Objective: To investigate the epidemiological and spatio-temporal characteristics of influenza in Jiaxing City, Zhejiang Province, so as to provide insights into perfecting the prevention and control strategies of influenza. Methods: Data of influenza in Jiaxing City from 2019 to 2023 were collected from the Chinese Disease Prevention and Control Information System. Population data of the same period were collected from the Zhejiang Health Information Network Reporting System. The epidemiological characteristics of influenza were analyzed using descriptive analysis. Vector map information was collected from the Open Street Map, and the spatio-temporal clustering characteristics of influenza were analyzed using spatial autocorrelation and spatio-temporal scanning. Results: A total of 181 501 cases of influenza were reported in Jiaxing City from 2019 to 2023, with an average annual reported incidence of 653.93/105. The majority of cases were aged 5 to <15 years (59 785 cases, 32.94%). The majority of the occupations were students (78 239 cases, 43.11%) and pre-school children (33 715 cases, 18.58%). The county (city, district) with the highest reported incidence was Haining City (1 451.70/105), and the town (street) with the highest reported incidence was Chang'an Town (1 932.78/105). Spatial autocorrelation analysis showed that the incidence of influenza in Jiaxing City from 2019 to 2023 had positive spatial correlations (all Moran's I>0, all P<0.05), with a high-high clustering in the southern region. Spatio-temporal scanning analysis showed that there was a spatio-temporal clustering of influenza in Jiaxing City from 2019 to 2023, with the southern region being the primary-type clustering area and the period between November and January of the following year being the clustering time. Conclusion There was a significant spatio-temporal clustering of influenza in Jiaxing City from 2019 to 2023, with winter being the peak season and the southern region being the primary area.

Objective:To analyze the experiences of implementing coverage with evidence development for cell and gene therapy products in the UK.to provide references for the future access of cell and gene therapy products in China.Methods:By systematically combing the strategies of coverage with evidence development adopted by National Health Service(NHS)in the UK.,and summarizing the four links of assessment,payment,further evidence collection and final decision-making,the implementation experience of coverage with evidence development of cell and gene therapy products was analyzed by taking the reimbursement of four typical cell gene therapy products as an example,and suggestions were made for the access of this type of products in China.Results:Access to cell and gene therapy products in the UK.is cautious,with assessment focused on clinical utility.Management access agreement is used to control the risk of overspending during specialized fund reimbursement,while a unified data collection system has been established.Conclusion:China could learn from the experience of the UK.and promote the admission of cell gene therapy products from three aspects:exploring the evidence-based reimbursement model for universal commercial medical insurance;developing a targeted data collection framework based on actual data needs;establishing a unified data collection platform to provide the support for product access decision.

Objective:To analyze the experiences of implementing coverage with evidence development for cell and gene therapy products in the UK.to provide references for the future access of cell and gene therapy products in China.Methods:By systematically combing the strategies of coverage with evidence development adopted by National Health Service(NHS)in the UK.,and summarizing the four links of assessment,payment,further evidence collection and final decision-making,the implementation experience of coverage with evidence development of cell and gene therapy products was analyzed by taking the reimbursement of four typical cell gene therapy products as an example,and suggestions were made for the access of this type of products in China.Results:Access to cell and gene therapy products in the UK.is cautious,with assessment focused on clinical utility.Management access agreement is used to control the risk of overspending during specialized fund reimbursement,while a unified data collection system has been established.Conclusion:China could learn from the experience of the UK.and promote the admission of cell gene therapy products from three aspects:exploring the evidence-based reimbursement model for universal commercial medical insurance;developing a targeted data collection framework based on actual data needs;establishing a unified data collection platform to provide the support for product access decision.

Objective:To investigate the clinical, epidemic and laboratory characteristics of brucellosis in Hainan, and to summarize the experience of diagnosis and treatment.Methods:The epidemiological characteristics, clinical manifestations, laboratory results, treatment and prognosis of 27 inpatients with brucellosis admitted to the Second Affiliated Hospital of Hainan Medical University from January 2019 to December 2023 were retrospectively analyzed.Results:In 27 cases, the male to female ratio was 2.38 ∶ 1.00 (19 ∶ 8). Occupational distribution was dominated by farmers and herdsmen, with a total of 21 cases (77.8%). Twenty-one patients (77.8%) had a clear history of contact with cattle, sheep, and related products, and there was a phenomenon of family clustering. Eighteen patients (66.7%) developed symptoms from March to July. The clinical manifestations of the patients were lack of specificity, mainly fever (24 cases, 88.9%), dizziness and headache (13 cases, 48.1%), and low back pain (11 cases, 40.7%). Some patients also had symptoms and signs such as fatigue (8 cases), muscle pain (6 cases), chest tightness (4 cases), and splenomegaly (6 cases). Complications commonly included pulmonary infection (13 cases, 48.1%) and spinal involvement (11 cases, 40.7%). The positive rates of Brucella blood culture, tube agglutination test, Rose Bengal plate agglutination test, and cerebrospinal fluid or joint cavity effusion culture were 76.9% (20/26), 100.0% (21/21), 100.0% (11/11), and 3/4, respectively. The combination therapy of doxycycline and rifampicin showed good therapeutic effects, and 22 patients were cured. Conclusions:Hainan is not an epidemic area of brucellosis, and the clinical manifestations of the disease are not specific. The epidemic and clinical characteristics of the disease should be paid attention to in order to improve the level of diagnosis and treatment and control effectiveness.

