Objective: To explore the intra class transmission pattern of acute hemorrhagic conjunctivitis (AHC) among students, so as to provide a basis for formulating precise prevention and control strategies. Methods: The data of AHC students in 2023 was obtained from the teacher-student health information module of the "Xiamen i-Education" platform. Taking the onset date from January 1st to December 31st, 2023 as the search criteria, the epidemiological data of confirmed AHC cases among students in the whole city in 2023 was collected. And the Knox test method was employed to quantify cluster risk at the class level. Subgroup comparisons were conducted to examine differences in cluster risk between academic stages and gender combinations. Cross analysis was performed to investigate the interactive effects of two characteristics on cluster risk. Results: In 2023, 708 cases of AHC students were reported in Xiamen, among which 54 class clustered outbreaks were identified. These outbreaks accounted for 40.54% of total cases. Among them, the incidence of class clustered outbreaks with male first onset cases was higher than that with female first onset cases ( χ 2=4.55, P <0.05). The class cluster risk was at a relatively high level within the incubation period (0-2 d) after AHC onset ( RR =4.61-6.43, P <0.05). Subgroup analysis revealed that female-female case pairs had a higher class cluster risk ( RR = 4.81- 10.29) compared to other gender combinations ( P <0.05). Primary school case pairs showed a higher risk ( RR =4.60-6.77) than middle school case pairs ( RR =3.85-4.57) (both P <0.05). Cross analysis indicated that primary school and female-female combinations had a higher risk ( RR =4.70-11.24) than other combinations, while middle school and male-female combinations showed a positive interaction ( RR =3.68-6.68)(both P <0.05). Conclusions AHC infection among students is primarily transmitted within classes. Gender and educational stage are key demographic factors influencing class cluster transmission risks. Transmission risks should be assessed by analyzing population characteristics and contact patterns, and targeted interventions should be implemented.

The universal salt iodization project is considered a successful example in the global public health field. In the past 30 years, most countries have implemented mandatory salt iodization policies, effectively improving the iodine nutrition status of the population and preventing the occurrence and development of iodine deficiency disorders. However, with the rising incidence of thyroid diseases in recent years, especially thyroid carcinoma (TC), the question whether excessive iodine supplementation will lead to an increase in the incidence rate of TC has aroused concern. There are significant differences in iodine nutrition levels among countries in the Asia-Pacific, and the iodine fortification policies adopted are also different. Therefore, this article will review the iodine fortification policies, iodine nutrition status, and recent incidence and mortality of TC in some countries in the Asia-Pacific, aiming to study the relationship between iodine fortification policies, iodine nutrition status, and TC incidence.

Background/Aims: Ubiquitination is widely involved in the progression of hepatocellular carcinoma (HCC) by regulating various cellular processes. However, systematic strategies for screening core ubiquitin-related genes, clarifying their functions and mechanisms, and ultimately developing potential therapeutics for patients with HCC are still lacking. Methods: Cox and LASSO regression analyses were performed to construct a ubiquitin-related gene prediction model for HCC. Loss- and gain-of-function studies, transcriptomic and metabolomics analysis were used to explore the function and mechanism of UBE2S on HCC cell glycolysis and growth. Results: Based on 1,423 ubiquitin-related genes, a four-gene signature was successfully constructed to evaluate the prognosis of patients with HCC. UBE2S was identified in this signature with the potential to predict the survival of patients with HCC. E2F2 transcriptionally upregulated UBE2S expression by directly binding to its promoter. UBE2S positively regulated glycolysis in a HIF-1α-dependent manner, thus promoting the proliferation of HCC cells. Mechanistically, UBE2S enhanced K11-linkage polyubiquitination at lysine residues 171 and 196 of VHL independent of E3 ligase, thereby indirectly stabilizing HIF-1α protein levels by mediating the degradation of VHL by the proteasome. In particular, the combination of cephalomannine, a small molecule compound that inhibits the expression of UBE2S, and PX-478, an inhibitor of HIF-1α, significantly improved the anti-tumor efficacy. Conclusions UBE2S is identified as a key biomarker in HCC among the thousands of ubiquitin-related genes and promotes glycolysis by E3 enzyme-independent ubiquitination, thus serving as a therapeutic target for the treatment of HCC.

