Objective: To investigate the characteristics of rabies-exposed population in Wenzhou City, Zhejiang Province from 2014 to 2023, so as to provide insights into the prevention and control of rabies. Methods: Data of rabies-exposed population in Wenzhou City from 2014 to 2023 were collected through Wenzhou Rabies-Exposed Population Summary Sheet reported by dog injury clinics. The species of animals causing injuries, exposure time, exposure grade, exposure site, and post-exposure treatment were descriptively analyzed. Results: Totally 709 900 patients were admitted to dog injury clinics in Wenzhou City from 2014 to 2023, and the exposure rate showed an increasing trend (Z=7.238, P<0.001), with an average annual exposure rate of 750.75/105. The number of cases with exposure to rabies peaked in July (79 230 cases, 11.16%) and August (78 570 cases, 11.07%). Dogs were predominant animals causing injuries (448 900 cases, 63.23%), and the exposure rate showed a downward trend (Z=-5.921, P<0.001); cats were the second (175 142 cases, 24.67%), and the exposure rate showed an upward trend (Z=23.314, P<0.001). The upper (379 695 cases, 53.49%) and lower limbs (287 521 cases, 40.50%) were the main exposure sites. There were 21 034 cases (2.96%) exposed to head and face, and the exposure rate of head and face showed an upward trend (Z=3.549, P<0.001). Grade II exposure was the most common (403 881 cases, 56.89%), and the exposure rate showed an upward trend (Z=8.769, P<0.001). The proportion of using human rabies immune globulin was 23.13% in Grade III exposed population, showing a downward trend (Z=-12.848, P<0.001). Conclusions The exposure rate of rabies in Wenzhou City showed an upward trend from 2014 to 2023, with July and August as the peak months of exposure. Injuries mainly caused by dogs, while the exposure rate of cat bites showed an upward trend. The proportion of using human rabies immune globulin needs to be improved.

A 15-year-old female with Hodgkin's lymphoma underwent ovarian tissue cryopreservation for preserving fertility in Reproductive Department of Sir Run Run Shaw Hospital,Zhejiang University School of Medical after receiving one course of chemotherapy.During the ovarian tissue cryopreservation,one MⅡmature oocyte and three germinal vesicle oocytes were found.The three immature oocytes underwent in vitro maturation but failed.Ultimately,one mature oocyte and 12 ovarian cortex slices were cryopreserved using vitrification.This case indicates that for patients with established gonadal axis feedback,ovarian tissue cryopreservation may not be the only method for fertility preservation.It is advisable to consider ovarian stimulation and oocyte retrieval for oocyte cryopreservation.Alternatively,for individuals in the ovulation phase of their menstrual cycle,attempting oocyte retrieval before ovarian tissue cryopreservation to obtain mature oocytes from the natural cycle,followed by oocyte cryopreservation,may enhance the likelihood of successful fertility preservation.

Objective To screen the differentially expressed proteins in glomeruli during the treatment of lupus nephritis(LN)with hydroxychloroquine sulfate(HCQ).Methods Sixty female NZB/WF1 mice were used.At the age of 28 weeks,40 mice with proteinuria of 3+to 4+were divided into HCQ and control groups.After feeding for 36 weeks,the glomerular proteins were extracted by magnetic beads and analyzed by two-dimensional fluorescence difference gel electrophoresis(2D-DIGE)and matrix-assisted laser desorption/ioniza-tion time-of-flight mass spectrometry(MALDI-TOF-MS).The expression of the candidate proteins in the glomeruli of the LN mice was exa-mined by immunohistochemistry.Results A total of 31 differentially expressed proteins were identified between the two groups,including 24 upregulated and seven downregulated proteins.Conclusion The expression of proteins like RI and ENOA in the glomeruli of LN mice was significantly different during HCQ treatment.These proteins may be involved in the pathogenesis of LN and are therefore potential targets of HCQ in the treatment of LN.

Post-stroke depression （PSD） is the most common neuropsychiatric complication after stroke. PSD can lead to unfavorable outcomes， increasing disability， morbidity， and mortality. Understanding the pathogenesis and risk factors of PSD is critical for its diagnosis and treatment， which can provide new possibilities for the treatment of PSD.

