ObjectiveTo analyze the infection status of main respiratory pathogens in influenza-like illness (ILI) cases in Anji County, Huzhou City, Zhejiang Province, and to provide a reference for the prevention, diagnosis, and treatment of respiratory infections. MethodsThroat swab samples were collected from 520 ILI cases in an influenza sentinel surveillance hospital in Anji County of Zhejiang Province from December 2023 to November 2024. Multiplex real-time fluorescence quantitative polymerase chain reaction (mRT-PCR) was used to detect 18 pathogens and their subtypes, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza A virus (Flu A), influenza A (H1N1) virus, influenza A (H3N2) virus, influenza B virus (Flu B), influenza B virus Victoria lineage (BV), influenza B virus Yamagata lineage (BY), coronavirus (CoV), human parainfluenza virus (HPIV), respiratory syncytial virus (RSV), human metapneumovirus (HMPV), adenovirus (ADV), human bocavirus (HBoV), enterovirus (EV), rhinovirus (RV), Mycoplasma pneumoniae (MP), Chlamydia pneumoniae (CP), and Streptococcus pneumoniae (SP). ResultsThe overall positivity rate of pathogens in 520 samples was 33.65%, among which the detection rates of Flu (9.14%), ADV (7.50%), SARS-CoV-2 (6.15%), and EV (3.65%) were relatively high. There were statistically significant differences in the overall positivity rate of pathogens by age and season (all P<0.05). The highest overall positivity rate was observed in the 5‒14 years old group (42.77%), and the overall positivity rate in winter (53.08%) was significantly higher than that in other seasons. ConclusionFrom 2023 to 2024, the main respiratory pathogens detected in ILI cases in Anji County were Flu, ADV, SARS-CoV-2, and EV. The epidemic characteristics showed age and seasonal specificity, so it is necessary to strengthen prevention and control for high-risk populations and epidemic seasons in a targeted manner.

China emerges as a major country in nuclear energy development and the application of nuclear and radiologic technology. The diagnosis and treatment of acute radiation syndrom (ARS) caused by external irradiation represent a core function in the country′s medical rescue of nuclear and radiological emergencies. Clinically, ARS manifests hematopoietic, gastrointestinal, cutaneous, and central nervous system syndromes, with specific clinical manifestations, signs, severity, and prognosis strongly correlated with radiation dose. China has established a number of national and provincial centers for treating radiation-induced damage. Nevertheless, most medical staff have limited experience in ARS treatment. This consensus presents a summary of recent experience in treating ARS of China. In combination with recommendations from international organizations such as the World Health Organization (WHO), this consensus proposes key evidence of critical clinical issues of ARS, covering all links in the rescue of external irradiation-induced ARS. Initially, clinical diagnosis, syndromes, and severe degrees should be determined based on clinical symptoms and dose estimates. It is necessary to normalize clinical treatment measures for hematopoietic recovery, gastrointestinal injury treatment, infection control, symptomatic treatment, and multi-organ function preservation. To this end, this consensus offers cautions. This consensus provides principles of treatment with traditional Chinese medicine, psychological intervention, and follow-up. Additionally, it highlights multidisciplinary collaboration. It is recommended that this consensus be applied in relevant treatment centers.

[This corrects the article DOI: 10.1016/j.apsb.2021.08.008.].

Immune checkpoints include a series of receptor-ligand pairs that play a key role in the proliferation, activation, and immune regulatory responses of immune cells. Although immune checkpoint inhibitors (ICIs), such as programmed death protein 1 (PD-1) and cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) have achieved good therapeutic effects in clinical practice, some patients still experience ineffective treatment and immune resistance. A large amount of evidence has shown that immune checkpoint proteins are related to cell metabolism during immune regulation. On the one hand, immune checkpoints connect to alter the metabolic reprogramming of tumor cells to compete for nutrients required by immune cells. On the other hand, immune checkpoints regulate the metabolic pathways of immune cells, such as phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin (PI3K/AKT/mTOR) to affect the activation of immune cells. Based on a review of the literature, this article reviews the mechanisms by which PD-1, CTLA-4, T cell immunoreceptor with Ig and ITIM domains (TIGIT), T cell immunoglobulin and mucin domain-containing protein 3 (TIM-3), cluster of differentiation 47 (CD47), and indoleamine 2,3-dioxygenase 1 (IDO1) regulate cell metabolic reprogramming, and looks forward to whether targeting the ligand-receptor pairs of immune checkpoints in a "dual regulation" manner and inhibiting metabolic pathways can effectively solve the problem of tumor immune resistance.
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Humans ; Neoplasms/genetics* ; Metabolic Networks and Pathways/immunology* ; Animals ; Immune Checkpoint Inhibitors/pharmacology*

