Objective To explore the impact of meteorological factors on the incidence of scarlet fever in Xicheng District of Beijing, and to provide a scientific basis for formulating targeted prevention and control measures. Methods Daily scarlet fever incidence data and corresponding meteorological data from 2010 to 2019 in Xicheng District of Beijing were collected. Using year, month, and day of the week as time-stratified variables, a conditional logistic regression model with a time-stratified case-crossover design was employed to analyze the impact of different meteorological factors on the number of scarlet fever cases in Xicheng District, while controlling for long-term trends, seasonality and other confounding factors. Results From 2010 to 2019, a total of 3,195 cases of scarlet fever were reported in Xicheng District, with an average annual incidence rate of 24.17/100 000. The overall trend showed fluctuating decline, during which three incidence peaks occurred, with the highest incidence rate observed in 2011. No severe or fatal cases were reported. The incidence of scarlet fever exhibited a distinct seasonal bimodal distribution, primarily concentrated between April to June and November to January of the following year. The conditional logistic regression results showed that the average relative humidity and average temperature were positively correlated with scarlet fever cases (β=0.0203, β=0.0613, P＜0.001), while the average vapor pressure was negatively correlated with scarlet fever cases (β=-0.1468, P＜0.001). Increases average relative humidity and average temperature were risk factors for scarlet fever incidence (OR=1.0205，95%CI=1.0150 -1.0261；OR=1.0632，95%CI=1.0379 -1.0891). For every 1.00% increase in average relative humidity, the number of scarlet fever cases increased by 2.05% (1.50% –2.61%). Similarly, for every 1^。C rise in average temperature, the number of cases increased by 6.32% (3.79% – 8.91%). In contrast, an increase in average vapor pressure had a protective effect against scarlet fever (OR=0.8635,95%CI=0.8392-0.8885). For every 1 hPa increase in average vapor pressure, the number of scarlet fever cases decreased by 13.65% (11.15%–16.08%). Conclusion The average relative humidity, average temperature and average vapor pressure are the primary meteorological factors influencing the incidence of scarlet fever in Xicheng District of Beijing, and can be utilized as indicators for the prevention, control, surveillance and early warning of scarlet fever.

Objective To compare the epidemic characteristics of seasonal influenza in Xicheng District, Beijing, between 2018-2019 and 2023-2024. Methods The present study was a cross-sectional study. The influenza cases and etiological surveillance data of Xicheng District, Beijing in 2018-2019 and 2023-2024, respectively, were analyzed to study the differences in the incidence rate of influenza cases in different ages, regions, occupations, and etiological detection results during the four years. Results There were significant differences in the incidence rates of influenza (χ²=37 038.65，P＜0.05) and the interval between visits (Z=468.692, P < 0.05) in 2018, 2019, 2023 and 2024. There were statistically significant differences in the incidence rates of influenza among different age groups, streets, and occupations during the four years (Z=75.646, 209.276, 72.132, 361.176, 43.570, all P < 0.05). Compared with 2018-2019, the growth rate of influenza in Xicheng District, Beijing in 2023-2024 was the highest in the 15-24 year-old group, Tianqiao Street, and housework and unemployed people. The difference in the interval between influenza visits among people of different age groups during these 4 years was statistically significant (P < 0.05). The growth rate of the interval between influenza visits in Xicheng District, Beijing in 2023-2024 was the highest in the 15-24 year-old group, while it showed a decrease in the 0-4 year-old group. The etiology in 2018-2019 was mainly H1N1 and H3N2 subtypes, and in 2023-2024 it was mainly H3N2 subtype and influenza B, and the peak values of H1N1, H3N2 subtype and influenza B in 2023-2024 were all higher than those in 2018-2019. Conclusion During the epidemic period, non-medical interventions have changed the transmission mode, seasonal peak and subtype distribution of influenza virus. As the epidemic has eased, the pattern of influenza has gradually rebounded.

