Objective To investigate and compare the epidemiological characteristics of common respiratory viruses among influenza-like illness(ILI)and severe acute respiratory infection(SARI)cases in Huzhou,Zhejiang Province before and after the COVID-19 pandemic,so as to provide a basis for formulating and adjusting the prevention and control strategies for viral respiratory infectious diseases.Methods ILI and SARI cases at two influenza surveillance sentinel hospitals in Huzhou and had throat swab samples collected during Nov 2017 to Feb 2020(pre-COVID-19 pandemic period)and Dec 2022 to Apr 2024(post-COVID-19 mitigation phase)were selected as the participants.Seven common viral respiratory pathogens were tested,including influenza A virus(H1N1 and H3N2 subtypes),influenza B virus(Victoria lineage,FluB),respiratory syncytial virus(RSV),rhinovirus(HRV),adenovirus(ADV),and severe acute respiratory syndrome coronavirus-2(SARS-CoV-2).The positive rates of respiratory pathogens before and after the COVID-19 pandemic were compared across different age groups and different time.Results A total of 7 948 ILI samples and 2 294 SARI samples were included.The overall positive rate of ILI samples increased from 33.6%to 47.1%,primarily due to the increase in influenza and COVID-19 infections;the overall positive rate of SARI samples decreased from 31.4%to 24.8%,mainly due to the reduction in HRV and ADV infections.During the post-COVID-19 mitigation phase,SARS-CoV-2(22.1%),H3N2(12.7%),and FluB(6.0%)were the primary pathogens in ILI samples,while RSV(7.1%),H3N2(5.3%),and HRV(4.5%)dominated in SARI samples.During the post-COVID-19 mitigation phase,the influenza virus circulation period was shortened.Before the COVID-19 pandemic,RSV was mainly detected in autumn and winter,while during the post-COVID-19 mitigation phase,out-of-season RSV epidemics were observed in spring and summer.Co-infection rate in ILI cases increased significantly in the post-COVID-19 mitigation phase,predominantly consisting of co-infections of COVID-19 and influenza A virus,while co-infection rate in SARI cases showed a decline.Conclusion We found important epidemiological changes in respiratory viruses in Huzhou during the post-COVID-19 mitigation phase compared to pre-COVID-19 period,including increased positive rates of influenza and COVID-19,and disruptions to the seasonal patterns of influenza and RSV.The prevention and control strategies should be adjusted in a timely manner based on the monitoring data.

Objective:To explore the value of dual-layer spectral CT virtual monoenergetic images (VMI) in contrast-enhanced abdominal CT scans with reduced contrast medium volume in pediatric tumor patients.Methods:The study is a self-matched case-control study. From January to October 2024, pediatric patients admitted to Shandong Cancer Hospital with abdominal tumors who underwent low contrast dose spectral CT contrast-enhanced scans during follow-up were prospectively included. A total of 47 patients aged (6.2±2.2) years (4-14 years) were enrolled. Usual contrast dose enhanced CT served as the conventional-dose group, while the follow-up low-dose spectral CT scans employed a protocol with half the contrast agent dose (low-dose group). Images were reconstructed as conventional CT images and VMI at 45, 55, and 65 keV. Using muscle as the reference background, differences in CT values and contrast-to-noise ratio (CNR) in the aorta, kidneys, liver, and spleen were compared between the low-dose group and conventional-dose group. Multi-group comparisons were performed using the Friedman test. Post-hoc pairwise comparisons were conducted with Bonferroni correction for P-values. Results:CT values and CNRs for all measured regions progressively increased with decreasing keV levels in spectral CT VMI. Significant overall differences were found in CT values and CNRs for the aorta, kidneys, liver, and spleen among the low-dose group (all VMIs) and the conventional-dose group (all P<0.001). At 65 keV VMI in the low-dose group, both CT values and CNRs (except for the liver CNR) were significantly lower than those in the conventional-dose group (all adjusted P<0.05). At 55 keV VMI in the low-dose group, CT values and CNRs for all regions did not show statistically significant differences compared to the conventional-dose group (all adjusted P>0.05). At 45 keV VMI in the low-dose group, CT values for all structures and CNR for the spleen were significantly higher than those in the conventional-dose group (all adjusted P<0.05). However, no statistically significant difference was found in CNRs for the aorta, kidneys, and liver (adjusted P=1.000, 0.313, and 0.503, respectively). Conclusion:When the contrast dose is halved, spectral CT 45 keV VMI enhances CT attenuation values and CNR in the abdomen of pediatric tumor patients, while 55 keV VMI provides image quality comparable to that of conventional-dose CT.

