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.

ObjectiveTo investigate the epidemiological characteristics of respiratory adenovirus (AdV) infection among hospitalized patients under 18 years of age with pneumonia in Yancheng City of Jiangsu Province from 2023 to 2024, and to provide a basis for the prevention and control of adenovirus infection. MethodsNasopharyngeal swab samples were collected from hospitalized patients under 18 years of age diagnosed with pneumonia at two national influenza sentinel hospitals in Yancheng City from February 2023 to June 2024. A respiratory pathogen nucleic acid detection kit was used to test for 28 pathogens, including influenza A virus, influenza B virus, respiratory syncytial virus, human rhinovirus, adenovirus, Mycoplasma pneumoniae, Chlamydia pneumoniae, human metapneumovirus, human bocavirus, enterovirus, polyomavirus K1, polyomavirus WU, parainfluenza viruses 1‒4, coronavirus 229E, HKU1, OC43, and NL63, Haemophilus influenzae, Bordetella pertussis, Group A Streptococcus, Staphylococcus aureus, Streptococcus pneumoniae, Legionella pneumophila, Klebsiella pneumoniae, and the novel coronavirus, and to analyze patients’ mixed infections. Adenovirus-positive samples were subjected to polymerase chain reaction (PCR) amplification using Hexon and Fibre as target genes, and the products were analyzed by sequencing. Whole-genome sequencing analyses were performed on positive samples with Ct values less than 22. ResultsAmong 368 hospitalized pneumonia patients under 18 years of age in Yancheng City from February 2023 to July 2024, most were male (51.63%, 190/368), with preschool-aged children (42.66%, 157/368) and primary school-aged children (40.22%, 148/368) comprising the majority. A total of 44 cases tested positive for adenovirus, yielding a positivity rate of 11.96%. Single infections, dual infections, and multiple infections accounted for 61.36% (27/44), 36.36% (16/44), and 2.27% (1/44), respectively. From November 2023, the adenovirus positivity rate rose sharply, peaking at 51.61% in December. Following PCR amplification and sequencing, valid sequences were successfully obtained for 37 strains, comprising 36 AdV-3 strains and 1 AdV-C strain. Eight adenovirus-positive samples with Ct values below 22 were inoculated into HEp-2 cell lines for virus isolation, and whole-genome sequencing analyses were performed on the five successfully isolated strains. Phylogenetic analyses revealed that the AdV-3 strains collectively belonged to the same evolutionary clade. Whole-genome sequencing results indicated that four AdV-3 strains (HAdV-B3) showed no evidence of genetic recombination, whereas one AdV-C strain (HAdV-89) might have undergone genetic recombination. ConclusionThe adenovirus positivity rate among hospitalized pneumonia patients aged under 18 years of age in Yancheng from 2023 to 2024 was slightly higher than that reported in previous studies. Adenovirus infection exhibited a pattern of high incidence in winter, with the AdV-3 type being the predominant pathogen; one AdV-C strain (HAdV-89) might have undergone genetic recombination. It is recommended to strengthen surveillance of respiratory adenovirus type AdV-3 and its variants during the winter season, promote the use of multiplex pathogen detection techniques, and explore the clinical application of an AdV-3 vaccine.

ObjectiveTo investigate the biological reparative effects of platelet-rich fibrin （PRF） extract on injured endometrial stromal cells （ESCs） induced by mifepristone and the underlying molecular mechanisms. MethodsAn ESCs injury model was established using mifepristone treatment. Cells were divided into four groups： untreated control （Con）， mifepristone-injured group （M）， mifepristone treatment+PRF extract group （M+P）， and mifepristone treatment+PRF extract+growth factor inhibitors treatment group， including M+P+T， M+P+Me， and M+P+CJ. Cell viability was detected using the CCK-8 assay， and migration ability was evaluated via the scratch wound healing assay. The release kinetics of growth factors， including vascular endothelial growth factor （VEGF）， platelet-derived growth factor-BB （PDGF-BB）， and transforming growth factor-beta 1 （TGF-β1） from PRF extract were measured by ELISA. The mRNA and protein expression levels of apoptosis-related factors （Bcl-2， Bax， and Caspase-3） were analyzed by RT-qPCR and Western blot， respectively. ResultsVEGF， PDGF-BB， and TGF-β1 were continuously released from the PRF extract over two weeks， with peak release observed on days 3-7. The extract significantly restored the proliferation and migration of mifepristone-injured ESCs （all P<0.000 1）. PRF extract up-regulated the mRNA and protein expression of the anti-apoptotic factor Bcl-2 （all P<0.000 1） and down-regulated that of the pro-apoptotic factors Bax and Caspase-3 （all P<0.000 1） in mifepristone-injured ESCs. Inhibitors of VEGF， PDGF-BB， and TGF-β1 （Tanshinone IIA， Methylnissolin， and CJJ300） significantly reversed the protective effects of PRF extract on mifepristone-injured ESCs （all P<0.05）. ConclusionPRF extract promotes the repair of injured ESCs by enhancing cell proliferation， attenuating apoptosis， and increasing migration capacity， which involve multiple growth factors， including VEGF， PDGF-BB， and TGF-β1.

