ObjectiveTo investigate the epidemiological characteristics of hand, foot, and mouth disease (HFMD) in Baoshan District of Shanghai from 2008 to 2023, and to provide scientific evidence for surveillance and standardized management of HFMD. MethodsCase data for HFMD reported in the China Disease Control and Prevention Information System from 2008 to 2023 were collected. Descriptive epidemiological methods were used to analyze the population characteristics, and the Joinpoint regression models were applied to assess the temporal trends of HFMD in Baoshan District. ResultsA total of 43 853 HFMD cases were reported from 2008 to 2023 in Baoshan District, with a male-to-female ratio of 1.50∶1. The majority of cases were children, among which scattered children and preschool children accounted for 54.67% and 36.58%, respectively, with 88.00% occurring in children under 5 years old. The average annual incidence rate was147.22/100 000 individuals. The pathogen detection rate in 2018 was 58.60% (109/186). Prior to 2020, CoxA16 was the predominant strain, while EV71 was not detected after 2019. ConclusionThe incidence of HFMD in Baoshan District of Shanghai was influenced by multiple factors including the inclusion in the notifiable infectious disease surveillance system, the introduction of EV71 vaccination, and the COVID-19 pandemic timeline. Populations characterized by highly mobility and frequent external contacts were at high risk for HFMD in Baoshan District. The predominant circulating strains had shifted sequentially from EV71 and CoxA16 to CoxA6.

Acute kidney injury(AKI)remains a global public health problem with high incidence,high mortality rates,expensive medical costs,and limited treatment options.AKI can further progress to chronic kidney disease(CKD)and eventually end-stage renal disease(ESRD).Previous studies have shown that trauma,adverse drug reactions,surgery,and other factors are closely associated with AKI.With further in-depth exploration,the role of gut microbiota in AKI is gradually revealed.After AKI occurs,there are changes in the composition of gut microbiota,leading to disruption of the intestinal barrier,intestinal immune response,and bacterial translocation.Meanwhile,metabolites of gut microbiota can exacerbate the progression of AKI.Therefore,elucidating the specific mechanisms by which gut microbiota is involved in the occurrence and development of AKI can provide new insights from the perspective of intestinal microbiota for the prevention and treatment of AKI.

Objective:To analyze the relationship between stress hyperglycemia (SHG) and the prognosis of acute myocardial infarction (AMI) without diabetes mellitus (DM).Methods:Using a retrospective cohort study method, 396 AMI patients without DM or impaired glucose tolerance (IGT) and admitted glycated hemoglobin A 1c (HbA 1c)≤6.0% from January 2018 to December 2020 in Xuanwu Hospital, Capital Medical University were selected. Among them, 238 patients did not have SHG at admission (group A), 85 patients had SHG at admission but their blood glucose level did not reach the diagnostic criteria for DM (group B), and 73 patients had SHG at admission and their blood glucose level reached the diagnostic criteria for DM (group C). The baseline data and the incidence of main adverse cardiovascular and cerebrovascular events (MACCE) were recorded. Multivariate Cox regression was used to analyze the independent risk factors of MACCE after discharge in AMI patients without DM. Results:The incidence of MACCE after discharge in group B and group C was significantly higher than that in group A: 29.4% (25/85) and 35.6% (26/73) vs. 18.5% (44/238), the incidence in group C was significantly higher than that in group B, and there was statistical difference ( P<0.05). Multivariate Cox regression analysis result showed that SHG on admission was an independent risk factor for MACCE after discharge in AMI patients without DM ( P<0.05), and LVEF on admission was an independent protective factor for MACCE after discharge in AMI patients without DM ( P<0.01). Conclusions:SHG on admission is the independent risk factor of MACCE in AMI patient without DM. Early detection, assessment and proper intervention measures based on clinical reality should be advocated for the AMI patients with SHG to further improve the prognosis.

