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 investigate the effectsof adipocyte-specific Structural maintenance of chromosomes 5(Smc5)knockouton glucose and lipid metabolism in mice.Methods Adipocyte-specific Smc5 knockout mice(AKO mice)were constructed based onclustered regularly interspaced short palindromic repeats/CRISPR-associated nuclease 9(CRISPR/Cas9)systems,and Smc5flox/flox mice(Flox mice)were used as controls.The Smc5 knockout efficiency of adipose tissue in mice was verified by qRT-PCR and Western blot.The body fat content was detected by dual energy X-ray absorptiometry(DEXA).The morphology of adipose tissue was observed by hematoxylin-eosin staining and the area distribution of adipocytes was calculated.TG,HDL-C,LDL-C,free fatty acid(FFA),intraperitoneal glucose tolerance test(IPGTT)and intraperitoneal insulin tolerance test(IPITT)were compared.Results The AKO mouse model of fat specific knockout of Smc5 gene was successfully constructed.Smc5 mRNA in groin fat(iWAT),epididymal fat(eWAT)and brown adipocyte(BAT)of AKO mice,body weight after 15 weeks,organ weight of iWAT at 31 weeks,organ weight of eWAT,organ weight of BAT,body weight,fat mass,fat mass/weight,LDL-C,and percentage of 15-minute blood glucose in IPITT were lower than those of Flox mice(P<0.05 or P<0.01).Conclusions Adipocyte-specific Smc5 gene knockout improves glucose and lipid metabolism by affecting adipose tissue production.

Objective To understand the spatial epidemic characteristics of hand-foot-mouth disease in Pudong New Area of Shanghai from 2015 to 2018, and to provide reference for prevention and control. Methods SPSS 21.0 software was used for statistical analysis of the reported incidence of hand-foot-mouth disease, ArcGIS 10.2 software was used to make geographic distribution map, and OpenGeoDa software was used to make spatial autocorrelation analysis. Results The global Moran's I autocorrelation coefficient of the reported incidence rate of hand-foot-mouth disease in various streets and towns in Pudong New Area of Shanghai was 0.38, which was statistically significant (P=0.001). Local spatial autocorrelation analysis found that 5 streets were in high-high area. Conclusion The geographical distribution of reported incidence of hand-foot-mouth disease in various streets and towns of Pudong New Area in Shanghai was spatially aggregated, and the reported incidence decreased from north to south.

Objective: To investigate the regulatory effect of miR-1297 on the malignant biological behaviors of breast cancer cells and its underlying mechanism. Methods: Twenty pairs of breast cancer tissues and para-cancer tissues resected at the Department of Thyroid and Breast Surgery of Leshan People′ s Hospital from May 2016 to May 2018, as well as breast cancer cell lines MCF-7, SW626, HCC1937 and human breast epithelial MCF-10A cells were collected for this study. qPCR was performed to evaluate the expression of miR-1297 in breast cancer tissues and cell lines. The experimental cells were divided into control group, miR-1297 inhibitor group; TET3 over-expression group and simultaneous over-expression of TET3 and miR-1297 group. CCK-8 assay was used to detect the cell proliferation of MCF-7 cells; Transwell assay was carried out to detect the migration and invasion of MCF-7 cells; and WB was used to measure the expressions of TET3 and EMT related proteins (E-cadherin, N-cadherin and vimentin). Dual luciferase reporter gene assay was used to verify the relationship between miR-1297 and TET3. Results: miR-1297 was up-regulated in both breast cancer tissues and cell lines (P<0.01 or P<0.05). Knockdown of miR-1297 dramatically repressed the proliferation, migration, invasion and EMT of MCF-7 cells (P<0.01 or P<0.05). Over-expression of TET3 significantly up-regulated the expression of TET3 in MCF-7 cells (P<0.05). Simultaneous over-expression of TET3 and miR-1297 could reverse the expression level of TET3 in MCF-7 cells and the inhibitory effect of TET3 on the proliferation, migration, invasion and EMT of MCF-7 cells. Dual luciferase reporter gene assay results showed that miR-1297 targetedly bound to the 3' UTR of TET3. Further experiment results demonstrated that miR-1297 targetedly down-regulated TET3 and promoted the malignant biological behaviors of MCF-7 cells. Conclusion: miR-1297 is up-regulated in breast cancer tissues and cells; it promotes the malignant biological behaviors such as proliferation, migration, invasion and EMT through targetedly down-regulating the expression of TET3.

