ObjectiveTo understand the infection characteristics of multidrug-resistant organisms (MDROs) in hospitalized patients in a tertiary sentinel hospital in Shanghai, so as to provide an evidence for the development of targeted prevention and control measures. MethodsData of MDROs strains and corresponding medical records of some hospitalized patients in a hospital in Shanghai from 2021 to 2023 were collected, together with an analysis of the basic information, clinical treatment, underlying diseases and sources of sample collection. ResultsA total of 134 strains of MDROs isolated from hospitalized patients in this hospital were collected from 2021 to 2023 , including 63 strains of methicillin-resistant Staphylococcus aureus (MRSA), 57 strains of carbapenem-resistant Acinetobacter baumannii (CRAB), and 14 strains of carbapenem-resistant Klebsiella pneumoniae (CRKP). Of the 134 strains, 30 strains were found in 2021, 47 strains in 2022 and 57 strains in 2023. The male-to-female ratio of patients was 2.05∶1, with the highest percentage (70.90%) in the age group of 60‒<90 years. The primary diagnosis was mainly respiratory disease, with lung and respiratory tract as the cheif infection sites. There was no statistically significant difference in the distribution of strains between different genders and infection sites (P>0.05). However, the differences in the distribution of strains between different ages and primary diagnosis were statistically significant (P<0.05). Patients who were admitted to the intensive care unit (ICU), had urinary tract intubation, were not artery or vein intubated, were not on a ventilator, were not using immunosuppresants or hormones, and were not applying radiotherapy or chemotherapy were in the majority. There was no statistically significant difference in the distribution of strains for whether received radiotherapy or chemotherapy or not (P>0.05), while the differences in the distribution of strains with ICU admission history, urinary tract intubation, artery or vein intubation, ventilator use, and immunosuppresants or hormones use or not were statistically significant (all P<0.05). The type of specimen was mainly sputum, the hospitalized ward was mainly comprehensive ICU, the sampling time was mainly in the first quarter throughout the year, the number of underlying diseases was mainly between 1 to 2 kinds, the application of antibiotics ≥4 kinds, and those who didn’t receive any surgery recently accounted for the most. There were statistically significant differences in the distribution of strains between different specimen types, wards occupied and history of ICU stay (P<0.05), but no statistically significant difference in the distribution of strains between different sampling times, number of underlying diseases and types of antibiotics applied (P>0.05). ConclusionThe situation of prevention and control on MDROs in this hospital is still serious. Focus should be placed on high-risk factors’ and infection monitoring and preventive measures should be strengthened to reduce the incidence rate of MDROs infection.

ObjectiveTo investigate the infection and genotypes of Wolbachia in Aedes albopictus. MethodsAdult and larval samples of Aedes albopictus were collected from different residential and wild areas from 2020 to 2021， Wolbachia surface protein （wsp） gene was amplified and genotyped for wAlbA and wAlbB by PCR， and sequenced for phylogenetic analysis. The difference of detection rate among different habitats， male and female adult mosquitoes， adult and larvae was compared by χ² analysis. ResultsThe detection rate of Wolbachia in adult and larvae of Aedes albopictus were 43.5% （77/177） and 70.4% （190/270）， respectively， with a statistically significant difference （χ²=32.086，P<0.001）， and wAlbA and wAlbB were mainly detected together. The detection rate of Wolbachia in female and male Aedes albopictus were 50.7% （76/150） and 3.7% （1/27）， respectively， with a statistically significant difference（χ²=20.533，P<0.001）. The detection rate of adult Aedes albopictus in Songjiang wild area， residential area and Hongkou residential area were 91.7% （55/60）， 18.8% （22/117） and 41.7% （30/72）， respectively， with a statistically significant difference （χ²=54.322，P<0.001）. Genotyping and phylogenetic analysis showed that adult and larvae of Aedes albopictus infected with Wolbachia were mainly wAlb A and wAlb B. In addition， some sequences formed clades independently， and the genetic distance from other sequences was relatively large. ConclusionInfection of Wolbachia in Aedes albopictus is relatively common in Songjiang District. The main genotypes are wAlb A and wAlb B and there may be other subtypes， which are worthy of further exploration and research.

