ObjectiveTo compare colonoscopy compliance rates under different screening strategies, to explore ways to enhance colonoscopy compliance among residents with colorectal carcinoma. MethodsResidents aged between 50‒80 years were recruited through extensive community outreach and voluntary participation. A total of 210 630 residents who participated in the colorectal carcinoma screening program in Jiading District, Shanghai, between 2013 and 2019 were selected as the research subjects. All subjects underwent a colorectal carcinoma risk assessment questionnaire survey and two fecal occult blood tests (FOBT). Positive results in the initial screening were defined as a positive questionnaire survey or a positive result in at least one FOBT. Participants with positive initial screening results were advised to undergo colonoscopy screening in a hospital. Colonoscopy results were collected from hospital reports and physician follow-ups. Compliance with colonoscopy was analyzed under different screening strategies to identify possible factors influencing residents’ willingness to undergo the procedure. ResultsA total of 21 403 individuals (10.16%) were identified as positive with the questionnaire survey, 31 595 individuals (15.00%) tested positive with at least one FOBT. Combined questionnaire and FOBT positivity was observed in 3 501 individuals (1.66%). Among the 48 453 individuals with positive initial screening results, 17 230 (35.56%) underwent colonoscopy, and a total of 315 cases of colorectal cancer were detected. The sensitivity, specificity value of FOBT initial screening were 83.81% and 84.66%, respectively. According to the combined risk assessment and FOBT initial screening preliminary screening, the lowest colonoscopy compliance rate (25.63%) was observed among individuals with only a positive questionnaire, and the highest compliance rate (52.55%) was among those with both positive questionnaire survey and two positive FOBT results. Multivariate analysis revealed that FOBT positivity had the greatest impact on colonoscopy compliance. Those with one positive FOBT test result were 2.64 times more likely to undergo colonoscopy screening than those with negative FOBT results, while individuals with two positive FOBT results were 3.18 times more likely to do so. After adjusting for FOBT results, individuals with positive questionnaire survey results were 1.43 times more likely to undergo colonoscopy screening than those with negative results (95%CI: 1.34‒1.52). Compared to questionnaire-based risk assessment, FOBT results were more influential in determining compliance with colonoscopy. ConclusionThe choice of initial screening method significantly impacts residents’ compliance with colonoscopy. While implementing colorectal carcinoma screening programs, it is necessary to strictly adhere to screening protocols, including risk assessment and FOBT. Additionally, efforts should be made to raise public awareness, encouraging residents to actively participate in risk assessments and FOBT, thereby improving their compliance with colonoscopy.

ObjectiveTo investigate the contamination status of Staphylococcus aureus in food and the presence of enterotoxin genes in Jiading District， Shanghai， and to provide a basis for the prevention and treatment of foodborne Staphylococcus aureus disease. MethodsFrom 2021 to 2023， 15 types of food were sampled for S. aureus testing， and the presence of five enterotoxin genes， including sea⁃see， was tested in the strains. ResultsOut of 705 food samples， 88 （12.48%） were positive for S. aureus. S. aureus was detected in 12 of the 15 food types， with the three food types with the highest positive rates being cold noodles （45.00%）， raw poultry （26.25%）， and vegetable salads （20.00%）. The enterotoxin gene carriage rate was 32.95% in food strains. The carriage rates for sea， seb， and sec were 7.95%， 12.50%， and 14.77%， respectively. Neither sed nor see was detected. The detection rate of strains carrying two types of enterotoxin genes was 2.27%. The enterotoxin carriage rates in strains from vegetables， beverages， and raw meat were 57.14%， 40.00%， and 30.00%， respectively. ConclusionThe S. aureus detection rate in food in Jiading District is much higher than the national average. The enterotoxin gene carriage rates are high， with food strains carrying sea， seb， and sec， with sec being the most prevalent. There is a need to enhance monitoring of S. aureus and enterotoxins， especially in high-risk foods such as noodles， vegetables， and non-packaged beverages.

