ObjectiveTo understand the seropositivity of neutralizing antibodies (NAb) and low-level NAb against SARS-CoV-2 infection in the community residents, and to explore the impact of COVID-19 vaccination and SARS-CoV-2 infection on the levels of NAb in human serum. MethodsOn the ground of surveillance cohort for acute infectious diseases in community populations in Shanghai, a proportional stratified sampling method was used to enroll the subjects at a 20% proportion for each age group (0‒14, 15‒24, 25‒59, and ≥60 years old). Blood samples collection and serum SARS-CoV-2 NAb concentration testing were conducted from March to April 2023. Low-level NAb were defined as below the 25^th percentile of NAb. ResultsA total of 2 230 participants were included, the positive rate of NAb was 97.58%, and the proportion of low-level NAb was 25.02% (558/2 230). Multivariate logistic regression analysis indicated that age, infection history and vaccination status were correlated with low-level NAb (all P<0.05). Individuals aged 60 years and above had the highest risk of low-level NAb. There was a statistically significant interaction between booster vaccination and one single infection (aOR=0.38, 95%CI: 0.19‒0.77). Compared to individuals without vaccination, among individuals infected with SARS-CoV-2 once, both primary immunization (aOR=0.23, 95%CI: 0.16‒0.35) and booster immunization (aOR=0.12, 95%CI: 0.08‒0.17) significantly reduced the risk of low-level NAb; among individuals without infections, only booster immunization (aOR=0.28, 95%CI: 0.14‒0.52) showed a negative correlation with the risk of low-level NAb. ConclusionsThe population aged 60 and above had the highest risk of low-level NAb. Regardless of infection history, a booster immunization could reduce the risk of low-level NAb. It is recommended that eligible individuals , especially the elderly, should get vaccinated in a timely manner to exert the protective role of NAb.

Objective This study aims to evaluate the effectiveness of intelligent bed management model in integrating bed resources in a large comprehensive hospital.Methods Inpatient data from a tertiary hospital between January 2021 and De-cember 2024 were collected.An intelligent hospital-wide bed management platform was constructed to implement bed resource sharing mechanisms and establish a standardized bed reservation grading system.The implementation effect of the system was e-valuated from the perspective of bed occupancy rate,average length of stay,and patient satisfaction.Results After implementa-tion,bed occupancy rates in key monitored departments moved into a reasonable range:Rehabilitation Medicine Department fell from 113.18％to 101.48％(t=4.26,P＜0.01),while Neurology Department increased from 88.18％to 96.20％(t=3.85,P＜0.01).Annual inpatient admissions increased from 83,931 to 103,852(x2=156.82,P＜0.001),and average length of stay shortened from 7.15 days to 6.21 days(t=4.73,P＜0.01).The admission waiting time was cut by 72.7 hours(-43.1％),and satisfaction with bed allocation rationality improved by 11.2 points(t=5.94,P＜0.001).Staff time spent on bed-assignment fell by 42 minutes per shift(t=8.92,P＜0.001),and cross-department transfers increased by 378 episodes per month(x2=145.26,P＜0.001).Conclusion The intelligent bed management model can effectively improve hospital bed utili-zation efficiency,enhance healthcare service quality,reduce staff workload,and merits wider application in similar hospitals.

With the widespread adoption of low-dose CT screening and the extensive application of high-resolution CT, the detection rate of sub-centimeter lung nodules has significantly increased. How to scientifically manage these nodules while avoiding overtreatment and diagnostic delays has become an important clinical issue. Among them, lung nodules with a consolidation tumor ratio less than 0.25, dominated by ground-glass shadows, are particularly worthy of attention. The therapeutic challenge for this group is how to achieve precise and complete resection of nodules during surgery while maximizing the preservation of the patient's lung function. The "watershed topography map" is a new technology based on big data and artificial intelligence algorithms. This method uses Dicom data from conventional dose CT scans, combined with microscopic (22-24 levels) capillary network anatomical watershed features, to generate high-precision simulated natural segmentation planes of lung sub-segments through specific textures and forms. This technology forms fluorescent watershed boundaries on the lung surface, which highly fit the actual lung anatomical structure. By analyzing the adjacent relationship between the nodule and the watershed boundary, real-time, visually accurate positioning of the nodule can be achieved. This innovative technology provides a new solution for the intraoperative positioning and resection of lung nodules. This consensus was led by four major domestic societies, jointly with expert teams in related fields, oriented to clinical practical needs, referring to domestic and foreign guidelines and consensus, and finally formed after multiple rounds of consultation, discussion, and voting. The main content covers the theoretical basis of the "watershed topography map" technology, indications, operation procedures, surgical planning details, and postoperative evaluation standards, aiming to provide scientific guidance and exploration directions for clinical peers who are currently or plan to carry out lung nodule resection using the fluorescent microscope watershed analysis method.