BACKGROUND: Previous studies have demonstrated that short-term exposure to ambient particulate matter elevates the risk of ischemic stroke in major urban areas of various countries. However, there is a notable gap in research focusing on remote areas inhabited by ethnic minorities and the cumulative effects of air pollutants. Our study conducted in the area aims to explore the potential association between ischemic stroke and air pollutants and contribute to improving health outcomes among the community. METHODS: This retrospective observational study was conducted at the Xing'an League People's Hospital in Inner Mongolia. The medical records of 4,288 patients admitted for IS between November 1, 2019, and October 31, 2020, were reviewed. Data on demographics (age and sex), air pollutants (PM₁₀, PM_2.5, NO₂, NO, CO, and O₃), and meteorological factors (daily average temperature, daily average wind speed, and daily average atmosphere pressure) were collected and analyzed. The statistical analysis included descriptive statistics, Poisson distribution analysis to evaluate the adverse effects of atmospheric pollutants on daily hospitalizations, and subgroup analysis to determine whether gender and age could modify the impact on hospitalizations. RESULTS: A substantial correlation was revealed in single-day lags model. The peak delayed effects of PM₁₀, PM_2.5, SO₂, and NO₂ were observed at lag8 (PM₁₀ (OR = 1.016, 95%CI 1.002, 1.030), PM_2.5 (OR = 1.027, 95%CI 1.007, 1.048), SO₂ (OR = 1.153, 95%CI 1.040, 279) and NO₂ (OR = 1.054, 95%CI 1.005, 1.105)) while males exhibited a consistent trend from lag0 to lag8 (PM₁₀ (OR = 1.035, 95%CI 1.018, 1.053), PM_2.5 (OR = 1.056, 95%CI 1.030, 1.082), SO₂ (OR = 1.220, 95%CI 1.072, 1.389), NO₂ (OR = 1.126, 95%CI 1.061, 1.120), CO (OR = 10.059, 95%CI 1.697, 59.638) and O₃ (OR = 0.972, 95%CI 0.946, 0.999)). When gender and age were considered, a positive impact was also observed after three days cumulative effect in males. CONCLUSIONS There is a significant cumulative effect of exposure to air pollution on IS hospital admissions, especially the males and patients under the age of 65. Our results also suggested that a notable association between CO and NO₂ in two-pollutant models.
Humans ; Male ; Female ; Air Pollution/analysis* ; China/epidemiology* ; Retrospective Studies ; Middle Aged ; Air Pollutants/analysis* ; Aged ; Particulate Matter/analysis* ; Hospitalization/statistics & numerical data* ; Adult ; Ischemic Stroke/chemically induced* ; Environmental Exposure/adverse effects* ; Aged, 80 and over

