Objective: To investigate the status and influencing factors of influenza vaccination among the elderly, so as to provide insights into improving the strategies for influenza vaccination among the elderly. Methods: Elderly people aged 60 years and above were recruited from one community each in five sub-districts of Shihezi City, Xinjiang Uygur Autonomous Region using a random sampling method. Demographic information, knowledge about influenza and influenza vaccines, vaccine literacy and influenza vaccination status in the past year were collected through questionnaire surveys. Factors affecting influenza vaccination among the elderly were analyzed using a multivariable logistic regression model. Results: Totally 1 121 valid questionnaires were recovered, with an effective recovery rate of 95.08%. There were 417 males (37.20%) and 704 females (62.80%). The majority were aged 60-<81 years, accounting for 80.37% (901 individuals). The awareness of knowledge about influenza and influenza vaccines was 78.86%. Low vaccine literacy was observed in 786 individuals, representing 70.12%. The influenza vaccination rate was 20.96%. Multivariable logistic regression analysis showed that age (71-<81 years, OR=1.607, 95%CI: 1.041-2.479; ≥81 years, OR=1.719, 95%CI: 1.040-2.842), educational level (middle school/technical secondary school, OR=0.616, 95%CI: 0.416-0.911), medical expense payment (employee medical insurance, OR=6.531, 95%CI: 2.030-21.010; resident medical insurance, OR=3.385, 95%CI: 1.095-10.466; public expense, OR=4.828, 95%CI: 1.700-13.712), vaccination willingness (yes, OR=6.237, 95%CI: 3.277-11.871), influenza vaccination history (yes, OR=14.600, 95%CI: 8.733-24.408) and vaccine literacy (medium and above, OR=2.412, 95%CI: 1.636-3.555) were associated with influenza vaccination among the elderly. Conclusion The influenza vaccination rate among the elderly was relatively low, and was mainly affected by age, educational level, medical expense payment, vaccination willingness, influenza vaccination history and vaccine literacy.

Salmonella,an important foodborne pathogen,is responsible for numerous diseases in both humans and animals.We conducted a genome-wide analysis of Salmonella isolates from diarrheal and foodborne infection cases in Gansu Province between 2021 and 2023.A total of 163 Salmonella strains were collected and subjected to biochemical identification,followed by serological typing,whole-genome sequencing,and bioinformatics characterization.The results revealed 27 distinct serotypes,among which Sal-monella typhimurium variant(S.4,[5],12∶1∶-),Salmonella enteritidis,and Salmonella enterica London were predominant.Notably,the serotype distribution exhibited significant variation across sample sources.Multilocus sequence typing(MLST)classified the iso-lates into 27 sequence types(STs),among which ST34,ST11,ST155,and ST19 had the highest prevalence.The MLST profiles dem-onstrated strong concordance with serological classifications.For Salmonella,we detected a total of 17 673 virulence genes in 374 cat-egories,carrying multiple virulence islands.Some strains carried virulence plasmid genes,among which 45 strains of Salmonella enter-itidis had higher types and numbers of virulence factors detected than other serotypes of Salmonella.Antimicrobial resistance profiling identified 69 resistance genes conferring resistance to 13 classes of antimicrobial agents,and multidrug resistance patterns were preva-lent among isolates.Plasmid characterization revealed 35 plasmid types,some containing antimicrobial resistance determinants.Addi-tionally,three disinfectant resistance genes were identified.This study highlights the extensive diversity of Salmonella serotypes and STs in Gansu Province and the complex repertoire of virulence and resistance genes.The emergence of disinfectant resistance genes un-derscores challenges in conventional disinfection protocols.These findings provide critical insights for refining Salmonella surveillance and control strategies in public health and food safety contexts.

