Objective To understand the research hotspot and development trend of meteorological factors in the field of hand, foot and mouth disease at home and abroad, and to provide references for domestic scholars to explore the frontier of this field. Methods Relevant literature published from the retrievable date to August 31, 2022 was searched in CNKI, Wanfang, VIP, China Biomedical Literature Database, Web of Science Core Collection and PubMed database. CiteSpace and VOSviewer software were used to retrieve related research literature on hand, foot and mouth disease and meteorological factors, and visualization analysis was conducted from the aspects of publication volume, relevant authors, keywords and journal analysis. Results A total of 610 literatures were included in this study, including 339 foreign documents and 271 Chinese documents. The number of published literatures in this field showed an increasing trend year by year. In foreign literature, there were 147 core authors, and 209 keywords appeared more than 3 times. In Chinese literature, there were 57 core authors, and 66 keywords appeared more than 3 times. In recent years, time series analysis and Bayesian spatiotemporal models had been widely used to explore the relationship between hand, foot and mouth disease and meteorological factors. Science of the Total Environment (28 articles) and Disease Surveillance (12 articles) accounted for the largest number of publications in foreign and Chinese journals, respectively. Compared with Chinese journals, foreign journals formed a stable group of journals. Conclusion In general, the research content in this field is rich, and the research trend has shifted from epidemiological research to the application of new methods in this field to explore the impact of meteorological factors on the incidence of hand, foot and mouth disease.

Background::There is a need for effective and safe therapies for psoriasis that provide sustained benefits. The aim of this study was to assess the efficacy and safety of tildrakizumab, an anti-interleukin-23p19 monoclonal antibody, for treating moderate-to-severe plaque psoriasis in Chinese patients.Methods::In this multi-center, double-blind, phase III trial, patients with moderate-to-severe plaque psoriasis were enrolled and randomly assigned (1:1) to receive subcutaneous tildrakizumab 100 mg or placebo at weeks 0 and 4. Patients initially assigned to placebo were switched to receive tildrakizumab at weeks 12, 16, and every 12 weeks thereafter. Patients in the tildrakizumab group continued with tildrakizumab at week 16, and every 12 weeks until week 52. The primary endpoint was the Psoriasis Area and Severity Index (PASI 75) response rate at week 12.Results::At week 12, tildrakizumab demonstrated significantly higher PASI 75 response rates (66.4% [73/110] vs. 12.7% [14/110]; difference, 51.4% [95% confidence interval (CI), 40.72, 62.13]; P <0.001) and Physician’s Global Assessment (60.9% [67/110] vs. 10.0% [11/110]; difference, 49.1% [95% CI, 38.64, 59.62]; P <0.001) compared to placebo. PASI 75 response continued to improve over time in both tildrakizumab and placebo-switching to tildrakizumab groups, reaching maximal efficacy after 28 weeks (86.8% [92/106] vs. 82.4% [89/108]) and maintained up to 52 weeks (91.3% [95/104] vs. 87.4% [90/103]). Most treatment-emergent adverse events were mild and not related to tildrakizumab. Conclusion::Tildrakizumab demonstrated durable efficacy through week 52 and was well tolerated in Chinese patients with moderate-to-severe plaque psoriasis.Trial registration::ClinicalTrials.gov, NCT05108766.

