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.

BACKGROUND:Among the pathogenic factors of cervical spondylosis,herniation of the intervertebral disc,dislocation of the facet joint and the stenosis of the intervertebral foramen are important factors leading to symptoms in patients.Moreover,inappropriate manipulation may aggravate the possibility of cervical disc rupture,leading to exacerbation of symptoms in patients. OBJECTIVE:To compare the effect between sagittal cervical manipulation and traditional cervical rotation manipulation on the area of the intervertebral disc,facet joint and intervertebral foramen at the operative segment by the finite element analysis. METHODS:The neck CT data of a male volunteer with a normal neck were selected and imported into Mimics 17.0 three-dimensional reconstruction software.Geo-magic Studio 12.0,Solidworks 2017 and Ansys Workbench 17.0 software were used for the construction of the finite element model of cervical vertebrae(C3-6)including intervertebral disc and articular cartilage.The lower end plate of the C5 vertebral body was fixed.A uniformly distributed vertical downward 50 N load was applied on the upper surface of the upper vertebral body(C3).The stress,deformation and deformation direction of the C4-5 intervertebral disc,joint capsule stress,the displacement of facet joints and the area of bilateral intervertebral foramen were compared between sagittal cervical manipulation and traditional rotation reduction. RESULTS AND CONCLUSION:(1)When using the rotation technique,the maximum normal equivalent stress(von Mises stress)of the C4-5 disc was 8.06 MPa;the total deformation was 1.05 mm,and the fiber ring expanded to the left and outside.When using the sagittal tip lifting technique,the maximum normal equivalent stress(von Mises stress)of the C4-5 disc was 2.60 MPa;the total deformation was 0.90 mm,and the fiber ring expanded to the left and back.Compared with the rotation technique,the pressure of the cervical manipulation technique on the disc was less(about 32.3%of the rotation technique),and the deformation degree of the disc was also light(about 85.7%of the rotation technique).(2)When the rotation technique was used,the maximum stresses of the left and right articular capsule ligaments were 0.37 MPa and 1.69 MPa,respectively.The overall displacement of the facet joint was 2.21 mm.The area of the right intervertebral foramen decreased by about 3.8%and the area of the left intervertebral foramen increased by about 0.9%.When the sagittal end lifting manipulation was performed,the maximum stresses of the left and right articular capsule ligaments were 0.27 MPa and 1.70 MPa,respectively;the overall displacement of the facet joint was 1.63 mm;the area of the right intervertebral foramen increased by about 2.6%,and the area of the left intervertebral foramen decreased by about 0.9%.Compared with rotation manipulation,sagittal end lifting manipulation had fewer changes in the displacement of facet joint,joint capsule stress and intervertebral foramen area,so it was safer to operate.(3)In conclusion,compared with cervical rotation manipulation,sagittal end lifting manipulation has fewer changes in facet joint displacement,intervertebral disc stress/deformation degree,joint capsule stress,and foraminal area.In clinical practice,more appropriate manipulation should be selected based on biomechanical results after an accurate assessment of patients'conditions.

In the study of embryo development process, the morphological features at different stages are essential to evaluate developmental competence of the embryo, which can be used to optimize and improve the system for
Blastocyst ; Embryo Culture Techniques ; Embryonic Development ; Fertilization in Vitro

Objective: To analyze recent trends in waist circumference(WC) and central obesity rate of Chinses children and adolescence aged 7-18 from 1993 to 2015, and to provid the theoretical basis for further prevention and control of children obesity. Methods: The samples were derived from the China Health and Nutrition Survey from 1993 to 2015 (both boys and girls aged 7-18). The criteria of WS/T 586—2017 were adopted as classification standard for central obesity and the coefficient of skewness-median-coefficient of variation method was used to reveal the trends of waist circumference distribution. Results: From 1993 to 2015,waist circumference curves flattened and expanded at higher levels in boys and girls. The P50 and P85th percentile WC curves showed an increasing trend with high percentile increasing more obviously. WC increased 3.84 and 1.55 cm for boys and girls. The prevalence rate of central obesity increased in both genders, which increased from 4.08% to 20.64% in boys and from 6.29% to 20.98% in girls. Besides, higher increasing rate was observed among boy, and urban. Conclusion A rapid increase in waist circumference was present among Chinese children and adolescence. A gradient of increasing prevalence of central obesity was also observed in boys and girls, as well as in different BMI levels. Appropriate measures should be taken to control the increase in the course of the central obesity epidemic.

