Objective To explore the feasibility of applying artificial intelligence (AI) technology in chromosomal aberration (CA) analysis for occupational health surveillance of radiation workers and in biological dose estimation during nuclear emergency responses. Methods Peripheral blood samples from healthy volunteers were irradiated in vitro with X-rays and cobalt-60 (⁶⁰Co) γ rays. Chromosome slides were prepared using an automated harvesting and dropping device. The data training and outcome evaluation of CA analysis was performed on the AI software using chromosome images from occupational medical examination of radiation workers from the current lab or chromosome slides from blood samples irradiated with X-rays. The trained AI software was then used to assist in CA analysis and biological dose estimation among occupational medical examination of radiation workers, with results compared with manual reading and actual exposure doses. Results The trained AI software achieved a CA recognition accuracy of 95.11%. In the occupational health examination of radiation workers, the positive CA detection rate using AI + manual review was 2.25% higher than that in manual reviewing alone. The errors in biological dose estimation for ⁶⁰Co γ rays and X-rays using AI + manual review analysis were 11.86% and 7.33%, respectively, both within the acceptable 20.00% error margin. Conclusion AI + manual review can be effectively applied in CA analysis for occupational health examination and biological dose estimation during nuclear emergencies, significantly improving analysis efficiency.

Objective To analyze epidemiological characteristics and changing trends of common respiratory infectious diseases among 6-19 year-old population in Shenzhen from 2013 to 2021, and to provide a reference for prevention and control. Methods Data of influenza, mumps and varicella reported cases among the population aged 6-19 years in Shenzhen from 2013 to 2021 were collected, and descriptive methods and Joinpoint regression model were used to analyze epidemiological characteristics and trends of incidences. Results Between 2013 and 2022 in Shenzhen, the average annual incidence rates of influenza, mumps, and varicella among the population aged 6-19 years were 961.44/100 000, 157.70/100 000, and 664.34/100 000 respectively. The incidence of influenza showed an upward trend in 10 years, with an annual percent change (APC) of 52.88% (P<0.05). The incidence of mumps and varicella both showed an 'up-down' trend, with an inflection point in 2019. The incidence APC of mumps were 11.51% and -43.49%, respectively (P>0.05), while the incidence APC of varicella were 28.88% and -50.03%, respectively (P<0.05), respectively. From the point of seasonal distribution, the incidence of three infectious diseases all showed bimodal distribution, with peaks in winter (December to January of the following year) and at the turn from spring to summer (April to June). The proportion of reported cases of three infectious diseases among people aged 6-<10 years old exceeded 60%. The proportion of varicella cases among people aged 10-<15 and 15-19 was on the rise. The incidence rate of influenza and varicella in people aged 15-19 years increased fastest, with APCs of 77.89% and 33.00%, respectively (both P<0.05). Conclusions The trend analysis based on Joinpoint regression model displayed that the reported incidence of influenza among people aged 6-19 years in Shenzhen during 2013-2022 showed an upward trend, and the incidence of varicella had an 'up-down' trend. Children aged 6-<10 years old are the main incidence group, and the prevention and control of infectious diseases in primary schools should be further promoted. Meanwhile, the rapid rise in the incidence of respiratory infectious diseases among people aged 15-19 years old and the increase in the proportion of varicella cases among people aged 10-19 years old suggest that intervention should be carried out to address the influential factors such as immunization gaps and concentrated accommodation in the older age group of minors.

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.

Objective:To investigate the mortality burden among permanent residents in Shenzhen from 2014 to 2021 and to provide scientific evidence for establishing precision disease prevention and control strategy.Methods:Based on the cause-of-death surveillance data, we described the distribution of mortality rate, cause-specific rankings, and years of life lost (YLL) for the total population and subgroups in Shenzhen from 2014 to 2021. The seventh national population census data was used as the standard population to calculate the standardized mortality rate. Joinpoint log-linear regression model was used to analyze the chronic trend of mortality burden.Results:From 2014 to 2021, 49 734 deaths among the permanent population were recorded in Shenzhen, with a 140.90/100 000 average crude mortality rate, standardized as 366.77/100 000. Both the crude mortality rate and standardized mortality rate showed fluctuating increases from 2014 to 2016 [annual percent change (APC)=20.72%, P=0.048, APC=28.59%, P=0.016] and fluctuating decreases from 2016 to 2021 (APC=-1.55%, P=0.317, APC=-1.89%, P=0.190). The mortality rates of the <20 and 20- age groups decreased over time, with a statistically significant decrease observed in the <20 age group [average annual percent change (AAPC)=-11.91%, P<0.001]. The mortality rates of the 40-, 60-, and ≥80 age groups increased over time, with an increase observed in the ≥80 age group from 2014 to 2016 (APC=45.25%, P=0.016) and a decrease from 2016 to 2021 (APC=-2.18%, P=0.280). There was no statistical significance in the mortality rate trend for the remaining age groups (all P>0.05). The top three causes of death among permanent residents in Shenzhen from 2014 to 2021 were consistently malignant tumors, cardiovascular and cerebrovascular diseases, and respiratory system diseases, with crude mortality rates of 49.59/100 000, 47.95/100 000, and 7.90/100 000 respectively in 2021. From 2014 to 2021, 1 003 287.43 YLL were observed, with YLL for the total population, males and females all showing an upward trend (all P<0.001). Conclusions:The mortality burden among the elderly permanent residents in Shenzhen displayed a continuously increasing trend from 2014 to 2021. Strengthening the need for substantial efforts and actions to improve the prevention and control of chronic non-communicable diseases.

