Objective: To investigate the characteristics of public health emergencies in Jinhua City, Zhejiang Province from 2014 to 2023, so as to provide the reference for prevention and control of public health emergencies. Methods: Data of public health emergencies and related information in Jinhua City from 2014 to 2023 were collected through Emergency Public Reporting System of Chinese Disease Prevention and Control Information System. Attack rates, and distribution of time, areas and places were descriptively analyzed. Results: A total of 276 public health emergencies were reported in Jinhua City from 2014 to 2023. There were 10 324 reported cases and 7 deaths, with an attack rate of 0.32%. There were 53 Ⅳ-level (19.20%) and 223 unclassified public health emergencies (80.80%). Infectious disease emergencies were predominant types, accounting for 97.83% (270 events). The three most common infectious disease emergencies were other infectious diarrhea (42.03%), influenza (21.01%) and COVID-19 (16.30%). The reported public health emergencies peaked in November and December, with 66 and 45 events reported, respectively. The three most counties (cities, districts) included Yiwu City, Wucheng District and Lanxi City, accounting for 24.28% (67 events), 18.48% (51 events) and 11.96% (33 events), respectively. School and preschool institutions were predominant places where public health emergencies occurred (198 events, 71.74%). Conclusions The public health emergencies in Jinhua City from 2014 to 2023 were Ⅳ-level and unclassified emergencies, and infectious disease emergencies were predominant. November and December were the peak reporting periods, and schools and preschool institutions were the main places where these events occurred.

Objective To construct and validate a risk prediction model for delayed healing of venous leg ulcer(VLU),so as to provide a reference basis for early identification of people at high risk of delayed healing.Methods Using a convenience sampling method,331 VLU patients attending vascular surgery departments in 2 tertiary A hospitals in Sichuan Province from January 2018 to December 2022 were selected as a modeling group and an internal validation group,and 112 patients admitted to another tertiary A hospital were selected as an external validation group.Risk factors for delayed healing in VLU patients were screened using univariate analysis,LASSO regression,and multivariate logistic regression analysis,and a risk prediction model was constructed using R software,and the predictive effects of the models were examined using the area under the receiver operating characteristic curve,the Hosmer-Lemeshow test,decision curve,and the bootstrap resampling for internal validation and spatial external validation were performed,respectively.Results The predictors that ultimately entered the prediction model were diabetes(OR=4.752),deep vein thrombosis(OR=4.104),lipodermatosclerosis(OR=5.405),ulcer recurrence(OR=3.239),and ankle mobility(OR=5.520).The model had good discrimination(AUC:0.819 for internal validation and 0.858 for external validation),calibration(Hosmer-Lemeshow test:χ2=13.517,P=0.095 for internal validation and χ2=3.375,P=0.909 for external validation)and clinical validity.Conclusion The model constructed in this study has good differentiation and calibration,and it can effectively predict people at high risk of delayed healing of VLU,which facilitates targeted clinical interventions to improve ulcer outcomes and reduce the risk of delayed ulcer healing.

With the deepening research of comprehensive treatment for gastric cancer, the FLOT regimen has begun to be used for the treatment of gastric cancer patients. FLOT neoadjuvant regimen can significantly improve the R 0 resection rate and prolong the overall survival time of locally advanced gastric cancer patients. FLOT regimen combined with immune-checkpoint inhibi-tors, targeted therapy and hyperthermic intraperitoneal chemotherapy have great potential in neo-adjuvant therapy for gastric cancer. The authors systematically analyse the development history and latest clinical research progress of FLOT neoadjuvant regimen for gastric cancer based on their clinical practice experience.

Theaflavins are a class of natural products extracted from black tea or green tea, with significant anti-tumor effects on gastric cancer, liver cancer, breast cancer and other tumors. Theaflavins were once considered as the new products for anticancer therapy. However, the anti-tumor mechanism of theaflavins involves a variety of biological processes, and the regulation is complex. Therefore, this article summarizes the role of theaflavins in promoting tumor cell apoptosis, inducing tumor cell mitotic arrest and regulating tumor immunity, and reviews the inhibition of tumorigenesis and growth through MAPK, PI3K/AKT, Hedgehog, NF-κB, JAK/STAT and Wnt/β-Catenin signal pathways, in order to provide new ideas for cancer treatment and anti-cancer drug development.

Gastric neuroendocrine tumors are rarely seen in the gastric tumors, because there are few case reports and the clinical diagnosis rate is low. There is no consensus treatment method in the world. However, with the benefit of esophagogastrodenoscopy and widespread use of proton pump inhibitors, the diagnostic rate of gastric neuroendocrine tumors is on the increase, which gives us an updated understanding for the pathogenesis and pathophysiology of the disease. By studying its pathogenesis, scholars have found that hypergastrinemia caused by various causes is closely related to its occurrence. Gastric neuroendocrine tumors are classified into different types or pathological grades depending on the state of progression of the disease and the unique clinical manifestations. Clinically used diagnostic methods include gastroscopy, medical imageology, nuclear medicine, gastrin, CgA, etc. There are also differences in treatments depending on the clinical classification. If the disease progresses rapidly and the grade is high, surgical resection of the lesion plus postoperative adjuvant chemotherapy should be actively performed. Other better treatments are still being explored.
Gastrins ; Gastroscopy ; Humans ; Neuroendocrine Tumors ; Proton Pump Inhibitors ; Stomach Neoplasms

