Objective To explore the effectiveness of the cumulative sum (CUSUM) and the exponentially weighted moving average (EWMA) for early warning of influenza epidemic using two datasets of reported influenza cases and influenza-like illness (ILI) cases. Methods Using the reported cases of influenza and ILI in Daxing District, Beijing, from week 23 of 2018 to week 22 of 2024 as data sets, the CUSUM and EWMA models were established, respectively. The positive rate of influenza etiology was used as the ^“gold standard^”, and the Youden index was used as the evaluation index to compare the early warning effect of the two models under different data sets and different parameters. Results In CUSUM, the optimal Youden indices of the reported influenza cases set and the ILI cases set were 0.751 and 0.635, respectively. In EWMA, the optimal Youden indices of the reported influenza cases set and the ILI cases set were 0.544 and 0.464, respectively. The optimal EWMA and CUSUM models could both issue early warning signals in advance of the ^“gold standard^”. Conclusion In the influenza epidemic early warning in Daxing District, Beijing, the CUSUM model established with the reported cases of influenza can achieve good early warning effects, but the model parameters need to be dynamically adjusted according to the local epidemic characteristics.

Objective To study the clinical application value of abdominal pressure band in CT-guided puncture biopsy of lower lung nodules.Methods A retrospective analysis was conducted on 100 patients who underwent lower lung nodule punc-ture biopsy at the Cancer and Radiotherapy Center of Tongji Hospital affiliated to Huazhong University of Science and Technol-ogy from January to December 2022.They were divided into abdominal pressure band group and control group.There were 40 patients in abdominal pressure band group,among which abdominal pressure bands were applied during the puncture process.There were 60 patients in control group who did not use abdominal pressure bands during the puncture process.The CT scan frequency,puncture depth,success rate,intraoperative time,incidence of complications,and radiation dose for puncture biopsy were compared between the two groups.Results The median value of CT scan frequency during puncture biopsy in ab-dominal pressure band group was 5 times,with a success rate of 100％(40/40).The median value of intraoperative time was 7.9 min,and the incidence of complications was 10％(4/40).The median value of radiation dose was 210.4 mGy·cm.The median value of CT scan frequency during puncture biopsy in control group was 8 times,with a success rate of 86.7％(52/60).The me-dian value of intraoperative time was 13 min,and the incidence of complications was 40％(24/60).The median value of radiation dose was 287.7 mGy·cm.Differences in five indicators were statistically significant between the two groups(all P＜0.05).Conclusion Application of the abdominal pressure bands in lower lung nodule puncture biopsy can significantly reduce the number of scans,shorten surgical time,reduce the radiation dose received by patients,and have a higher success rate and lower incidence of complications.Utilization of pressure band should be promoted in clinical practice.

Primary ciliary dyskinesia (PCD) is a congenital, motile ciliopathy with pleiotropic symptoms. Although nearly 50 causative genes have been identified, they only account for approximately 70% of definitive PCD cases. Dynein axonemal heavy chain 10 (DNAH10) encodes a subunit of the inner arm dynein heavy chain in motile cilia and sperm flagella. Based on the common axoneme structure of motile cilia and sperm flagella, DNAH10 variants are likely to cause PCD. Using exome sequencing, we identified a novel DNAH10 homozygous variant (c.589C > T, p.R197W) in a patient with PCD from a consanguineous family. The patient manifested sinusitis, bronchiectasis, situs inversus, and asthenoteratozoospermia. Immunostaining analysis showed the absence of DNAH10 and DNALI1 in the respiratory cilia, and transmission electron microscopy revealed strikingly disordered axoneme 9+2 architecture and inner dynein arm defects in the respiratory cilia and sperm flagella. Subsequently, animal models of Dnah10-knockin mice harboring missense variants and Dnah10-knockout mice recapitulated the phenotypes of PCD, including chronic respiratory infection, male infertility, and hydrocephalus. To the best of our knowledge, this study is the first to report DNAH10 deficiency related to PCD in human and mouse models, which suggests that DNAH10 recessive mutation is causative of PCD.
Humans ; Male ; Animals ; Mice ; Semen/metabolism* ; Dyneins/metabolism* ; Cilia/metabolism* ; Mutation ; Ciliary Motility Disorders/genetics*

