ObjectiveTo understand the surveillance of influenza-like illness (ILI) and influenza vaccination status in Jing’an District, Shanghai, and to provide a basis for optimizing influenza prevention and control strategies. MethodsThe sentinel surveillance data for ILI and virological surveillance data of influenza viruses in Jing’an District were collected from the Chinese influenza surveillance information system, and data for influenza vaccination were collected from Shanghai immunization information system from September 2017 to August 2023. Epidemiological characteristics of ILI, influenza etiology, and the temporal and population distributions of influenza vaccination were analyzed using descriptive epidemiological methods. ResultsILI as a percentage of total visit surveillance units (ILI%) reported by sentinel hospital was increased in Jing’an District of Shanghai from September 2017 to August 2023 (F=18.841, P=0.012). The peak of the influenza cases mainly appeared in winter-spring, but there were two peaks in winter-spring and summer from September 2019 to August 2020, from September 2020 to August 2021, and from September 2021 to August 2022. In particular, there were two peaks in winter-spring from September 2022 to August 2023, with a rebound during the descending process. The average positive rate of ILI was 21.64% (2 421/11 189) during the 6 years. There was a peak in winter-spring during every year with the exception of the period from September 2020 to August 2021. The dominant strains were B/Yamagata and A/H1N1 in winter-spring from September 2017 to August 2018. The dominant strain was A/H1N1 in winter-spring from September 2018 to August 2019 and from September 2022 to August 2023. The dominant strain was B/Victoria in winter-spring from September 2019 to August 2020 and from September 2021 to August 2022. Different subtype strains occurred alternately, and the dominant strains were A/H1N1 and A/H3N2 in recent years. The influenza vaccination coverage was 2.94% from September 2017 to August 2023, and the vaccination coverage was highest in young children. The vaccination coverage for females was higher than that for males (χ²=546.963, P<0.001), and the vaccination coverage for registered residents was higher compared to that for migrants (χ²=123.141, P<0.001). ConclusionILI% exhibits an upward trend in Jing’an District of Shanghai, and the dominant strain is A subtype. The influenza vaccination coverage is still low, which is insufficient to have an impact on the spread of influenza. It is recommended that the surveillance of ILI and variations of influenza virus strains should be improved continuously, and effective steps should be taken to promote influenza vaccination.

Nuclear radiation exposure events and tumor radiotherapy are highly susceptible to a range of psychological, physiological and other health problems, which can seriously affect patients' quality of life. It has been shown that 87.5 % of tumor patients are exposed to varying degrees of radiation injury during radiotherapy. The treatment of radiation injury (RI) in modern medicine is limited to drug therapy, cell therapy, etc. Among them, the most chemical drugs cause many adverse reactions including fatigue, nausea, vomiting, etc., and there are very few drugs dedicated to the treatment of RI. Traditional Chinese medicine (TCM) is a rich natural medicinal resource, which has a wide range of pharmacological activities, multiple targets of action and minimal toxic side effects. Many studies have demonstrated that TCM and its compound preparations have enormous potential in the treatment of radiation induced comprehensive diseases. However, TCM is limited in clinical application due to its slow onset of action, complex active ingredients, and low bioavailability. Therefore, the article reviews the application, molecular mechanisms, and new dosage forms of TCM in the prevention and treatment of RI. On this basis, we will focus on discussing the development advantages and application prospects of the combination of traditional Chinese and Western medicine to achieve highly efficient treatment of RI. This review aims to provide scientific and effective drug delivery strategies and basic theoretical support for the clinical effective treatment of RI with TCM, and further promote the innovative development of TCM.

Objective To explore the prognostic value of neuroimaging score in patients with acute vertebrobasilar artery occlusion(VBAO)with successful revascularization.Methods A total of 83 patients with acute VBAO who underwent endovascular treatment with successful recanalization,modified thrombolysis for cerebral infarction grade 2b or 3 were retrospectively selected.Based on baseline diffusion weighted imaging(DWI)sequences,posterior circulation infarcts were assessed using the novel posterior circulation score(N-PCS),brainstem score(BSS),and posterior circulation Alberta stroke program early CT score(pc-ASPECTS).A 90 d modified Rankin scale(mRS)score ≤2 points was defined as functional independence.The predictive value of the three scores was assessed by the receiver operating characteristic(ROC)curve analysis.Results The N-PCS[median(interquartile range):2(1-2)vs 4(2-5)]was statistically significant between the functional independent group(50 cases)and the poor group(33 cases)(P＜0.001).Multifactorial logistic regression analysis showed that age[adjusted odds ratio(OR)1.08;95％confidence interval(CI)1.02-1.14;P=0.006],baseline National Institutes of Health Stroke Scale(NIHSS)(adjusted OR 1.12;95％CI 1.03-1.20;P=0.005),and N-PCS(adjusted OR 2.84;95％CI 1.30-6.19;P=0.009)were independent prognostic factors for a favorable prognosis.Conclusion The N-PCS based on DWI can predict the prognosis of acute VBAO patients with successful revascularization.

