ObjectiveTo investigate the influenza vaccination coverage among kindergarten and primary school children in Zhejiang Province in 2023 and analyze the influencing factors, and to provide the basis for improving the effect of influenza vaccination in children. MethodsA multi-stage random cluster sampling method was used to select 3 681 parents of children from 10 primary schools and kindergartens based on economic level and geographical distribution in Zhejiang Province, who participated in an online questionnaire survey, including basic information about the children and their parents, parents’ knowledge about influenza, and their willingness to vaccination. ResultsAmong the 3 681 parents surveyed, 33.82% (1 245/3 681) reported that their children received influenza vaccination in 2023. Multivariate logistic regression analysis showed that factors contributing to children’s influenza vaccination included both parents [adjusted OR (95%CI): 1.56 (1.32‒1.84)] and children [6.04 (5.04‒7.27)] having a history of influenza vaccination, parents’ conviction the influenza vaccine could protect children from severe diseases [1.43 (1.19‒1.74)], and the willingness of most parents would let their children get vaccinated [1.40 (1.13‒1.74)]. In contrast, vaccine hesitancy among parents [0.55 (0.43‒0.69)] and the belief that influenza is just a common cold [0.80 (0.65‒1.00)] were hindering factors. ConclusionThe influenza vaccination coverage among children is insufficient. Both the vaccination history of parents and children, as well as parents’ correct understanding of influenza and the effectiveness of influenza vaccine, significantly influence the influenza vaccination status in children. Efforts to address vaccine hesitancy and misconceptions about influenza are essential to improve vaccination rates.

The rationale for the design of control groups in tuina clinical trial is the foundation for rigorously validating the effectiveness and safety of this therapy. This article reviewed the current state of the design of tuina placebo in control groups of clinical trials， pointed out the necessity of setting up tuina placebo in clinical trials of tuina， analyzed the challenges in implementing blinding of tuina manipulation， and concluded that tuina placebo is still challenged by the placebo effect， the diversification of tuina manipulation but the lack of standardization， and the difficulty of implementing blinding due to the high level of public awareness of tuina. This article also summarized the design of placebo manipulation in three types of clinical trials， including spinal manipulation， acupressure， and paediatric tuina， and proposed four strategies for designing placebo tuina manipulation-controlling placebo effects， developing operational standards for placebo tuina manipulation， ensuring the rigor of blinding implementation， and applying new technologies to enhance the standardization and blinding capacity of placebo tuina methods. So the article is aimed at improving the methodological quality of tuina clinical trial designs， and promoting the standardization and scientificity of tuina clinical trial design.

ObjectiveTo analyze the epidemiological characteristics of pathogens in foodborne disease cases in Haining City， Zhejiang Province， and to provide a basis for the prevention and investigation of foodborne diseases and outbreak events. MethodsInformation on foodborne disease patients from 2014 to 2023 was collected， and stool or anal swab samples were tested for relevant pathogens. The χ² test was used to compare the differences in pathogen detection rates among different groups， and multivariate logistic regression analysis was used to analyze the risk factors for pathogen detection. ResultsA total of 5 814 samples were tested， with a positive detection rate of 15.36%. The detection rates were 4.95% for norovirus， 4.49% for Escherichia coli， 3.59% for Salmonella， 2.22% for Vibrio parahaemolyticus， and 0.11% for Shigella. The positive detection rates showed seasonal characteristics， with a minor peak in March-April dominated by norovirus and a major peak in July-September dominated by bacteria. The three groups with the highest detection rates were workers， white-collar workers and other groups. Multivariate logistic regression analysis showed that age， season， and antibiotic use before consultation were significant influencing factors for pathogen detection （P<0.05）. Total pathogen detection risk was lower in the group that took antibiotics before visiting the clinic compared to those who did not （OR=0.29， 95%CI： 0.15‒0.49）. The detection risk for norovirus was lower in the preschool age group （OR=0.19， 95%CI： 0.04‒1.00）， in summer and autumn （OR range 0.23‒0.41）， and in the group taking antibiotics （OR=0.42， 95%CI： 0.15‒0.92）， but higher in the adolescent group （OR=1.40， 95%CI： 1.05‒1.88）. The detection risk for enteropathogenic Escherichia coli was higher in summer （OR=1.82， 95%CI： 1.30‒2.60）. The detection risk for Salmonella increased in the elderly group and in summer （OR range 1.44‒2.21）， but decreased in the adolescent group， in winter， and in the group taking antibiotics （OR range 0.22‒0.65）. The detection risk for Vibrio parahaemolyticus increased in summer and autumn （OR range 1.80‒1.90）， but decreased in the primary and secondary school student group and in winter （OR range 0.10‒0.32）. ConclusionThe prevalence of foodborne disease pathogens in Haining City is relatively high. Age， season， and antibiotic use before consultation are independent influencing factors for pathogen detection. These findings suggest that specific hypotheses regarding pathogenic factors can be proposed based on the time of occurrence and the age distribution of cases during field investigations of foodborne outbreaks.

