ObjectiveTo identify the rate， population characteristics， and vaccination history of repeat infections among previously infected people in the current epidemic based on the rate of repeat infection and population characteristics of different mutant strains at different times in Pudong New Area of Shanghai， and to provide reference for the prevention and control strategies of novel coronavirus repeat infections. MethodsA total of 9 250 investigated subjects were randomly selected from the new cases of asymptomatic infection and confirmed cases reported by Pudong New Area from March to May 2022. The investigation mainly focused on demographic characteristics， nucleic acid or antigen test results， and symptoms after infection. The repeat infection rates among different populations were compared， and logistic regression was used to analyze the impact of gender， age， and vaccination status on repeat infections. ResultsThe survey sample of 9 250 people had a response rate of 81.85%. There were 4 043 males （53.40%） and 3 528 females （46.60%）， with a median age of 34 years old （P₂₅， P₇₅： 7， 61）. The overall vaccine uptake rate was 59.44% （4 500/7 571）. In December of 2022， there were 563 cases of repeat infection， with an infection rate of 7.44%. The lowest rate of repeat infection was seen in the 3‒ year-old group （2.86%） and the highest rate in the 30‒ year-old group （12.42%）， with significant differences between different age groups. The repeated infection rate for those who had completed their vaccinations was significantly lower （6.57%） compared to those who had not （7.11%）. The age groups of 3‒ years， 70‒79 years， as well as individuals who completed full vaccination and received booster shots were protective factors against repeat infections. ConclusionThe overall rate of reinfection among the infected in Shanghai during the spring of 2022 was low in the outbreak of the Omicron variant， and the rate of reinfection in the 3‒ year-old group was significantly lower than in other age groups. Completing the full course of vaccination significantly reduces the risk of reinfection. Although the reinfection rate is high in individuals who received booster shots， it remains a mitigating factor compared to those who do not receive the vaccine. It is recommended to continue monitoring reinfections in key populations and further strengthen immunization efforts.

Objective:To explore the differences between the deep learning-based image reconstruction (DLIR) and the adaptive statistical iterative reconstruction V (ASiR-V) algorithms in the radiation dose and image quality of head and neck CT angiography (CTA).Methods:The data of 80 patients undergoing head and neck CTA due to vascular diseases in the head and neck were prospectively collected. These patients were randomly divided into groups A and B based on their examination sequence. The CTA images of group A were reconstructed based on ASiR-V 50%, with a tube voltage of 120 kV and a noise index of 11.0. In contrast, those of group B were reconstructed based on ASiR-V 50% (for group B1) and DLIR-H (for group B2), with a tube voltage of 80 kV and a noise index of 9.0. Then, the radiation doses and image quality of both groups were compared using the independent-sample t-test. The radiation doses, and both subjective and objective image quality of the two imaging method were compared through the Kruskal-Wallis test and the Wilcoxon rank-sum test. The independent- or paired-sample t-test was employed to measure inter-group vascular enhanced CT values, as well as signals and noise from regions of interest (ROIs), with signal-to-noise ratios (SNRs) and contrast-to-noise ratios (CNRs) calculated. Results:The effective doses of groups A and B were (0.77±0.08) and (0.45±0.05) mSv, respectively, with a statistically significant difference ( t = 21.96, P < 0.001). The vascular enhanced CT values, SDs, SNRs, and CNRs in the arch of the aorta, the initial and bifurcation parts of the common carotid artery, and the M1 segment of the middle cerebral artery showed statistically significant differences among groups A, B1, and B2 ( F = 67.69, 68.50, 50.52, 74.10, 63.10, 91.22, 69.16, P < 0.001). Additionally, statistically significant differences were observed in the subjective scores of image quality among groups A, B1, and B2 ( Z = 71.06, P < 0.05). Conclusions:The DLIR algorithm can further reduce the radiation dose in head and neck CTA examination while significantly reducing image noise and ensuring image quality, thus demonstrating high clinical application value.

