ObjectiveTo analyze the epidemiological characteristics and etiology of clustered outbreaks of hand， foot， and mouth disease （HFMD） in Pudong New Area， Shanghai from 2017 to 2022， and to provide a scientific basis for the prevention and control of HFMD in the area. MethodsThe data related to HFMD clustered outbreaks from 2017 to 2022 were obtained from the Pudong New Area HFMD outbreak database. Descriptive analysis was conducted to explore the outbreak scope， seasonal characteristics， distribution of occurrence settings， and etiological composition. ResultsFrom 2017 to 2022， Pudong New Area reported a total of 2 547 HFMD clusters， involving 8 884 cases， with an average of 3.49 cases per event. The majority of events （78.52%） had between 2 and 4 cases. The peak reporting periods for clustered HFMD from 2017 to 2019 and in 2021 were during the summer （May‒July） and autumn （September‒November）. The seasonal pattern was less distinct in 2020 and 2022， likely due to the impact of the COVID-19 pandemic. The majority of clustered outbreaks occurred in childcare facilities （44.64%）， followed by households/neighborhood committees （44.21%）， with schools accounting for a smaller proportion （12.39%）. The etiology revealed the coexistence of multiple enterovirus genotypes， with a positive detection rate of 60.46%， and CoxA6 being the dominant strain. ConclusionHFMD clustered outbreaks in Pudong New Area show fluctuating trends， with significant yearly differences in the number of incidents. The predominant seasons for outbreaks are summer and autumn， with CoxA6 identified as the dominant strain. The implementation of prevention and control measures for COVID-19 significantly reduced the occurrence of HFMD outbreaks. Continuous monitoring and focus on large-scale clustered outbreaks in key institutions are essential for the future.

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.

[摘 要] 目的：探讨抑制素β亚基A反义RNA1（INHBA-AS1）对宫颈癌HeLa细胞EMT和鸟氨酸代谢途径的影响及其机制。方法：体外常规培养HeLa细胞，实验分为10组：对照组、阴性对照（NC）组、sh-INHBA-AS1组、PluriSIn 1[硬脂酰辅酶A去饱和酶（stearyl CoA desaturase，SCD）抑制剂]组、NC+PluriSIn 1组、sh-INHBA-AS1+PluriSIn 1组、10058-F4（c-Myc抑制剂）组、NC+10058-F4组、sh-INHBA-AS1+10058-F4组、sh-INHBA-AS1+OE-c-Myc组。平板克隆实验检测各组细胞的增殖能力，FCM检测各组细胞的凋亡情况，Transwell小室实验检测各组细胞的侵袭、迁移能力，qPCR法检测各组细胞中INHBA-AS1、c-Myc、SCD和EMT相关基因（N-cadherin、TGF-β、ZEB1）mRNA的表达，WB法检测各组细胞中c-Myc、SCD、EMT相关（N-cadherin、TGF-β、ZEB1）、S-腺苷-甲硫氨酸脱羧酶（SAMDC）和亚精胺/精胺N1-乙酰转移酶（SSAT）蛋白的表达，ELISA检测各组细胞上清液中鸟氨酸脱羧酶（ODC）的含量。结果：敲减INHBA-AS1表达使HeLa细胞的增殖、侵袭和迁移能力显著降低（均P<0.05）而细胞凋亡率显著升高（P<0.05），qPCR、WB法检测结果显示，敲减INHBA-AS1均可显著抑制HeLa细胞中c-Myc、SCD、N-cadherin、TGF-β、ZEB1和SAMDC的表达（均P<0.05），而促进SSAT的表达（P<0.05），并降低HeLa细胞上清液中ODC的含量（P<0.05）。与c-Myc抑制剂和SCD抑制剂单独处理相比，其联合敲减INHBA-AS1后上述作用更加显著（均P<0.05）；与sh-INHBA-AS1组相比，进一步过表达c-Myc后HeLa细胞的增殖能力显著升高（P<0.05）、SCD和N-cadherin蛋白表达水平显著升高（P<0.05）、细胞上清液中ODC含量显著升高（P<0.05）。结论：INHBA-AS1可通过c-Myc调控SCD的表达，从而影响HeLa细胞鸟氨酸代谢和EMT进程，进而促进HeLa细胞的增殖、侵袭和迁移能力。

