Objective To analyze the epidemiological characteristics of statutory infectious diseases in Yichang City from 2015 to 2023 and evaluate the effectiveness of non-pharmaceutical interventions (NPIs) in infectious disease prevention and control, and to provide a basis for formulating prevention and control strategies. Methods Descriptive epidemiological methods were used to analyze annual incidence rates. SARIMA and SARIMA intervention models were constructed to predict the incidence rates of infectious diseases. Interrupted time series analysis (ITS) was applied to assess the control effectiveness. Results The average annual incidence rate from 2015 to 2023 was 787.47/100 000, with the top five diseases being influenza, hand-foot-and-mouth disease, hepatitis B, tuberculosis, and diarrheal diseases. The average incidence rate from 2015 to 2019 (654.31/100 000) was significantly higher than that from 2020 to 2022 (489.01/100 000) (χ²= 3 499.6, P < 0.05). The total incidence rate in 2023 (2 396.51/100 000) was significantly higher than the average annual incidence rates from 2015-2019 (χ²= 108 186.1, P < 0.05) and 2020-2022 (χ²= 112 869.4, P < 0.05). SARIMA model results indicated that the actual incidence rate from 2020 to 2022 decreased by 73.49% compared to the predicted rate without intervention, with the highest decline observed in respiratory infectious diseases (79.57%). The SARIMA-intervention model showed a 55.48% relative decrease in the total incidence rate for 2023, with the largest reduction in respiratory infectious diseases (63.28%) and a slight increase in intestinal infectious diseases (5.48%). Conclusion NPIs effectively reduce the incidence of statutory infectious diseases in the short term, especially for acute respiratory and intestinal infectious diseases. However, long-term effectiveness faces challenges, necessitating the development of differentiated prevention and control strategies.

Objective To investigate the therapeutic efficacy of the combination of upper limb rehabilitation robots(ULRR)and ultrasound-guided extracorporeal shock wave(ESW)in the treatment of mild to moderate rotator cuff injuries.Methods A total of 90 patients with mild to moderate rotator cuff injuries,who were admitted to the Second Affiliated Hospital of Anhui Medical University between January 2023 and March 2024,were selected and randomly assigned to three groups:Group A(basic rehabilitation),Group B(basic rehabilitation+ESW),and Group C(basic rehabilitation+ESW+ULRR),with 30 patients in each group.Before and after treatment,shoulder pain was assessed using the visual analogue scale(VAS).Proprioception was evaluated based on shoulder joint position reproduction error.The integral electromyography(iEMG)and root mean square(RMS)values of the median tract,supraspinatus,infraspinatus,and deltoid muscles on the affected side were measured using surface electromyography(sEMG).The active range of motion(AROM)for external rotation,abduction,and forward flexion of the affected shoulder was measured using a standard goniometer.Overall shoulder function was evaluated using the Constant-Murley Shoulder Score(CMS).The clinical efficacy rate and patient satisfaction levels were compared among the three groups.Results After treatment,the VAS score and shoulder position reproduction deviation angle in all three groups significantly decreased.Additionally,the iEMG and RMS values of the middle deltoid,supraspinatus,and infraspinatus muscles;the AROM of shoulder external rotation,abduction,and forward flexion;and the CMS scores(including pain,activities of daily living,active range of motion,and muscle strength)all showed significant improvement.Furthermore,the degree of improvement in all evaluated parameters in Group C was significantly greater than that observed in Groups A and B(P<0.05).Moreover,Group C demon-strated a significantly higher clinical response rate and greater patient satisfaction compared to Groups A and B(P<0.05).Conclusion For patients with mild to moderate rotator cuff injuries,the integration of an upper limb rehabilitation robot with extracorporeal shock wave therapy demonstrates superior therapeutic outcomes,effectively alleviating pain,enhancing motor function and proprioception,and increasing overall patient satisfaction.