Objective To construct an NZB/W(F1)mouse model of systemic lupus erythematosus and evaluate the effects of nicotinamide on each index of lupus nephritis pathogenesis of NZB/W(F1)mice in order to provide data for research on the role of nicotinamide in the treatment of lupus nephritis.Methods Female NZB/W(F1)mice were obtained by crossing male NZW mice with female NZB ones.Urine samples were collected using metabolic cages and proteinuria test strips were used to detect proteinuria.Blood samples were collected through the orbital venous plexus in mice.Enzyme-linked immunosorbent assay(ELISA)was used to detect the level of anti-dsDNA antibody.Levels of serum creatinine and urea nitrogen and liver function indexes were detected using an automatic blood analyzer.Hematoxylin-eosin staining and immunofluorescence technique were used to detect the pathological state of the kidney.Results The levels of proteinuria,double-stranded DNA antibodies,serum creatinine,and urea nitrogen were gradually increased during the natural course of the disease in female NZB/W(F1)mice,indicating that the lupus nephritis disease model was constructed in female NZB/W(F1)mice.Compared to the control group,nicotinamide feeding could obviously decrease the level of proteinuria(P=0.0070),inhibit the production of double-stranded DNA antibodies(P=0.0325),and retard the progression of serum creatinine(P=0.0067)and urea nitrogen indexes(P=0.0166)in serum.In addition,the pathological state of the kidney in the nicotinamide feeding group was significantly alleviated compared with the control group.Conclusion A lupus nephritis disease model is constructed in NZB/W(F1)mice.Nicotinamide feeding can obviously alleviate the disease state of lupus nephritis in NZB/W(F1)mice.

Objective:To report the results of national surveillance on the distribution and antimicrobial resistance profile of clinical Gram-positive bacteria isolates from bloodstream infections in China in 2022.Methods:The clinical isolates of Gram-positive 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:A total of 3 163 strains of Gram-positive pathogens were collected from 51 member units，and the top five bacteria were Staphylococcus aureus（ n=1 147，36.3%），coagulase-negative Staphylococci（ n=928，29.3%）， Enterococcus faecalis（ n=369，11.7%）， Enterococcus faecium（ n=296，9.4%）and alpha-hemolyticus Streptococci（ n=192，6.1%）. The detection rates of methicillin-resistant Staphylococcus aureus（MRSA）and methicillin-resistant coagulase-negative Staphylococci（MRCNS）were 26.4%（303/1 147）and 66.7%（619/928），respectively. No glycopeptide and daptomycin-resistant Staphylococci were detected. The sensitivity rates of Staphylococcus aureus to cefpirome，rifampin，compound sulfamethoxazole，linezolid，minocycline and tigecycline were all >95.0%. Enterococcus faecium was more prevalent than Enterococcus faecalis. The resistance rates of Enterococcus faecium to vancomycin and teicoplanin were both 0.5%（2/369），and no vancomycin-resistant Enterococcus faecium was detected. The detection rate of MRSA in southern China was significantly lower than that in other regions（ χ2=14.578， P=0.002），while the detection rate of MRCNS in northern China was significantly higher than that in other regions（ χ2=15.195， P=0.002）. The detection rates of MRSA and MRCNS in provincial hospitals were higher than those in municipal hospitals（ χ2=13.519 and 12.136， P<0.001）. The detection rates of MRSA and MRCNS in economically more advanced regions（per capita GDP≥92 059 Yuan in 2022）were higher than those in economically less advanced regions（per capita GDP<92 059 Yuan）（ χ2=9.969 and 7.606， P=0.002和0.006）. Conclusions:Among the Gram-positive pathogens causing bloodstream infections in China， Staphylococci is the most common while the MRSA incidence decreases continuously with time；the detection rate of Enterococcus faecium exceeds that of Enterococcus faecalis. The overall prevalence of vancomycin-resistant Enterococci is still at a low level. The composition ratio of Gram-positive pathogens and resistant profiles varies slightly across regions of China，with the prevalence of MRSA and MRCNS being more pronounced in provincial hospitals and areas with a per capita GDP≥92 059 yuan.

