ObjectiveTo delineate the species composition structure and seasonal density fluctuations of mosquito populations in Yangpu District, Shanghai, and to provide scientific insights for the prevention and control of vector-borne diseases. MethodsA total of 12 monitoring sites from different habitats were selected to conduct adult mosquito monitoring using the CO₂ trap light method during 2019‒2023, elucidating the temporal and spatial distribution and change patterns of mosquito populations and densities in Yangpu District. ResultsFrom 2019 to 2023, a total of 1 321 female mosquitoes was captured, with an overall density of 0.16 case·(lamp·h)^-1. The species identified were predominantly Culex pipiens pallens (87.28%), followed by Aedes albopictus (12.64%), and Culex tritaeniorhynchus (0.08%). Seasonal distribution showed a typical single-peak pattern, with June‒August being the peak period. In terms of habitat distribution, the highest mosquito population density was found in residential areas [0.18 case·(lamp·h)^-1], followed by hospitals [0.13 case·(lamp·h)^-1] and parks [0.11 case·(lamp·h)^-1]. Culex pipiens pallens was the dominant species in all habitats, with a density of [0.14 case·(lamp·h)^-1]. Notably, there was a statistically significant difference in the composition of Culex pipiens pallens and Aedes albopictus among the three habitats mentioned(χ²=38.396, P<0.001; χ²=36.790, P<0.001). The mosquito density of the 12 streets from high to low is Changhai Road, Pingliang, Yinhang, Xinjiangwan City, Yanji, Daqiao, Wujiaochang, Kongjiang, Changbai New Village, Jiangpu, Siping and Dinghai.The distribution of mosquito density was relatively balanced across different communities (H=1.559, P=1.000). ConclusionThe results of CO₂ trap light monitoring reveals a relatively low density of adult mosquitoes in Yangpu District, with Culex pipiens pallens as the predominant species, and summer being the peak season for mosquitoes. In light of the threat of mosquito-borne diseases such as dengue fever, more effective and evidence-based mosquito control strategies, aligning with the distribution and behavioral patterns of mosquitoes, should be developed.

Objective:To investigate the optimal angle of bedhead elevation during logrolling of patients with severe stroke supported by continuous enteral nutrition via gastric tube administration, and to provide a basis for safe infusion of enteral nutrition in clinical practice.Methods:This study was a prospective study, and the repeated measurement method was used. A total of 154 patients with severe stroke who were admitted to the Neurology Intensive Care Unit of the the 960th Hospital of the Joint Logistic Support Force of the Chinese People′s Liberation Army and treated with continuous enteral nutrition support from January to October 2023 were selected as the study participants by convenience sampling method. The times and duration of cardia reflux in 5 min were observed under ultrasound when the bedhead elevation angle during logrolling of the study participants was 30°, 20°, 10°, and 0°, respectively, and the incidence of reflux and aspiration during the observation period were recorded.Results:A total of 148 patients were eventually included. Among them, 81 were males and 67 were females, aged 38-80 (65.79 ± 10.96) years. There were no significant differences in the incidence of reflux [18.24% (27/148) vs. 12.16% (18/148)] and aspiration [4.05% (6/148) vs. 1.35% (2/148)] when the angle of bedhead elevation during logrolling of patients with continuous enteral nutrition via gastric tube administration was 10° and 20° (all P>0.05). Nevertheless, compared with the incidence of reflux [37.16% (55/148)] and aspiration [(10.81% (16/148)] at the bedhead elevation angle of 0°, those measured at 10° or 20° were significantly different ( χ2 values were 4.91-24.89, all P<0.05). Conclusions:For patients with severe stroke supported by continuous enteral nutrition, bedhead elevation angle of 10° can not only prevent aspiration caused by gastric reflux, but also conform to the labor-saving principle during logrolling, which is the recommended angle of logrolling for patients with severe neurological diseases supported by continuous enteral nutrition.

