Objective: To understand the epidemiological characteristics and disease burden of influenza like illness (ILI) among student populations, so as to provide data support for policy formulation and optimal allocation of health resources. Methods: From January 2024 to February 2025, a questionnaire survey was conducted among parents of kindergarten, primary school, junior and senior high school students in 9 districts of Shenzhen, including Longhua, Futian, Bao an, Longgang, Luohu, Nanshan, Guangming, Pingshan and Yantian. Parents were asked to complete the questionnaire based on whether their children had fever, cough, vomiting, diarrhea, rash and other common symptoms in 2024. A total of 3 537 parents were investigated, and 444 ILI cases were included as study subjects. The epidemiological burden, including incidence rate of influenza, visitation rate, years lived with disability (YLDs) and economic burden (including direct economic burden, indirect economic burden and intangible burden) were analyzed. Results: The incidence rate of influenza among students in Shenzhen in 2024 was 12.55%. The ILI incidence rates in kindergarten, primary school, junior and senior high school were 14.01%, 11.69% and 5.23%, respectively, with a statistically significant difference ( χ 2= 45.20, P <0.01). The ILI consultation rate among students was 85.36%, and the consultation rates in kindergarten (87.36%) and primary school students (84.62%) were higher than those in junior and senior high school students ( 56.52 %) ( χ 2=16.47, P <0.01). A total of 78.88% of cases did not receive etiological detection.The median total economic burden per ILI case was 2 354.62 yuan, including direct medical costs of 300.00 yuan, direct non medical costs of 212.50 yuan, indirect costs of 1 000.00 yuan, and intangible burden of 500.00 yuan. Conclusions Schools are high risk environment for influenza, and younger students are a high risk group for ILI. The disease burden caused by student ILI remains substantial.

As a major challenge in the global field of critical care medicine, sepsis is associated with high morbidity and mortality, driving intensive research into the development of precise risk prediction models. Among these, machine learning and deep learning-based predictive models have garnered particular attention. This article systematically reviews the evolution of sepsis risk prediction models and the challenges associated with their clinical translation, with a focus on their clinical applicability in common septic complications, including acute kidney injury, encephalopathy, and coagulation disorders. Current evidence indicates that machine learning models, by integrating multidimensional dynamic data from electronic health records, significantly enhance early warning capabilities and individualized predictive performance. However, major bottlenecks limiting clinical translation include insufficient data standardization, lack of model interpretability, and inadequate external validation. Future research should prioritize multicenter collaboration, time-series modeling strategies, and explainable artificial intelligence frameworks to optimize clinical translation pathways and facilitate the paradigm shift from traditional empirical approaches to data-driven precision strategies in sepsis risk stratification.

ObjectiveThis study aimed to elucidate the specific molecular mechanism by which PAGE5 promotes breast cancer cell invasion and hepatic metastasis through regulating the PI3K/AKT signaling pathway and its downstream effector， matrix metalloproteinase 1 （MMP1）. MethodsBioinformatics analysis using the TCGA database was performed to evaluate PAGE5 expression in metastatic breast cancer tissues. The effects of PAGE5 on the proliferation， migration， and invasion capabilities of breast cancer cells were analyzed using CCK-8， EdU， Transwell， and wound healing assays. A splenic injection hepatic metastasis model in NOD-SCID mice was employed to validate the impact of PAGE5 on breast cancer liver metastasis. Transcriptome sequencing and KEGG enrichment analysis were conducted to identify potential signaling pathways regulated by PAGE5. Western blot was used to detect AKT phosphorylation levels. Quantitative real-time polymerase chain reaction （qPCR） was applied to screen and validate downstream target molecules of PAGE5. ResultsBioinformatic analysis revealed that PAGE5 expression was significantly upregulated in distant metastasis of breast cancer. Both in vitro and in vivo experiments confirmed that PAGE5 overexpression markedly enhanced the migration and invasion abilities of breast cancer cells and promoted the formation of liver metastatic lesions， whereas PAGE5 knockdown suppressed breast cancer liver metastasis （P＜0.000 1）. Transcriptome sequencing and KEGG enrichment analysis indicated that PAGE5 significantly activated the PI3K-AKT signaling pathway （P=0.028 5）. Western blot confirmed that PAGE5 upregulated p-AKT levels， which could be reversed by MK2206. The qPCR results confirmed that MMP1 is a key downstream effector of PAGE5， and its expression can be inhibited by MK2206 （P＜0.000 1）. ConclusionsThis study preliminarily demonstrates that PAGE5 can activate the PI3K/AKT signaling pathway and mediate the invasion and liver metastasis of breast cancer through MMP1.

