Background Aedes albopictus is the dominant mosquito species in residential areas in Shanghai. There are many types of small containers with accumulated water in residential areas, providing a large number of breeding environments for Aedes alpopicuts and leading to an increasing transmission risk of mosquito-borne diseases. Objective To use random forest to predict breeding of Aedes mosquitoes in small aquatic container habitat in two concentrated reconstruction communities of rural areas in Shanghai, and to understand associated influence of environmental factors on the breeding of Aedes mosquitoes in the process of urbanization.Methods Small-scale habitat surveys of Aedes mosquitoes were carried out in two suburb concentrated reconstruction communities (Community A and B) in Shanghai, and the environment where the habitat was located was recorded and analyzed in both communities. The habitat where eggs, larvae, or pupae were found was recorded as positive. Spatial weight matrix was applied on a household basis, and global Moran's I index was used to carry out spatial autocorrelation analysis on the small-scale habitat and positive habitat in the environment of the two communities. When Moran's I is greater than 0, it means that the data present a positive spatial correlation; when Moran's I is less than 0, it means that the data are spatially negatively correlated; when Moran's I is 0, the spatial distribution is random. Combining the results of P and Z values, we explored the spatial distribution characteristics of small-scale habitat and positive habitat in the community environment. Random forest algorithm in machine learning was used to classify and sort environmental-related factors, and predict the breeding of Aedes mosquitoes in small aquatic habitat; receiver operating characteristic (ROC) curve was used to carry out model fitting evaluation. Results The environmental factors including building location (χ²=23.35, P<0.001), open space (χ²=8.83, P=0.003), and having trees (χ²=11.02, P=0.001) had a significant impact on the positive rate of small-scale habitat. The results of spatial characteristics analysis showed that the global Moran's I index of small-scale habitat was −0.092 (Z=−1.09, P=0.274) in Community A and 0.034 (Z=0.52, P=0.602) in Community B, and the global Moran's I index of positive habitat was −0.092 (Z=−1.14, P=0.255) in Community A and 0.070 (Z=0.95, P=0.342) in Community B. Since the P values of Community A and B were greater than 0.1 and the Z values were between −1.65 and 1.65, for both small-scale habitat and positive habitat the spatial characteristics were randomly distributed and no significant spatial aggregation was found. In the fitted random forest algorithm classification prediction model with the top 10 characteristic factors of importance, the area under curve (AUC) value was 0.95, and the prediction fitting effect was satisfactory. The results of classification and sorting indicated that counts of household small-scale habitat and positive habitat were the most important factors for breeding. Conclusion The random forest model constructed by environmental factor indicators can be used to predict the breeding situation of Aedes mosquitoes in small-scale aquatic habitat, and provide a basis for scientific prevention and control of mosquito breeding for the target area.

【Objective】 To investigate whether there is a correlation between the differences in ABO blood group distribution in patients with pancreatic cancer, and to evaluate the relative risk. 【Methods】 Patients with pathological diagnosis or discharge diagnosis of pancreatic cancer who underwent ABO blood group typing in our hospital from January 2017 to October 2021 were selected, and the blood group distribution of patients and the correlation were analyzed. 【Results】 There was a statistically significant difference between the pancreatic cancer group and the control group (P<0.05). The study showed that type A may be a relative risk factor for pancreatic cancer patients (χ²=42.44, P<0.001), and type B may play a protective role (χ²=16.28, P<0.01). Significant differences were found in distribution between different gender groups (χ²=64.35, P<0.05). The test results showed that type A may be a risk factor for pancreatic cancer in men (χ²=35.2, OR=1.7, 95%CI=0.59-1.02, P<0.001), and type O may play a protective role in pancreatic cancer(χ²=18.22, OR=0.6, 95%CI=0.25-0.32, P<0.01); type A may be a relative risk factor for female pancreatic cancer patients (χ²=7.06, OR=1.4, 95%CI=0.59-1.02, P<0.001), while type B may play a protective role (χ²=20.32, OR=0.5, 95%CI=0.32-0.43, P<0.01). In pancreatic cancer group, the risk factors of blood type A were higher than those of non-A group, and the protective effect of type B was significantly higher than that of non-B group. 【Conclusion】 The distribution of blood group and relative risk factors in pancreatic cancer patients suggest that A type is predominant; in the population with A blood group, more attention should be paid to early prevention and early treatment, so as to reduce the risk of disease.