Objective: To evaluate the effect of Triangle hierarchical management among community patients with hypertension, so as to provide insights into the improvements of standardized hypertension management. Methods: Patients with newly diagnosed hypertension from 2 community health service centers in Qiantang District of Hangzhou City by the end of 2020 were randomly assigned to the conventional group and the Triangle group. Patients in the conventional group were given health management services according to the requirements of basic public health service standard for one year, while patients in the Triangle group were given Triangle hierarchical management. The blood pressure, self-management behaviors, treatment compliance, smoking, alcohol consumption and exercise were collected using the self-management behavior scale, treatment compliance scale and self-designed questionnaires, and were compared before and after intervention with analysis of covariance and generalized estimation equations. Results: Totally 200 patients with hypertension were recruited, including 100 patients in the conventional group and 100 patients in the Triangle group. There were no significant differences between the two groups before implementation of interventions in terms of gender, age, educational level or occupation (P>0.05). The reduction in blood pressure, increase in the score of treatment, diet, exercise and living habitat management and the total score of self-management behaviors, increase in the score of adherence to medication regimens, daily living management behaviors, smoking and alcohol consumption preference and the total score of treatment compliance, and increase in the number of patients with normal standard of quitting smoking, quitting alcohol consumption, exercise and blood pressure were significantly higher in the Triangle group than in the conventional group after intervention (P<0.05). Conclusions Triangle hierarchical management may increase the treatment compliance, improve the self-management behavior and facilitate hypertension control among hypertensive patients, which may be popularized for health management among community patients with hypertension.

Ferroptosis is drived by lipid reactive oxygen species, which plays an important role in the development of tumors. It has been found that a variety of clinical medicines, such as artemisinin derivatives, itraconazole, sulfasala zine, cucurbitacin B, paclitaxel, disulfiram/copper can induce ferroptosis and inhibit tumor growth in head and neck cancer (HNC) through different mechanisms. To study the regulatory mechanism of ferroptosis induced by commonly used drugs in the treatment of HNC can provide reference for the targeted treatment of ferroptosis in HNC.

JAK2-STAT3 signaling pathway, as the main chain of intracellular signal transmission, plays an important role in cell proliferation, apoptosis, invasion, migration and immune response. Triggered by cytokines and interferon, this pathway can quickly transduce extracellular signals into the nucleus, and it has abnormal expression in various tumors, such as squamous cell carcinoma of the head and neck, lung cancer, esophageal cancer, gastric cancer, liver cancer, breast cancer and myeloproliferative neoplasms. Further understanding of the carcinogenic mechanism of JAK2-STAT3 signaling pathway can provide new ideas for clinical treatment of tumors and prognosis.

Objective To assess the safety of infliximab (IFX) treatment in patients with Crohn's disease(CD).Methods From January 2009 to May 2018,at inflammatory bowel disease (IBD) center of Sir Run Run Shaw Hospital,School of Medicine,Zhejiang University,486 CD patients received the treatment of IFX were enrolled and their clinical data were collected.Univariate and multivariate regression of binary logistic were performed for statistical analysis.Results The median follow-up duration was 31.1 months (12.0 months to 40.0 months).The median duration of IFX therapy was 13.0 months (7.0 months to 21.0 months).Among 486 patients,98 (20.16％) patients reported adverse effects,and 12 (2.47％) patients discontinued the therapy because of adverse effects.Acute infusion reaction was the most common adverse effect in CD patients who received IFX treatment accounting for 41.84％ (41/98) of all the adverse effects,and the incidence was 8.44％.Thirty-nine patients had mild and moderate infusion reaction,and all improved after symptomatic treatment (eight patients discontinued IFX therapy because of recurrent infusion reaction).Two patients developed severe infusion reaction as allergic shock,and both relieved after emergency rescue.Four patients developed late-phase allergic reactions.Among 486 patients,39 (8.02％) patients had infections,including infections of Clostridium difficile,cytomegalovirus,herpeszoster virus,Mycobacterium tuberculosis,and other opportunistic pathogens.There was no cases of infection related death.Thirty-six patients continued with IFX treatment after infection controlled.Among 486 patients,14 (2.88％) patients had severe infection,and all the cases improved after anti-infection treatment.Twenty-seven CD patients with hepatitis B virus (HBV) infection received anti-viral treatments,no active HBV infection was observed.Colon adenocarcinoma was found in one patient under colonoscopy at 22 months after discontinuation of IFX therapy.There were six patients with the history of benign tumors,and no evidence of recurrence,progress or malignancy during treatment.In terms of other rare adverse effects in 486 patients,there were eight (1.64％) patients with liver function injury,two (0.41％) patients with anemia,one (0.21％) patient with peripheral neuropathy,and four (0.82％) patients with skin lesion.Prolonged duration of IFX therapy,without combination of immune-suppressors and with increased baseline body mass index (BMI) were the risk factors of acute infusion reactions.Prolonged duration of IFX therapy and with low baseline albumin level were the risk factors of infections.Conclusions IFX is generally safe as the treatment for CD patients,and its adverse effects can be clinically controlled.Screening before therapy and monitoring during therapy may reduce the risks of adverse effects.