ObjectiveThis study aimed to elucidate the specific molecular mechanism by which PAGE5 promotes breast cancer cell invasion and hepatic metastasis through regulating the PI3K/AKT signaling pathway and its downstream effector， matrix metalloproteinase 1 （MMP1）. MethodsBioinformatics analysis using the TCGA database was performed to evaluate PAGE5 expression in metastatic breast cancer tissues. The effects of PAGE5 on the proliferation， migration， and invasion capabilities of breast cancer cells were analyzed using CCK-8， EdU， Transwell， and wound healing assays. A splenic injection hepatic metastasis model in NOD-SCID mice was employed to validate the impact of PAGE5 on breast cancer liver metastasis. Transcriptome sequencing and KEGG enrichment analysis were conducted to identify potential signaling pathways regulated by PAGE5. Western blot was used to detect AKT phosphorylation levels. Quantitative real-time polymerase chain reaction （qPCR） was applied to screen and validate downstream target molecules of PAGE5. ResultsBioinformatic analysis revealed that PAGE5 expression was significantly upregulated in distant metastasis of breast cancer. Both in vitro and in vivo experiments confirmed that PAGE5 overexpression markedly enhanced the migration and invasion abilities of breast cancer cells and promoted the formation of liver metastatic lesions， whereas PAGE5 knockdown suppressed breast cancer liver metastasis （P＜0.000 1）. Transcriptome sequencing and KEGG enrichment analysis indicated that PAGE5 significantly activated the PI3K-AKT signaling pathway （P=0.028 5）. Western blot confirmed that PAGE5 upregulated p-AKT levels， which could be reversed by MK2206. The qPCR results confirmed that MMP1 is a key downstream effector of PAGE5， and its expression can be inhibited by MK2206 （P＜0.000 1）. ConclusionsThis study preliminarily demonstrates that PAGE5 can activate the PI3K/AKT signaling pathway and mediate the invasion and liver metastasis of breast cancer through MMP1.

ObjectiveTo determine the prevalence of hepatitis C virus （HCV） infection and identify the underlying risk factors among drug users in Taizhou City of Zhejiang Province during 2009‒2020. MethodsA consecutive cross-sectional survey was conducted. A total of 400 drug users in correctional settings were randomly selected from April to August. The drug users were interviewed with a questionnaire to collect demographic characteristics， AIDS-related knowledge， detoxification service， drug use， and sexual behavior. Blood samples were then collected for anti-HCV antibody testing. Chi-square test and multivariate conditional logistic regression were used. ResultsA total of 5 042 drug users were included in this study. Seroprevalence of HCV was determined to be 22.7%. From 2009 to 2019， the seroprevalence showed a significant downward trend， from 34.9% to 8.8% （χ²=221.025， P<0.001）. However， in 2020， the seroprevalence was 12.7%. The multivariate logistic regression analysis showed that senior age （≥25 years old）， cohabitation， taking traditional or mixed drugs， injection drug use， and needle sharing were risk factors associated with HCV seroprevalence. ConclusionSince 2009， HCV seroprevalence among drug users in Taizhou City has shown a downward trend， however， it has increased slightly in 2020. It warrants strengthening prevention and treatment measures in response to risk factors related to HCV infection among drug users.

Objective: To understand the situation of varicella prevalence and vaccination of susceptible population in Longhua District，and to provide reference for the varicella immunization program. Methods: A total of 23 706 children from 30 childcare facilities and primary schools in 6 streets were randomly selected throughout the Longhua District. Date on age, grade, recent year and dosage of vaccination, varicella incidence, the overview of vaccination were collected and analyzed. Results: The rate of vaccination in childcare facilities and primary schools was 86.01%, including 55.61% of 1 dose and 30.41% of 2 doses of vaccine. The differences of rate vaccination rate between the childcare facilities and primary schools had statistical significance(χ2=154.95, P<0.05).Rate of no-vaccination,1 dose vaccination and 2 doses vaccination across 6 streets differed significantly(χ2=146.09, 103.93, 127.31, 146.09, P<0.05). There was an increasing positive association between grades and attack rate(χ2=8.65，P<0.05). The differences of attack rate between the childcare facilities and primary schools was of statistical significance(χ2=478.69, P<0.05). The differences of attack rate in street of no vaccination,1 dose vaccination and total attack rate showed statistical significance(χ2=54.49, 74.59, 151.49，P<0.05). There was an increasing linear trend of attack rate of primary school childrenby each year(χ2=24.28，P<0.05). The attack rate increased with time after 1 dose vaccination, immune protection was obtuined for a longer period time after additional doses of vaccine.Negative association was found between grades and protective efficacy rate of varicella. The protective rate and efficacy index of different doses of vaccine in different grades were correlated(r=0.80，0.63，P<0.05). It was most effective after 1 dose vaccination among children in junior grade in kindergarten and 2 dose vaccination in senior grade. Conclusion After the implementation of vaccination program in Longhua District, the vaccination rate of 2 doses significantly increased, but not for a long time. Varicella vaccine should be included in immunization programme to protect vulnerable populations.

