In recent years, with the clinical application of minimally invasive surgical techniques and comprehensive preoperative treatment, the survival rate of locally advanced esophageal cancer has significantly improved. However, the treatment of metastatic esophagogastric cancer still relies mainly on systemic therapy, and immunotherapy combined with chemotherapy has become a first-line treatment option, prolonging the survival of patients with metastatic esophageal cancer. Oligometastatic esophageal cancer is expected to bring survival benefits through systemic therapy combined with local treatment. The 2024 European clinical practice guidelines for oligometastatic esophagogastric cancer have been officially released, which standardize the definition, diagnosis, and treatment of oligometastatic esophageal cancer for further prospective studies. The authors interpret this guideline, especially by reviewing the clinical evidence of oligometastatic esophageal squamous cell carcinoma, to provide reference for the diagnosis and treatment of oligometastatic esophageal cancer in China.

The aim of this study was to prepare a self-assembled nanoparticle monkeypox vaccine candidate and study its immune response characteristics,so as to provide reference test data for its vaccine design.The antigen protein A29L-SpyTag and the backbone protein Mi3-SpyCatcher were expressed and purified by prokaryotic system,and nanoparticles A29L-Mi3 were prepared by chemical assembly,then the antibody titers were determined by ELISA,the antibody neutralization was determined by plaque test,and the cytokine secretion of lymphocytes was determined by flow cytometry to describe the immune response characteristics.Data showed that A29L-Mi3 nanoparticles were successfully prepared,and the particles were uniformly distributed in hollow cages,with an average particle size of(29±0.19)nm.After the A29L-Mi3 nanoparticle vaccine candidate was combined with SP01 adjuvant,the neutralizing antibody titer was stronger than that of the A29L protein candidate,and the A29L-Mi3 nanoparticle vaccine candidate could obtain neutralizing antibodies with similar titers after two immunizations.The level of mouse T lymphocyte immune response activated by the A29L-Mi3 nanoparticle vaccine candidate was higher than that of the A29L protein vaccine candidate.In conclusion,A29L-Mi3 protein nanoparticles with uniform structure have successfully assembled in vitro,which has strong immunogenicity and improved neutralization ability after combination with SP01 adjuvant,thus provided reference data for the optimization of immune programs.In addition,the level of cellular immune response is higher than that of A29L protein alone,which provides a reference for the design and development of monkeypox vaccine.

Objective To analyze the impact of feedforward control nursing intervention on emergence agitation and recovery quality in general anesthesia surgery patients. Methods A total of 118 patients undergoing general anesthesia surgery were selected by convenient sampling, and randomly divided into control group and observation group, with 59 patients in each group. The control group received routine nursing intervention during emergence anesthesia, while the observation group received feedforward control nursing intervention. The incidence of emergence agitation, recovery quality, pain condition, and nursing quality were compared between the two groups. Results The incidence of emergence agitation during emergence in the observation group was significantly lower than that in the control group (42.37% versus 69.49%, P < 0.05). The Richmond Agitation-Sedation Scale (RASS) scores, duration and frequency of agitation were lower or shorter in the observation group than those in the control group (P < 0.05). The observation group exhibited shorter time for spontaneous respiration recovery, eye opening, extubation, full consciousness, and stay in the postanesthesia care unit compared to the control group(P < 0.05). The Steward emergence score was higher in the observation group (P < 0.05). The postoperative pain score was lower, while nursing quality score was higher in the observation group than those in the control group(P < 0.05). Conclusion Feedforward control nursing intervention can reduce the incidence of emergence agitation in general anesthesia surgery patients, improve recovery quality, alleviate postoperative pain, and enhance nursing quality.