Objective: To describe the secular trend of BMI and its consistency with self-rated BMI status in Chinese children and adolescents, and to further investigate the related factors affecting self-rated BMI,so as to provide a scientific reference for interventional measures. Methods: A total of 6 238 children and adolescents aged 6-18 years were selected according to date from Chinese Health and Nutrition Svrvey during 2000-2015 and the criteria from National Health Commission of China.The Lambda-Mu-Sigma method(LMS) and Kappa consistency test were, respectively, applied to describe the percentiles for BMI and its agreement with self-rated BMI status. Multinomial Logistic model was used to assess the related factors influencing self-rated BMI status. Results: P50 and P85 percentiles showed an increasing trend, especially the increase of high percentile of BMI. Regardless of age and sex, the measured and self-rated BMI showed low agreement. More than 50% of over-weighted or underweighted children perceived themselves as normal-weight, and about 1/4 of normal weight students misclassified themselves as abnormal in weight. Urban boys were more likely to evaluate themselves as underweight [OR(95%CI) =1.43(1.18-1.73)]. Boys who favored popular showed[OR(95%CI)=1.80(1.23-2.55) and cartoon [OR (95%CI) =1.39(1.00-1.96)] were more likely to consider themselves as overweight. Girls in the older age group [OR (95%CI)=2.74(2.08-3.61)] and urban [1.53(1.21-1.94)] who favored popular programs [OR(95%CI) =1.74(1.27-2.38)] were more likely to perceived themselves as overweight. But girls who like anime/cartoons were more likely to think they were underweight [OR(95%CI)=1.78(1.33-2.40)]. Conclusion The trend of BMI has shown an increasing trend in the past decade and it demonstrated a large bias with perceived BMI. Age, area and type of video were significant factors that influenced the self-rated BMI status.

Objective To research the clinical value between gene polymorphism of human platelet alloantigens (HPA) 1-6, 9, 15 and platelet transfusion refractoriness ( PTR) .Methods Totally 40 patients with platelet transfusion refractoriness( PTR) were randomly selected, and patients and donors’ peripheral blood specimens were collected and tested these samples with platelet GP specific antibodies, and judged the results of platelet transfusion, and with the help of the combination of PCR and direct sequencing for classification of HPA 1-6,9,15 antigens and observe the percent platelet recovery ( PPR ) after the same type of platelet transfusion, and explore the relationship between HPA gene polymorphism and PTR. Results There was no HPA-b gene was found neither on patients and donors’ HPA 1,4,9, showed the distribution of aa homozygous form; HPA 5,6 were mainly aa homozygous form, little bb homozygous form was discorvered.And HPA 2,3,15 were distributed of polymorphism, the frequency of HPA 2,3,5,6,15 were found with polymorphism.Conclusion For these patients who were happened with PRT many times, in addition to taking HLA into account, HPA gene polymorphism are also need to be considered.Most people only need to test patients and donors’ HPA2,3,15 gene to decrease the occurrence of PTR significantly when making HPA matching.

Objective To provide a good anatomical foundation for transposition of the branch of median nerve superficial flexor muscle repairing the movement branch of ulnar nerve to recover the function of intrinsic muscle, by anatomic study of the muscle branch of the superficial flexor muscle of the median nerve and the movement branch of ulnar nerve. Methods Twenty adult upper limb specimens immersed fixed by formalin were elected and expose the midian nerve and ulnar nerve. Then every anatomical index was measured. Simulate to manipulate that the branch of superficial flexor muscle repair the motor b ranch of ulnar nerve. Calculate the number of myelinated nerve fibers of the branch of superficial flexor muscle. Results The distance between the position into muscle and styloid process of radius and styloid process of ulna: (21.4±1.8)mm, the distance that can be separated: (27.1±1.2)mm, the transverse diameter: (1.2±0.2)mm, anteroposterior diameter: (0.7 ± 0.1 )mm. No injury separated distance between the sensory branch and motor branch of ulnar nerve: (7.1 ± 0.7)cm. The 4th muscular branches of median nerve flexor digitorum superficialis was 1378.9± 107.9. Conclusion The 4th muscular branches of median nerve flexor digitorum superficialis can be used to repair the motor branch of the ulnar nerve to recover the function of intrinsic muscle of hand.