ObjectiveTo evaluate the detection specificity for clinical samples and the detection capability for standard substances of five commercially available multiplex polymerase chain reaction (PCR) nucleic acid detection kits (hereinafter referred to as the kits) for respiratory pathogens, and to provide a reference for selecting appropriate detection kits for multi-pathogen nucleic acid testing of respiratory infections. MethodsA total of 60 respiratory pathogen-positive clinical samples with known redults were selected and tested using the five kits (labeled as A, B, C, D, and E). The detection rates and Kappa coefficients were calculated to evaluate the consistency between the results from these kits and those from single-pathogen PCR kits. According to the limit of detection (LOD) provided by the kits, standard substances of respiratory pathogens (including 12 types such as influenza virus, Mycoplasma pneumoniae, and Bordetella pertussis) were diluted to four concentrations (250, 500, 1 000, and 2 000 copies·mL⁻¹). All five kits were used for detection to evaluate their respective detection capabilities. ResultsCompared with the results from single-pathogen PCR kits, the five tested kits demonstrated good consistency (all Kappa >0.80). Among them, Kit A had the highest detection rate (100.00%), followed by Kits C and E (98.33%), and then Kits B and D (95.00%). All five kits showed a relatively low false negative rate (FNR) for samples with a cycle threshold (Ct) value ≤35 (≤2.38%). However, for samples with Ct values>35, the FNR increased accordingly(average FNR=6.67%, P=0.029). Kit C exhibited the highest detection sensitivity for the tested standard substances (average LOD: 458.33 copies·mL⁻¹), followed by Kit D, then Kits A/E, and finally Kit B. ConclusionThe five multiplex PCR kits showed good consistency with single-pathogen detection results, but each had its own performance emphasis. Kit A, with the highest detection rate and high throughput, is suitable for targeted viral screening. Kit B, covering the broadest pathogen spectrum (including fungi/bacteria), is suitable for comprehensive respiratory pathogen screening. Kits C, D and E, are applicable for rapid detection. It is important to note that the detection efficacy of all kits decreases for low viral load samples with Ct values >35. In practical application, selection should be based on specific screening objectives, throughput requirements, and sample types.

ObjectiveTo analyze the composition of respiratory virus pathogen spectrum and epidemiological characteristics among adult influenza-like illness (ILI) cases in Putuo District of Shanghai from 2015 to 2024, to summarize the epidemic patterns of respiratory viruses across different time periods and populations, and to provide scientific evidence for the prevention and control of adult respiratory virus infections in Putuo District of Shanghai. MethodsSurveillance data of 2 273 adult ILI cases from sentinel hospitals under the comprehensive surveillance system for acute respiratory infections in Putuo District of Shanghai from 2015 to 2024 were retrospectively collected. Descriptive epidemiological methods were adopted to analyze the temporal and population distribution characteristics of respiratory viruses, including influenza virus (IFV), respiratory syncytial virus (RSV), adenovirus (ADV), and human metapneumovirus (HMPV). The mixed infection status among different age groups was compared, and the distribution of influenza virus subtypes was described. SPSS 22.0 and WPS Office software were used for statistical analyses. ResultsThe overall detection rate of respiratory viruses in 2 273 adult ILI cases was 43.51%. The detection rate in females (45.48%) was significantly higher than that in males (41.25%), with statistical significance (χ²=4.113, P=0.043). Individuals aged 60 years old and above had the highest detection rate (47.41%) (χ²=8.430, P=0.014). The detection rates in winter (50.41%) and summer (48.42%) were higher than those in other seasons (χ²=47.028, P<0.001). The overall viral detection rate decreased after 2020 (χ²=208.411, P<0.001). Detection rates of various viruses varied by year, with IFV and ADV showing high rates from 2015 to 2019 (all P<0.001), while human coronavirus (HCoV) and rhinovirus/enterovirus (HRV/EV) exhibited higher rates from 2020 to 2022 (all P<0.001). Co-infection with IFV and HCoV was the most common, followed by co-infection with IFV and ADV, together accounting for 50.00% of all mixed infections. During the surveillance period, the detection rate of IFV was significantly higher than that of other respiratory viruses. Influenza B/Victoria lineage predominated in 2021, followed by successive predominance of influenza A(H1N1), A(H3N2), and the co-circulation of the two subtypes from 2022 to 2023. Influenza A(H1N1) re-emerged as the predominant subtype in the first half of 2024. ConclusionFrom 2015 to 2024, respiratory virus infections in adults prevailed in winter and summer, and people aged 60 years old and above were the key high-risk population. The detection rates of respiratory viruses declined after 2020. IFV was the predominant pathogen detected, and different influenza virus subtypes circulated alternately each year.

