Objective: To analyze the epidemiological characteristics, etiological distribution and risk factors of recurrent hand, foot and mouth disease (HFMD) in Jiaxing City, so as to provide scientific evidence for developing targeted prevention and control strategies. Methods: Based on the China Disease Prevention and Control Information System, data of all reported HFMD cases in Jiaxing City from January 1, 2016 to December 31, 2024 were collected. Epidemiological and etiological distribution characteristics of recurrent HFMD cases were described. The Kaplan-Meier method was applied to estimate the cumulative risk probability of reinfection, and the Cox proportional hazards regression model was used to identify risk factors for HFMD reinfection. Results: A total of 3 105 recurrent HFMD cases were reported in Jiaxing City during 2016-2024, with a reinfection rate of 3.99%. The majority of reinfections were second episodes (97.68%). HFMD reinfection was associated with sex, age, population category and etiological serotype ( χ 2=26.44, 609.92, 459.72, 32.01, all P <0.01). The incidence of recurrent HFMD exhibited a bimodal seasonal pattern, with peaks occurring from June to July and September to November. Spatial distribution indicated that Nanhu District, Jiashan County and Tongxiang City accounted for 49.02% of all recurrent cases citywide. Among 264 laboratory confirmed recurrent cases, EV-A71 was the predominant pathogen (29.92%). The proportion of EV-A71 showed a trend of initial decline followed by rebound, while the proportion of CV-A6 increased over time ( χ 2 trend =6.94, 47.43, both P <0.05). Of 51 patients with ≥2 etiological test results, 56.86 % experienced reinfection with a different serotype. The median time to HFMD reinfection was 17.23 (0.50, 105.03) months after the primary episode. The reinfection probability was 0.61% at 6 months, 3.68% at 36 months, and remained approximately 5% at 64.37 months. Multivariate Cox regression revealed that male sex ( HR =1.23), age ≤ 3 years ( HR = 1.84), and scattered children and preschool children ( HR =3.78, 3.47, respectively) were independent risk factors for HFMD reinfection (all P <0.05). Conclusions Recurrent HFMD in Jiaxing City presents temporal and population heterogeneity, and its etiology shows an alternating serotype evolution pattern. Enhanced surveillance should be implemented among priority populations and high incidence regions, and multivalent vaccines should be developed to confer broader protection.

Objective To explore the relationship between PANoptosis and hepatic ischemia-reperfusion injury (HIRI), and to screen the key genes of PANoptosis in HIRI. Methods PANoptosis-related differentially expressed genes (PDG) were obtained through the Gene Expression Omnibus database and GeneCards database. Gene ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and Gene Set Enrichment Analysis (GSEA) were used to explore the biological pathways related to PDG. A protein-protein interaction network was constructed. Key genes were selected, and their diagnostic value was assessed and validated in the HIRI mice. Immune cell infiltration analysis was performed based on the cell-type identification by estimating relative subsets of RNA transcripts. Results A total of 16 PDG were identified. GO analysis showed that PDG were closely related to cellular metabolism. KEGG analysis indicated that PDG were mainly enriched in cellular death pathways such as apoptosis and immune-related signaling pathways such as the tumor necrosis factor signaling pathway. GSEA results showed that key genes were mainly enriched in immune-related signaling pathways such as the mitogen-activated protein kinase (MAPK) signaling pathway. Two key genes, DFFB and TNFSF10, were identified with high accuracy in diagnosing HIRI, with areas under the curve of 0.964 and 1.000, respectively. Immune infiltration analysis showed that the control group had more infiltration of resting natural killer cells, M2 macrophages, etc., while the HIRI group had more infiltration of M0 macrophages, neutrophils, and naive B cells. Real-time quantitative polymerase chain reaction results showed that compared with the Sham group, the relative expression of DFFB messenger RNA in liver tissue of HIRI group mice increased, and the relative expression of TNFSF10 messenger RNA decreased. Cibersort analysis showed that the infiltration abundance of naive B cells was positively correlated with DFFB expression (r=0.70, P=0.035), and the infiltration abundance of M2 macrophages was positively correlated with TNFSF10 expression (r=0.68, P=0.045). Conclusions PANoptosis-related genes DFFB and TNFSF10 may be potential biomarkers and therapeutic targets for HIRI.