Objective This study aims to evaluate the effectiveness of intelligent bed management model in integrating bed resources in a large comprehensive hospital.Methods Inpatient data from a tertiary hospital between January 2021 and De-cember 2024 were collected.An intelligent hospital-wide bed management platform was constructed to implement bed resource sharing mechanisms and establish a standardized bed reservation grading system.The implementation effect of the system was e-valuated from the perspective of bed occupancy rate,average length of stay,and patient satisfaction.Results After implementa-tion,bed occupancy rates in key monitored departments moved into a reasonable range:Rehabilitation Medicine Department fell from 113.18％to 101.48％(t=4.26,P＜0.01),while Neurology Department increased from 88.18％to 96.20％(t=3.85,P＜0.01).Annual inpatient admissions increased from 83,931 to 103,852(x2=156.82,P＜0.001),and average length of stay shortened from 7.15 days to 6.21 days(t=4.73,P＜0.01).The admission waiting time was cut by 72.7 hours(-43.1％),and satisfaction with bed allocation rationality improved by 11.2 points(t=5.94,P＜0.001).Staff time spent on bed-assignment fell by 42 minutes per shift(t=8.92,P＜0.001),and cross-department transfers increased by 378 episodes per month(x2=145.26,P＜0.001).Conclusion The intelligent bed management model can effectively improve hospital bed utili-zation efficiency,enhance healthcare service quality,reduce staff workload,and merits wider application in similar hospitals.

Objective:To compare 99Tc m-hydrazinonicotinamide-(polyethylene glycol) 4-E((polyethylene glycol) 4-c((Arg-Gly-Asp)fK)) 2(3PRGD 2) SPECT/CT with 18F-FDG PET/CT in the evaluation of patients with oral malignancy and cervical lymph node metastases. Methods:From January 2019 to October 2019, 22 patients (16 males, 6 females; age (56.9±9.8) years) with oral malignancy who underwent both 99Tc m-3PRGD 2 SPECT/CT and 18F-FDG PET/CT at the First Affiliated Hospital of Fujian Medical University were retrospectively analyzed. The pathology was used as the gold standard, and McNemar test was used to compare the diagnostic efficacy of the two imaging methods for cervical lymph node metastases. ROC curve analysis was performed to determine the diagnostic performance for lymph node metastases. The correlation between 99Tc m-3PRGD 2 uptake and integrin α vβ 3 expression was analyzed by Spearman rank correlation analysis. Results:Both imaging modalities identified all primary tumors. Diagnostic efficiency analyses based on patient, neck side, nodal region and lymph node all showed that there were no significant differences in the sensitivity, specificity and accuracy between the two imaging modalities in diagnosing cervical metastatic lymph nodes ( χ2 values: 0-3.36, all P>0.05). The AUC of SUV max in metastatic lymph nodes detected by 99Tc m-3PRGD 2 and 18F-FDG imaging were 0.825 and 0.855, with the sensitivity, specificity and accuracy of 71.9%(23/32), 93.9%(92/98), 88.5%(115/130) and 78.1%(25/32), 93.9%(92/98), 90.0%(117/130), respectively ( χ2 values: 0.05-0.10, all P>0.05). SUV max of 99Tc m-3PRGD 2 in primary tumors and cervical metastatic lymph nodes were positively correlated with the expression of integrin α vβ 3 ( rs values: 0.58, 0.51, P values: 0.019, 0.013). Conclusion:99Tc m-3PRGD 2 SPECT/CT is a valuable diagnostic tool for oral malignancy and cervical lymph node metastases, which is comparable to 18F-FDG PET/CT.