Objective To investigate the effects of varying pulse intervals in the programmed intermittent epidural bolus(PIEB)mode on labor analgesia in primiparous and multiparous women,and to evaluate the differ-ences in analgesic outcomes between these two groups.Methods A total of 60 primiparous and 60 multiparous women who met the inclusion criteria were recruited and randomly allocated into two groups:a 45-minute pulse interval group(P45 group,n=30)and a 60-minute pulse interval group(P60 group,n=30).Epidural labor anal-gesia was initiated when cervical dilation reached 1～3 cm.The programmed intermittent epidural bolus(PIEB)mode was started 45 minutes after analgesia commencement in the P45 group and 60 minutes after analgesia com-mencement in the P60 group.Each pulse delivered 10 ml of a solution containing 0.08%ropivacaine and 0.5 μg/ml sufentanil.Pain scores were assessed using the Visual Analog Scale(VAS)at five specific time points:baseline(t0),1 hour post-analgesia initiation(t1),2 hours post-analgesia initiation(t2),full cervical dilation(t3),and delivery(t4).Secondary outcomes included Bromage scores,the number of patient-controlled analgesia(PCA)button presses,total drug consumption,and adverse reactions.Results In primiparous women,the VAS score at t1 was significantly lower in the P45 group compared to the P60 group(P<0.05),whereas no significant differences were observed in VAS scores between the two groups at t2—t4.The median PCA press count was also significantly lower in the P45 group than in the P60 group(P<0.05).However,there were no significant differences between the groups in terms of total drug consumption,Bromage scores,or the incidence of adverse events(P>0.05).In multiparous women,no significant differences were found in VAS scores,Bromage scores,or PCA press counts between the P45 and P60 groups at any time point(P>0.05).Conversely,total drug consumption was significantly higher in the P45 group compared to the P60 group(P<0.05).Conclusions For primiparous women,a 45-minute pulse interval in the PIEB mode not only provides superior labor analgesia but also significantly reduces the frequency of PCA presses without escalating the risk or severity of motor block or adverse events.For multiparous women,the pulse interval does not substantially influence the effectiveness of labor analgesia.These findings contribute valuable new evidence for refining clinical labor analgesia protocols.

Objective:This study aims to analyze the trends,hotspots,and interrelations in research on retroperito-neal tumors through bibliometric methods,providing the latest scientific information support for clinicians and research-ers.Methods:Data were sourced from the SCI-expanded database of the Web of Science Core Collection,covering the period from 2004 to 2023.Statistical analysis and visualization of the number of publications,total citations,average citations per article,countries,institutions,journals,and keywords were conducted using Microsoft Excel 2019,VOS-viewer,and CiteSpace.Results:A total of 6,842 relevant articles were retrieved,with a total of 113 753 citations and an average of 16.63 citations per article.The number of publications had been increasing annually,peaking in 2022.The United States,China,and Japan are the major research countries,with the United States contributing the most.Memo-rial Sloan Kettering Cancer Center and the University of Texas MD Anderson Cancer Center are the leading research in-stitutions.The journal with the most publications was the Cureus Journal of Medical Science.Gronchi Alessandro was the most prolific author.The ain keywords were"Management","Surgery",and"Tumor",and the most cited papers focus on surgery and multicenter studies.Conclusion:Research on retroperitoneal tumors is increasing annually,with hot-spots focusing on treatment methods and prognosis analysis.The United States is the main contributor to this field,with significant international collaboration.Future research should further explore the pathogenesis of retroperitoneal tumors and more effective treatment strategies.

Objective:This study aims to analyze the trends,hotspots,and interrelations in research on retroperito-neal tumors through bibliometric methods,providing the latest scientific information support for clinicians and research-ers.Methods:Data were sourced from the SCI-expanded database of the Web of Science Core Collection,covering the period from 2004 to 2023.Statistical analysis and visualization of the number of publications,total citations,average citations per article,countries,institutions,journals,and keywords were conducted using Microsoft Excel 2019,VOS-viewer,and CiteSpace.Results:A total of 6,842 relevant articles were retrieved,with a total of 113 753 citations and an average of 16.63 citations per article.The number of publications had been increasing annually,peaking in 2022.The United States,China,and Japan are the major research countries,with the United States contributing the most.Memo-rial Sloan Kettering Cancer Center and the University of Texas MD Anderson Cancer Center are the leading research in-stitutions.The journal with the most publications was the Cureus Journal of Medical Science.Gronchi Alessandro was the most prolific author.The ain keywords were"Management","Surgery",and"Tumor",and the most cited papers focus on surgery and multicenter studies.Conclusion:Research on retroperitoneal tumors is increasing annually,with hot-spots focusing on treatment methods and prognosis analysis.The United States is the main contributor to this field,with significant international collaboration.Future research should further explore the pathogenesis of retroperitoneal tumors and more effective treatment strategies.

