Objective: To investigate the characteristics of public health emergencies in Jinhua City, Zhejiang Province from 2014 to 2023, so as to provide the reference for prevention and control of public health emergencies. Methods: Data of public health emergencies and related information in Jinhua City from 2014 to 2023 were collected through Emergency Public Reporting System of Chinese Disease Prevention and Control Information System. Attack rates, and distribution of time, areas and places were descriptively analyzed. Results: A total of 276 public health emergencies were reported in Jinhua City from 2014 to 2023. There were 10 324 reported cases and 7 deaths, with an attack rate of 0.32%. There were 53 Ⅳ-level (19.20%) and 223 unclassified public health emergencies (80.80%). Infectious disease emergencies were predominant types, accounting for 97.83% (270 events). The three most common infectious disease emergencies were other infectious diarrhea (42.03%), influenza (21.01%) and COVID-19 (16.30%). The reported public health emergencies peaked in November and December, with 66 and 45 events reported, respectively. The three most counties (cities, districts) included Yiwu City, Wucheng District and Lanxi City, accounting for 24.28% (67 events), 18.48% (51 events) and 11.96% (33 events), respectively. School and preschool institutions were predominant places where public health emergencies occurred (198 events, 71.74%). Conclusions The public health emergencies in Jinhua City from 2014 to 2023 were Ⅳ-level and unclassified emergencies, and infectious disease emergencies were predominant. November and December were the peak reporting periods, and schools and preschool institutions were the main places where these events occurred.

Objective:To explore the correlation between serum uric acid/high-density lipoprotein cholesterol ratio (UHR) and the risk of hypertension in elderly physical examination populations.Methods:This study was a cross-sectional study. A total of 1 028 patients aged≥60 years who underwent physical examinations at the Health Management Center of Fuwai Central China Cardiovascular Hospital from September 2023 to February 2024 were included in this study. The general demographic data, past medical history, physical examination and laboratory examination indicators of the physical examiners were collected, and according to whether they had hypertension or not, they were divided into hypertension group (390 cases) and non-hypertension group (638 cases), and all UHR values were arranged from small to large, and the UHR was divided into three groups by tertiles of UHR, and the general data and blood biochemical indexes between the groups were compared. Spearman rank correlation was used to analyze the correlation between UHR level and body mass index, total cholesterol, triglyceride and other indexes in the elderly population. Logistic regression was used to explore the relationship between UHR level and hypertension in the elderly population, and the stratification analysis of the physical examination population was carried out according to diabetes, coronary heart disease and dyslipidemia, and the interaction test between groups was carried out.Results:Among the 1 028 geriatric physical examination cases, 580 (56.4%) were males and 448 (43.6%) were females, aged (66.7±5.8) years. UHR levels were higher in the hypertensive group compared to the non-hypertensive group [248.88 (191.19, 322.25) vs 213.52 (165.94, 275.29); Z=-5.445, P<0.05]. With the increase of UHR level, the detection rate of hypertension in the elderly population increased (accounted for 27.8%, 38.2% and 47.8%, respectively; χ2=29.211, P<0.05). Spearman rank correlation analysis showed that UHR was positively correlated with body mass index, triglycerides, serum uric acid, serum creatinine and fasting blood glucose ( r=0.318, 0.334, 0.774, 0.474, 0.080; all P<0.05), and negatively correlated with total cholesterol, glomerular filtration rate and low-density lipoprotein cholesterol ( r=-0.239, -0.303, -0.154; all P<0.05). When the confounding factors were not adjusted (model 1), the risk of hypertension in high UHR group was 2.382 times higher than that in low UHR group and 1.607 times higher than that in medium UHR group; after adjusting for all confounding factors such as age, gender, body mass index, systolic blood pressure, diastolic blood pressure, junior high school education or below, smoking, alcohol consumption, glomerular filtration rate, etc., the risk of hypertension in the high-level UHR group was 1.732 times higher than that in the low-level UHR group (95% CI: 1.139-2.635) ( P<0.05). The elderly physical examination population was further stratified according to whether there was diabetes, dyslipidemia and coronary heart disease, and it was found that there was no interaction between UHR and diabetes, dyslipidemia and coronary heart disease on the prevalence of hypertension (all P>0.05). Conclusions:Hypertension detection rate increases with higher UHR levels. UHR is closely related to the incidence of hypertension in the elderly population.