Objective:To evaluate the effectiveness of esketamine during perioperative anesthesia for acute and chronic pain after cesarean section.Methods:One hundred and fifty patients scheduled for elective cesarean section under spinal anesthesia were randomly assigned into 2 equal groups ( n=75) using a random number table: esketamine group (group E) and control group (group C). Subarachnoid block was administered with 9-11 mg of hyperbaric bupivacaine with 0.33% glucose concentration. After the delivery of the fetus, 0.15 mg/kg (1 mg/ml) esketamine was pumped intravenously for 30 min in the group E, while the same dosage of normal saline was administered in the group C. Furthermore, patients received an intravenous patient controlled intravenous analgesia (PCIA) pump after surgery (100 μg sufentanil + 1.25 mg/kg esketamine + 8 mg ondansetron for the group E, 100 μg sufentanil + 8 mg ondansetron for the group C). Heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were recorded in the initial time of esketamine administration, and 5, 15 min, and 30 min after administration. The pain Numerical Rating Scale (NRS) score at rest and during coughing were recorded at 2, 6, 12, 24 h and 48 h after surgery. The first analgesic time and cumulative sufentanil consumption were recorded at 0-12 h, 12-24 h, 24-48 h, 0-24 h and 0-48 h after surgery. Moreover, we recorded the incidence of chronic pain at 3 and 6 months after surgery. Results:There were no significant differences in HR, SBP and DBP between the two groups immediately after administration of esketamine and 5, 15 min and 30 min after administration (all P>0.05). At rest or during coughing, the pain NRS score were significantly lower at 2, 6 h, and 12 h postoperatively in group E compared to group C (all P<0.05). The time to first analgesia in group E was significantly longer than the group C [(176.8±18.3)min vs (148.5±16.9)min, P<0.05]. The cumulative sufentanil consumption was significantly lower in group E during 0-12 h, 12-24 h, 0-24 h and 0-48 h postoperatively than in group C (all P<0.05), but there was no statistical significance between the two groups at 24-48 h ( P>0.05). There were no significant difference between the two groups in the incidence of chronic pain at 3 months and 6 months after surgery ( all P>0.05). The incidence of chronic pain in group E was lower than that in group C at 3 months [13.4%(9/67) vs 18.8%(13/69), P=0.392] and 6 months [10.7%(6/56) vs 16.1%(10/62), P=0.391], but the difference was not statistically significant. Conclusions:Perioperative administration of esketamine provided superior short-term analgesia after cesarean section and did not increase the psychotomimetic adverse event rate. However, the development of chronic pain was not restrained.

Objective To investigate the resistance development of Aedes albopictus to commonly used insecticides in Yangpu District of Shanghai， China， and to provide scientific bases for the control of A. albopictus and the emergency treatment of dengue fever. Methods The larva immersion method recommended by WHO was used to assay the median lethal concentration （LC₅₀） of A. albopictus larva. SPSS 25.0 was used to calculate the toxicity baselines of insecticides. Results A. albopictus kept a medium resistance to beta-cypermethrin， and the resistance ratios were 14.44， 10.00， 17.78， respectively， in 2015， 2017， 2019. The mosquitos kept a high resistance to permethrin， and the resistance ratios were 54.00， 140.00， 52.00 respectively， in 2015， 2017， 2019. Besides， A. albopictus also kept a medium resistance to propoxur， and the resistance ratios were 15.34， 13.06， 10.83 respectively， in 2015， 2017， 2019. To deltamethrin， A. albopictus showed high resistance in 2015 and medium resistance in 2017， the resistance ratios were 40.00 and 35.00. To temephos， A. albopictus showed low resistance in 2015， with the resistance ratio of 9.38. Conclusion A. albopictus has developed high resistance to permethrin in Yangpu District of Shanghai， and cautious and reduced use of permethrin is suggested. It is necessary to implement and adopt the strategy of comprehensive management， in order to establish the long-term mechanism for mosquito control and prevention.