ObjectiveTo investigate the relationship between mosquito density fluctuations and meteorological factors, so as to provide a scientific basis for mosquito surveillance analysis, risk assessment, and comprehensive prevention and control. MethodsMosquito surveillance and monitoring data of 2020‒2023 was obtained from on-site supervisory sampling by Songjiang Center for Disease Control and Prevention, and meteorological data was obtained from the Wheat A wheat malt-agro-meteorological big data system. Excel 2019 and SPSS 25.0 software were used to organize and analyze the mosquito number, species composition, and seasonal changes in mosquito density captured by the CO₂-light trap at rach monitoring site. Circular distribution method was used to calculate the peak time of mosquito density, combined with the meteorological data of the same period to explore the impact of meteorological factors on the results of mosquito surveillance. ResultsThere was a statistical difference in the overall distribution of mosquito quantity in different habitats(H=23.11, P<0.05), 2020‒2023. In addition, the results showed that July 28th was the peak day for mosquito density, and the duration from June 13th to September 11th was the seasonal peak period for mosquitoes. Pearson correlation analysis showed a positive correlation between mosquito density and average air temperature, average highest air temperature, average lowest air temperature, extreme maximum air temperature, extreme minimum air temperature, precipitation, and number of precipitation days (all P<0.01). While, there was no significant correlation between average wind speed and mosquito density (P>0.05). Multiple stepwise regression analysis resulted in the equation of Y=0.151X_{extreme minimum temperature}+0.321X_{number of precipitation days}+1.002X_{SQRT precipitation}-1.288 (F=102.635, P<0.05). ConclusionThe CO₂-light trap is advisable to monitor the habitats of farmers, livestock sheds, residential areas, parks, hospitals, and other external environments. Air temperature and precipitation have a significant impact on mosquito density. It is recommended to implement comprehensive prevention and control measures to reduce mosquito density and prevent mosquito-borne diseases before the peak period of mosquitoes.

Objective:This study aimed to investigate the predictive value of N-terminal pro-B-type natriuretic peptide (NT-proBNP) trajectory on future major adverse cardiovascular events (MACE) in patients with stable coronary artery disease (SCAD) after percutaneous coronary intervention (PCI).Methods:A retrospective cohort study was conducted on SCAD patients admitted to the Department of Cardiology at Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, from January 2013 to December 2021. A total of 828 subjects were enrolled, comprising 592 males and 236 females, with an average age of (66.44±11.71) years. SCAD patients post-percutaneous coronary intervention (PCI) were stratified into three NT-proBNP trajectory groups: T1 Low-Low (219 cases), T2 Medium-Low (363 cases), and T3 High-High (246 cases). The median follow-up time was 2.1 years, and the maximum follow-up time was 9 years. The primary clinical endpoint event was MACE. The NT-proBNP concentration in patients′ serum was measured using enzyme-linked fluorescent assay, and different trajectory groups were determined using latent class trajectory modeling. The association between NT-proBNP trajectory and occurrence of MACE in SCAD patients was evaluated using Kaplan-Meier survival curves and multivariable Cox proportional hazards regression models.Results:A total of 67 (8.1%) major adverse cardiovascular events occurred, including 43 cases (5.2%) of all-cause mortality, 13 cases (1.6%) of heart failure death, 9 cases (1.1%) of non-fatal myocardial infarction, and 15 cases (1.8%) of non-fatal stroke. Kaplan-Meier survival curve analysis showed significant differences in survival rates among T1, T2, and T3 groups of SCAD patients for MACE, all-cause mortality, and heart failure death (all P<0.001). In the multivariable Cox regression analysis, the risk of MACE occurrence for patients in the T2 group and T3 group was 1.708 times (95% CI 0.72-4.05) and 3.842 times (95% CI 1.625-9.081) compared to the T1 group, respectively. Moreover, a statistically significant linear trend was observed for the risk of MACE occurrence across trajectory groups ( P<0.001). Conclusions:NT-proBNP trajectory groups after PCI in SCAD patients are strongly associated with the risk of MACE occurrence and can serve as an independent predictor for MACE. Dynamic monitoring of NT-proBNP during follow-up to obtain longitudinal trajectories helps identify high-risk SCAD patients and implement timely effective intervention measures.