Objective To investigate the effect of extracellular heat shock protein(HSP)22 on Toll-like receptor(TLR)4/nuclear factor-κB(NF-κB)signaling pathway in oxidative-low-density lipoprotein(ox-LDL)-induced inflammatory damage in coronary endothelial cells(HCAECs).Methods HCAECs were cul-tured in vitro and pretreated with ox-LDL to establish a model of high-lipid-induced endothelial cell injury.Re-combinant human HSP22(rhHSP22)was exogenously treated.The effects of rhHSP22 on the expression of inflammation-related proteins such as interleukin(IL)-8,vascular cell adhesion molecule(VCAM)-1 and NF-κB in endothelial cells and endothelial cell apoptosis were observed.The relationship between HSP22 and TLR4/NF-κB signaling pathway was investigated under the action of TLR4 inhibitor E5564.Western blot was used to detect the expression of IL-8,VACM-1 and NF-κB proteins,and flow cytometry was used to detect the apoptosis of endothelial cells in each group.Results Compared with the CNT group,the relative expression levels of IL-8,VACM-1 and NF-κB protein in the rhHSP22 group,rhHSP22+ox-LDL group,rhHSP22+E5564 group and rhHSP22+E5564+ox-LDL group were significantly increased,and the differences were sta-tistically significant(P<0.05).Compared with the rhHSP22 group,the relative expression levels of IL-8,VACM-1 and NF-κB protein in the rhHSP22+ox-LDL group were significantly increased,and the differences were statistically significant(P<0.05).Compared with the rhHSP22+ox-LDL group,the relative expression levels of IL-8 and VACM-1 in the rhHSP22+E5564+ox-LDL group were decreased,and the differences were statistically significant(P<0.05).Compared with the CNT group,the apoptosis rate in the rhHSP22 group,rhHSP22+ox-LDL group and rhHSP22+E5564+ox-LDL group was significantly increased,and the differ-ence was statistically significant(P<0.05).Compared with the rhHSP22 group,the apoptosis rate in the rhHSP22+ox-LDL group was increased,and the difference was statistically significant(P<0.05).Compared with the rhHSP22+ox-LDL group,the apoptosis rate in the rhHSP22+E5564+ox-LDL group was de-creased,and the difference was statistically significant(P<0.05).Conclusion In ox-LDL-induced inflamma-tory damage of HCAECs,extracellular HSP22 induces the expression of IL-8,VACM-1 and NF-κB proteins by activating the TLR4/NF-κB signaling pathway,and promotes endothelial cell apoptosis.

Objective To explore the value of dual factor combined detection using tuberculosis(TB)specific cy-tokines interferon-γ(IFN-γ)and interleukin-2(IL-2)in TB diagnosis in patients with human immunodeficiency vi-rus(HIV)infection,and the influencing factors for underdiagnosis.Methods HIV-infected patients admitted to and underwent TB-related examination in the Department of Infectious Diseases in Hezhou People's Hospital from July 2022 to September 2024 were collected.According to the clinical diagnosis criteria,patients were divided into the HIV infection with TB group(HIV/TB group)and the HIV infection without TB group(control group).Diag-nostic efficacy of dual factor combined detection was evaluated.HIV/TB group was further divided into a true-posi-tive group and a false-negative group based on the detection results.The independent influencing factors for underdia-gnosis was analyzed using multivariate logistic regression.Results A total of 306 patients were included in the analysis,with an average age of(55.69±14.02)years.There were 105 patients in the HIV/TB group and 201 in the control group.The sensitivity and specificity of dual factor combined detection for TB in all HIV-infected pa-tients were 72.4％(76/105)and 87.1％(175/201),respectively.There was a statistically significant difference in sensitivity(x2=9.488,P=0.009)and no statistically significant difference in specificity(x2=5.846,P=0.054)among the three CD4+T lymphocyte count gradients in the dual factor detection.Among them,patients with CD4+T cell count＜100 cells/μL had lower sensitivity(58.8％)in dual factor detection than patients with CD4+T cell count ≥200 cells/μL(88.9％)and 100-199 cells/μL(81.5％),differences were both statistically significant(both P＜0.05).In HIV/TB co-infected patients with CD4+T lymphocyte count ≥100 cells/μL,the general sensi-tivity and the specificity of dual factor combined detection were 85.2％(46/54)and 82.0％(91/111),respectively.Multivariate analysis showed that CD4+T lymphocyte count was an independent influencing factor for the underdia-gnosis in HIV/TB patients conducting dual factor combined detection(P＜0.05),while age,gender,pathogen re-sults,and the presence or absence of TB had no statistically significant impact on the results of dual factor combined detection(all P＞0.05).Conclusion Dual factor combined detection using tuberculosis-specific cytokines IFN-γand IL-2 has a high diagnostic value in the diagnosis of TB in HIV-infected patients,especially in those with CD4+T lymphocyte count ≥100/μL,which can provide auxiliary diagnostic value for the clinical diagnosis of HIV infection combined with TB.