Objective To investigate the correlation between clinical characteristics of self-limited epilepsy in children with spines in the central temporal region(SeLECTS)and plasma levels of ammonia,25-hydroxyvitamin D[25(OH)D].Methods A total of 90 SeLECTS children admitted to Suzhou Hospital Affiliated to Anhui Medical University from September 2021 to October 2023 were selected as the case group,and 90 healthy children were included in the control group during the same period.The differences in plasma ammonia and serum 25(OH)D levels between the two groups were compared.The correlation between clinical characteristics of SeLECTS and plasma levels of ammonia,25(OH)D was retrospectively analyzed.Results Plasma ammonia concentration in case group was significantly higher than that in control group(P＜0.05).The level of 25(OH)D was significantly lower than that of control group(P＜0.05).There were statistically significant differences in plasma ammonia concentration among patients with different age,duration and frequency of SeLECTS(P＜0.05).There were statistically significant differences in serum 25(OH)D content among children with different age,frequency and season of SeLECTS(P＜0.05).The correlation between onset time,onset age and onset frequency was significant at 0.01 level.The correlation between plasma ammonia concentration and age of onset,time of onset and frequency of onset was significant at 0.05 level.At the same time,the correlation between 25(OH)D content and seizure time,seizure frequency and plasma ammonia concentration was significant at 0.05 level.The age of onset,frequency and duration of attacks were positively correlated with plasma ammonia levels of SeLECTS.Age of onset was positively correlated with 25(OH)D level,and frequency of onset was negatively correlated with 25(OH)D level.Conclusion SeLECTS attacks are significantly correlated with plasma ammonia and serum 25(OH)D levels,and both elevated plasma ammonia levels and decreased 25(OH)D levels increase the risk of SeLECTS attacks.Therefore,detection of plasma ammonia and serum 25(OH)D levels in children can provide evidence for prevention,disease assessment,diagnosis and treatment of SeLECTS.

Objective:To understand the knowledge, attitude and practice of edema in patients with critically illness of ICU nurses, and to analyze its influencing factors.Methods:After developing the Knowledge-Attitude-Practice Scale of Edema Status in Critically Ill Patients for ICU nurses by Delphi expert consultation method, the level of knowledge, attitude and practice of edema status of ICU nurses in six tertiary hospitals in Shanghai City was investigated by using convenience sampling method.Results:A total of 292 ICU nurses were investigated by questionnaire. The total scores of knowledge dimension, attitude dimension and practice dimension of critical patients with edema in ICU nurses were 38.27 ± 5.52, 58.33 ± 8.34 and 43.04 ± 8.05, respectively. Multiple stepwise regression analysis showed that age ( β=0.28, P<0.05) was the main factor affecting ICU nurses′ knowledge about edema state of critically ill patients; age( β=0.20, P<0.05) and education ( β=0.28, P<0.05) were the factors affecting ICU nurses' attitude towards edema state of critically ill patients; and years of nursing work ( β=0.28, P<0.05) was the factor affecting the practice of critically ill patients of ICU nurses. Conclusions:The level of knowledge and attitude towards edema in critically ill patients of ICU nurses is good, but the level of behavior is general. Nursing managers should strengthen the training related to edema for ICU nurses, further to form a standardized prevent-treatment plan and nursing process in order to actively improve the nursing practice of edema in critically ill patients.

