ObjectiveTo investigate the current awareness and optimization recommendations on pneumonia with unknown etiology (PUE) surveillance among Shanghai healthcare professionals, and to provide evidence for the improvement of the surveillance system. MethodsIn December 2024, healthcare professional participants from diverse medical and health institutions were randomly selected within each stratum using a stratified cluster sampling method in all 16 districts of Shanghai for questionnaire surveys on their knowledge and suggestions for optimization of the PUE surveillance system. Descriptive statistics analyses, multivariate logistic regressions, and content analyses were used for data analyses. ResultsA total of 385 survey subjects were involved in the study, including 119 professional staffs from disease prevention and control centers and 266 from medical institutions. Those who understood the case definition for PUE correctly accounted for 67.01% (258/385). Multivariate regression model analyses showed that female gender (aOR=2.22, 95%CI: 1.36‒3.66), professionals from disease control institutions (aOR=2.02, 95%CI: 1.12‒3.72), and those who self-assessed as being familiar with the monitoring system (aOR=2.18, 95%CI:1.23‒3.89) had better understanding of the definition. Overall, 89.61% (345/385) of the survey subjects acknowledged the necessity of the surveillance system. Small number of cases meeting the case definition (54.46%, 214/379), insufficient diagnostic awareness (39.84%, 151/379), and lack of incentives for case reporting (29.29%, 111/379) were major problems for the current surveillance system, with variations observed across different types of institutions. Suggested segments for optimizing the surveillance system included monitoring purpose, case definition, form of monitoring and reporting procedure, organization mechanism, and epidemiological investigation and response. ConclusionThe necessity of PUE surveillance is commonly recognized among healthcare workers. However, the existing system falls short in terms of mastery of case definition and overall surveillance adaptability. There is an urgent need for optimization and improvement to enhance the capacity for preventing and controlling emerging and sudden respiratory infectious diseases.

Objective:To describe epidemiological characteristics and their influencing factors of diabetes and pre-diabetes among adult residents in Hainan Province and provide a theoretical basis to develop epidemic prevention and control strategies for diabetes.Methods:This study used a two-stage unequal proportion cluster sampling method, and 32 857 subjects (≥18 years old) were collected from 24 cities/counties/districts in Hainan Province. All the subjects were investigated with questionnaires, physical examination, and laboratory tests from January to June 2023. The χ2 and Mantel-Haenszel trend χ2 tests were used to analyze the data. Multivariate logistic regression was used to analyze the factors influencing diabetes and pre-diabetes. SPSS 23.0 software was used to analyze the data. Results:The crude prevalence of diabetes and pre-diabetes in adult residents of Hainan Province were 18.1% and 22.8%, while the weighted rates were 13.7% and 20.7%, respectively. The results of multivariate logistic regression analysis showed that: aging (30-39 years old: OR=2.65, 95% CI: 2.06-3.41; 40-49 years old: OR=5.64, 95% CI: 4.40-7.24; 50- 59 years old: OR=9.88, 95% CI: 7.71-12.67; 60-69 years old: OR=18.34, 95% CI: 14.28-23.55; 70-79 years old: OR=21.30, 95% CI: 16.41-27.65; 80 years old and above: OR=24.13, 95% CI: 17.94-32.46), nationality (Li minority group: OR=1.50, 95% CI: 1.38-1.63; other ethnic groups: OR=1.53, 95% CI: 1.20-1.94), urban ( OR=1.12, 95% CI: 1.04-1.21), central obesity ( OR=2.14, 95% CI: 2.01-2.29), higher frequency of alcohol consumption (5-7 day/week: OR=1.24, 95% CI: 1.11-1.38), physical inactivity ( OR=1.09, 95% CI: 1.02-1.17) were risk factors for diabetes, while aging (30-39 years old: OR=1.53, 95% CI: 1.31-1.79; 40-49 years old: OR=2.36, 95% CI: 2.01-2.76; 50-59 years old: OR=3.03, 95% CI: 2.58-3.55; 60-69 years old: OR=4.22, 95% CI: 3.58-4.97; 70-79 years old: OR=5.05, 95% CI: 4.23-6.04; 80 years old and above: OR=6.08, 95% CI: 4.86-7.61), nationality: (Li minority group: OR=1.18, 95% CI: 1.10-1.28; other ethnic groups: OR=1.40, 95% CI: 1.14-1.71), urban ( OR=1.12, 95% CI: 1.04-1.19), central obesity ( OR=1.72, 95% CI: 1.62-1.83), higher frequency of alcohol consumption (1-4 day/week: OR=1.12, 95% CI: 1.01-1.23; 5-7 day/week: OR=1.35, 95% CI: 1.22-1.49) were risk factors for pre-diabetes. Conclusions:The epidemic situation of diabetes and pre-diabetes among adult residents in Hainan Province was not optimistic. In order to control the development of abnormal blood glucose, measures and targeted health education should be carried out to strengthen the screening, treatment, and management of people with abnormal blood glucose among different populations.

