BACKGROUND: In China, lung cancer remains the cancer with the highest incidence and mortality rate. Among early-stage lung adenocarcinomas (LUAD), the micropapillary (MPP) component is prevalent and typically exhibits high aggressiveness, significantly correlating with early metastasis, lymphatic infiltration, and reduced five-year survival rates. Therefore, the study is to explore the similarities and differences between MPP and non-micropapillary (non-MPP) components in malignant pulmonary nodules characterized by GGOs in early-stage LUAD, identify unique mutational features of the MPP component and analyze the relationship between the ZNF469 gene, a member of the zinc-finger protein family, and the prognosis of early-stage LUAD, as well as its correlation with immune infiltration. METHODS: A total of 31 malignant pulmonary nodules of LUAD were collected and dissected into paired MPP and non-MPP components using microdissection. Whole-exome sequencing (WES) was performed on the components of early-stage malignant pulmonary nodules. Mutational signatures analysis was conducted using R packages such as maftools, Nonnegative Matrix Factorization (NMF), and Sigminer to unveil the genomic mutational characteristics unique to MPP components in invasive LUAD compared to other tumor tissues. Furthermore, we explored the expression of the ZNF469 gene in LUAD using The Cancer Genome Atlas (TCGA) database to investigate its potential association with the prognosis. We also investigated gene interaction networks and signaling pathways related to ZNF469 in LUAD using the GeneMANIA database and conducted Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. Lastly, we analyzed the correlation between ZNF469 gene expression and levels of immune cell infiltration in LUAD using the TIMER and TISIDB databases. RESULTS: MPP components exhibited a higher number of genomic variations, particularly the 13th COSMIC (Catalogue of Somatic Mutations in Cancer) mutational signature characterized by the activity of the cytidine deaminase APOBEC family, which was unique to MPP components compared to non-MPP components in tumor tissues. This suggests the potential involvement of APOBEC in the progression of MPP components in early-stage LUAD. Additionally, MPP samples with high similarity to APOBEC signature displayed a higher tumor mutational burden (TMB), indicating that these patients may be more likely to benefit from immunotherapy. The expression of ZNF469 was significantly upregulated in LUAD compared to normal tissue, and was associated with poor prognosis in LUAD patients (P<0.05). Gene interaction network analysis and GO/KEGG enrichment analysis revealed that COL6A1, COL1A1, COL1A2, TGFB2, MMP2, COL8A2 and C2CD4C interacted with ZNF469 and were mainly involved in encoding collagen proteins and participating in the constitution of extracellular matrix. ZNF469 expression was positively correlated with immune cell infiltration in LUAD (P<0.05). CONCLUSIONS The study has unveiled distinctive mutational signatures in the MPP components of early-stage invasive LUAD in the Asian population. Furthermore, we have identified that the elevated expression of mutated ZNF469 impacts the prognosis and immune infiltration in LUAD, suggesting its potential as a diagnostic and prognostic biomarker in LUAD.
Humans ; Lung Neoplasms/genetics* ; Adenocarcinoma of Lung/genetics* ; China ; Prognosis ; Transcription Factors

The incidence rate of aortic dissection (AD) is low, but it is highly fatal in the acute phase. Miss diagnosis and misdiagnosis can occur occasionally, resulting the miss of the best intervention time. Research on the epidemiological characteristics and of AD and related risk factors can identify high-risk groups, make screening and diagnosis as soon as possible and effectively control the changeable risk factors to reduce the incidence of AD and improve the outcome of AD cases. This paper summarizes the progress in research of the epidemiological characteristics of AD and related risk factors in order to promote early prevention and diagnosis of AD, improve the AD case management and intervention level.

Purpose/Significance The present situation of the talent team construction in the information departments of public hospi-tals of traditional Chinese medicine(TCM)in Guangxi is analyzed to provide references for optimizing the talent team construction in this field.Method/Process Taking the personnel in the information departments of secondary and above public TCM hospitals in Guangxi in 2022 as the research objects,statistical methods such as Wilcoxon rank sum test,x2 test and Spearman correlation analysis are used to an-alyze the distribution of the research objects and discuss the existing problems in talent team construction.Result/Conclusion The aver-age number of personnel in the information departments of secondary and above public TCM hospitals in Guangxi is 4.39,accounting for 0.80％of the total number of employees.The overall quantity is insufficient,and the distribution is uneven among regions and hospital levels.The talent structure of tertiary TCM hospitals is relatively better than that of secondary TCM hospitals.