Objective:To explore the protective effect of vitamin D in acute liver failure through a mouse model.Methods:Acute liver failure was induced by combining D-galactosamine (D-GalN) lipopolysaccharide (LPS) to observe the effect of long-term vitamin D deficiency on liver injury and inflammatory signals in a mouse model. Acute liver failure was induced by thioacetamide (TAA) to observe the effect of vitamin D deficiency on the survival rate, and further high-dose of vitamin D supplementation protective effect was determined in a mouse model. Liver function was evaluated by measuring serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and liver inflammation by hematoxylin-eosin staining. The expressions of tumor necrosis factor (TNF-α), interleukin (IL) -1β, NOD-like receptor family, pyrin domain containing 3 (NLRP-3), chemokines (CCL2, CXCL1 and CXCL2), etc. in liver tissues were detected by RT-qPCR. The quantitation of macrophages in liver tissue was detected by immunohistochemistry. The comparison between groups were performed by t-test. The survival curve was analyzed by log-rank (Mantel-Cox) test.Results:Long-term vitamin D deficiency had increased acute liver failure sensitivity in mice, which was manifested by increased blood cell extravasation, massive necrosis of parenchymal cells, up-regulation of TNF-α, IL-1β, and NLRP-3 mRNA expression ( P < 0.05), and increased macrophages quantitation ( P < 0.05) in liver tissues. At the same time, vitamin D deficiency had increased the mice mortality rate because of liver injury ( P < 0.01). On the contrary, pre-administration of high dose of vitamin D (100 IU/g) had significantly reduced liver injury, inhibited ALT and AST rise ( P < 0.01), alleviated liver necrosis, and down-regulated the mRNA expression of inflammatory factors in liver tissues ( P < 0.05). Conclusion:Mouse model shows that long-term vitamin D deficiency can aggravate drug-induced acute liver failure and reduce survival rates. Furthermore, high-dose of vitamin D has a certain hepatoprotective effect, which can significantly improve liver necrosis condition and inhibit inflammation. Therefore, adequate vitamin D can retain liver physiological balance to resist liver injury.

The E class MADS-box genes SEPALLATA (SEP)-like play critical roles in angiosperm reproductive growth, especially in floral organ differentiation. To analyze the sequence characteristics and spatio-temporal expression patterns of E-function MADS-box SEP-like genes during kale (Brassica oleracea L. var. acephala) flower development, BroaSEP1/2/3 (GenBank No. KC967957, KC967958, KC967960) homologues, three kale SEP MADS-box gene, were isolated from the kale variety 'Fourteen Line' using Rapid amplification of cDNA ends (RACE). Sequence and phylogenetic analysis indicated that these three SEP genes had a high degree of identity with SEP1, SEP2, SEP3 from Brassica oleracea var. oleracea, Brassica rapa, Raphanus sativus and Brassica napus, respectively. Alignment of the predicted amino acid sequences from these genes, along with previously published subfamily members, demonstrated that these genes comprise four regions of the typical MIKC-type MADS-box proteins: the MADS domain, intervening (I) domain and keratin-like (K) domain, and the C-terminal domain SEPⅠ and SEP Ⅱ motif. The longest open reading frame deduced from the cDNA sequences of BroaSEP1, BroaSEP2, and BroaSEP3 appeared to be 801 bp, 759 bp, 753 bp in length, respectively, which encoded proteins of 266, 252, and 250 amino acids respectively. Expression analyses using semi-quantitative RT-PCR and quantitative real-time PCR indicate that BroaSEP1/2/3 are specifically expressed in floral buds of kale during flower development process. The expression levels of the three genes are very different at different developmental stages, also in wild type, mutant flower with increased petals, and mutant flower with decreased petals. These different patterns of gene expression maybe cause the flowers to increase or decrease the petal number.
Brassica/metabolism* ; Flowers/genetics* ; Gene Expression Regulation, Plant ; MADS Domain Proteins/metabolism* ; Phylogeny ; Plant Proteins/metabolism*

