OBJECTIVE To explore the clinical characteristics of patients with hematologic tumors combined with Fusarium infection and analyze the prevention and control measures.METHODS Six patients with hematologic neo-plasms combined with Fusarium infection diagnosed at the First Medical Center of the People's Liberation Army General Hospital from Apr.2019 to Dec.2023 were selected as research objects.Through retrospective analysis of patients' clinical data,the clinical manifestations,diagnosis,treatment and prevention strategies of Fusarium in-fection in hematologic neoplasms were analyzed.RESULTS All six patients with hematologic neoplasms combined with Fusarium infection were neutropenic or deficient patients,with main symptoms including moderate fever,painful skin nodules,rash,skin broken and crusted,and scrotal swelling and pain.Patients with severe neutrophil deficiency were susceptible to blood-borne Fusobacterium infections.Four patients had a markedly elevated G-test and Fusorium was first detected by microbiome metagenomic next-generation sequencing(mNGS)in blood,earli-er than traditional pathogenic culture methods.Five patients had Fusarium detected in urine or stool cultures.All six patients received empirical antibacterial and antifungal treatments,but the fungal infection treatment effects were poor.Treatment was adjusted according to the pathogenetic findings,mainly using a combination regimen based on liposomal amphotericin B or posaconazole tablets,with three patients cured and three death.Two pa-tients were from the same ward with a sixteen-day interval.Although no evidence of infection transmission was found,there was still a risk of cross-infection in patients with hematological malignancies and severe immunodefi-ciency.Measures for the prevention and control of hospital-acquired infections were implemented for patients with Fusarium infection and the ward.CONCLUSIONS The clinical manifestations of patients with hematological tumors combined with Fusarium infection are complex and varied with high mortality rates.MNGS testing is valuable in the early diagnosis of Fusarium infection,and it is necessary to explore new treatment options and hospital-ac-quired infectious disease prevention and control measures to improve the prognosis.

Objective To investigate the sequencing results of the SLC26A4 gene in 34 nuclear families and the genetic diagnosis on the offspring in the nuclear families who have been screened for SLC26A4 gene single-allele mutation in the deafness genetic screening,to provide a basis for genetic consulting.Methods A retrospective anal-ysis was performed on the results of SLC26A4 gene testing in 34 nuclear families,in which the offspring with SLC26A4 gene single-allele mutation in deafness genetic screening of each nuclear family.The offspring of 34 nucle-ar families with the second mutation site detected by sequencing,their audiological results were included in the anal-ysis;and if they suffered from hearing loss,the results of temporal bone CT or inner ear MRI were also included in the analysis.Results The sequencing results of 34 nuclear families showed that there were 23 offsprings(67.65％,23/34)with SLC26A4 gene single-allele mutation,and one parent was SLC26A4 gene single-allele mutation.There were 11 offsprings(32.35％,11/34)with second site,among which 7 offsprings(63.64％,7/11)with SLC26A4 gene complex heterozygous mutations,and their parents were SLC26A4 gene single-allele mutations.Among the 7 offsprings with SLC26A4 gene complex heterozygous mutation,3 cases were with hearing loss,all of which were diagnosed as large vestibular aqueduct syndrome,and the other 4 cases were normal.While 4 offsprings(36.36％,4/11)with SLC26A4 gene double heterozygous mutation(cis mutation),and one parent was SLC26A4 gene double heterozygous mutation.The hearing 4 offsprings with SLC26A4 gene double heterozygous mutations were normal.Among the 34 nuclear families,3 pairs of parents were SLC26A4 gene single-allele mutation,and both mutation sites were pathogenic,risk of reproducing children with hereditary hearing loss was 25％.Conclusion The detec-tion sites of deafness gene chip are limited.Using gene sequencing technology to sequence the nuclear family can fur-ther clarify the gene mutation type in offspring and provide guidance for parents to reproduce.