[Purpose]To analyze the incidence,mortality and survival of cancers in Xiamen City in 2020.[Methods]The data relating to the incidence and mortality of cancers in Xiamen was collected from the Tumor Registration Information Direct Reporting Platform of Fujian Province to calculate the crude rate,age-standardized rate by Chinese standard population(ASRC),cumula-tive rate,truncated rate and their rank.The 5-year survival rate was analyzed by Period Analysis method.[Results]In 2020,the reported incidence rate of cancers in Xiamen residents was 350.46/105.The ASRC,the cumulative rate(0～74 years old),and the truncated rate of incidence(35～64 years old)were 275.12/105,29.70％,477.37/105,respectively.The top five cancers of in-cidence were lung cancer,female breast cancer,thyroid cancer,colorectal cancer and liver cancer.The incidence of cancers in men was higher than that in women(ASRC:280.14/105 vs 271.45/105).The curde mortality rate of cancers was 150.62/105.The ASRC,the cumulative rate(0～74 years old),and the truncated rate(35～64 years old)of mortality were 109.62/105,12.27％,160.38/105,respectively.The top five cancer deaths were lung cancer,liver cancer,colorectal cancer,esoph-agus cancer and stomach cancer.The mortality of caners in men was much higher than that in women(ASRC:155.01/105 vs 69.11/105).The 5-year observed survival rate(OSR),relative sur-vival rate(RSR)and age-standardized relative survival rate(ARSR)were 53.09％(95％C1:51.80％～54.36％),56.30％(95％CI:54.94％～57.65％)and 48.14％(95％CI:46.67％～49.64％),respectively.The 5-year ARSR was lower in men than that in women(40.23％vs 57.75％).[Conclusion]The comprehensive diagnosis and treatment level of cancers in Xiamen is in the middle and above level of the country,but the incidence rate is high.Prevention and control should be strengthened,fo-cusing on the growth trend of thyroid cancer,lung cancer,breast cancer,colorectal cancer and so on.

The universal salt iodization project is considered a successful example in the global public health field. In the past 30 years, most countries have implemented mandatory salt iodization policies, effectively improving the iodine nutrition status of the population and preventing the occurrence and development of iodine deficiency disorders. However, with the rising incidence of thyroid diseases in recent years, especially thyroid carcinoma (TC), the question whether excessive iodine supplementation will lead to an increase in the incidence rate of TC has aroused concern. There are significant differences in iodine nutrition levels among countries in the Asia-Pacific, and the iodine fortification policies adopted are also different. Therefore, this article will review the iodine fortification policies, iodine nutrition status, and recent incidence and mortality of TC in some countries in the Asia-Pacific, aiming to study the relationship between iodine fortification policies, iodine nutrition status, and TC incidence.

Objective:To investigate the resistance of adult Aedes albopictus to commonly used insecticides, in order to scientifically select and use insecticides. Methods:In Siming, Jimei and Haicang districts of Xiamen City in September 2018, and in Siming, Jimei and Xiang'an districts of Xiamen City in August 2019, larvae and egg blocks of Aedes albopictus in the field were collected by ladle method, and then raised to adult mosquitoes in the laboratory. The resistance of adult Aedes albopictus to 7 commonly used insecticides was determined by the contact tube method, and the knockdown rate of 1 h and mortality rate of 24 h recovery were calculated. The resistance level was determined according to the mortality rate: ≥98% was the sensitive group (S); 80% - < 98% was potential resistant group (M); < 80% was resistant group (R). Results:In 2018 and 2019, adult Aedes albopictus were exposed to 0.1% deltamethrin, 0.4% beta-cypermethrin, 0.5% lambda-cyhalothrin, 1.4% alpha-cypermethrin, 3% permethrin, 0.5% malathion and 0.05% propoxur, the knockdown rates of 1 h were 95.1% (117/123), 98.3% (115/117), 100.0% (116/116), 99.2% (120/121), 98.4% (123/125), 97.5% (119/122), 100.0% (127/127) and 96.7% (118/122), 98.6% (143/145), 100.0% (139/139), 100.0% (149/149), 98.0% (146/149), 96.8% (121/125), and 100.0% (126/126), respectively. In 2018, the mortality rates of 24 h recovery were 91.1% (112/123), 78.6% (92/117), 75.0% (87/116), 88.4% (107/121), 96.0% (120/125), 99.2% (121/122), and 100.0% (127/127), respectively. In 2019, the adjusted mortality rates of 24 h recovery were 74.9%, 76.9%, 79.5%, 91.4%, 92.3%, 100.0%, and 100.0%, respectively. Conclusions:Adult Aedes albopictus in Xiamen City is sensitive to malathion and propoxur, and it has a high resistance to pyrethroids insecticides such as deltamethrin, beta-cypermethrin and lambda-cyhalothrin. Therefore, it is necessary to strengthen resistance monitoring and use different insecticides in turn to reduce and delay the development of resistance.