Objective:To analyze the epidemiological characteristics of reinfection of 2019-nCoV and influencing factors, and provide evidence for effective prevention and control of COVID-19 epidemic.Methods:The incidence data of COVID-19 in Ningbo from January 1, 2020 to November 30, 2022 were collected from the infectious disease surveillance system of Chinese information system for disease control and prevention. The incidence of reinfection of 2019-nCoV was investigated by using questionnaire. logistic regression analysis was used to analyze the influences of gender, age, time interval from the first infection, history of underlying disease, 2019-nCoV vaccination dose and disease severity on the reinfection.Results:A total of 897 previous 2019-nCoV infection cases were investigated, of which 115 experienced the reinfection of 2019-nCoV, the reinfection rate was 12.82%. The interval between the two infections M( Q1, Q3) was 1 052 (504, 1 056) days. Univariate analysis showed that age, 2019-nCoV vaccination dose, history of underlying disease, type of 2019-nCoV variant causing the first infection, time interval from the first infection and severity of the first infection were associated with the reinfection rate (all P<0.05). Multivariate logistic regression analysis showed that the risk for reinfection in age group 30- years was higher than that in age group ≥60 years ( OR=2.10, 95% CI: 1.11-3.97). No reinfection occurred in those with time interval from the first infection of <6 months, and the risk for reinfection was higher in those with the time interval of ≥12 months than in those with the time interval of 6- months ( OR=6.68, 95% CI: 3.46-12.90). The risk for reinfection was higher in the common or mild cases than in the asymptomatic cases ( OR=2.64, 95% CI: 1.18-5.88; OR=2.79, 95% CI: 1.27-6.11). Conclusion:The time interval from the first infection was an important influencing factor for the reinfection of 2019-nCoV, and the probability of the reinfection within 6 months was low.

Objective:To explore the temporal and spatial distribution characteristics of reported incidence of schizophrenia in Ningbo from 2018 to 2022 and to provide a scientific basis for rational allocation of mental health resources and comprehensive prevention and treatment of schizophrenia.Methods:The reported incidence data of schizophrenia from 2018 to 2022 were collected from Ningbo's mental health information management system, and the reported incidence was calculated by township. The spatial correlation analysis and the spatiotemporal scan analysis were used to study the spatiotemporal distribution of schizophrenia.Results:The reported incidence of schizophrenia decreased from 2018 to 2022, with 4 133 new cases reported, and the annual average reported incidence was 9.76/100 000. Global and local spatial autocorrelation analysis showed positive spatial correlations and hot spots in 2018-2020. The space-time scan analysis showed an incidence cluster in Dongqiao Town, Haishu District, during 2018-2019. The RR was 2.46, and the log-likelihood ratio was 256.89. Conclusions:The reported incidence of schizophrenia in Ningbo has obvious temporal and spatial aggregation, and the high incidence area explored can provide clues for further research on the correlation between environmental factors and the incidence of schizophrenia and has certain guiding significance for the rational allocation of mental health resources in Ningbo.

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 analyze the trend in the mortality of liver cancer in Ningbo City from 2002 to 2021, so as to provide the evidence for improving the liver cancer control measures. Methods: The liver cancer mortality data in Ningbo City from 2002 to 2021 were collected from Ningbo Municipal Chronic Disease Surveillance System. The crude mortality and standardized mortality by the 2 000 national population census data of liver cancer were estimated, and the proportion of concomitant diseases was analyzed among all dead patients with liver cancer. In addition, the trends in liver cancer mortality were analyzed with annual percentage change (APC) and average annual percentage change (AAPC). Results: Both the crude and standardized mortality of liver cancer appeared a tendency towards a decline year by year in Ningbo City from 2002 to 2021, with AAPC of -3.47% (95%CI: -4.08% to -2.85%, P<0.001) and -6.56% (95%CI: -7.25% to -5.87%, P<0.001), and a the decline in liver cancer mortality was larger during the period between 2006 and 2021 than during the period between 2002 and 2006. The annual mean crude and standardized mortality of liver cancer was 35.39/105 and 20.98/105, and the crude mortality of liver cancer was 52.69/105 in men and 18.13/105 in women, respectively. After adjustment for age, the risk of liver cancer mortality was 3.03 (95%CI: 2.96-3.09) times greater among men than among women, and the mortality of liver cancer appeared a tendency towards a rise with age (χ2trend=45 684.254, P<0.001). Concomitant diseases were found among 9 985 dead cases with liver cancer (24.44%), and the concomitant diseases mainly included digestive system diseases (predominantly liver diseases) and infectious and parasitic diseases (predominantly virus hepatitis). Conclusions The mortality of liver cancer appeared a tendency towards a decline in Ningbo City from 2002 to 2021, and men and middle-aged and elderly residents were at high risk of liver cancer mortality. Digestive system diseases and infectious and parasitic diseases were predominant concomitant diseases among dead patients with liver cancer.