AIM:To investigate the function of mitochondrial reactive oxygen species(mtROS)/nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3)signaling pathway in modulating macrophage polarization in liver fibrosis resulting from iron overload.METHODS:Thirty-two male C57BL/6 mice were randomly allocated into four groups:control group,model group(iron dextran,50 mg/kg),MitoTEMPO(3 mg/kg)group,and MCC950(10 mg/kg)group,comprising eight mice per group.All mice,with the exception of the control group,were administered daily in-traperitoneal injections of iron dextran for a duration of seven consecutive weeks,whereas the control group received equiv-alent volumes of normal saline.Starting in week four,the MitoTEMPO and MCC950 cohorts received their designated treatments through intraperitoneal injection three times weekly.Serum alanine aminotransferase(ALT)and aspartate ami-notransferase(AST)concentrations were assessed through biochemical analysis.Liver tissues were analyzed utilizing HE,Masson,Sirius red and immunohistochemical staining.The concentrations of mtROS were evaluated utilizing the MitoSOX Red probe.Cytokines and polarization markers,such as interleukin-1β(IL-1β),IL-18,IL-6,tumor necrosis factor-α(TNF-α),inducible nitric oxide synthase(iNOS),IL-10,and arginase-1(Arg-1),were quantified via ELISA.Western blot analysis was performed to quantify the protein expression levels of Arg-1,iNOS,NLRP3,apoptosis-associated speck-like protein containing a caspase recruitment domain(ASC),and caspase-1.The mRNA expression of NLRP3,ASC,and caspase-1 was assessed using RT-qPCR.Immunofluorescence double labeling was employed to identify M1 and M2 macrophages.RESULTS:(1)In comparison to the control group,the model group demonstrated notable inflammatory cell infiltration,pronounced fibrous tissue hyperplasia,significant disruption of hepatic lobular architecture,and the develop-ment of pseudo-lobules in certain areas.Serum ALT and AST levels were markedly elevated(P<0.01),as were the mRNA and protein expression levels of NLRP3,ASC,caspase-1,and mtROS(P<0.01).Iron overload resulted in markedly ele-vated serum iron,ferritin,total liver iron,and ferrous iron concentrations(P<0.01).Markers indicative of M1 macrophage polarization,including IL-6,TNF-α,and iNOS,exhibited upregulation(P<0.01),whereas M2 markers such as IL-10,Arg-1,and CD206 were significantly downregulated(P<0.01).(2)Compared with model group,inhibiting mtROS or NL-RP3 substantially reduced inflammation and fibrous tissue hyperplasia.ALT and AST levels were markedly diminished(P<0.01),as were the areas of positive staining for α-smooth muscle actin and collagen type Ⅰ(P<0.01).Markers of iron over-load,such as serum iron,ferritin,total liver iron,and ferrous iron,were significantly ameliorated(P<0.01).M1 polariza-tion markers were significantly downregulated(P<0.01).CONCLUSION:The mtROS/NLRP3 signaling pathway facili-tates liver fibrosis caused by iron overload by enhancing macrophage polarization to the M1 phenotype.

Objective To investigate the effect of joint end micro fracture treatment combined with arthroscopy on the long-term effect of ankle joint fusion and the effects on perioperative oxidative stress and complications.Methods 108 patients with end-stage ankle arthritis with internal and external inversion angles with ≤20° matching baseline data from February 2021 to April 2023 were selected.Among them,54 patients underwent arthroscopic ankle fusion as arthroscopic group,54 patients were treated with joint end microfracture combined with arthroscopic ankle joint fusion as improved group.The surgical indexes,perioperative oxidation indexes[malondialdehyde(MDA),total oxidation state(TOS),oxidative stress index(OSI)before surgery,1 d after surgery and 3 d after surgery]and antioxidant indexes[glutathione peroxidase(GSH-Px),superoxide dismutase(SOD),total antioxidant capacity(TAC)before surgery,1 d after surgery and 3 d after surgery]of the two groups were compared.Visual analogue scale(VAS score),American Orthopaedic Foot and Ankle Society(AOFAS score),before surgery,6 months after surgery and 1 year after surgery,excellent and good rate and complications were compared between the two groups,and fusion time and AOFAS score at 1 year after surgery of patients with different internal and external inversion angles were compared between the two groups.Results The intraoperative blood loss in the improved group was less than that in the arthroscopic group,postoperative hospital stay in the improved group was shorter than that in the arthroscopic group,the differences were statistically significant(P＜0.05).The MDA,TOS and OSI levels in the improved group were lower than those in the arthroscopic group on day 1 and day 3 after operation,the differences were statistically significant(P＜0.05).The GSH-Px,SOD and TAC levels in the improved group were significantly higher than those in the arthroscopic group at 1 and 3 days after surgery,the differences were statistically significant(P＜0.05).The VAS score and AOFAS score at 6 months and 1 year after surgery in the improved group were not significantly different from those in the arthroscopic group(P＞0.05).Comparison of the excellent rate of patients in the two groups,the difference was not statistically significant(P＞0.05).The total complication rate of the improved group was significantly lower than that of the arthroscopic group,the difference was statistically significant(P＜0.05).There was no significant difference in AOFAS scores between patients with 10°～20° and patients with＜10° at 1 year after surgery(P＞0.05).The fusion time of patients with internal and external inversion angles 10°～20° was longer than that of patients with＜10°(P＜0.05).Conclusion Joint end microfracture treatment combined with arthroscopy ankle fusion for end-stage ankle arthritis with ≤20° internal and external varus can avoid bone grafting and osteotomy with satisfactory efficacy,and has advantages in reducing intraoperative bleeding and complications,alleviating perioperative oxidative stress,and accelerating postoperative recovery.However,when internal and external varus malformations are obvious,the time of osseous fusion can be prolonged.