【Objective】 To explore the correlation between abnormal thalamic functional connectivity (FC) and memory loss in maintenance hemodialysis patients with end-stage renal disease (ESRD). 【Methods】 An auditory verbal learning test (AVLT-H) was conducted on 22 patients with ESRD and 28 age-, sex-, and education-matched healthy controls (HC) to evaluate memory function. After that, resting-state functional magnetic resonance imaging (rs-fMRI) data were gathered, and a whole-brain FC analysis centered on the thalamus was executed to discern variations in thalamic FC between the two groups. Finally, Pearson and Spearman correlation analyses were carried out. 【Results】 Compared to the HC group, the ESRD group exhibited notably lower scores in IR-S (P=0.002), SR-S (P<0.001), and LR-S (P=0.005). Concurrently, the ESRD group demonstrated diminished FC of the right thalamus with the left superior frontal gyrus, the left parietal lobule, the right suproccipital gyrus, the right anterior cuneus, and the right middle frontal gyrus (P<0.05, TFCE correction). Additionally, reduced FC were observed between the left thalamus and the left gyrus rectus, the left parietal lobule, and the right parietal lobule in the ESRD group (P<0.05, TFCE correction). Moreover, the FC values between the left thalamus and the left gyrus rectus in the ESRD group displayed significant negative correlations with IR-S (r=-0.499), SR-S (r=-0.458), and LR-S (r=-0.455) (all P<0.05). 【Conclusion】 Memory impairment is evident in ESRD patients undergoing maintenance hemodialysis, and it appears to be intricately linked to anomalous FC within the left thalamus and the left gyrus rectus. These findings offer potential imaging markers for monitoring memory dysfunction in individuals with ESRD.

Objective : To explore the effect of MPZL1 knockdown in A549 Taxol resistant (A549 / Tax) cells and whether it affect drug resistance and tumor cell stemness by regulating β-catenin． Methods : A549 and A549 / Tax cells were treated with different concentrations of doxorubicin and paclitaxel to observe the differences in drug resist- ance between the two cells．Quantitative real-time PCR (qRT-PCR) and Western blot were used to detect the MP- ZL1 expression level in A549 and A549 / Tax cells． After knockdown or overexpression of MPZL1 in A549 / Tax cells，cells were divided into control group，small hairpin RNA negative control ( sh-NC) group，MPZL1 knock- down(sh-MPZL1) group，overexpression negative control ( OE-NC) group，MPZL1 overexpression ( OE-MPZL1) group．Cell counting kit-8 ( CCK-8 ) and clone formation assay were utilized to investigate cell proliferation and clone formation ablity．Western blot assay was used to detect the protein expression after the cells treated with Wnt / β-catenin signaling inhibitor XAV939 and activator CHIR-99201 . Results : The half inhibitory concentration ( IC50 ) of doxorubicin and paclitaxel in A549 / Tax cells significantly increased compared to A549 cells(P＜0. 01) . MPZL1 presented a higher expression trend in A549 / Tax cells．The IC50 values of A549 / Tax for doxorubicin and paclitaxel were 2. 731 mg / ml and 4. 939 μg / ml after MPZL1 knockdown，compared to 4. 541 mg / ml and 13. 55 μg / ml in the NC group (P＜0. 01) ．The results of CCK-8 and clone formation assay showed that the knockdown of MPZL1 reduced the viability of cells proliferation and clonal formation ability (P＜0. 05) ．Western blot results in- dicated that the expression levels of MPZL1 protein，tumor cell stemness associated proteins ( CD44，CD133) ，β - catenin and multidrug resistance protein 1 (MDR1) ，lung resistance-related protein ( LRP) were significantly re- duced in the sh-MPZL1 group． Furthermore ，XAV939 could inhibit the expression levels of MPZL1 ，CD44， CD133，MDR1，LRP and β-catenin(P＜0. 01) ．The inhibitory effect of knockdown MPZL1 on the aforementioned proteins was significantly reversed by CHIR-99201 treatment． Conclusion MPZL1 is highly expressed in A549 / Tax cells．Knockdown MPZL1 suppresses the tumor cell stemness and proliferation，thereby reversing the drug re- sistance of doxorubicin and paclitaxel in A549 / Tax cells.

