Objective To explore the short-term efficacy of endoscopic submucosal dissection (ESD) in the treatment of early carcinoma in the remnant stomach. Methods A retrospective study was conducted on 45 patients with early residual gastric cancer underwent ESD at the Endoscopy Center of Zhongshan Hospital, Fudan University from December 2014 to April 2024, with a total of 45 lesions. The patients were divided into an anastomotic group (n=15) and a non-anastomotic group (n=30) based on the location of tumor occurrence, and their clinical data, endoscopic diagnosis and treatment, and histopathological conditions were compared between the two groups. Results All 45 patients had lesions with redness and erosion. There were 9 cases of poor lifting of submucosal injection in the anastomotic group and 2 cases in the non-anastomotic group, respectively, and the difference was statistically significant (P<0.05). ESD surgery was performed on 13 lesions in the anastomotic group and 28 lesions in the non-anastomotic group, with surgery times of 80.00 (50.00, 100.00) min and 55.00 (43.75, 80.00) min, respectively. The difference in surgery time between the two groups was statistically significant (P=0.03). Among the 45 patients, ESD surgery achieved curative resection in 35 cases, including 11 cases in the anastomotic group and 24 cases in the non-anastomotic group, with no statistically significant difference. Conclusions Careful preoperative evaluation of early carcinoma in the remnant stomach is essential to prevent oversight. Lesions at anastomotic sites and suture lines present higher technical challenges for complete resection. ESD is safe and effective, with auxiliary traction technique available when necessary.

Objective To compare the effect of immediately wearing different running shoes and foot-strike patterns on the in vivo Achilles tendon(AT)length and loading of habitual rearfoot striking(RFS)runners.Methods Eleven male running enthusiasts were recruited(age:33.7±8.7 years old,running experience:5.3±2.3 years).They were randomly assigned to wear cushioned running shoes or minimalist shoes,and run at 10 km/h on a Bertec 3-D force platform with forefoot striking(FFS)and RFS,respectively.The ultrasound imaging probe was fixed at the junction of the AT and the me-dial head of the gastrocnemius muscle with an elastic bandage,synchronized with the Vicon high-speed infrared motion capture system,which collected and calculated real-time length changes and loading characteristics of the AT in vivo.A 2×2 two-way ANOVA was used to determine the effect of different running shoes(cushioned running shoes vs.minimalist shoes)and foot strike patterns(FFS vs.RFS)on the in vivo AT loading characteristics during running,and the significance level α was set at 0.05.Results There was a significant interaction between footwear type and footstrike patterns on the foot strike angle.Within the same shoe condition(cushioned or minimalist),foot strike angle(FSA)was significantly greater during RFS than during FFS(P<0.05).Moreover,during RFS,FSA was significantly greater in cushioned shoes than in minimalist shoes(P<0.05).In addition,under acute manipulations of footwear and strike pattern,the instantaneous AT loading rate also exhibited a signifi-cant footwear and foot strike patterns interaction(P<0.05).The instantaneous AT loading rate was sig-nificantly greater when immediately wearing minimalist shoes with RFS than when wearing cushioned running shoes with RFS,as well as significantly greater when immediately wearing cushioned running shoes with FFS than when running with RFS(P<0.05).In addition,there was no interaction effect for the other parameters,except the significant group or time main effects(P<0.05).The peak AT force,average AT loading rate,AT impulse,peak AT stress,peak AT length change,and AT work during FFS were significantly greater than those during RFS(P<0.05).What's more,the peak AT force when immediately wearing minimalist shoes was significantly greater than that when wearing cushioned run-ning shoes(P<0.05).Conclusion It is suggested that immediately wearing minimalist shoes and/or transi-tioning to FFS could provide higher tendon loading intensity,which might improve the morphology and mechanical properties of the AT.However,the increased AT loading rate also indicated that if RFS was maintained while running in minimalist shoes,the reduced cushioning could have led to a greater risk of injury without an appropriate adaptation process.

