Objective:To analyze the efficacy of enzyme replacement therapy and anti-drug antibody production in children with Fabry disease.Methods:The clinical data of 7 children with Fabry disease treated with enzyme replacement therapy for more than 1 year at Children′s Hospital of Zhejiang University School of Medicine from July 2021 to June 2024 were retrospectively analyzed. The basic information and the changes of related clinical indicators before and after treatment were collected. Paired sample t test was used to compare renal function, left heart mass index, pain score and other related indexes before and after treatment. The anti-drug antibodies were detected by enzyme-linked immunosorbent assay. Results:A total of 6 boys and 1 girl were included. The age of diagnosis was (12.2±1.8) years. After 1 year of enzyme replacement therapy, the abnormal substrate globotriaosylsphingosine and brief pain inventory scores of all children were significantly lower than those before treatment ((16±11) vs. (63±42) μg/L, 22±19 vs. 45±29, t=3.88, 3.43, both P<0.05). There were no significant differences in glomerular filtration rate, urinary microalbumin to creatinine and left heart mass index before and after treatment ((124±35) vs. (136±26) ml/(min·1.73 m 2), (9.3±8.3) vs. (3.8±2.5) mg/g, (38±9) vs. (33±6) g/m 2.7, t=1.33, 1.74, 1.19, all P>0.05). Patients 4, 5 and 6 developed anti-drug antibodies at 1 month, 4 months and 1 month after medication, respectively. Patient 4 had persistently high anti-drug antibody titers (absorbance 3.65-3.73) accompanied by urticaria, elevated globotriaosylsphingosine and worsening clinical symptoms. Conclusions:The enzyme replacement therapy can effectively improve the clinical symptoms and reduce the level of globotriaosylsphingosine in children with Fabry disease. The anti-drug antibody is common in patients after long-term enzyme replacement therapy and may diminish the efficacy, which needs dynamic monitoring.

Objective To investigate the epidemiological characteristics of dengue fever in Shenzhen City in 2024, so as to provide insights into formulation of the preventive and control measures for dengue fever. Methods The epidemiological data of dengue cases reported in Shenzhen City in 2024 were extracted from the China Disease Prevention and Control Information System and field epidemiological survey data of dengue fever in Shenzhen City, and the temporal, regional and population distributions of dengue fever cases, source of acquire dengue virus infections, disease diagnosis and treatment and outbreaks were analyzed. The dengue virus nucleic acid was tested and the serotypes of dengue virus were characterized using real-time quantitative reverse transcription PCR (RT-qPCR) assay, and the dengue virus gene was sequenced using next-generation sequencing (NGS). In addition, the surveillance on the density of Aedes albopictus was performed using Breteau index (BI) and mosquito oviposition index (MOI). Results A total of 1 735 dengue fever cases were reported in Shenzhen City in 2024, including 952 local cases and 783 imported cases. Most imported dengue fever cases acquired infections from eight cities of Foshan, Guangzhou, Zhongshan, Jiangmen, Dongguan, Zhaoqing, Huizhou, and Zhuhai in the Pearl River Delta region (664 cases, 84.8% of total imported cases) into Baoan, Longgang, and Nanshan districts. The epidemic exhibited an early onset and rapid progression, peaking during the period between September and November (1 632 cases, 94.1% of total cases), and dengue fever cases were distributed across 73 subdistricts in 10 districts, with most cases reported in densely populated central and western regions. The dengue fever cases had a male-to-female ratio of 1.9∶1.0, and a median age of 37 (21) years, with a higher median age among local cases than among imported cases [40 (20) years vs. 33(15) years; Z = -10.30, P < 0.05]. Housework, unemployment, workers, and business service were predominant occupations (1 405 cases, 81.0% of total cases), and there was a significant difference in the constituent ratio of occupations between local and imported cases (χ² = 92.30, P < 0.05). Among the 1 735 dengue fever cases, the median duration from onset to definitive diagnosis was 3.3 (2.9) days, and 1 686 cases (97.2%) were identified in healthcare facilities, with a low rate of hospitalization and isolation seen in 1 701 inpatients with available epidemiological data (485 cases, 28.5% of total inpatients). A total of 29 outbreaks of dengue fever occurred in Shenzhen City across 2024, which primarily in construction sites (27 outbreaks, 93.1% of total). Dengue virus type I was the dominant serotype causing dengue fever in Shenzhen City in 2024. Sequencing showed that the genomes of dengue virus from multiple dengue fever cases in Shenzhen City shared a high sequence homology with those from cities neighboring Shenzhen City, and there might be intra-city transmission of dengue virus among multiple construction sites in Shenzhen City. The Aedes albopictus density was significantly higher in Shenzhen City in 2024 than in 2023, peaking from May to September. The annual MOI values ranged from 0.9 to 14.0, and the BI values ranged from 0.6 to 6.0. Conclusions The overall epidemic of dengue fever was severe in Shenzhen City in 2024, which was greatly affected by case importation from neighboring cities, construction sites-centered local transmission, and the effectives of routine mosquito vector control was not satisfactory. Integrated dengue fever control measures should be implemented, focusing on regional joint prevention and control mechanisms, capacity building for mosquito vector control, addressing challenges in epidemic containment at construction sites, and strengthening case detection and management systems.