Aim To investigate the role of mesence-phalic astrocyte-derived neurotrophic factor(MANF)in the inhibitory effect of rhynchophylline(Rhy)on the malignant biological behaviors of gastric cancer cells and its underlying regulatory mechanisms.Meth-ods SGC-7901 gastric cancer cells were transfected using adenovirus and liposome transfection techniques.The experimental groups included:Control group,Rhy group,Rhy+NC group(Rhy+adenovirus-transfected MANF-irrelevant fragment),Rhy+si-MANF group(Rhy+adenovirus-transfected MANF siRNA),Vec-tor group(empty vector),OVE-MANF group(recom-binant plasmid overexpressing MANF).After 24 hours of intervention,cell proliferation,apoptosis,migra-tion,and invasion were assessed using the MTT assay,Hoechst staining,and Transwell assays,respectively.The expressions of MANF,Cyclin D1,and cleaved caspase-3 proteins were measured using Western blot.NF-κB transcriptional activity was evaluated via a lucif-erase reporter assay.Results Compared to the control group,Rhy treatment significantly inhibited gastric cancer cell growth in a dose-dependent manner(P＜0.05),induced typical apoptotic morphological chan-ges,and increased the expression of MANF and cleaved caspase-3 proteins(P＜0.05),while reduc-ing Cyclin D1 protein expression and NF-κB transcrip-tional activity(P＜0.05).Additionally,Rhy treat-ment markedly decreased cell migration and invasion capabilities(P＜0.05).In comparison to the Rhy group,adenovirus-mediated transfection of MANF siR-NA suppressed apoptosis,promoted gastric cancer cell proliferation,migration,and invasion,inhibited MANF and cleaved caspase-3 expression(P＜0.05),and enhanced Cyclin D1 protein levels and NF-κB transcriptional activity(P＜0.05).Compared to the Vector group,OVE-MANF(overexpression of MANF)induced apoptosis,suppressed proliferation,invasion,and metastasis of gastric cancer cells,upregulated MANF and cleaved caspase-3 expression(P＜0.05),and inhibited Cyclin D1 protein levels and NF-κB tran-scriptional activity(P＜0.05).Conclusion Rhy in-hibits the proliferation,migration,and invasion of gas-tric cancer cells and induces apoptosis,with its mecha-nism linked to the promotion of MANF expression and suppression of NF-κB transcriptional activity.

Objective:To explore the therapeutic effect of Bupiqiangli compound on experimental myasthenia gravis with sub-clinical hypothyroidism in rats and the influence of hypothalamus-pituitary-thyroid-thymus(HPTT)axis.Methods:SPF Lewis rats were randomly divided into normal group,model group,Bupiqiangli compound low-dose,medium-dose and high-dose groups.Model rats were immunized with AchR-α subunit 97-116 peptide sequence to construct an experimental myasthenia gravis model,and then methimazole was used to prepare an experimental myasthenia gravis with subclinical hypothyroidism model.Bupiqiangli compound low-dose,medium-dose and high-dose groups were given 4.57 g/kg,7.12 g/kg and 9.49 g/kg of Bupiqiangli compound by gavage,nor-mal group and model group were given an equal volume of normal saline by gavage,once a day,for 4 weeks.After the last gavage,Lennon scores of rats in each group were recorded;HE staining was used to detect pathological changes of thymus and thyroid;ELISA was used to detect expression levels of acetylcholine receptor antibody(AchRab),thyroid stimulating hormone(TSH),thyrotropin releasing hormone(TRH),free thyroxine(FT4)and thyroxine(T4)in serum;mRNA level of TRH in hypothalamus and TSH in pituitary tissue were detected by qPCR;Western blot detected changes of protein expressions of Cleaved Caspase3,Bcl2 associated X protein(Bax)and B-cell lymphoma-2(Bcl2)in thymus.Results:Compared with normal group,model group showed obvious symp-toms of muscle weakness,Lennon score increased significantly(P<0.05),obvious pathological changes in thymus and thyroid tissues,while no significant changes in expressions of FT4 and T4 in serum(P>0.05),expressions of AchRab,TSH and TRH in serum were significantly increased(P<0.05),expressions of TRH in hypothalamus and TSH in pituitary were significantly increased(P<0.05),protein expressions of Cleaved Caspase3 and Bax in thymus were significantly decreased(P<0.05),while expression of Bcl2 protein in thymus increased significantly(P<0.05).Compared with model group,myasthenia symptoms of compound high-dose group were im-proved,Lennon score was significantly decreased(P<0.05),pathological changes of thymus and thyroid tissues were improved,ex-pressions of FT4 and T4 in serum had no significant changes(P>0.05),expressions of AchRab,TSH and TRH in serum were signifi-cantly decreased(P<0.05),expressions of TRH in hypothalamus and TSH in pituitary were significantly decreased(P<0.05),expres-sions of Cleaved Caspase3 and Bax in thymus were significantly increased(P<0.05),while expression of Bcl2 in thymus was signifi-cantly decreased(P<0.05).Conclusion:Bupiqiang compound can improve clinical symptoms of experimental myasthenia gravis with subclinical hypothyroidism in rats,and its mechanism may be related to the regulation of HPTT axis.