Objective To investigate the effect of joint end micro fracture treatment combined with arthroscopy on the long-term effect of ankle joint fusion and the effects on perioperative oxidative stress and complications.Methods 108 patients with end-stage ankle arthritis with internal and external inversion angles with ≤20° matching baseline data from February 2021 to April 2023 were selected.Among them,54 patients underwent arthroscopic ankle fusion as arthroscopic group,54 patients were treated with joint end microfracture combined with arthroscopic ankle joint fusion as improved group.The surgical indexes,perioperative oxidation indexes[malondialdehyde(MDA),total oxidation state(TOS),oxidative stress index(OSI)before surgery,1 d after surgery and 3 d after surgery]and antioxidant indexes[glutathione peroxidase(GSH-Px),superoxide dismutase(SOD),total antioxidant capacity(TAC)before surgery,1 d after surgery and 3 d after surgery]of the two groups were compared.Visual analogue scale(VAS score),American Orthopaedic Foot and Ankle Society(AOFAS score),before surgery,6 months after surgery and 1 year after surgery,excellent and good rate and complications were compared between the two groups,and fusion time and AOFAS score at 1 year after surgery of patients with different internal and external inversion angles were compared between the two groups.Results The intraoperative blood loss in the improved group was less than that in the arthroscopic group,postoperative hospital stay in the improved group was shorter than that in the arthroscopic group,the differences were statistically significant(P＜0.05).The MDA,TOS and OSI levels in the improved group were lower than those in the arthroscopic group on day 1 and day 3 after operation,the differences were statistically significant(P＜0.05).The GSH-Px,SOD and TAC levels in the improved group were significantly higher than those in the arthroscopic group at 1 and 3 days after surgery,the differences were statistically significant(P＜0.05).The VAS score and AOFAS score at 6 months and 1 year after surgery in the improved group were not significantly different from those in the arthroscopic group(P＞0.05).Comparison of the excellent rate of patients in the two groups,the difference was not statistically significant(P＞0.05).The total complication rate of the improved group was significantly lower than that of the arthroscopic group,the difference was statistically significant(P＜0.05).There was no significant difference in AOFAS scores between patients with 10°～20° and patients with＜10° at 1 year after surgery(P＞0.05).The fusion time of patients with internal and external inversion angles 10°～20° was longer than that of patients with＜10°(P＜0.05).Conclusion Joint end microfracture treatment combined with arthroscopy ankle fusion for end-stage ankle arthritis with ≤20° internal and external varus can avoid bone grafting and osteotomy with satisfactory efficacy,and has advantages in reducing intraoperative bleeding and complications,alleviating perioperative oxidative stress,and accelerating postoperative recovery.However,when internal and external varus malformations are obvious,the time of osseous fusion can be prolonged.