Objective:To observe the relationship between early quality of life symptom clusters and psychological stress and its influencing factors,so as to lay a foundation for clinical timely control of symptom clusters,improving of psychological stress state,and improving the early quality of life after lung cancer surgery.Methods:A total of 248 patients with lung cancer who received surgical treatment in our hospital from Oct 2021 to Oct 2023 were selected to evaluate their general condition,quality of life,symptom clusters,and psychological stress by general situation questionnaire,Functional Assessment of Cancer Therapy(FACT),Anderson Symptom Assessment Scale,and Symptom Self-Rating Scale(SCL-90).Pearson method was used to analyze the correlation between FACT score symptom clusters and SCL-90 score.On the basis of multivariable logistic regression analysis,cumulative ratio regression model was used to analyze the early quality of life after lung cancer surgery.Results:A total of 239 patients with lung cancer were enrolled.FACT-L score was(53.66±6.85),SCL-90 score was(109.24±11.97),symptom clusters score was(104.03±16.83),including 117 patients in low group,69 patients in middle group,and 53 patients in high group,48.95%,28.87%and 22.18%,respectively.Pearson analysis showed that FACT score was negatively correlated with SCL-90 score and symptom clusters(r value was-0.779 and-0.737,respectively,P＜0.05).Multivariate cumulative ratio logistic regression analysis showed that seven factors including clustered airway management and sleep quality were protective factors for early quality of life after lung cancer surgery(P＜0.05),and malnutrition,pain degree,operation duration,SCL-90 score and symptom clusters score were risk factors for early quality of life after lung cancer surgery(P＜0.05).Conclusions:The influencing factors of early postoperative quality of life of lung cancer patients come from many aspects.Clinical prevention and control strategies can be formulated according to the influencing factors to improve the level of early postoperative quality of life of lung cancer patients.

Objective:To investigate the effects of paricalcitol on bone metabolism and transforming growth factor-β(TGF-β)/bone morphogenetic protein-7(BMP-7)/Smad signaling pathway in rats with renal osteodystrophy(ROD).Methods:Total 90 rat were randomly divided into 6 groups:control group,model group,paricalcitol low-dose(0.2 μg/kg)group,paricalcitol medium-dose group(0.4 μg/kg)group,paricalcitol high-dose(0.8 μg/kg)group,calcitriol(10 μg/kg)group,with 15 rats in each group.Rats in control group were fed with ordinary feed,and rats in other groups were fed with feed containing adenine to induce the establishment of ROD model.After grouping and drug treatment,the blood urea nitrogen(BUN)and blood creatinine(Scr)levels,blood calcium and blood phosphorus levels,femoral bone mineral density(BMD),maximum load,elasticity modulus and yield load,serum inflammatory fac-tors IL-6 and IL-17 levels of each group were measured;and the expression of TGF-β/BMP-7/Smad pathway protein in bone tissue was detected with Western blot.Another 45 rats were randomly divided into 3 groups:paricalcitol(0.8 μg/kg)group,TGF-β inhibition(LY2157299,150 mg/kg)group,paricalcitol(0.8 μg/kg)+TGF-β inhibition(LY2157299,150 mg/kg)group,with 15 rats in each group.ROD model was established with the same method.After drug treatment,the renal function indexes and femoral biomechanical indexes were measured.Results:Compared with control group,the blood calcium level,BMD,elastic modulus,maximum load,yield load,bone tissue TGF-β/BMP-7/Smad pathway proteins TGF-β and BMP-7 expressions,p-Smad3/Smad3 were significantly re-duced in the model group(P<0.05),the BUN and Scr levels,blood phosphorus level,and serum IL-6 and IL-17 levels were signifi-cantly increased(P<0.05).Compared with the model group,the blood calcium level,BMD,elastic modulus,maximum load,yield load,bone tissue TGF-β/BMP-7/Smad pathway protein TGF-β and BMP-7 expression,p-Smad3/Smad3 were significantly increased in the paricalcitol low,medium and high dose groups and calcitriol group(P<0.05),the BUN and Scr levels,blood phosphorus level,and serum IL-6 and IL-17 levels were significantly reduced,and paricalcitol groups showed a dose-dependent relationship(P<0.05),there was no significant difference in the indexes of rats in high-dose paricalcitol group and calcitriol group(P>0.05).Compared with paricalcitol+TGF-β inhibition group,the renal function indexes BUN,SCR and blood phosphorus level in paricalcitol group were de-creased(P<0.05),while the blood calcium level,BMD,elastic modulus,maximum load and yield load were increased(P<0.05).In TGF-β inhibition group,the renal function indexes BUN,SCR and blood phosphorus levels were increased(P<0.05),while the blood calcium level,BMD,elastic modulus,maximum load and yield load were decreased(P<0.05).Conclusion:Paricalcitol can activate the TGF-β/BMP-7/Smad signaling pathway,inhibit inflammation,improve renal function and abnormal bone metabolism in ROD rats,reduce blood phosphorus level,increase blood calcium level and bone density,repair bone biomechanics,and improve the symptoms of osteodystrophy.