Objective To determine the current disinfection quality and understand existing problems in clinical institutions in Yangpu District， and provide scientific evidence for improving hospital infection control. Methods From 2018 to 2020， the specimens were collected from medical instruments， disinfectant in use， dialysis water in hemodialysis rooms， air， surface of objects， sterilization equipment， hands of medical staff， dental therapy water and sewage in clinical institutions in Yangpu District， and then examined for disinfection quality. Results A total of 1 420 samples were collected consecutively in 3 years， in which the total qualified rate was determined to be 88.52%. The qualified rates in secondary and tertiary hospitals， primary health centers， and private clinics were 94.86%， 90.22% and 75.74%， respectively， with a significant difference （χ²=95.01， P<0.01）. The qualified rates in sterilization equipment， air， and dialysis water were all 100.00%； in contrast， the rates in medical instruments， surface of objects， hands of medical staff， disinfectants in use， dental therapy water， and sewage were 98.28%， 97.63%， 95.05%， 93.39%， 54.71% and 50.00%， respectively. Conclusion Overall disinfection quality remains good in clinical institutions in Yangpu District of Shanghai， whereas the quality in private clinics is low. In addition， dental therapy water and hospital sewage might be susceptible to contamination， which warrants further improvement in the disinfection and monitoring.

Objective:To evaluate the intestinal function in rats with exertional heat stroke (EHS) and explore the protective role of Ruifuping pectin (RFP) against heat related intestinal mucosal injury.Methods:One hundred and twenty healthy special pathogen free (SPF) male Sprague-Dawley (SD) rats were randomly divided into normothermic control group, EHS model group, hyperthermic plus drinking water group (H 2O+EHS group) and hyperthermic plus pectin group (RFP+EHS group) with 30 rats in each group. The rats in the H 2O+EHS group and RFP+EHS group were given water 20 mL/kg or RFP 20 mL/kg orally for 5 days during adaptive training period. After 1 week, the temperature control range was adjusted to (37±1)℃ using the temperature control treadmill, and the rat model of EHS was reproduced by one-time high temperature exhaustive exercise. No rehydration intervention was given during the training adaptation period in the EHS model group. The rats in the normothermic control group were maintained to room temperature (25±2)℃ and humidity (55±5)% without other treatment. Behavior tests including withdraw response, righting, and muscle strength were performed immediately after onset of EHS. Blood of inferior vena cava was collected, and the serum inflammatory cytokines [tumor necrosis factor-α (TNF-α) and interleukins (IL-6, IL-1β, IL-10)] and activity of diamine oxidase (DAO) were detected by enzyme linked immunosorbent assay (ELISA). The intestinal mucosa was collected, after hematoxylin-eosin (HE) staining, and Chiu score was performed to assess EHS induced pathological changes under light microscope. Results:The rats in the EHS model group had behavioral, inflammatory and pathological changes, such as delayed withdraw response and righting, decreased forelimb pulling, increased inflammatory index, and obvious intestinal mucosal injury, which indicated that the reproduction of the EHS model was successful. There was no significant difference in above parameters between the H 2O+EHS group and the EHS model group except that the inflammatory index in the RFP+EHS group was improved. Compared with the EHS model group, the withdraw reflex to pain and righting after RFP pretreatment in the RFP+EHS group were significantly improved (righting score: 1.4±0.2 vs. 0.3±0.2, withdraw reflex to pain score: 1.0±0.1 vs. 0.2±0.1, both P < 0.05), the muscle strength was significantly increased (N: 13.0±0.5 vs. 8.2±0.6, P < 0.01). The levels of pro-inflammatory factors in the RFP+EHS group were significantly lower than those in the EHS model group [TNF-α (ng/L): 67.5±9.2 vs. 194.3±13.7, IL-6 (ng/L): 360.0±54.1 vs. 981.2±84.4, IL-1β (ng/L): 33.7±9.0 vs. 88.7±6.1, all P < 0.01], while the level of anti-inflammatory factor IL-10 was higher than that in the EHS model group (ng/L: 208.7±10.5 vs. 103.7±7.0, P < 0.01). The degree of intestinal mucosal injury in the RFP+EHS group was less severe than that in the EHS model group, and the Chiu score and DAO were significantly lower than those in the EHS model group [Chiu score: 1.5±0.2 vs. 3.8±0.0, DAO (U/L): 83.7±6.7 vs. 128.7±10.5, both P < 0.05]. Conclusions:High temperature training can damage the intestinal barrier function, and induce endotoxemia and systemic inflammatory response syndrome (SIRS) in rats. Oral prophylactic RFP can protect the intestinal barrier function, alleviate SIRS, and promote the recovery of basic nerve reflex and muscle strength after the occurrence of EHS in rats.