AIM:To investigate the prevalence and associated factors of comorbid myopia and scoliosis among primary and junior school students in Binhu District, Wuxi, China.METHODS:A stratified cluster random sampling method was used to select students from 10 primary and junior schools in Binhu District for visual acuity testing, scoliosis examination, and a questionnaire survey on related factors. The relationship between scoliosis and myopia was detected using univariate analysis. A binary multivariable logistic regression model was applied to analyze the risk factors associated with comorbid myopia and scoliosis.RESULTS: A total of 17 951 students were selected, including 8948(49.85%)boys and 9003(50.15%)girls; 9784(54.50%)primary school students and 8167(45.50%)junior school students. The detection rates of myopia, scoliosis, and comorbidity were 68.30%, 2.95%, and 2.76%, respectively. The comorbidity rate was higher in girls(3.78%)than in boys(1.74%). Junior school students(3.67% in Grade 7-9)had a higher total comorbidity detection rate than primary school students(2.00% in Grade 4-6; all P<0.001). Logistic regression analysis showed that being in Grade 7-9 [odds ratio(OR)=4.43, 95% confidence interval(CI): 2.36-7.85], spending 2-3 h(OR=1.46, 95%CI: 1.02-2.16)or ≥3 h(OR=1.5, 95%CI: 1.21-2.55)on homework or reading after school, engaging in >60 min of moderate-to-vigorous physical activity >6 days per week(OR=1.39, 95%CI: 1.08-1.7), and not adjusting desk and chair height to match the student's height(OR=1.73, 95%CI: 1.2-2.25)were positively associated with comorbidity(all P<0.05).CONCLUSION: The prevalence of comorbid myopia and scoliosis among primary and junior school students in Binhu District of Wuxi is concerning. Reducing the time ofhomework or reading and writing after school and engaging in ≥60 min of moderate-to-vigorous physical activity at least three days per week may help lower the risk of comorbid myopia and scoliosis in this population.

Objective:To evaluate the clinical outcomes of combined complete preservation of chordal structure mitral valve replacement (C-MVR) with total anatomical arterial myocardial revascularization (TACR) in coronary patients with moderate-to-severe or severe ischemic mitral regurgitation (IMR).Methods:This is a retrospective multi-center case series study. Data were retrospectively collected from 127 patients with coronary artery disease with moderate to severe or severe IMR who received TACR with C-MVR from July 2015 to April 2024 in 13 hospitals in China. There were 90 males and 37 females, aged (56.5±10.7) years (range: 33 to 74 years). Perioperative data and follow-up data including left ventricular ejection fraction, left ventricular end-diastolic diameter, and patency rate of arterial grafts of patients were collected. Comparisons were made using paired sample t-test or χ2 test. Results:In this cohort of 127 patients, 67 underwent concurrent tricuspid valve repair. During surgery, 113 grafts of the left internal mammary artery (LIMA), 127 grafts of the left radial artery, 80 grafts of the right radial artery, and 110 grafts of the right internal mammary artery (RIMA) were harvested. The number of the distal anastomosis was 4.2±0.4 (range: 3 to 5). The aortic cross-clamp time and cardiopulmonary bypass time were (97.5±23.4) minutes (range: 90 to 161 minutes) and (145.4±19.2) minutes (range: 101 to 210 minutes), respectively. There was one operative death. Intraoperative placement of an intra-aortic balloon pump was performed in 21 patients to improve the left ventricular ejection. No sternal ischemic occurred. All patients completed follow-up, with a mean follow-up period of (64.3±7.5) months (range: 4 to 110 months). No major cerebrovascular events occurred during the follow-up period, and all patients survived. Left ventricular ejection fraction improved postoperatively (55.0%±5.3% vs. 41.0%±15.3%, t=17.23, P<0.01). The proportion of patients with New York Heart Association functional class ≤2 increased postoperatively (23.6% (30/127) vs. 87.3% (110/126), χ2=103.77, P<0.01). The proportion of patients with Canadian Cardiovascular Society Angina Classification ≤3 decreased postoperatively (4.8% (6/126) vs. 78.7% (100/127), χ2=142.19, P<0.01). The left ventricular end-diastolic diameter decreased postoperatively ((5.70±4.50) cm vs. (6.10±0.23) cm, t=12.15, P<0.01). Coronary multi-detector computed tomography angiography (MDCTA) follow-up was conducted for (60.5±11.7) months (range: 6 to 109 months) postoperatively. MDCTA confirmed the patency rates of the grafts: 96.4% (108/112) for the LIMA grafts, 88.9% (112/126) for the left radial artery grafts, 93.7% (74/79) for the right radial artery grafts, and 90.9% (100/110) for the free RIMA grafts. No significant differences in graft patency rates were observed between the arterial grafts ( χ2=5.24, P=0.155). Conclusion:The results of this multi-centre study demonstrate satisfactory mid-term results of C-MVR with TACR for the treatment of coronary artery disease with moderate to severe or severe IMR.

