This study investigated the epidemic status of H3N2 influenza virus and the genetic evolution characteristics of hemagglutinin(HA)and neuraminidase(NA)of H3N2 subtype influenza viruses isolated in Shandong Province during 2023-2024,to understand their compatibility with vaccine strains and drug resistance status.A total of 25 H3N2 subtype influenza virus strains were randomly selected from the strains isolated by the influenza surveillance network laboratory.The HA and NA genes were sequenced with the vaccine strains recommended by the WHO as a reference.Monitoring of sensitivity to oseltamivir and zanamivir was conducted through neuraminidase inhibition experiments.The H3N2 influenza viruses in Shandong Province belonged to the 3C.2a1b.2a.2a.3a.1 clade.Nucleotide sequence analysis revealed that the HA1 and NA genes were closely related to the WHO-recommended vaccine strain A/Darwin/9/2021 for the current season,with homology rates of 97.8%-98.2%and 98.9%-99.3%,respectively.Amino acid sequence analysis indicated 22 amino acid sequence variations in the HA1 protein,and antigenic drift was detected in 8 strains.A glycosylation site was added at position 94 of the HA protein in all 25 strains.Variations occurred in the NA antigenic determinants of some strains.Neuraminidase inhibition experiments indicated that all tested influenza viruses were sensitive to oseltamivir and zanamivir.Some differences in HA and NA proteins were observed between the monitored strains and vaccine strains.Continued monitoring of the molecular evolution characteristics of influenza viruses is necessary to understand the risk of influenza outbreaks,and their effects on the effectiveness of influenza vaccines and therapeutic drugs.

Objective:To analyze the respiratory virus infection status and epidemiological characteristics of influenza-like illness (ILI) cases in Shandong Province during the 2020 -2021 influenza surveillance year. Methods:According to the National Influenza Surveillance Plan (2017 version), throat swab samples of ILI cases were collected from 14 surveillance sentinel hospitals in Shandong Province. Nucleic acid was extracted from all samples. Real-time fluorescence quantitative PCR (RT-PCR) was utilized to detect six common viruses, including human metapneumovirus (HMPV), human parainfluenza virus (HPIV) types 1, 2 and 3, respiratory syncytial virus (RSV), and adenovirus (ADV). Subsequently, the obtained detection results were analyzed.Results:A total of 2 386 specimens were collected, with a detection rate of 24.22% (578). Six viruses were detected, with detection rates of 6.75% (162 cases) for HMPV, 5.87% (140 cases) for RSV, 3.56% (85 cases) for HPIV3, 3.14% (75 cases) for HPIV2, 2.98% (71 cases) for HPIV1, and 2.77% (66 cases) for ADV. There was no significant difference in detection rates between genders, but a notable variation among different age groups ( P<0.001). The highest detection rate was observed in individuals aged 0-4 years (31.94%), followed by those aged≥60 years (26.06%). The prevalence of six viruses showed a monthly variation, with the detection rate of HMPV being higher in December and HPIV1 being higher in February. HPIV2, HPIV3, RSV, and ADV had higher detection rates in November. The co-detection rate of multiple viruses was 0.80%, with RSV being the most common pathogen involved in co-detection, primarily in individuals aged 0-4 years. Conclusion:The detection of six multiple pathogens in ILI cases in Shandong Province is dominated by HMPV, RSV and HPIV3. The prevalence of respiratory viruses varies by age and time.

With the rapid development of generative artificial intelligence(GAI)technologies,their widespread application in academic research and writing is continuously expanding the boundaries of sci-entific inquiry.However,this trend has also raised a series of ethical and regulatory challenges,inclu-ding issues related to authorship,content authenticity,citation accuracy,and accountability.In light of the growing involvement of AI in generating academic content,establishing an open,controllable,and trustworthy ethical governance framework has become a key task for safeguarding research integrity and maintaining trust within the academic community.This expert consensus outlines ethical requirements across key stages of AI-assisted academic writing-including topic selection,data management,citation practices,and authorship attribution.It aims to clarify the boundaries and ethical obligations surrounding AI use in academic writing,ensuring that technological tools enhance efficiency without compromising in-tegrity.The goal is to provide guidance and institutional support for building a responsible and sustainable research ecosystem.