Objective To conduct a scoping review on the application of mobile health in the home management of patients with urinary incontinence after radical prostatectomy,providing references for future research and clinical practice.Methods A literature search was performed in the PubMed,Web of Science,Embase,CINAHL,Cochrane Library,China National Knowledge Infrastructure(CNKI),China Biomedical Literature Database(SinoMed),Wanfang Database,VIP Database,the website of the American Urological Association and so on from the establishment of databases to March 7,2025.The included literature was summarized and analyzed.Results A total of 19 pieces of literature were included.The forms of intervention included applications,online platforms,and communication software.The intervention contents covered health education,functional exercise,self-management,communication and interaction,and follow-up management.The outcome indicators included physiological indicators,psychological indicators,quality of life,self-management,patient experience.Conclusion The application of mobile health in the home management of patients with urinary incontinence after radical prostatectomy has certain feasibility.Howe ver,its forms of intervention,contents and evaluation indicators still need to be further expanded and improved.In the future,it is possible to explore the integration of emerging technologies,combine the multi-disciplinary collaboration model,and construct a more scientific and systematic home management plan for urinary incontinence patients.

Objective:To investigate the correlation between remnant cholesterol/high-density lipoprotein cholesterol ratio (RC/HDL-C) and metabolic dysfunction-associated fatty liver disease (MAFLD) in health check-up population.Methods:It was a cross-sectional study. A total of 5 299 subjects who received physical examination in the Health Management Center of Renmin Hospital of Wuhan University from January to December in 2023 and met the admission criteria were selected as the research subjects. The subjects were examined by demography, anthropometry, laboratory tests and liver instantaneous elastography. The Chi-square test, t-test, one-way analysis of variance, Mann-Whitney U test and Kruskal-Wallis H test were used to compare the indexes between the subjects with and without MAFLD. The subjects were divided into 4 groups (Q1-Q4 groups) according to the RC/HDL-C ratio quartiles by quartile method, and the indexes in each group were compared. The receiver operating characteristic (ROC) curves were drawn using MedCalc software and compared to assess the diagnostic efficacy of the RC/HDL-C ratio for MAFLD. Results:With the increase of RC/HDL-C ratio, the detection rate of MAFLD (12.56% vs 43.48%), male proportion (55.68% vs 85.60%), total cholesterol (TC) [(4.63±0.82) vs (5.10±1.06) mmol/L], triglyceride (TG) [0.90(0.71, 1.15) vs 2.58(1.96, 3.50) mmol/L], alanine aminotransferase (ALT) [17.00(13.00, 24.00) vs 26.00(19.00, 38.00) U/L], aspartate aminotransferase (AST) [20.00(17.00, 24.00) vs 23.00(19.00, 29.00) U/L], and controlled attenuation parameter (CAP) [(239.32±40.52) vs (274.60±44.98) dB/m] increased gradually, while high-density lipoprotein cholesterol (HDL-C) [1.40(1.20, 1.64) vs 0.93(0.84, 1.04) μmol/L] decreased gradually (all P<0.05). ROC curves showed that the AUC value of RC/HDL-C ratio was significantly higher in identifying MAFLD when compared with TC, HDL-C, LDL-C, non-HDL-C and RC (AUC=0.676, P<0.05). Conclusions:The RC/HDL-C ratio is positively correlated with the risk of morbidity of MAFLD in health check-up population.