Objective:To compare 99Tc m-hydrazinonicotinamide-(polyethylene glycol) 4-E((polyethylene glycol) 4-c((Arg-Gly-Asp)fK)) 2(3PRGD 2) SPECT/CT with 18F-FDG PET/CT in the evaluation of patients with oral malignancy and cervical lymph node metastases. Methods:From January 2019 to October 2019, 22 patients (16 males, 6 females; age (56.9±9.8) years) with oral malignancy who underwent both 99Tc m-3PRGD 2 SPECT/CT and 18F-FDG PET/CT at the First Affiliated Hospital of Fujian Medical University were retrospectively analyzed. The pathology was used as the gold standard, and McNemar test was used to compare the diagnostic efficacy of the two imaging methods for cervical lymph node metastases. ROC curve analysis was performed to determine the diagnostic performance for lymph node metastases. The correlation between 99Tc m-3PRGD 2 uptake and integrin α vβ 3 expression was analyzed by Spearman rank correlation analysis. Results:Both imaging modalities identified all primary tumors. Diagnostic efficiency analyses based on patient, neck side, nodal region and lymph node all showed that there were no significant differences in the sensitivity, specificity and accuracy between the two imaging modalities in diagnosing cervical metastatic lymph nodes ( χ2 values: 0-3.36, all P>0.05). The AUC of SUV max in metastatic lymph nodes detected by 99Tc m-3PRGD 2 and 18F-FDG imaging were 0.825 and 0.855, with the sensitivity, specificity and accuracy of 71.9%(23/32), 93.9%(92/98), 88.5%(115/130) and 78.1%(25/32), 93.9%(92/98), 90.0%(117/130), respectively ( χ2 values: 0.05-0.10, all P>0.05). SUV max of 99Tc m-3PRGD 2 in primary tumors and cervical metastatic lymph nodes were positively correlated with the expression of integrin α vβ 3 ( rs values: 0.58, 0.51, P values: 0.019, 0.013). Conclusion:99Tc m-3PRGD 2 SPECT/CT is a valuable diagnostic tool for oral malignancy and cervical lymph node metastases, which is comparable to 18F-FDG PET/CT.

ObjectiveTo analyze the epidemiological characteristics of clustered vomiting and diarrhea outbreaks in Minhang District of Shanghai, to identify the influencing factors of outbreak scale and duration of epidemic, and to provide scientific evidence for further strengthening surveillance early-warning efforts in key settings and for optimizing prevention and control measures. MethodsThe data for describing epidemiological characteristics of clustered vomitting and diarrhea outbreaks in Minhang District from 2018 to 2023 were collected, multivariable logistic regression models were applied to analyze the influencing factors for epidemic scale,and Spearman rank correlation analyses were applied to analyze the factors duration. ResultsA total of 136 clustered vomiting and diarrhea outbreaks were reported in Minhang District from 2018 to 2023, all occurring in school settings, with an overall attack rate of 0.90%. The outbreaks exhibited distinct seasonality, predominantly occurring from October to December (43.38%) and March to May (32.35%). The primary settings were preschools (45.59%) and elementary schools (44.12%), with students accounted for the majority of cases (99.48%). The predominant clinical manifestation was vomiting (90.44%), with person-to-person contact being the primary transmission route (98.53%). Norovirus genogroup Ⅱ was identified as the main pathogen (71.32%). Standardized terminal disinfection of outbreak sites (OR=0.39, 95%CI=0.20‒0.74) and effective isolation of affected classes (OR=0.23, 95%CI=0.09‒0.57) were significant protective factors for reducing outbreak scale. Both response time (r=0.64, P<0.001) and the number of case generations (r=0.71, P<0.001) showed positive correlations with outbreak duration. ConclusionSchools are the key settings for the prevention and control of clustered vomiting and diarrhea outbreaks in Minhang District, with peak occurring in autumn and spring. Early detection, timely reporting, and prompt response to outbreaks are crucial. Strengthening school-based surveillance systems and standardizing outbreak management protocols are of particular importance.