Protein tyrosine phosphatase nonreceptor type 2 (PTPN2) is a promising target for sensitizing solid tumors to immune checkpoint blockades. However, the highly polar active sites of PTPN2 hinder drug discovery efforts. Leveraging small interfering RNA (siRNA) technology, we developed a novel glutathione-responsive nano-platform HPssPT (HA/PEIss@siPtpn2) to silence PTPN2 and enhance immunotherapy efficacy in hepatocellular carcinoma (HCC). HPssPT showed potent transfection and favorable safety profiles. PTPN2 deficiency induced by HPssPT amplified the interferon γ signaling in HCC cells by increasing the phosphorylation of Janus-activated kinase 1 and signal transducer and activator of transcription 1, resulting in enhanced antigen presentation and T cell activation. The nano-platform was also able to promote the M1-like polarization of macrophages in vitro. The unique tropism of HPssPT towards tumor-associated macrophages, facilitated by hyaluronic acid coating and CD44 receptor targeting, allowed for simultaneous reprogramming of both tumor cells and tumor-associated macrophages, thereby synergistically reshaping tumor microenvironment to an immunostimulatory state. In HCC, colorectal cancer, and melanoma animal models, HPssPT monotherapy provoked robust antitumor immunity, thereby sensitizing tumors to PD-1 blockade, which provided new inspiration for siRNA-based drug discovery and tumor immunotherapy.

Objective:To analyze the epidemiological characteristics of child injuries（CI）and provide a scientific basis for developing CI prevention and treatment strategies.Methods:Clinical data of CI cases admitted to Kunshan Woman and Children’s Healthcare Hospital from January 1st，2020 to December 31st，2022 were collected. The cases were classified into three age groups：infants and toddlers（0-3 years），preschoolers（4-6 years），and school-age children（7-14 years）. Post hoc testing was used for pairwise comparisons between groups，and differences were determined based on adjusted standardized residuals（AR）. The epidemiological characteristics that were analyzed included the type，location，and nature of injuries across these age groups.Results:A total of 12 449 CI cases were collected with a male-to-female ratio of 1.72∶1. School-age boys were more prone to injuries（72.2%， AR=16.3）compared to the other two age groups. The major CI types were falls（50.4%），blunt injuries（15.9%），and strains（9.9%）. The infant and toddler group showed higher rates of strains（21.9%， AR=34.9）and poisonings（7.9%， AR=19.6）compared to the other two groups，while preschoolers group had higher rates of falls（55.6%， AR=6.5）and motor vehicle accidents（4.8%， AR=3.6）compared to other age groups. The most frequently injured body regions were upper limbs（43.9%），head/face/neck（27.0%），and lower limbs（16.7%）. The infant and toddler group had higher rates of head/face/neck（34.8%， AR=15.4），upper limb（46%， AR=3.6），and whole body（8.9%， AR=18.7）injuries. The nature of CI mainly includes contusion/bruise/crush injury（34.3%），fractures（20.0%）and sharp/open wounds（19.5%）. School-age children exhibited higher rates of fractures（30.1%， AR=22.1），strains/sprains（10.1%， AR=13.0），contusion/bruise/crush injury（36.6%， AR=4.2），and multi-site injuries（0.7%， AR=4.4）compared to the other two groups. Injuries were mostly mild（90.8%），with infants and toddlers showing higher mild injury rates（95.0%， AR=12.7），whereas school-aged children had more moderate injuries（11.7%， AR=11.0）. Conclusion:The epidemiological characteristics of CI in infants and toddlers，preschoolers and school-age children are different，and different intervention strategies are needed for different age groups.