Objective Investigating the effect and mechanism of resveratrol on cardiac function in exercise-induced fatigue rats by regulating mitochondrial energy metabolism.Methods Forty-eight healthy male Sprague Dawley rats(6～8 weeks old)were selected and divided randomly into a blank control(C)group,resveratrol administration(R)group,exercise-induced fatigue(E)group,and exercise-induced fatigue+resveratrol administration group(ER)(n=12 rats per group).Rats in the E and ER groups were subjected to weight-bearing 5％of their body weight for 60 minutes each day and exercise for 6 days per week for 6 weeks.Rats in the R and ER groups received resveratrol 50 mg/kg by gavage,1 hour after exercise.The biochemical kit was used to detect the indicators of motor fatigue,myocardial injury and mitochondrial energy metabolism enzymes in rat myocardium.The mRNA expression levels of myocardial energy metabolism related regulatory factors were detected by real-time fluorescent quantitative PCR(RT-qPCR).Results Plasma levels of blood urea nitrogen(BUN)and creatine kinase(CK)were significantly increased in rats in group E compared with group C(P＜0.05,P＜0.05),CK-MB and cTnI activity were also significantly increased(P＜0.01,P＜0.05),while activity levels of myocardial cytochrome C oxidase(COX)and succinate dehydrogenase(SDH)were significantly reduced(P＜0.01,P＜0.05).mRNA expression levels of the mitochondrial energy metabolism-related genes silent information regulator 1(SIRT1),peroxisome proliferator-activated receptor γ coactivator 1-α(PGC-1α),and estrogen receptor-related receptor α(ERRα)were also significantly reduced(P＜0.01,P＜0.01,P＜0.01).Serum levels of BUN and CK were significantly decreased in the ER group compared with group E(P＜0.05,P＜0.05),while CK-MB and cTnI activities were significantly decreased(P＜0.05,P＜0.05),myocardial COX and SDH activities were significantly increased(P＜0.01,P＜0.05),and SIRT1,PGC-1α and ERRα mRNA levels were also significantly increased(P＜0.05,P＜0.01,P＜0.01).Conclusions Resveratrol can effectively activate the sirtuin 1/peroxisome proliferator-activated receptor γ coactivator 1α/estrogen-related receptor α signaling pathway,improve myocardial energy metabolism in exercise-fatigued rats,and protect against myocardial injury.

OBJECTIVE To investigate the epidemiological characteristics of hospital-associated infections caused by multidrug-resistant organisms(MDROs)among the burn wound patients so as to provide bases for taking tar-geted control measures.METHODS A systematic search was conducted in the worldwide database for nosocomial outbreaks,PubMed and CNKI databases so as to summarize and analyze the data regarding to outbreaks of MDROs hospital-associated infections among burn wound patients.RESULTS A total of 61 incidents of MDROs hospital-associated infections outbreaks among the burn wound patients were included,involving 2 293 patients from 21 countries and regions,50(81.97％)of which were reported for the infection sites or colonization sites in-volving burn wound,12(19.67％)involving the respiratory tract,10(16.39％)involving the bloodstream infec-tions.Methicillin-resistant Staphylococcus aureus(28 incidents,45.90％)was dominant among the pathogens causing the infections,followed by multidrug-resistant Acinetobacter baumannii(17 incidents,27.87％)and multidrug-resistant Pseudomonas aureus(9 incidents,14.75％).52 incidents(82.25％)of outbreaks were reported the contact as the major transmission mode.The suspected sources of the outbreaks included the patients(37 incidents,28.46％),health care workers(30 incidents,23.08％),ward environments(28 incidents,21.54％),medical equipments(19 incidents,30.56％),drainage systems(6 incidents,4.62％).The major pre-vention and control measures included environmental cleaning and disinfection,screening of colonization in patients and health care workers,isolation of patients with infections and hand hygiene;8 incidents were taken the measure of closing the ward.CONCLUSIONS The outbreaks of MDROs infections in the burn wound patients are mostly associated with the high frequently contact environments,medical equipments and hand hygiene of health care workers.In view of the peculiarities of the burn wound patients,it is feasible to take the targeted measures based on the summarized prevention and control combinations for MDROs so as to prevent the outbreak of hospital-asso-ciated infections.

OBJECTIVE To understand the current management status of the special campaign for enhancing the pathogen detection rate before antimicrobial therapy in hospitalized patients in China,analyze identified issues dur-ing implementation,and propose improvement suggestions.METHOD A questionnaire survey was conducted to collect data from medical institutions participating in the special campaign within the region from May to Jul.2024,covering aspects such as quality control management,coordination mechanisms,data sources,indicator connotations and existing issues.RESULTS Variations were observed among medical institutions in the manage-ment of pathogen detection rates,primarily reflected in inconsistent usage of detection rate indicators,varying im-plementation levels of quality control measures and differences in multi-departmental participation.Additionally,discrepancies in data sources,statistical methods and interpretations of indicator connotations limited the compara-bility of data.CONCLUSIONS To address these issues,improvement measures such as strengthening informatiza-tion construction,standardizing indicator statistical methods and enhancing multi-departmental coordination mech-anisms should be implemented.These efforts will provide a scientific basis for the implementation of special cam-paign and robust support for the rational use of antimicrobial agents.