Objective To investigate the correlation between plasma vitamin D levels and a novel inflam-matory marker,the systemic immune-inflammatory index(SII),in patients with type 2 diabetes.Methods This study adopted a cross-sectional design,in which patients diagnosed with type 2 diabetes who were admitted to the First Affiliated Hospital of Guangxi Medical University were enrolled as study participants.Data on demographic characteristics,medical history,physical examination findings,and laboratory test results were systematically collected.Participants were categorized into three groups based on their serum vitamin D levels:deficient,insuffi-cient,and sufficient.The relationship between vitamin D levels and the SII was evaluated using a multivariate linear regression model.Additionally,a restricted cubic spline model was employed to assess the nonlinear dose-response association between vitamin D levels and SII.Results This study enrolled a total of 5,716 patients with type 2 diabetes.A statistically significant difference in the SII was observed across groups with varying vitamin D levels(P<0.05),with the highest SII value found in the vitamin D-deficient group.Multivariate linear regression analysis revealed that,after adjusting for potential confounding factors including gender,age,season of blood collection,body mass index,hypertension,dyslipidemia,and chronic kidney disease,vitamin D levels were negatively associ-ated with SII(β=-2.68,95%CI:-3.56 to-1.81,P<0.001).Compared with the vitamin D-deficient group,the vitamin D-sufficient group exhibited significantly lower SII levels(β=-78.42,95%CI:-137.90 to-18.93,P=0.01).Furthermore,the restricted cubic spline model indicated a nonlinear dose-response relationship between vita-min D levels and SII(P<0.001).Conclusion There is a significant inverse correlation between plasma vitamin D levels and the SII in patients with type 2 diabetes.

Salmonella,an important foodborne pathogen,is responsible for numerous diseases in both humans and animals.We conducted a genome-wide analysis of Salmonella isolates from diarrheal and foodborne infection cases in Gansu Province between 2021 and 2023.A total of 163 Salmonella strains were collected and subjected to biochemical identification,followed by serological typing,whole-genome sequencing,and bioinformatics characterization.The results revealed 27 distinct serotypes,among which Sal-monella typhimurium variant(S.4,[5],12∶1∶-),Salmonella enteritidis,and Salmonella enterica London were predominant.Notably,the serotype distribution exhibited significant variation across sample sources.Multilocus sequence typing(MLST)classified the iso-lates into 27 sequence types(STs),among which ST34,ST11,ST155,and ST19 had the highest prevalence.The MLST profiles dem-onstrated strong concordance with serological classifications.For Salmonella,we detected a total of 17 673 virulence genes in 374 cat-egories,carrying multiple virulence islands.Some strains carried virulence plasmid genes,among which 45 strains of Salmonella enter-itidis had higher types and numbers of virulence factors detected than other serotypes of Salmonella.Antimicrobial resistance profiling identified 69 resistance genes conferring resistance to 13 classes of antimicrobial agents,and multidrug resistance patterns were preva-lent among isolates.Plasmid characterization revealed 35 plasmid types,some containing antimicrobial resistance determinants.Addi-tionally,three disinfectant resistance genes were identified.This study highlights the extensive diversity of Salmonella serotypes and STs in Gansu Province and the complex repertoire of virulence and resistance genes.The emergence of disinfectant resistance genes un-derscores challenges in conventional disinfection protocols.These findings provide critical insights for refining Salmonella surveillance and control strategies in public health and food safety contexts.

Objective To investigate the correlation between plasma vitamin D levels and a novel inflam-matory marker,the systemic immune-inflammatory index(SII),in patients with type 2 diabetes.Methods This study adopted a cross-sectional design,in which patients diagnosed with type 2 diabetes who were admitted to the First Affiliated Hospital of Guangxi Medical University were enrolled as study participants.Data on demographic characteristics,medical history,physical examination findings,and laboratory test results were systematically collected.Participants were categorized into three groups based on their serum vitamin D levels:deficient,insuffi-cient,and sufficient.The relationship between vitamin D levels and the SII was evaluated using a multivariate linear regression model.Additionally,a restricted cubic spline model was employed to assess the nonlinear dose-response association between vitamin D levels and SII.Results This study enrolled a total of 5,716 patients with type 2 diabetes.A statistically significant difference in the SII was observed across groups with varying vitamin D levels(P<0.05),with the highest SII value found in the vitamin D-deficient group.Multivariate linear regression analysis revealed that,after adjusting for potential confounding factors including gender,age,season of blood collection,body mass index,hypertension,dyslipidemia,and chronic kidney disease,vitamin D levels were negatively associ-ated with SII(β=-2.68,95%CI:-3.56 to-1.81,P<0.001).Compared with the vitamin D-deficient group,the vitamin D-sufficient group exhibited significantly lower SII levels(β=-78.42,95%CI:-137.90 to-18.93,P=0.01).Furthermore,the restricted cubic spline model indicated a nonlinear dose-response relationship between vita-min D levels and SII(P<0.001).Conclusion There is a significant inverse correlation between plasma vitamin D levels and the SII in patients with type 2 diabetes.