Objective: To investigate the origin of infection and risk factors of a case with SARS-CoV-2 infection associated with overseas countries in the Ningbo-Zhoushan Port, Zhejiang Province, so as to provide the evidence for improving the COVID-19 control measures at ports. Methods: Ningbo Center for Disease Control and Prevention ( CDC ) and Beilun CDC conducted case finding and epidemiological surveys immediately after being informed. The general information, history of vaccination and the travel during the latest 14 days were collected from the positive case, and all close contacts were tracked. Saliva samples were collected for SARS-CoV-2 nucleic acid testing and whole-genome sequencing, and the sequencing results were aligned with the GISAID's EpiCoV database. The origin of infection and transmission route of the positive case was investigated. Results: A case was identified positive for SARS-CoV-2 nucleic acid during company M's routine screening in the Ningbo-Zhoushan Port on August 10, 2021, and was confirmed positive for SARS-CoV-2 nucleic acid by Beilun CDC and Ningbo CDC on August 11. Whole-genome sequencing showed SARS-CoV-2 B.1.617.2 ( Delta ) variant, which shared the highest homology with the virus sequence uploaded by Russia on June, 2021 ( Russia/MOW-RII-MH27356S/2021 ). The case was a bundling worker for overseas container ships, and reported communicated with foreign boatmen and contacted materials without protected interventions on the SINOKOR AKITA Container Ship between August 4 and 5, 2021. This ship anchored at Vladivostok, Russia from July 27 to 29, anchored at Ningbo Harbor on August 4, and departed on August 5. Then, 11 boatmen from this ship were tested positive for SARS-CoV-2 nucleic acid on August 8. One asymptomatic case was reported in this epidemic; 254 close contacts and 617 secondary close contacts were identified, and all were tested negative for SARS-CoV-2 nucleic acid. No new cases with SARS-CoV-2 infections were detected until August 25, 2021, and the emergency response was therefore terminated. Conclusions The infection was a sporadic COVID-19 epidemic associated with overseas countries, which was caused by Delta variant infection through contacts with foreign boatmen or materials by a bundling worker in Ningbo-Zhoushan Port; fortunately, no epidemic spread occurred. Intensified closed-loop management and increased frequency of SARS-CoV-2 nucleic acid test among high-risk populations, and improving the precision and rapid emergency treatment of COVID-19 epidemics are required for the containment of COVID-19 at ports.

Objective:To investigate the availability, prices and affordability of essential medicines in pediatric population across China, in the hope of improving rational use of medicines.Methods:A multicenter cross-sectional survey of medicine prices, availability and affordability was conducted in 17 provinces, municipalities and autonomous region across east, south-central part, west and north of China. Data on 42 medicines used in pediatric population, both original and generic, were collected in 55 public hospitals from May 26 to June 2, 2017. Availability was expressed as the percentage of hospitals with stock of the target medicine on the day of data collection,and median price ratio (MPR) was the ratio of price upon investigation to international reference. Based on national minimum daily wage, affordability represents the number of working days needed to earn the expense which covers a standard course using the target medicine. Statistical software SPSS 13.0 was applied for descriptive analysis of availability, MPR and affordability.Results:Mean Availability of original and generic medicine was 33% and 32%, with median MPR being 5.43 and 1.55. Among the 19 medicines with price information for both original and generic product, the median MPR was 7.73 and 2.04 respectively. Regarding the five medicines used to treat four common pediatric diseases (pneumonia,peptic ulcer, congenital hypothyroidism, refractory nephrotic syndrome), the affordability was 0.63 (0.16-6.17) d for generic medicine, and 1.03 (0.16-11.53) d for its original counterpart.Conclusions:The availability to both original and generic products of the 42 medicines used in pediatric population was low in China. The prices of generic medicines seem to be lower and affordability higher than those of original medicines. There is an urgent need to improve the availability and affordability of pediatric medicines.