Objective:To investigate the influence of echinoside on the expressions of inducible nitric oxide synthase (iNOS) and transforming growth factor-β1 (TGF-β1) in renal tissues of diabetic nephropathy rats.Methods:A total of 60 male SD rats were randomly divided into the normal group, model group, glibenclamide group and low-, medium-, high-dose echinoside treatment group. the rat model of diabetic nephropathy was established through the streptozocin induction and the glibenclamide treatment was applied as control. After molding, glibenclamide group was given 5 mg/(kg?d) of glibenclamide, and low-, medium-, high-dose echinoside treatment group was given 50, 100 and 200 mg/(kg?d) of echinacoside solution. The normal group and model group were intragastrically given equal volume of normal saline. After 4 weeks, the change rate of body weight, kidney weight/body weight, blood glucose, serum TC, TG, BUN, SCR and 24 h urinary protein levels were measured, and the NO release concentration in renal tissue cell culture medium was measured, the renal pathology was observed by HE staining, the expression of iNOS and TGF-β1 proteins in renal tissues was detected by Western blotting.Results:Compared with the model group, the body weight of rats in the medium-dose group significantly increased ( P<0.05); the weight change rate and kidney weight/body weight of rat in the medium-, high-dose group significantly decreased ( P<0.05), and the NO release concentration in the medium-, high-dose group decreased ( P<0.05); the level of blood glucose, TC, TG, BUN, SCr, and 24-hour urinary protein in the low-, medium- and high-dose groups significantly decreased ( P<0.05), and iNOS in renal tissue of rats in the low-, medium- and high-dose groups was significantly lower ( P<0.05). Compared with the model group, the relative expression levels of TGF-β1 (1.35 ± 0.06, 1.15 ± 0.05, 0.91 ± 0.04 vs. 4.58 ± 0.09) and TGF-β1 (1.24 ± 0.04, 1.41 ± 0.05, 0.89 ± 0.04 vs. 3.04 ± 0.05) in the low-, medium- and high-dose groups significantly decreased ( P<0.05). Conclusions:The echinoside can prevent weight loss, reduce blood glucose and triglyceride, inhibit the production of NO in renal tissues, reduce the expression of iNOS and TGF-β1 among diabetic nephropathy rats. It has been proved to play a protective role in diabetic nephropathy pathological tissues.

Objective To further improve the value of clinical application of a quantitative analysis method called LF-index (LFI) which based on real-time tissue elastography (RTE). Methods We prospectively enrolled 116 consecutive patients with chronic hepatitis B (CHB) and all patients underwent a liver biopsy and RTE between January 2015 and December 2015 at the First affiliated hospital of Wenzhou Medical University. Univariate and multivariate analyses were performed, and the prediction models for predicting significant fibrosis and cirrhosis were derived from independent predictors. Results (1) In multivariate analyses, spleno-portal index (SPI) (OR=13.956, P=0.002) and LFI (OR=6.283, P=0.023) were confirmed as independent predictors of significant fibrosis. In multivariate analyses of patients with and without cirrhosis, we found significant differences in the γ-Glutamyl transferase (GGT) (OR=1.012, P=0.049), SPI (OR=5.676, P=0.002) and LFI (OR=14.102, P=0.001). (2)A novel model called LFI-SPI score (LSPS) for prediction of significant fibrosis was developed (area under receiver operating characteristic curve [AUROC]=0.87), showing the superiority of diagnostic accuracy than LFI (AUROC=0.76, P=0.0109), aspartate aminotransferase to platelet ratio index (APRI) (AUROC=0.64, P=0.0031), fibrosis-4 index (FIB-4) (AUROC=0.67, P= 0.0044) and Fibroscan (AUROC=0.68, P=0.0021). (3) We also developed a LFI-SPI-GGT score (LSPGS) for predicting cirrhosis, with an AUROC of 0.93. The diagnostic accuracy of LSPGS was similar to that of Fibroscan (AUROC=0.85, P=0.134), and was superior to LFI (AUROC=0.81, P=0.0113), APRI (AUROC=0.67, P<0.0001), and FIB-4 (AUROC=0.72, P=0.0005). Conclusions We developed new formulas, LSPS and LSPGS for predicting significant fibrosis and cirrhosis in this prospective study. LSP score was mainly used for screening of significant liver fibrosis, and LSPG score was mainly used to exclude cirrhosis.