Objective:To identify the risk factors of non-sentinel lymph node (nSLN) metastasis in breast cancer patients with 1~2 positive axillary sentinel lymph node (SLN) and construct an accurate prediction model.Methods:Retrospective chart review was performed in 917 breast cancer patients who underwent surgery treatment between 2002 and 2017 and pathologically confirmed 1-2 positive SLNs. According to the date of surgery, patients were divided into training group (497 cases) and validation group (420 cases). A nomogram was built to predict nSLN metastasis and the accuracy of the model was validated.Results:Among the 917 patients, 251 (27.4%) had nSLN metastasis. Univariate analysis showed tumor grade, lymphovascular invasion (LVI), extra-capsular extension (ECE), the number of positive and negative SLN and macro-metastasis of SLN were associated with nSLN metastasis (all P<0.05). Multivariate Logistic regression analysis showed the numbers of positive SLN, negative SLN and macro-metastasis of SLN were independent predictors of nSLN metastasis (all P<0.05). A nomogram was constructed based on the 6 factors. The area under the receiver operating characteristic curve was 0.718 for the training group and 0.742 for the validation group. Conclusion:We have developed a nomogram that uses 6 risk factors commonly available to accurately estimate the likelihood of nSLN metastasis for individual patient, which might be helpful for radiation oncologists to make a decision on regional nodal irradiation.

Objective:To identify the risk factors of non-sentinel lymph node (nSLN) metastasis in breast cancer patients with 1~2 positive axillary sentinel lymph node (SLN) and construct an accurate prediction model.Methods:Retrospective chart review was performed in 917 breast cancer patients who underwent surgery treatment between 2002 and 2017 and pathologically confirmed 1-2 positive SLNs. According to the date of surgery, patients were divided into training group (497 cases) and validation group (420 cases). A nomogram was built to predict nSLN metastasis and the accuracy of the model was validated.Results:Among the 917 patients, 251 (27.4%) had nSLN metastasis. Univariate analysis showed tumor grade, lymphovascular invasion (LVI), extra-capsular extension (ECE), the number of positive and negative SLN and macro-metastasis of SLN were associated with nSLN metastasis (all P<0.05). Multivariate Logistic regression analysis showed the numbers of positive SLN, negative SLN and macro-metastasis of SLN were independent predictors of nSLN metastasis (all P<0.05). A nomogram was constructed based on the 6 factors. The area under the receiver operating characteristic curve was 0.718 for the training group and 0.742 for the validation group. Conclusion:We have developed a nomogram that uses 6 risk factors commonly available to accurately estimate the likelihood of nSLN metastasis for individual patient, which might be helpful for radiation oncologists to make a decision on regional nodal irradiation.

