Background Public places are important areas for daily human activities. Frequent contact with public items promotes their role as vehicles for microbial spread, creating a substantial risk for the transmission of pathogenic microorganisms. Objective To understand the hygiene status and influencing factors of public items in typical public places in Shanghai from 2010 to 2024, and to provide a scientific basis for optimizing the hygiene management of public items. Methods Based on the monitoring data of public items in public places in Shanghai from 2010 to 2024, the hygiene status was evaluated in three stages: 2010–2019, 2020–2022, and 2023–2024. Chi-square test and logistic regression were used to analyze the impact of factors such as monitoring stages, public place types, and public item categories on the hygiene status. Results The public items in 13807 public places were monitored. A total of 1 022 bed sheets and 9 271 towels were tested for pH value, with qualified rates of 77.66% and 87.81%, respectively. The OR (95%CI) for the pH compliance of towels relative to bed sheets was 1.77 (1.45, 2.15). Compared with bathing places, the ORs for pH compliance of towels in hair salons and beauty salons were 2.24 (1.75, 2.87) and 2.15 (1.57, 2.95), respectively. Additionally, a total of 221 650 samples from various public items were tested for microorganisms, yielding 215554 qualified samples, with an average qualified rate of 97.25%. The qualified rates for total bacterial count, total fungal count, coliforms, and Staphylococcus aureus were 92.66%, 94.63%, 98.85%, and 99.84%, respectively. The logistic regression analysis showed that, compared to the 2016–2019 baseline, no statistically significant differences were observed in the qualified rates of total fungal count across different stages; however, significantly higher qualified rates for total bacterial count, total fungal count, coliforms, and Staphylococcus aureus were recorded during 2020–2022, with ORs (95%CI) of 1.27 (1.16, 1.38), 23.20 (8.42, 63.94), and 12.08 (1.63, 89.92), respectively. Conclusion The pH compliance ranks among the top tier nationwide for cotton textile goods in Shanghai, suggesting minimal detergent retention. Furthermore, continuous improvement in cleaning and disinfection measurements has markedly enhanced the microbial hygiene of public items in public places.

Background As common public facilities essential to daily life, hair and beauty salons frequently contain various airborne toxic and hazardous pollutants potentially leading to adverse health effects for salon practitioners. Objective To characterize the indoor air pollution profiles of common contaminants in hair and beauty salons in Shanghai and to evaluate the associated health risks for practitioners, in order to provide a scientific basis for strengthening the public health management in Shanghai and protecting the health of practitioners. Methods The air quality monitoring data of hair and beauty salons in Shanghai from 2016 to 2024 were obtained from the “Health Hazard Factors Monitoring Program for Public Places” of the National Institute of Environmental Health, Chinese Center for Disease Control and Prevention. Monitoring indicators included particulate matter ≤10 μm in aerodynamic diameter (PM₁₀), particulate matter ≤2.5 μm in aerodynamic diameter (PM_2.5), formaldehyde, ammonia, benzene, toluene, and xylene. Indicator compliance rates were calculated across various years in accordance with GB 9666-1996 Hygienic standard for barber shop and beauty shop and GB 37488-2019 Hygiene indicators and limit for public places; specifically, PM_2.5 was assessed against the limits stipulated in GB/T 18883-2022 Standards for indoor air quality. A questionnaire survey was conducted among salon practitioners to collect weekly working days and daily working hours. The non-carcinogenic risks associated with inhalation exposure to formaldehyde, ammonia, benzene, toluene, and xylene as well as the carcinogenic risks posed by formaldehyde and benzene were evaluated following WS/T 777-2021 Technical guide for environmental health risk assessment of chemical exposure and the U.S. Environmental Protection Agency inhalation risk model. Results The overall compliance rates of PM₁₀, formaldehyde, ammonia, benzene, and toluene in the air of hair and beauty salons in Shanghai from 2016 to 2024 were 92.13%, 96.59%, 96.15%, 94.93%, and 94.97%, respectively; the overall compliance rate of xylene was a little lower (85.92%), and the overall compliance rate of PM_2.5 was 57.18%. The P₅₀ concentrations of PM₁₀, PM_2.5, formaldehyde, ammonia, benzene, toluene, and xylene did not exceed the corresponding limits. The P₅₀ of non-carcinogenic risk indicator (hazard quotient, HQ) for formaldehyde, ammonia, benzene, toluene, and xylene were <1. The probabilities of non-carcinogenic risk HQ >1 for formaldehyde and xylene were 41.4% and 10.9%, respectively, which were higher than that of other pollutants. The P₅₀ of carcinogenic risk (CR) for formaldehyde and benzene were between 1.0×10⁻⁶ and 1.0×10⁻⁴, while the probabilities of CR >1.0×10⁻⁴ were 16.9% and 14.0%, respectively. Conclusion The overall compliance rate of common pollutant concentrations in the air of hair and beauty salons in Shanghai is high, and the hygienic condition meets the requirements of national standards. The non-carcinogenic health risks posed by formaldehyde and xylene to employees (with formaldehyde being more prominent), as well as the carcinogenic risks associated with formaldehyde and benzene, deserve heightened attention in future health supervision.