ObjectiveTo explore the compliance related factors of repeated screening for colorectal cancer in Jiading District， and to provide a scientific basis for the prevention and control of colorectal cancer. MethodsBased on the natural population cohort in Jiading District， and the screening situation in 2017‒2019 and 2020‒2022， the study subjects were divided into the groups of never participating in screening and participating in screening. Subjects in the participating group were further divided into participating in one round of screening or having repeated screening. SPSS 21.0 software was used to analyze the demographic characteristics of each group. χ² test or Fisher precise probability test were used to conduct univariate analysis of the factors such as gender， age， education level， marital status， retirement status， and type of medical insurance. Factors with the significant difference （P<0.05） were selected for inclusion in multivariate analysis， and factors related to compliance with repeated screening were analyzed by multivariate logistic regression. ResultsA total of 8 179 subjects were included in the study， including 3 323 males （40.6%） and 4 856 females （59.4%）. The average age of the subjects was （61.26±6.06） years old. A total of2 652 （32.4%） had educated in primary school or below， 4 242 （51.9%） in secondary school， and 1 285 （15.7%） in higher secondary school. Mostly， 7 579 （92.7%） were married. Among the participants， 4 062 people had never participated in screening， 4 117 people had participated in screening， and 1 485 of them had repeated screening， with a repeated screening rate of 18.2%. Multivariate logistic regression analysis showed that women had better compliance with repeated screening than men （OR=1.31， 95%CI： 1.14‒1.50）. Compared with the population aged 50 to 54 years， the population aged 55‒59 years （OR=1.57， 95%CI： 1.19‒2.08）， 60-64 years （OR=2.77， 95%CI： 2.13‒3.61）， and 65-69 years （OR=3.31， 95%CI： 2.51‒4.36） had higher compliance with repeated screening. Compared with employees' medical insurance， residents' medical insurance group had worse compliance with repeated screening （OR=0.76， 95%CI： 0.66‒0.87）. People with a history of intestinal polyps were more likely to undergo repeat screening than those without （OR=2.07， 95%CI： 1.50‒2.87）. ConclusionCompliance with repeated screening for colorectal cancer still needs to be improved， and there are differences in compliance with repeated screening for different populations with different characteristics. Identifying groups that are unlikely to adhere to community-based colorectal cancer screening and taking targeted interventions can help improve the continued compliance of residents with colorectal cancer screening.

ObjectiveTo investigate the prevalence of Staphylococcus aureus in patients with diarrhea, and to analyze the genes carriage of enterotoxin in the strains of these patients in Jiading District, Shanghai. MethodsFrom 2021 to 2023, anal swabs of diarrhea outpatients from one sentinel hospital and nine community health service centers in different townships in Jiading District, Shanghai, were tested for Staphylococcus aureus, from which five enterotoxin virulence genes such as SEA, SEB, SEC, SED, and SEE were tested simultaneously. ResultsA total of 1 080 anal swabs were collected, 81 of which were tested positive for S. aureus, with a detection rate of 7.50%, and the detection rate of S. aureus was similar in patients with diarrhea from 2021‒2023. There was no statistically significant difference in detection rates between males and females (χ²=0.821, P=0.365). S. aureus detection rate was highest in infants and young children with diarrhea (29.51%), followed by 14.06% in the people aged between 4‒<31 years, and 2.99% in those aged ≥31 years. Significant differences were observed in the detection rate of S. aureus in the diarrhoeal patients from different townships of Jiading District(χ²=66.134,P<0.05). The carriage rates of the 5 enterotoxin genes, namely SEA, SEB, SEC, SED, SEE, were 13.58%, 14.81%, 11.11%, 7.41%, and 0, respectively. ConclusionThe prevalence of S. aureus among the patients with diarrhea in Jiading District is relatively stable but with distinct geographical patterns. Children and adolescents are high-risk groups. SEB were the dominant gene, followed by SEA.