Objective:To investigate the dietary iodine intake levels of residents and the dietary iodine contribution rates in Hainan Province.Methods:Using cluster random sampling method, common foods sold in 21 counties (cities, districts) markets in Hainan Province in 2023 were collected to determine iodine content. Each county (city, district) was divided into five sampling areas by east, west, south, north, and center, with one township (street) selected from each area, and 20 permanent residents over 18 years old (non same household, half male and half female) and 20 pregnant women were selected from each township (street). The "Iodine-Specific Food Frequency Questionnaire (I-FFQ)" was used to investigate the daily dietary intake of adults and pregnant woman. The average daily salt intake of the survey subjects was measured by the 3-day weighing method, and the dietary iodine intake and the dietary iodine contribution rates were calculated.Results:A total of 632 food samples were collected, and the iodine content of seaweed was relatively high (4 424.76 μg/100 g); the iodine content of seasoning was relatively low (2.41 μg/100 g). A total of 4 227 individuals in Hainan Province were surveyed for dietary iodine intake. The median dietary iodine intake level of residents was 211.6 μg/d, with the medians dietary iodine intake level of adults and pregnant women being 204.5 and 218.4 μg/d ( n = 2 120, 2 107), respectively. There was a statistically significant differences between different populations ( Z = - 8.64, P < 0.001). The medians dietary iodine intake level in the western coastal areas, central mountainous regions, and eastern coastal areas were 210.0, 207.3 and 211.6 μg/d ( n = 1 205, 1 203, 1 819), respectively, with statistically significant differences between different regions ( H = 15.33, P < 0.001). The contribution rate of dietary iodine from iodized salt was the most (59.4%), followed by kelp (8.1%). Conclusions:Under the condition of consuming iodized salt, the dietary iodine intake of adults in Hainan Province meets the recommended dietary iodine intake ( > 120 μg/d), but the dietary iodine intake of pregnant women is insufficient ( < 230 μg/d). Iodized salt is the main source of dietary iodine for residents in Hainan Province.