Objective:To study the role of ML-SA5, an agonist of the lysosomal Ca 2+ channel transient receptor potential mucolipin 1 (TRPML1), in promoting lysosomal exocytosis to facilitate intracellular uranium removal and alleviate uranium-induced cellular damage for human renal proximal tubule epithelial cells (HK-2) exposed to uranyl acetate. Methods:HK-2 cells were divided into the following groups to be exposed to uranyl acetate at either 0 or 300 μmol/L for 24 h, followed by treatment with ML-SA5 and/or the lysosomal exocytosis inhibitor vacuolin-1 for 0.5 h: control group (Ctrl group), ML-SA5 group (M group), vacuolin-1 group (V group), ML-SA5 plus vacuolin-1 group (M+ V group), uranium exposure group (U group), uranium exposure plus ML-SA5 group (U+ M group), uranium exposure plus vacuolin-1 group (U+ V group), and uranium exposure plus ML-SA5 plus vacuolin-1 group (U+ M+ V group). We localized lysosome-associated membrane protein-1 (LAMP-1) on the plasma membrane (surface LAMP-1) by immunofluorescence assay; measured intracellular uranium content by inductively coupled plasma mass spectrometry; measured the level of kidney injury molecule-1 (KIM-1) by immunofluorescence assay; measured the rate of cell death with Calcein-AM/PI double staining; determined the subcellular localization of transcription factor EB (TFEB) and the levels of LAMP-1 and TRPML1 proteins by immunofluorescence assay; and measured the number of lysosomes using LysoTracker probes.Results:Compared with the Ctrl group, the U group showed significant increases in the surface LAMP-1 protein level ( t = 12.86, P < 0.05), KIM-1 protein level ( t = 18.86, P < 0.05), cell death rate ( t = 38.53, P < 0.05), TFEB nuclear translocation ( t = 9.12, P < 0.05), the protein expression levels of TFEB’s downstream target genes LAMP-1 ( t = 16.47, P < 0.05) and TRPML1 ( t = 32.33, P < 0.05), and the number of lysosomes labeled with LysoTracker probes ( t = 7.75, P < 0.05). Compared with the U group, the U+ M group showed a significantly increased surface LAMP-1 level ( t = 3.33, P < 0.05) and significant decreases in the intracellular uranium level ( t = 5.01, P < 0.05), KIM-1 protein expression level ( t = 3.81, P < 0.05), and cell death rate ( t = 3.24, P < 0.05); all these effects in the U+ M group could be neutralized by the lysosomal exocytosis inhibitor vacuolin-1; and in addition, ML-SA5 significantly increased TFEB nuclear translocation ( t = 9.20, P < 0.05), the protein expression levels of LAMP-1 ( t = 3.05, P < 0.05) and TRPML1 ( t = 3.17, P < 0.05), and the number of lysosomes labeled with LysoTracker probes ( t = 3.13, P < 0.05). Conclusions:The TRPML1 agonist ML-SA5 can promote lysosomal exocytosis to enhance intracellular uranium clearance and reduce uranium-induced cellular damage/death in uranium-loaded HK-2 cells, through activating TFEB to up-regulate lysosome biogenesis and TRPML1 protein expression.

Under the background of " Internet+ medical treatment" and the continuous deepening of face recognition technology research, the face recognition industry has continued to mature, and face recognition has been initially applied in medical fields such as hospital management, auxiliary medical care, and epidemic prevention and control. At the same time, face recognition technology brings problems including error risk, technical cracking risk, privacy risk, equality risk, abuse risk, and other issues in practice, which seriously threaten the personal and property rights and interests of the public. On the basis of summarizing the specific application direction of face recognition technology in hospitals, the authors sorted out the legal regulation of face recognition in China, and proposed that it should be based on technology research and development, strengthen the " gatekeeper" responsibility of medical institutions, improve legal system and recommendations for strengthening judicial leadership in order to improve the legal regulations of face recognition technology, reduce the risk of infringement by medical institutions in the application of face recognition technology, and protect the legitimate rights and interests of citizens.

Objective To investigate the epidemiological and pathogenic characteristics of viral diarrhea in Minhang District, Shanghai. Methods Random sampling on diarrhea was conducted in intestinal outpatient departments of 2 sentinel hospitals according to a certain sampling interval in Minhang District，Shanghai from 2014 to 2020. Real time PCR technology was used to detect Rotavirus, Norovirus, adenovirus, Astrovirus and Sapovirus in fecal samples. Results A total of 646 out of 1 839 stool specimenswere tested positive, and the positive rate was 35.13%.Five pathogenic viruses were detected , mostly norovirus (421 cases, 65.17%) followed by rotavirus (151 cases, 23.37%).The positive rate of norovirus was higher in the age group of 20- 69 years, and the positive rate of Rotavirus was higher in the age group of 0- 9 years. Conclusions Norovirus and rotavirus accounted for the majority of reported infection diarrhea cases in MinhangDistrict of Shanghai from 2014 to 2020, with significant seasonal peaks. Tailored prevention and control measures should be carried out, particularly in risk seasons.