Objective To conduct an epidemiological analysis on the incidence of varicella in Jiading District, Shanghai from 2016 to 2021, and to provide theoretical strategies for the prevention and control of varicella. Methods The data of reported cases of varicella from 2016 to 2021 were collected, and descriptive epidemiological methods were used to analyze the area, time, age and occupational distribution of varicella. Results During 2016-2021, 7261 cases of varicella were reported in Jiading District, including 3993 males and 3268 females. The ratio of male to female incidence was 1.05:1, and the incidence was not statistically different. Anting Town had the largest average annual incidence cases of 227. Malu Town had the highest average annual incidence rate of 92.29/100 000. Varicella occurred every month in Jiading District, of which the peaks were from June to August and from November to January of the following year. The incidence of varicella had periodicity and seasonality, showing ^“double peaks^”. According to the age of onset, the top three groups with the largest number of cases were 0-5 years old group, 6-10 years old group and 26-30 years old group. According to the occupational distribution, the top three groups were students, scattered children and kindergarten children. Conclusion It is necessary to further strengthen the active monitoring of the varicella epidemic and take comprehensive measures to prevent its outbreak. At the same time, it is necessary to increase publicity efforts to improve the vaccination rate of school-age children.

Objective: The relationship between serum uric acid (SUA) levels and glycemic indices, including plasma glucose (FPG), 2-hour postload glucose (2h-PG), and glycated hemoglobin (HbA1c), remains inconclusive. We aimed to explore the associations between glycemic indices and SUA levels in the general Chinese population. Methods: The current study was a cross-sectional analysis using the first follow-up survey data from The China Cardiometabolic Disease and Cancer Cohort Study. A total of 105,922 community-dwelling adults aged ≥ 40 years underwent the oral glucose tolerance test and uric acid assessment. The nonlinear relationships between glycemic indices and SUA levels were explored using generalized additive models. Results: A total of 30,941 men and 62,361 women were eligible for the current analysis. Generalized additive models verified the inverted U-shaped association between glycemic indices and SUA levels, but with different inflection points in men and women. The thresholds for FPG, 2h-PG, and HbA1c for men and women were 6.5/8.0 mmol/L, 11.0/14.0 mmol/L, and 6.1/6.5, respectively (SUA levels increased with increasing glycemic indices before the inflection points and then eventually decreased with further increases in the glycemic indices). Conclusion An inverted U-shaped association was observed between major glycemic indices and uric acid levels in both sexes, while the inflection points were reached earlier in men than in women.
Aged ; Asian Continental Ancestry Group ; Blood Glucose/analysis* ; China/epidemiology* ; Cohort Studies ; Diabetes Mellitus/blood* ; Female ; Glucose Tolerance Test ; Glycated Hemoglobin A/analysis* ; Glycemic Index ; Humans ; Male ; Middle Aged ; Uric Acid/blood*

Objective To learn the population and infestation rates of cockroaches from 2017 to 2019 in Jiading District of Shanghai, to evaluate the effect of cockroach termination in household, and to provide information for cockroach control. Methods Cockroaches were controlled by dinotefuran baits and clean-up in households.Sticky trap and visual method were employed for density monitoring in farmers markets, supermarkets, hotels, restaurants, hospitals, and residential areas.Visual method was used in households before and after using the insecticide. Results Sticky trap result showed the room infestation rate was 3.24%, mean adhesion rate was 3.29%, the density was 0.06 per board, and the density peak appeared in May.Rate of invasion and density decreased year by year.Blattella germanica was the dominant species, counting for 71.88%.The density, and rate of infestation, as determined by sticky trap method, were the highest in the farmers markets, followed by hospitals and residential areas.Determined by visual method, room infestation rate was 1.16%, and the infestation rate was 4.44%.The peak appeared in January.Infestation rate of the farmers markets was the highest, followed by hospitals and residential areas.By visual method, the room infestation rate was 59.01%, and 48.45% for nymphs.The room infestation and ootheca rates were 54.04% and 17.39%.The rate decreased more than 80% in 30 days after use of the insecticide. Conclusion Infestation rate of cockroach remains at low level in Jiading District.The effect of bait combined with environmental cleaning is remarkable.Future work should strengthen monitoring and control in farmers markets, hospitals and residential areas.