Objective: To understand the changing trends and related factors of knowledge, attitude and practice (KAP) regarding the three major infectious diseases (acquired immunodeficiency syndrome, tuberculosis, hepatitis B) among freshmen in Jiangsu from 2019 to 2022, so as to provide a reference basis for the health education of infectious diseases in schools. Methods: From 2019 to 2022, a total of 33 944 freshmen from 20 universities in Jiangsu Province were randomly selected for four consecutive years to investigate their KAP levels online through self designed questionnaires on three major infectious diseases. The multiple linear regression model was used to analyze the changing trends of students KAP levels of the three major infectious diseases, and to explore the influencing factors of KAP. Results: From 2019 to 2022, the knowledge scores(18.0±3.1,18.4±3.2,18.7±3.2,18.8±3.2), related to the three major infectious diseases showed an upward trend ( F=436.50, P <0.01), and the positive attitude reporting rates were 81.77%, 81.46%, 82.68% and 81.74%, respectively. The reporting rates of positive practice were 80.11%, 79.25%, 79.08 % and 79.04%, respectively. Multiple linear regression showed that school type, parental education level, mother s occupation, average income per person in family and living arrangements during high school all had an impact on the knowledge ( β = -1.510 -0.559), attitudes ( β =-0.043-0.065) and practice ( β =-0.028-0.027) of the three major infectious diseases ( P < 0.05 ). The family residence areas only affected the reporting rate of positive attitude scores ( β =0.002-0.065), and whether only children or not affected the reporting rate of positive practice scores ( β =0.009)( P <0.05). The knowledge score showed an upward trend ( β= 0.297, P <0.01), the positive attitude reporting rate showed no statistically significant change ( β=0.001, P =0.22), and the positive practice reporting rate showed a downward trend ( β=-0.005, P <0.01). Conclusions Freshman in Jiangsu Province from 2019 to 2022 have shown a separation in KAP scores regarding the three major infectious diseases. Targeted measures should be taken to improve their health practice level.

Objective To understand the distribution of M protein gene (emm) of group A streptococcus (GAS) infections among children in Xicheng District of Beijing. Methods Throat swab samples from scarlet fever and pharyngeal infection cases were collected in sentinel hospitals of Xicheng District, Beijing from 2011 to 2024. GAS strains were isolated and identified, and emm gene was amplified and sequenced by PCR to determine the genotype. The differences in emm genotype between different groups were compared. Results A total of 3 130 throat swab samples were collected, and 400 GAS strains were isolated, with a positive rate of 12.78%. The highest positive rate was 19.93% in 2011. The positive rate of scarlet fever (45.71%) was higher than that of pharyngeal infection (6.14%) (P<0.001). There were 391 emm gene positive strains, and the differences in the positive rate of emm gene among different cases were statistically significant (P<0.001). A total of 7 genotypes and 27 gene subtypes were detected. Among different groups, the emm genotypes were mainly emm12 and emm1. The emm gene subtypes were mainly emm12.00 and emm1.00. Except for some years, the genotypes and their subtypes were dominated by emm12 and emm12.00, and the distribution differences of the two major genotypes and their subtypes were statistically significant from 2011 to 2019 (P<0.001). There were differences in genotypes and subtypes among different age groups (P=0.002). Conclusion The dominant types of emm genes in group A streptococcus infections among children were emm12 and emm1 in Xicheng District of Beijing from 2011 to 2024, and the dominant gene subtypes were emm12.00 and emm1.00. It is necessary to comprehensively strengthen the monitoring of the epidemic situation and genotype, timely grasp the distribution and variation of emm gene.

Objective To investigate the epidemiological characteristics and effectiveness of emergency responses to epidemic foci in Guangzhou City in 2024, so as to optimization of the dengue fever control strategy in Guangzhou City. Methods All data pertaining to dengue fever cases in Guangzhou City in 2024 were collected from the National Notifiable Infectious Disease Surveillance Information Reporting System. The temporal, spatial and population distributions of dengue fever cases and sources of infections were descriptively analyzed, and the effectiveness of emergency responses to epidemic foci of dengue fever was evaluated through standard space index (SSI), the interval from disease onset to case reporting and the percentage of isolation in hospital. Results A total of 3 656 dengue fever cases were reported in Guangzhou City in 2024, including 3 102 local cases and 554 imported cases. Of all cases, 67.86% (2 481 cases) occurred at ages of 20 to 59 years, and the three most common occupations included housework/unemployment (793 cases, 21.69%), business servants (744 cases, 20.35%) and retirees (669 cases, 18.30%). The peak of dengue fever epidemics was concentrated during the period from the 39th to the 45th weeks in 2024, when a total of 2 317 local cases were reported, accounting for 74.69% of all local cases in 2024. Dengue fever cases were reported across all 11 districts in Guangzhou City in 2024, with local cases concentrated in Baiyun District (754 cases, 24.31%), Liwan District (398 cases, 12.83%), Panyu District (365 cases, 11.77%), Haizhu District (332 cases, 10.70%) and Tianhe District (328 cases, 10.57%). Imported dengue fever cases were predominantly domestically imported (492 cases, 88.81%), with the majority imported from Foshan City (377 cases), and overseas imported cases were predominantly imported from southeastern Asian countries. The mean proportion of case isolation in hospital was 9.16% (284/3 102), and the mean interval from disease onset to case reporting was (3.99 ± 2.70) days, while the percentages of mosquito density meeting the required standard were 61.68% (462/ 749) and 66.32% (126/190) on the 4th and 7th day of emergency responses to epidemic foci, respectively. Conclusions The prevention and control cycle of dengue fever in Guangzhou in 2024 took longer than in previous years, with a larger scale of the epidemic. Although some progress has been made in epidemic management, there are still problems such as unsustainable mosquito vector control and low hospitalization isolation rates for cases. Further optimization of control measures in mosquito vector control, case monitoring and management is required to improve the effectiveness of dengue fever control measures.