OBJECTIVE To es tablish the fingerprints of pith-nodecayed and pith-decayed Scutellaria baicalensis ，and to investigate the difference of their anti-inflammatory activities. METHODS HPLC method was adopted to establish the fingerprints of 5 batches of pith-nodecayed S. baicalensis and 5 batches of pith-decayed S. baicalensis . SIMCA 14.1 software was adopted to screen the markers of weight difference between pith-decayed S. baicalensis and pith-nodecayed S. baicalensis ，using variable importance in projection （VIP）＞1 as standard. Using the inhibitory rates of NO ，IL-6 and IL- 1β in supernatant of lipopo- lysaccharide（LPS）-induced monocyte macrophages （RAW264.7 cells）as indexes ，the anti-inflammatory activities of pith-decayed and pith-nodecayed S. baicalensis were evaluated and median effective concentration （EC50）of NO were calculated. The gray correlation method was used for spectrum-effect relationship analysis ；SPSS 26.0 software was used for cluster analysis using the inhibitory rates of NO ，IL-6 and IL- 1β in cells at the concentration of 50 μg/mL. RESULTS There were 15 common peaks in 5 batches of pith-nodecayed S. baicalensis and 5 batches of pith-decayed S. baicalensis ，and the similarity of them was greater than 0.990. There were total of 8 peaks with VIP 1.0，they were peak 14，12，15，6，10，13，11 and 4. At jcqinge@163.com the concentration of 50 μg/mL，the inhibitory rates of pith- decayed S. baicalensis extract to NO ，IL-6，IL-1 β and the average EC 50 were 62.14％-71.13％，3.32％ -18.38％ and 93.12％-95.47％ and 25.35 μg/mL，respectively；those of pith-nodecayed S. baicalensis extract were 39.52％-50.19％， 6.21％-22.55％，94.10％-96.44％ and 58.63 μg/mL，respectively. Average NO inhibition rate of pith-decayed S. baicalensis extract was significantly higher than that of pith- nodecayed S. baicalensis extract；average EC 50 and average IL- 6 inhibitory rate of pith-decayed S. baicalensis extract were significantly lower than those of pith-nodecayed S. baicalensis extract（P＜0.05）. There was no statistical significance in average inhibitory rate of IL- 1β（P＞0.05）. The correlation degrees of peaks 2-3，5-8 and 10-11 with inhibitory rate of NO were all greater than 0.8. The correlation degrees of peaks 2，5，8-9 with inhibitory rate of IL- 1β were all greater than 0.9. The correlation degrees of 15 common peaks with inhibitory rate of IL- 6 were all less than 0.8. Ten batches of samples could be grouped into two categories ，K1-K5 were clustered into one category and T 12-T16 were clustered into one category. CONCLUSIONS At the concentration of 50 µg/mL，the inhibitory effect of pith-decayed S. baicalensis extract to NO is stronger than that of pith-nodecayed S. baicalensis extract，while the inhibitory effect on IL- 6 is weaker than that of pith-nodecayed S. baicalensis extract；they have similar inhibitory effect on IL- 1β. The corresponding components of peak 6，10-11 are preliminarily identified as main chemical components of the difference in anti-inflammatory activity between pith-decayed S. baicalensis and pith-nodecayed S. baicalensis .

Objective:To investigate the epidemiological characteristics of influenza-like illnesses (ILI) and the etiological characteristics of influenza viruses in Minhang District of Shanghai from 2010 to 2021.Methods:The surveillance data collected by influenza surveillance sentinel hospitals and the influenza laboratory network from the first week of 2010 to the 52 nd week of 2021 were used for a statistical analysis. Results:A total of 122 903 cases with ILI were reported by the national influenza surveillance sentinel hospitals in Minhang during 2010 to 2021, and the average percentage of ILI cases was 0.94%, showing an increasing trend ( P<0.001). Among them, those aged 0-4, 5-14, 15-24, 25-59 and ≥60 years accounted for 4.35%, 13.30%, 14.30%, 54.32% and 13.73%, respectively. The percentage of ILI showed obvious periodicity. The seasonal incidence of ILI peaked from December to February and from July to September. But the winter peak at the beginning of 2013 was postponed. There was no significant peak in 2021. A total of 11 625 samples were tested from 2010 to 2021, in which the detection rate of influenza viruses was 20.92% (2 432/11 625). The positive rate was 12.83% (1 492/11 625) for influenza A viruses and 8.09% (940/11 625) for influenza B viruses, indicating that the epidemic intensity caused by influenza A viruses was greater than that caused by influenza B viruses. The overall positive rates for influenza A/H3N2 virus, influenza A/H1N1 virus, influenza B/Victoria lineage and influenza B/Yamagata lineage were 9.04% (1 051/11 625), 3.79% (441/11 625), 2.69% (313/11 625) and 2.19% (255/11 625) during 2010 to 2021. The predominant circulating strains altered between influenza A and influenza B viruses in Minhang District of Shanghai during 2010 to 2019. It generally took six months for an epidemic strain to be replaced by a new one. No obvious regularity was observed in 2020 or 2021. The tendency of the incidence of ILI reported from 2010 to 2019 was basically the same as that of the positive rate of influenza viruses, while there were significant differences in 2020 and 2021. Conclusions:Influenza viruses circulated seasonally in Minhang District of Shanghai with alternating prevalent viral subtypes and the infections mostly occurred in the winter and summer seasons. During the epidemic of COVID-19, the intensity of influenza was decreased, but with the normalization of prevention and control measures, the influenza epidemic showed an obvious upward trend. Therefore, it was important to strengthen the prevention and monitoring of influenza and analyze the virus variations in time.

