[Objective] To explore the accuracy and feasibility of non-invasive prenatal diagnosis of fetal RhE genotype using cell-free fetal DNA (cff-DNA) from maternal peripheral blood. [Methods] A total of 134 pregnant women with single fetuses and RhE-negative blood group were selected from our hospital from November 2023 to August 2024. Free DNA extraction kit was used to extract free DNA from peripheral blood of pregnant women, and the RhE blood group genotype of free DNA was detected by real-time fluorescent quantitative PCR (RT-qPCR). If the qPCR amplification signal of the sample was negative, the methylated RASSF1A gene was amplified, and the positive amplification result was used as a sign of successful extraction of cff-DNA. Serological microcolumn gel method was used to detect the phenotype of RhE blood group in neonatal peripheral blood. [Results] Among the 134 maternal peripheral blood samples, the cff-DNA detection of RhE blood group phenotypes was consistent with the RhE blood group genotyping of neonatal peripheral blood in 133 cases, including 90 cases of Rhee genotype and 43 cases of RhE genotype, with diagnostic concordance rate of 99.3%, sensitivity of 97.7%, specificity of 100%, youden index of 0.977, area under ROC curve of 0.995, the Kappa value of 0.983, positive predictive value of 100%, and negative predictive value of 98.9%. The sample of 1 case failed to be detected. After the amplification of methylated RASSFIA gene, it was confirmed that the reason for the failure was that no cff-DNA was extracted from the sample. The diagnostic concordance rates of the first, second and third trimesters were 93.8% (15/16), 100% (51/51) and 100% (67/67), respectively. Fisher's exact test method was used to calculate the P value, which was P>0.05, indicating that there was no statistical significance in the difference of diagnostic concordance rate among the three pregnancy periods, and there was no difference in the detection concordance rate of this method in different pregnancy periods. [Conclusion] The use of cff-DNA in maternal peripheral blood for the detection of fetal RhE blood group genotype is an accurate and highly feasible non-invasive prenatal diagnostic method, which is helpful for the clinical diagnosis of fetal and neonatal hemolytic disease caused by anti-E antibody.

Objective To investigate the population density and seasonal fluctuations of Aedes albopictus in Guangzhou City, Guangdong Province, from 2021 to 2023, so as to provide insights into A. albopictus control and management of dengue fever. Methods The surveillance of A. albopictus density was performed in all surveillance sites assigned across all streets (townships) in Guangzhou City during the period from January to December from 2021 to 2023. The surveillance frequency was twice every half month from May to September, and once every month for the rest of a year. In each surveillance period, A. albopictus mosquito larvae were captured from indoor and outdoor small water containers in residential areas, parks, medical facilities, schools, other government sectors and social organizations, construction sites, special industries and others for mosquito species identification. Adult mosquitoes were captured using electric mosquito suction apparatus for species identification and gender classification. Adult mosquitoes and mosquito eggs were collected with mosquito and egg traps at the breeding and dwelling places of Aedes mosquitoes for identification. The mosquito oviposition index (MOI), Breteau index (BI), adult mosquito density index (ADI) and standard space index (SSI) were calculated. The A. albopictus density was classified into grades 0, 1, 2 and 3 in each surveillance site, with Grade 0 density defined eligible, and the eligible rate of A. albopictus density was calculated at all surveillance sites each year from 2021 to 2023. In addition, the changing trends in MOI, SSI, BI and ADI of A. albopictus were analyzed in Guangzhou City from 2021 to 2023. Results The eligible rates of A. albopictus density were 61.69%, 68.75% and 55.15% in surveillance sites of Guangzhou City from 2021 to 2023 (χ² = 297.712, P < 0.001), and appeared a tendency towards a reduction followed by a rise each year, which gradually reduced since January, maintained at a low level during the period between May and October, and gradually increased from November to December. The MOI, SSI, BI and ADI of A. albopictus all appeared a tendency towards a rise followed by a reduction in Guangzhou City during the period between January and December from 2021 to 2023. The BI of A. albopictus peaked in the first half of June in 2021 (4.03), the first half of July in 2022 (3.89) and the last half of August in 2023 (5.02), and the SSI of A. albopictus peaked in the last half of June in 2021 (0.93), the last half of May in 2022 (0.59), and the last half of June (0.94) and the first half of September in 2023 (1.12). In addition, the MOI of A. albopictus peaked in the first half of May in 2021 (8.64), the first half of June in 2022 (8.96), and the last half of May (10.21) and the last half of June in 2023 (10.89), and the ADI of A. albopictus peaked in the first half of June in 2021 (3.41), the last half of June in 2022 (4.06), and the first half of July in 2023 (3.61). Conclusions The density of A. albopictus is high in Guangzhou City during the period from May to October, and the risk of local outbreak caused by imported dengue fever is high. Persistent intensified surveillance of the density and seasonal fluctuation of A. albopictus is recommended and timely mosquito prevention and control is required according to the fluctuation in the A. albopictus density.