Objective To investigate the effect of tooth extraction with antibiotics on atherosclerosis, and to examine the expression of serum interleukin 6(IL-6) and the pathological changes of the carotid artery in chronic periodontitis(CP) rats with or without atherosclerosis(As).Methods A total of 44 SD rats were randomly divided into four groups, group A(normal control), group B(As), group C(CP),group D(CP+As).After model establishment, group C and group D were randomly divided into group C1/D1 (tooth extraction) and group C2/D2(tooth extraction with antibiotics) according to random number table and received the corresponding oral intervention treatment respectively.Serum IL-6 levels were determined by enzyme linked immunosorbent assay(ELISA) respectively one week before the intervention, one week after the first intervention, one, three, five weeks after the second intervention.The pathological changes of the carotid artery were accessed under light microscope.Results At all sampling time points, the levels of serum IL-6 in group B, C, D were higher than that of group A, with group D 1 being increased most obviously,significantly higher than that of group A(P＜ 0.001).One week after the second intervention, the content of IL-6 in group C and group D peaked[C1(127.0±29.9) ng/L, C2: (120.6±23.1) ng/L, D1: (175.1±50.8) ng/L,D2: (160.5±37.7) ng/L], and was significantly higher than that of group B[B: (43.4±7.5) ng/L, P＜0.001].Then they all had varying degrees of decline, 5 weeks after the second intervention, group C1 and D1 were still higher than that of group B, but group C2 and D2 were lower than that of group B.At all sampling time points, the levels of serum IL-6 in group C2/D2 were lower than those in group C1/D1, 5 weeks after the second intervention the difference was most obvious and statistically significant(P＜0.001).Pathology showed that the carotid artery wall in group A was normal.The carotid artery wall was thickened in group B,inflammatory cells and foam cells could be seen, and elastic fibers disordered.The carotid artery wall in group C 1 was uneven, foam cells and a small amount of inflammatory cells were visible, and elastic fiber disordered.Obvious thickening was not seen in the carotid artery wall of group C2, a small amount of foam cells and inflammatory cells were found, and elastic fiber mildly disordered.The carotid artery wall in group D1 was obviously uneven, calcium salt deposits were visible in the artery wall, a large amount of inflammatory cells and foam cells could be found, and elastic fiber disordered.Obvious thickening was not seen in the carotid artery wall of group D2, a small amount of inflammatory cells and a large amount of foam cells could be seen, and elastic fiber disordered.Conclusions Periodontitis and hyperlipidemia could increase the level of serum IL-6 and the risk of the As.In chronic periodontitis rats with or without atherosclerosis, when periodontal inflammation was not controlled, tooth extraction may increase the risk of the As.At the time of tooth extraction, giving the anti-inflammatory treatment can reduce the risk to a certain extent.

Objective To investigate the effect of periodontal mechanical treatment on serum interleukin-6 (IL-6) and carotid artery matrix metalloproteinase(MMP)-2 and MMP-9 expression in chronic periodontitis(CP) SD rats with atherosclerosis (As).Methods Forty-four six-week-old male SD rats were randomly divided into three groups:control group(group A),As group (group B),As + CP group (group C).According to different periodontal interventions,group C was randomly subdivided into four groups:natural process group (C 1),the periodontal mechanical treatment group (C2),the periodontal mechanical treatment + local drugs group(C3),and the periodontal mechanical treatment + local and system drugs group(C4).Each group received the appropriate treatment and periodontal interventions.Serum IL-6 levels were determined by enzyme linked immunosorrbent assay (ELISA).MMP-2 and MMP-9 levels in the proximal aorta were examined by immunohistochemistry.Results The gray value of MMP-2 and MMP-9 was basically the same in all groups.Compared with group A,the gray value of MMP-2 and MMP-9 of group B and C were decreased.C1 group showed the formation of atherosclerotic plaque and fibrous cap.Compared with group B (126.4 ± 2.0,124.8 ± 2.8),the gray value of group C1 (101.3 ± 2.4,101.2 ± 4.1) was significantly weaker(P ＜ 0.05).The staining depth of MMP-2 and MMP-9 of groups C1,C2,C3 and C4 were sequentially decreased,and the differences of gray value were statistically significant(P ＜ 0.05).The levels of serum IL-6 in groups B and C1 increased gradually with time and became significantly higher than that of group A(P ＜ 0.01).The levels of serum IL-6 in groups C2,C3,and C4 increased gradually and reached the peak 5 weeks after the establishment of model (P ＜ 0.001).After that,the levels of serum IL-6 decreased gradually and was lower than baseline.The levels of serum IL-6 in groups C3 and C4 were significantly lower than that in group C2 7 weeks after the establishment of model(P ＜ 0.01).Conclusions In rats with periodontitis and cardiovascular diseases,chronic periodontal inflammation may significantly increase the severity of As and promote the formation of atherosclerotic plaque.Mechanical periodontal therapy may cause short-term systemic inflammation and then reduce vascular inflammation in long term.With supplement use of local and systemic antibiotics,the mechanical periodontal therapy may get the vascular disease and systemic inflammation improved.