CRY1/2,as important transcriptional regulators of the circadian clock system,play a crucial role in maintaining metabolic homeostasis in body.This article analyzes existing re-search and focuses on the regulatory mechanisms of CRY1/2 in glucose and lipid metabolism.CRY1 plays an important regula-tory role in gluconeogenesis,glycolysis and insulin secretion,maintaining blood glucose homeostasis by regulating the expres-sion of key enzymes.Additionally,CRY1/2 regulate lipid me-tabolism by modulating fat synthesis and absorption,thereby af-fecting energy balance in the body.This article also discuss the potential applications of CRY1/2 in obesity and xenobiotic de-toxification,highlighting their potential value as therapeutic tar-gets.As core factors in metabolic regulation,CRY1/2 have sig-nificant clinical application prospects,and a deeper understand-ing of their molecular mechanisms in glucose and lipid metabo-lism will provide new ideas and strategies for the treatment of chronic metabolic diseases.

CRY1/2,as important transcriptional regulators of the circadian clock system,play a crucial role in maintaining metabolic homeostasis in body.This article analyzes existing re-search and focuses on the regulatory mechanisms of CRY1/2 in glucose and lipid metabolism.CRY1 plays an important regula-tory role in gluconeogenesis,glycolysis and insulin secretion,maintaining blood glucose homeostasis by regulating the expres-sion of key enzymes.Additionally,CRY1/2 regulate lipid me-tabolism by modulating fat synthesis and absorption,thereby af-fecting energy balance in the body.This article also discuss the potential applications of CRY1/2 in obesity and xenobiotic de-toxification,highlighting their potential value as therapeutic tar-gets.As core factors in metabolic regulation,CRY1/2 have sig-nificant clinical application prospects,and a deeper understand-ing of their molecular mechanisms in glucose and lipid metabo-lism will provide new ideas and strategies for the treatment of chronic metabolic diseases.

Objective To investigate and compare the epidemiological characteristics of common respiratory viruses among influenza-like illness(ILI)and severe acute respiratory infection(SARI)cases in Huzhou,Zhejiang Province before and after the COVID-19 pandemic,so as to provide a basis for formulating and adjusting the prevention and control strategies for viral respiratory infectious diseases.Methods ILI and SARI cases at two influenza surveillance sentinel hospitals in Huzhou and had throat swab samples collected during Nov 2017 to Feb 2020(pre-COVID-19 pandemic period)and Dec 2022 to Apr 2024(post-COVID-19 mitigation phase)were selected as the participants.Seven common viral respiratory pathogens were tested,including influenza A virus(H1N1 and H3N2 subtypes),influenza B virus(Victoria lineage,FluB),respiratory syncytial virus(RSV),rhinovirus(HRV),adenovirus(ADV),and severe acute respiratory syndrome coronavirus-2(SARS-CoV-2).The positive rates of respiratory pathogens before and after the COVID-19 pandemic were compared across different age groups and different time.Results A total of 7 948 ILI samples and 2 294 SARI samples were included.The overall positive rate of ILI samples increased from 33.6%to 47.1%,primarily due to the increase in influenza and COVID-19 infections;the overall positive rate of SARI samples decreased from 31.4%to 24.8%,mainly due to the reduction in HRV and ADV infections.During the post-COVID-19 mitigation phase,SARS-CoV-2(22.1%),H3N2(12.7%),and FluB(6.0%)were the primary pathogens in ILI samples,while RSV(7.1%),H3N2(5.3%),and HRV(4.5%)dominated in SARI samples.During the post-COVID-19 mitigation phase,the influenza virus circulation period was shortened.Before the COVID-19 pandemic,RSV was mainly detected in autumn and winter,while during the post-COVID-19 mitigation phase,out-of-season RSV epidemics were observed in spring and summer.Co-infection rate in ILI cases increased significantly in the post-COVID-19 mitigation phase,predominantly consisting of co-infections of COVID-19 and influenza A virus,while co-infection rate in SARI cases showed a decline.Conclusion We found important epidemiological changes in respiratory viruses in Huzhou during the post-COVID-19 mitigation phase compared to pre-COVID-19 period,including increased positive rates of influenza and COVID-19,and disruptions to the seasonal patterns of influenza and RSV.The prevention and control strategies should be adjusted in a timely manner based on the monitoring data.