OBJECTIVE: To investigate the effectiveness of 5G remote robotic surgery in the treatment of pelvic fractures. METHODS: A retrospective analysis was conducted on the clinical data of 160 patients with pelvic fractures admitted between July 2023 and June 2024 who met the selection criteria. Among these patients, 80 underwent internal fixation surgery with the assistance of 5G remote robotic surgery (5G group), while 80 received local robotic surgical assistance (control group). Baseline characteristics, including gender, age, body mass index, disease duration, cause of injury, and fracture classification, were compared between the two groups, and no significant difference was found ( P>0.05). The incision length, operation time, intraoperative blood loss, hospital stay, accuracy of screw placement, maximum residual displacement postoperatively, quality of fracture reduction, incidence of complications, Majeed pelvic function score and classification at last follow-up were recorded and compared between the two groups. RESULTS: In the 5G group, 180 screws were implanted during surgery, while 213 screws were implanted in the control group. The 5G group demonstrated significantly reduced intraoperative blood loss and shorter incision length compared to the control group ( P<0.05). No significant difference was observed between the two groups in terms of operation time or hospital stay ( P>0.05). Radiographic evaluation revealed excellent and good reduction rates of 98.8% (79/80) in the 5G group and 97.5% (78/80) in the control group, while excellent and good screw placement accuracy rates were 98.3% (177/180) in the 5G group and 95.8% (204/213) in the control group. No significant difference was found between the two groups in maximum residual displacement, reduction quality, or screw placement accuracy ( P>0.05). All patients were followed up 7-16 months (mean, 11.3 months), with no significant difference in follow-up duration between the groups ( P>0.05). No perioperative or follow-up complication, such as wound infection, iatrogenic fractures, iatrogenic neurovascular injury, screw loosening or breakage, or nonunion, were observed in either group. The control group exhibited a worse degree of gait alteration compared to the 5G group ( P<0.05), while no significant difference was found in incidences of squatting limitation or persistent pain ( P>0.05). At last follow-up, no significant difference was observed between the groups in Majeed pelvic function scores or grading ( P>0.05). CONCLUSION Compared with the local surgery group, 5G remote robotic surgery supported by remote expert technical guidance demonstrated smaller incision lengths, less intraoperative blood loss, and fewer postoperative complications, and was shown to be a precise, minimally invasive, safe, and reliable surgical method.
Humans ; Robotic Surgical Procedures/instrumentation* ; Pelvic Bones/surgery* ; Male ; Retrospective Studies ; Fracture Fixation, Internal/instrumentation* ; Female ; Fractures, Bone/surgery* ; Middle Aged ; Bone Screws ; Adult ; Operative Time ; Treatment Outcome ; Blood Loss, Surgical ; Length of Stay ; Postoperative Complications/epidemiology* ; Aged ; Young Adult