Objective:To understand the personal dose level of nuclear medical workers in a hospital, and to provide basis for health management of nuclear medicine occupational population.Methods:From January 2014 to December 2018, 147 radiation workers in a hospital were selected as the monitoring objects, and the individual dose monitoring data were analyzed. The correlation between individual dose and clinical workload was analyzed.Results:The average annual personal dose of 147 staff members was below the national dose limit. Compared with the radiation department, the average annual personal dose of nuclear medical staff was higher, and the difference was statistically significant ( P<0.05) . There was a positive correlation between the annual average personal dose and the corresponding injection workload (Rs=0.69, P<0.05) . Conclusion:The occupational exposure risk of nuclear medical technicians and nurses is high, and reasonable protective measures should be taken to reduce the radiation exposure dose. Conclusion The occupational exposure risk of nuclear medical technicians and nurses is high, and reasonable protective measures should be taken to reduce the radiation exposure dose.

Objective:To understand the personal dose level of nuclear medical workers in a hospital, and to provide basis for health management of nuclear medicine occupational population.Methods:From January 2014 to December 2018, 147 radiation workers in a hospital were selected as the monitoring objects, and the individual dose monitoring data were analyzed. The correlation between individual dose and clinical workload was analyzed.Results:The average annual personal dose of 147 staff members was below the national dose limit. Compared with the radiation department, the average annual personal dose of nuclear medical staff was higher, and the difference was statistically significant ( P<0.05) . There was a positive correlation between the annual average personal dose and the corresponding injection workload (Rs=0.69, P<0.05) . Conclusion:The occupational exposure risk of nuclear medical technicians and nurses is high, and reasonable protective measures should be taken to reduce the radiation exposure dose. Conclusion The occupational exposure risk of nuclear medical technicians and nurses is high, and reasonable protective measures should be taken to reduce the radiation exposure dose.

Objective To explore the clinical efficacy of bone grafting in the treatment of type Ⅱ odontoid fracture with pedicle screw fixation .Methods Of 14 cases with type Ⅱ odontoid fractures ,8 patients in group A received pedicle screw,lamina autologous bone grafts,6 cases of group B received simple posterior pedicle screw fixation.The operative time ,the amount of surgical bleeding and the postoperative cervical spine flexion and rotationwere observed at 3 months postoperatively ,and the patients were followed up for 5-45 months.Results All patients were followed up for 5-45 months,with an average of 26.5 months.The operation time was (1.83 ±0.5) h in the bone graft group,and (1.58 ±0.9)h in the non-bone graft group,the difference was statistically significant (t=2.842,P>0.05).The blood loss of the bone graft group was (150 ±16)mL,which of the non-bone graft group was (120 ±14) mL,the difference between the two groups was statistically significant (t =3.57,P >0.05).After 3 months,the flexion of the cervical spine of the bone graft group was (31.2 ±4.6)°,which in the non -grafted group was (32.3 ±5.7)°,the difference was statistically significant (t=0.675,P<0.05).The rotation of the bone graft group was (40.6 ±4.5)°,which in the non -graft group was (41.3 ±3.5)°,the difference was statistically significant (t=0.278,P<0.05).Both two groups had no vertebral artery and spinal cord injury ,wound healing. During the follow-up period,the two groups of patients had a good reduction of cervical spine ,no internal fixation lossening,fracture,fracture healing well,group A bone graft fusion.Conclusion For this type of fracture,simple atlantoaxial pedicle screw fixation compared with autologous iliac bone graft fusion treatment ,can save the operation time,reduce the amount of bleeding .

Objective To examine the clinical features of sporadic patients with H7N9 avian influenzain Taizhou city of Zhejiang province and to characterize its viral genes.Methods Fifteen patients with H7N9 influenza infection confirmed by Zhejiang Provincial Centre for Disease Control and Prevention during January 201 4 and January 201 5 were included in the study.The basic diseases,poultry exposure history,clinical manifestation,laboratory examination,imaging features,treatment and outcome and viral gene sequencing were analyzed retrospectively.Results The first clinical symptoms were fever and cough in all patients,acuterespiratory distress syndrome(ARDS)occurred in 1 3 patients,the average time from onset to antiviral therapy was (7 ±2)d.Among 1 5 patients,9 survived and 6 died,including 2 died of multiple organ failure (MOF).The phylogenetic tree showed that there was highly homologous in hemagglutinin (HA)and neuraminidase(NA)genes between human H7N9 virus strains and poultry reference strains.The result of genetic sequencing indicated that human H7N9 virus strains had mutations at 226 (Q226L)sites in HA protein.Conclusions ARDS is likely to occur in patients with H7N9 viral infection,and early antiviral treatment usually leads to a good prognosis.With the occurrence of adaptive mutation in avian influenza virus H7N9,spread from poultry to the human beings may take place.