Objective: To study the infection rate of secondary close contacts of COVID-19 patients, and assess the infection risk in the contacts. Methods: COVID-19 patients' close contacts (with a clear exposure time to index case) with negative nucleic acid test results and secondary close contacts were surveyed in continuous isolation and medical observation in this prospective study. The dynamic nucleic acid test results of the close contacts and secondary contacts of COVID-19 patients were collected to assess their risk of infection. Results: A total of 4 533 close contacts were surveyed, in whom 14 were confirmed as COVID-19 patients with overall secondary attack rate of 0.31%, and 4 201 secondary contacts were tracked, in whom no subsequent infections occurred. Conclusion: Close contacts of COVID-19 patients entered in centralized isolation for medical observation with negative nucleic acid tese results,the secondary close contacts of COVID-19 patients have no risk of infection.
COVID-19/epidemiology* ; Contact Tracing ; Humans ; Incidence ; Nucleic Acids ; Prospective Studies ; SARS-CoV-2

Objective: To explore the short-term effects of ambient PM_2.5 on the outpatient visits of chronic obstructive pulmonary disease (COPD) in Ningbo city. Methods: Through the regional health information platform, number of daily COPD outpatients from the four general hospitals in Ningbo was gathered. Related data on meteorological and air pollution from 2014 to 2016 was also collected. Generalized additive model (GAM) of Possion regression was used to estimate the impact of PM_2.5 pollution on COPD outpatients and the lagging effects. Results: In cold (November- April) or warm seasons (May-October), an 10 μg/m³ increase of PM_2.5 would result in the excessive number of COPD outpatients as 1.87% (95%CI: 0.98%-2.76%), 2.09% (95%CI: 1.11%-3.08%) and 2.56% (95%CI: 0.56%-4.59%), respectively. In terms of the short-term effects of PM_2.5 the strongest was seen in the days of warm season but without delay (P<0.05). The strongest effect appeared at day 4 in cold season and the effect was particularly significant seen in the over 65 year-old group or in the female population. After the introduction of PM₁₀, SO₂ and NO₂, the concentration of PM_2.5, did not show significant effect on the number of hospital visits due to COPD on the same day (P>0.05). The effect of COPD on the fourth day showed a slight change after the lagging, and the effect was statistically significant (P<0.05). Conclusion The increase of PM_2.5 concentration in Ningbo was related to the increase of COPD outpatient numbers. Effective prevention measures should be taken to protect the vulnerable population and to reduce the risk of COPD.

Objective: To Assess occupational health risks of exposuring to low concentrations (lower than occupational exposure limit, OEL) benzene, toluene and Xylenes. Methods: Qualitative evaluation, semi-quantitative evaluation and quantitative evaluation from guidelines for occupational health risk assessment of chemicals in the workplace were conducted to assess occupational health risks exposure to benzene compounds in different workplaces of 5 manufacturing enterprises, respectively. Results: Concentrations of benzene, toluene and Xylenes in all workplaces were lower than OEL. Qualitative evaluation showed that occupational health risk level was 4 exposure to benzene and Xylenes in all workpalces, while 2 exposure to toluene. Semi-quantitative evaluation showed low level (2 of 5) risks in all workplaces exposured to benzene compounds excepted 4 workpalces exposured to benzene, the latter was moderate (3 of 5) . Quantitative evaluation gave unacceptable carcinogenic risk (higher than 10^-4) of benzene in the wood toy manufactory, and the highest risk was (1.48~5.26) ×10^-4. The occupational health risks of benzene and Xylenes were all unacceptable (HQ>1) in 9 workplaces. Conclusion There still need more attention to occupational health risks exposure to benzene, toluene and Xylenes lower than OEL.