ObjectiveTo analyze the epidemiological characteristics of 8 major respiratory pathogens in influenza-like illness (ILI) cases with acute respiratory infections at fever clinics in Huangpu District, Shanghai from 2015 to 2024, and to provide a scientific basis for the prevention and treatment of respiratory diseases. MethodsA retrospective study was conducted in Huangpu District. Individuals meeting the case definition of ILI from 2015 to 2024 was registered. Their nasopharyngeal swabs were collected for pathogen detection. A total of 8 respiratory viruses were tested, including Influenza A virus (Flu A), Influenza B virus (Flu B), adenovirus (ADV), enterovirus/human rhinovirus (EV/HRV), human parainfluenza virus (HPIV), human coronavirus (HCoV), respiratory syncytial virus (RSV), and human metapneumovirus (HMPV). ResultsFrom 2015 to 2019, a total of 344 ILI cases were tested, of which 192 out of 344 cases (55.81%) were tested positive for single respiratory pathogen. From 2023 to 2024, 1 557 ILI cases were tested, with 572 out of 1 557 cases (36.74%) being positive for single pathogen. From 2023 to 2024, the positive rate of single pathogen in ILI cases was significantly lower than that in 2015‒2019 (χ²=42.66, P<0.001). Specifically, the positive rate of Flu A (χ²=74.43, P<0.001) decreased, while that of HPIV (χ²=8.66, P=0.003) increased, both with statistically significant differences. According to the seasonal pattern, the epidemic intensity of Flu A decreased in summer, while that of HPIV increased in summer and autumn. Demographic results showed statistically significant differences in the positive rates of EV/HRV between genders (χ²=22.38, P<0.001), with males exhibiting a higher positive rate than females. No statistically significant differences were identified in the positive rates of single pathogen among different age groups (χ²=4.42, P=0.110). Nevertheless, statistically significant differences were noted when comparing the positive rates of EV/HRV, Flu A, Flu B and HPIV across different age groups (P<0.05). EV/HRV was more commonly detected in the 15‒<25 age group (10.93%), while Flu A and HPIV had the highest positive rates in the ≥60 age group (21.24% and 4.77%). Flu B had the highest positive rate in the 25‒<60 age group (11.26%). 52.63% of cases with co-infections occurred during winter, with the primary pathogens involved being EV/HRV (9 cases) and HCoV (6 cases). The most prevalent combination of co-infection was Flu A with EV/HRV. ConclusionThe prevalence of respiratory pathogens among ILI cases from 2023 to 2024 exhibited notable fluctuations compared to that from 2015 to 2019. Therefore, influenza surveillance should be strengthened, and attention should also be paid to the prevalence of respiratory pathogens such as HPIV. These findings have profound implications for future research, surveillance, vaccine planning, and public health policy making.

OBJECTIVE: To investigate the effectiveness of delayed replantation of degloving skin preserved at 4℃ in treatment of limb degloving injuries. METHODS: Between October 2020 and October 2023, 12 patients with limb degloving injuries were admitted. All patients had severe associated injuries or poor wound conditions that prevented primary replantation. There were 7 males and 5 females; age ranged from 29 to 46 years, with an average of 39.2 years. The causes of injury included machine entanglement in 6 cases, traffic accidents in 5 cases, and sharp instrument cuts in 1 case. Time from injury to hospital admission was 0.5-3.0 hours, with an average of 1.3 hours. Injury sites included upper limbs in 7 cases and lower limbs in 5 cases. The range of degloving skin was from 5 cm×4 cm to 15 cm×8 cm, and all degloving skins were intact. The degloving skin was preserved at 4℃. After the patient's vital signs became stable and the wound conditions improved, it was trimmed into medium-thickness skin grafts for replantation. The degloving skin was preserved for 3 to 7 days. At 4 weeks after replantation, the viability of the degloving skin grafts was assessed, including color, elasticity, and sensation of pain. The Vancouver Scar Scale (VSS) was used to assess the scars of the skin grafts during follow-up. RESULTS: At 4 weeks after replantation, 8 cases of skin grafts completely survived and the color was similar with normal skin, with a survival rate of 66.67%. The elasticity of skin grafts (R0 value) ranged from 0.09 to 0.85, with an average of 0.55; moderate pain was reported in 4 cases, mild pain in 3 cases, and no pain in 5 cases. All patients were followed up 12 months. Over time, the VSS scores of all 12 patients gradually decreased, with a range of 4-11 at 12 months (mean, 6.8). CONCLUSION For limb degloving injuries that cannot be replanted immediately and do not have the conditions for deep low-temperature freezing preservation, the method of preserving the degloving skin at 4℃ for delayed replantation can be chosen.
Humans ; Male ; Adult ; Replantation/methods* ; Female ; Degloving Injuries/surgery* ; Middle Aged ; Skin Transplantation/methods* ; Treatment Outcome ; Extremities/injuries* ; Time Factors ; Skin/injuries* ; Tissue Preservation/methods*