Objective:To evaluate the systemic absorption and safety of multiple doses of topical tazarotene/betamethasone dipropionate cream in healthy subjects and patients with psoriasis.Methods:From September 2008 to April 2009, 12 healthy subjects collected from Hospital for Skin Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College were randomly and equally divided into tazarotene 0.15%/betamethasone dipropionate 0.15% cream group and tazarotene 0.2%/betamethasone dipropionate 0.2% cream group; these subjects were instructed to apply 0.03 g of the test drug per day on each of the 4 body sites, including the flexor aspects of bilateral forearms, waist and back, for 7 consecutive days, and venous blood samples were obtained before, and 1, 3, 5 and 7 days after the start of drug application. From October 2010 to August 2011, 60 patients with non-cephalic psoriasis collected from the Hospital for Skin Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College were randomly divided into 3 groups at a ratio of 3∶1∶1, i.e., tazarotene 0.05%/betamethasone dipropionate 0.05% cream group ( n = 36) and tazarotene 0.05% gel group ( n = 12) topically treated with a cream vehicle in the morning and the test drug at night, and betamethasone dipropionate 0.05% cream group ( n = 12) topically treated with the test drug twice a day (once in the morning and again in the evening) ; the treatment lasted 6 consecutive weeks, and venous blood samples were collected before, and 2, 4 and 6 weeks after drug application. Liquid chromatography-tandem mass spectrometry was performed to determine the concentrations of tazarotenic acid and betamethasone in plasma. During the trial, adverse events in the subjects were recorded, routine blood and urine examinations were carried out, and liver and kidney function were evaluated before and after treatment. Results:The plasma concentrations of tazarotenic acid and betamethasone in the 12 healthy subjects were below the lower limit of quantitation (0.04 μg/L) after 1-, 3-, 5- and 7-day treatment. After the consecutive treatment, tazarotenic acid and betamethasone were detected in 2 (5.56%) and 4 (11.11%) patients respectively at week 2, 4 or 6 in the tazarotene 0.05%/betamethasone dipropionate 0.05% cream group, and the highest plasma concentrations of tazarotenic acid and betamethasone were 0.112 and 0.201 μg/L respectively; in the betamethasone dipropionate 0.05% cream group, betamethasone was detected in 2 of 12 patients, and the highest plasma concentration of betamethasone was 0.112 μg/L. No test drug-related systemic adverse reactions or laboratory abnormalities were observed in any of the healthy subjects or patients.Conclusion:Multiple doses of topical tazarotene/betamethasone dipropionate cream has advantages of little systemic absorption, no long-term accumulation and good systemic safety.

Objective:To explore the clinical application of five flaps method in epicanthus correction.Methods:From May 2009 to July 2016, 39 surgical cases were collected, including 2 males and 37 females, aged 18-55 years, with an average age of 32 years. Patients with single eyelid accompanied by epicanthus and epicanthus alone were treated with the five-flap method to correct epicanthus combined with double eyelid plasty or the five-flap method to correct epicanthus. Postoperative follow-up was conducted for 2 weeks to 10 years.Results:All incisions healed in one stage without triangular flap necrosis. From 2 weeks to 3 months after operation, the medial canthus had slight scar hyperplasia reaction. Three months after operation, the scar hyperplasia reaction subsided without complications, no obvious scar, epicanthus correction, natural shape of the inner canthus angle, obvious narrowing of the distance between the inner canthus, and increased length of bilateral eyelid fissure. The eyelid shape was natural, and the inner canthus connected smoothly and naturally.Conclusions:Five-flap method for correction of epicanthus can effectively alleviate the tension of epicanthus skin by lengthening the main axis of epicanthus, relax the tension-free cross-joint of local tissues, relieve epicanthus, fully expose the angle of epicanthus, enlarge the transverse diameter of palpebral fissure, and avoid contracture of arc scar of epicanthus.