Objective:To investigate the site and characteristic ofp53 gene mutations in familial or early-onset breast cancer patients in part population of southern China.Methods:A total of 150 patients with familial and early-onset breast cancer in parts population of southern China were enrolled.Genomic DNA was isolated from each peripheral blood sample,and the entire coding sequence and exon and intron splicing region of p53 gene were amplificated by PCR in the 150 patients.The mutation analysis were detected by denaturing high performance liquid chromatography (DHPLC) and confirmed by DNA sequence analysis.Results:In the 150 patients with familial and early-onset breast cancer,6 mutations including one novel pathogenic mutation 869_888 ins20 (insert mutation) and 5 previously reported pathogenic mutations (deletion mutation 643_660de118 and 4 missense mutation 91G＞A,215C＞G,537T＞G,743G＞A) were identified in p53 gene encoding region in 9 patients of breast cancer.Moreover,one same sense mutation 141G＞A in exon 4,one 16 bases deletion in intron 3,and 9 single nucleotide polymorphisms in p53 gene introns were also identified.The total mutation frequency ofp53 gene in 150 patients with familial breast cancer and early-onset breast cancer from part population of southern China was 6.00％,and the mutation frequency of familial breast cancer and early-onset breast cancer was 6.81％ and 6.25％,respectively.Conclusion:The total mutation frequency ofp53 gene in 150 patients with familial breast cancer and early-onset breast cancer from partpopulation of southern China is higher than the frequency previously reported.The pathogenicity of the novel mutations (insert mutation) 869_888ins20 will be confirmed by function analysis in the future study.The deletion mutation 643_660de118 enriches the p53 gene mutation database among Chinese population,which is probably the specific mutation of breast cancer in Chinese population.

Objective:To observe the clinical effect of TOMY self-ligation appliance technique in the treatment of anterior crossbite and moderate crowding, and to explore its clinical application.Methods:A patient, manifested as anterior crossbite and moderate dentition crowing, diagnosed as Angle class Ⅲ subclass malocclusion, MaoⅡ1+Ⅰ1 malocclusion, high angle,and facial asymmetry, was selected.This patient was treated with TOMY self-ligation appliance technique without tooth extraction.The length and width of the dental arch, the width of the alveolar bone and the width of the basal arch were measured before and after treatment;the lateral radiographs of the patient were taken too.Results:After treatment,the upper and lower dentition arranged in neat rows, reached a neutral occlusal relationship;SNA, SNB and ANB had no obvious changes;the lip inclination of anterior teeth was increased by 10 degrees, and reached the normal value;the upper and lower dental arch width, alveolar bone width, basal bone arch width and dental arch length were lower than before treatment.Conclusion:For the patient with anterior crossbite and moderate dental crowding treated with non-extraction, the TOMY self-ligation technique can be considered to use, by increasing the arch width and length to improve the anterior crossbite and moderate crowding, in order to achieve the effective treatment.

Objective To investigate the situation of infectious diseases prevention and control and its possible influencing factors of primary and middle schools in Pudong New Area,in order to provide evidence for establishment of effective control system of primary and middle schools.Methods The situation of infectious diseases prevention and control of 368 primary and middle schools in Pudong New Area was investigated.Results Organization and relevant system for infectious diseases prevention and control were carried well,but the proportion of full-time health care personnel was low.There had been infectious diseases in 297 (80.71％) schools from 2013 to 2015,involving 4 326 cases.And 129 (35.05％) schools had 255 infectious diseases clusters.Whether the disinfection of sanitary ware and indoor air were qualified were the possible influencing factors of infectious diseases prevention and control.Conclusions The overall work of infectious diseases prevention and control is developed well,but some aspects need further improvement.