Objective To compare the effect of immediately wearing different running shoes and foot-strike patterns on the in vivo Achilles tendon(AT)length and loading of habitual rearfoot striking(RFS)runners.Methods Eleven male running enthusiasts were recruited(age:33.7±8.7 years old,running experience:5.3±2.3 years).They were randomly assigned to wear cushioned running shoes or minimalist shoes,and run at 10 km/h on a Bertec 3-D force platform with forefoot striking(FFS)and RFS,respectively.The ultrasound imaging probe was fixed at the junction of the AT and the me-dial head of the gastrocnemius muscle with an elastic bandage,synchronized with the Vicon high-speed infrared motion capture system,which collected and calculated real-time length changes and loading characteristics of the AT in vivo.A 2×2 two-way ANOVA was used to determine the effect of different running shoes(cushioned running shoes vs.minimalist shoes)and foot strike patterns(FFS vs.RFS)on the in vivo AT loading characteristics during running,and the significance level α was set at 0.05.Results There was a significant interaction between footwear type and footstrike patterns on the foot strike angle.Within the same shoe condition(cushioned or minimalist),foot strike angle(FSA)was significantly greater during RFS than during FFS(P<0.05).Moreover,during RFS,FSA was significantly greater in cushioned shoes than in minimalist shoes(P<0.05).In addition,under acute manipulations of footwear and strike pattern,the instantaneous AT loading rate also exhibited a signifi-cant footwear and foot strike patterns interaction(P<0.05).The instantaneous AT loading rate was sig-nificantly greater when immediately wearing minimalist shoes with RFS than when wearing cushioned running shoes with RFS,as well as significantly greater when immediately wearing cushioned running shoes with FFS than when running with RFS(P<0.05).In addition,there was no interaction effect for the other parameters,except the significant group or time main effects(P<0.05).The peak AT force,average AT loading rate,AT impulse,peak AT stress,peak AT length change,and AT work during FFS were significantly greater than those during RFS(P<0.05).What's more,the peak AT force when immediately wearing minimalist shoes was significantly greater than that when wearing cushioned run-ning shoes(P<0.05).Conclusion It is suggested that immediately wearing minimalist shoes and/or transi-tioning to FFS could provide higher tendon loading intensity,which might improve the morphology and mechanical properties of the AT.However,the increased AT loading rate also indicated that if RFS was maintained while running in minimalist shoes,the reduced cushioning could have led to a greater risk of injury without an appropriate adaptation process.

Abstract: Objective　To analyze the serotypes, drug resistance, and molecular epidemiological characteristics of non-typhoidal Salmonella in Chaozhou City, Guangdong Province in 2022, providing pathogenic support for the effective prevention and control of foodborne diseases. Methods In 2022, human-derived non-typhoidal Salmonella strains and food-derived strains were isolated through sentinel surveillance and food risk monitoring in Chaozhou City, Guangdong Province. The strains were subjected to serotyping, drug susceptibility testing, and whole-genome sequencing analysis. Results A total of 1 257 fecal specimens were collected for diarrhea surveillance in Chaozhou City in 2022, and 58 strains of non-typhoidal Salmonella were detected, with an isolation rate of 4.61%. Among 116 foodstuffs, 2 strains of non-typhoidal Salmonella were detected, with an isolation rate of 1.72%. Early childhood was the main age group for infection (14/144, 9.72%). The highest detection rate was in June (12/123, 9.76%). The 58 human-derived non-typhoidal Salmonella strains were classified into 12 serotypes, with Salmonella typhimurium being the most prevalent (44/58, 75.86%). In terms of drug resistance, 55 strains showed resistance, with a resistance rate of 91.67%, among which ampicillin, tetracycline, chloramphenicol, and streptomycin had the highest resistance rates, 76.67%, 70.00%, 67.67%, and 60.00%, respectively. Forty-nine strains were multi-resistant, accounting for 81.67%. From the molecular characteristics standpoint, multilocus sequence typing (MLST) divided the strains into 14 sequence typing (ST), with Salmonella typhimurium ST34 being the dominant type. Whole-genome single nucleotide polymorphism (wg-SNP) evolutionary analysis revealed high genetic heterogeneity among the studied strains, with Salmonella typhimurium clustering together and showing close evolutionary relationships to clinical samples of Salmonella enteritidis. Conclusions In 2022, the non-typhoidal Salmonella strains from Chaozhou showed a diversity of serotypes, with Salmonella typhimurium being predominant and exhibiting severe multidrug resistance. Molecular typing revealed diverse evolutionary characteristics.