OBJECTIVE To offer a reference for the treatment of Mycobacterium iranicum infection by analyzing the diagnosis and management of a single case alongside literature-reported cases. METHODS Through case report and literature reviews， this study synthesized the clinical features， therapeutic regimens， and patient outcomes of those infected with M. iranicum. RESULTS In the single case documented in this report， subsequent to clinical pharmacists’ involvement in the consultation， the patient was prescribed a therapeutic regimen comprising levofloxacin （0.5 g， qd， ivgtt）+Clarithromycin sustained-release tablets （1 000 mg， qd， po） + Ethambutol tablets （0.75 g， qd， po）. The patient exhibited clinical improvement and was discharged after treatment. This article integrated 12 published studies， encompassing 13 patients （7 male and 6 female）， of whom 69.23% were aged ≥50 years. Patients infected with M. iranicum exhibited non-specific clinical manifestations and imaging features， with pulmonary infection as the primary presentation. Antimicrobial susceptibility test revealed that M. iranicum was susceptible to multiple agents， including amikacin， clarithromycin， linezolid， and ethambutol. The three-drug combination therapy was the most frequently employed regimen. In terms of clinical outcomes， there were 9 cases （69.23%） of clinical cure， 3 cases （23.08%） of bacteriological negativity conversion， and 1 case （7.69%） of treatment failure. CONCLUSIONS For M. iranicum infection， a triple-drug therapeutic regimen consisting of three agents with distinct mechanisms of action selected from amikacin， clarithromycin， moxifloxacin， levofloxacin， minocycline， ethambutol， and other relevant drugs may represent a relatively optimal strategy.

Background Swimming is becoming increasingly popular for its combined leisure and fitness benefits. However, polluted swimming pool water may pose various health risks. Previous studies have indicated that health indicators of swimming venues have lower qualification rates compared to other public places, highlighting the urgent need to optimize hygiene management measures. Objective To assess the overall hygiene status and identify the key factors influencing water quality in Shanghai’s swimming venues from 2010 to 2024, and to provide a scientific basis for optimizing water quality management. Methods Water quality was assessed in three stages (2010—2019, 2020—2022, and 2023—2024) based on the monitoring data of Shanghai’s swimming venues (2010—2024). The influences of monitoring stage, region, season, scale, day of week, and per capita attendance on water quality were analyzed using chi-square tests and logistic regression. Results From 2010 to 2024, water quality was monitored in 1478 swimming venues. The compliance rates of turbidity, pH, urea, oxidation-reduction potential, free residual chlorine, combined residual chlorine, total bacteria, coliforms, and heat-resistant coliforms in swimming pool water, and free residual chlorine in the foot disinfection basin water samples were 99.56%, 94.73%, 73.00%, 47.50%, 56.55%, 54.12%, 97.74%, 99.49%, 99.90%, and 69.19%, respectively. The overall water quality compliance rate was 85.28%. The main non-compliant indicators for swimming pool water were urea, ORP, free residual chlorine, and combined residual chlorine, along with free chlorine residual in the foot disinfection basin water samples. Using the period before the implementation of the new national standard as reference, the results of logistic regression revealed that the qualification rates of urea, ORP, and free residual chlorine in the swimming pool water samples, as well as free residual chlorine in foot disinfection basin water samples, were significantly higher during the two phases after launching the new standard (2020–2022 and 2023–2024), and the associated odds ratios (95%CI) were 1.28 (1.00, 1.64) and 1.48 (1.12, 1.95), 13.35 (7.63, 23.37) and 10.78 (7.00, 16.60), 2.54 (1.81, 3.58) and 3.18 (2.41, 4.20), and 3.14 (2.14, 4.60) and 2.83 (1.89, 4.23), respectively. Compared with the reference group, those sampled in urban pools and in non-summer seasons showed higher qualification rates of urea and ORP; in contrast, the pools with high visitor flow showed lower qualification rates of free residual chlorine in both water samples of swimming pools and foot disinfection basins (P<0.05). Conclusion The implementation of the new national standard has effectively enhanced the management standards and significantly improved overall water quality of swimming venues in Shanghai. However, the compliance rates of free residual chlorine and urea in swimming pool water still need further improvement. The compliance of some indicators is influenced by region, season, scale, and average passenger flow, particularly in small suburban swimming venues. Future efforts should focus on refining water quality management strategies and enhancing public health management.