Objective To establish chronic periodontitis model in SD rats,and to investigate the effect of oral intervention on atherosclerosis.Methods Fifty male SD rats were randomly divided into three groups,group A(normal control),group B(atherosclerosis,As) and group C(chronic periodontitis,CP).Group C was further divided into group C1(natural process),group C2(simple mechanical treatment),group C3 (systemic antibiotics),group C4-1(teeth extraction) and group C4-2(teeth extraction+systemic antibiotics),each group consisted of 7 rats.Every group received oral intervention.Serum interleukin(IL)-6 levels were detected in five different time points(1,3,5,7,9 weeks after a successful modeling) by enzyme linked immunosorbent assay.All animals were killed after 24 weeks.Matrix metalloproteinase(MMP)-2,9 in the proximal aorta was detected by immuno histochemistry.Results The levels of serum IL-6 in groups B and C1 increased gradually with time and became significantly higher than that in group A(P＜0.01).Levels of serum IL-6 were increased gradually in each intervention group(C2,C3,C4-1,C4-2) and reached its peak at 5 weeks after modeling[C2:(62.3 ± 14.3) ng/L,C3:(58.2±8.7) ng/L,C4-1:(127.0±29.9) ng/L,C4-2:(120.6± 23.1) ng/L].Compared with group B,group C4-1 and C4-2 increased most significantly(P＜0.01).Levels of serum IL-6 decreased gradually.Eventually,group C2[(28.6± 8.1) ng/L],C3[(40.8 ± 15.1) ng/L] and C4-2 [(32.7± 11.1) ng/L] were significantly lower than group B(P＜0.05),and in group C2 IL-6 was the lowest.Although levels of serum of IL-6 significantly decreased in group C4-1[(72.8± 16.4) ng/L],but remained the highest.Immunohistochemistry showed that MMP-2,9 were expressed in group B,C 1 and C4-1,and significantly higher than in group A(183.0±2.0,181.3 ± 2.0),the gray value differences were statistically significant(P＜0.01).Group C4-1 (123.1 ±2.9,121.0± 3.2) was the strongest,group B (126.4±2.0,124.8 ±2.8)and C1 (140.0±2.2,139.7±3.2) were decreased (P＜0.01).While group C2(169.3±3.4,169.7±2.3),C3 (149.0±1.7,145.1±2.5) and C4-2(157.7± 1.2,155.8±2.7) were significantly lower than group C1(P＜0.01),and group C2 was close to normal.Conclusions Periodontitis could increase the risk of atherosclerosis in rats with chronic periodontitis.Periodontal mechanical treatment and teeth extraction may increase the risk of As in the short time.However,the risk would gradually reduce in a long time.

OBJECTIVEThe aim of this study is to investigate the effects of serum high-sensitivity C-reactive protein (hsCRP) and the pathological changes in the carotid artery after periodontal mechanical therapy with local and systemic drugs in SD rats with chronic periodontitis (CP) associated with atherosclerosis (As).

METHODSThirty-five SD rats were randomly divided into two groups: control group (group A) and CP+As group (group B). Group B was further divided into the natural process group (B1), the periodontal mechanical treatment group (B2), the periodontal mechanical treatment plus local drugs group (B3), and the periodontal mechanical treatment plus local and systemic drugs group (B4). Each group comprised seven rats. Serum hsCRP levels were evaluated at baseline 1 week after the first periodontal therapy and 1, 3, and 5 weeks after the second periodontal therapy by enzyme linked immunosorbent assay (ELISA). The pathological lesion in the carotid artery plaque was stained with hematine and eosin.

RESULTSThe levels of serum hsCRP in group B1 increased gradually as time passed and became significantly higher than that of the other groups five weeks after periodontal therapy (P < 0.001). The levels of serum hsCRP in groups B2, B3, and B4 increased gradually and reached the peak 1 week after the second periodontal therapy. After that, the levels of serum hsCRP decreased gradually but were still higher than that of group A (P < 0.05). The levels of serum hsCRP in groups B3 and B4 were significantly lower than that in group B2 3 and 5 weeks after the second periodontal therapy (P < 0.001). Histologic sections revealed increased foam cell infiltration and disordered and destructed elastic fibers in groups B1 and B2. The thickness of the blood vessels in groups B3 and B4 was more uniform than that in groups B1 and B2. The elastic fibers in groups B3 and B4 were lined up in order.

CONCLUSIONDirect periodontal mechanical treatment results in acute, short-term, systemic inflammation and might increase the risk of atherosclerosis in SD rats. However, the levels of serum hsCRP decreased gradually 3 to 5 weeks after therapy. With periodontal mechanical treatment, the benefits of local and systemic drugs are associated with improvement in atherosclerotic lesion progression.

Animals ; Atherosclerosis ; C-Reactive Protein ; Carotid Arteries ; Chronic Periodontitis ; Male ; Rats ; Rats, Sprague-Dawley