OBJECTIVE: To compare the effect of acupuncture-moxibustion on idiopathic facial palsy (IFP) at acute phase and recovery phase. METHODS: According to whether received acupuncture-moxibustion at acute phase or not, 198 IFP patients were divided into an early-phase intervention group (118 cases) and a non-early-phase intervention group (80 cases). With the propensity score matching employed, 70 cases were included in each group. On the basis of the conventional treatment of western medicine, acupuncture-moxibustion was supplemented in the two groups. In the early-phase intervention group, acupuncture-moxibustion was delivered at the acute phase (duration of illness≤7 days); in the non-early-phase intervention group, acupuncture-moxibustion was operated at the recovery phase (duration of illness>7 days). At the acute phase, warm needling was performed at Yifeng (TE17), Xiaguan (ST7), Hegu (LI4) and Zusanli (ST36) on the affected side; and at the recovery phase, electroacupuncture was delivered at Cuanzhu (BL2), Sizhukong (TE23) and Yangbai (GB14), etc. on the affected side, with the disperse-dense wave and 2 Hz/100 Hz of frequency. The intervention was operated for 30 min each time, once every two days, three treatments weekly and for 4 weeks. Before treatment, 1 week and 4 weeks of treatment, the House-Brackmann (H-B) facial nerve function grade, the score of Sunnybrook facial nerve function, and the score of facial disability index (FDI) were compared between the two groups. The clinical effect in 1 and 4 weeks of treatment and safety were evaluated. RESULTS: In 1 and 4 weeks of treatment, the H-B grade was improved when compared with that before treatment in each group (P<0.05), and in 4 weeks of treatment, H-B grade in the early-phase intervention group was superior to that of the non-early-phase intervention group (P<0.05). In 1 and 4 weeks of treatment, Sunnybrook scores and the scores of physical function of FDI were elevated in comparison with those before treatment in the two groups (P<0.05); and in 4 weeks of treatment, the elevation of these two indexes in the early-phase intervention group was greater than that of the non-early-phase intervention group (P<0.05). In 4 weeks of treatment, the scores of social function in FDI were reduced when compared with those before treatment in the two groups (P<0.05). In 4 weeks of treatment, the total effective rate (97.1%, 68/70) in the early-phase intervention group was higher than that (87.1%, 61/70) of the non-early-phase intervention group (P<0.05). There was no significant difference in the incidence of adverse events between the two groups (P>0.05). CONCLUSION Acupuncture-moxibustion therapy starting at the acute phase is more beneficial to the functional recovery of the impaired facial nerve than at the recovery phase in the IFP patients.
Humans ; Female ; Male ; Acupuncture Therapy ; Moxibustion ; Adult ; Middle Aged ; Young Adult ; Acupuncture Points ; Treatment Outcome ; Facial Paralysis/therapy* ; Cohort Studies ; Aged ; Bell Palsy/therapy* ; Adolescent