Objective:After general anesthesia and mechanical ventilation for laparoscopic colorectal cancer resection, about 90% of patients would have different degrees of atelectasis. Authors speculated that an open-lung strategy (OLS) comprising moderate positive end-expiratory pressure (PEEP) and intermittent recruitment maneuvers (RM) can reduce atelectrauma and thus reduce the incidence of oxygenation-impairment during low-tidal-volume ventilation for laparoscopic colorectal cancer resection. The purpose of this study was to verify this hypothesis and provide a better intraoperative ventilation scheme for laparoscopic colorectal cancer resection.Methods:This was a prospectively randomized controlled clinical trial which was approved by the Ethics Committee of the Sixth Affiliated Hospital, Sun Yat-sen University (2017ZSLYEC-002), and registered at the ClinicalTrials.gov (NCT03160144). From January to July 2017, patients who underwent laparoscopic colorectal cancer resection, with age > 40 years, estimated pneumoperitoneum time ≥ 1.5 h, pulse oxygen saturation ≥ 92%, and risk grade for postoperative pulmonary complications ≥ 2 were prospectively enrolled. The patients with American Society of Anesthesiologists physical status ≥ IV, body mass index ≥ 30 kg/m 2, pneumonia, acute respiratory failure or sepsis within 1 month, severe chronic obstructive pulmonary disease, pulmonary bullae and progressive neuromuscular diseases, and those participating in other interventional clinical trials were excluded. The enrolled patients were randomly assigned (1:1) to the OLS group (with a PEEP of 6-8 cm H 2O and intermittent RM), and the NOLS group (without using PEEP and RM). Partial pressure of arterial oxygen (PaO 2) /fraction of inspired oxygen (FiO 2) and shunt fraction (Q S/Q T) were calculated via arterial and central venous blood gas analysis performed at 0.5 h (T 1), 1.5 h (T 2) after pneumoperitoneum induction and at 20 min after admission to the recovery room. Driving pressure immediately before pneumoperitoneum induction (T 0) and at T 2 were calculated via monitoring data. The primary outcome was oxygenation-impairment (PaO 2/FiO 2 ≤ 300 mmHg) during mechanical ventilation. Results:In each group, 48 patients under general anesthesia and low-tidal-volume ventilation were included in the final analysis. During ventilation, the oxygenation-impairment occurred in 7 patients (14.6%) of OLS group and in 17 patients (35.4%) of NOLS group, whose difference was statistically significant between two groups (χ 2=5.556, RR=0.31, 95%CI: 0.12 to 0.84, P=0.033). During ventilation, the patients in the OLS group had higher PaO 2/FiO 2 [T 1: (427±103) mmHg vs. (366±109) mmHg, t=-2.826, P=0.006; T 2: (453±103) mmHg vs. (388±122) mmHg, t=-2.739, P=0.007], lower Q S/Q T [ T 1: (9.2±6.5) % vs. (12.6±7.7) %, t=2.322, P=0.022; T 2: (7.0±5.8)% vs.(10.9±9.2)%, t=2.408, P=0.019], and lower driving pressure [T 0: (6±3) cm H 2O vs. (10±2) cm H 2O, t=7.421, P<0.001; T 2: (13±3) cm H 2O vs. (17±4) cm H 2O, t=5.417, P<0.001] than those in the NOLS group, with stratistical differences in all comparisons. In recovery room, though PaO 2/FiO 2 [(70.3±9.4) mmHg vs. (66.8±9.4) mmHg, P=0.082] was still higher and Q S/Q T [(18.6±8.3)% vs. (21.8±8.4)%, P=0.070] was still lower in the OLS group as compared to the NOLS group, the differences were not statistically significant (both P>0.05). Conclusion:The application of such an OLS during low-tidal-volume ventilation can greatly reduce the incidence of oxygenation-impairment in laparoscopic colorectal cancer resection, and such effect may last to the period of emergence from anesthesia.

