Objective:To investigate the pathogen spectrum and the epidemiological characteristics of hospitalized severe acute respiratory tract infection (SARI) cases in a sentinel hospital in Tongzhou District of Beijing from 2019 to 2022, and provide reference for scientific prevention and control of SARI.Methods:This study enrolled SARI patients in the Beijing Luhe Hospital from January 2019 to December 2022. Nasopharyngeal swabs or respiratory secretions of the patients were collected and analyzed by quantitative real-time PCR to detect the pathogens and their types. The epidemiological and clinical characteristics of the cases were analyzed.Results:In this study, 1 124 SARI cases were enrolled, of which 379 were positive for respiratory pathogens with a detection rate of 33.72%. Most of the SARI cases were positive for bacteria pathogens, and the detection rates of Mycoplasma pneumoniae, Streptococcus pneumoniae, and Stenotrophomonas maltophilia were high. Influenza A virus, parainfluenza virus, and respiratory syncytial virus were the main viral pathogens detected in the cases. There were significant differences in the number of cases and the detection rate of respiratory pathogens among different age groups (χ 2=555, P=0.000 1). The predominant pathogens in different years were different. Mycoplasma pneumoniae [27.27% (51/187)] and influenza A virus [17.65% (33/187), ] were the predominant pathogens in 2019; parainfluenza virus [16.67% (10/60)], Mycoplasma pneumoniae [11.67% (7/60)], and Haemophilus influenzae [11.67% (7/60)] were the predominant pathogens in 2020; Stenotrophomonas maltophilia [24.39% (20/82)] and respiratory syncytial virus [19.51% (16/82)] were the predominant pathogens in 2021; Stenotrophomonas maltophilia [20% (10/50)] and parainfluenza virus [12% (6/50)] were the predominant pathogens in 2022. Conclusions:Most of the SARI cases in Tongzhou district of Beijing from 2019 to 2022 are caused by bacteria. More attention should be paid to the prevalence of Stenotrophomonas maltophilia and Mycoplasma pneumoniae, as well as the prevalence of respiratory syncytial virus, parainfluenza virus, and influenza A virus. The predominant pathogens change every year from 2019 to 2022. Therefore, the prevention and control strategies should be made accordingly. This study provides basis data for the national respiratory multipathogen surveillance program.

Objective To study the epidemiological features of hand， foot， and mouth disease （HFMD） in Minhang District of Shanghai and to explore the possible effects of meteorological factors on the onset of HFMD， aiming to provide a reference for the prevention and control of HFMD. Methods The incidence data of HFMD in Minhang District from 2014 to 2018 were collected for descriptive analysis. The data of meteorological factors that might affect HFMD were analyzed by Pearson analysis and multiple linear stepwise regression. Results The average incidence rate of HFMD in Minhang District from 2014 to 2018 was 271.51 per 100 000. The incidence of Huacao， Pujiang and Maqiao community were the highest. The incidence of HFMD in males was higher than in females and the 0‒5 age group had the largest number of cases， mainly in scattered children and children in kindergartens. The results of multiple linear stepwise regression analysis showed that the incidence of HFMD was negatively correlated with the weekly average air pressure （ b =-4.32， P =0.004）， and was positively correlated with the weekly minimum temperature （ b =2.62， P =0.040） and the weekly average relative humidity （ b =1.71， P =0.010）. The correlation with weekly average temperature， weekly maximum temperature， weekly precipitation， weekly average air pressure and weekly average water vapor pressure was not significant. Conclusion Meteorological factors in Minhang District of Shanghai are closely related to the occurrence of HFMD. Comprehensive measures should be taken to prevent and control HFMD.

Radiotherapy is the most common treatment for nasopharyngeal carcinoma, and the radiotherapy technique is essential for the prognosis of nasopharyngeal carcinoma. Due to the complexity of the structure of the intensity-modulated device and the accuracy of the clinical requirements of radiotherapy, it is inevitable that higher requirements will be imposed on the process of intensity-modulated radiotherapy. Currently, gaps exist in the radiotherapy equipment and personnel qualification among radiotherapy units, and thus the homogenization in the radiotherapy remains to be strengthened in China. With the application of radiotherapy information management system, digital medicine and artificial intelligence technologies in the field of radiotherapy, the original process fails to meet the application needs of the new precise radiotherapy technology. Therefore, this process is designed based on the existing radiotherapy procedures for nasopharyngeal carcinoma in combination with the latest developments in the field of radiotherapy, aiming to establish a novel standard process recommendation, ensuring the standardization and homogenization of radiotherapy and achieve the individualized intensity-modulated radiotherapy for nasopharyngeal carcinoma patients.