Objective:To understand the molecular characteristics of the mutant strain of polymerase basic protein 2 (PB2) gene of influenza A (H1N1pdm) in Guangdong province, and to explore its specific molecular sites, so as to provide scientific basis for the prevention and control of influenza virus.Methods:Throat swab samples were collected from 2 cases infected with PB2 gene variant strains for virus isolation, and 23 influenza virus strains were selected from Guangdong province for sequencing analysis. The reference sequences and vaccine strain sequences provided by GISAID were used to perform evolutionary analysis on hemagglutinin (HA) and PB2 genes. Virus strain antigen analysis and neuraminidase (NA) inhibition test were carried out. PB2 protein model was constructed and polymerase activity was analyzed.Results:H399N amino acid mutation occurred in the HA gene of PB2-D701N and PB2-A271S variant strains, both of which belonged to the branch of 6B.1A.5a.2a. They belonged to the same big branch and different small branches as the vaccine strain A/Victoria/4897/2022, and they are all vaccine-like strains. In the three-dimensional structure, the mutations of PB2-D701N and PB2-A271S change charge and hydrophobicity.Conclusions:PB2-D701 and A271 were highly conserved, and PB2 mutant strains were not the dominant strains. The PB2 mutant had high antigenicity with the vaccine. The PB2 mutant strain is sensitive to NA inhibitors. The three-dimensional model predicted that PB2-D701N mutation could enhance virulence and affect transmissibility of influenza virus, while PB2-A271S mutation could affect polymerase activity and polymerase complex synthesis of influenza virus.

Objective To investigate the correlation between serum miR-27b-3p and N-terminal propeptide of type Ⅰ procollagen (PINP) and C-terminal telopeptide of type Ⅰ collagen 1 (CTX-1) in postmenopausal women. Methods Forty-nine patients with postmenopausal osteoporosis treated in the Second Affiliated Hospital,Zhejiang Chinese Medical University from February 2022 to February 2023 were selected as study objects. They were divided into osteoporosis (OP) group (T≤-2.5SD,26 cases) and osteopenia (OPn) group (-2.5SD

Objective To investigate the correlation between serum miR-27b-3p and N-terminal propeptide of type Ⅰ procollagen (PINP) and C-terminal telopeptide of type Ⅰ collagen 1 (CTX-1) in postmenopausal women. Methods Forty-nine patients with postmenopausal osteoporosis treated in the Second Affiliated Hospital,Zhejiang Chinese Medical University from February 2022 to February 2023 were selected as study objects. They were divided into osteoporosis (OP) group (T≤-2.5SD,26 cases) and osteopenia (OPn) group (-2.5SD

Objective To investigate the etiological characteristics of food poisoning isolates of Vibrio parahaemolyticus (VP) from 2019 to 2021 in Zhongshan City. Methods A total of 37 strains of Vibrio parahaemolyticus isolated from 8 food poisoning incidents in Zhongshan City from 2019 to 2021 were collected, including 1 residual food isolate and 36 human isolates. The genetic correlation of Vibrio parahaemolyticus food poisoning isolates in this region was analyzed by serological typing, virulence gene detection (TLH, TDH, and TRH), drug sensitivity test, pulsed field gel electrophoresis (PFGE) and multipoint sequence typing (MLST). Results The 37 strains of Vibrio parahaemolyticus were divided into 4 serotypes: O3:K6, O10:K4, O4:K8, and O4:KUT. The tdh+ and trh- were the main virulence genotypes, accounting for 97.30% (36/37). The drug resistance rate of cefazolin was 40.54% (15 strains R, 22 strains I), and no multidrug-resistant strains were found. The 37 VP strains were divided into 23 PFGE types and 6 cluster groups, with correlation coefficients ranging from 60.4%-100%. The multipoint sequencing typing showed that the 37 VP strains were divided into 9 ST types and 3 complex groups, of which ST3 type was the main type (23 strains, 62.1%). Conclusion This study has found that the dominant virulence types of Vibrio parahaemolyticus food poisoning isolates in Zhongshan City from 2019 to 2021 are tdh⁺ and trh^-, and 37 representative strains can be divided into 6 PFGE clusters and 9 ST types with MLST type being mainly ST3. This study has identified the rare serotype O10:K4 which has caused an increase in the proportion of food poisoning events, suggesting that we should strengthen detection and be alert to the risk of continued local epidemics of new rare serotype strains.