Objective To explore the effectiveness of high-definition diffusion weighted imaging(DWI)sequence combined with T1 WI-fat suppression(FS)dynamic contrast enhancement(DCE)sequence for preoperative T-stage of rectal cancer by using 3.0T MRI standardized scanning.Methods A retrospective analysis was conducted on MRI images of 57 patients with rectal cancer confirmed by pathology.Before surgery,the patients underwent 3.0T MRI standardized rectal cancer scan methods,including routine sequence,high-definition DWI sequence,and T1 WI-FS DCE sequence,etc.Then two experienced physicians evaluated the T-stage of preoperative rectal cancer through high-definition DWI(transverse and sagittal sections)and T1 WI-FS DCE sequences in the double-blind method.Using the postoperative pathological results of rectal cancer as the"gold standard",two sequences were combined to evaluate the accuracy,sensitivity,and specificity of rectal cancer T-stage.Results Among the 57 cases,there were 9 cases of upper rectal cancer,39 cases of middle rectal cancer,and 9 cases of lower rectal cancer.The accuracy rates of preoperative T-stage diagnosis for rectal cancer by two evaluator were both 85.7％(6/7)in T1 stage,88.2％(15/17)and 94.1％(16/17)in T2 stage,96.9％(31/32)and 93.8％(30/32)in T3 stage,and both 100.0％(1/1)in T4 stage.For evaluator 1,the sensitivity and specificity of the rectal cancer T-stage diagnosis were 96.1％and 83.3％,and for evaluator 2 were 94.1％and 83.3％,respectively.For rectal cancer MRI diagnosis,the accuracy rates and sensitivity were higher when combining the high-definition DWI sequence and T1 WI-FS DCE sequence,compared with a single high-definition DWI sequence or T1 WI-FS DCE sequence,and the difference was statistically significant.The average preoperative apparent diffusion coefficient(ADC)value of rectal cancer was compared between the corresponding postoperative pathological T1 to T4 stage groups,and the difference was statistically significant.Conclusion The combination of high-definition DWI sequence and T1 WI-FS DCE sequence improves the accuracy of rectal cancer T-stage,providing assistance for personalized clinical treatment.

Objective To analyze and discuss the medication rule of professor Ruan Yan in the treatment of children with allergic rhinitis by using data mining method,and to provide reference for the clinical research and patented drugs development for the treatment of children with allergic rhinitis.Methods The outpatient medical records of professor Ruan Yan for the treatment of children with allergic rhinitis were collected.Microsoft Excel 2010 software was used for frequency statistics.SPSS Clementine 12.0 software was used for association rule analysis,cluster analysis and factor analysis to obtain the data.The frequency of use of various drugs and the association rules between drugs were obtained.Then the medication rules in professor Ruan Yan's prescription were analyzed.Results A total of 308 Chinese medicine compounds were included,involving 80 kinds of Chinese medicines,among which relieving drugs and qi-invigorating herbs were high-frequently used.The distribution of traditional Chinese medicine syndrome types was mainly characterized by lung-qi deficiency-cold syndrome and lung-spleen qi deficiency syndrome.The medicinal properties were mainly spicy,warm and sweet,and most of them belonged to the lung,spleen and stomach meridians.Five core prescriptions were extracted by factor analysis.Four drug combinations were obtained by systematic cluster analysis.Conclusion Ventilating lung and opening the orifices,expelling wind and removing cold,strengthening the spleen and replenishing qi are basic therapeutic principles for professor Ruan Yan in the treatment of children with allergic rhinitis.The treatment mainly focused on dispelling evil,ventilating lung and opening the orifices,expelling wind and removing cold during the acute stage of allergic rhinitis.In the remission period,according to the principle of"treating disease must be based on its origin",the treatment should enhance children's physical fitness,tonify lung and strengthen spleen,thereby reducing recurrence.

Purpose: This study was performed to compare the therapeutic efficacy of endoscopic surgery and open surgery and their effects on postoperative blood coagulation state in patients with thyroid cancer, and to provide evidence for the prevention measurement of thrombosis in the perioperative period. Methods: One hundred patients with thyroid cancer who received treatment in our hospital from January 2021 to December 2021, were randomly divided into an endoscopic group and an open surgery group, with 50 patients in each group. The patients in the open surgery group were treated by traditional open surgery, while patients in the endoscopic group accepted endoscopic surgery. The clinically therapeutic effect and blood coagulation of the 2 groups were compared. Results: Intraoperative blood loss and length of hospital stay were lower, and operative time was longer in the endoscopic group than in the open surgery group (P < 0.05). The 24-hour postoperative fibrinogen and D-dimer levels were higher in both groups than in the preoperative period, while PT was shorter (P < 0.05). There were no significant differences in postoperative complications and follow-up between the 2 groups (P > 0.05), but the incidence of complications, postoperative metastases, and thrombosis was relatively low in the endoscopic group. Conclusion In the treatment of patients with thyroid cancer, endoscopic surgery has the advantages of less blood loss, fewer complications, and so on. Endoscopic and open surgery can lead to a hypercoagulable state, but the effect of endoscopic surgery is better than that of open surgery.