Objective To evaluate left ventricular ( LV ) myocardial mechanical transmural longitudinal displacement ( LD ) and radial displacement ( RD ) with contrast agent and different power irradiation in open‐chest Beagle canines by ultrasound velocity vector images ( VVI) workstation . Methods T he anesthetized open‐chest Beagle canines were assigned into two groups randomly :Group A ( n ＝6) for baseline ,diagnostic ultrasound power irradiation ( 300 mW) 5 min ,combined with contrast agent irradiation 5 min and contrast agent 20 min conditions ; Group B ( n ＝ 6 ) for baseline and intensity ultrasound irradiation ( 1 W ,2 W and 3 W ,5 min respectively) conditions . T he standard short‐axis and long‐axis gray‐scale view s during three complete cardiac cycles in open‐chest Beagle canine models were acquired . T he peak LD subendomyocardium ( LD‐subendo) ,LD subepimyocardium ( LD‐subepi) ,RD subendomyocardium ( RD‐subendo) and RD subepimyocardium ( RD‐subepi ) of LV were analyzed using a dedicated Syngo VVI method . Results In group A ,the LV LD‐subendo ,LD‐subepi ,RD‐subendo and RD‐subepi in the most of segments showed increasing trend in diagnostic power irradiation ,contrast agent irradiation 5 min and contrast agent 20 min compared with baseline condition ,however the differences were not significant ( P ＞0 .05 ,respectively) . T he peak LD‐subendo and LD‐subepi ,RD‐subendo and RD‐subepi of LV in group A with the same condition were significant different ( all P ＜0 .05) . In group B ,LV LD‐subendo in ultrasonic power 3 W was lower than baseline condition ( P ＜ 0 .05 ) ,LV RD‐subendo was higher compared with baseline condition ( P ＜0 .05) . T he peak LD‐subendo and LD‐subepi ,RD‐subendo and RD‐subepi of LV in group B with the same condition were significant different ( all P ＜ 0 .05) . Conclusions On ultrasonic power 3 W ,LV LD‐subendo is decreased resulting to negative inotropic effect and RD‐subendo is increased to maintain the normal heart work .LV LD and RD on diagnostic ultrasound power irradiation 5 min , combined with contrast agent irradiation 5 min ,contrast agent 20 min conditions ,ultrasonic power 1 W and 2 W are not prominent changes .

Objective To evaluate left ventricular ( LV ) myocardial mechanical synchrony with contrast agent and different power irradiation in open-chest Beagle canines . Methods The anesthetized open-chest Beagle canines were assigned into two groups randomly : Group A ( n = 6 ) for baseline , diagnostic ultrasound power irradiation ( 300 mW ) 5 min ,combined with contrast agent irradiation 5 min and contrast agent 20 min conditions ;Group B ( n = 6) for baseline and intensity ultrasound irradiation ( 1 W ,2 W and 3 W ,5 min respectively) conditions . The standard short-axis gray-scale views at levels of mitral annulus ( MV) ,papillary muscle( PM ) ,and apex( AP) during 3 complete cardiac cycles in open-chest Beagle canine models were acquired . The global radial displacement peak time ( RD-PT) and standard deviation of peak time ( RD-PT SD ) of LV subendomyocardium ( subendo ) and subepimyocardium ( subepi ) were measured and analyzed by using a dedicated Syngo velocity vector imaging ( VVI) method . Results In group A ,compared with baseline condition , the RD-PT and RD-PT SD of subendo and subepi had no significant different among diagnostic power irradiation ,contrast agent irradiation 5 min and contrast agent 20 min ( all P < 0 .05) . There was no significant different in the RD-PT and RD-PT SD between subendo and subepi in A group in all conditions ( all P < 0 .05) . In group B ,the RD-PT and RD-PT SD of subendo and subepi with power 1 W ,2 W and 3 W was higher than those with baseline condition ;the RD-PT and RD-PT SD of subendo were significant different on 2 W compared with those on baseline condition ( all P <0 .05) ;the RD-PT and RD-PT SD of subendo ,subepi were significant different on 3 W compared with baseline condition ( all P < 0 .05) ;the RD-PT and RD-PT SD were significant difference between subendo and subepi in only 3 W condition ( all P < 0 .05 ) . Conclusions Diagnostic ultrasound power irradiation 5 min and combined with contrast agent irradiation 5 min and contrast agent 20 min conditions do not effect the synchrony of LV myocardial mechanics . Power more than 1 W can induce the delay of RD-PT and RD-PT SD of LV subendo and subepi . Power 3 W can result in dyssynchrony of LV myocardial mechanics .