Objective To investigate the expression levels of serum microRNA-21(miR-21)and microRNA-23a(miR-23a)in patients with Parkinson's disease(PD)and their correlations with cognitive function and inflammatory responses.Methods A total of 120 PD patients admitted to the Second Affiliated Hospital of Hebei North University between December 2019 and January 2022 were enrolled,along with 115 healthy controls from the same period.Serum miR-21 and miR-23a levels were measured by quantitative real-time PCR,while serum levels of IL-6,CRP,and TNF-α were determined by ELISA.According to Mini-Mental State Examination(MMSE)scores,PD patients were classified into a cognitive impairment group(MMSE<26,n=72)and a normal cognition group(MMSE≥26,n=48).General characteristics in clinical and biochemical indicators levels were compared between the two groups.Spearman correlation analysis was used to assess the relationships of miRNAs and MMSE scores.Multivariate logistic regression analysis was employed to identify risk factors for cognitive impairment.The predictive value of miR-21 and miR-23a was evaluated using Receiver Operating Characteristic(ROC)curve analysis.Results Serum miR-21,miR-23a,IL-6,CRP,and TNF-α levels were significantly higher in the PD group than in the control group(P<0.01).The cognitive impairment group showed higher levels of miR-21,miR-23a,and inflammatory factor than the cognitively normal group(P<0.01).Correlation analysis revealed that miR-21 and miR-23a levels were negatively correlated with MMSE scores(r=-0.472,-0.514;P<0.001)and positively correlated with IL-6,CRP,and TNF-α(P<0.001).Multivariate Logistic regression analysis revealed that high expression of miR-21,miR-23a,and a higher UPDRS score,were independent risk factors for cognitive impairment in PD patients(P<0.05).Combined detection of miR-21 and miR-23a showed higher predictive accuracy for cognitive impairment than either marker alone(P<0.05).Conclusion Serum expression levels of miR-21 and miR-23a was upregulated in PD patients,which were associated with cognitive function and inflammatory response.Combined detection shows good predictive value for cognitive impairment..

The operation assistant work team of public hospitals is an important bridge and link to realize the integration of industry and finance,and an important practitioner to promote the realization of lean operation management.It examines the service model of the operation assistant team engaged in Similar Multi-disciplinary Treatment,focusing on organizational structure,job responsibilities,and service mechanisms.Build a four-tiered lean operational management system and set up an operation assistant work team that combines production,university and research.Based on specific management matters,establish an operation assistant service mechanism such as problem assessment and classification management mechanism,project standardization management mechanism,reward and punishment assessment mechanism,etc.,to promote the optimization and integration of hospital medical education,research,prevention and management and core elements such as human,talent,material and technology resources.Help public hospitals to continuously improve their lean operation management level.

Objective To evaluate the effectiveness of active screening in improving the detection rate of carbape-nem-resistant Enterobacterales(CRE)in the intensive care units(ICUs).Methods From July 2023 to June 2024,active screening of rectal swab CRE was conducted on ICU patients in 10 hospitals.ICU patients who underwent ac-tive screening from July 2023 to June 2024 were selected as the study group,while those who did not undergo active screening from July 2022 to June 2023 were selected as the control group.Difference in CRE detection rates between the two groups of patients was compared.Results A total of 7 803 ICU patients were included in the study group,744 CRE strains were detected,with a detection rate of 9.53％,out of which 304 CRE strains were detected through routine detection(detection rate 3.90％),3 707 patients underwent active screen,440 CRE strains were detected(detection rate 11.87％).7 561 ICU patients were included in the control group,out of which 250 CRE strains were detected through routine detection,with a detection rate of 3.31％.There was a statistically significant difference in the overall detection rate of CRE between two groups of patients(x2=246.18,P＜0.001).In the study group,CRE detection rate of active screening(11.87％)was higher than that of routine detection(3.90％),with statistically significant difference(x2=264.26,P＜0.001).A total of 17 CRE strains were detected from the study group.The proportions of Klebsiella pneumoniae(80.92％vs 73.41％)and Serratia marcescens(2.30％vs0.23％)in the routine detection group were both higher than in the active screening group,while the proportion of Escherichia coli in the routine detection group was lower(8.22％vs 19.55％),all with statistically significant differences(all P＜0.05).Conclusion The prevalence of CRE in ICUs is relatively high,with a wide range of bac-terial species.Active screening can improve the detection rate of CRE.

Objective To evaluate the effectiveness of active screening in improving the detection rate of carbape-nem-resistant Enterobacterales(CRE)in the intensive care units(ICUs).Methods From July 2023 to June 2024,active screening of rectal swab CRE was conducted on ICU patients in 10 hospitals.ICU patients who underwent ac-tive screening from July 2023 to June 2024 were selected as the study group,while those who did not undergo active screening from July 2022 to June 2023 were selected as the control group.Difference in CRE detection rates between the two groups of patients was compared.Results A total of 7 803 ICU patients were included in the study group,744 CRE strains were detected,with a detection rate of 9.53％,out of which 304 CRE strains were detected through routine detection(detection rate 3.90％),3 707 patients underwent active screen,440 CRE strains were detected(detection rate 11.87％).7 561 ICU patients were included in the control group,out of which 250 CRE strains were detected through routine detection,with a detection rate of 3.31％.There was a statistically significant difference in the overall detection rate of CRE between two groups of patients(x2=246.18,P＜0.001).In the study group,CRE detection rate of active screening(11.87％)was higher than that of routine detection(3.90％),with statistically significant difference(x2=264.26,P＜0.001).A total of 17 CRE strains were detected from the study group.The proportions of Klebsiella pneumoniae(80.92％vs 73.41％)and Serratia marcescens(2.30％vs0.23％)in the routine detection group were both higher than in the active screening group,while the proportion of Escherichia coli in the routine detection group was lower(8.22％vs 19.55％),all with statistically significant differences(all P＜0.05).Conclusion The prevalence of CRE in ICUs is relatively high,with a wide range of bac-terial species.Active screening can improve the detection rate of CRE.