Peptide receptor radionuclide therapy (PRRT) with radiolabeled SSTR2 agonists is a treatment option that is highly effective in controlling metastatic and progressive neuroendocrine tumors (NETs). Previous studies have shown that an SSTR2 agonist combined with albumin binding moiety Evans blue (denoted as ¹⁷⁷Lu-EB-TATE) is characterized by a higher tumor uptake and residence time in preclinical models and in patients with metastatic NETs. This study aimed to enhance the in vivo stability, pharmacokinetics, and pharmacodynamics of ¹⁷⁷Lu-EB-TATE by replacing the maleimide-thiol group with a polyethylene glycol chain, resulting in a novel EB conjugated SSTR2-targeting radiopharmaceutical, ¹⁷⁷Lu-LNC1010, for PRRT. In preclinical studies, ¹⁷⁷Lu-LNC1010 exhibited good stability and SSTR2-binding affinity in AR42J tumor cells and enhanced uptake and prolonged retention in AR42J tumor xenografts. Thereafter, we presented the first-in-human dose escalation study of ¹⁷⁷Lu-LNC1010 in patients with advanced/metastatic NETs. ¹⁷⁷Lu-LNC1010 was well-tolerated by all patients, with minor adverse effects, and exhibited significant uptake and prolonged retention in tumor lesions, with higher tumor radiation doses than those of ¹⁷⁷Lu-EB-TATE. Preliminary PRRT efficacy results showed an 83% disease control rate and a 42% overall response rate after two ¹⁷⁷Lu-LNC1010 treatment cycles. These encouraging findings warrant further investigations through multicenter, prospective, and randomized controlled trials.

Skeletal muscle dysfunction is a common extra-pulmonary complication in patients with chronic ob-structive pulmonary disease(COPD),significantly impacting exercise capacity and quality of life,leading to a poorer prognosis and increased mortality.Oxidative stress closely associates with the development and progression of skeletal muscle dysfunction in COPD.Exercise,a core component of pulmonary rehabilitation,stands as the primary non-pharma-cological treatment for skeletal muscle dysfunction in COPD patients and exerts a positive modulating effect on oxidative stress.This paper reviews the effects of oxidative stress on skeletal muscle dysfunction in COPD and discusses the mecha-nisms by which exercise improves skeletal muscle dysfunction in COPD from an anti-oxidative stress perspective.It has been found that oxidative stress affects the structure and function of muscles in COPD patients by upregulating the protein hydrolysis system,disrupting mitochondrial function,and impairing calcium homeostasis.Mechanisms by which exercise modulates oxidative stress to improve skeletal muscle dysfunction include the activation of antioxidant genes such as silent mating type information regulation 2 homolog 1 and nuclear factor erythroid 2 related factor to enhance the body's antioxi-dant capacity,inhibiting muscle atrophy.Exercise also regulates mitochondrial reactive oxygen species metabolism,im-proving mitochondrial function,and reduces oxidase activity to protect sarcoplasmic reticulum calcium regulation.In con-clusion,the regulation of skeletal muscle oxidative stress by exercise is a crucial target for improving skeletal muscle dys-function in COPD.

Skeletal muscle dysfunction is a common extra-pulmonary complication in patients with chronic ob-structive pulmonary disease(COPD),significantly impacting exercise capacity and quality of life,leading to a poorer prognosis and increased mortality.Oxidative stress closely associates with the development and progression of skeletal muscle dysfunction in COPD.Exercise,a core component of pulmonary rehabilitation,stands as the primary non-pharma-cological treatment for skeletal muscle dysfunction in COPD patients and exerts a positive modulating effect on oxidative stress.This paper reviews the effects of oxidative stress on skeletal muscle dysfunction in COPD and discusses the mecha-nisms by which exercise improves skeletal muscle dysfunction in COPD from an anti-oxidative stress perspective.It has been found that oxidative stress affects the structure and function of muscles in COPD patients by upregulating the protein hydrolysis system,disrupting mitochondrial function,and impairing calcium homeostasis.Mechanisms by which exercise modulates oxidative stress to improve skeletal muscle dysfunction include the activation of antioxidant genes such as silent mating type information regulation 2 homolog 1 and nuclear factor erythroid 2 related factor to enhance the body's antioxi-dant capacity,inhibiting muscle atrophy.Exercise also regulates mitochondrial reactive oxygen species metabolism,im-proving mitochondrial function,and reduces oxidase activity to protect sarcoplasmic reticulum calcium regulation.In con-clusion,the regulation of skeletal muscle oxidative stress by exercise is a crucial target for improving skeletal muscle dys-function in COPD.