Objective:To explore the effect of anterior traction orthodontic treatment in adolescents with bone type Ⅲ malocclusion of different bone ages.Methods:Two hundred patients with bony class Ⅲ malocclusion admitted to the Department of Stomatology of the Zhangjiakou First Hospital were prospectively selected as the research subjects; An experienced physician divided the research subjects into the Cvs1 stage group ( n=54), the Cvs2 stage group ( n=56), the Cvs3 stage group ( n=47), and the Cvs4 stage group ( n=43) based on the morphological changes of the second, third, and fourth cervical vertebrae in the modified cervical spine analysis method. Before and after orthodontic treatment, X-ray lateral cranial films were taken respectively to compare the indicators of the upper airway and the structural indicators of the temporomandibular joint. Results:The nasopharyngeal volume (NPvolume), nasopharyngeal minimum cross-sectional area (NParea), and nasopharyngeal minimum cross-sectional sagittal diameter (NPsag) of the four groups of adolescents after treatment all increased significantly compared with those before treatment (all P<0.05), especially the increase was the most obvious in the Cvs3 stage group ( P<0.05). In the Cvs1 stage group, Cvs2 stage group, and Cvs3 stage group, except for the Y-axis to Mandibular first molar (Y-Mn6), Overbite, and the ratio of the Angle between the Posterior maxillary vertical to Occlusal plane angle (PMV/OP), there was no statistically significant difference before and after treatment (all P>0.05). The differences in other items before and after treatment were statistically significant (all P<0.05). Conclusions:Anterior traction orthodontic treatment has a significant effect on adolescents of different bone ages with skeletal class Ⅲ malocclusion, and can improve the maxillofacial structure and the position of the temporomandibular joint. There are differences in therapeutic effects among different bone age groups, and the effect of the Cvs3 stage group is the most obvious. These results provide important reference basis for clinical treatment decisions.

Objective:To explore the effect of anterior traction orthodontic treatment in adolescents with bone type Ⅲ malocclusion of different bone ages.Methods:Two hundred patients with bony class Ⅲ malocclusion admitted to the Department of Stomatology of the Zhangjiakou First Hospital were prospectively selected as the research subjects; An experienced physician divided the research subjects into the Cvs1 stage group ( n=54), the Cvs2 stage group ( n=56), the Cvs3 stage group ( n=47), and the Cvs4 stage group ( n=43) based on the morphological changes of the second, third, and fourth cervical vertebrae in the modified cervical spine analysis method. Before and after orthodontic treatment, X-ray lateral cranial films were taken respectively to compare the indicators of the upper airway and the structural indicators of the temporomandibular joint. Results:The nasopharyngeal volume (NPvolume), nasopharyngeal minimum cross-sectional area (NParea), and nasopharyngeal minimum cross-sectional sagittal diameter (NPsag) of the four groups of adolescents after treatment all increased significantly compared with those before treatment (all P<0.05), especially the increase was the most obvious in the Cvs3 stage group ( P<0.05). In the Cvs1 stage group, Cvs2 stage group, and Cvs3 stage group, except for the Y-axis to Mandibular first molar (Y-Mn6), Overbite, and the ratio of the Angle between the Posterior maxillary vertical to Occlusal plane angle (PMV/OP), there was no statistically significant difference before and after treatment (all P>0.05). The differences in other items before and after treatment were statistically significant (all P<0.05). Conclusions:Anterior traction orthodontic treatment has a significant effect on adolescents of different bone ages with skeletal class Ⅲ malocclusion, and can improve the maxillofacial structure and the position of the temporomandibular joint. There are differences in therapeutic effects among different bone age groups, and the effect of the Cvs3 stage group is the most obvious. These results provide important reference basis for clinical treatment decisions.

Objective To investigate the sequencing results of the SLC26A4 gene in 34 nuclear families and the genetic diagnosis on the offspring in the nuclear families who have been screened for SLC26A4 gene single-allele mutation in the deafness genetic screening,to provide a basis for genetic consulting.Methods A retrospective anal-ysis was performed on the results of SLC26A4 gene testing in 34 nuclear families,in which the offspring with SLC26A4 gene single-allele mutation in deafness genetic screening of each nuclear family.The offspring of 34 nucle-ar families with the second mutation site detected by sequencing,their audiological results were included in the anal-ysis;and if they suffered from hearing loss,the results of temporal bone CT or inner ear MRI were also included in the analysis.Results The sequencing results of 34 nuclear families showed that there were 23 offsprings(67.65％,23/34)with SLC26A4 gene single-allele mutation,and one parent was SLC26A4 gene single-allele mutation.There were 11 offsprings(32.35％,11/34)with second site,among which 7 offsprings(63.64％,7/11)with SLC26A4 gene complex heterozygous mutations,and their parents were SLC26A4 gene single-allele mutations.Among the 7 offsprings with SLC26A4 gene complex heterozygous mutation,3 cases were with hearing loss,all of which were diagnosed as large vestibular aqueduct syndrome,and the other 4 cases were normal.While 4 offsprings(36.36％,4/11)with SLC26A4 gene double heterozygous mutation(cis mutation),and one parent was SLC26A4 gene double heterozygous mutation.The hearing 4 offsprings with SLC26A4 gene double heterozygous mutations were normal.Among the 34 nuclear families,3 pairs of parents were SLC26A4 gene single-allele mutation,and both mutation sites were pathogenic,risk of reproducing children with hereditary hearing loss was 25％.Conclusion The detec-tion sites of deafness gene chip are limited.Using gene sequencing technology to sequence the nuclear family can fur-ther clarify the gene mutation type in offspring and provide guidance for parents to reproduce.