ObjectiveTo investigate the prevalence of Staphylococcus aureus in a hospital in Jiading District， Shanghai， and to determine the enterotoxin gene profiles of Staphylococcus aureus isolated from patients and environment. MethodsSpecimens were collected from environment and patients from a hospital for Staphylococcus aureus isolation and identification. Furthermore， enterotoxin genes （SEA‒SEE） of Staphylococcus aureus were detected. ResultsA total of 54 Staphylococcus aureus strains were isolated from 780 hospital environmental specimens from 2018 to 2021， with a prevalence of 6.92%. In the armrests in the wards， patient’s pillows/quilts， and bedside cupboards， the prevalence was determined to be 20.00%， 20.00% and 16.67%， respectively. In contrast， in the computer’s mouse and keyboard and work clothes of physicians and nurses， the prevalence was 17.42% and 16.67%， respectively. Meanwhile， from 2018 to 2021， a total of 75 strains were collected from patients， of which 36.00%， 14.67% and 14.67% were from the departments of intensive care medicine （ICU）， neurosurgery and orthopedics， respectively. The prevalence of Staphylococcus aureus enterotoxin genes were 48.15% and 61.33% in the environment and patients， respectively. Furthermore， the prevalence of SEA， SEB， SEC， SED， and SEE genes were 14.67%， 41.33%， 9.33%， 1.33%， 1.33% in patients， respectively ， whereas 20.37%， 25.93%， 1.85 %， 1.85% and 0% in environmental specimens， respectively. In the environmental specimens isolated from comprehensive ICU， the prevalence of enterotoxin genes was 77.27%. In the patient's specimens， Staphylococcus aureus was mostly isolated in sputum. Additionally， the prevalence of enterotoxin genes was high in the patients of departments of respiratory medicine， ICU， and orthopedics. ConclusionPrevalence of Staphylococcus aureus remains moderate in the hospital environment. Enterotoxin genes of Staphylococcus aureus are common， with seb gene as the most common gene， followed by SEA gene. It warrants strengthening the disinfection and control of Staphylococcus aureus in the hospital， especially in the ICU.

ObjectiveTo investigate the contamination status and drug resistance of Campylobacter spp. in poultry sold in Jiading District， Shanghai. MethodsFour types of poultry meats （chickens， ducks， geese and pigeons） were sampled from commercial markets， and potential Campylobacter spp. contamination was isolated and identified. Furthermore， resistance of isolated Campylobacter spp. to 15 commonly used antibiotics was tested. ResultsTotally 29 Campylobacter jejuni strains and 34 Campylobacter. coli were isolated from 236 commercial poultry samples. The most severe contamination of Campylobacter spp. was found in chicken samples， with a detection rate of 34.04%， while the lowest detection rate of Campylobacter spp. was found in duck （19.67%）. Contamination status was categorized with different storage conditions. The lowest detection rate of 6.67% was noted under frozen condition， while highest detection rate of 41.27% was noted under cold storage. Campylobacter jejuni was completely resistant to cefazolin， ciprofloxacin， nalidixic acid and tetracycline， and Campylobacter coli was completely resistant to cefazolin， cefoxitin and nalidixic acid； Campylobacter spp. showed the lowest resistance to imipenem. Multi-drug resistant strains accounted for 100.00% of the isolated strains. 96.83% of the strains were resistant to more than 5 drugs， with the highest number reaching 14 kinds of antibiotics. ConclusionThere is a significant difference in the contamination status and drug resistance of Campylobacter spp. isolated from four types of poultry meats sold in Jiading District， Shanghai， and the drug resistance is serious. It is strongly recommended that the use of antibiotics should be strictly controlled. Freezing can effectively reduce Campylobacter spp. pollution.