Objective To analyze the clinical features of patients with coronavirus disease 2019 (COVID-19) in Shanghai and to investigate the risk factors for disease progression to severe cases. Methods The clinical data of 292 adult patients with COVID-19 hospitalized in Shanghai Public Health Clinical Center from January 20, 2020 to February 10, 2020 were retrospectively analyzed, including 21 severe patients and 271 mild patients. The demographic characteristics, epidemiological history, history of underlying diseases and laboratory examinations were compared between the two groups. Measurement data were compared using t test or Mann-Whitney U test. The count data were compared using hi-square test. The binary logistic regression equation was used to analyze the risk factors for the progression of patients to severe cases. Results Among the 292 patients, 21 were severe cases with the rate of 7.2% (21/292). One patient died, and the mortality rate was 4.8% in severe patients. The severe patients aged (65.0±15.7) years old, 19 (90.5%) were male, 11 (52.4%) had underlying diseases, 7 (33.3%) had close relatives diagnosed with COVID-19. The mild patients aged (48.7±15.7) years old, 135 (49.8%) were male, 74 (27.3%) had underlying diseases, 36 (13.3%) had close relatives diagnosed with COVID-19. The differences between two groups were all significant statistically ( t =-4.730, χ 2 =12.930, 5.938 and 4.744, respectively, all P <0.05). Compared with the mild patients, the levels of absolute numbers of neutrophils, alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, creatinine, serum cystatin C, C reactive protein (CRP), procalcitonin , D -dimer, pro-B-type natriuretic peptide (proBNP), serum myoglobin, creatine kinase (CK), creatine kinase isoenzyme (CK-MB), serum troponin I (cTnI) in severe patients were all significantly higher ( U =2 091.5, 1 928.0, 1 215.5, 729.0, 1 580.5, 1 375.5, 917.5, 789.5, 1 209.0, 1 434.0, 638.0, 964.5, 1 258.0 and 1 747.5, respectively, all P <0.05), while the levels of lymphocyte count, albumin, transferrin, CD3 + T lymphocyte count, CD8 + T lymphocyte count and CD4 + T lymphocyte count in severe patients were all significantly lower ( U =1 263.5, t =4.716, U =1 214.0, 962.0, 1 167.5 and 988.0, respectively, all P <0.05). Further logistic regression analysis showed that the albumin (odds ratio ( OR )=0.806, 95% CI 0.675-0.961), CRP ( OR =1.016, 95% CI 1.000-1.032), serum myoglobin ( OR =1.010, 95% CI 1.004-1.016), CD3 + T lymphocyte count ( OR =0.996, 95% CI 0.991-1.000) and CD8 + T lymphocyte count ( OR =1.006, 95% CI 1.001-1.010) at admission were independent risk factors for the progression of COVID-19 patients to severe illness (all P <0.05). Conclusions Severe cases of patients with COVID-19 in Shanghai are predominantly elderly men with underlying diseases. Albumin, CRP, serum myoglobin, CD3 + T lymphocyte count and CD8 + T lymphocyte count could be used as early warning indicators for severe cases, which deserve more clinical attention.

Background: Zhongyi paste is a traditional Chinese medicine herbal paste that is externally applied to reduce inflammation and relieve pain. Methods: An acute foot swelling inflammation model in C57BL/6J mice was established by carrageenan-induced pathogenesis. Zhongyi paste raised the pain threshold and also reduced the degree of swelling in mice with carrageenan-induced foot swelling. Results: Analysis indicated that serum tumor necrosis factor-alpha, interleukin-1 beta, and prostaglandin E2 (PGE2) cytokine levels and PGE2levels in the paw tissue of the mice were decreased by Zhongyi paste treatment. The quantitative polymerase chain reaction and western blot results showed that Zhongyi paste downregulated the mRNA and protein expression of extracellular signal-regulated kinase 1/2 (ERK1/2), and cyclooxygenase-2 (COX-2), and also downregulated the mRNA expression of PGE2 . At the same time, the Zhongyi paste exerted a stronger effect as an external drug than that of indomethacin, which is an oral drug, and voltaren, which is an externally applied drug. Conclusions Our results indicated that Zhongyi paste is a very effective drug to reduce inflammatory swelling of the foot, and its mechanism of action is related to regulation of the ERK1/2–COX-2–PGE2 pathway.