OBJECTIVE To explore the clinical characteristics of patients with hematologic tumors combined with Fusarium infection and analyze the prevention and control measures.METHODS Six patients with hematologic neo-plasms combined with Fusarium infection diagnosed at the First Medical Center of the People's Liberation Army General Hospital from Apr.2019 to Dec.2023 were selected as research objects.Through retrospective analysis of patients' clinical data,the clinical manifestations,diagnosis,treatment and prevention strategies of Fusarium in-fection in hematologic neoplasms were analyzed.RESULTS All six patients with hematologic neoplasms combined with Fusarium infection were neutropenic or deficient patients,with main symptoms including moderate fever,painful skin nodules,rash,skin broken and crusted,and scrotal swelling and pain.Patients with severe neutrophil deficiency were susceptible to blood-borne Fusobacterium infections.Four patients had a markedly elevated G-test and Fusorium was first detected by microbiome metagenomic next-generation sequencing(mNGS)in blood,earli-er than traditional pathogenic culture methods.Five patients had Fusarium detected in urine or stool cultures.All six patients received empirical antibacterial and antifungal treatments,but the fungal infection treatment effects were poor.Treatment was adjusted according to the pathogenetic findings,mainly using a combination regimen based on liposomal amphotericin B or posaconazole tablets,with three patients cured and three death.Two pa-tients were from the same ward with a sixteen-day interval.Although no evidence of infection transmission was found,there was still a risk of cross-infection in patients with hematological malignancies and severe immunodefi-ciency.Measures for the prevention and control of hospital-acquired infections were implemented for patients with Fusarium infection and the ward.CONCLUSIONS The clinical manifestations of patients with hematological tumors combined with Fusarium infection are complex and varied with high mortality rates.MNGS testing is valuable in the early diagnosis of Fusarium infection,and it is necessary to explore new treatment options and hospital-ac-quired infectious disease prevention and control measures to improve the prognosis.

ObjectiveTo analyze the trends in life expectancy and cause-eliminated life expectancy of the registered residents in Qingpu District, Shanghai from 2002 to 2021, and to identify the major diseases causing life expectancy loss in the area, so as to provide a theoretical basis for strengthening disease prevention and interventions and optimizing health resources allocation. MethodsUsing the International Classification of Diseases (ICD)-10 classification of death causes, average life expectancy and cause-eliminated life expectancy were calculated with the abbreviated life table and the cause-eliminated life expectancy table. A trend forecast of life expectancy from 2022 to 2029 was made. ResultsFrom 2002 to 2021, the life expectancy of Qingpu District residents showed an increasing trend, with an average annual growth of 0.32 years (AAPC=0.39%, P<0.001). Among the seven major causes of death, the cause-eliminated expected life expectancy for circulatory system diseases showed the most significant upward trend (AAPC=0.53%, P<0.001), rising from the third leading cause of death in 2002 to the first in 2021. The life expectancy loss rate due to circulatory system diseases increased from 3.79% to 7.97%. Respiratory system diseases showed the largest decline, decreasing from the first leading cause of death in 2002 to the fourth in 2021, with the life expectancy loss rate decreasing from 6.83% to 0.99%. ConclusionLife expectancy of the registered residents in Qingpu District has reached a leading level in China. Future efforts should focus on effectively increasing the life expectancy of male residents, strengthening the comprehensive prevention and treatment of chronic diseases such as cerebrovascular diseases, diabetes, and malignant tumors, and improving health promotion policies for residents to achieve a steady long-term increase in regional life expectancy.

ObjectiveTo establish the Shanghai twin birth cohort （STBC） and analyze the effects of genetic factors， shared environment， and non-shared environment interactions on birth health and growth and development of newborns. MethodsBased on the population-wide birth cohort in Shanghai， a comprehensive survey was conducted on the families with double and multiple babies born after January 1， 2015 to collect information on birth health， growth and development， and the family environment of the babies. ResultsBy December 31， 2021， a total of 7 195 pairs （14 405 cases） of twins were successfully included in the STBC survey. The average birth length of twins was 47.2 cm and average birth weight was 2 465.3 g. Heterozygous twins accounted for 69.05% and preterm babies accounted for 57.07%. The average age of the mothers of twins was 31.82 years， and the average age of the fathers was 33.87 years， with more than 80% of the parents having a college degree or above. 44.50% of the mothers used assisted reproductive technologies， 7.40% had illnesses during pregnancy， and 15.90% were exposed to passive smoking during pregnancy. During the survey period， the average monthly increase in the length of the twin infants was 2.09 cm， and the average monthly weight gain was 0.53 kg. ConclusionThe incidence of adverse outcomes such as maternal cesarean section rate， preterm birth， and low birth weight is higher in the twin birth population. Information on birth health as well as growth and development in childhood and adolescence in the twin birth population is collected based on STBC， which can provide a solid data foundation for studying children’s chronic non-communicable diseases， psychological and behavioral disorders and other complex health problems caused by the combined effects of genetics and the environment.