OBJECTIVE To analyze the efficacy and safety of luspatercept in the treatment of myelodysplastic syndromes （MDS） anemia， and provide reference for clinical medication. METHODS The literature related to luspatercept for MDS anemia in PubMed， Cochrane Library， Embase and Web of Science were searched by computer， and the search time was from the establishment of the database to January 2024. The quality of literature was evaluated after they were screened according to inclusion and exclusion criteria， the single-group rate meta-analysis and sensitivity analysis were performed by using RevMan 5.4 software， and the subgroup analysis was conducted. RESULTS A total of 756 patients in 9 articles were included in this study. The results of meta-analysis showed that the proportion of MDS patients who reached ≥8 weeks of red blood cell transfusion independence （RBC-TI） was 46% after using luspatercept [95%CI （0.28， 0.64）， P＜0.000 01]. The proportion of MDS patients whose hematological improvement in erythrocyte （HI-E） was 59% [95%CI （0.43， 0.74）， P＜0.000 01]. Among them， 5 articles reported that the proportion of MDS patients with grade 3-4 adverse reactions was 14% [95%CI （0.07， 0.22）， P＝0.000 2]， and the poor general condition， infection， blood and lymphatic system disease were the common adverse reactions. Subgroup analysis showed that the source of heterogeneity was the blood transfusion burden in the proportion of MDS patients with RBC-TI≥8 weeks， and the source of heterogeneity was the 0931-8356251。revised international prognostic scoring system （IPSS-R） risk grade， SF3B1 mutation status and blood transfusion burden in the proportion of MDS patients with HI-E. Sensitivity analysis showed that the results of this study were stable. CONCLUSIONS Luspatercept can significantly improve blood transfusion dependence， reduce blood transfusion burden and promote hematology improvement in MDS patients. But attention should be paid to the occurrence of grade 3-4 adverse events； adverse events such as poor general condition， infection， blood and lymphatic system diseases are more common.