Objective To evaluate left ventricular ( LV ) myocardial mechanical rotation and twist with contrast agent and different power irradiation in open-chest beagle canines by ultrasound velocity vector images ( VVI ) . Methods The anesthetized open-chest Beagle canines were assigned into two groups randomly :group A ( n = 6 ) for baseline ,diagnostic ultrasound power irradiation ( 300 mW ) 5 min , combined with contrast agent irradiation 5 min and contrast agent 20 min conditions ;group B ( n = 6) for baseline and intensity ultrasound irradiation ( 1 W ,2 W and 3 W ,5 min respectively ) conditions . The standard short-axis gray-scale views at basal level (BL) ,and apical level( AL) during three complete cardiac cycles in open-chest beagle canine models were acquired . The peak subendomyocardium rotation ( subendo-rot) ,subepimyocardium rotation ( subepi-rot) of BL and AL were analyzed using a dedicated Syngo velocity vector imaging ( VVI) method and LV subendomyocardium twist ( subendo-twi) and subepimyocardium twist ( subepi-twi) were defined as apical subendo-rot/subepi-rot - basal subendo-rot/subepi-rot . Results In group A ,the LV subendo-twi ,subepi-twi ,subendo-rot and subepi-rot of BL and AL in the most of segments were significant different on diagnostic power irradiation ,contrast agent irradiation 5 min and contrast agent 20 min ( P < 0 .05 ) compared with baseline condition ;LV subendo-twi was higher than subepi-twi in group A under the same condition ( P < 0 .05) . In group B ,LV subendo-twi ,subepi-twi and subendo-rot ,subepi-rot of BL and AL on power 1 W ,2 W were higher and subendo-twi ,subepi-twi on power 3 W were lower than those on baseline condition ( P < 0 .05) ;There was no difference in subendo-rot and subepi-rot of LV BL compared with baseline condition ( P > 0 .05) ;subendo-rot and subepi-rot of LV AL were different compared with those on baseline condition ( P < 0 .05) ;LV subendo-twi and subepi-twi in group B under the same condition were significant difference ( P < 0 .05) . Conclusions LV rotation and twist increase on diagnostic ultrasound power irradiation 5 min ,combined with contrast agent irradiation 5 min ,contrast agent 20 min conditions ,1 W and 2 W ;LV twist and AL rotation decrease on ultrasound power 3 W ,but BL rotation is not affected on ultrasound power 3 W .

Objective To study the clinical efficacy and safety of microwave ablation (MWA) in the treatment of autonomous functional thyroid nodules(AFTN) . Methods Sixty-seven nodules of 53 AFTN patients who refused or were not suitable for surgical resection and 131I therapy were enrolled in the study . All the nodules were evaluated by ultrasound ,color Doppler flow imaging ( CDFI) and contrast enhanced ultrasound(CEUS) ,and all of them were benign and confirmed by pathology . And then ,percutaneous MWA was performed . Fluid isolation and mobile ablation were used to completely inactivate the nodules ,and CEUS was used to evaluate the efficacy of the treatment . The following items included thyroid hormone level ,nodule volume ,nodular blood supply ,thyroid radionuclide imaging ,conscious symptom ,beauty score and complication . Finally ,the factors influencing the curative effect were analyzed . Results The follow-up period was at least 12 months . Compared with before treatment ,the differences of thyroid hormone level , the volume of nodules ,the nodule blood supply were statistically significant ( P ＜ 0 .01) . The 61 hot nodules" changed to cold or warm nodules" . The differences between the improvement ratio of conscious symptoms and beauty scores were statistically significant( P ＜ 0 .05) . The cure ratio in this study was 81 .13% ,and the incidence of complications was 11 .32% ,and the recurrence ratio was 4 .48% . The nodule volume≥14 .04 ml or in a dangerous position were the main factors affecting the curative effect . Conclusions MWA can inactivate the AFTN in situ ,make it lose the secretory function and reduce the volume of nodules . Therefore ,percutaneous MWA guided by ultrasound and CEUS treatment of AFTN can be regarded as another safe and effective treatment besides surgical resection or 131I therapy .

Objective To investigate the nutritional status of elderly patients with diabetic foot ulcers and to explore its influencing factors and relationship.Methods Convenience sampling method was used to recruit 182 elderly patients with diabetic foot ulcers.The mini nutritional assessment (MNA) was adopted to assess nutritional status,and patients' clinical information,hemoglobin A1c,hemoglobin,serum albumin,C-reactive protein were also collected.Results The average score of MNA was 16.36±3.68 for 182 patients,and 121 patients suffered from malnutrition(66.48％),while 61 patients suffered from potential malnutrition(33.52％).The occurrence of malnutrition was positively correlated with age,course of diabetes,classification of foot ulcer,infection,C-reactive protein,hemoglobin A1c and food intake (P＜0.05);the incidence of malnutrition and C-reactive protein for patients with Wagner grade 3 and above were higher than those for patients with low Wagner grades,and hemoglobin A1c and hemoglobin were lower for patients with Wagner grade 3 and above(P＜0.05).Conclusion There was high incidence rate of malnutrition in elderly patients with diabetic foot ulcers,closely related to inflammatory state.Health care providers should provide targeted interventions in time,improve condition of malnutrition,and promote rehabilitation.