Background The substantial health damage attributed to heat waves, along with their increasing intensity and frequency in the context of global warming, highlights the importance of exploring the health effects of heat waves. Objective To calculate the excess heat stroke cases during heat waves in the summer of 2013—2023 in Shanghai, analyze the association between heat waves and heat stroke, and to further explore the modifying effects of heat wave characteristics on heat stroke. Methods Using a retrospective ecological study design, data on heat stroke cases were collected from the heat stroke case reporting system of the Chinese Center for Disease Control and Prevention, and concurrent meteorological data from Xujiahui Meteorological Station. A heat wave was defined as at least 3 consecutive days with daily maximum temperature meeting or exceeding 35 ℃ in this study, excess heat stroke cases related to heat waves were assessed as the difference between the numbers of heat stroke cases observed on a given day and the corresponding 31 d (15 d before and after that day) moving average, and statistical analyses using generalized linear model based on time series study were performed to assess the impact of heat waves on heat stroke. Results Overall 25 heat waves during the study period were observed, leading to a total of estimated 792.6 extra heat stroke cases. The risk of heat stroke significantly increased during heat waves (RR=2.60, 95%CI: 2.08, 3.26), but no statistically significant differences in heat wave effects were observed among different genders, ages, or regions. In terms of the timing of heat waves, the risk of heat stroke was highest during the first heat wave (RR=3.58, 95%CI: 2.82, 4.55), which was significantly higher than that during the second heat wave (RR=2.19, 95%CI: 1.66, 2.90), and no significant effect was observed during the third or subsequent heat waves. The impact of heat waves on heat stroke persisted for more than 4 d, with the risk higher on the fourth day and beyond (RR=2.95, 95%CI: 2.28, 3.83), significantly higher than on the first day of heat wave (RR=1.74, 95%CI: 1.18, 2.56). Conclusion Heat waves had a substantial effect on heat stroke in Shanghai from 2013 to 2023, and special attention need to be paid to heat waves with early onset and long duration.

Although somatic cells can be reprogrammed to pluripotent stem cells (PSCs) with pure chemicals, authentic pluripotency of chemically induced pluripotent stem cells (CiPSCs) has never been achieved through tetraploid complementation assay. Spontaneous reprogramming of spermatogonial stem cells (SSCs) was another non-transgenic way to obtain PSCs, but this process lacks mechanistic explanation. Here, we reconstructed the trajectory of mouse SSC reprogramming and developed a five-chemical combination, boosting the reprogramming efficiency by nearly 80- to 100-folds. More importantly, chemical induced germline-derived PSCs (5C-gPSCs), but not gPSCs and chemical induced pluripotent stem cells, had authentic pluripotency, as determined by tetraploid complementation. Mechanistically, SSCs traversed through an inverted pathway of in vivo germ cell development, exhibiting the expression signatures and DNA methylation dynamics from spermatogonia to primordial germ cells and further to epiblasts. Besides, SSC-specific imprinting control regions switched from biallelic methylated states to monoallelic methylated states by imprinting demethylation and then re-methylation on one of the two alleles in 5C-gPSCs, which was apparently distinct with the imprinting reprogramming in vivo as DNA methylation simultaneously occurred on both alleles. Our work sheds light on the unique regulatory network underpinning SSC reprogramming, providing insights to understand generic mechanisms for cell-fate decision and epigenetic-related disorders in regenerative medicine.
Male ; Mice ; Animals ; Cellular Reprogramming/genetics* ; Tetraploidy ; Pluripotent Stem Cells/metabolism* ; Induced Pluripotent Stem Cells/metabolism* ; DNA Methylation ; Spermatogonia/metabolism* ; Germ Cells/metabolism*