The operation assistant work team of public hospitals is an important bridge and link to realize the integration of industry and finance,and an important practitioner to promote the realization of lean operation management.It examines the service model of the operation assistant team engaged in Similar Multi-disciplinary Treatment,focusing on organizational structure,job responsibilities,and service mechanisms.Build a four-tiered lean operational management system and set up an operation assistant work team that combines production,university and research.Based on specific management matters,establish an operation assistant service mechanism such as problem assessment and classification management mechanism,project standardization management mechanism,reward and punishment assessment mechanism,etc.,to promote the optimization and integration of hospital medical education,research,prevention and management and core elements such as human,talent,material and technology resources.Help public hospitals to continuously improve their lean operation management level.

Objective:To explore the correlation between serum uric acid/high-density lipoprotein cholesterol ratio (UHR) and the risk of hypertension in elderly physical examination populations.Methods:This study was a cross-sectional study. A total of 1 028 patients aged≥60 years who underwent physical examinations at the Health Management Center of Fuwai Central China Cardiovascular Hospital from September 2023 to February 2024 were included in this study. The general demographic data, past medical history, physical examination and laboratory examination indicators of the physical examiners were collected, and according to whether they had hypertension or not, they were divided into hypertension group (390 cases) and non-hypertension group (638 cases), and all UHR values were arranged from small to large, and the UHR was divided into three groups by tertiles of UHR, and the general data and blood biochemical indexes between the groups were compared. Spearman rank correlation was used to analyze the correlation between UHR level and body mass index, total cholesterol, triglyceride and other indexes in the elderly population. Logistic regression was used to explore the relationship between UHR level and hypertension in the elderly population, and the stratification analysis of the physical examination population was carried out according to diabetes, coronary heart disease and dyslipidemia, and the interaction test between groups was carried out.Results:Among the 1 028 geriatric physical examination cases, 580 (56.4%) were males and 448 (43.6%) were females, aged (66.7±5.8) years. UHR levels were higher in the hypertensive group compared to the non-hypertensive group [248.88 (191.19, 322.25) vs 213.52 (165.94, 275.29); Z=-5.445, P<0.05]. With the increase of UHR level, the detection rate of hypertension in the elderly population increased (accounted for 27.8%, 38.2% and 47.8%, respectively; χ2=29.211, P<0.05). Spearman rank correlation analysis showed that UHR was positively correlated with body mass index, triglycerides, serum uric acid, serum creatinine and fasting blood glucose ( r=0.318, 0.334, 0.774, 0.474, 0.080; all P<0.05), and negatively correlated with total cholesterol, glomerular filtration rate and low-density lipoprotein cholesterol ( r=-0.239, -0.303, -0.154; all P<0.05). When the confounding factors were not adjusted (model 1), the risk of hypertension in high UHR group was 2.382 times higher than that in low UHR group and 1.607 times higher than that in medium UHR group; after adjusting for all confounding factors such as age, gender, body mass index, systolic blood pressure, diastolic blood pressure, junior high school education or below, smoking, alcohol consumption, glomerular filtration rate, etc., the risk of hypertension in the high-level UHR group was 1.732 times higher than that in the low-level UHR group (95% CI: 1.139-2.635) ( P<0.05). The elderly physical examination population was further stratified according to whether there was diabetes, dyslipidemia and coronary heart disease, and it was found that there was no interaction between UHR and diabetes, dyslipidemia and coronary heart disease on the prevalence of hypertension (all P>0.05). Conclusions:Hypertension detection rate increases with higher UHR levels. UHR is closely related to the incidence of hypertension in the elderly population.