ObjectiveTo investigate the contamination status， serotype distribution and drug resistance of Salmonella in retail poultry in Jiading District， Shanghai. MethodsFour types of poultry （chicken， duck， goose and pigeon） have been sampled from commercial markets. Salmonella contamination has been isolated and identified using serotype analysis. Furthermore， resistance of isolated Salmonella strains towards 16 commonly used antibiotics has been determined. ResultsA total of 60 Salmonella strains were isolated from 80 poultry samples. The detection rates of Salmonella in pigeon， goose， duck and chicken were 86.67%， 81.82%， 72.73% and 59.38%， respectively. Contamination status has been categorized by storage conditions. Lowest detection rate （65.63%） has been noted in poultry samples under refrigeration storage. The majority serotypes of Salmonella have been revealed as Salmonella typhimurium， Salmonella enteritidis and Salmonella corvallis. Relatively higher drug resistance was discovered with tetracycline， nalidixic acid， ampicillin and chloramphenicol， with drug resistance rate of 60.00%， 58.33%， 50.00% and 48.33%， respectively. Low drug resistance was revealed with cefotaxime. In addition， these Salmonella strains were completely sensitive to imipenem. Significant difference in drug resistance was identified across the types of poultry or Salmonella serotypes. The 11.67% of Salmonella strains were non-resistant to any tested drugs. Multi-drug resistant strains accounted for 46.67% of isolated strains， which were resistant to 13 different antibiotics. Ampicillin-tetracycline or chloramphenirol-cefazolin drug resistance pattern suggested that the Salmonella strain was multi-drug resistant. ConclusionSalmonella contamination remains high in retail poultry in Jiading District， Shanghai. Drug resistance to antibiotics is increasing. Therefore， monitoring and control of Salmonella should be strengthened.

ObjectiveTo investigate the contamination situation， serotype distribution and drug resistance of salmonella in poultry sold in Jiading District， Shanghai. MethodsBetween 2019 and 2020， four types of poultry meat （chicken， duck， goose and pigeon） were sampled from markets， and potential salmonella contamination was isolated and identified via serotyping. Furthermore， resistance detection of isolated salmonella to 13 commonly-used antibiotics was conducted. ResultsA total of 32 salmonella strains were isolated from 156 commercial poultry samples. No salmonella was identified in pigeon samples， while the most severe contamination was detected in goose samples， with a detection rate of 28.00%. Contamination situation was categorized with different storage conditions. The lowest detection rate of 12.90% was noted under cold storage， while the highest rate of 26.67% was detected under frozen condition. The major serotypes of salmonella were Salmonella typhimurium， Salmonella enteritidis and Salmonella Argonne. Relatively higher drug resistance was detected with nalidixic acid and tetracycline， with drug resistance rate of 59.38% and 40.63%， respectively. Low drug resistance was detected with cephalosporins， and no drug resistance was detected with imipenem. Significant difference in drug resistance was noted in the serotype of Salmonella isolated from meat of chicken， duck and goose. Three major salmonella strains had different drug resistance. 21.88% （7/32） of salmonella strains were non-resistant to any tested drugs. Multi-drug resistant strains accounted for 31.25% （10/32） of the isolated strains. At most， salmonella was resistant to 11 kinds of different antibiotics. ConclusionThere is a significant difference in the contamination situation and drug resistance of Salmonella isolated from four types of poultry meat sold in Jiading District， Shanghai. It is strongly recommended that different supervision strategies and management upon classification be implemented.

Objective: To study the clinical features of dengue cases infected with hepatotropic virus and Mycobacterium tuberculosis in Xishuangbanna, and to provide evidences to set up effective treatment programs for the dengue patients infected with the other diseases for hospitals. Methods: The clinical characteristics of dengue cases infected hepatotropic virus and Mycobacterium tuberculosis were analyzed retrospectively on their symptoms and biochemical parameters from the People′s Hospital and the Infectious Disease Hospital of Xishuangbanna Prefecture in 2013 and 2015. Results: The clinical characteristics of dengue cases infected with hepatotropic virus were typical, and inclued low incidence of urinary abnormalities, coagulation disorders and high-lactate dehydrogenase. Dengue cases infected with Mycobacterium tuberculosis had high incidence of shock, high-hematocrit, renal function and coagulation abnormalities, which suggested a trend of more serious illness than other groups obviously. Conclusions The rate of severe disease was higher in dengue cases infected with Mycobacterium tuberculosis than those infected with hepatotropic virus, which suggests that the dengue cases infected with Mycobacterium tuberculosis should be treated timely to reduce the severity of the diseases in the hospital.

