFU-induced imaging ability in contrast-enhanced ultrasound mode of RGD-PFH-NPs were investigated in vivo and vitro . The tagetability of nanoparticles to human gastric cancer cell line MGC803 and tumor-bearing nude mouse were observed through targeting group and non-targeting group . Results The prepared sample was milky white suspension liquid . The RGD-PFH-NPs were spherical uniform size ,good dispersion when observed through the optical microscope and transmission electron microscopy . The particle size was ( 259 .3 ± 42 .6) nm and the Zeta potential was ( -17 .6+5 .4) mV . The connection probability of RGD peptide was 89 .13％ . With 70℃ water bath and LIFU stimulation RGD-PFH-NPs can remarkably change phase and show good imaging performance in both conventional ultrasound and contrast-enhanced ultrasound mode in vivo and vitro . The connection probability to MGC803 cells in targeting group ( RGD-PFH-NPs ) and the non-targeting group( PFH-NPs)were 82 .59％ and 2 .96％ . The accumulation of nanoparticles in the RGD-PFH-NPs group in tumor tissues was significantly higher than that in the non-targeted PFH-NPs group( P) . Conclusions The constructed nanoparticles RGD-PFH-NPs ,providing contrast-enhanced ultrasonic imaging and excellent targeting ability to human gastric cancer cells MGC803 and gastric cancer tissue ,is expected to become a new type of gastric cancer targeted ultrasound contrast agent .

Objective The clinical benefits of carbohydrate intake 2-3 h before surgery in patients with digestive tract malignant tumor without diabetes mellitus have been confirmed by foreign experts,the"High level evidence" for perioperative nutrition support were also written in China"Guidelines for perioperative nutritional support in adults".However,there are few hospitals in China that prefer preoperative glucose pretreatment,taking into account the differences between domestic and foreign data.In this paper,the clinical randomly controlled experimental data about the effect of preoperative glucose pretreatment on the prognosis of patients with malignant tumor of digestive tract was analyzed by Meta analysis,in order to evaluate the efficacy and safety of preoperative glucose pretreatment in Chinese patients,and to achieve the clinical significance.Methods Retrieving the database from establishment to March 2017,the related literatures about preoperative glucose pretreatment and prognosis of patients with digestive tract malignant tumor were collected.Revman5.3 software was used to perform Meta analysis of 10 randomized controlled trials(606 patients)who met the inclusion criteria.Results Compared with the traditional fasting and non drinking group,the preoperative subjective discomfort of the preoperative group was significantly reduced(SMD = -1.29,95%CI = -2.00--0.59,P = 0.000 3), postoperative insulin resistance was significantly reduced(SMD=-1.92,95%CI=-2.68--1.16,P<0.01), postoperative blood glucose concentration,insulin concentration increased,and no vomiting and aspiration occur in any patient as shown by the literature.Conclusion In the patients with malignant tumor of digestive tract, perioperative nutrition support and pretreatment show significant clinical benefits,preoperative subjective comfort improves,the risk of aspiration does not increase significantly,postoperative insulin resistance decreases.It is proved that preoperative carbohydrate pretreatment is effective and safe in the operation of domestic digestive tract cancer.

Objective To investigate the expression level of serum miR-193a-3p,miR-337-5p and miR-483-5p in esophageal squamous cell carcinoma (ESCC) patients and to explore their value for diagnosis and prognosis of ESCC.Methods Serum samples were collected from 63 ESCC patients before and after surgery in Nanjing General Hospital and Xuzhou Cancer Hospital between June 2013 and May 2014 and serum sanples of 63 age-and sex-matched healthy individuals acted as the normal controls.TaqMan Low Density Assay was used to detect the deregulated miRNA in ESCC patients and then quantitative real-time PCR was used to validate the upregulated miRNA miR-193a-3p,miR-337-5p and previously reported miR483-5p that was upregulated in oral squamous cell carcinoma (OSCC).Finally,the three miRNA were evaluated for their clinical value in the diagnosis and predicting prognosis of ESCC.Results Compared with normal controls,serum levels of miR193a-3p,miR-337-5p and miR-483-5p in ESCC patients were significantly up-regulated (0.459±0.339 vs 0.195±0.084,U =591;5.686±5.211 vs 2.476±0.808,U=605;32.545 ± 22.479 vs 19.509±10.601,U=1 037,respectively,all P＜ 0.0001) and their levels were significantly reduced after the surgical treatment (P＜0.05).The areas under the ROC curve of serum miR-193a-3p,miR-337-5p,miR-483-5p and miR-Panel were all larger than that of CEA.Univariate Kaplan-Meier analysis revealed that ESCC patients with low expression level of miR-483-5p in postoperative serum exhibited higher survival rate than those with high level(P=0.022).Conclusion Serum miR-193a-3p,miR-337-5p and miR-483-5p can be potential molecular biomarkers in the diagnosis and predicting prognosis of ESCC.

This paper introduced the measures to construct the hierarchical medical system in Yichang city. The authors identified problems found and proposed the city to take the following countermeasures. Such steps included service capacity building at primary level, motivating primary medical workers, attracting patients to primary care, and improving policies of hierarchical medical system.