Objective To systematically evaluate the research progress of risk prediction models for periprosthetic joint infection(PJI)after total joint arthroplasty(TJA),analyze the limitations of current researches,and propose optimized suggestions.Methods Chinese and English databases such as PubMed,Embase,Web of Science,Co-chrane Library,SinoMed,Wanfang Database,VIP Database,and CNKI were retrieved systematically.The re-trieved period was from the establishment of each database to August 31,2024.Two researchers independently screened literatures and extracted data according to the CHARMS checklist,and the risk of bias in the included studies was evaluated by the PROBAST tool.Results A total of 14 studies were included in this study,involving 17 prediction models.The most common predictors included history of diabetes mellitus,obesity(body mass index[BMI]≥30 kg/m2),advanced age(≥65 years old),history of traumatic fracture,and prolonged operation time(≥2 hours).All of the included studies had high risks of bias,mainly study subject selection bias(such as single-center sample)and statistical analysis bias(such as unadjusted confounding factors).Conclusion Most of the cur-rently published risk prediction models for PJA after TJA have good predictive performance,however,there are sig-nificant limitations in the research design,especially in the insufficient control of bias risk.Future research needs to focus on improving methodological design,including adoption of prospective multi-center studies,definition of standardized predictive variables,and sufficient adjustment of confounding factors.

Objective Investigating the effect and mechanism of resveratrol on cardiac function in exercise-induced fatigue rats by regulating mitochondrial energy metabolism.Methods Forty-eight healthy male Sprague Dawley rats(6～8 weeks old)were selected and divided randomly into a blank control(C)group,resveratrol administration(R)group,exercise-induced fatigue(E)group,and exercise-induced fatigue+resveratrol administration group(ER)(n=12 rats per group).Rats in the E and ER groups were subjected to weight-bearing 5％of their body weight for 60 minutes each day and exercise for 6 days per week for 6 weeks.Rats in the R and ER groups received resveratrol 50 mg/kg by gavage,1 hour after exercise.The biochemical kit was used to detect the indicators of motor fatigue,myocardial injury and mitochondrial energy metabolism enzymes in rat myocardium.The mRNA expression levels of myocardial energy metabolism related regulatory factors were detected by real-time fluorescent quantitative PCR(RT-qPCR).Results Plasma levels of blood urea nitrogen(BUN)and creatine kinase(CK)were significantly increased in rats in group E compared with group C(P＜0.05,P＜0.05),CK-MB and cTnI activity were also significantly increased(P＜0.01,P＜0.05),while activity levels of myocardial cytochrome C oxidase(COX)and succinate dehydrogenase(SDH)were significantly reduced(P＜0.01,P＜0.05).mRNA expression levels of the mitochondrial energy metabolism-related genes silent information regulator 1(SIRT1),peroxisome proliferator-activated receptor γ coactivator 1-α(PGC-1α),and estrogen receptor-related receptor α(ERRα)were also significantly reduced(P＜0.01,P＜0.01,P＜0.01).Serum levels of BUN and CK were significantly decreased in the ER group compared with group E(P＜0.05,P＜0.05),while CK-MB and cTnI activities were significantly decreased(P＜0.05,P＜0.05),myocardial COX and SDH activities were significantly increased(P＜0.01,P＜0.05),and SIRT1,PGC-1α and ERRα mRNA levels were also significantly increased(P＜0.05,P＜0.01,P＜0.01).Conclusions Resveratrol can effectively activate the sirtuin 1/peroxisome proliferator-activated receptor γ coactivator 1α/estrogen-related receptor α signaling pathway,improve myocardial energy metabolism in exercise-fatigued rats,and protect against myocardial injury.