ObjectiveTo characterize the prevalence and epidemic situation of imported malaria cases in Songjiang District of Shanghai from 2013 to 2022， and to provide evidence for malaria prevention and control. MethodsRelated data were collected and analyzed， including malaria cases， blood testing of febrile patients， and mosquito surveillance in Songjiang from 2013 to 2022. ResultsA total of 13 002 febrile patients in Songjiang were tested for plasmodium parasites from 2013 to 2022， among which 18 malaria cases were confirmed， including 17 cases of falciparum malaria and 1 case of ovale malaria. Moreover， a total of 36 malaria cases were notified in Songjiang through the National Notifiable Disease Reporting System from 2013 to 2022， including cases reported from Songjiang District and other districts or provinces with physical addresses in Songjiang. Of them， there were 31 cases of falciparum malaria， 2 cases of vivax malaria， 2 cases of ovale malaria and 1 case of quartan malaria. The gender ratio of male to female cases was 17∶1， and the majority was young and middle aged. In addition， 35 cases were imported from Africa and 1 case from southeast Asia； 34 cases were migrant workers， and 2 cases were travellers abroad； 17 cases were found and reported in Songjiang， 15 cases were reported from other districts of Shanghai， and 4 cases were reported from other provinces； 27 cases were treated in Shanghai， 3 cases were treated in other provinces and 6 cases were treated with self-provided antimalarial drugs. Mosquito surveillance in Songjiang showed that density of Anopheles sinensis was extremely low. ConclusionNo indigenous malaria case has been notified in Songjiang since 2008. Malaria surveillance on migrant workers remains the focus of malaria prevention and control. Furthermore， achievement of malaria elimination in Songjiang should be continually enhanced to avoid potential further transmission of imported malaria.

Objective:To analyze the treatment process of a renal transplant patient infected with coronavirus disease 2019 (COVID-19), and discuss the management strategy for the immunocompromised hosts.Methods:The diagnosis and treatment of a case of transplant patients with COVID-19 admitted to Horgos designated hospital of Xinjiang Uygur Autonomous Region in October 2021 were reviewed. The medical history and laboratory and imaging examination treatment and outcome of this case were analyzed.Results:The recipient was a middle-aged male with a time from renal transplantation of 3 years. The onset was moderate to low fever, accompanied by cough and fatigue. Chest CT showed multiple ground glass shadows under the pleura of both lungs, mainly in both lower lungs, gradually worsening until "white lung" appeared, with early renal and cardiac insufficiency. In the course of treatment, immunosuppressants were reduced and the dosage of glucocorticoid was increased. In the early stage, due to renal insufficiency and hyperkalemia, dialysis was conducted for 3 times. Oral abidol and Lianhua Qingwen capsule were given as antiviral and anti-infection treatment. Special immunoglobulin and convalescent plasma of COVID-19 were used to boost the immunity of patients. The patient was eventually clinically cured.Conclusions:The clinical manifestations and diagnosis of COVID-19 for the kidney transplantation recipient are not significantly different from other populations, but immunocompromised hosts are more likely to suffer from organ dysfunction. The adjustment of immunosuppressants and glucocorticoids, respiratory support, selection of antibiotics, organ protection, nutritional support and traditional Chinese medicine intervention in the treatment of renal transplant recipients with severe COVID-19 need further discussion.