Objective: To analyze the epidemiological characteristics of dengue fever outbreaks in schools from Guangzhou in 2024, so as to provide a reference for formulating targeted prevention and control policies and measures. Methods: By using the National Infectious Disease Surveillance Information Reporting Management System to obtain information on dengue fever cases in Guangzhou from January 1st to December 31st, 2024. Descriptive data analysis was conducted on the temporal distribution, regional distribution, and school distribution of dengue fever outbreaks in schools. A mediation effect model was used to analyze the mediating effect of the time between onset and reporting between the type of school and the occurrence of recurrent cases. Results: In 2024,12.41% (385 cases) of dengue fever cases in Guangzhou involved schools, with 300 schools affected. Among these, 16 schools (5.33%) reported cluster outbreaks, and 24 schools (8.00%) reported secondary cases. The first dengue case at the school was reported at 26 July and the last case was reported at 4 December, the peak reporting period for cases was October 7 to November 3. The incidence of secondary cases in schools in central urban areas (5.19%) was lower than that in suburban schools ( 17.39 %), and the difference was statistically significant ( χ 2=9.15, P <0.01). The time from onset to reporting partially mediated the relationship between school type and the occurrence of recurrent cases ( β=0.23, P <0.05), accounting for 21.50% of the total effect. Conclusions Dengue fever is a key infectious disease facing schools in Guangzhou during summer and autumn. Surveillance of dengue fever outbreaks in schools should be strengthened during the peak season to reduce the risk of cluster outbreaks and the occurrence of secondary cases.

Objective To investigate the change in choroid plexus(CP)volume in Parkinson's disease(PD)patients with different cognitive states and its correlation with structural volumes of other brain regions.Methods A cross-sectional study was conducted on 48 PD patients admitted in Department of Neurosurgery of the First Affiliated Hospital of Army Medical University between May 2023 and April 2024,and on 35 healthy controls(HC)recruited through a physical exam center.According to the results of Mini-Mental State Examination(MMSE),the patients were divided into PD with cognitive impairment(PD-CI)group(n=27)and PD with normal cognitive function(PD-NC)group(n=21).3.0T magnetic resonance imaging(MRI)was performed using MPRAGE sequences,and CP volume and volumes of other brain regions were obtained using FreeSurfer 6.0 software.The CP volume was adjusted by calculating the ratio of its volume to estimated total intracranial volume(eTIV).After controlling for confounders,partial correlation analysis was used to assess the relationship between the CPV/eTIV ratio and the volumes of other brain regions as well as cognitive scale scores.Additionally,multiple linear regression analysis was performed to further explore the relationship between CPV and cognitive function in the PD-CI group.Results Compared to the HC group,the CPV in the PD-CI group was significantly larger(P=0.029).In the PD-CI group,the CPV/eTIV ratio showed significant positive correlations with the volume of the lateral ventricles(r=0.689,P=0.001),the volume of the third ventricle(r=0.592,P=0.006),the volume of cerebrospinal fluid(CSF)(r=0.508,P=0.022),and white matter hyperintensities(WMH)(r=0.486,P=0.030),but was negatively correlated with the volume of the caudate nucleus(r=-0.530,P=0.016),the volume of the thalamus(r=-0.477,P=0.033),and the MMSE scores(r=-0.483,P=0.031).But in the PD-NC group,the CPV/eTIV ratio was only positively correlated with CSF volume(r=0.571,P=0.021).Multiple linear regression analysis indicated that the CPV/eTIV ratio and MMSE scores remained significantly negatively correlated in the PD-CI group(β=-0.388,P=0.046).Conclusion Cognitive impairment in PD patients may be closely associated with the change in CP volume,suggesting that the volume can serve as a potential imaging marker in assessment of cognitive impairment in PD patients.