Objective To evaluate the effectiveness of the integrated schistosomiasis control programme in Wuhan City from 2005 to 2023, so as to provide insights into precision control and elimination of schistosomiasis. Methods The integrated measures for schistosomiasis control implemented by health, agriculture, water resources, and forestry departments of Wuhan City, and the epidemiological data of schistosomiasis in Wuhan City were collected from 2005 to 2023, and the prevalence of human schistosomiasis, prevalence of Schistosoma japonicum infections in humans and bovines, areas of S. japonicum-infected snail habitats, areas of snail habitats in inner embankments, and actual areas of snail habitats were retrieved. In addition, the trends in prevalence of schistosomiasis in humans and livestock and snail status were evaluated in Wuhan City from 2005 to 2023 using Mann-Kendall test and a Joinpoint regression model. Results Mann-Kendall test revealed a tendency towards a decline in the prevalence of human schistosomiasis (Z = -4.41, P < 0.01), prevalence of S. japonicum infections in humans (Z = -4.89, P < 0.01) and bovines (Z = -4.50, P < 0.01), areas of S. japonicum-infected snail habitats (Z = -3.91, P < 0.01), areas of snail habitats in inner embankments (Z = -2.28, P = 0.02), and actual areas of snail habitats (Z = -5.95, P < 0.01) in Wuhan City from 2005 to 2023. Joinpoint regression analysis showed an average annual reduction of 8.58% in the prevalence of human schistosomiasis in Wuhan City from 2005 to 2023 [average annual percent change (AAPC) = -8.58%, 95% confidence interval (CI): (-10.02%, -6.65%), P < 0.01], with two joinpoints in 2013 and 2016, respectively, and the tendency towards a decline showed statistical significance during the period from 2013 through 2016 [annual percent change (APC) = -34.41%, 95% CI: (-40.36%, -20.01%), P < 0.01]. The prevalence of S. japonicum human infections appeared an average annual reduction of 51.91% in Wuhan City from 2005 to 2023 [AAPC = -51.91%, 95% CI: (-58.12%, -44.25%), P < 0.01], with two joinpoints in 2014 and 2017, respectively, and the tendency towards a decline showed statistical significance during the period from 2014 through 2017 [APC = -98.17%, 95% CI: (-99.17%, -90.87%), P < 0.01]. The prevalence of S. japonicum infections in bovines appeared an average annual reduction of 53.12% in Wuhan City from 2005 to 2023 [AAPC = -53.12%, 95% CI: (-59.65%, -42.44%), P < 0.01], with two joinpoints in 2011 and 2014, respectively, and the tendency towards a decline showed statistical significance during the period from 2014 through 2017 [APC = -98.63%, 95% CI: (-99.44%, -90.93%), P < 0.01]. The areas of S. japonicum-infected snail habitats appeared an average annual reduction of 47.09% in Wuhan City from 2005 to 2023 [AAPC = -47.09%, 95% CI: (-52.92%, -38.26%), P < 0.01], with two joinpoints in 2011 and 2014, respectively, and the tendency towards a decline showed statistical significance during the period from 2011 through 2014 [APC = -97.27%, 95% CI: (-98.65%, -88.06%), P < 0.01]. The areas of snail habitats in inner embankments appeared an average annual reduction of 4.45% in Wuhan City from 2005 to 2023 [AAPC = -4.45%, 95% CI: (-5.18%, -3.82%), P < 0.01], with three joinpoints in 2011, 2015 and 2018, respectively, and statistical significance was seen in the tendency towards a decline during the period from 2005 through 2011 [APC = -16.38%, 95% CI: (-20.15%, -14.25%), P < 0.01]. In addition, the actual areas of snail habitats appeared an average annual reduction of 2.65% in Wuhan City from 2005 to 2023 [AAPC = -2.65%, 95% CI: (-2.89%, -2.40%), P < 0.01], with a joinpoint in 2013, and the tendency towards a decline showed statistical significance during the period from 2013 through 2023 [APC = -4.06%, 95% CI: (-4.66%, -3.58%), P < 0.01]. Conclusions The integrated schistosomiasis control programme achieved significant effectiveness in Wuhan City from 2005 to 2023, with a tendency towards a decline in morbidity due to schistosomiasis in humans and livestock and snail status. The integrated schistosomiasis control strategy with emphasis on management of the source of S. japonicum infections should continue to be implemented to consolidate the schistosomiasis control achievements and achieve the goal of schistosomiasis elimination in the city.