Severe acute respiratory syndrome coronavirus（SARS-CoV-2）is highly infectious and people are generally susceptible to it. In this article,we reviewed current research into the epidemiological characteristics of coronavirus disease 2019（COVID-19）,introduced China's effective prevention and control experience,preliminarily summarized the phased Results of China's fight against the COVID-19,and reviewed the early measures taken by Singapore,Japan,Italy,Iran and South Korea. We recommended China’s prevention and control measures in response to COVID-19 to the world;appealed to pay attention to non-drug interventions,to strengthen the cooperation and sharing of COVID-19 epidemic data and research,to improve the global ability in respond to public health emergencies,and to reduce the impact of COVID-2019 on the sustainable development of economy and society.

With the strengthening of nuclear weapon development and the expanding of neutron application in economic area,the injury accidents of neutron radiation are happening from time to time.Neutron exposure,with high linear energy transfer,has high casualty rate,severe symptom and poor prognosis.In comparison with low-LET radiation damage,neutron irradiation induced injuries are more difficult to rescue.This review focused on the recent research progresses of radiation effects,intrinsic mechanisms and clinical prevention measures of neutron radiation,and to provide a theoretical clue for establishing an effective prevention protocol of neutron radiation damage.

Objective To investigate the clinical characteristics of acute pulmonary embolism in the elderly and its differences between the elderly and non-elderly patients,and explore the predictive effect of red blood cell distribution width(RDW)on chronic thromboembolic pulmonary hypertension (CTEPH)in patients with acute pulmonary embolism.Methods A total of 129 consecutive patients with acute pulmonary embolism admitted into Affiliated Hospital of Binzhou Medical College were selected from Jan.2009 to Dec.2013.Clinical data including the basic data,blood routine test,blood gas analysis,Doppler echocardiography during admission were retrospectively analyzed.All the patients were followed-up.Ancillary findings and changes of the disease were recorded in detail during the follow-up period.SPSS 19.0 was used to analyze the results.Results The incidences of CEPPH and venous thromboembolism(VTE)in APE patients were higher in the elderly than in non-elderly.The mean RDW and pulmonary arterial systolic pressure on admission in APE patients were higher in the elderly than in non-elderly [(14.22±2.11)％ vs.(13.48± 1.69)％,P=0.033,for mean RDW] and [(54.82± 21.77)mmHg vs.(42.20 ± 19.36) mmHg,P=0.010 for pulmonary arterial systolic pressure].The mean RDW was higher in CTEPH patients than in patients without CTEPH [(16.79 ± 3.08) ％ vs.(13.68± 1.68)％,P=0.016].Multivariate Logistic analyses showed that the increased RDW level was an independent risk factors for CTEPH in APE patients(OR=1.535,95％ CI:1.094-2.155,P=0.013).The area under receiver operating characteristics curve(AUC)of RDW level for predicting CTEPH in APE patients was 0.856(95％ CI:0.706-0.987,P＜0.001),the corresponding cut-off point was 14.85％,and the sensitivity and specificity were 88.9％ and 87.5％ respectively.Conclusions The increased RDW level could predict the risk of CTEPH to a certain extent in APE patients.

To investigate the effect of apigenin on self-renewal for sphere-forming cells in human small cell lung cancer cell line NCI-H446 and the underlying mechanisms.
 Methods: Sphere-forming cells from NCI-H446 cell line were cultured in stem cell-conditioned culture medium with ultra-low attachment surface plates. The rate of sphere-forming cells in the second passage sphere-forming cells was used to evaluate the inhibitory effects of apigenin on the self-renewal for sphere-forming cells. The protein level of urokinase-type plasminogen activator receptor (uPAR) in spheroids was analyzed by Western blot.
 Results: Apigenin signifcantly inhibited the self-renewal of the second passage sphere-forming cells [0, 5.0, 10.0, 20.0 μmol/L apigenin: (18.2±1.9)%, (13.6±1.7)%, (10.6±1.6)%, (6.9±1.3)%, respectively] and down-regulated uPAR expression in a concentration-dependent manner (P<0.05).
 Conclusion: Apigenin inhibits the self-renewal capacity of sphere-forming cells in NCI-H446 cells, which may be associated with down-regulation of uPAR expression.
Apigenin ; pharmacology ; Cell Line, Tumor ; Down-Regulation ; drug effects ; genetics ; Humans ; Lung Neoplasms ; Neoplastic Stem Cells ; drug effects ; pathology ; physiology ; Receptors, Cell Surface ; Receptors, Urokinase Plasminogen Activator ; drug effects ; genetics ; metabolism ; Signal Transduction ; Small Cell Lung Carcinoma ; drug therapy ; pathology ; Spheroids, Cellular ; drug effects ; physiology ; Stem Cells