Sirtuins(SIRTs),a group of NAD+dependent deacetylases,have attracted considerable attention in the field of neuro-degenerative diseases,especially Parkinson's disease(PD).They have critical impacts on cell survival and death through modulation of various biological processes,such as intracellular metabolism,stress response and DNA repair.In the pathogenesis of PD,Sirtuins play a crucial role and associated with pathophysiological processes such as mitochondrial function,oxidative stress,and neuronal apoptosis.Activa-tion of Sirtuins alleviates dyskinesia and neuronal damage in animal models of PD and also regulates the aggre-gation and clearance of α-synuclein,a pathological feature of the disease.Therefore,the modulation of Sirtuins is a potential strategy for treating PD.

Objective To investigate the changes of cortical thickness in patients with insomnia disorder(ID).Methods High-resolution MRI data were collected from 32 ID patients(ID group)and 30 healthy controls(HC)(HC group).The cortical thickness of both groups were analyzed using statistical parametric mapping 12(SPM12)software,while considering age,gender,and educational level as covariates.The cortical thickness in brain regions showed statistically significant differences was extracted for Pearson's correla-tion analyses with sleep and mood-related scales.Results Compared with the HC group,the ID group exhibited significantly decreased cortical thickness in brain regions such as the left insula,fusiform gyrus,orbitofrontal lobe,superior temporal gyrus,middle temporal gyrus,lateral occipital lobe and right caudal anterior cingulate gyrus[P＜0.05,family-wise error(FWE)correction].Furthermore,reduced cortical thickness of the cingulate gyrus was negatively correlated with the Pittsburgh sleep quality index(PSQI)score(r=-0.437,P=0.012).Conclusion The cortical thickness of several brain regions associated with sleep and mood are significantly reduced in patients with ID,providing potential neuroimaging evidence for understanding the pathophysiological mechanism of ID.

Objective To explore the risk factors and prognosis of cardiogenic shock in elderly pa-tients with acute myocardial infarction(AMI).Methods A retrospective trial was conducted on 398 AMI patients admitted to our hospital from January 2020 to December 2023.Based on occur-rence of cardiogenic shock during hospitalization or not,they were divided into a cardiogenic shock group(n=99)and a control group(n=299).Clinical characteristics were compared between the two groups to analyze the risk factors of cardiogenic shock,and the impact of cardiogenic shock on the prognosis was investigated.Results The cardiogenic shock group had significantly larger pro-portions of aged ≥80 years,diabetes,coronary artery lesion ≥2 branches,left main coronary ar-tery disease,history of myocardial infarction than the control group(P＜0.05,P＜0.01).Aged 80 years,diabetes,diseased branches ≥2,left main artery disease and history of myocardial infarc-tion were independent influencing factors of cardiogenic shock in elderly AMI patients(OR=2.280,95％CI:1.294-4.017,P=0.004;OR=2.326,95％CI:1.281-4.225,P=0.006;OR=3.868,95％CI:2.145-6.975,P=0.000;OR=3.587,95％CI:1.868-6.886,P=0.000;OR=4.040,95％CI:1.951-8.365,P=0.000).Based on these relevant risk factors,a prediction model was constructed.The AUC value of the model in the training set was 0.799(95％CI:0.736-0.862),while the value for the validation set was 0.737(95％CI:0.634-0.840).Hosmer-Lemeshow Goodness of Fit test showed the model had good reliability(x2=7.117,P=0.524).The in-hospital mortality rate was significantly higher in the cardiogenic shock group than the control group(12.12％vs 0.67％,P=0.000).Conclusion Cardiogenic shock can lead to poor prognosis in elderly AMI patients.Aged ≥80 years,diabetes,diseased branches ≥2,left main ar-tery disease and history of myocardial infarction are independent risk factors for cardiogenic shock.