Objective:To describe epidemiological characteristics and their influencing factors of diabetes and pre-diabetes among adult residents in Hainan Province and provide a theoretical basis to develop epidemic prevention and control strategies for diabetes.Methods:This study used a two-stage unequal proportion cluster sampling method, and 32 857 subjects (≥18 years old) were collected from 24 cities/counties/districts in Hainan Province. All the subjects were investigated with questionnaires, physical examination, and laboratory tests from January to June 2023. The χ2 and Mantel-Haenszel trend χ2 tests were used to analyze the data. Multivariate logistic regression was used to analyze the factors influencing diabetes and pre-diabetes. SPSS 23.0 software was used to analyze the data. Results:The crude prevalence of diabetes and pre-diabetes in adult residents of Hainan Province were 18.1% and 22.8%, while the weighted rates were 13.7% and 20.7%, respectively. The results of multivariate logistic regression analysis showed that: aging (30-39 years old: OR=2.65, 95% CI: 2.06-3.41; 40-49 years old: OR=5.64, 95% CI: 4.40-7.24; 50- 59 years old: OR=9.88, 95% CI: 7.71-12.67; 60-69 years old: OR=18.34, 95% CI: 14.28-23.55; 70-79 years old: OR=21.30, 95% CI: 16.41-27.65; 80 years old and above: OR=24.13, 95% CI: 17.94-32.46), nationality (Li minority group: OR=1.50, 95% CI: 1.38-1.63; other ethnic groups: OR=1.53, 95% CI: 1.20-1.94), urban ( OR=1.12, 95% CI: 1.04-1.21), central obesity ( OR=2.14, 95% CI: 2.01-2.29), higher frequency of alcohol consumption (5-7 day/week: OR=1.24, 95% CI: 1.11-1.38), physical inactivity ( OR=1.09, 95% CI: 1.02-1.17) were risk factors for diabetes, while aging (30-39 years old: OR=1.53, 95% CI: 1.31-1.79; 40-49 years old: OR=2.36, 95% CI: 2.01-2.76; 50-59 years old: OR=3.03, 95% CI: 2.58-3.55; 60-69 years old: OR=4.22, 95% CI: 3.58-4.97; 70-79 years old: OR=5.05, 95% CI: 4.23-6.04; 80 years old and above: OR=6.08, 95% CI: 4.86-7.61), nationality: (Li minority group: OR=1.18, 95% CI: 1.10-1.28; other ethnic groups: OR=1.40, 95% CI: 1.14-1.71), urban ( OR=1.12, 95% CI: 1.04-1.19), central obesity ( OR=1.72, 95% CI: 1.62-1.83), higher frequency of alcohol consumption (1-4 day/week: OR=1.12, 95% CI: 1.01-1.23; 5-7 day/week: OR=1.35, 95% CI: 1.22-1.49) were risk factors for pre-diabetes. Conclusions:The epidemic situation of diabetes and pre-diabetes among adult residents in Hainan Province was not optimistic. In order to control the development of abnormal blood glucose, measures and targeted health education should be carried out to strengthen the screening, treatment, and management of people with abnormal blood glucose among different populations.

Objective:To investigate the dietary iodine intake levels of residents and the dietary iodine contribution rates in Hainan Province.Methods:Using cluster random sampling method, common foods sold in 21 counties (cities, districts) markets in Hainan Province in 2023 were collected to determine iodine content. Each county (city, district) was divided into five sampling areas by east, west, south, north, and center, with one township (street) selected from each area, and 20 permanent residents over 18 years old (non same household, half male and half female) and 20 pregnant women were selected from each township (street). The "Iodine-Specific Food Frequency Questionnaire (I-FFQ)" was used to investigate the daily dietary intake of adults and pregnant woman. The average daily salt intake of the survey subjects was measured by the 3-day weighing method, and the dietary iodine intake and the dietary iodine contribution rates were calculated.Results:A total of 632 food samples were collected, and the iodine content of seaweed was relatively high (4 424.76 μg/100 g); the iodine content of seasoning was relatively low (2.41 μg/100 g). A total of 4 227 individuals in Hainan Province were surveyed for dietary iodine intake. The median dietary iodine intake level of residents was 211.6 μg/d, with the medians dietary iodine intake level of adults and pregnant women being 204.5 and 218.4 μg/d ( n = 2 120, 2 107), respectively. There was a statistically significant differences between different populations ( Z = - 8.64, P < 0.001). The medians dietary iodine intake level in the western coastal areas, central mountainous regions, and eastern coastal areas were 210.0, 207.3 and 211.6 μg/d ( n = 1 205, 1 203, 1 819), respectively, with statistically significant differences between different regions ( H = 15.33, P < 0.001). The contribution rate of dietary iodine from iodized salt was the most (59.4%), followed by kelp (8.1%). Conclusions:Under the condition of consuming iodized salt, the dietary iodine intake of adults in Hainan Province meets the recommended dietary iodine intake ( > 120 μg/d), but the dietary iodine intake of pregnant women is insufficient ( < 230 μg/d). Iodized salt is the main source of dietary iodine for residents in Hainan Province.

In recent years,there has been a deeper understanding of the role and mechanisms of common inflammatory cytokines in the development and progression of liver cirrhosis,such as interleukin-1β,interleukin-6,interleukin-10,interleukin-17,tumor necrosis factor-α,interferon-γ,and C-reactive protein,and significant achievements have also been made in the research on the association of these inflammatory cytokines with disorder of glucose metabolism and pancreatic islet dysfunction.This article reviews the role of inflammatory cytokines in patients with liver cirrhosis and their impact on disorder of glucose metabolism and pancreatic islet dysfunction,in order to provide a theoretical basis for clarifying the pathogenesis of hepatogenous diabetes and performing the clinical management of the disease.