Objective:To explore the application effect of the modified presentation assimilation discussion combined with heuristic clinical medicine teaching in training of extracorporeal membrane oxygenation specialist nurses.Methods:The convenient sampling method was used to select 62 nurses who participated in training of extracorporeal membrane oxygenation specialist nurses in the Second Affiliated Hospital of Zhengzhou University from January to June 2023 as the research objects. A total of 30 nurses who participated in the 25th training session from January to March 2023 were selected as the control group, and 32 nurses who participated in the 26th training session from April to June 2023 were selected as the observation group. The control group received conventional training method, while the observation group received modified presentation assimilation discussion combined with heuristic clinical medicine teaching. The theoretical knowledge and operational skills of nurses, core competence of extracorporeal membrane oxygenation specialist nurses and training satisfaction were compared between the two groups after training.Results:After training, the scores of theoretical knowledge and operational skills, core competence of extracorporeal membrane oxygenation specialist nurses and training satisfaction in observation group were higher than those in control group, and the differences were statistically significant ( P<0.05) . Conclusions:The modified presentation assimilation discussion combined with heuristic clinical medicine teaching can improve the theoretical knowledge and operational skills of extracorporeal membrane oxygenation specialist nurses, and the nurses' training satisfaction is higher.

Objective:To investigate the clinical, epidemic and laboratory characteristics of brucellosis in Hainan, and to summarize the experience of diagnosis and treatment.Methods:The epidemiological characteristics, clinical manifestations, laboratory results, treatment and prognosis of 27 inpatients with brucellosis admitted to the Second Affiliated Hospital of Hainan Medical University from January 2019 to December 2023 were retrospectively analyzed.Results:In 27 cases, the male to female ratio was 2.38 ∶ 1.00 (19 ∶ 8). Occupational distribution was dominated by farmers and herdsmen, with a total of 21 cases (77.8%). Twenty-one patients (77.8%) had a clear history of contact with cattle, sheep, and related products, and there was a phenomenon of family clustering. Eighteen patients (66.7%) developed symptoms from March to July. The clinical manifestations of the patients were lack of specificity, mainly fever (24 cases, 88.9%), dizziness and headache (13 cases, 48.1%), and low back pain (11 cases, 40.7%). Some patients also had symptoms and signs such as fatigue (8 cases), muscle pain (6 cases), chest tightness (4 cases), and splenomegaly (6 cases). Complications commonly included pulmonary infection (13 cases, 48.1%) and spinal involvement (11 cases, 40.7%). The positive rates of Brucella blood culture, tube agglutination test, Rose Bengal plate agglutination test, and cerebrospinal fluid or joint cavity effusion culture were 76.9% (20/26), 100.0% (21/21), 100.0% (11/11), and 3/4, respectively. The combination therapy of doxycycline and rifampicin showed good therapeutic effects, and 22 patients were cured. Conclusions:Hainan is not an epidemic area of brucellosis, and the clinical manifestations of the disease are not specific. The epidemic and clinical characteristics of the disease should be paid attention to in order to improve the level of diagnosis and treatment and control effectiveness.

Objective: To investigate the epidemiological characteristics of human brucellosis in Jiaxing City from 2010 to 2021, so as to provide insights into the development of the brucellosis control strategy. Methods: The epidemiological and clinical data of brucellosis patients and epidemiological data of brucellosis outbreaks in Jiaxing City from 2010 to 2021 were collected from Chinese Disease Control and Prevention Information System, and the epidemiological features and outbreaks of brucellosis were analyzed descriptively. Results: Totally 160 brucellosis patients were reported in Jiaxing City from 2010 to 2021, and the incidence of brucellosis appeared a tendency towards a rise (χ2trend=28.564, P=0.002), with annual mean incidence of 0.29/105. No deaths due to brucellosis occurred in Jiaxing City from 2010 to 2021. Brucellosis cases were reported each month, which were concentrated in the first and second quarters, and the greatest number was seen in May (27 cases, 16.88%). The brucellosis cases were predominantly reported in Tongxiang City (114 cases, 71.25%), and 75.00% were male (120 cases) and 70.63% were occupational populations (113 cases). The patients had a median (interquartile range) age of 57 (12) years at onset, and the median duration (interquartile range) from onset to definitive diagnosis was 18 (28) days. The clinical manifestations mainly included fever and weakness, and a total of 18 Brucella melitensis isolates and one B. bovis isolate were cultured. Conclusions The incidence of brucellosis was rising in Jiaxing City from 2010 to 2021. The brucellosis patients were predominantly reported in Tongxiang City in the first and second quarters, and young, middle-aged men and occupational populations were at a high risk of brucellosis.