ObjectiveTo analyze the characteristics and changing trend of injury cause of mortality of residents in Qingpu District from 2002 to 2020， and to provide scientific reference for formulating regional prevention and control measures. MethodsThe injury mortality data of the registered residents in Qingpu District from 2002 to 2020 were collected. The indicators such as crude mortality rate， standardized mortality rate， and the ranking of causes of death were calculated. ResultsFrom 2002 to 2020， the average annual crude mortality rate was 50.27/100 000， the age-standardized mortality rate based on the world standard population（ASRW） was 30.08/100 000， and the age-standardized mortality rate based on the 2010 Chinese census（ASMRC） was 35.58/100 000. The average annual crude mortality rate of males was higher than that of females ［Z=54.402， Mantel-Hanszel χ²=1 742.509， P<0.01）. The overall injury mortality rate showed a downward trend with an average annual percent change（AAPC）of -4.07% （95%CI： -5.23%‒-2.90%）， P<0.001］. The top four causes of injury death were transportation accident， indeliberate fall， drowning， and suicide. The leading causes of death in 0‒ years old， 15‒ years old and ≥65 years old were drowning， transportation accident and indeliberate fall， respectively. The ASRW of transportation accident， drowning and suicide all showed a decreasing trend， and the AAPC were -8.22% （95%CI： -10.16%‒-6.24%）， -6.99% （95%CI： -9.68%‒-4.22%） and -6.21% （95%CI： -9.38%‒-2.94%）， respectively. ConclusionThe injury death rate of residents in Qingpu District shows a decreasing trend， and the distribution characteristics of injury death are different among different genders and age groups. Corresponding prevention and control strategies should be adopted for different populations.

Objective:To explore the effect and safety of mesenchymal stem cell exosome microneedle introduction in the treatment of melasma.Methods:Thirty cases of female patients with stable melasma in the Department of Dermatology, Changsha Meilai Medical Beauty Hospital, aged (36±5) years and with a disease duration of (42.4±20.7) months, from July 2021 to July 2022, were retrospectively included. According to Fitzpatrick skin typing, 23 cases of type Ⅲ and 7 cases of type Ⅳ were included. All patients were locally anesthetized with lidocaine cream for 30 min, and rolled with a 0.5 mm needle in a zigzag pattern with even force, in the order of the right cheek, the left cheek, the forehead, the nose, the mandible, and the upper lip. During the rolling process, 3 ml of MSC exosome medical liquid wound dressing was applied to the facial skin, and after it was fully absorbed, exosome was locally readministered in the area of melasma. Treatment ended with a slight redness at the site of application. 1 MSC exosome wound dressing was appllied as a cold compress for 15 min after treatment. Treatment was given once every 2 weeks for 6 consecutive sessions. All the patients were followed up at 4 and 12 weeks after the last session, and the area and severity index of melasma (MASI) were scored before and after the treatment, the clinical efficiency and patient satisfaction rate and the incidence of adverse reactions were also counted.Results:At 4 and 12 weeks after the end of treatment, the skin color of all 30 patients was brighter than that before treatment, and no recurrence of melasma symptoms seen. At 12 weeks after the end of treatment, the decrease rate of MASI score was 66.1%, among which the decrease rate of MASI score in patients with type Ⅲ melasma was 63.9%, and the decrease rate of MASI score in patients with type Ⅳ melasma was 63.9%. Among the 30 patients, 1 case was cured, 25 cases showed obvious improved, 4 cases were improved, and no cases were ineffective, with an effective rate of 86.7% (26/30). Five patients were very satisfied, 18 patients were satisfied, 6 patients were generally satisfied, and 1 patient was dissatisfied; the patient satisfaction rate was 76.7% (23/30). No serious adverse reactions occurred in all patients.Conclusions:MSC exosome microneedle introduction is safe and effective in the treatment of melasma without serious adverse reactions.