Objective To investigate the effects and mechanisms of extracellular-signal regulated protein kinase-motogenactived protein kinase(ERK-MAPK)signaling pathway in gastrin-induced cell proliferation and apoptosis of colorectal cancer cells.Methods HT-29 cells were incubated in different media,and then were divided into the control group,gastrin group,proglumide group and gastrin + proglumide group.No reagent was added in the control group,and other groups were dealed with reagent in different concentrations.The changes of proliferation of the HT-29 cells were detected by MTT assay,and the optimal concentration of gastrin and proglumide were determined.The changes of proliferation index and apoptotic rates of HT-29 cells were detected by cell cytometry.The mRNA expressions of gastrin receptor/cholecystokinin-B receptor(CCK-BR),ERK1/2 and K-ras were detected by RT-PCR.The protein of ERK1/2,K-ras protein and phosphorylation levels were detected by Western blot.All data were analyzed by analysis of variance and SNK-q test.Results The proliferation of HT-29 was stimulated by gastrin when the concentration of the gastrin was 6.25-100.00 mg/L,and the optimal concentration of gastrin was 25.00 mg/L(F =31.36,P ＜ 0.05).Proglumide had no obvious effects on the proliferation of HT-29 cells,while it significantly inhibited the proliferation of HT-29 cells stimulated by gastrin when the concentration of proglumide was 8.00-128.00 mg/L,and the optimal concentration was 32.00 mg/L(F =24.31,P ＜ 0.05).The proliferation index of the gastrin(25.00 mg/L)group was 37.5 ％ ± 5.2％,which was significantly higher than 27.7％ ± 5.0％ of the control group and 27.3％ ± 5.8％ of the gastrin(25.00 mg/L)+ proglumide(32.00 mg/L)group(q =4.56,4.75,P ＜ 0.05).The apoptotic index of the gastrin(25.00 mg/L)group was 1.9％ ± 0.4％,which was significantly lower than 2.5％ ± 0.4％ of the control group and 2.4％ ± 0.3％ of the gastrin(25.00 mg/L)+ proglumide(32.00 mg/L)group(q =4.23,4.06,P＜0.05).The mRNA expression of CCK-BR was detected in the HT-29 cells.The levels of phosphorylated ERK1/2 protein and phosphorylated K-ras protein were 0.43％ ± 0.04％ and 0.45％ ± 0.06％,which were significantly higher than 0.32％ ± 0.02％ and 0.31％ ± 0.05 ％ of the control group(q =7.78,4.95,P ＜ 0.05),and they were also higher than 0.36％ ± 0.01％ and 0.35 ％ ± 0.04％ of the gastrin(25.00 mg/L)+ proglumide(32.00 mg/L)group(q =5.72,4.08,P ＜0.05).There were no significant differences in the mRNA and protein expressions of ERK1/2 and K-ras among the control group,gastrin(25.00 mg/L)group,proglumide(32.00 mg/L)group and gastrin (25.00 mg/L)+ proglumide(32.00 mg/L)group(F =0.52,0.72,0.78,0.28,P ＞0.05).Conclusion Gastrin could stimulate the proliferation of HT-29 cells and inhibit their apoptosis by upregulate the phosphorylation levels of ERK and K-ras through the Ras→Raf→ MEK1/2→ ERK1/2 pathway,while the effect can be restrained by gastrin receptor antagonist proglumide.