Background Since the outbreak of the COVID-19 epidemic, staff of the centers for disease control and prevention (CDC) have been burdened with heavy epidemic prevention control, and excessive occupational stress can cause depression and other psychological problems. Objective To explore the status of occupational stress, resilience, and depression of CDC staff and potential relationships between them. Methods From December 2020 to April 2021, a survey was conducted at provincial and municipal levels, and the stratified cluster sampling method was used at county (district) level to select a total of 3514 samples. Their occupational stress, resilience, and depression status were evaluated using the Chinese Effort-Reward Imbalance Scale (ERI), the Chinese Connor-Davidson Resilience Scale (CD-RISC), and the Patient Health Questionnaire (PHQ-9). Independent sample t test, analysis of variance, χ² test, Pearson correlation analysis, and mediation test (structural equation model) were conducted. Results The positive rate of occupational stress was 34.29% in the CDC staff, the resilience score was 66.28±15.32, and the positive rate of depression was 48.58%. Significant differences were found in the positive rates of occupational stress among different groups of gender, age, education background, marital status, administrative duty, weekly exercise frequency, chronic disease prevalence, and participation in epidemic control (P<0.05); in the resilience scores among different groups of gender, age, administrative duty, weekly exercise frequency, chronic disease prevalence, and participation in epidemic control (P<0.05); in the positive rates of depression among different groups of gender, age, educational background, personal monthly income, weekly exercise frequency, chronic disease prevalence, and participation in epidemic control (P<0.05). Occupational stress was negatively correlated with resilience (r=−0.165, P<0.01). Resilience was negatively correlated with depression (r=−0.383, P<0.01). Occupational stress was positively correlated with depression (r=0.343, P<0.01). The structural equation embracing a partial mediating effect of resilience on the relationship occupational stress and depression was established, and the partial mediating effect was 0.039, accounting for 10.46% of the total effect. Conclusion High positive rates of occupational stress, reduced resilience, and depression are shown among CDC staff in the context of the COVID-19 epidemic, and resilience partially mediates the effect of occupational stress on depression. The study findings suggest that improving resilience may reduce occupational stress and depression in CDC staff.

ObjectiveTo investigate the preventive and curative effect of Chaishao Liujunzi Tang （CSLJZT） on colonic mucosal injury induced by dextran sulfate sodium （DSS） in mice with ulcerative colitis （UC） and its mechanism. MethodFifty Balb/c male mice were randomly divided into normal group， model group， CSLJZT low-dose group， CSLJZT high-dose group， and sulfasalazine group. Except for the normal group， other groups were given 2.5% DSS freely for 7 d， and were given drug intervention after successful modeling for 7 d. Bodyweight， feces， and other general physiological statuses of mice were recorded every day， and disease activity index （DAI） scores were calculated.The colon length was measured， and stained by hematoxylin-eosin （HE） staining to observe the morphological changes of the colon.The enzyme-linked immunosorbent assay （ELISA） was used to determine the content of interleukin-1β （IL-1β）， myeloperoxidase （MPO）， and superoxide dismutase （SOD） in the serum. Western blot was used to determine the protein expression levels of Toll-like receptor 4 （TLR4）， myeloid differentiation factor 88 （MyD88）， nuclear factor kappa B （NF-κB）， inhibitor-kappa binding protein （IκB）， Caspase-1， and nucleotide-binding oligomerization domain-like receptor 3 （NLRP3） in the colon tissues. ResultAs compared with the normal group， mice in the model group had significantly decreased body weight （P<0.01）， severe diarrhea and hematochezia， and significantly increased DAI score （P<0.01）. As compared with the model group， the decreasing trend of body weight was significantly alleviated in the CSLJZT groups （P<0.01）， diarrhea and hematochezia were significantly improved， DAI score was significantly decreased （P<0.01）， and colon length increased （P<0.05）. HE staining showed that the pathological damage of colon tissue was significantly improved and the inflammatory cell infiltration was reduced in the CSLJZT groups as compared with the model group. As compared with the normal group， the serum levels of IL-1β and MPO were significantly higher （P<0.01） and SOD levels were significantly lower （P<0.01） of mice in the model group.Compared with the model group， the treated group reduced the serum IL-1β and MPO levels （P<0.01）， and raised the SOD level （P<0.01）. The results of Western blot showed that as compared with the normal group， the expression levels of TLR4， MyD88， NF-κB， Ccaspase-1， and NLRP3 proteins were significantly increased （P<0.01）， whereas the expression level of IκB protein was significantly decreased （P<0.01） in the colonic tissue of mice in the model group. As compared with the model group， the expression levels of TLR4， MyD88， NF-κB， Caspase-1， and NLRP3 proteins were decreased （P<0.01）， whereas the expression level of IκB protein was increased （P<0.01） in the colonic tissue of mice in the CSLJZT groups. ConclusionCSLJZT improves the inflammatory injury of the colon tissue in DSS-induced UC mice through TLR4/MyD88/NF-κB signaling pathway.