Objective To explore the effects of different CO2 pneumoperitoneum pressures during surgery on overweight or obese patients with laparoscopic panhysterectomy in Trendelenburg position.Methods A total of 88 overweight or obese patients who underwent laparoscopic panhysterectomy were selected and randomly divided into the low-pressure group and the high-pressure group according to random number table method,with 44 patients in each group.All patients used CO2 as the pneumoperitoneum medium during surgery,with 10 mmHg of CO2 pneumoperitoneum pressure in the low-pressure group and 15 mmHg of CO2 pneumoperitoneum pressure in the high-pressure group.The operation-related indexes,respiratory indicators,nasopharyngeal temperature and adverse reactions of patients were compared between the two groups.Results There was no significant difference in the surgical time,blood loss,intraoperative infusion volume,incidence of organ injury,and laparotomy rate between the two groups(P>0.05).The recovery time of anesthesia of patients in the low-pressure group was shorter than that in the high-pressure group(P<0.05).At 30 minutes after the establishment of pneumoperitoneum,the peak airway pressure(Ppeak)and plateau pressure(Pplat)of patients in the high-pressure group were significantly higher than those in the low-pressure group(P<0.05),while the dynamic lung compliance(Cdyn)of patients in the high-pressure group was significantly lower than that in the low-pressure group(P<0.05).At 60 minutes after the establishment of pneumoperitoneum and the end of pneumoperitoneum,the nasopharyngeal temperature of patients in the high-pressure group were significantly lower than those in the low-pressure group(P<0.05).The incidences of intraoperative hypothermia and shivering in the high-pressure group were significantly higher than those in the low-pressure group(P<0.05).Conclusion Compared with 15 mmHg of CO2 pneumoperitoneum pressure,10 mmHg of CO2 pneumoperitoneum pressure on overweight or obese patients with laparoscopic panhysterectomy in Trendelenburg position does not increase surgical difficulty,and the patients has lower airway pressure,better lung compliance,fewer adverse reactions,and faster recovery,which can also avoid intraoperative hypothermia.

Objective To investigate the effects of preoperative anxiety on the intraoperative body temperature,recessive blood loss,and wound healing in elderly patients undergoing laparoscopic hysterectomy under general anesthesia.Methods A total of 118 elderly patients who underwent laparoscopic hysterectomy in Yancheng Third People's Hospital from January 2021 to December 2023 were selected as the research subjects,and they were divided into the normal group(69 cases with normal emotions)and the anxiety group(49 cases with anxiety emotions)according to the self-rating anxiety scale(SAS)score 1 day before operation.The core temperature at different time points and the incidence of intraoperative hypothermia were compared between the two groups.The intraoperative bleeding volume,incision drainage bleeding volume,recessive blood loss,incidence of adverse reactions,and wound healing were compared between the two groups.Results The core temperature 60 minutes after operation and at the end of operation in the anxiety group were significantly lower than those in the normal group(P<0.05).The incidence of intraoperative hypothermia in the anxiety group was significantly higher than that in the normal group(P<0.05).There was no statistically significant difference in the intraoperative bleeding volume or incision drainage bleeding volume between the two groups(P>0.05),while the recessive blood loss in the anxiety group was significantly higher than that in the normal group(P<0.05).The incidence of shivering in the anxiety group was significantly higher than that in the normal group(P<0.05);the incidence of poor wound healing in the anxiety group was significantly higher than that in the normal group(P<0.05).Conclusion For elderly patients who undergo laparoscopic hysterectomy for more than 60 minutes,the body temperature will significantly decrease,the incidence of intraoperative hypothermia and shivering is high,the recessive blood loss will significantly increase,which is prone to poor wound healing and is not conducive to the rapid recovery of patients after operation,if combined with anxiety before surgery.