Objective:After general anesthesia and mechanical ventilation for laparoscopic colorectal cancer resection, about 90% of patients would have different degrees of atelectasis. Authors speculated that an open-lung strategy (OLS) comprising moderate positive end-expiratory pressure (PEEP) and intermittent recruitment maneuvers (RM) can reduce atelectrauma and thus reduce the incidence of oxygenation-impairment during low-tidal-volume ventilation for laparoscopic colorectal cancer resection. The purpose of this study was to verify this hypothesis and provide a better intraoperative ventilation scheme for laparoscopic colorectal cancer resection.Methods:This was a prospectively randomized controlled clinical trial which was approved by the Ethics Committee of the Sixth Affiliated Hospital, Sun Yat-sen University (2017ZSLYEC-002), and registered at the ClinicalTrials.gov (NCT03160144). From January to July 2017, patients who underwent laparoscopic colorectal cancer resection, with age > 40 years, estimated pneumoperitoneum time ≥ 1.5 h, pulse oxygen saturation ≥ 92%, and risk grade for postoperative pulmonary complications ≥ 2 were prospectively enrolled. The patients with American Society of Anesthesiologists physical status ≥ IV, body mass index ≥ 30 kg/m 2, pneumonia, acute respiratory failure or sepsis within 1 month, severe chronic obstructive pulmonary disease, pulmonary bullae and progressive neuromuscular diseases, and those participating in other interventional clinical trials were excluded. The enrolled patients were randomly assigned (1:1) to the OLS group (with a PEEP of 6-8 cm H 2O and intermittent RM), and the NOLS group (without using PEEP and RM). Partial pressure of arterial oxygen (PaO 2) /fraction of inspired oxygen (FiO 2) and shunt fraction (Q S/Q T) were calculated via arterial and central venous blood gas analysis performed at 0.5 h (T 1), 1.5 h (T 2) after pneumoperitoneum induction and at 20 min after admission to the recovery room. Driving pressure immediately before pneumoperitoneum induction (T 0) and at T 2 were calculated via monitoring data. The primary outcome was oxygenation-impairment (PaO 2/FiO 2 ≤ 300 mmHg) during mechanical ventilation. Results:In each group, 48 patients under general anesthesia and low-tidal-volume ventilation were included in the final analysis. During ventilation, the oxygenation-impairment occurred in 7 patients (14.6%) of OLS group and in 17 patients (35.4%) of NOLS group, whose difference was statistically significant between two groups (χ 2=5.556, RR=0.31, 95%CI: 0.12 to 0.84, P=0.033). During ventilation, the patients in the OLS group had higher PaO 2/FiO 2 [T 1: (427±103) mmHg vs. (366±109) mmHg, t=-2.826, P=0.006; T 2: (453±103) mmHg vs. (388±122) mmHg, t=-2.739, P=0.007], lower Q S/Q T [ T 1: (9.2±6.5) % vs. (12.6±7.7) %, t=2.322, P=0.022; T 2: (7.0±5.8)% vs.(10.9±9.2)%, t=2.408, P=0.019], and lower driving pressure [T 0: (6±3) cm H 2O vs. (10±2) cm H 2O, t=7.421, P<0.001; T 2: (13±3) cm H 2O vs. (17±4) cm H 2O, t=5.417, P<0.001] than those in the NOLS group, with stratistical differences in all comparisons. In recovery room, though PaO 2/FiO 2 [(70.3±9.4) mmHg vs. (66.8±9.4) mmHg, P=0.082] was still higher and Q S/Q T [(18.6±8.3)% vs. (21.8±8.4)%, P=0.070] was still lower in the OLS group as compared to the NOLS group, the differences were not statistically significant (both P>0.05). Conclusion:The application of such an OLS during low-tidal-volume ventilation can greatly reduce the incidence of oxygenation-impairment in laparoscopic colorectal cancer resection, and such effect may last to the period of emergence from anesthesia.