Objective:To evaluate and compare the efficacy and safety of ultra-rapid lispro insulin (URLi) and humalog lispro (HL) in the treatment of type 2 diabetes mellitus.Methods:This was an international multicenter, double-blind, randomized controlled study. From May 2019 to January 2021, a total of 481 patients with type 2 diabetes mellitus, who had been using insulin for at least 90 days and had poor glycemic control, were included. These patients were recruited from 34 research centers in China, including Shanghai Jiao Tong University School of Medicine Affiliated Sixth People′s Hospital. They were assigned to either the URLi group (319 patients) or the HL group (162 patients) using stratified blocked randomization. The primary endpoint was the change in hemoglobin A 1c (HbA 1c) relative to baseline after 26 weeks of treatment. Secondary endpoints included the proportion of patients who achieved HbA 1c<7.0% and ≤6.5% after 26 weeks of treatment, 1-h postprandial glucose (1hPG) or 2-h postprandial glucose (2hPG) excursions during a mixed meal tolerance test at week 26, as well as safety parameters. Continuous variables were compared using mixed model repeated measures or analysis of covariance, and categorical variables were compared using logistic regression or Fisher′s exact test. Results:Data based on the Chinese subgroup showed that there were no statistically significant differences between the URLi and HL groups in terms of male percentage [56.1% (179/319) vs. 56.2% (91/162); P=0.990], age [(59.5±8.4) vs. (59.6±9.3) years; P=0.839] and other baseline characteristics. Regarding the change in HbA 1c relative to baseline, the URLi group was non-inferior to the HL group (-0.59%±0.05% vs. -0.66%±0.06%; P=0.312). There were no statistically significant differences between the URLi and HL groups in proportion of patients who achieved HbA 1c<7.0% [47.3% (138/292) vs. 45.2% (70/155); P=0.907] and≤6.5% [27.7% (81/292) vs. 27.7% (43/155); P=0.816]. The excursions in 1hPG [(6.20±0.21) vs. (6.90±0.25) mmol/L; P=0.001] and 2hPG [(8.10±0.27) vs. (9.30±0.31) mmol/L; P<0.001] were lower in the URLi group than the HL group, with statistically significant differences. In terms of safety, there were no statistically significant differences in the percentage of subjects who reported treatment-emergent adverse events between the URLi and HL groups [49.8% (159/319) vs. 50.0% (81/162); P=1.000]. The event rate of nocturnal hypoglycemia was lower in the URLi group than the HL group, with statistically significant differences [(0.53±0.10) vs. (0.89±0.16) events per patient -year; P=0.040]. Conclusions:With good glycemic control, URLi showed non-inferiority for HbA 1c improvement versus HL and was superior to HL for postprandial glucose excursion control. Meanwhile the rate and incidence of nocturnal hypoglycemia were lower in the URLi group than the HL group.

Objective To understand the seasonal and etiological characteristics of the epidemic situation of cluster fever in Pudong New Area, Shanghai, and to provide a scientific basis for the formulation of prevention and control strategies. Methods The epidemic data of cluster fever in Pudong New Area of Shanghai from 2013 to 2021 were collected, and the data were analyzed by concentration degree and circular distribution methods. Results From 2013 to 2021, there were 109 cases of cluster fever reported in Pudong New Area, with primary schools reporting the most cases, 77 cases (70.64%). The M value was 0.59. Circular distribution results showed that angle dispersion index r value was 0.54, the average angle was 357.32^°, and the average angle of Rayleigh’s test Z value was 32.07. The peak day was December 28, and the peak period was from October 25 to March 3 of the following year. The cluster of fever in Pudong New Area was mainly caused by influenza virus. Most cases were single pathogen infection, and some were double pathogen infection. Influenza A virus had the highest detection rate in both single pathogen infection and double pathogen infection. Conclusion Primary schools are the focus of prevention and control of the cluster of fever in Pudong New Area. The epidemic situation of cluster fever has a strong seasonal characteristic, and the peak of incidence is from late October to early March of the next year. Respiratory pathogens such as influenza virus are the main causes of the epidemic situation.