Objective To investigate the effects of low contrast agent concentration and optimal monoenergetic image on myocardial image quality in dual source, dual energy coronary CT angiography (CCTA).Methods Sixty patients,who were clinically suspected of coronary heart disease and referred to perform dual energy CCTA examination,were prospectively collected between January and June 2016 in the first affiliated hospital of Xinjiang Medical University and then randomly divided into two groups with thirty cases in each group.Dual-energy CCTA was performed in both groups with the same parameters expect the iodine contrast agent concentration.The iopamidol concentrations were 370 and 320 mg/ml for groups A and B, respectively. The raw images of the two groups were reconstructed to get conventional mixed energy images and 60,65,70,75,80,85,90 keV single energy images,respectively labeled as group A1 to A8 and group B1 to B8.The CT attenuation,noise,signal-to-noise ratio(SNR)and contrast to noise ratio(CNR)were measured in images from groups A1 to A8 and B1 to B8. And the optimal monoenergetic image set was selected.Rank sum test was used to compare the CT value,noise,SNR and CNR between groups A1 to A8 and B1 to B8.The differences of above-mentioned parameters between A1 and B5 group,A5 group and B5 group were compared by independent sample t test.Results The differences of CT value,noise,SNR and CNR between groups A1 and A8, B1 and B8 were statistically significant (P<0.05). The CNR and SNR of group A5 were significantly higher than that of group A1,and the image noise of group A5 was lower than that of group A1(all P<0.05),and the images of A5 group(75 keV)were the optimal monoenergetic image. The SNR and CNR of the left ventricular lateral wall in group B5 were significantly higher than those in group B1,and the noise was lower than that in group B1(all P<0.05),and the image of B5 group(75 keV) was the optimal monoenergetic image. The difference of image noise between groups A1 and B5 was statistically significant(P<0.05),while the differences of SNR and CNR between these two groups were not significant(all P>0.05).The differences of image noise,SNR and CNR between groups A5 and B5 were not significant(all P>0.05).Conclusions The myocardial CCTA image quality by using iodine contrast agent (320 mg/ml) and optimal monoenergetic imaging (75 keV) is equivalent to that of conventional iodine contrast agent(370 mg/ml)mixed energy image.The strategy can effectively reduce the amount of contrast agent when meeting the needs of the clinical diagnosis.

Objective: To investigate the incidence and pathogen distribution of ventilator-associated pneumonia (VAP) among preterm infants admitted to level Ⅲ neonatal intensive care units (NICU) in China. Method: A prospective study was conducted in 25 level Ⅲ NICU, enrolling all preterm infants <34 weeks gestational age admitted to the participating NICU within the first 7 days of life from May 2015 to April 2016. Chi-square test, t test and Mann-Whitney U test were used for statistical analysis. Result: A total of 7 918 patients were enrolled, within whom 4 623(58.4%) were males. The birth weight was (1 639±415) g and the gestational age was (31.4±2.0) weeks; 4 654(58.8%) infants required non-invasive mechanical ventilation and 2 154(27.2%) required intubation. Of all the mechanically ventilated patients, VAP occurred in 95 patients. The overall VAP rate was 7.0 episodes per 1 000 ventilator days, varying from 0 to 34.4 episodes per 1 000 ventilator days in different centers. The incidence of VAP was 9.6 and 6.0 per 1 000 ventilator days in children′s hospitals and maternity-infant hospitals respectively, without significant differences (t=1.002, P=0.327). Gram-negative bacilli (76 strains, 91.6%) were the primary VAP microorganisms, mainly Acinetobacter baumannii (24 strains, 28.9%), Klebsiella pneumonia (23 strains, 27.7%), and Pseudomonas aeruginosa (10 strains, 12.0%). Conclusion The incidence of VAP in China is similar to that in developed counties, with substantial variability in different NICU settings. More efforts are needed to monitor and evaluate the preventable factors associated with VAP and conduct interventions that could effectively reduce the occurrence of VAP.