Aim To investigate the effect of ACSL4 on the malignant biological behavior of esophageal cancer cells and gefitinib resistance by regulating FASN,and to explore the related mechanism.Methods Thirty-five fresh esophageal cancer tissues and adjacent nor-mal tissues,and 30 esophageal cancer tissues with ge-fitinib resistance were collected.The expressions of ACSL4 and FASN were detected by qRT-PCR and im-munohistochemistry.The expression levels of ACSL4 and FASN in human normal esophageal cells HET-1 A,esophageal cancer cell lines ECA109,EC9706,TE-1 and TE-1/GR were detected by qRT-PCR.Cells in each group were constructed by liposome transfection technique,and the drug resistance and proliferation a-bility of cells were detected by cloning and CCK-8 as-say,cell apoptosis was detected by flow cytometry,cell invasion ability was detected by Transwell,and EMT pathway protein expression was detected by Western blot.Results Compared with adjacent normal tis-sues,the expression of ACSL4 and FASN genes in cancer tissues increased,and there was a positive corre-lation.The expression of ACSL4 significantly increased in ECA109,EC9706 and TE-1 cells compared with HET-1 A cells.With the increase of gefitinib concen-tration,the expression of ACSL4 in TE-1 cells gradually increased,and the expression of ACSL4 in TE-1/GR cells was higher than that of TE-1.Compared with the control group and the si-NC group,the cell proliferation and invasion ability of si-ACSL4 group decreased,the number of apoptosis increased,the expression of E-Cadherin increased,and the expression of N-Cadherin,Vimentin and β-catenin decreased.The response ex-periment showed that compared with the si-ACSL4 group and the si-ACSL4+oe-NC group,the cells in the si-ACSL4+oe-FASN group increased drug resistance,increased proliferation and invasion ability,decreased apoptosis number and decreased expression of E-Cad-herin.The expressions of N-Cadherin,Vimentin and β-catenin increased.Conclusions By down-regulating the expression of FASN,ACSL4 reverses the resistance of esophageal cancer TE-1/GR cells to gefitinib and in-hibits the proliferation,invasion and accelerates apopto-sis of TE-1/GR cells,which may be related to the regu-lation of EMT signaling pathway.

Objective:To analyze the effect of joint management of type 2 diabetes mellitus (T2DM) between specialty and community under the model of National Diabetes Prevention and Control Center (DPCC).Methods:A total of 2 527 T2DM patients managed by DPCC Pingshan Center of Shenzhen from January 1, 2022 to December 31, 2024 were retrospectively included. After management, the rate of downturn, reexamination rate, blood pressure compliance rate, metabolic indicators (waist circumference, body mass index, fasting blood glucose, glycosylated hemoglobin, blood lipids) and screening rate of chronic complications of diabetes (atherosclerotic cardiovascular disease, microvascular disease, diabetic peripheral neuropathy) were analyzed. Those included 2022 ( n=564), 2023 ( n=1 477), and 2024 ( n=2 527). Results:The downturn rate in 2022, 2023 and 2024 increased year by year (22.8% vs 67.2% vs 89.9%, P<0.01), and the review rate (41.1% vs 62.2% vs 52.7%, P<0.01), complication screening rate (51.6% vs 85.3% vs 62.2%, P<0.01), blood pressure compliance rate (53.1% vs 78.0% vs 67.2%, P<0.01), body mass index compliance rate (13.2% vs 17.3% vs 28.6%, P<0.01), fasting blood glucose meeting rate (46.4% vs 60.2% vs 68.5%, P<0.01), glycated hemoglobin meeting rate (58.4% vs 63.2% vs 45.6%, P<0.01) were relatively improved. Waist circumference compliance rate (30.6% vs 27.7% vs 21.6%) and blood lipid compliance rate (33.6% vs 35.5% vs 31.9%) were not significantly improved, and the review rate, blood pressure compliance rate and complication screening rate in 2024 were lower than those in 2023 and higher than those in 2022. Conclusions:The combined management of type 2 diabetes under the DPCC model has significant effects on improving the down-conversion rate, rediagnosis rate, blood pressure compliance rate, metabolic index compliance rate and the screening rate of diabetes-related chronic complications in patients with diabetes. At the same time, it was also found that with the progress of hierarchical diagnosis and treatment, the review rate, complication screening rate, blood pressure, waist circumference, blood lipid and glycosylated hemoglobin reached the standard of patients decreased compared with the previous situation, which needs to be further analyzed and improved.