Objective:To investigate the clinical effect of Flow-through perforator flap of posterior interosseous artery in repair of dorsal digital soft tissue defect with disorder of blood supply in digital tip.Methods:From January 2018 to June 2020, 12 patients who had digital dorsum soft tissue defect with digital tip blood supply disorder were treated with Flow-through perforator flap of posterior interosseous artery. The size of flaps was 2.0 cm× 2.0 cm-5.5 cm×3.0 cm. The posterior interosseous artery in the flap was bridged with the proper palmar artery of digit, 1 subcutaneous vein in the flap was anastomosed with the dorsal subcutaneous vein, and 1 subcutaneous vein in the posterior interosseous artery with the palmar subcutaneous vein. The donor sites were sutured directly. The wound healing, blood supply of digit and flap survival were observed after operation. The quality of flap survival and digital joint function were observed in the follow-up reviews at outpatient clinic.Results:All the 12 Flow-through perforator flaps of posterior interosseous artery survived, the blood supply of digit was good, and the wounds healed in the first stage. The follow-up period was 6-24 months. The appearance and texture of the flaps were good without obvious bloating. Only linear scar was left in the forearm donor site. According to the Trial Standard of Upper Limb Function Evaluation of Chinese Society of Hand Surgery, the results were excellent in 11 cases and good in 1 case.Conclusion:The perforator flap of posterior interosseous artery has constant anatomy, and the diameter of blood vessel matches the blood vessels of digits. It is suitable for Flow-through technique. It has less subcutaneous tissue, no secondary thinning, and the donor site can be closed directly. It is a good method to repair the dorsal soft tissue defect with disorder of digital end blood circulation.

Background Non-occupational carbon monoxide (CO) poisoning is a public health problem that seriously affect people’s health and lives. Objective To describe the prevalence of non-occupational CO poisoning during 2007—2018 in Shanghai, analyze its epidemiological characteristics and potential influencing factors, and explore effective prevention and control measures. Methods Daily reported non-occupational CO poisoning cases and meteorological factors from 2007 to 2018 were collected in Shanghai, epidemiological characteristics were analyzed by descriptive epidemiology methods, and a distributed lag nonlinear model was used to assess the association between temperature and non-occupational CO poisoning. Results A total of 2264 non-occupational CO poisoning events and 3866 cases from 2007 to 2018 were reported in Shanghai, including 59 death cases. More than half of the poisoning cases were female (56.3%), and young adults accounted for more cases than any other age group (54.8%). The poisoning events mainly occurred in winter (from December to next February); however, cases reported in summer increased in recent years. The peak period of the events was from 20:00 to 24:00. Households (85.2%) and restaurants (8.0%) were the common places of non-occupational CO poisoning events, and the main cause was improper use of gas water heater (36.9%). A nonlinear curve was found between daily average temperature of current day and the occurrence of non-occupational CO poisoning. Temperature was negatively associated with the risk of non-occupational CO poisoning when the temperature was lower than 9.6 ℃, while a positive association was found during 9.7-26.0 ℃. Conclusion Winter is a high season for non-occupational CO poisoning in Shanghai, rising cases reported in summer is also worthy of attention. Supervision should be strengthened to ban sales of unqualified gas water heaters, and health education on CO poisoning prevention and control should be conducted through multiple channels, in order to reduce the incidence of CO poisoning.

Objective:To explore the clinical effect and nursing experience of papaverine intramuscular injection after finger replantation with self-designed hip intramuscular injection positioning device.Methods:Totally 216 cases of patients treated with palavering for anti-vasospasm after of severed fingers from January 2018 to December 2019 were randomly divided into control group (108 cases) and observation group (108 cases) by random number table method. The control group received intramuscular injection of buttock muscle according to the conventional method, and the observation group used the auxiliary intramuscular injection with self-designed glutei muscle positioning device. The incidence of postoperative hip indurations and ecchymosed, survival rate of and buttock were analyzed Pain scores were compared.Results:Totally 76 cases (70.37%) and 62 cases (48.15%) in the control group, 12 cases (11.11%) and 6 cases (5.56%) in the observation group. The difference between the two groups was statistically significant ( χ2 values were 78.545, 67.307, P<0.01). 78 cases (72.22%) survived in the control group and 96 cases (88.89%) survived in the observation group ( χ2 value was 11.416, P<0.01). After papaverine intramuscular injection, there was no significant difference in hip pain score between the two groups on the first and second day ( P>0.05), but there was significant difference between the two groups on the third to seventh day ( t values were 17.17 to 45.97, P<0.05). Conclusion:Palavering intramuscular injection can reduce the incidence of hip indurations and ecchymosed, relieve buttock pain and improve the survival rate of amputated finger, which is worthy of clinical application.

To enhance primary and secondary stroke prevention, the Stroke Prevention and Control Project committee of the National Health Commission launched since October 2017 a nationwide training program for cerebrocardiac health advisors in the country. The authors introduced the standardized training system for such advisors, and the health management plan for stroke patients, in an effort to provide full-course health management scheme for stroke patients, and explore a stroke management model led by cerebrocardiac health advisors. Such efforts were designed to promote effective implementation of integrated prevention and control strategies for stroke, and provide a reference for the clinical practice of cerebrocardiac health advisors in a comprehensive and in-depth manner.