Objective:To investigate the clinical manifestations, endoscopic characteristics, and prognostic factors of patients with colorectal extranodal NK/T cell lymphoma.Methods:The clinical data of 52 patients with colorectal extranodal NK/T cell lymphoma admitted to the First Affiliated Hospital of Zhengzhou University from January 2013 to January 2023 were retrospectively analyzed. Their clinical manifestations and endoscopic characteristics were summarized, and the prognostic factors were analyzed by Cox regression model.Results:Among the 52 patients with colorectal extranodal NK/T cell lymphoma, there were 35 males and 17 females, with a male-to-female ratio of 2.06∶1. Among the general symptoms, abdominal pain was the most common (39 cases), and B symptoms occurred in 47 patients, among which fever was the most common lymphoma B symptom (42 cases), and gastrointestinal perforation was the most common complication (18 cases). Forty-three patients underwent colonoscopy, and the main manifestations under endoscopy were the ulceration type (24 cases). The ulcers were irregular at the edges and often covered with moss at the bottom. The median survival time was 4.3 months. Multivariate Cox regression analysis showed that hemocytic syndrome ( HR=8.50,95% CI: 1.679-8.328, P=0.001), serum albumin ( HR=3.59,95% CI: 1.017-6.551, P=0.048), and with or without chemotherapy ( HR=0.31, 95% CI: 0.246-1.061, P=0.025) were independent factors influencing the overall survival of patients with colorectal extranodal NK/T cell lymphoma. Conclusions:Colorectal extranodal NK/T cell lymphoma is a rare disease with a very poor prognosis. When patients present with abdominal pain and lymphoma B symptoms, and when ulcers with irregular edges and moss covering the bottom are found under endoscopy, the disease should be considered, and endoscopic biopsy should be taken in time for pathological diagnosis. The prognosis of patients with hemophagocytic syndrome and hypoproteinemia is poor. This disease should be treated with chemotherapy and surgery, and on this basis, hemophagocytic syndrome and hypoproteinemia should be treated to improve the prognosis of patients.

Objective:To investigate the clinical manifestations, endoscopic characteristics, and prognostic factors of patients with colorectal extranodal NK/T cell lymphoma.Methods:The clinical data of 52 patients with colorectal extranodal NK/T cell lymphoma admitted to the First Affiliated Hospital of Zhengzhou University from January 2013 to January 2023 were retrospectively analyzed. Their clinical manifestations and endoscopic characteristics were summarized, and the prognostic factors were analyzed by Cox regression model.Results:Among the 52 patients with colorectal extranodal NK/T cell lymphoma, there were 35 males and 17 females, with a male-to-female ratio of 2.06∶1. Among the general symptoms, abdominal pain was the most common (39 cases), and B symptoms occurred in 47 patients, among which fever was the most common lymphoma B symptom (42 cases), and gastrointestinal perforation was the most common complication (18 cases). Forty-three patients underwent colonoscopy, and the main manifestations under endoscopy were the ulceration type (24 cases). The ulcers were irregular at the edges and often covered with moss at the bottom. The median survival time was 4.3 months. Multivariate Cox regression analysis showed that hemocytic syndrome ( HR=8.50,95% CI: 1.679-8.328, P=0.001), serum albumin ( HR=3.59,95% CI: 1.017-6.551, P=0.048), and with or without chemotherapy ( HR=0.31, 95% CI: 0.246-1.061, P=0.025) were independent factors influencing the overall survival of patients with colorectal extranodal NK/T cell lymphoma. Conclusions:Colorectal extranodal NK/T cell lymphoma is a rare disease with a very poor prognosis. When patients present with abdominal pain and lymphoma B symptoms, and when ulcers with irregular edges and moss covering the bottom are found under endoscopy, the disease should be considered, and endoscopic biopsy should be taken in time for pathological diagnosis. The prognosis of patients with hemophagocytic syndrome and hypoproteinemia is poor. This disease should be treated with chemotherapy and surgery, and on this basis, hemophagocytic syndrome and hypoproteinemia should be treated to improve the prognosis of patients.