Objective To evaluate the value of dynamic electrocardiography(ECG)parameters combined with CT angiography(CTA)parameters in the evaluation of major adverse cardiovascu-lar events(MACE)in elderly patients with coronary heart disease(CHD).Methods A total of 110 elderly CHD patients admitted to our Hospital from January 2021 to May 2023 were prospec-tively recruited,and then divided into a MACE group(30 cases)and a non-MACE group(80 ca-ses)according to whether MACE occurred within 1 year of follow-up.The parameters of Holter,including QT interval variability(QTV),total standard deviation of N-N interval(SDNN),per-centage of total adjacent N-N over 50 ms(PNN50),and standard deviation of the average N-N in-tervals in all 5-min segment of a 24-h recording(SDANN),and the CTA parameters,such as min-imum lumen diameter(MLD),minimum lumen area(MLA),percentage of stenosis area(AS)and percentage of stenosis diameter(DS),were compared between the two groups.A nomogram-based prediction model for MACE risk was then constructed.ROC curve and calibration curve were drawn to evaluate the prediction efficiency of the risk model.Results The MACE group had significantly advanced age,more coronary lesions,and higher AS and DS values,but obviously lower SDNN,SDANN,PNN50,QTV,MLA and MLD values than the non-MACE group(P＜0.05,P＜0.01).The risk prediction model showed that advanced age,multivessel lesions,smaller SDNN,SDANN,PNN50,QTV,MLA and MLD values,and larger AS and DS values indicated higher risk of MACE in the elderly CHD patients.ROC curve analysis revealed that the AUC val-ue of our risk prediction model was 0.872(95％CI:0.764-0.975),with a sensitivity of 93.33％(28/30),a specificity of 91.25％(73/80),and an accuracy of 91.82％(101/110).Calibration curve analysis indicated that the model had a good fit(Chi-square=2.879,P=0.410),and Bootstrap in-ternal verification suggested that the model had a good accuracy(C-index=0.834).Conclusion Dynamic ECG parameters and CT A parameters are abnormal in elderly patients with MACE.Our risk prediction model based on these parameters has high value in evaluating the occurrence of MACE in the patients.

The new cultural construction of high-quality development of public hospitals proposes a patient-oriented ap-proach.People with disabilities,represented by the hearing-impaired community,faces many difficulties in the process of seeking medical care,and their needs have not been adequately addressed.This inadequacy adversely affects the development of harmoni-ous doctor-patient relationships and the patient medical experience.This study takes the deaf assistance outpatient clinic,first es-tablished by Shanghai East Hospital as an example to elaborate the practice of cultural brand construction under the leadership of Party building.Medical social workers,healthcare professionals,and volunteers work together to build a cultural brand through institutional guarantees,detailed care,and the establishment of a full process service system.This is expected to provide refer-ences for the construction of hospital cultural brands..