Objective:To compare the prognostic values of different classification by using transpulmonary pressure gradient (TPG), diastolic pressure gradient (DPG) and pulmonary vascular resistance (PVR) in patients with pulmonary hypertension due to left heart disease (PH-LHD), and investigated hemodynamic and clinical factors associated with mortality in patients with PH-LHD.Methods:This was a single-center prospective cohort study. In-hospital patients diagnosed with PH-LHD via right heart catheterization at the Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, from September 2013 to December 2019 were enrolled. Patients were divided according to TPG (cutoff value 12 mmHg; 1 mmHg=0.133 kPa), DPG (cutoff value 7 mmHg), PVR (cutoff value 3 Wood Units), and the combination of TPG and PVR. Baseline characteristic was recorded. All patients were followed up until the occurrence of endpoint event, defined as all-cause death that occurred during the follow-up period, or until April 18, 2022. Receiver operating characteristic curves were used to compare the predictive value of 3 classification methods for all-cause death in PH-LHD patients. The optimal cutoff values were calculated using Jorden index. Survival analysis was performed using Kaplan-Meier analysis, and log-rank test was used to compare the predictive efficacy of classification methods based on optimal cutoff values or guidance-recommended thresholds for the survival of PH-LHD patients. Variables showing statistical significance in the univariate analysis were incorporated into multivariate Cox regression model to analyze the independent risk factors for all-cause mortality.Results:A total of 243 patients were enrolled, aged (54.9±12.7) years old, including 169 (69.5%) males. During a median follow-up of 57 months, there were 101 (41.6%) deaths occurred. Grouping results were as follows: (1) TPG: TPG≤12 mmHg group 115 patients, TPG>12 mmHg group 128 patients; (2) DPG: DPG<7 mmHg group 193 patients, DPG≥7 mmHg group 50 patients; (3) PVR: PVR≤3 Wood Units group 108 patients, PVR>3 Wood Units group 135 patients; (4) TPG and PVR: TPG≤12 mmHg and PVR≤3 Wood Units group 89 patients, TPG>12 mmHg and PVR>3 Wood Units group 109 patients. PVR ( AUC=0. 698,95% CI:0.631-0.766) had better predictive value for all-cause mortality than TPG ( AUC=0.596, 95% CI: 0.523-0.669) and DPG ( AUC=0.526, 95% CI: 0.452-0.601) (all P<0.05). The optimal cutoff values for TPG, DPG, and PVR were13.9 mmHg, 2.8 mmHg, and 3.8 Wood Units, respectively. Kaplan-Meier analysis based on the optimal cutoff values or guidance-recommended thresholds showed that PVR and TPG were the predictors of survival ( P<0.05), while DPG did not showed significance ( P>0.05). Multivariate Cox regression analysis showed that age, PVR and log 2N-terminal pro-B-type natriuretic peptide were independent risk factors for all-cause mortality in PH-LHD patients (all P<0.05). Conclusion:Classification according to PVR was most valuable in predicting all-cause death in PH-LHD patients, while TPG showed moderate predictive ability and DPG had no predictive value.

Objective:To analyze the clinical outcomes of initial radioactive iodine 131I therapy (RIT) for patients with familial differentiated thyroid cancer (FDTC) and sporadic differentiated thyroid cancer (SDTC), along with their influencing factors. Methods:The clinical data of 120 FDTC and 480 SDTC patients who received RIT at the Department of Nuclear Medicine, Tianjin Medical University General Hospital from January 2016 to January 2022 were retrospectively analyzed. These patients, categorized into the FDTC and SDTC groups, were further divided into three subgroups based on their response to initial RIT: no evidence of disease (NED), biochemical persistence of disease (BPD), or structural/functional persistence of disease (S/FPD). For the NED subgroup, the disease-free survival (DFS) was analyzed. For the BPD and S/FPD subgroups, the progression-free survival (PFS) was investigated. Furthermore, risk factors for failure to reach the NED status were identified.Results:After initial RIT, 56 (46.7%), 50 (41.7%), 14 (11.6%) patients in the FDTC group reached the NED, BPD, and S/FPD statuses, respectively, while 284 (59.1%), 160 (33.3%), 36 (7.5%) and SDTC patients in the SDTC group were in the NED, BPD, and S/FPD statuses, respectively ( χ2 = 10.10, P = 0.013). The last follow-up revealed that 71 (59.1%), 36 (30.1%), 13 (10.8%) patients in the FDTC group were in the NED, BPD and S/FPD statuses, respectively, while 337 (70.2%), 114 (23.7%), 29 (6.1%) patients in the SDTC group reached the NED, BPD and S/FPD statuses, respectively ( χ2 = 8.99, P = 0.026). The F-NED and S-NED subgroups exhibited 5-year DFS rates of 92.4% and 97.4%, respectively, the F-BPD and S-BPD subgroups displayed 5-year PFS rates of 88.3% and 90.8%, respectively, while the F-S/FPD and S-S/FPD subgroups yielded in 5-year PFS rates of 78.2% and 79.6%, respectively. Univariate binary logistic regression analysis indicated that the maximum diameter of tumors, T stage, M stage, recurrence risk stratification, and postoperative stimulated thyroglobulin (p-sTg) were correlated with the achievement of the NED status ( χ2=6.37-13.10, P < 0.05). Multivariable binary logistic regression analysis showed that T stage and p-sTg were independent risk factors in the achievement of the NED status ( χ2=0.11-11.33, P < 0.05). Conclusions:The response to initial RIT assists in guiding the development of subsequent treatment and follow-up strategies for DTC patients. Given that the SDTC patients exhibited better outcomes than the FDTC patients, more alertness should be paid to the RIT for FDTC patients. For patients with higher p-sTg and T stage, the initial RIT dose and follow-up interval should be increased and reduced respectively as appropriate.