Currently, the academic community, industry, and governmental institutions worldwide are dedicated to developing and applying artificial intelligence and other advanced analytical tools to drive the transformation of healthcare services. However, there are still many challenges, with only a few artificial intelligence tools having achieved sufficient effectiveness in improving clinical outcomes for cardiovascular diseases and strokes to be widely used. In response, the American Heart Association has formulated related scientific statements outlining the latest research developments in artificial intelligence algorithms and data science for the diagnosis, classification, and treatment of cardiovascular diseases. These statements also summarize the current best practices, research gaps, and existing challenges of artificial intelligence tools, aiming to promote the development of this field. This article interprets this scientific statement in conjunction with the relevant research practices of the author's team.

Objective To analyze and compare the treatment of HeppleⅤ talus osteochondral injury(OLT)with autologous periosteal iliac bone graft and allogeneic bone powder combined with platelet rich gel(PRP).Methods Totally 62 HeppleⅤOLT patients admitted to our hospital from October 2018 to October 2022 were selected as the research subjects.They were divided into a transplantation group(31 patients received autologous periosteal iliac bone transplantation treatment)and a combination group(31 patients received allogeneic bone powder combined with PRP treatment)based on their treatment methods.Conduct a 12 month postoperative outpatient follow-up study on patients,evaluate and compare the treatment effectiveness,ankle joint range of motion(ROM),American Society of Orthopedic Foot and Ankle Surgeons(AOFAS)ankle posterior foot score,pain score,satisfaction,and incidence of complications between the two groups of patients at 12 months after surgery.Results The total effective rate of the transplantation group(96.77%)was not significantly different from that of the combination group(93.55%,P>0.05).At 12 months after surgery,the ROM and AOFAS scores of both groups improved(P<0.05),and there was no statistically significant difference between the groups(P>0.05).At 1 month,3 months,6 months,and 12 months after surgery,the pain scores of both groups decreased compared to before surgery(P<0.05).The subjective overall satisfaction of patients in the transplantation group(77.42%)was lower than that in the combination group(96.77%,P<0.05).The total incidence of complications in the transplantation group(19.35%)was significantly higher than that in the combination group(3.23%,P<0.05).Conclusion Allogeneic bone powder combined with PRP can avoid additional surgical incisions,increase patient subjective satisfaction,and increase the incidence of postoperative complications.

Objective To explore the relationship between postoperative restenosis and vascular endothelial function in patients with lower extremity arterial disease(LEAD).Methods A retrospective analysis was performed on 133 patients with diabetic lower extremity arteriopathy who had successfully undergone interventional therapy in our hospital,and the patients were followed up for one year,and the patients were grouped according to whether restenosis occurred,with 25 cases in the restenosis group and 108 cases in the non-stenosis group.The patient's vascular endothelial function index,inflammatory factor level,blood lipid four items and hemoglobin A1c(HbAlc)were detected,and peripheral blood cells of patients in the stenosis group and non-stenosis group were isolated for transcriptome sequencing.Multivariate unconditional logistic regression analysis was used to screen for independent risk factors for vascular endothelial function in postoperative restenosis.Results Serum endothelin-1(ET-1),von Willebrand factor(vWF),thromboxane B2(TXB2),vascular cell adhesion protein 1(VCAM-1),and nitric oxide(NO)were significantly higher in the stenosis group than in the non-stenosis group,while endothelial nitric oxide synthase(eNOS)and vascular endothelial growth factor(VEGF)were significantly lower than those in the non-stenosis group(P<0.01).There was no significant difference in blood lipids between the two groups(P>0.05).The HbAlc of the stenosis group was significantly higher than that of the non-stenosis group(P<0.01).The inflammatory factors in the stenosis group were significantly higher than those in the non-stenosis group(P<0.05).Transcriptome sequencing analysis results are consistent with test results.Multivariate Logistic regression analysis showed that TNF-α,IL-6,ET-1,and vWF were independent risk factors for LEAD vascular restenosis(P<0.05).Conclusion Vascular endothelial function indexes(ET-1,vWF)and inflammatory factors(TNF-α,IL-6)are independent risk factors for restenosis after interventional surgery.