Objective To acquire the basic information on diagnostic radiology and radiotherapy institutions and the frequency of medical radiation of Hebei province in 2016.Methods A survey was made using questionnaires for basic information on medical X-ray diagnosis,interventional radiology,radiotherapy and clinical nuclear medicine.Values of frequencies were derived for each type of medical X-ray procedure by dividing the total population.Results In 2016 there were 2 951 institutions at province level and 6 966 pieces of equipment involved in diagnostic radiology and radiotherapy treatments.Frequency values were estimated to be 379.25 examinations per 1 000 population in medical X-ay diagnosis,2.31 per 1 000 in interventional radiology,0.55 per 1 000 in radiotherapy and 1.65 per 1 000 in clinical nuclear medicine.The frequency for CT examination was 136.39 per 1 000,accounting for 36％ of the total frequencies in the province,with average annual growth rate of 12.4％.The highest value of frequency in clinical nuclear medicine was from Shijiazhuang among all types of medical procedures in different regions,11 times higher than the lowest value found in Hengshui city.Although the number of tertiary hospitals only accounted for 2.3％ of the total number of institutions,they contributed 25.5％,by examination number,of the medical X-ray diagnosis and 35.3％ of the CT examination.Interventional radiology and radiotherapy contributed more than 70％ of the total frequencies in the province,and clinical nuclear medicine was as high as 97.7％.Conclusions The basic information on diagnostic radiology and radiotherapy institutions and the frequency of medical procedures in Hebei in 2016 have been preliminarily made clear.Medical exposure could maintain a long-term growth trend.The frequency distribution of medical procedures in various regions and medical institutions is highly unbalanced.It is desirable to enhance the macroeconomic regulation and the management of medical radiation protection in order to rationally perform all types of diagnostic radiology and radiotherapy treatments to protect the health and safety of the patients and the examined individuals,and to promote the sustainable development of the health care services.

Objective To understand the occurrence of vancomycin-associated acute kidney injury (AKI)in patients in the pediatric intensive care unit(PICU)and explore the risk factors. Methods Medical records data of children in the PICU receiving vancomycin treatment,treatment course>48 h,and having vancomycin trough concentration monitoring data in the First Affiliated Hospital of Sun Yat-sen University from January 2013 to July 2017 were collected from the hospital information system and retrospectively analyzed. Occurrence of AKI was judged based on Pediatric-Modified RIFLE(pRIFLE) criteria. The children were divided into the AKI group and non-AKI group. The risk factors of vancomycin-associated AKI were analyzed using the multivariable logistic regression model. Results A total of 170 patients were entered in this study. Of them,104 patients were male and 66 were female with ages from 5 days to 15.4 years and the median age was 1.3 years. Thirty-six patients(21.05%)developed AKI, including 31 patients(18.24%)with risk of kidney injury,4 patients(2.35%)with kidney injury,and 1 patient(0.59%)with kidney failure,no patient with kidney loss and end-stage kidney disease. The results of multivariate logistic regression analysis showed that the elevated estimated creatinine clearance (OR=1.010,P<0.001),more than 5 kinds of concomitant nephrotoxic drugs(OR=2.808,P=0.019), average vancomycin trough level ≥17 mg/L(OR =10.426,P <0.001),combined with carbapenems antibacterial drugs(OR=4.263,P=0.013),and combined with voriconazole injection(OR=3.165,P=0.038)were all the independent risk factors of AKI occurrence. Conclusions The incidence of vancomycin-associated AKI was 21.18% in PICU patients in our hospital. Vancomycin trough level ≥17 mg/L and more than 5 kinds of concomitant nephrotoxic drugs would increase risk of AKI in PICU patients.