Objective:To identify the incidence and prevalence of inflammatory bowel disease (IBD) in the northern Chinese population of Jinan, Shangdong Province, along with its temporal trends from 2005 to 2022.Methods:By utilizing the data from the Jinan basic medical insurance system, a population-based IBD cohort was constructed. This facilitated the computation of both the incidence and prevalence rates of IBD, alongside their temporal trends throughout the 2005 to 2022 timeframe. The 95% confidence intervals were estimated using poisson regression.Results:The overall incidence rate of IBD showed a yearly increasing trend, with age-standardized incidence rates rising from 0.03/100 000 in 2005 to 5.39/100 000 in 2022. The age-standardized incidence rate of ulcerative colitis (UC) increased from 0.03/100 000 in 2005 to 4.97/100 000 in 2022. The age-standardized incidence rate of Crohn's disease (CD) rose from 0.05/100 000 in 2011 to 0.44/100 000 in 2022. The crude prevalence of IBD increased from 0.60/100 000 in 2005 to 32.39/100 000 in 2022. Specifically, the crude prevalence of UC increased from 0.60/100 000 in 2005 to 31.44/100 000 in 2022, while the crude prevalence of CD increased from 0.05/100 000 in 2011 to 1.19/100 000 in 2022.Conclusions:Analysis of recent medical insurance data reveals a continuous uptrend in both the incidence and prevalence of IBD in Jinan, a northern city in China. This underscores the urgent need for enhanced medical resources and healthcare guaruntee to ensure the well-being of individuals afflicted with IBD.

Objective To investigate the distribution and antimicrobial resistance profiles of clinically isolated Haemophilus influenzae and Moraxella catarrhalis in hospitals across China from 2015 to 2021,and provide evidence for rational use of antimicrobial agents.Methods Data of H.influenzae and M.catarrhalis strains isolated from 2015 to 2021 in CHINET program were collected for analysis,and antimicrobial susceptibility testing was performed by disc diffusion method or automated systems according to the uniform protocol of CHINET.The results were interpreted according to the CLSI breakpoints in 2022.Beta-lactamases was detected by using nitrocefin disk.Results From 2015 to 2021,a total of 43 642 strains of Haemophilus species were isolated,accounting for 2.91％of the total clinical isolates and 4.07％of Gram-negative bacteria in CHINET program.Among the 40 437 strains of H.influenzae,66.89％were isolated from children and 33.11％were isolated from adults.More than 90％of the H.influenzae strains were isolated from respiratory tract specimens.The prevalence of β-lactamase was 53.79％in H.influenzae strains.The H.influenzae strains isolated from children showed higher resistance rate than the strains isolated from adults.Overall,779 strains of H.influenzae did not produce β-lactamase but were resistant to ampicillin(BLNAR).Beta-lactamase-producing strains showed significantly higher resistance rates to these antimicrobial agents than the β-lactamase-nonproducing strains.Of the 16 191 M.catarrhalis strains,80.06％were isolated from children and 19.94％isolated from adults.M.catarrhalis strains were mostly susceptible to both amoxicillin-clavulanic acid and cefuroxime,evidenced by resistance rate lower than 2.0％.Conclusions The emergence of antibiotic-resistant H.influenzae due to β-lactamase production poses a challenge for clinical anti-infective treatment.Therefore,it is very important to implement antibiotic resistance surveillance for H.influenzae and guide rational antibiotic use.All local clinical microbiology laboratories should actively improve antibiotic susceptibility testing and strengthen antibiotic resistance surveillance for H.influenzae.