Objective To investigate the impact of nucleophosmin 1-mutated(NPM1m)subtypes,variant allele frequency(VAF)and co-mutations on the survival outcomes of patients with acute myeloid leukemia(AML).Methods Clinical data,mutation status,and outcomes of 86 NPM1m-AML patients admitted in Department of Hematology,First Hospital of Lanzhou University between June 2017 and September 2024 were collected and retrospectively analyzed.Spearman correlation analysis,Kaplan-Meier curve analysis,Log-rank test,and Cox regression analysis was applied for correlation analysis,survival analysis,and factors affecting survival.Results The overall survival(OS)was significantly shorter in the Rares subtype of NPM1m than the ABD subtype(median OS:164 d vs 416 d,P=0.043).The VAF of NPM1m was positively correlated with the initial peripheral blood white blood cell count and lactate dehydrogenase(LDH)level(P<0.05).OS was reduced when VAF was≥0.37(median OS:164 d vs 730 d,P=0.003).The presence of myelodysplasia-related gene(MR)mutations was associated with a poorer prognosis when compared to the MR wild-type(median OS:45 d vs 395 d,P<0.001).The triple mutation of FMS-like tyrosine kinase 3-internal tandem duplication(FLT3-ITD)and DNMT3A also indicated a worse prognosis than the non-triple mutation(median OS:173 d vs 483 d,P=0.007).The presence of PTPN11 mutations was associated with improved OS(median OS:395 d vs 240 d,P=0.027),while the patients with coexistence of N/KRAS mutations trended toward better prognosis than the wild-type patients(median OS:662 d vs 189 d)though no statistical significance(P=0.070).Multivariate analysis revealed that LDH(HR=1.002,95%CI:1.000～1.003,P=0.005),NPM1m VAF(HR=2.415,95%CI:1.208～4.829,P=0.013),Rares subtype(HR=3.037,95%CI:1.134～8.136,P=0.027),and MR mutations(HR=5.283,95%CI:1.991～14.017,P<0.001)were independent risk factors associated with OS in the patients.Conclusion Molecular heterogeneity of NPM1m should be taken into account in prognostic stratification of NPM1m-AML.Factors including the Rares subtype,VAF≥0.37,coexistence of FLT3-ITD and DNMT3A mutations,and MR mutations are associated with poor prognosis of NPM1m-AML.The presence of PTPN11 mutations improves the prognosis,while the presence of N/KRAS mutations shows a trend toward better prognosis.LDH,NPM1m VAF,Rares subtype,and MR mutations are independent risk factors affecting OS of patients with NPM1m-AML.

The nucleophosmin 1(NPM1)muta-tion is one of the most frequent subtypes in acute myeloid leukemia(AML).Under the conditions of FLT3-internal tandem duplications(FLT3-ITD)and/or DNMT3A co-mutations or adverse cytogenetics,the originally favorable prognosis will deteriorate.In recent years,studies have found that multiple endocrine neoplasia protein(Menin)inhibitors tar-geting Menin-KMT2A complex can downregulate the overexpression of leukemia causing genes HOX(homeotic gene)and MEIS1(myeloid ecotropic vi-ral integration site 1)in NPM1-mutated AML,dem-onstrating remarkable anti-leukemia activity.This article aims to review the mechanism and clinical research of Menin inhibitors,novel small molecule targeted drugs in NPM1-mutated AML,as well as the resistance mechanism of Menin inhibitors,hop-ing to provide promising approaches for the subse-quent treatment of NPM1-mutated AML patients.

The nucleophosmin 1(NPM1)muta-tion is one of the most frequent subtypes in acute myeloid leukemia(AML).Under the conditions of FLT3-internal tandem duplications(FLT3-ITD)and/or DNMT3A co-mutations or adverse cytogenetics,the originally favorable prognosis will deteriorate.In recent years,studies have found that multiple endocrine neoplasia protein(Menin)inhibitors tar-geting Menin-KMT2A complex can downregulate the overexpression of leukemia causing genes HOX(homeotic gene)and MEIS1(myeloid ecotropic vi-ral integration site 1)in NPM1-mutated AML,dem-onstrating remarkable anti-leukemia activity.This article aims to review the mechanism and clinical research of Menin inhibitors,novel small molecule targeted drugs in NPM1-mutated AML,as well as the resistance mechanism of Menin inhibitors,hop-ing to provide promising approaches for the subse-quent treatment of NPM1-mutated AML patients.