OBJECTIVE: To investigate the effects of sevelamer carbonate combined with routine treatment on serum inflammatory factors, heme oxygenase-1 (HO-1) and intact parathyroid hormone (iPTH) levels of chronic renal failure (CRF) patients with hyperphosphatemia.METHODS: Totally 60 chronic renal failure patients with hyperphosphatemia in department of renal internal medicine, Tangshan Workers' Hospital during Jan. 2014 to Jan. 2015 were divided into control group and observation group according to random number table, with 30 cases in each group. Control group received routine treatment as reducing blood glucose, lowering blood lipid, lowering blood pressure, reducing phosphorus, protecting kidney. Observation group was additionally given sevelamer carbonate (dose was 0. 8 g, 3 times a day, during meal) on the basis of control group, for 4 weeks. The levels of IL-6, CRP, HO-1, iPTH, Ca and P were compared between 2 groups. The occurrence of ADR was compared between 2 groups. RESULTS: Two cases were withdrewn from the study in each group, finally 28 cases were included in the study in each group. Before treatment, there was no statistical significance in each index between 2 groups (P>0. 05). Compared with before treatment, the serum levels of IL-6, CRP, iPTH and P in 2 groups were decreased significantly after treatment (P<0. 05), while serum level of Ca was increased significantly (P<0. 05); the improvement of above indexes in observation group were more dovious than control group (P<0. 05). There was no statistical significance in the incidence of ADR between 2 groups (P>0. 05). CONCLUSIONS: Sevelamer carbonate combined with routine treatment can effectively reduce the serum levels of IL-6, CRP, HO-1 and iPTH and regulate Ca and P metabolism of CRF patients with hyperphosphatemia with good safety.

Objective To investigate the prenatal diagnosis and postnatal clinical outcomes of fetal congenital choledochal cyst (CCC) to improve the recognition and treatment of fetal CCC.Methods Clinical data of 23 cases of fetal CCC which were diagnosed during routine prenatal ultrasonic examination in Jinhua Municipal Central Hospital from June 2009 to May 2015 were retrospectively analyzzed. Maternal age, gestational age at diagnosis of CCC, location and size of cyst, postnatal examination, age at operation and follow-up outcomes were recorded and statistically analyzed by Wilcoxon rank-sum test.Results (1) Among the 23 cases, six (26%) were terminated and the rest 17 continued their pregnancies (74%). (2) Results of the prenatal ultrasonography of the 23 cases indicated that hepatic portal cysts were closely related to hepatic portal veins or arteries. Six of the cysts communicated with gall bladder and eight connected to intrahepatic bile duct. The maximum diameter of the cysts in the 23 cases was 16.0-31.0 mm, averagely (24.7±3.7) mm. The maximum diameter of cysts diagnosed in the third trimester was significantly larger than that in the second trimester [ 27.0 (22.0-31.0) vs 23.0 (21.0-25.0) mm,Z=-2.134,P<0.05]. (3) Among the 17 cases of continued pregnancy, one underwent cesarean section at 35+ weeks of gestation and 16 delivered at term with the average gestational age at delivery of (38.2±1.1) weeks. All neonates were re-examined by abdominal ultrasound at 1-2 postnatal weeks and confimed prenatal diagnosed of CCC. (4) The 17 neonates were re-examined by abdominal ultrasound during the second postnatal week and the results showed that cyst size remained the same in four, decreased in one and gradually increased with the gestational age in 12 neonates. Among the 16 cases of confirmed CCC, 12 received surgery, including 11 (Ⅰa, 6;Ⅰc, 3;Ⅳb, 2) within one year-old and one (Ⅰc) around 18 months old. The prognosis was uneventful. Four out of the 16 cases rejected surgical operation and were followed up in outpatient. One neonate was diagnosed with congenital biliary atresia and transferred to Children's Hospital for operation.Conclusions When fetal abdominal cyst presented with hepatic portal cyst which communicates with gallbladder or intra-hepatic duct in ultrasonography, a congenital choledochal cyst should be taken into consideration by excluding the possibility of biliary atresia in the first place. Surgery for CCC infants without symptoms or signs is suggested to be performed around three months after birth. The postoperative prognosis of CCC is favorable, so termination is not recommended for gravidas with fetal CCC in prenatal consultation.