Objective To develop a refined management model for operating rooms and assess its clinical impact on op-erational efficiency and cost control.Methods The study included 10,728 elective surgeries from January to June 2024 as the study group and 9 414 elective surgeries from January to June 2023 as the control group.The differences in operational metrics before and after implementing the refined management model were compared.The model was developed through comprehensive management by hospital leadership and multi-department collaboration,focusing on management structure,systems,processes,information technology,and resource allocation.Results In terms of efficiency,the on-time start rate of the first surgeries in the study group was significantly higher than in the control group(P＜0.05).The turnover time between surgeries was shorter in the study group(P＜0.01),and the rate of unexpected surgery cancellations was lower(P＜0.01).The average cost per surgery for consumables,excluding the impact of centralized procurement of consumables,was approximately 971 yuan,representing an 11% reduction compared to the previous year,despite a 14% increase in surgical volume.The average daily operating cost per operating room was about 12 303 yuan,a 7% reduction.Economic benefits increased by 8.43 million yuan,a 38% year-on-year increase.Conclusion Implementing a refined management model in operating rooms can significantly enhance efficiency,re-duce costs,and achieve dual improvements in social and economic benefits.

Objective:To investigate the predictive value of endothelial activation and stress index(EASIX)for the prognosis of patients with mantle cell lymphoma(MCL).Methods:A retrospective analysis was conducted to assess prognosis and compare the clinical features of patients diagnosed with MCL who were admitted to the Affiliated Hospital of Xuzhou Medical University from January 2010 to June 2023,had therapeutic indications and received standard treatment.Results:A total of 66 patients were included and divided into high EASIX group and low EASIX group,according to a cutoff value of 0.97 determined by the receiver operating characteristic(ROC)curve.Multivariate Cox regression analysis showed that prealbumin＜0.2 g/L,high EASIX,and ECOG PS score ≥2 were independent risk factors influencing overall survival(OS)in MCL patients.The median OS of patients in the high and low EASIX group was 13.0 and 37.5 months,and the median progression-free survival was 8.8 and 26.0 months,respectively.The proportions of patients with ECOG PS score ≥2 and prealbumin＜0.2 g/L at onset significantly increased in the high EASIX group compared to those in the low EASIX group.Conclusion:At the time of initial diagnosis,EASIX can serve as an independent prognostic indicator impacting OS in patients with MCL.Furthermore,patients in the high EASIX group experience a poorer prognosis and shorter survival duration compared with those in the low EASIX group.

Objective:To investigate the characteristics of metabolic indicators in patients with allergic rhinitis (AR) and the potential relationship between AR and metabolic syndrome (MetS).Methods:A total of 179 patients with MetS admitted to the Dahua Hospital in Xuhui District, Shanghai, from June 2021 to May 2024 were retrospectively included. They were divided into an AR group (69 cases) and a non-AR group (110 cases) based on the presence of AR. Clinical data including demographic information, metabolic indicators, and immunological test results were collected. Multivariate logistic regression analysis was used to identify clinical risk factors associated with MetS complicated with AR, and a nomogram prediction model was constructed. The model′s discriminative ability, calibration, and clinical predictive performance were evaluated using receiver operating characteristic (ROC) curves, consistency index (C-index), and decision curve analysis.Results:The AR group had a significantly higher proportion of males, fasting C-peptide levels, total cholesterol, low-density lipoprotein cholesterol, CD4/CD8 ratio, immunoglobulin M, immunoglobulin E, CD3 cell count, CD4 cell count, and interleukin-6 levels compared to the non-AR group, while hip circumference was significantly lower (all P<0.05). Logistic regression analysis showed that male sex ( OR=2.156, P=0.042), total cholesterol ( OR=1.504, P=0.003), fasting C-peptide ( OR=3.342, P=0.016), CD4 cell count ( OR=1.002, P=0.011), and interleukin-6 ( OR=1.124, P=0.002) were risk factors for AR in MetS patients, while hip circumference ( OR=0.956, P=0.026) was a protective factor. The area under the ROC curve of the nomogram model was 0.771(95% CI: 0.698-0.841), and the C-index was 0.769(95% CI: 0.732-0.806), indicating good predictive ability and consistency of the model. Conclusions:The occurrence of AR is closely associated with multiple metabolic indicators, suggesting that AR may not only be a local inflammatory condition but also involve systemic metabolic abnormalities. The nomogram model based on these risk factors can be used for individualized risk assessment and early intervention.