OBJECTIVE: To investigate the effectiveness of endoscopic-assisted median nerve decompression with one-stage extensor indicis proprius (EIP) tendon transfer for reconstruction of thumb abduction in patients with severe carpal tunnel syndrome (CTS). METHODS: The clinical data of 12 patients with severe CTS who met the selection criteria between December 2019 and December 2024 were retrospectively analyzed. There were 2 males and 10 females with an average age of 55.4 years ranging from 35 to 67 years. The symptom duration of CTS was 12-120 months (mean, 48.7 months) and the thenar muscle atrophy duration was 6-48 months (mean, 13.4 months). The median nerve was released with the help of endoscope, and the EIP tendon was transferred to reconstruct the abduction function of the thumb. The operation time and complications were recorded. Two-point discrimination, palmar abduction angle of the thumb, radial abduction angle of the thumb, and pinch force of the thumb were measured and compared before operation and at last follow-up, and the effectiveness was evaluated by Kapandji score and Disabilities of the Arm, Shoulder and Hand (DASH) score. The satisfaction of the operation was evaluated at last follow-up. RESULTS: All surgeries were successfully completed with a mean operation time of 54 minutes (range, 45-68 minutes). All patients were followed up 6-50 months, with an average of 15.3 months. There was no complications such as wound infection, scar pain of wrist, or tendon rupture of transposition, and there were 3 cases of mild limitation of finger extension in the donor site of index finger. At last follow-up, two-point discrimination, palmar abduction angle of the thumb, radial abduction angle of the thumb, Kapandji score, and DASH score were significantly better than those before operation ( P<0.05), but there was no significant difference in thumb pinch force between pre- and post-operation ( P>0.05). The evaluation of surgical satisfaction showed that 7 cases were very satisfied and 5 cases were satisfied. CONCLUSION The combination of endoscopic-assisted median nerve decompression and one-stage EIP tendon transfer effectively improves hand function and quality of life in patients with severe CTS by restoring thumb abduction and alleviating neurological symptoms.
Humans ; Tendon Transfer/methods* ; Male ; Middle Aged ; Carpal Tunnel Syndrome/physiopathology* ; Female ; Decompression, Surgical/methods* ; Aged ; Adult ; Thumb/physiopathology* ; Endoscopy/methods* ; Retrospective Studies ; Median Nerve/surgery* ; Treatment Outcome ; Plastic Surgery Procedures/methods*

AIM: To screen the predictors of disease progression risk in patients with diabetic macular edema(DME), establish a joint prediction model and analyze its predictive efficiency.METHODS:A retrospective selection was made of 240 patients with DME who were treated in our hospital from July 2021 to October 2024 as the research subjects. The patients were divided into a low-risk group(n=102)and a high-risk group(n=138)based on the central macular thickness(CMT)and whether the fovea was accumulated. The basic information of the patients and relevant examination data such as glycolipid metabolism indicators and liver and kidney function indicators were collected. The indicators with differences in the univariate analysis(P<0.05)were included in the multivariate analysis to screen out the independent influencing factors of disease progression in DME patients and construct a predictive model. The fitting effect of the prediction model was evaluated by the area under the receiver operating characteristic curve, and the prediction model was verified by sensitivity, specificity and Youden index.RESULTS: The general data of the two groups of patients are comparable, and there was no statistically significant difference in blood pressure between the two groups of patients(both P>0.05). Univariate analysis showed that the glycated hemoglobin(HbA1c), fasting blood glucose(FBG), advanced glycation end products(AGEs), total cholesterol(TC), low-density lipoprotein cholesterol(LDL-C), triglycerides(TG), serum creatinine(Scr), uric acid(UA), and cystatin C(Cys-C)at 3 and 6 mo in the high-risk group at baseline, 3 and 6 mo were higher than those in the low-risk group(all P<0.01). The baseline, 3 and 6 mo estimated glomerular filtration rate(eGFR), total bilirubin(TBIL), and 3 and 6 mo high-density lipoprotein cholesterol(HDL-C)in the high-risk group were all lower than those in the low-risk group(P<0.05). Regression analysis showed that baseline HbA1c, 3 mo FBG, 3 mo AGEs, baseline LDL-C, 3 mo TG, 3 mo eGFR, baseline TBIL, and 6 mo TBIL were risk factors for disease progression in DME patients. The area under curve(AUC)of the combined prediction model was 0.909(95%CI: 0.872-0.945), with a sensitivity of 79.00% and a specificity of 94.10%.CONCLUSION: HbA1c, FBG, AGEs, LDL-C, TG, eGFR and TBIL are risk factors for the risk of disease progression in patients with DME. The combined prediction model can provide a reference for predicting the risk of disease progression in patients with DME.