Objective: To evaluate the impact of intracoronary administration of eptifibatide oncoronary no-reflow and myocardium perfusion in patients with ST-elevation myocardial infarction (STEMI) at percutaneous coronary intervention (PCI). Methods: A total of 80 STEMI patients with emergent PCI were randomly divided into 2 groups: Eptifibatide group, the patients received intracoronary administration of eptiifbatide and Control group, the patients received the same volume of normal saline.n=40 in each group. The baseline condition, post-operative vascular recanalization, changes of platelet aggression at pre- and post-medication were compared between 2 groups. Echocardiography was examined at immediately and 24 weeks after operation;myocardial infusion imaging was examined at l week after operation. All patients were followed-up for 24 weeks to observe the incidence of major adverse cardiovascular events (MACE). Results: Compared with Control group, Eptifibatide group showed increased ratios of post-operative TIMI grade 3 (72.5%vs 92.5%) and myocardium perfusion (70.0% vs 90.0%), bothP<0.05; decreased post-operative and 2h post-medicinal platelet aggression and they were both lower than Control group at the same period, allP<0.05. Eptiifbatide group had obviously improved LVEDD and LVEF at 24-week than 1-week after PCI and they were both superior to Control group, allP<0.05. There were 7 (17.5%) patients in Eptiifbatide group and 7 (7.5%) in Control group suffering from small bleeding events, P>0.05; no severe bleeding eventand no in-hospital thrombocytopeniaoccurred. MACE occurrence rates during 24-week follow-up period were 12.5% vs 22.5%, P>0.05. Conclusion: Intracoronary administration of eptiifbatide in STEMI patients at emergent PCI could effectively improve coronary blood lfow,increase myocardium perfusion and enhance cardiac function without severe bleeding events.

Objective To explore the correlation of uncertainty , coping styles and personal growth in the postoperative colorectal cancer patients undergoing chemotherapy .Methods One hundred and eighty-five of the postoperative colorectal cancer patients undergoing chemotherapy were surveyed face -to-face. The demographic form , the Mishel Uncertainty in Illness Scale ( MUIS-A ) , Cancer Coping Modes Questionnaire (CCMQ), and Growth Through Uncertainty Scale (GTUS) were used.Analysis of the correlation betwcen the data.Results Two hundred and eighteen questionnaires were sent out , and one hundred and eighty-five valid questionnaires were recovered , valid response rate was 84 .9%.The average score of uncertainty of postoperative colorectal cancer patients during chemotherapy was (88.06 ±12.02);the level of uncertainty was middle .Face to the disease was the most often taken style of coping style of postoperative colorectal cancer chemotherapy patients, with a score of (18.44 ±3.73), followed by avoidance/depressed, yield, fantasy, vent.Personal growth score was (153.72 ±16.35).Personal growth score and uncertainty in illness was negatively correlated (r=-0.164,P<0.05).Face coping styles and personal growth score was positively correlated (r=0.347, P<0.05).Yield, vent, and fantasy had a negative correlation with personal growth (r=-0.229,-0.166,-0.058, respectively;P <0.05).Conclusions Medical staff should pay attention to the assessment and management of uncertainty in the postoperative colorectal cancer patients undergoing chemotherapy , optimize their coping style and promote personal growth .