Objective　To analyze and visualize the epidemic changes of schistosomiasis in Wuhan from 2013 to 2022 based on a geographical information system (GIS), providing references for further schistosomiasis control activities. Methods　According to the historical data of the annual reports of schistosomiasis screening and street-level vector map of Wuhan City from 2013 to 2022, a spatial database of epidemic information at the street level was established. The Joinpoint regression model was utilized to analyze the trend of phased changes in blood positivity rate for schistosomiasis. ArcMap 10.8 was employed for the spatial visualization of the positive rate of serological tests for schistosomiasis among the screened population in the endemic areas of Wuhan over the past decade, as well as conducting hot spot analysis (Getis-Ord Gi*) to explore the spatial clustering relationship and spatiotemporal trends. Heatmaps were generated to reflect the changes in the positive rate of blood tests for schistosomiasis over a decade in various streets, and the areas were classified by the ward’s method of hierarchical clustering using the sum of squared deviations. Results　Over the past decade, the overall annual positive rate of schistosomiasis screening in Wuhan declined from 2.23% in 2013 to 0.47% in 2022, showing a general downward trend. The Joinpoint regression model analysis of the blood positive rate indicated the presence of one connection point in 2015; from 2013 to 2015, the annual percent change (APC) of the positive rate was 2.17%, showing an upward trend (P>0.05); from 2015 to 2022, the APC was -23.34%, indicating a downward trend (P<0.05). The map of positive street-level schistosomiasis screening rates for 2013-2022 shows that the positive rate count on the streets of Caidian District and Hannan District in southwestern Wuhan and Huashan Street on the east side, had a significant decrease over the ten years, while the rate in the streets under the jurisdiction of Dongxihu District in the west showed an increase. The hot spot analysis graph revealed that hot spots of the positive rate in Wuhan shifted from the southwest to the west beginning in 2018. The heatmap indicated the largest disparity in trend changes, with the most noteworthy decline in streets under Caidian District and an increasing trend in the streets under Dongxihu District. Conclusions　The overall epidemic situation of schistosomiasis in Wuhan is on a downtrend, although the positive rate of blood tests has increased in some areas. This has been attributed to a reduction in the total number of people participating in the blood tests and the slow decrease of antibodies in certain patients who were repeatedly sampled for testing. It is important to further strengthen the construction of monitoring capabilities, improve the sensitivity of monitoring systems, identify potential risks promptly, and handle them properly.

Objective To analyze the trends in Oncomelania hupensis distribution in Wuhan City, Hubei Province from 2003 to 2022, so as to provide insights into precision schistosomiasis control. Methods Data pertaining to O. hupensis snail survey in Wuhan City from 2003 to 2022 were collected. The trends in the proportion of areas with snail habitats, actual area with snail habitats, mean density of living snails and prevalence of Schistosoma japonicum infection in snails were evaluated in schistosomiasis-endemic areas of Wuhan City from 2003 to 2022 with the slope of trend curve (β), annual percent change (APC) and average annual percent change (AAPC) using a Joinpoint regression model. Results During the period from 2003 through 2022, there were two turning points for the proportion of areas with snail habitats in Wuhan City in 2005 and 2015, with a rise during the period from 2003 to 2005 (β₁ = 5.93, t = 1.280, P > 0.05), a decline from 2005 to 2015 (β₂ = −0.88, t = −2.074, P > 0.05) and a rise from 2015 to 2022 (β₃ = 1.46, t = −2.356, P < 0.05). During the period from 2003 through 2022, there were two turning points for the proportion of areas with snail habitats in islet endemic areas of Wuhan City in 2006 and 2015, with no significant