Objective: To investigate the value of Cytomegalovirus(CMV) DNA real-time quantitative-polymerase chain reaction(RT-PCR) in different body fluids for diagnosing CMV pneumonia in immunocompetent infants. Methods: The clinical data of immunocompetent infants with CMV pneumonia who were treated in Pediatric Intensive Care Unit of Guangdong Women and Children′s Hospital from January 1^st, 2016 to February 5^th, 2018 were retrospectively analyzed.The clinical data included CMV DNA load of bronchoalveolar lavage fluid(BALF), urine, blood and cerebrospinal fluid(CSF); blood immunoglobulin(Ig)M CMV, alanine aminotransferase (ALT), X-ray and CT test of chest, combined infection, clinical manifestation and treatment. Results: Nine hundred and twenty-six infants received bronchoalveolar lavage by bronchoscope, and 34 cases were diagnosed as immunocompetent with CMV pneumonia.The infants with CMV pneumonia: the positive percentage of urine CMV DNA, blood CMV DNA, blood IgM CMV and ALT elevation were 100.0%(34/34 cases), 61.8%(21/34 cases), 52.9%(18/34 cases) and 20.6%(7/34 cases), respectively.There was no difference in positive percentage between blood CMV DNA and blood IgM CMV (χ²=0.5, P>0.05). Both the positive percentages of blood CMV DNA and blood IgM CMV were lower than those in the urine CMV DNA, and the differences were statistically significant (χ²=16.1, 20.9, all P<0.05). The positive percentages of ALT elevation were lower than those in the positive percentage of urine CMV DNA, blood CMV DNA and blood IgM CMV, and the differences were statistically significant (χ²=44.8, 11.9, 7.7, all P<0.05). Ten patients′ CSF CMV DNA were tested, and they were all negative.The median load of CMV DNA in BALF, urine and blood was 170.0×10⁵ copies/L, 130.0×10⁵ copies/L and 6.0×10⁵ copies/L.There was no difference in median load between BALF and urine (U=561, P>0.05). BALF CMV DNA load and blood CMV DNA load had a weak positive correlation (r=0.35, P<0.05), BALF CMV DNA load and age had a negative correlation (r=-0.42, P<0.05), and urine CMV DNA load and blood CMV DNA load had a positive correlation (r=0.52, P<0.05). No matter whether blood IgM CMV was positive, BALF CMV DNA load had no differences (U=92, P>0.05). The main radiographic signs were pulmonary interstitial lesions.Thirty-four immunocompetent infants with CMV pneumonia, 18 patients (52.9%) with symptoms lasted for over 2 weeks, 20 patients (58.8%) had complicated infections.They all received inductive treatment of Ganciclovir, 55.9%(19/34 cases) patients′ urine CMV DNA turned to be negative.When patients got combined infections by bacteria or mycoplasma, antibiotics were used.All discharged patients had symptoms relieved and signs improved. Conclusions BALF RT-PCR is instant, sensitive and distinctive method to diagnose CMV pneumonia.Urine RT-PCR gets specimens conveniently and safely, its positive percentage and DNA load are present well according to BALF, and is suitable for screening and monitoring CMV infection.Blood CMV DNA load and blood IgM CMV indicate viral dissemination and immunocompetence, but it is not recommended for diagnosing CMV pneumonia solely.

Objective To evaluate the changes in the expression of hippocampal α7 nicotinic ace-tylcholine receptor (α7nAChR) , acetylcholinesterase ( AChE) and choline acetyltransferase ( ChAT) after sevoflurane anesthesia in neonatal rats. Methods Seventy-two healthy Sprague-Dawley rats of both sexes, aged 7 days, weighing 25-40 g, were divided into 3 groups ( n=24 each) using a random number table method: control group ( group C) , air and oxygen group ( group A∕O) and sevoflurane group ( group S) . Rats were exposed to carrier gas ( air 1 L∕min plus oxygen 1 L∕min) for 2 h in group A∕O. Rats were ex-posed to 3. 4％ sevoflurane in carrier gas for 2 h in group S. Eight rats in each group were selected at 2 h, 1 week and 4 weeks after the end of inhalation, and sacrificed, brains were removed and hippocampal tis-sues were obtained for determination of α7nAChR, AChE and ChAT protein and mRNA by Western blot and real-time polymerase chain reaction, respectively. Results Compared with group A∕O, the expression of α7nAChR mRNA was significantly down-regulated at each time point after the end of inhalation, and the expression of TnAChR was down-regulated at 2 h after the end of inhalation and up-regulated at 1 week after the end of inhalation, the expression of AChE mRNA was up-regulated at 2 h after the end of inhalation and down-regulated at 4 weeks after the end of inhalation, the expression of AChE was down-regulated at 4 weeks after the end of inhalation, the expression of ChAT mRNA was up-regulated at 2 h after the end of in-halation, and the expression of ChAT was down-regulated at each time point after the end of inhalation in group S ( P<0. 05) . Conclusion The expression of hippocampal α7nAChR is down-regulated at first and then up-regulated after sevoflurane anesthesia, the expression of ChAT and AchE in the later period is down-regulated, the tendency of protein expression mentioned above is different from that of its mRNA ex-pression, suggesting that sevoflurane may affect the protein expression through other pathways.