Objective : To investigate the characteristics and the chronic health risks of metals in fine particulate matter（PM2.5） of Wucheng District,Jinhua . Methods: The PM2.5 samples were collected in Wucheng District of Jinhua from the year 2015 to 2017.Chromium(Cr), manganese (Mn),nickel(Ni),arsenic(As),selenium(Se),cadmium(Cd),antimony(Sb),lead(Pb),beryllium(Be),aluminum(Al),thallium（Tl）and mercury（Hg） were measured by inductively coupled plasma mass spectrometry（ICP-MS）. The health risks of the metals were assessed based on the standard method recommended by United States Environmental Protection Agency . Results: From 2015 to 2017,the average concentration of PM2.5 in Wucheng District was（53.42±26.95）μg/m3,and the average concentration of PM2.5 in each season and each year were significantly different（P<0.05）. The median（interquartile range）concentration of metal elements in PM2.5 was 136.66（117.14）ng/m3,with higher concentration of Al,Pb,Mn,Cd and Se. From 2016 to 2017,the average concentration of Cd exceeded the reference limit（5.00 ng/m3）. The median （interquartile range） concentration of metal elements in PM2.5 in winter was 175.12（132.45）ng/m3,the highest,and in summer was 92.55（52.81）ng/m3,the lowest. The total hazard quotient（HQ）of nine kinds of metal elements in PM2.5 was 2.90;the HQ of As,Be,Ni,Se,Hg,Al,Mn and Sb were all less than 1,except Cd. The total carcinogenic risk of five kinds of metal elements in PM2.5 was more than 10-6,among which the carcinogenic risk of As and Cd were more than 10-6,and the carcinogenic risk of Be,Pb and Ni were less than 10-6 . Conclusion The concentrations of Al,Pb,Mn,Cd and Se in PM2.5 of Wucheng District were higher and the concentration of Cd exceeded the reference limit. The non-carcinogenic and carcinogenic risk of Cd were both higher,the carcinogenic risk of As was also higher.

Objective: To understand the health risk of drinking water in rural areas of Jinhua and to provide evidence for water sanitary management in rural areas. Methods: Totally 2 032 samples of drinking water in rural areas of Jinhua were collected from 2016 to 2018. According to GB/T 5750-2006 Standard Examination Methods for Drinking Water,five chemical carcinogens（As,Cd,Cr6+,CHCl3 and CCl4）and twelve non-carcinogenic chemicals（Pb,Hg,Se、CN-、F-、NO3-、Al、Fe、Mn、Cu、Zn and NH3-N）were detected. The health risk assessment in rural drinking water was conducted by United States Environmental Protection Agency（USEPA）model. Results: The total health risk,total carcinogenic risk and total non-carcinogenic risk of rural drinking water caused by the seventeen chemicals were 34.8×10-6/a,34.80×10-6/a and 6.65×10-9/a,respectively. The carcinogenic risk of five chemical carcinogens accounted for 99.98% of the total health risk,and the carcinogenic risk of Cr6+ accounted for 89.95% of the total health risk. The total health risk of the fully processed,partially processed and unprocessed water samples were 31.68×10-6/a,34.78×10-6/a and 34.77×10-6/a,respectively. The total health risk of finished water and peripheral water were 34.79×10-6/a and 34.82×10-6/a. Conclusion The health risk of drinking water in rural areas of Jinhuacaused by chemicals is low. The hexavalent chromium has the highest health risk and need more attention to be paid on.

Gastric cancer is one of the most common malignant gastrointestinal tumors.Docetaxel alone or combination with other drugs can attenuate the progress of disease,prolong the overall response rate and the median overall survival rate in advanced gastric cancer.However,the incidence of toxicities is high.Moreover,there is no uniform standard for dosage and course for docetaxel treatment.Currently,its efficacy is not definite.

Objective The aim to assess the methodology and feasibility of ultrasound guided percutaneous thrombin injection(UGTI) for the treatment of Iarogenic Femoral Arterial Complexity Pseudoaneurysms(IFACP).Methods Thirty two iarogenic femoral arterial complexity pseudoaneurysms patients following femoral arerial puncture for arterial angiography were treated with UGTI.Twenty-three IFACP with 2 lobes,8 IFACP with 3 lobes,1 IFACP with 4 lobes.Under local anesthesia the lobe was pene trated by artery needle successively and thrombin jection was performed slowely into distal lobe with US guide precise localization.Dynamical observation was performed for the status of thrombogenesis and cavity plugging.US follow-up examination were performed after 24 h and 7 d.Results Reperfusion occurred in IFACP with 3 lobes after 24 h and UGTI failure.IFACPs with 4 lobes failure.Nothromboembolic,infectious,allergic complication soccurred.Conclusion UGTI is the first mothed for the treatment of IFACP.Precise localization and percutaneous can enhance the ratio of treatment of IFACPs and avoid the severe complications.

Pancreatic cancer is a highly lethal disease in gastrointestinal malignant tumors.The mortality of pancreatic cancer closely parallels its incidence.Most patients with pancreatic cancer remain asymptomatic until the disease reaches an advanced stage.There is no program for screening patients at high risk of pancreatic cancer.Although CT,MRI,positron emission tomography,endoscopic ultrasonography,and endoscopic ultrasonography-guided fine-needle aspiration offer high diagnostic ability for pancreatic cancer,it cannot be found at the early stage easily.Surgical resection is regarded as the only potentially curative treatment and adjuvant chemotherapy is given after surgery.This article reviews epidemiology,risk factors,diagnosis and treatment for pancreatic cancer by summarizing relevant literature.