Objective To investigate the effects of preoperative anxiety on the intraoperative body temperature,recessive blood loss,and wound healing in elderly patients undergoing laparoscopic hysterectomy under general anesthesia.Methods A total of 118 elderly patients who underwent laparoscopic hysterectomy in Yancheng Third People's Hospital from January 2021 to December 2023 were selected as the research subjects,and they were divided into the normal group(69 cases with normal emotions)and the anxiety group(49 cases with anxiety emotions)according to the self-rating anxiety scale(SAS)score 1 day before operation.The core temperature at different time points and the incidence of intraoperative hypothermia were compared between the two groups.The intraoperative bleeding volume,incision drainage bleeding volume,recessive blood loss,incidence of adverse reactions,and wound healing were compared between the two groups.Results The core temperature 60 minutes after operation and at the end of operation in the anxiety group were significantly lower than those in the normal group(P<0.05).The incidence of intraoperative hypothermia in the anxiety group was significantly higher than that in the normal group(P<0.05).There was no statistically significant difference in the intraoperative bleeding volume or incision drainage bleeding volume between the two groups(P>0.05),while the recessive blood loss in the anxiety group was significantly higher than that in the normal group(P<0.05).The incidence of shivering in the anxiety group was significantly higher than that in the normal group(P<0.05);the incidence of poor wound healing in the anxiety group was significantly higher than that in the normal group(P<0.05).Conclusion For elderly patients who undergo laparoscopic hysterectomy for more than 60 minutes,the body temperature will significantly decrease,the incidence of intraoperative hypothermia and shivering is high,the recessive blood loss will significantly increase,which is prone to poor wound healing and is not conducive to the rapid recovery of patients after operation,if combined with anxiety before surgery.

Objective:To analyze the epidemiological, etiological and genetic characteristics of influenza virus in Shandong Province during 2023-2024.Methods:The surveillance data of influenza-like illness (ILI) in sentinel hospitals in Shandong from 2023 to 2024 were collected and analyzed. The isolated influenza strains with hemagglutination titers ≥8 were selected for antigenicity analysis, drug susceptibility test, gene sequencing and evolutionary analysis.Results:From 2023 to 2024, the positive rate of influenza virus in Shandong was 8.51% (23 663/277 995), the highest positive rate was in the age group of 5-14 years (15.78%, 6 073/38 478), and the highest positive rate was in the 49 th week (35.86%, 2 264/6 313). Both antigenicity analysis and evolutionary analysis showed that the A(H1N1)pdm09 subtype and B(Victoria) strain had good matching effect and close evolutionary distance with the 2023-2024 surveillance year vaccine strain. The A(H3N2) subtype strain did not have a high matching effect with the 2023-2024 vaccine strain and had a long evolutionary distance, but had a close evolutionary distance with the 2024-2025 vaccine strain. Drug susceptibility test showed that oseltamivir sensitivity of influenza A(H1N1)pdm09 strain decreased greatly, and the amino acid site mutation of neuraminidase was H275Y. Conclusions:In the 2023-2024 surveillance year, the peak of influenza virus epidemic in Shandong was mainly occurred in winter and spring, and the age group of 5-14 years was the focus of prevention and control. The dominant strain was subtype A(H3N2), which had poor matching effect with the vaccine strain in the 2023-2024 surveillance year. One A(H1N1)pdm09 resistant strain was found in the drug resistance monitoring work. Follow-up prevention and control work should be strengthen the surveillance for the epidemiological characteristics, genetic variation and drug resistance of influenza viruses, timely understand the epidemic trend and mutation of influenza viruses, timely discover drug-resistant strains of influenza viruses, promote influenza vaccination, and improve of influenza prevention and control.

Objective To investigate the effect of individual pretreatment of preoperative medical multi-dimensional carbohydrates on intraoperative body temperature in elderly patients with hip replacement under general anesthesia. Methods A total of 81 elderly patients who underwent unilateral hip replacement in Yancheng Third People's Hospital from January 2022 to June 2024 were selected as the study subjects,and they were randomly divided into the conventional group and the pretreatment group. Both groups of patients were given routine fasting and drinking restriction before operation,and patients in the pretreatment group were given individual pretreatment of 5 mL/kg medical multi-dimensional carbohydrates 2 hours before anesthesia. The perioperative related indicators,body temperature,intraoperative hypothermia,adverse reactions during the recovery period,and pre-anesthesia gastric antral ultrasound examination results of patients in the two groups were compared. Results There was no statistically significant difference in the surgical time or intraoperative intravenous fluid infusion between the two groups (P>0.05). The anesthesia recovery time,tracheal extubation time and intraoperative bleeding volume of patients in the pretreatment group were significantly shorter/less than those in the conventional group (P<0.05). At 30 minutes,60 minutes and the end of the surgery,the body temperature of patients in the pretreatment group was significantly higher than that in the conventional group (P<0.05),and the incidences of intraoperative hypothermia and shivering in the pretreatment group were significantly lower than those in the conventional group (P<0.05). There was no statistically significant difference in the cross-sectional area (CSA) of gastric antrum,gastric volume (GV) or ratio of gastric volume/weight (GV/W) between the two groups of patients (P>0.05). Conclusion The individual pretreatment of 5 mL/kg medical multi-dimensional carbohydrates before surgery can significantly reduce the incidence of intraoperative hypothermia in elderly patients with hip replacement under general anesthesia,promote anesthesia recovery,reduce intraoperative bleeding volume and adverse reactions,and not increase the risk of reflux aspiration.