Objective To investigate the mechanism of kaempferol(KPF)in the treatment of macular edema sec-ondary to retinal vein occlusion(RVO-ME).Methods RVO model was established in SD rats using photocoagulation.Twenty SD rats were randomly divided into:Control group(normal rats,saline injection),Model group(RVO model rats,saline injection),Low KPF group[RVO model rats,KPF injection(8 mg·kg-1·d-1)],High KPF group[RVO model rats,KPF injection(16 mg·kg-1·d-1)],with 5 rats per group for 14 days.Fundus photography observed retinal vessels;HE staining evaluated retinal structural changes.HRMECs were randomly divided into:control group(no intervention),CoCl2 group(300 μmol·L-1 CoCl2),Low-dose KPF group(300 μmol·L-1 CoCl2+20 μmol·L-1 KPF),High-dose KPF group(300 μmol·L-1 CoCl2+30 μmol·L-1 KPF)and pathway inhibitor group(DAPT group)(300 μmol·L-1 CoCl2+20 μmol·L-1 DAPT),with 24-hour intervention.CCK-8 assay detected cell viability;Scratch test measured cell migration rate;ELISA quantified inflammatory factors[interleukin(IL)-6,tumor necrosis factor(TNF)-α];FITC-dextran assay evalu-ated endothelial monolayer permeability;Immunofluorescence detected zonula occludens(ZO)-1 expression;Western blot and RT-PCR measured protein and mRNA levels of ZO-1,Occludin,Notch1,and Hes1.Results Fundus photography showed interrupted venous blood flow and retinal edema in Model group,alleviated by KPF.HE staining revealed disorder-ed retinal arrangement and severe edema in the Model group,improved by KPF.Compared with CoCl2 group,Low-and High-dose KPF groups showed reduced cell migration rate,increased cell vitality(both P＜0.05),IL-6 and TNF-α levels de-creased in Low-and High-dose KPF groups and DAPT group(all P＜0.05),permeability coefficient decreased in Low-and High-dose KPF groups and DAPT group(all P＜0.05),ZO-1 expression increased in Low-and High-dose KPF groups and DAPT group(all P＜0.05),ZO-1 and Occludin protein/mRNA levels increased;Notch1 and Hes1 protein/mRNA levels de-creased in Low-and High-dose KPF groups and DAPT group(all P＜0.05).Conclusion KPF treat RVO-ME by inhibiting the Notch1/Hes1 pathway,exerting anti-inflammatory effects and improving intercellular tight junctions.

The new cultural construction of high-quality development of public hospitals proposes a patient-oriented ap-proach.People with disabilities,represented by the hearing-impaired community,faces many difficulties in the process of seeking medical care,and their needs have not been adequately addressed.This inadequacy adversely affects the development of harmoni-ous doctor-patient relationships and the patient medical experience.This study takes the deaf assistance outpatient clinic,first es-tablished by Shanghai East Hospital as an example to elaborate the practice of cultural brand construction under the leadership of Party building.Medical social workers,healthcare professionals,and volunteers work together to build a cultural brand through institutional guarantees,detailed care,and the establishment of a full process service system.This is expected to provide refer-ences for the construction of hospital cultural brands..

Objective To investigate the mechanism of kaempferol(KPF)in the treatment of macular edema sec-ondary to retinal vein occlusion(RVO-ME).Methods RVO model was established in SD rats using photocoagulation.Twenty SD rats were randomly divided into:Control group(normal rats,saline injection),Model group(RVO model rats,saline injection),Low KPF group[RVO model rats,KPF injection(8 mg·kg-1·d-1)],High KPF group[RVO model rats,KPF injection(16 mg·kg-1·d-1)],with 5 rats per group for 14 days.Fundus photography observed retinal vessels;HE staining evaluated retinal structural changes.HRMECs were randomly divided into:control group(no intervention),CoCl2 group(300 μmol·L-1 CoCl2),Low-dose KPF group(300 μmol·L-1 CoCl2+20 μmol·L-1 KPF),High-dose KPF group(300 μmol·L-1 CoCl2+30 μmol·L-1 KPF)and pathway inhibitor group(DAPT group)(300 μmol·L-1 CoCl2+20 μmol·L-1 DAPT),with 24-hour intervention.CCK-8 assay detected cell viability;Scratch test measured cell migration rate;ELISA quantified inflammatory factors[interleukin(IL)-6,tumor necrosis factor(TNF)-α];FITC-dextran assay evalu-ated endothelial monolayer permeability;Immunofluorescence detected zonula occludens(ZO)-1 expression;Western blot and RT-PCR measured protein and mRNA levels of ZO-1,Occludin,Notch1,and Hes1.Results Fundus photography showed interrupted venous blood flow and retinal edema in Model group,alleviated by KPF.HE staining revealed disorder-ed retinal arrangement and severe edema in the Model group,improved by KPF.Compared with CoCl2 group,Low-and High-dose KPF groups showed reduced cell migration rate,increased cell vitality(both P＜0.05),IL-6 and TNF-α levels de-creased in Low-and High-dose KPF groups and DAPT group(all P＜0.05),permeability coefficient decreased in Low-and High-dose KPF groups and DAPT group(all P＜0.05),ZO-1 expression increased in Low-and High-dose KPF groups and DAPT group(all P＜0.05),ZO-1 and Occludin protein/mRNA levels increased;Notch1 and Hes1 protein/mRNA levels de-creased in Low-and High-dose KPF groups and DAPT group(all P＜0.05).Conclusion KPF treat RVO-ME by inhibiting the Notch1/Hes1 pathway,exerting anti-inflammatory effects and improving intercellular tight junctions.