The department of critical care medicine, the clinical base of critical care medicine, is the centralized management unit for the treatment of critical patients. Medicine and nursing are independent disciplines, but both can be fully utilized from different perspectives when dealing with critically ill patients. With the development of critical care medicine understanding and technology, the concept of doctor-nurse integration construction in the department of critical care medicine has emerged. Doctor-nurse integration construction in the department of critical care medicine needs to take severe diseases as the core and academic development as the orientation. Clinical practice should be carried out through medical cooperation, based on critical cognition and unified thinking mode.

Nasal drug delivery efficiency is highly dependent on the position in which the drug is deposited in the nasal cavity. However, no reliable method is currently available to assess its impact on delivery performance. In this study, a biomimetic nasal model based on three-dimensional (3D) reconstruction and three-dimensional printing (3DP) technology was developed for visualizing the deposition of drug powders in the nasal cavity. The results showed significant differences in cavity area and volume and powder distribution in the anterior part of the biomimetic nasal model of Chinese males and females. The nasal cavity model was modified with dimethicone and validated to be suitable for the deposition test. The experimental device produced the most satisfactory results with five spray times. Furthermore, particle sizes and spray angles were found to significantly affect the experimental device's performance and alter drug distribution, respectively. Additionally, mometasone furoate (MF) nasal spray (NS) distribution patterns were investigated in a goat nasal cavity model and three male goat noses, confirming the in vitro and in vivo correlation. In conclusion, the developed human nasal structure biomimetic device has the potential to be a valuable tool for assessing nasal drug delivery system deposition and distribution.

Objective: The study aims to investigate the impact of moderate intensity gymnastics on the development of executive function in children aged 5-6, thereby providing a theoretical foundation for exercise interventions targeting executive function. Methods: A total of 63 preschool children, randomly seleted from 3 senior classes in a private kindergarten in Shangqiu, were randomly allocated to the intervention group ( n =31) and control group ( n =32). Children in the intervention group participated in 60 minute gymnastics at a moderate intensity, three times per week, for a total duration of 12 weeks. Concurrently, myzone technology was utilized to monitor exercise intensity throughout the entire intervention period. Children in the control group maintained their regular activities. Inhibitory control (Flanker task), working memory (Empty house task), and cognitive flexibility (Dots task) were assessed before and after the experiment. Results: There was no statistically significant difference in the performance of inhibitory control, working memory, and cognitive flexibility tasks between the two groups of children before intervention ( P >0.05) .The results of covariance analysis revealed significant differences in reaction time [(782.88±24.29，805.13±23.74；719.90±119.99， 833.55± 177.87；1 042.39±72.75，1 091.29±49.42) ms] and accuracy[(73.86±7.26)%，(67.02±8.22)%;(86.36±7.63)%，( 80.50± 9.39 )%;(76.45±9.48)%，(69.59±7.66)%] across inhibitory control, working memory, and cognitive flexibility between the intervention group and the control group ( F =6.84, 4.50，4.87, 6.11, 3.74 , 5.06 , P <0.05). The intervention effect exhibited modest effects( d =0.17-0.74). Conclusions Moderate intensity gymnastics can make modest or moderate effect on improving children s executive function. Brain imaging technology can be incorporated into future research designs to investigate the underlying mechanisms of gymnastics impact on the brain structure and executive function in young children.