Objective:To evaluate the clinical outcomes of combined complete preservation of chordal structure mitral valve replacement (C-MVR) with total anatomical arterial myocardial revascularization (TACR) in coronary patients with moderate-to-severe or severe ischemic mitral regurgitation (IMR).Methods:This is a retrospective multi-center case series study. Data were retrospectively collected from 127 patients with coronary artery disease with moderate to severe or severe IMR who received TACR with C-MVR from July 2015 to April 2024 in 13 hospitals in China. There were 90 males and 37 females, aged (56.5±10.7) years (range: 33 to 74 years). Perioperative data and follow-up data including left ventricular ejection fraction, left ventricular end-diastolic diameter, and patency rate of arterial grafts of patients were collected. Comparisons were made using paired sample t-test or χ2 test. Results:In this cohort of 127 patients, 67 underwent concurrent tricuspid valve repair. During surgery, 113 grafts of the left internal mammary artery (LIMA), 127 grafts of the left radial artery, 80 grafts of the right radial artery, and 110 grafts of the right internal mammary artery (RIMA) were harvested. The number of the distal anastomosis was 4.2±0.4 (range: 3 to 5). The aortic cross-clamp time and cardiopulmonary bypass time were (97.5±23.4) minutes (range: 90 to 161 minutes) and (145.4±19.2) minutes (range: 101 to 210 minutes), respectively. There was one operative death. Intraoperative placement of an intra-aortic balloon pump was performed in 21 patients to improve the left ventricular ejection. No sternal ischemic occurred. All patients completed follow-up, with a mean follow-up period of (64.3±7.5) months (range: 4 to 110 months). No major cerebrovascular events occurred during the follow-up period, and all patients survived. Left ventricular ejection fraction improved postoperatively (55.0%±5.3% vs. 41.0%±15.3%, t=17.23, P<0.01). The proportion of patients with New York Heart Association functional class ≤2 increased postoperatively (23.6% (30/127) vs. 87.3% (110/126), χ2=103.77, P<0.01). The proportion of patients with Canadian Cardiovascular Society Angina Classification ≤3 decreased postoperatively (4.8% (6/126) vs. 78.7% (100/127), χ2=142.19, P<0.01). The left ventricular end-diastolic diameter decreased postoperatively ((5.70±4.50) cm vs. (6.10±0.23) cm, t=12.15, P<0.01). Coronary multi-detector computed tomography angiography (MDCTA) follow-up was conducted for (60.5±11.7) months (range: 6 to 109 months) postoperatively. MDCTA confirmed the patency rates of the grafts: 96.4% (108/112) for the LIMA grafts, 88.9% (112/126) for the left radial artery grafts, 93.7% (74/79) for the right radial artery grafts, and 90.9% (100/110) for the free RIMA grafts. No significant differences in graft patency rates were observed between the arterial grafts ( χ2=5.24, P=0.155). Conclusion:The results of this multi-centre study demonstrate satisfactory mid-term results of C-MVR with TACR for the treatment of coronary artery disease with moderate to severe or severe IMR.