Objective To investigate the treatment of neonatal respiratory distress syndrome by less invasive surfactant administration(LISA)clinical efficacy,complications and influence on blood gas analysis.Methods A total of 100 cases of neonatal respiratory distress syndrome requiring pulmonary surfactant(PS)tracheal injection therapy and admitted to the Jinhua Central Hospital between December 1st 2019 and August 1st 2022 were randomly assigned into treatment group(50 cases)and control group(50 cases).The treatment group of children received PS treatment using LISA technology,while the control group of children received PS treatment using tracheal intubation tracheal instillation PS extubation followed by intubation-surfactant-extubation technology.The clinical treatment effect,blood gas analysis,non-invasive ventilation time,length of hospitalization,and incidence of complications were compared between the two groups.Results The total effective rate of treatment in the treatment group was higher than that in the control group;After 1 hour of PS treatment,the oxygen partial pressure and blood oxygen saturation of the treatment group were higher than those of the control group,while the carbon dioxide partial pressure was lower than that of the control group.The non-invasive assisted ventilation time of the treatment group was shorter than that of the control group.The incidence of bronchopulmonary dysplasia was lower than that of the control group.Their difference were statistically significant(P<0.05).Conclusion The use of LISA technology for PS treatment of NRDS can improve blood gas indicators,shorten non-invasive ventilation time,improve diagnostic and therapeutic effects,reduce the risk of bronchopulmonary dysplasia,and do not increase the incidence of complications such as tracheal mucosal injury and pulmonary hemorrhage in children.

Objective:To report the results of national surveillance on the distribution and antimicrobial resistance profile of clinical Gram-negative bacteria isolates from bloodstream infections in China in 2022.Methods:The clinical isolates of Gram-negative bacteria from blood cultures in member hospitals of national bloodstream infection Bacterial Resistant Investigation Collaborative System（BRICS）were collected during January 2022 to December 2022. Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical and Laboratory Standards Institute（CLSI）. WHONET 5.6 and SPSS 25.0 software were used to analyze the data.Results:During the study period，9 035 strains of Gram-negative bacteria were collected from 51 hospitals，of which 7 895（87.4%）were Enterobacteriaceae and 1 140（12.6%）were non-fermenting bacteria. The top 5 bacterial species were Escherichia coli（ n=4 510，49.9%）， Klebsiella pneumoniae（ n=2 340，25.9%）， Pseudomonas aeruginosa（ n=534，5.9%）， Acinetobacter baumannii complex（ n=405，4.5%）and Enterobacter cloacae（ n=327，3.6%）. The ESBLs-producing rates in Escherichia coli， Klebsiella pneumoniae and Proteus spp. were 47.1%（2 095/4 452），21.0%（427/2 033）and 41.1%（58/141），respectively. The prevalence of carbapenem-resistant Escherichia coli（CREC）and carbapenem-resistant Klebsiella pneumoniae（CRKP）were 1.3%（58/4 510）and 13.1%（307/2 340）；62.1%（36/58）and 9.8%（30/307）of CREC and CRKP were resistant to ceftazidime/avibactam combination，respectively. The prevalence of carbapenem-resistant Acinetobacter baumannii（CRAB）complex was 59.5%（241/405），while less than 5% of Acinetobacter baumannii complex was resistant to tigecycline and polymyxin B. The prevalence of carbapenem-resistant Pseudomonas aeruginosa（CRPA）was 18.4%（98/534）. There were differences in the composition ratio of Gram-negative bacteria in bloodstream infections and the prevalence of main Gram-negative bacteria resistance among different regions，with statistically significant differences in the prevalence of CRKP and CRPA（ χ2=20.489 and 20.252， P<0.001）. The prevalence of CREC，CRKP，CRPA，CRAB，ESBLs-producing Escherichia coli and Klebsiella pneumoniae were higher in provinicial hospitals than those in municipal hospitals（ χ2=11.953，81.183，10.404，5.915，12.415 and 6.459， P<0.01 or <0.05），while the prevalence of CRPA was higher in economically developed regions（per capita GDP ≥ 92 059 Yuan）than that in economically less-developed regions（per capita GDP <92 059 Yuan）（ χ2=6.240， P=0.012）. Conclusions:The proportion of Gram-negative bacteria in bloodstream infections shows an increasing trend，and Escherichia coli is ranked in the top，while the trend of CRKP decreases continuously with time. Decreasing trends are noted in ESBLs-producing Escherichia coli and Klebsiella pneumoniae. Low prevalence of carbapenem resistance in Escherichia coli and high prevalence in CRAB complex have been observed. The composition ratio and antibacterial spectrum of bloodstream infections in different regions of China are slightly different，and the proportion of main drug resistant bacteria in provincial hospitals is higher than those in municipal hospitals.