Objective:To explore the clinical effect of open reduction in the treatment of Tile C pelvic fracture combined with acetabular fracture in a specific sequence.Methods:Retrospectively analyzed the clinical data of 53 patients with Tile C type pelvic fracture combined with acetabular fracture from January 2014 to January 2019, and were divided into specific sequence group and non-specific sequence group according to the sequence of intraoperative reduction. A total of 29 cases were observed in the specific sequence group, including 20 males and 9 females; aged 43.8±14.8 years old (18-71 years), and the fractures were reduced in the sequence of "inside and out, then up and down" during the operation. There were 24 cases in the non-specific sequence group, including 14 males and 10 females; aged 44.4±14.7 years old (18-69 years), and fracture reduction was not performed in this sequence during the operation. According to the type of pelvic and acetabular fracture injury, we choose the appropriate position and surgical approach. After open reduction, the fracture was fixed with internal plants. The intraoperative blood loss, operation time, visual analogue scale (VAS) score were compared between the two groups. The quality of fracture reduction was evaluated by Matta score, pelvic fracture function recovery was evaluated by Majeed score, and acetabular fracture was evaluated by hip joint modified Merle d'Aubigné-Postel score.Results:There was no statistically significant difference in general data between the two groups before operation ( P>0.05), which was comparable. The intraoperative blood loss of the specific sequence group and the non-specific sequence group were 1 031.1±513.7 and 1 406.3±738.1 ml, and the operation time was 3.5±1.0 and 4.8±1.4 h; The differences between the two groups were statistically significant ( P<0.05). 53 patients were followed up for 14.8±1.6 months (12-18 months) after operation. The average postoperative VAS scores of specific sequence group and non-specific sequence group were 1.3±1.1 and 1.5±1.3 respectively, and there was no statistically significant difference. The effectiveness of the pelvic fracture Matta score standard was evaluated in the specific sequence group: excellent in 22 cases, good in 5 cases, fair in 2 cases, excellent and good rate was 93.1%; non-specific sequence group excellent in 10 cases, good in 6 cases, fair in 5 cases, poor in 3 cases, excellent and good rate was 66.7%, the difference was statistically significant ( P<0.05). Matta score of acetabular fracture: 21 cases were excellent in specific sequence group, 5 cases were good, 3 cases were poor, excellent and good rate was 89.7%; 9 cases were excellent in non-specific sequence group, 8 cases were good, 7 cases were poor, excellent and good rate was 70.8 %, the difference is statistically significant ( P<0.05). The results of the last follow-up pelvic fractures were evaluated by Majeed score: 20 cases were excellent in the specific sequence group, 7 were good, 2 were fair, excellent and good rate was 93.1%; 10 were excellent in the non-specific sequence group, 5 were good, 5 were fair, and 4 were poor, excellent and good rate was 62.5%, the difference was statistically significant ( P<0.05). At the last follow-up, the modified Merle d'Aubigné-Postel score was used to evaluate the efficacy: 20 cases were excellent in the specific sequence group, 5 were good, 4 were fair, the excellent and good rate was 86.2%; In the non-specific sequence group, 9 cases were excellent, 7 cases were good, 4 cases were fair, and 4 cases were poor, excellent and good rate was 66.7%, the difference was statistically significant ( P<0.05). During the follow-up period, none of the patients in the two groups developed fracture nonunion, heterotopic ossification, iatrogenic neurovascular injury, and femoral head necrosis. Trauma arthritis occurred in 4 patients in the non-specific sequence group. Conclusion:"Inside and out, then up and down" sequential reduction of Tile C pelvis combined with acetabular fracture can significantly shorten the operation time and reduce the amount of intraoperative blood loss. The surgical procedure is reasonable, which helps to improve the quality of fracture reduction and promote the functional recovery of patients.