Objective To explore the effectiveness of virtual autopsy-based postmortem computed tomography(PMCT)liver three dimensional slicer(3D slicer)artificial intelligence(AI)volume reconstruction to assist forensic practice.Methods Twenty cases of the deceased who underwent both virtual autopsy and traditional autopsy in our center were selected and subjected to liver volume segmentation by 3D slicer method,Tada's formula method and literature method,and the data obtained from the traditional autopsy were compared and analyzed to obtain the accuracy rate.Results The 3D slicer method yielded higher consistency(95%confidence interval),lower volumetric variability(standard deviation),and a smaller region(variance)of uncertainty than the Tada formula method and the methods mentioned in the literature.Conclusion 3D slicer AI reconstruction based on virtual autopsy can visualize virtual anatomy,help increase the diagnostic accuracy of traditional autopsy,assist in pathological diagnosis,and provide new directions and tools for the development of imaging histology of virtual autopsy.

Objective:To summarize the best evidence for early enteral nutrition support in postoperative patients with gastric cancer and evaluate its effectiveness.Methods:From March to August 2021, 108 postoperative patients with gastric cancer admitted to the Gastrointestinal Surgery of the First Affiliated Hospital of Ningbo University were selected. We applied evidence-based nursing methods to summarize the best evidence for early enteral nutrition support in postoperative gastric cancer patients, and constructed and implemented the best evidence application strategy through baseline review, evaluation of evidence application clinical scenarios and barriers. We compared the various indicators of two groups of patients before the application of evidence (March to May 2021, n=55) and after the application of evidence (June to August 2021, n=53) . Results:No adverse events occurred during the application of evidence. After applying evidence, the correct nutritional assessment rate increased from 41.82% (23/55) at baseline review to 90.57% (48/53), the implementation rate of early postoperative enteral nutrition increased from 0 to 45.28% (24/53), the start time of postoperative enteral nutrition shortened from (3.75±2.33) days to (2.06±1.38) days, and the implementation rate of postoperative priority oral nutrition increased from 63.64% (35/55) to 86.79% (46/53), nutritional related complications decreased from 40.00% (22/55) to 20.75% (11/53), and the differences were all statistically significant ( P<0.05) . Conclusions:The application of the best evidence for early enteral nutrition support in postoperative gastric cancer patients can shorten the start time of postoperative enteral nutrition, reduce postoperative nutrition related complications, and promote early recovery of patients.

Human dental pulp stem cells (DPSCs) have emerged as an important source of stem cells in the tissue engineering, and hypoxia will change various innate characteristics of DPSCs and then affect dental tissue regeneration. Nevertheless, little is known about the complicated molecular mechanisms. In this study, we aimed to investigate the influence and mechanism of miR-140-3p on DPSCs under hypoxia condition. Hypoxia was induced in DPSCs by Cobalt chloride (CoCl
Cell Differentiation ; Histone-Lysine N-Methyltransferase ; Humans ; Hypoxia ; Methyltransferases ; MicroRNAs

Objective:To retrospectively analyze of the prevention and management of major complications in surgical treatment of osteoradionecrosis (ORN) of the mandible by using vascularized free flaps and to provide a reference for improving clinical treatments.Methods:All cases diagnosed as mandibular ORN and received surgical treatment in the Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University from August 2014 to March 2019 were included. The patients′ clinical data, mainly including general information, primary tumor, interval time between radiotherapy and osteoradionecrosis, surgical methods and postoperative complications, were collected. The data of surgical methods and postoperative complications of these patients were compared with the similar data of patients with malignant tumor surgically treated by using vascularized free flaps during the same period.Results:The postoperative follow-up data of 104 patients with mandibular ORN, who underwent surgery in our hospital, were collected. In the control group, surgeries of vascularized free flap transfer were performed in 430 patients with malignant tumor. Among the 34 ORN cases (34/104, 32.7%) of segmental resection with vascularized free flap transfer, there were 13 cases (13/34, 38.2%) of postoperative local infection in maxillofacial area, 6 cases (17.6%) of pulmonary infection, 2 cases (5.9%) of venous thrombosis, 3 cases (8.8%) of anastomotic artery rupture and 5 cases (14.7%) of vascular crisis. One case died of depression and misanthropy. Meanwhile, among 430 patients with malignant tumor who underwent surgeries of vascular free flap reconstruction, 25 cases (5.8%) had postoperative local infection and 29 cases (6.7%) had pulmonary infection. Vascular crisis occurred in 12 cases (2.8%) and anastomotic artery rupture in 1 case (0.2%). No venous thrombosis and misanthropy occurred. The incidence of postoperative complications in mandibular ORN was much higher than that of vascularized free flap transfer surgeries in malignant tumor cases ( P<0.05). Conclusions:Compared with patients with malignant tumors undergoing vascularized free flap transfer surgeries, patients with mandibular ORN undergoing same surgeries are more likely to have postoperative complications. This study may help clinicians to fully understand the local, general and psychological conditions during the perioperative period of ORN patients.