Objective To compare the therapeutic effects of three therapeutics to earlier primary gastric diffuse large B cell lymphoma(PG-DLBCL).Methods By reviewing a data-base of 66 patients with earlier PG-DLBCL from Aug 2000 to Oct 2011 were enrolled,patients were divided into chemotherapy alone(21 cases),radiotherapy combined with chemotherapy(22 cases) and surgery followed chemotherapy group(23 cases),and to comparing the prognosis of the three therapeutics.Results The complete remission rates(CR) of the three groups was 47.6％,77.3％,65.2％ (P ＞ 0.05).The median progression-free survival(PFS)of the three groups in 66 patients was 61.5,90.4 and 79.1 months,the radiotherapy combined group was proven to be significantly better than chemotherapy alone group and surgery followed chemotherapy group(x2 =6.726,P ＜0.05).The 3-year survival rate of the three groups was 81.6％,90.5％ and 82.6％.The five year survival rate was 72.5％,90.5％,82.6％.There was no significant difference (P ＞ 0.05) in 3-year survival rate and 5-year survival rate.Conclusions Radiotherapy combined with chemotherapy can significantly improve the PFS without increasing the risk of other adverse outcomes,and could be the first treatment way for the earlier PG-DLBCL.

AIM: To observe the changes of transient receptor potential channel 5 (TRPC5) in vascular smooth muscle cells ( VSMCs) of apolipoprotein E-knockout ( ApoE-/-) mice and the effect of atorvastatin interference, and to investigate the mechanism of atorvastatin therapy.METHODS:Male ApoE-/-mice at 6 weeks of age were used to establish the atherosclerosis model by feeding with hyperlipidic diet.The mice were randomly divided into model group and atorvastatin group.The mice in atorvastatin group were lavaged with atorvastatin at 20 mg· kg-1 · d-1 , while the mice in model group received normal saline.The healthy C57BL/6J mice with the same age and the same genetic background, feeding with ordinary food, served as control group.At the time points of 14 and 24 weeks, the mice were sacrificed.The serum was collected for detecting the lipid levels.The aortic roots of the heart were taken to make paraffin sections with HE staining for measuring and comparing the relative atherosclerotic plaque area in each section.The expression of TRPC5 in VSMCs was examined with immunohistochemical staining.The mRNA levels of TRPC5 in the serum and the thoracoabdom-inal aorta were measured by real-time PCR.RESULTS: Compared with model group, blood lipids in atorvastatin group were significantly decreased, and the formation of plaque under aorta intima also decreased.The protein expression of TR-PC5 in atorvastatin group decreased significantly compared with model group.Compared with 20-week model group, TRPC5 in 30-week model group showed increasing tendency, but has no statistical significance.Compared with 20-week atorvasta-tin group, TRPC5 of 30-week atorvastatin group declined.CONCLUSION: Atorvastatin suppresses TRPC5 expression, thus attenuating atherosclerotic development in ApoE-/-mice.

Objective To evaluate the effect of evidence-based bundle intervention strategy on reducing the inci-dence of central line-associated bloodstream infection (CLABSI).Methods Prospective and multicenter study was adopted,patients admitted to 54 intensive care units (ICUs)of 41 hospitals and with central venous catheters (CVCs)between October 1 ,2013 and September 30,2014 were monitored .Baseline data between October 2013 and March 2014 were collected as pre-intervention data;from April to September 2014,the participated hospitals performed intervention strategy,post-intervention data were compared with pre-intervention data.Results The usage rate of CVCs before and after intervention was significantly different (44.18% vs 44.63%,χ2 =5.526,P =0.019).Incidence of CLABSI before and after intervention was not significantly different(RR ,0.82[95%CI ,0.59-1 .13],P =0.10).Constituent ratio of catheter insertion sites between pre-and post-intervention was significantly different (χ2 =76.264,P <0.001),femoral vein catheterization rate as well as proportion of two and above catheter insertion sites after intervention decreased(17.25% VS 13.72%;2.27% VS 1 .44%,respectively);hand hygiene implementation rate and accuracy rate after intervention were both higher than before intervention (79.73% vs 76.14%,P <0.001 ;91 .47% vs 74.26%,P <0.001 ,respectively);constituent ratio of skin disinfectant applica-tion before and after intervention was significantly different(χ2 =3.861 ,P <0.001 ),proportion of chlorhexidine ethanol increased (29.62% VS 50.56%);except daily assessment and record,compliance to other prevention and control measures before and after intervention were all significantly different(all P <0.001);utilization rate of max-imal sterile barrier,qualified rate of dressing of operators,and port disinfection were all significantly enhanced. Conclusion Bundle intervention in intubation and maintenance are implemented effectively,but intervention effect on CLABSI needs further study.