From April 2017 to September 2019, the START (standardized reception, teaching, analysis, research, training) method was adopted to train 50 general practitioners at the community general practice teaching clinic of Shanghai Huangdu Community Health Service Center. After 3 months of training, the progress of clinical competence and teaching ability were assessed. After training, the scores of clinical skills and communication skills were significantly higher than those before training (P<0.01). The scores of medical history taking, clinical thinking and health education were higher than before (all P<0.01). But there was no significant difference in record writing and reception time management between those before and after training (all P>0.05). The scores of the ability for building physician-patient relationship, collecting information and providing feedback, understanding complaints from patients′ perspective, sharing information and obtaining informed consents were higher than that before training (all P<0.01). The teaching ability of plan design and teaching method were significantly improved compared with that before training (all P<0.01). The satisfaction rate of START method was 96.0%(48/50). The START method applied in community teaching clinic can significantly improve the clinical competency and teaching ability of general practitioners.

Objective To provide reference indexes and theoretical basis for age estimation of blood pools by investigating the entire drying process and monitoring the change of morphology and mass. Methods Four 15 mL blood pool samples were prepared on the clean ceramic plate. The change of morphology and mass of blood pools in a closed dark environment with a temperature of （20.0±0.5） ℃ and a humidity of 35%-45% were dynamically observed from 0 h to 60 h. Images of the blood pools were recorded by digital camera. The area of blood pools was calculated by MATLAB R2014b, the length of cracks was measured by Image J and the statistical analysis was performed by SPSS 16.0. Results By summarizing and analyzing, the drying of blood pools was divided into five stages： coagulation （0-4.5 h）, gelation （>4.5-20.0 h）, gel-solid mixing （>20.0-37.0 h）, solid （>37.0-40.0 h） and final desiccation （>40.0-45.0 h）. From 0 to 45 h, the mass of the blood pools decreased linearly with time, and the decrease was not obvious from 45.0 to 60.0 h. The standardized mass （y₂） showed strong correlation with the time （x） y₂=0.018 2 x+0.271 4（R²=0.967 9）. The area change rate of blood pools, the distance that the edge of blood pools moved, the average length of radical cracks had little correlation with the time that passed. Conclusion The overall morphological characteristics of blood pools show a certain regularity with the time and the standardized indexes established provide a reference for the age estimation of blood pools.
Blood Coagulation ; Humidity ; Temperature ; Time Factors

BACKGROUNDThe normal range of red cell distribution width (RDW) level is <15%. Several studies have indicated that a high RDW level was associated with mortality in critically ill patients, and the patients with a high RDW level need increased focus in clinical practice. In view of the difficulty in defining the specific value of high RDW level, the key is to focus on the patient with the level beyond the normal upper limit. This study aimed to determine whether dynamic change of RDW levels, rather than the level itself, is predictive of death in elderly patients with septic shock when RDW level is beyond 15%.

METHODSBetween September 2013 and September 2015, the elderly septic shock patients with RDW level beyond 15% were enrolled in this study. The RDW levels were measured at enrollment (day 1), and days 4 and 7 after enrollment. Sequential Organ Failure Assessment (SOFA) scores were recorded simultaneously.

RESULTSA total of 45 patients, including 32 males and 13 females, were included in the final analysis. Based on their hospital outcomes, these patients were divided into the survivor group (n = 26) and the nonsurvivor group (n = 19). There were no significant differences in age, gender, body mass index, initial level of RDW, Acute Physiology and Chronic Health Evaluation II scores, and SOFA scores between survivors and nonsurvivors. At days 4 and 7 measurement, both RDW level (median [interquartile range]: day 4: 15.8 [2.0]% vs. 16.7 [2.0]%, P= 0.011; and day 7: 15.6 [1.8]% vs. 17.7 [2.5]%, P= 0.001) and SOFA scores (day 4: 7.0 [4.0] vs. 16.0 [5.0], P< 0.001, day 7: 5.5 [4.0] vs. 17.0 [5.0], P< 0.001) were significantly lower in survivors than those in nonsurvivors. Dynamic changes of RDW and SOFA scores in survivor group were significantly different from those in nonsurvivor group (all P< 0.05). Continuous increase in RDW level was observed in 10 of the 13 nonsurvivors, but only in 3 of the 26 survivors. The level of RDW7 and dynamic changes significantly correlated with their counterparts of SOFA scores (all P< 0.05), whereas the levels of RDW1 and RDW4 had no significant correlation with their counterparts of SOFA scores (all P> 0.05).