Objective: To retrospectively analyze the epidemic characteristics and spatial distribution of vomiting and diarrhea outbreaks in schools and kindergartens in Shanghai from 2015 to 2019, so as to provide the scientific evidence for optimizing prevention and control of vomiting and diarrhea outbreaks in schools and kindergartens. Methods: Data collection and analysis were carried out on the vomiting and diarrhea outbreaks reported to Shanghai Municipal Center for Disease Control and Prevention from 2015 to 2019. Epidemiological characteristics were analyzed and compared. The proportion and incidence of outbreaks in schools and kindergartens were calculated, and the influencing factors of outbreaks were analyzed by multivariate Logistic regression. The index of Moran s I was used for the global and local spatial auto correlation analysis. Results: Among the 344 vomiting and diarrhea outbreaks, 98.26% occurred in kindergartens, primary schools, middle schools and other educational institutions. The median number of cases per outbreak was 15. The number of suspected outbreaks and the percentage of cases involved peaked in 2015 ( 60.00% , 84.35%) and then decreased year by year to 16.00% and 38.80% in 2019. About 86.98% of the outbreaks were transmitted by human to human contact. Among the 329 outbreaks with samples collected from cases and/or environments, the main pathogen detected was norovirus ( n =280), and sapovirus was detected in outbreak for the first time in 2016. The outbreaks showed obvious seasonality, with two peaks (November, March) and one trough (July), and the majority of outbreaks occurred in primary schools (44.38%) and kindergartens (32.84%). Compared with kindergartens, the probabilities of suspected epidemic outbreaks in primary schools, combined schools, middle schools and other educational institutions were higher (adjusted OR =6.40, 9.16, 12.64 , 5.58, P <0.01). The proportion and incidence of outbreaks in educational institutions in different districts showed no high-high aggregation areas. Conclusions Primary schools and kindergartens are key places for the prevention and control of vomiting and diarrhea outbreaks. Targeted prevention and control measures should be strengthened at the beginning of each semester and before the peak of the epidemic each year. Timely reporting of symptoms, suspension of school admissions after symptoms appear and standardized disposal of vomit are effective measures to reduce interpersonal transmission and control the scale of an outbreak.

Objective:To explore the effect of getting out of bed activity 6 hours after silicone breast augmentation surgery on the comfort of patients.Methods:From May 2019 to August 2020, 84 female patients aged 20-37 (28.34±6.27) years who underwent silicone breast augmentation surgery at the Department of Plastic Surgery and Cosmetology at the Second People′s Hospital of Guangdong Province were randomly divided into a control group and an observation group, with 42 patients in each group, using a random number table method. The control group got out of bed 24 hours after surgery, while the observation group got out of bed 6 hours after surgery. The chest drainage and fixation patency, comfort, silicone prosthesis displacement, and incision bleeding rate between the two groups of patients were compared 24 hours after surgery.Results:The extraction time of the thoracic drainage tube in the observation group was (82.64±11.78 hours), which was shorter than that in the control group (90.67±12.44 hours), and the difference was statistically significant ( t=5.369, P<0.01). The comfort scores of the observation group patients at 6 hours after surgery (95.07±4.14) and 24 hours after surgery (97.52±4.07) were higher than those of the control group at 6 hours (91.14±4.03) and 24 hours (94.19±3.93), and the difference was statistically significant ( t=4.413, 3.832, both P<0.01); 7 days after surgery, there were 2 cases of silicone prosthesis displacement in the observation group, with an incidence rate of 4.76% (2/42); there were 2 cases of silicone prosthesis displacement in the control group, with an incidence rate of 4.76% (2/42); there were 6 cases of incision bleeding, with an incidence rate of 14.29% (6/42); there were 5 cases of incision bleeding in the control group, with an incidence rate of 11.90% (5/42). There was no statistically significant difference in the incidence of silicone implant displacement and incision bleeding between the two groups (χ 2=0.21, 0.10, P>0.05). Conclusions:Getting out of bed and moving around 6 hours after silicone breast augmentation surgery can help improve the patient′s physical comfort, ensure smooth fixation of the chest drainage tube, and do not increase the occurrence of incision bleeding in patients.