ObjectiveTo understand the death status of major chronic diseases among the registered residents in Xuhui District， Shanghai from 2007 to 2021， and to analyze the probability and trend of premature death， so as to provide an evidence for the policy-making of disease control and prevention. MethodsBased on the data from the death registration system of the registered residents in Xuhui District， Shanghai from 2007 to 2021， the mortality rate of major chronic diseases， life expectancy without cause of death， potential years of life lost （PYLL）， average years of life lost （AYLL）， and premature death rate were calculated. Joinpoint 4.8 software was used to calculate the annual percentage change （APC） of premature death rate and its trend. ResultsIn 2021， the mortality rate and standardized mortality rate of four major chronic diseases， namely cardiovascular and cerebrovascular diseases， malignant tumors， diabetes mellitus and chronic lower respiratory diseases among the registered residents in Xuhui District， Shanghai was 767.75/100 000 and 234.69/100 000， respectively， accounting for 85.63% of the total causes of death among the residents in Xuhui District， Shanghai. The PYLL， AYLL and PYLL rate were 10 710.00 person-years， 1.49 years per person， and 11.43‰， respectively. Life expectancy increased by 14.91 years after removing the four major chronic diseases. From 2007 to 2021， the premature death rate of chronic diseases among the registered residents in Xuhui District decreased from 9.38% to 7.91% （APC=-1.09%，P<0.05）. Malignant tumors had the highest rate in premature death， and the premature death rate was higher in males than that in females， with a slower rate of decline than in females. Cardiovascular and cerebrovascular diseases， malignant tumors and chronic lower respiratory diseases showed a significant decreasing trend in premature death rate （APC=-1.30%， -1.20%， -5.42%， P<0.05）， while diabetes mellitus showed a significant increasing trend in premature death rate （APC=3.20%， P<0.05）. There was a significant increasing trend in the rate of premature death from diabetes mellitus in males （APC=5.15%， P<0.05） and a decreasing trend in the rate of premature death from diabetes mellitus in females （APC=-0.76%， P<0.05）. ConclusionCardiovascular and cerebrovascular diseases， malignant tumors， diabetes mellitus and chronic lower respiratory diseases are the main causes of death among the registered residents in Xuhui District. The probability of premature death of the residents in Xuhui District from major chronic diseases is at a low level， indicating that the prevention and control of chronic diseases in Xuhui District has achieved some success， but it is still difficult to realize the goals of the Outline of the "Healthy China 2030" Plan. Therefore， it is necessary to comprehensively carry out the control of risk factors such as tobacco use， harmful alcohol consumption， salt intake， hypertension， hyperglycemia and obesity， especially to strengthen the control of risk factors for male residents， as well as early diagnosis and treatment of malignant tumors， cardiovascular and cerebral vascular diseases and diabetes mellitus， and to implement the disease management mechanism to reduce premature death.

BACKGROUND:Most of the studies on combined orthodontic-orthognathic treatment of skeletal class Ⅲ malocclusions have focused on the improvement of the patient's lateral appearance and recovery in the later stages of the treatment,while there are fewer studies observing the microcosmic nature of the alveolar bone remodeling of the lower anterior teeth. OBJECTIVE:To evaluate the therapeutic effect of lower anterior tooth decompensation and alveolar bone remodeling in patients with skeletal class Ⅲ malocclusion before and after orthodontic-orthognathic treatment based on oral X-ray lateral films and oral cone-beam CT. METHODS:From January 2015 to May 2023,15 patients with skeletal class Ⅲ malocclusion who underwent orthodontic-orthognathic surgery at Qingdao Hospital of Rehabilitation University were enrolled.All patients underwent lateral cephalography and cone beam computed tomography before and after treatment.Cephalometric measurement items related to the angle and line distance,lip/lingual bone cracking length(d-La/d-Li)and bone cracking/bone fenestration of the lower anterior teeth before and after treatment were measured. RESULTS AND CONCLUSION:Lateral X-ray films showed that the amount of alveolar bone remodeling after decompensation of the lower anterior teeth showed significant changes compared to before treatment.The root of the tooth moved significantly towards the center of the alveolar bone,and the specific data was closer to normal data,but there were still some differences compared with normal individuals.Based on the cone-beam CT measurement,the bone cracking/bone fenestration length and width of the alveolar bone were improved in almost all the teeth after orthodontic-orthognathic combined treatment,alveolar bone remodeling in some teeth even reached the level of healthy individuals.Before treatment,most patients often experienced bone fenestration/cracking on the lip/lingual side of the lower incisor due to compensatory tooth growth.However,during the preoperative orthodontic stage,decompensation triggered alveolar bone remodeling and significant changes in tooth angle.Preoperative orthodontic treatment caused the upper anterior teeth to retract and the lower anterior teeth to tilt and control the root,but the amount of decompensation before surgery was often insufficient.In the orthognathic surgery stage,the jaw was removed through the positioning guide plate,the maxilla moved forward,and the mandible retreated.During the postoperative orthodontic process,the effect of fine adjustment was better.Although there is a certain degree of recurrence trend in the position of teeth and jawbones,the postoperative orthodontic treatment is closer to the normal value.