differences in the trends from 2003 to 2006 (β₁ = 4.64, t = 1.888, P > 0.05) or from 2006 to 2015 (β₂ = −1.45, t = −2.143, P > 0.05), and with a tendency towards a rise from 2015 to 2022 (β₃ = 2.04, t = −3.100, P < 0.05). During the period from 2003 through 2022, there were two turning points for the proportion of areas with snail habitats in inner embankment endemic areas of Wuhan City in 2012 and 2020, with a tendency towards a decline from 2003 to 2012 (β₁ = −0.39, t = −4.608, P < 0.05) and with no significant differences in the trends from 2012 to 2020 (β₂ = 0.03, t = 0.245, P > 0.05) and from 2020 to 2022 (β₃ = 1.38, t = 1.479, P > 0.05). During the period from 2003 to 2022, the actual area with snail habitats all appeared a tendency towards a decline in Wuhan City, and in islet and inner embankment endemic areas of Wuhan City from 2003 to 2022 (AAPC = −2.39%, −5.75% and −2.35%, all P values < 0.05). The mean density of living snails reduced from 0.087 snails/0.1 m² in 2003 to 0.027 snails/0.1 m² in 2022 in Wuhan City, with a significant difference in the tendency towards the decline (APC = AAPC = −11.47%, P < 0.05). The annual mean decline rate of the mean density of living snails was 17.36% in outside embankment endemic areas of Wuhan City from 2003 to 2022 (APC = AAPC = −17.36%, P < 0.05), and there was no significant difference in the trends in the mean density of living snails in islet endemic areas of Wuhan City from 2003 to 2022 (APC = AAPC = −0.97%, P > 0.05). In addition, the prevalence of S. japonicum infection in snails appeared a tendency towards a decline in Wuhan City from 2003 to 2022 (APC = AAPC = −12.45%, P < 0.05). Conclusions The proportion of areas with snail habitats, actual area with snail habitats, mean density of living snails and prevalence of S. japonicum infection in snails all appeared a tendency towards a decline in Wuhan City from 2003 to 2022. Intensified snail control, modification of snail habitats, shrinking of areas with snails and implementation of grazing prohibition in snail-infested settings are required, in order to facilitate the progress towards schistosomiasis elimination in Wuhan City.

Objective:To elucidate the etiological and epidemiological characteristics and epidemiological patterns of viral acute respiratory infections (ARI) in Shanghai during 2023, with the aim of providing robust laboratory evidence for effective prevention and control strategies against related respiratory diseases and facilitating risk assessment.Methods:Respiratory pathogens were detected in the clinical surveillance specimens submitted by sentinel hospitals through multiplex PCR, as part of the multi-pathogen surveillance of acute respiratory infections in Shanghai during 2023. The obtained detection result were statistically analyzed in conjunction with sample information.Results:The positive detection rate of viral pathogens in 2023 was 21.17% (984/4 648), with rates of 33.53% (504/1 503) observed in ILI cases and 15.62% (480/3 145) in SARI cases. Influenza A virus (FluA) was the predominant virus detected, accounting for 13.7% (637/4 648). Other viruses identified in the surveillance samples included influenza B virus (Flu B), human rhinovirus/enterovirus (HRV/HEV), respiratory syncytial virus (RSV), human metapneumovirus (HMPV), parainfluenza virus (PIV), adenovirus (ADV) and human bocavirus (HBoV). Regarding temporal distribution, HRV/HEV and RSV exhibited the highest detection rates during the second quarter at 2.27% each (28/1 236). PIV had its peak during the third quarter at a rate of 2.49% (35/1 405), and HMPV showed prevalence mainly during the third and fourth quarters, with detection rates of 2.63% (37/1 405) and 2.35% (32/1 360), respectively.Conclusions:In acute respiratory infection surveillance cases in Shanghai in 2023, Flu A emerged as the predominant respiratory pathogen. The detection rate of HMPV ranked second only to Flu A, while other respiratory viruses such as HRV/HEV, RSV, and PIV were detected during different seasons and co-circulated. The prevalence of various respiratory viruses varied among different infected populations and over times.