Objective To analyze the epidemic characteristics of imported dengue fever in Pudong New Area of Shanghai from 2008 to 2020，and to explore its prevention and control strategy and measures． Methods The data of dengue fever cases in Pudong New Area from 2008 to 2020 were collected from the China Information System for Disease Control and Prevention. Descriptive epidemiological method was used to analyze the epidemic characteristics. Results A total of 45 cases of dengue fever were reported in Pudong during 2008-2020, all the cases were mild, and no deaths were reported．The male-to-female ratio was 2.46:1. The group aged 20-49 years accounted for 86.67%．The most common occupation was commercial service personnel and cadres (25 cases, accounting for 55.56%). The peak of incidence was from July to October with a total of 35 cases (77.78%). All the cases were imported from abroad, mainly from Southeast Asia and South Asia (43 cases, 95.56%). 15 cases (33.33%) had been ill before entry. 22 cases (48.89%) were first treated in tertiary hospitals. The median time intervals from onset to first clinic visit, from first clinic visit to diagnosis, and from onset to diagnosis were 1.0 d, 5.0 d, and 7.0 d, respectively. Serotypes of dengue virus were mainly Type I, Type III and Type II, which were 9 cases, 7 cases, and 6 cases, respectively. Conclusion The epidemic situation of dengue fever in Pudong New Area from 2008 to 2020 is relatively stable, all imported from abroad. The focus of the prevention and control is to promote the health education for overseas travelers, strengthen the monitoring sensitivity at border ports, enhance the diagnostic level of medical institutions, and timely find and report cases.

Abstract: To explore the effect and mechanism of palmitic acid sodium(PA) exposure for different time on HK-2 cells injury. Methods: CCK-8 assay was used to detect the activity of HK-2 cells treated with PA at different times; oil red staining was used to detect lipid deposition at different time of PA treatment; Annexin-Ⅴ-FITC/PI apoptosis kit was used to detect the apoptosis of HK-2 cells treated with PA at different times; reactive oxygen species(ROS) production was detected by ROS kit at different time of PA treatment; ELISA was used to detect GSH and SOD in cells as well as the levels of IL-1β and IL-18 in the cell supernatant; Western blot was used to determine the expressions of NLRP3, ASC, Caspase-1 and NOX4 in HK-2 cells. Results: CCK-8 assay showed that HK-2 cell viability decreased in PA(6, 9, 12, 24 h) groups; oil red staining showed that lipid deposition increased in PA(6, 9, 12, 24 h) groups; Annexin-Ⅴ-FITC/PI apoptosis kit results showed that the apoptosis rate increased; ROS kit results showed that ROS production significantly increased in PA(6, 9, 12, 24 h) groups; ELISA results showed that the activities of GSH and SOD decreased in PA(6, 9, 12, 24 h) groups, while the levels of IL-1β and IL-18 in supernatant increased; Western blot results showed that the expression levels of inflammatory related proteins NLRP3, Caspase-1, ASC and NOX4 in PA(6, 9, 12 and 24 h) increased. Conclusion PA exposure can induce lipid deposition and HK-2 cells damage, and the mechanism may be related to PA-induced inflammatory response by activating NLRP3 inflammasome in HK-2 cells.

Objective To understand the epidemiological characteristics of norovirus infectious diarrhea in Pudong New Area of Shanghai, and to provide reference for prevention and control of diarrhea caused by norovirus. Methods Epidemiological data and stool samples from diarrhea cases of 15 hospitals in 2015-2019 years were collected. The two subtypes of norovirus G I and G II were detected by RT-PCR and analyzed. Results A total of 9 397 diarrhea samples were collected in 2015-2019 years, and 1 938 positive norovirus samples were detected, with a positive rate of 20.62%. The majority of serotypes were GII (88.60%). Diarrhea caused by norovirus occurs all year round, with high incidence season in 2-3and 10-12 months every year. There was no significant difference in the positive rate of norovirus between different sexes（χ²=2.611，P=0.106）. The positive rate of the 15-64 year old group was higher than that of the 0-14 year old group and the 65 year old and above group（χ²=153.634，P<0.001）. The highest positive rate was for cadres /worker/ business services / teachers / medical staff / drivers. The positive rate of norovirus in diarrhea cases with vomiting was significantly higher than that in patients without vomiting. Conclusions Diarrhea caused by norovirus is related to season, age and occupation. Because there is no effective antiviral drugs and vaccine prevention, continuous monitoring should be carried out and targeted preventive measures should be carried out according to epidemiological characteristics.