Objective:To explore the combination of high risk screening and family screening for potential patients with Fabry disease in adult hemodialysis population, and to improve the diagnostic efficiency of the disease.Methods:It was a cross-sectional investigation study. High-risk screening for Fabry disease was performed on adult hemodialysis patients with end-stage kidney disease who were admitted to Yongkang First People's Hospital of Zhejiang Province between November 2022 and February 2023. Dry blood paper α-galactosidase A (α-Gal A) detection assay was performed in males, or glycosphingolipids (Lyso-GL-3) detection assay was performed in females. GLA genetic assay was performed for further diagnosis after abnormal screening results. Family screening was carried out on the family members of the confirmed Fabry disease patients, and α-Gal A activity and Lyso-GL-3 of peripheral blood were measured. Additionally, urine routine, blood biochemistry, eye examination, hearing test, cranial magnetic resonance imaging, and electrocardiogram were performed to assess organ damage. Results:Among 244 hemodialysis patients, 139 (56.97%) were males and 105 (43.03%) were females. The age ranged from 25 to 81 years (with median age of 61 years). One female patient with Fabry disease was identified GLA IVS4+919G>A mutation, resulting in a total prevalence of 0.41%. Pedigree screening was conducted on 41 family members of the patient, leading to the confirmation of 12 patients (including the proband), including 3 males and 9 females. Among them, 9 patients were abnormal in enzyme examination, 10 patients were abnormal in substrate, and 11 patients were abnormal in gene sequencing. None of the 12 patients exhibited limb pain, hypohidrosis, angiokeratoma, corneal opacity, and hearing impairment. Eight patients had heart abnormalities. Nine patients had abnormal urine routine (albuminuria or hematuria) and one patient had abnormal renal function. Four patients had abnormal cranial magnetic resonance imaging findings. Conclusions:One GLA IVS4+919G>A mutation family is successfully identified through the combination of high-risk screening and family screening in adult hemodialysis patients, with a total of 12 cases of Fabry disease. The combination of high-risk screening and family screening proves to be effective in detecting potential patients with Fabry disease, and improve the screening efficiency of Fabry disease.

From June 16 to 30, 2023, men who have sex with men (MSM) who had visited Voluntary Counseling Testing (VCT) clinics in the Luohu, Futian and Nanshan districts of Shenzhen were included in this study to analyze their awareness of Mpox and the influencing factors. The mean age of the 262 MSM was (34.78±8.94) years, with the majority being unmarried (75.2%) and 79.0% confirmed to be infected with HIV. The awareness rates for five primary indicators, current status of Mpox, pathogen and source of infection, mode of transmission, population susceptibility, clinical manifestations and treatment were 68.4%, 84.7%, 60.3%, 87.8%, and 52.5%, respectively. The awareness rates for five secondary indicators, earliest transmission location (44.7%), main mode of transmission (54.2%), role of masks (46.9%), drug accessibility (46.6%), and self-limiting nature (38.2%) were all below 60%. The MSM population in Shenzhen perceived their likelihood of being infected (2.76±1.32) and discriminated against (3.87±1.26) as relatively low. The logistic analysis showed that the high school or vocational school education ( OR:3.094, 95 %CI:1.180-9.299), college or above education ( OR:5.360, 95% CI:2.159-15.501), and higher scores on questions affecting learning or work ( OR:2.196, 95% CI:1.409-3.599) were promoting factors for Mpox awareness, while higher scores on questions concerning the possibility of Mpox mortality ( OR:0.591, 95% CI:0.432-0.791) was the hindering factor for Mpox awareness.