Objective To evaluate the value of dynamic electrocardiography(ECG)parameters combined with CT angiography(CTA)parameters in the evaluation of major adverse cardiovascu-lar events(MACE)in elderly patients with coronary heart disease(CHD).Methods A total of 110 elderly CHD patients admitted to our Hospital from January 2021 to May 2023 were prospec-tively recruited,and then divided into a MACE group(30 cases)and a non-MACE group(80 ca-ses)according to whether MACE occurred within 1 year of follow-up.The parameters of Holter,including QT interval variability(QTV),total standard deviation of N-N interval(SDNN),per-centage of total adjacent N-N over 50 ms(PNN50),and standard deviation of the average N-N in-tervals in all 5-min segment of a 24-h recording(SDANN),and the CTA parameters,such as min-imum lumen diameter(MLD),minimum lumen area(MLA),percentage of stenosis area(AS)and percentage of stenosis diameter(DS),were compared between the two groups.A nomogram-based prediction model for MACE risk was then constructed.ROC curve and calibration curve were drawn to evaluate the prediction efficiency of the risk model.Results The MACE group had significantly advanced age,more coronary lesions,and higher AS and DS values,but obviously lower SDNN,SDANN,PNN50,QTV,MLA and MLD values than the non-MACE group(P＜0.05,P＜0.01).The risk prediction model showed that advanced age,multivessel lesions,smaller SDNN,SDANN,PNN50,QTV,MLA and MLD values,and larger AS and DS values indicated higher risk of MACE in the elderly CHD patients.ROC curve analysis revealed that the AUC val-ue of our risk prediction model was 0.872(95％CI:0.764-0.975),with a sensitivity of 93.33％(28/30),a specificity of 91.25％(73/80),and an accuracy of 91.82％(101/110).Calibration curve analysis indicated that the model had a good fit(Chi-square=2.879,P=0.410),and Bootstrap in-ternal verification suggested that the model had a good accuracy(C-index=0.834).Conclusion Dynamic ECG parameters and CT A parameters are abnormal in elderly patients with MACE.Our risk prediction model based on these parameters has high value in evaluating the occurrence of MACE in the patients.

Objective To identify the disease burden and indirect economic burden caused by lung cancer in Kunshan City, Jiangsu Province, from 1981 to 2020. Methods The incidence and death cases of lung cancer were obtained from cancer registry and death cause monitoring data. The disability adjusted life years (DALY) was used as the evaluation index for burden posed by lung cancer on health, and the indirect economic burden was calculated by a human capital method. Results From 1981 to 2020, a total of 9272 deaths due to lung cancer were reported in Kunshan, of which 7106 were males and 2166 were females. The DALY caused by lung cancer in the whole population were 3.81, 4.14, 4.38, and 9.46 in 1981–1990, 1991–2000, 2001–2010, and 2011–2020, respectively. The indirect economic burden caused by lung cancer was 10.515, 141.657, 813.794, and 6659.149 million yuan. From 2011 to 2020, the ratios of years of life lost due to premature mortality to DALY in males, females, and the general population were 92.42%, 95.15%, and 93.60%, respectively. Conclusion The health burden and indirect economic burden for lung cancer are substantial in the Kunshan City. Moreover, age-specific DALY and indirect economic burden are not exactly symmetrical, suggesting that an effective control strategy to lower cost is urgently needed, especially for individuals aged 40-59.

Based on the service of stranded patients in D Hospital, this study aimed to explore the multiple needs of stranded patients and construct an intervention mode from the ecosystem perspective. Using the method of case study, taking the service of stranded patients in hospital D as an example, 49 case records and verbatim interviews with stakeholders were analyzed. The discharge and resettlement of stranded patients faces multiple obstacles from individuals, families, medical and social systems. This study constructed the social work intervention model from the ecosystem perspective: information collection and needs assessment, empowerment of individual system, reconstruction of family support system, coordination of medical system and linking social support system. The intervention process achieved efficient effects. Social work intervention of stranded patients should pay attention to patients’ psychosocial needs and improve awareness of system difficulties; mobilize the multi-system support network and deliver services in combination with case management method; conduct social advocacy for the breakthrough of law and policy.