Objective:This study aims to systematically sort out the effectiveness evaluation of the general education teaching models in epidemiology at home and abroad and provide a reference for the development and reform of epidemiology education.Methods:A systematic search of English databases such as PubMed, Embase, and Web of Science and Chinese databases such as CNKI, Sinomed, Wanfang, etc., were used to screen out the literature on different general teaching models of education in epidemiology. Each literature's teaching effect will be summarized and evaluated to conduct a systematic qualitative review in the narrative integration method, Results:A total of 45 articles (28 in Chinese and 17 in English) were included in this study, involving 14 teaching models, including mixed teaching models, PBL (problem-based learning), project designing models, and CBL (case-based learning) and other teaching models. Except for some teaching models such as project design, network platform, and flipped classroom model, the teaching effect of other innovative models is better than that of the traditional model. The distribution of teaching models was different in Chinese and foreign literature. Foreign teaching models were diverse, mainly concentrated in mixed teaching models and software/network platform learning. Domestic teaching models were relatively fixed. The mixed teaching model and PBL model were the most widely used in China, and there were fewer comparative studies between different teaching models than in foreign countries.Conclusion:General education in epidemiology is still in the early exploration stage. Compared with the traditional lecture model, the effect of various innovative teaching models has been improved. According to teaching objectives and student characteristics, we encourage extensive use of different teaching strategies, combining theoretical knowledge with practical applications and integrating epidemiological knowledge with inter-professional knowledge. Thus, students who can apply what they learn are becoming interdisciplinary talents our society needs.

【Objective】 To evaluate the performance of light initiated chemiluminescence assay in the detection of hepatitis c virus (HCV), human immunodeficiency virus (HIV) and Treponema pallidum (TP) antibodies. 【Methods】 According to Guidance on the Verification of Qualitative Measurement Procedures used in the Clinical Immunology(CNAS-GL038: 2019) and Guidance on the Verification of Quantitative Measurement Procedures used in the Clinical Chemistry(CNAS-GL037: 2019), the coincidence rate, detection limit, precision and critical value of the detection of HCV, HIV and TP antibodies by the automatic light initiated chemiluminescence assay system LICA500 were verified. 【Results】 The concordance rate of LICA500 and ELISA in HCV antibody and HIV antibody detection was 100%. In terms of syphilis antibody detection, the concordance rate with TPPA results was 95%. The detection limit test showed that the detection limits of LICA500 against HCV antibody, HIV antibody and TP antibody reached 0.04 NCU/mL, 0.5 NCU/mL and 0.25 NCU/mL, respectively, which were all higher than the manufacturer′s declared detection limits of 0.2 NCU/mL, 1 NCU/mL and 0.5 NCU/mL. The in-batch CV and total CV of LICA500 for HCV, HIV and TP antibodies were less than 10%. The C50 was verified by critical value experiment, and the positive results of HCV antibody, HIV antibody and TP antibody at the critical concentration accounted for 45%, 45% and 48%, respectively. The percentage of negative results for (critical concentration -20%) was 98%, and the percentage of positive results for (critical concentration + 20%) was 100%, indicating that the concentration range from (critical concentration -20%) to (critical concentration + 20%) was in the 95% range of this method. 【Conclusion】 The detection of HCV, HIV and TP antibodies by LICA500 has a high concordance rate with the current commonly used detection methods, suitable for rapid screening and batch examination before surgery and blood transfusion.