This study investigated the epidemic status of H3N2 influenza virus and the genetic evolution characteristics of hemagglutinin(HA)and neuraminidase(NA)of H3N2 subtype influenza viruses isolated in Shandong Province during 2023-2024,to understand their compatibility with vaccine strains and drug resistance status.A total of 25 H3N2 subtype influenza virus strains were randomly selected from the strains isolated by the influenza surveillance network laboratory.The HA and NA genes were sequenced with the vaccine strains recommended by the WHO as a reference.Monitoring of sensitivity to oseltamivir and zanamivir was conducted through neuraminidase inhibition experiments.The H3N2 influenza viruses in Shandong Province belonged to the 3C.2a1b.2a.2a.3a.1 clade.Nucleotide sequence analysis revealed that the HA1 and NA genes were closely related to the WHO-recommended vaccine strain A/Darwin/9/2021 for the current season,with homology rates of 97.8%-98.2%and 98.9%-99.3%,respectively.Amino acid sequence analysis indicated 22 amino acid sequence variations in the HA1 protein,and antigenic drift was detected in 8 strains.A glycosylation site was added at position 94 of the HA protein in all 25 strains.Variations occurred in the NA antigenic determinants of some strains.Neuraminidase inhibition experiments indicated that all tested influenza viruses were sensitive to oseltamivir and zanamivir.Some differences in HA and NA proteins were observed between the monitored strains and vaccine strains.Continued monitoring of the molecular evolution characteristics of influenza viruses is necessary to understand the risk of influenza outbreaks,and their effects on the effectiveness of influenza vaccines and therapeutic drugs.

Objective To analyze the expression and diagnostic value of procalcitonin(PCT),white blood cell count(WBC),and C-reactive protein(CRP)in respiratory infections in the intensive care unit(ICU),and their correlation with the clinical pulmonary infection score(CPIS).Methods A total of 105 patients with respiratory infections admitted to the ICU from March 2019 to June 2024 were selected as the observation group,while 117 patients with no respiratory infection in the ICU were selected as the control group.PCT levels in both groups were measured using the Zybio-Q7 immunoquantitative analyzer,WBC levels were measured using XT-4000i white blood cell analyzer,and CRP levels were measured using the immunoturbidimetric method.The relationship between the expression of PCT,WBC and CRP and the clinical characteristics and CPIs score of respiratory infection in ICU were analyzed.Results The proportion of patients in the observation group with ICU stay>15 days and mechanical ventilation>7 days was significantly higher than that in the control group(P<0.05).Compared to the control group,the levels of PCT,WBC,CRP and CPIS score in the observation group were elevated,with statistically significant differences(P<0.05).Multivariate logistic regression analysis showed that ICU stay>15 days(OR=4.087),PCT(OR=6.543),WBC(OR=2.652),and CRP(OR=8.964)were risk factors for the occurrence of respiratory infections in the ICU.Pearson correlation analysis indicated a positive correlation between PCT and CPIS scores(r=0.925,P=0.001),a positive correlation between WBC and CPIS scores(r=0.739,P=0.001);and a positive correlation between CRP and CPIS scores(r=0.948,P=0.001).The ROC curve demonstrated that the combined diagnostic value of the three markers for ICU respiratory infections was higher than that of PCT,WBC,or CRP alone(P=0.002).Conclusion The combination of PCT,WBC,and CRP has high diagnostic value for ICU respiratory infections and is positively correlated with CPIs scores.Therefore,the above indicators can provide a reliable basis for the early diagnosis of respiratory infection in ICU.