Objective: To evaluate the feasibility of dynamic contrast-enhanced MRI (DCE-MRI) in differentiating tumor deposits (TDs) from metastatic lymph nodes (MLNs) in rectal cancer. Materials and Methods: A retrospective analysis was conducted on 70 patients with rectal cancer, including 168 lesions (70 TDs and 98 MLNs confirmed by histopathology), who underwent pretreatment MRI and subsequent surgery between March 2019 and December 2022. The morphological characteristics of TDs and MLNs, along with quantitative parameters derived from DCE-MRI (K trans , kep, and v e) and DWI (ADCmin, ADCmax, and ADCmean), were analyzed and compared between the two groups.Multivariable binary logistic regression and receiver operating characteristic (ROC) curve analyses were performed to assess the diagnostic performance of significant individual quantitative parameters and combined parameters in distinguishing TDs from MLNs. Results: All morphological features, including size, shape, border, and signal intensity, as well as all DCE-MRI parameters showed significant differences between TDs and MLNs (all P < 0.05). However, ADC values did not demonstrate significant differences (all P > 0.05). Among the single quantitative parameters, v e had the highest diagnostic accuracy, with an area under the ROC curve (AUC) of 0.772 for distinguishing TDs from MLNs. A multivariable logistic regression model incorporating short axis, border, v e, and ADC mean improved diagnostic performance, achieving an AUC of 0.833 (P = 0.027). Conclusion The combination of morphological features, DCE-MRI parameters, and ADC values can effectively aid in the preoperative differentiation of TDs from MLNs in rectal cancer.

Objective To discuss the perioperative anesthesia management strategy for the surgical resection of rec-tal cancer in a patient with a rare neuromuscular disease-Facioscapulohumeral Muscular Dystrophy(FSHD)compli-cated by restrictive ventilatory dysfunction.Methods Clinical data of a patient with FSHD complicated by moder-ate-to-severe restrictive ventilatory dysfunction undergoing rectal cancer surgery were retrospectively collected;the clinical manifestations,complication,preoperative evaluation,intraoperative anesthesia management and postopera-tive pain treatment were analyzed and summarized.Results FSHD is a rare genetic disorder,and preopera-tive multidisciplinary evaluation is critical.In this case,total intravenous anesthesia was employed,with invasive arterial pressure monitoring,blood gas analysis,body temperature,sufficient analgesia,close respiratory monitoring and lung protective ventilation strategy after preoperative multidisciplinary evaluation.After thorough sputum suction,lung expansion,and complete recovery of muscle strength,the patient was successfully extubated;ensuring respiratory monitoring after surgery,sufficient analgesia was administered,and transferred to the ICU for monitoring,and ultimately discharged with satisfactory treatment results.Conclusions For patients with rare neuro-muscular diseases such as FSHD,thorough preoperative evaluation and optimization are essential.Clinicians should be aware of related complications,such as restrictive ventilatory dysfunction,and develop individualized anesthesia plans.Intraoperative monitoring,particularly of the respiratory and hemodynamic systems,should aim to prevent hypoxia and carbon dioxide retention,thereby reducing the risk of complications.

Non-steroidal anti-inflammatory drugs(NSAIDs),commonly utilized analgesics,are extensively employed for managing pain associated with musculoskeletal disorders or injuries.Recent clinical studies have demonstrated a heightened risk of bone stress injuries(BSI)in soldiers and athletes,particularly during high-intensity training,due to NSAID usage.Furthermore,the impact of NSAIDs on fracture healing is well-documented;however,the precise mechanism by which their use during training contributes to an increased incidence of stress bone injuries remains unclear.This article aims to summarize potential mechanisms through an extensive review of domestic and international literature in order to standardize the utilization and clinical management of NSAIDs,optimize pain management strategies,and prevent stress bone injuries or fractures in specific populations such as soldiers and elite athletes.

Long non-coding RNA(lncRNA)play crucial roles in cell development,differentia-tion,and proliferation,serving as one of key molecules in regulating gene expression.Studies have shown that abnormal expression of lncRNAs is closely associated with the onset,malignant progression,and metastasis of various tumors.Prostate cancer associated transcript 1(PCAT1),as an important member of lncRNA,has been demonstrated to be highly expressed in multiple cancers and involved in multiple biological regulatory processes,thereby promoting cancer development.This article reviewed the roles,mechanisms,and regulatory targets of lncRNA PCAT1 in cancer initiation and progression,aiming to provide a reference for subsequent research.