Objective:To explore the safety and feasibility of optimized pathological evaluation system of donor's kidney and modified surgery during adult dual kidney transplantation(DKT)and evaluate its effectiveness to provide more alternative protocols for kidney transplantation from extended criteria donors.Methods:DKT was performed in 10 recipients using the same protocol from June 2019 to May 2021.And retrospective reviewing was performed for clinical data, including characteristics of donors and recipients, optimized pathological evaluation system, modified surgery, treatment regimens, complications and follow-ups.Results:There were 8 male and 2 female donors with an age of(57.9±12.8)years and BMI(24.1±4.1)kg/m 2.The percentage of DCD was 70% and DBD 30%.The serum creatinine before procurement was 107.6(93.3-163.5)μmol/l.Zero-point puncture biopsy was performed for both kidneys and optimized pathological evaluation system was implemented(Banff criteria & Remuzzi score). The pathological results indicated that glomerular sclerosis for left and right kidneys were 2.0(1.5-2.0)and 1.5(1.0-2.0). And Remuzzi score for left and right kidneys were(4.4±1.2)and(3.6±1.5)points respectively.All recipients were male with an age of(43.1±9.0)years and BMI(22.2±1.9)kg/m 2.All PRAs were negative pre-operation.Modified surgery was performed in all recipients(two kidneys were implanted outside iliac vessels without patch and artery of superior kidney was anastomosed to internal iliac artery). Operative duration was(195±54.3)min and serum creatinine before discharge 125.0(102.0-199.0)μmol/L.Renal dynamic scintigraphy indicated that glomerular filtration rate was(30.0±8.2)ml/min for left kidney and(29.2±13.9)ml/min for right kidney.MRA results indicated that morphologies of renal arteries and veins were regular.The time between operation and discharge was(22.4±4.7)days.Compared with SKT, serum creatinine before discharge of DKT was lower and DGF incidence of DKT was higher without statistical significance.The time between operation and discharge was longer for DKT than that for SKT( P<0.05). The complications consisted of 20% donor derived infection(DDI)and 50% DGF.And there was no surgical complication associated with vessels and ureter.Renal function remained stable during 6-month follow-ups. Conclusions:Optimized pathological evaluation system of donor's kidney and modified surgery during adult dual kidney transplantation are both safe and feasible.The postoperative function of transplanted dual kidney is successfully restored.However, long-term follow-ups are required for evaluating its effectiveness.