Brain metastasis is an uncommon complication that occurs in the advanced stage of gynecologic malignancies. Brain metastasis tends to be one of the major factors contributing to the poor prognosis of patients. There have been more reports about brain metastasis in cervical, ovarian and endometrial cancers in recent years due to the growth of large databases and improved diagnostic methods. Great attention has been paid to the selection of appropriate therapeutic options to improve the survival of gynecologic malignancies patients with brain metastasis. This article reviews the research progress of brain metastasis in cervical, ovarian and endometrial cancers, aiming to provide better options for treatment of patients with common advanced gynecologic malignancies.

ObjectiveTo determine the antibody levels of varicella-zoster virus （VZV） in healthy individuals aged 1 to 30 years in Songjiang District of Shanghai， and to provide evidence for further development of varicella immunization strategies for healthy population. MethodsSix village committees were selected in Songjiang District through multi-stage stratified random sampling method from July to September 2022. Healthy individuals aged 1 to 30 years old in these villages were recruited and 3‒5 mL of venous blood was collected. Anti-VZV IgG antibody was tested by ELISA. Positive rate of anti-VZV IgG antibody and geometric mean concentration （GMC） were determined. ResultsA total of 315 healthy individuals aged （10.97±8.38） years were included in this study， of which 165 were males aged （11.00±8.52） years and 150 were females aged （10.96±8.25） years. Blood samples were collected and tested for anti-VZV IgG antibody， with the overall positive rate of 55.24% （174/315）. The GMC was calculated to be 99.73 mIU·mL^-1， with the GMC in those tested positive for anti-VZV IgG antibody of 413.11 mIU·mL^-1. The positive rate of anti-VZV IgG antibody and GMCs across age groups ranged between 13.33%‒86.67% and 16.36‒355.14 mIU·mL^-1， respectively. The highest GMC was found in the group of 20‒30 years old （355.14 mIU·mL^-1）， followed by 132.41 mIU·mL^-1 in the group of 5‒ years old and 138.12 mIU·mL^-1 in the group of 15‒ years old. Moreover， the positive rate was 38.47% in the group with 1-dose varicella vaccine and 63.49% in the group with 2 doses， while the GMC were 53.28 mIU·mL^-1 and 130.79 mIU·mL^-1 in these two groups， respectively. Multivariable analysis revealed that occupation was a risk factor associated with anti-VZV IgG antibody （OR=2.540）. Stratified analysis by varicella immunization history showed that among 2-dose vaccination group， time interval since the last dose was a protective factor （OR=0.315）. ConclusionsThe overall positive rate of anti-VZV IgG antibody in healthy population in Songjiang District of Shanghai remains low. The 2-dose varicella vaccination should be strengthened to improve the coverage in susceptible population.

Objective: To explore the associations of physical activity and sleep quality with anxiety and depressive symptoms in college students, in order to provide empirical support and theoretical guidance for mental health intervention among college students. Methods: From March to April 2023, 2 099 college students from universities in 6 different provinces were selected by a convenient sampling method. Physical activity, sleep quality, anxiety and depressive symptoms were evaluated by the International Physical Activity Questionnaire Short Form (IPAQSF), the Pittsburgh Sleep Quality Index (PSQI), the Center for Epidemiologic Studies Depression Scale (CESD) and the Anxiety SelfRating Scale (SAS), respectively. Descriptive statistics and Logistic regression models were used to analyze the data. Results: The reporting rates of lowintensity, moderateintensity, and highintensity physical activity among college students were 30.3%, 45.3%, and 24.4%, respectively. Moreover, among the participants, anxiety was detected in 21.6% and depressive symptoms in 39.9%, while 62.3% experienced poor sleep quality. Compared with males, females exhibited a lower proportion of highintensity physical activity (22.3% vs 42.8%), while reported higher proportions of moderateintensity (48.1% vs 40.8%) and lowintensity physical activity (29.5% vs 16.4%). Additionally, the proportion of females reporting poor sleep quality (65.0%) was higher than that of males (58.0%) (χ2=110.15, 10.70, P<0.05). The proportion of girls (43.8%) with depressive sypmtoms was higher than that of boys (33.9%) (χ2=20.48, P<0.05). Logistic regression analysis showed that high physical activity was negatively correlated with anxiety and depression (OR=0.45, 0.33), poor sleep quality was positively correlated with anxiety and depressive symptoms (OR=3.89, 3.94) (P<0.01).The interaction effect between high physical activity and good sleep quality was associated with the reduction of anxiety and depression among college students (OR=0.14, 0.08, P<0.01). Conclusions Physical activity and sleep quality are associated with anxiety and depressive symptoms among college students. The interventions for mental health problems such as depression and anxiety among college students should aim to improve physical activity and sleep quality.