Objective: To investigate the efficacy of massage combined with microwave therapy in treating Children's bronchial pneumonia with syndrome of deficiency of lung-spleen Qi. Methods: Two hundred forty-four bronchial pneumonia Children were selected in our hospital and randomly divided into the control group and the observation group with 122 cases in each group referring to random number table. The control group was administered with the routine treatment. Based on the control group, the observation group received the massage and microwave therapy. The course was 2 week for both groups. The syndrome scores of traditional Chinese medicine were performed before and after treatment, and the disappearance of gasping, antipyretic, disappearance of moist rale in the lungs, and absorption time of chest X-ray were observed and recorded. the flow cytometry was used to detect peripheral blood levels of CD4⁺ and CD8⁺, and serum levels of IL-6 and IL-8 were detected by ELISA. The clinical effect rate was evaluated. Results: The total effective rate was 97.5% (118/121) in the observation group and 91.7% (110/120) in the control group,with statistically significant differences (χ²=4.406, P=0.044). After treatment, the scores of cough, phlegm, shortness of breath, pale face, fatigue, spontaneous perspiration, poor appetite in the observation group were significantly lower than those in the control group (t value were 10.008, 11.529, 11.778, 12.043, 11.309, 10.128, 11.008, P<0.01), and elapsed time of gasping, antifebrile time, disappear time of lung moist crackles, absorption time were significantly earlier than the control group (t value were 15.121, 10.099, 18.441, 14.310, P<0.01). After 2 week’ treatment, the scores of symptoms of deficiency of lung-spleen Qi in the observation group were significantly lower than those of control group (P<0.01). Compared with the control group, the duration of wheezing and antipyretic, duration of lung dampness and chest X-ray absorption in the observation group were significantly decreased (P<0.05). The total effective rate of the observation group was 97.52%, which was significantly higher than the control group 92.67% (P<0.05). After 2 week treatment, the CD4⁺ (41.03% ± 4.55% vs. 33.52% ± 3.95%, t=14.011) in the observation group was significantly higher, CD8⁺ (22.71% ± 2.83% vs. 26.65% ± 3.05%, t=10.061) was significantly lower than the control group, serum levels of IL-6 (28.13 ± 3.63 ng/L vs. 40.09 ± 4.61 ng/L, t=14.890) and IL-8 (21.41 ± 2.75 ng/L vs. 29.05 ± 3.61 ng/L, t=11.439) were significantly lower than the control group (P<0.01). Conclusions Massage combined with microwave therapy for the Children's bronchial pneumonia with deficiency of lung-spleen Qi syndrome can promote the improvement of symptoms, enhance the efficacy, increase the immune function and reduce inflammation level.

Objective To investigate and analyze the performance of hand hygiene in clinical nurses and its influencing factors and provide a basis for further developing interventions and reducing the rate of nosocomial infections. Methods Totally 226 in-service clinical nurses were investigated with a self-designed hand hygiene questionnaire in January 2017. Results There were statistically significant differences in hand hygiene performance among nurses in different departments (F= 9.344,P< 0.01). Nurses in pediatric wards scored higher than those in intensive care units and general wards (t= 0.358, 0.273;P<0.05). The top 5 factors with higher recognition which contributed to the performance and effect of hand hygiene were:neglected hand washing and hand disinfection by nurses (93.8%), forgotten hand washing measures and indicators by nurses (93.4%), nurses' belief that gloves were an alternative to hand washing (93.4%), insufficient emphasis on hand washing in management (88.9%) and nurses' belief that the probability of hand-induced infections was low (85.8%). Conclusions The hospital should strengthen the training in hand-hygiene-related knowledge, enhance the concepts of hand hygiene in clinical nurses and improve the compliance with hand hygiene among medical staff so that the occurrence of nosocomial infections can be reduced effectively.

Objective To evaluate the effect of water improvement projects on drinking-water-borne endemic arsenism in Shanxi Province,to work out and refine sustainable prevention and control strategies.Methods The operating situation of water-improvement projects was investigated and monitored,and the arsenic content in drinking water was determined in drinking-water-borne arseniasis areas,which including 14 monitored sites in 5 countries from 2012 to 2017.The condition of arsenic poisoning in the resident population of the monitored sites was investigated and the arsenic content in the urine of patients was determined.Results Totally 14 monitored sites were already finished water improvement,the rate of water-improvement was 100％.Totally 11 water-improvement projects were monitored,including 7 small-scale water-improvement projects and 4 large-scale water-improvement projects,which all qualified and operated normally from 2012 to 2015.In 2016,one water-improvement project was found with excessive level (＞ 0.01 mg/L) of arsenic in drinking water in Shanyin County,and the other 10 water-improvement projects' arsenic contents were qualified.In 2017,two unqualified large-scale water-improvement projects had water arsenic content over (＞ 0.01 mg/L) in Shanyin County and Ying County,respectively.And the other 9 water-improvement projects were qualified.The detection rates of arsenic poisoning from 2012 to 2017 were 1.36％ (104/7 641),1.57％ (123/7 832),1.61％ (123/7 621),1.53％ (120/7 857),1.28％ (102/7 963) and 1.56％ (124/7 958),respectively,and the differences were not statistically significant (x2 =4.979 9,P ＞0.05).Most patients with arsenic poisoning were mild to moderate patients,accounted for 82.61％ (575/696) and no new case was detected.Conclusions Arsenic poisoning in drinking-water-borne arseniasis areas in Shanxi Province has been controlled.Natural operation of water-improvement projects has kept water arsenic levels normal.Water arsenic content has exceeded the standard in some of the water-improvement projects.The key point of next stage is strengthen the management of water improvement projects in prevention and treatment of drinking-water type endemic arsenism.