Objective:To observe the effect of isorhmnetin on the ER/TGF-β1/Smad3 signaling pathways in human dermal fibroblasts (HSF) damaged by UVA.Methods:HSF were divided into control group, model group, estradiol group, isorhmnetin groups with 100, 10, 1, 0.1, 0.01, 0.001 μmol/L by random number table method, and cell photoaging models were established in all groups excepting the control group. After the intervention with corresponding drugs, cell proliferation rates were detected with MTT method, and the effective concentration of isorhmnetin was screened. Then the cells were divided into control group, model group, estradiol group, isorhmnetin group, TGF-β1 blocker group, Samd3 blocker group, and COL1A1 blocker group. Cell photoaging models were established in all groups excepting the control group. After intervened with corresponding drugs, the TGF-β1, Smad3, Ⅰ collagen α1 (collagen, type Ⅰ, alpha 1, COL1A1) mRNA and protein expression in all groups were detected by the real-time quantitative PCR and the Wester blot method.Results:The proliferation rate of isor administration group were increased than those in the control group ( P<0.01). Compared to the UVA irradiation group, the expression of TGF-β1 mRNA (0.956 ± 0.020 vs. 0.718 ± 0.036), Smad3 mRNA (0.981 ± 0.044 vs. 0.753 ± 0.047), COL1A1 mRNA (0.998 ± 0.032 vs. 0.786 ± 0.031), TGF-β1 protion (0.761 ± 0.026 vs. 0.542 ± 0.023), Smad3 protion (0.776 ± 0.016 vs. 0.551 ± 0.025), COL1A1 protion (0.792 ± 0.025 vs. 0.584 ± 0.012) in isor administration group significantly increased ( P<0.01). Compared to the isor administration group, the TGF-β1 mRNA (0.762 ± 0.051, 0.802 ± 0.012, 0.828 ± 0.030 vs. 0.967 ± 0.026), Smad3 mRNA (0.784 ± 0.027, 0.816 ± 0.015, 0.830 ± 0.032 vs. 0.998 ± 0.021), COL1A1 mRNA (1.082 ± 0.025, 1.101 ± 0.012, 1.138 ± 0.011 vs. 1.263 ± 0.022), TGF-β1 protion (0.675 ± 0.028, 0.682 ± 0.026, 0.722 ± 0.015 vs. 0.862 ± 0.014), Smad3 protion (0.712 ± 0.013, 0.764 ± 0.012, 0.778 ± 0.011 vs. 0.901 ± 0.015), COL1A1 protion (0.738 ± 0.016, 0.770 ± 0.038, 0.792 ± 0.026 vs. 0.964 ± 0.017) in the TGF-β1 blocker group, Smad3 blocker group and COL1A1 blocker group significantly decreased ( P<0.01). Conclusions:Isorhmnetin can promote the collagen synthesis of photo aging HSF cells, and its mechanism is related to the regulation of ERβ/TGF-β1 signaling pathway.

Chronic obstructive pulmonary disease (COPD) has a high incidence, and leads to irreversible lung dysfunction. Preventing COPD acute exacerbation (AECOPD) and delaying the progression of the disease are the focus of treatment. However, there is still a lack of precise and effective preventive measures. A significant feature of AECOPD is the high incidence in winter. The traditional concept is that cold air in winter can be accompanied by increased virus replication, environmental pollution, and reduced air humidity. Various confounding factors intertwine to promote the occurrence of AECOPD, and the impact of low temperature itself has been neglected. In recent years, with the development of molecular biology, more and more studies have found that abnormal secretion of airway mucin can lead to obstruction of mucus clearance, increase the chance of infection, and participate in the development of COPD. Low temperature can affect mucin secretion through various mechanisms. This article summarizes the particularity of COPD airway temperature and the related ways of low temperature leading to mucin changes. It draws people's attention to low temperature in order to carry out basic research and provide new intervention methods for predicting and preventing the occurrence of AECOPD.

Objective: To understand the pathogenic spectrum characteristics of enteroviruses of non-enterovirus (EV) 71 and non-coxsackievirus (CV) A16 associated with hand, foot and mouth disease (HFMD) in Xinjiang. Methods: Specimens were collected from HFMD patients infected with non-EV-A71 non-CV-A16 enterovirus from 2011 to 2016 in Xinjiang. The virion protein (VP)1 gene sequence was amplified by reverse transcription polymerase chain reaction (RT-PCR) and sequenced. Sequencing and genotyping were performed through erterovirus genotyping tool. Results: A total of 119 sequences were obtained, 15 human enterovirus serotypes were identified including CV-A6, CV-A10, CV-A4, CV-A8, CV-B1, CV-B3 (4 strains), CV-B4, CV-B5, ECHO30, ECHO12, ECHO14, CV-A9, CV-A24, PV1 and PV3. The composition ratio of CV-A6 among non-EV-A71 non-CV-A16 enterovirus in 2013, 2015 and 2016 was 87.9%, 79.5% and 88.3% respectively. Conclusions The pathogens causing HFMD in Xinjiang included more than 17 kinds of human enterovirus serotypes. Since 2013, CV-A6 has become the main pathogen of HFMD simultaneously or alternately with EV-A71 and CV-A16.