Objective:To investigate the key points of reparation and clinical effects of the over-wide eyelid fold after double eyelid plasty.Methods:The widths of double eyelids were measured for 28 patients who were unsatisfied with their over-wide double eyelids even after surgery. The maximum width was 12 mm, the minimum width was 6.5 mm, with average of 8.59 mm. The major repair methods of simply over-wide double eyelids were used to release adhesion and reduce the width. The repair methods of complexly over-double eyelids were to release adhesion, and to reduce the width; at the same time, fat transplantation and filling, orbital septal fat transfer, shortening of levator palpebrae superioris muscle, anterior fixation of levator palpebrae superioris muscle aponeurosis or correction of upper eyelid retraction should be also performed.Results:After the over-wide double eyelids were repaired, the width of double eyelids was obviously reduced; the double eyelids were more natural and asymmetrical. The upper eyelid was no longer sunk and the cornea exposure rate was greatly improved. 26 patients were satisfied with their surgical results. One patient was dissatisfied with the surgical result affected by the skin which was thin and not elastic. One patient required doctors to get the eyelids slight wider.Conclusions:It is of referential significance to define the clinical characteristics and major shortcomings of over-wide double eyelid for determining surgical plan, surgical items, consultation and preoperative communication with patients.

Objective To evaluate the role of endogenous heme oxygenase-1/carbon monoxide ( HO-1/CO) signaling pathway in endoplasmic reticulum stress during endotoxin-induced acute lung injury ( ALI) in rats. Methods Forty healthy clean-grade male Sprague-Dawley rats, aged 8 weeks, weighing 190-210 g, were divided into 4 groups ( n=10 each) using a random number table method: control group (group C), ALI group, ALI plus ZnPP-IX group (group AZ), and ALI plus vehicle sodium bicarbonate group ( group AV) . ALI was induced by intravenously injecting lipopolysaccharide 5 mg/kg in anesthetized rats. At 30 min before establishing the model, ZnPP-IX 10μmol/kg (diluted to 1 ml in 50 mmol/L sodium bicarbonate) was intraperitoneally injected in group AZ, and 50 mmol/L sodium bicarbonate 1 ml was intra-peritoneally injected in group AV. After injecting lipopolysaccharide for 6 h, blood samples were collected from the common carotid artery for determination of plasma CO concentration, the rats were then sacrificed, and lungs were removed for microscopic examination of the pathological changes which were scored and for determination of CO level, wet to dry weight ratio ( W/D ratio) , cell apoptosis ( by TUNEL) , and expres-sion of heme oxygenase-1 ( HO-1) , glucose-regulated protein 78 ( GRP78) , phosphorylated protein kinase R-like endoplasmie reticulum kinase (p-PERK), phosphorylated eukaryotic translation initiation factor 2 alpha ( p-elF2 ) , CCAAT/enhancer-binding protein homologous protein ( CHOP ) and caspase-12 in lung tissues ( by Western blot) . Apoptosis index ( AI) was calculated. Results Compared with group C, the lung injury scores, W/D ratio, AI and CO levels in plasma and lung tissues were significantly increased, and the expression of HO-1, GRP78, p-PERK, p-elF2, CHOP and caspase-12 was up-regulated in the other three groups ( P＜0. 05) . Compared with group ALI, lung injury scores, W/D ratio and AI were sig-nificantly increased, CO levels in plasma and lung tissues were decreased, the expression of HO-1 was down-regulated, and the expression of GRP78, p-PERK, p-elF2, CHOP and caspase-12 was up-regula-ted in group AZ (P＜0. 05), and no significant change was found in the parameters mentioned above in group AV ( P＞0. 05) . Conclusion HO-1/CO signaling pathway produces endogenous protection possibly through inhibiting endoplasmic reticulum stress during endotoxin-induced ALI in rats.