Objective To understand the occurrence of vancomycin-associated acute kidney injury (AKI)in patients in the pediatric intensive care unit(PICU)and explore the risk factors. Methods Medical records data of children in the PICU receiving vancomycin treatment,treatment course>48 h,and having vancomycin trough concentration monitoring data in the First Affiliated Hospital of Sun Yat-sen University from January 2013 to July 2017 were collected from the hospital information system and retrospectively analyzed. Occurrence of AKI was judged based on Pediatric-Modified RIFLE(pRIFLE) criteria. The children were divided into the AKI group and non-AKI group. The risk factors of vancomycin-associated AKI were analyzed using the multivariable logistic regression model. Results A total of 170 patients were entered in this study. Of them,104 patients were male and 66 were female with ages from 5 days to 15.4 years and the median age was 1.3 years. Thirty-six patients(21.05%)developed AKI, including 31 patients(18.24%)with risk of kidney injury,4 patients(2.35%)with kidney injury,and 1 patient(0.59%)with kidney failure,no patient with kidney loss and end-stage kidney disease. The results of multivariate logistic regression analysis showed that the elevated estimated creatinine clearance (OR=1.010,P<0.001),more than 5 kinds of concomitant nephrotoxic drugs(OR=2.808,P=0.019), average vancomycin trough level ≥17 mg/L(OR =10.426,P <0.001),combined with carbapenems antibacterial drugs(OR=4.263,P=0.013),and combined with voriconazole injection(OR=3.165,P=0.038)were all the independent risk factors of AKI occurrence. Conclusions The incidence of vancomycin-associated AKI was 21.18% in PICU patients in our hospital. Vancomycin trough level ≥17 mg/L and more than 5 kinds of concomitant nephrotoxic drugs would increase risk of AKI in PICU patients.

As an important component of modern medicine , the critical care medicine has sprung up for years. Nevertheless, based on the postgraduate education and the further education like 5C training, the existing talent training pattern has been unable to solve the serious problem of the deficiency in the human capital of critical care medicine in hospitals of different levels. With the eco-nomic development of the society and the constant emergence of the new medical technologies , the critical care medical specialty should be quickly established in medical colleges, especially facing the modern demand on curriculum reformation in the undergraduate course. As the “National Compre-hensive Reforms Pilot Unit of Anesthesiology”, the School of Anesthesiology of Wannan Medical Col-lege is obliged to cater for the social need and respond to the national policy. Despite of the insuffi-ciency of teaching and cases, the school endeavors to build up the reformed “2+1+2” curriculum system on the basis of strengthening the major advantages. With the core of the teaching mold reform, the new system aims to enhance the clinical training and introduce the teaching mold reforms of “or-ganic system-based”, PBL and CBL, etc. Therefore, the sound training mold of critical care medicine could be further explored significantly.

Objective To observe the expressions of small heterodimer partner (SHP) in rat model of hepatic fibrosis and its role in fibrosis.Methods A total of 30 healthy male SD rats were divided into two groups: 6 rats in control group and 24 rats in model group.The model group was further divided into four subgroups which were sacrificed at different time points,2,4,6 and 8 weeks after intraperitoneal injection of dimethylnitrosamine (DMN).After establishment of the rat model,blood samples and liver tissue specimens were collected at week 2,4,6 and 8 respectively.The sections of liver tissue were stained with HE and Masson and then were observed under optical microscope.The expressions of SHP mRNA and protein were determined by reverse transcription-polymerase chain reaction (RT-PCR) and Western blot,respectively.The comparison of means among the groups was performed by univariate ANOVA.Results The hepatic fibrosis was most obvious at 4 weeks and 6 weeks after the intraperitoneal injection.In model groups,alanine aminotransferase (ALT) and aspartateaminotransferase (AST) levels gradually increased and reached a peak at week 4,which were (169.2±16.2) and (193.3±31.1) U/L,respectively.Meanwhile,albumin level in the model group decreased gradually,reaching the nadir at week 6,and the differences were statistically significant at all selected time points between the model group and control group (FAST =83.10,FALT =104.63,FAlb =54.24; all P＜0.05).After modeling,the expression of SHP mRNA and protein in model group were significantly increased than those in control group,and reached a peak at week 4 (0.4494±0.0555 and 1.1155 ±0.1546,respectively),then both mRNA and protein levels decreased gradually at week 6 and 8 which obviously lower than the control group.Transforming growth factor (TGF)β1 mRNA expression level also increased gradually,reaching a peak at week 4 (0.9625±0.1196),and the differences between model subgroups and control group were statistically significant (F=25.740,171.383,118.393 and 94.343; all P＜0.05).Linear correlation analysis showed that SHP mRNA was positively correlated with TGFβ1 mRNA (r=0.593,P＜0.01).Conclusion During the progression of hepatic fibrosis,the SHP expression increases at the beginning and then turns to decrease,which suggests that SHP may play an important role in the development of hepatic fibrosis.