CONCLUSIONSContinuous increase in RDW level, rather than the level of RDW itself, was more useful in predicting hospital death in elderly patients with septic shock when the level of RDW was >15%. The dynamic changes of RDW were highly correlated with the SOFA score in the patients.

APACHE ; Aged ; Aged, 80 and over ; Critical Illness ; Erythrocyte Indices ; physiology ; Female ; Hospital Mortality ; Humans ; Male ; Observational Studies as Topic ; Organ Dysfunction Scores ; Prognosis ; Shock, Septic ; blood ; mortality

Objective To investigatethe clinical value of troponin-I(cTnI)in patientswith septic shocka-nd left ventricular diastolic dysfunction. Methods As a retrospective analysis ,38 patients with left ventricular di-astolic dysfunction and septic shock(Sa group),as well as 20 patients with normal cardiac function(Sn group) were enrolled in this study. Moreover ,20 patients with left ventricular diastolic dysfunction and without septic shock were used as control group(Ca group). The ratio of early diastolic mitral inflow velocity to early diastolic mi-tral annulus velocity(E/e′)was measured as the evaluation index of left ventricular diastolicfunction by echocar-diography within 72 hours after admission to ICU. Level of cTnI was detected in all cases and the relationship was evaluated by E/e′. Receiver operating characteristic curve(ROC)was constructed to indicate the predictable value of left ventricular diastolic dysfunction in patients with septic shock. Results The level of cTnI was significantly elevated in both Sa group and Sn group(P<0.05),while the level of cTnI and E/e′in Sa group were significantly higher than those in Sn group(P < 0.05). cTnI was positively correlated with E/e′(r = 0.367 ,P = 0.004). The area under the curve(AUC)of cTnI was 0.834,with the cut-off value of 0.49 ng/mL(sensibility=77.6,specificity=80.7). Conclusion The level of cTnI was significantly higher in patients with septic shock. cTnI was significantly correlated to left ventricular diastolic dysfunction in patients with septic shock. cTnI ≥ 0.49 ng/mL could be an available predictor for left ventricular diastolic dysfunction in patients with septic shock.

Objective To investigate the expression of cardiac troponin-Ⅰ (cTnⅠ) levels in patients diagnosed with sepsis-associated myocardial dysfunction and explore the relationship between cTn Ⅰ and cardiac systolic and diastolic function.Additionally,we evaluated the prognostic value of cTn Ⅰ as a valuable biomarker.Methods We admitted 65 patients with sepsis.Using echocardiography,the ratio of early diastolic mitral inflow velocity to early diastolic mitral annulus velocity (E/e') and the left ventricular ejection fraction (LVEF) were measured as an evaluation index of left ventricular diastolic and systolic function,respectively.Patients were divided into a cardiac dysfunction and a normal cardiac function group.The cTn Ⅰ level was measured and compared between the two groups,and we determined the correlation between cTn Ⅰ levels and cardiac diastolic and systolic function.Based on assessment of 28-day mortality,cases were divided into a survivor and a death group.A receiver operating characteristic curve was constructed to predict the prognostic value of cTn Ⅰ.Results The cTn Ⅰ level in the cardiac dysfunction group was significantly higher than that observed in the normal cardiac function group (P ＜ 0.05) and showed a positive correlation with E/e'(r =0.421,P =0.008).However,there was no correlation noted between the cTn Ⅰ level and LVEF (P ＞ 0.05).Compared to the survivor group,the level of cTn]Ⅰ was significantly higher in the death group (P ＜ 0.05).The prognostic value of cTn Ⅰ area under the curve was 0.892,with a cut-off value of 0.82 ng/mL (sensitivity =88.0％ and specificity =82.5％).Conclusion The cTn Ⅰ level is noted to be significantly elevated in patients with sepsis-associated cardiac dysfunction and shows a positive correlation with left ventricular diastolic function.A cTn Ⅰ level ≥ 0.82 ng/mL can be used as a valuable predictor of mortality in patients with sepsis.