Objective:To understand the current status of foreign dual-degree programs of Medical Doctor (MD) and Master of Public Health (MPH) and provide evidence-based decision-making reference for promoting the education of high-level applied public health talents in China.Methods:The list of involved institutions and information of foreign MD-MPH dual-degree programs was collected through literature retrieval, online information searching, and additional survey of key figures. We extracted the details of each project regarding professional fields, core competence, length of schooling, teaching and learning arrangement, internship eligibility, and graduation assessment. Python 3.8.0 was used for data cleaning, and the occurrence frequency of related items in each dimension was calculated.Results:A total of 99 MD-MPH programs from 104 foreign institutions were included, among which 97.1% of them were implemented in universities from the United States. The School of Public Health provided 42.4% (42/99) of the programs. Epidemiology was the major discipline set up among most programs, accounting for 12.0% (29/241) of all the specialties involved. Epidemiological research methods, health policy management and practice, and public health practice were the top 3 core competencies to be mastered. Of the 99 programs, 87 gave information on the length of the program, of which 74.7% (65/87) were five years, 6.9% (6/87) were four years, and 18.4% (16/87) included both 4-year and 5-year programs.Conclusions:The international MD-MPH programs were sophisticated and mainly organized by the School of Public Health alone or in conjunction with the School of Medicine. Epidemiology is the core course and competence objective, with a length of 4-5 years. Through learning experience from international MD-MPH programs and the Chinese unique medical development background, China should optimize its medical education system to develop a suitable talent training strategy for MD-MPH dual-degree programs in the new era.

Objective:To investigate the clinical characteristics and change trend of patients with perianal lesions before or after Crohn′s disease (CD) diagnosed.Methods:From January 2008 to September 2018, at The Tenth People′s Hospital Affiliated to Tongji University, the clinical data of 747 hospitalized CD patients were retrospectively collected, 293 patients were PCD patients. The clinical characteristics of PCD patients before or after CD diagnosed were analyzed and the change trend was followed. T test, Mann-Whitney U test, and Chi-square test were performed for statistical analysis. Multivariate logistic regression analysis was used to analyze factors associated with perianal lesions onset time. Spearman correlation analysis was used to analyze the change trend of clinical characteristics. Results:Before CD diagnosis, 86.3% (253/293) PCD patients had perianal lesions. The median follow-up time (range) was 72 months (36 to 108 months). Compared with the patients presented with perianal lesions after CD diagnosis, the onset age of patients with perianal lesions before CD diagnosis was younger ((36.0±12.6) years vs. (24.2±10.2) years), and the rates of male (62.5%, 25/40 vs. 77.9%, 197/253), non-structuring and non-penetrating type (32.5%, 13/40 vs. 56.9%, 144/253) and perianal surgery (55.0%, 22/40 vs.76.7%, 194/253) were high, but low rate of abdominal surgery (37.5%, 15/40 vs. 13.0%, 33/253), and the differences were statistically significant ( t=2.630, χ2=4.442, 8.379, 8.379 and 15.081; all P<0.05). The results of logistic multivariate analysis showed that before CD diagnosis, non-structuring and non-penetrating type was more common than structuring type (odds ratio ( OR)=0.447, 95% confidence interval ( CI) 0.207 to 0.962, P=0.039) and penetrating type ( OR=0.264, 95% CI 0.089 to 0.780, P=0.016). The short disease duration of CD ( OR=0.981, 95% CI 0.968 to 0.995, P=0.008), structuring type ( OR=2.239, 95% CI 1.040 to 4.822, P=0.039) and penetrating type ( OR=3.788, 95% CI 1.281 to 11.198, P=0.016) were the risk factors of perianal lesions after CD diagnosed. The number of PCD patients ( r=0.964, P<0.01) and the proportion of biological agents ( r=0.879, P<0.01) increased with years, while PCD duration ( r=-0.828, P<0.01) and the rate of abdominal surgery significantly decreased with years ( r=-0.882, P<0.01). The proportion of biological agents was negatively correlated with the rate of abdominal surgery ( r=-0.770, P=0.006). Conclusions:The perianal lesions should be closely monitored in adult CD patients with short disease duration, structuring type and penetrating type for early diagnosis and treatment. Biological agents can improve the clinical outcomes of PCD.