Objective:To investigate the epidemiological and pathogenic characteristics of children's infectious diarrhea in Shanghai to provide evidence for developing strategies related to the control of the disease .Methods:Diarrhea outpatients were under surveillance at the pediatric intestinal clinic at five sentinel hospitals in Shanghai, with demographic, clinical, and epidemiological information collected. Fecal specimens were collected and detected for 12 bacteria and 5 viruses by district center for disease control and prevention. Characteristics of diarrhea patients were compared and analyzed from 2016 to 2021. Multi-stage systematic sampling method was adopted. The Chi-square test was used for statistical analysis.Results:Of 2 456 infectious diarrhea patients, the positive rate was 45.11% (1 108/2 456), 16.00% (393/2 456), 20.81% (511/2 456), 8.31% (204/2 456), for all pathogens, single bacteria, single virus, and diverse infections respectively. The prevalent detected pathogens were pathogenic Escherichia coli (12.95%, 318/2 456), norovirus (10.91%, 268/2 456), rotavirus (7.49%, 184/2 456), Salmonella (5.82%, 143/2 456) and Campylobacter jejuni (4.68%, 115/2 456). The pathogen spectrum of childhood infectious diarrhea patients showed noticeable seasonal changes, with a prevalent bacterial infection in summer [peaked in June, the positive rate was 34.50% (69/200)] and a prevalent viral infection in winter [peaked in January, the positive rate was 48.10% (101/210)]. The positive rates in different age groups, populations, and seasons were statistically different ( χ2=160.53, P<0.001; χ2=14.80, P=0.003; χ2=27.21, P<0.001). During 2020-2021, the number of cases of infectious diarrhea in children (284 cases/year) dropped significantly compared with the number in 2016-2019 (472 cases/year), the pathogen spectrum changed significantly ( χ2=39.02, P=0.001), and the positive findings of bacteria ( χ2=11.73, P<0.001) and viruses ( χ2=14.22, P<0.001) decreased significantly. However, the positive rate of enteric adenovirus increased. Conclusions:The pathogen spectrum of children's infectious diarrhea patients shows noticeable seasonal changes in Shanghai. Pathogenic Escherichiacoli, norovirus, and rotavirus are the most common diarrheal pathogens. In recent years, the detection of adenovirus in children with infectious diarrhea has increased. The number of children with infectious diarrhea and the positive rate have decreased significantly during 2020-2021. Specific prevention and control measures should be taken for infectious diarrhea of different ages, pathogens, and seasons.

The α-amino acid ester acyltransferase (SAET) from Sphingobacterium siyangensis is one of the enzymes with the highest catalytic ability for the biosynthesis of l-alanyl-l-glutamine (Ala-Gln) with unprotected l-alanine methylester and l-glutamine. To improve the catalytic performance of SAET, a one-step method was used to rapidly prepare the immobilized cells (SAET@ZIF-8) in the aqueous system. The engineered Escherichia coli (E. coli) expressing SAET was encapsulated into the imidazole framework structure of metal organic zeolite (ZIF-8). Subsequently, the obtained SAET@ZIF-8 was characterized, and the catalytic activity, reusability and storage stability were also investigated. Results showed that the morphology of the prepared SAET@ZIF-8 nanoparticles was basically the same as that of the standard ZIF-8 materials reported in literature, and the introduction of cells did not significantly change the morphology of ZIF-8. After repeated use for 7 times, SAET@ZIF-8 could still retain 67% of the initial catalytic activity. Maintained at room temperature for 4 days, 50% of the original catalytic activity of SAET@ZIF-8 could be retained, indicating that SAET@ZIF-8 has good stability for reuse and storage. When used in the biosynthesis of Ala-Gln, the final concentration of Ala-Gln reached 62.83 mmol/L (13.65 g/L) after 30 min, the yield reached 0.455 g/(L·min), and the conversion rate relative to glutamine was 62.83%. All these results suggested that the preparation of SAET@ZIF-8 is an efficient strategy for the biosynthesis of Ala-Gln.
Escherichia coli/genetics* ; Glutamine ; Zeolites/chemistry* ; Amino Acids