Objective To investigate the expression of alpha 7 nicotinic acetylcholine receptor (α7 nAchR), cholinesterase (AChE), choline acetyl translocase (ChaT) after sevoflurane anesthesia. Methods A total of 120 healthy Sprague-Dawley rats with both two genders, aged 1 week, were randomly divided into 5 groups: blank group; air/O2 group; sevoflurane group (group SEV); α7 nAchR agonist group (group PUN); α7 nAchR antagonist group (group MLA), 24 in each group. Blank group received free feeding, air/O2 group was inhaled 60％ oxygen (carrier gas: 1 L/min O2+1 L/min air) 2 h; group SEV was inhaled 3.4％ sevoflurane and carrier gas for 2 h; group PUN and group MLA were injected with PNU-282987 and methyllycaconitine, respectively, after 24 h inhaled of 3.4％ sevoflurane and carrier gas for 2 h. After that, hippocampus dissection carried out in 2 h, 1 w, 4 w, and Western blot method was used to detect α7 nAchR, AChE, ChaT proteins expression. Results Two hours after anesthesia recovery, α7 nAchR in groups SEV, PNU and MLA was significantly lower than that in air/O2 group (P ＜ 0.05); AChE in groups PNU and MLA was significantly lower than that in air/O2 group (P ＜ 0.05); ChaT in groups SEV, PNU and MLA was significantly lower than that in air/O2 group (P ＜ 0.05). One week after anesthesia recovery, α7 nAchR in blank group and groups SEV and PNU was significantly higher than that in air/O2 group (P ＜ 0.05), α7 nAchR in group MLA was significantly lower than that in air/O2 group (P ＜ 0.05); AChE in blank group and and group PNU was significantly higher than that in air/O2 group (P ＜ 0.05), ChaT in blank group was significantly higher than that in air/O2 group (P ＜ 0.05), ChaT in group SEV was significantly lower than that in air/O2 group (P ＜ 0.05). Four weeks after anesthesia awake, AChE in each group was not statistically significant; α7 nAchR in group SEV was significantly higher than that in blank group (P ＜ 0.05), α7 nAchR in group PNU and MLA was significantly lower than that in blank group (P ＜ 0.05); ChaT in blank group and group PNU was significantly lower than that in air/O2 group (P ＜ 0.05), ChaT in group MLA was significantly higher than that in air/O2 group (P ＜ 0.05). Conclusion Sevoflurane inhalation can inhibit ChaT, α7 nAChR, which had no direct effect on AChE; α7 nAChR agonist can effectively help α7 nAChR and ChaT inhibition inhaled sevoflurane, and reached a peak at about 1 week; oxygen concentration around 60％ can increase α7 nAChR expression quantity, to a certain extent against sevoflurane inhibition.

Objective To establish emergency disposal procedures of healthcare-associated infection(HAI) in Pudong New Area, evaluate on-site investigation method, identify the key links and risk factors for infection, and timely control HAI outbreak.Methods From January 2012 to December 2014, epidemiological investigation on HAI outbreaks in 65 hospitals in Pudong New Area was performed, emergency plan for disposal procedures of HAI was initiated, the emergency disposal procedures of each event was evaluated by experts.Results There were 6 infection outbreaks occurred in Pudong New Area from January 2012 to December 2014, all were HAI, and no community-associated infection existed simultaneously;6 cases of HAI outbreaks involved 119 persons, the major were hospitalized patients (n=99,83.19%) and care workers (n=16,13.45%);5 outbreaks all detected Norovirus, the main transmission route wasclose contact of nurses with patients during care for patients;the evaluation of each incident revealed that the total score was >90.Conclusion The emergency disposal procedure of HAI suitable for Pudong New Area has been established, the effect is good and proved effective according to the expert evaluation on practical outbreaks.

Objective To understand the epidemiological characteristics of norovirus detection based on the diarrhea syndromic surveillance in Pudong ,Shanghai .Methods Diarrhea syndromic surveillance program was conducted in outpatient and emergency departments of 12 sentinel hospitals during 2012 -2016 .The clinical and epidemiological data of diarrheal patients were collected .The fecal specimens were also sampled . The detections for norovirus by polymerase chain reaction and gene sequencing were performed .Chi-square test or Fisher exact probability test was used to compare the detection rate .Binary logistic regression was used to explore the impact factors of norovirus infection among diarrheal patients . Results The detective rate of norovirus among diarrheal patients was 21 .59％ ,peaking from October to next March .Among all the age groups ,the detection rate was highest among patients with 25 - 64 years old .The patients with more severe diarrhea symptoms (> 5 times a day) were more likely to be infected with norovirus than those with diarrhea 3 - 5 times a day (χ2 = 21 .167 ,P< 0 .01) .Vomiting was also an indicator of norovirus infection .Patients presented with vomiting had a higher norovirus detection rate (χ2 = 198 .543 , P < 0 .01) . Norovirus G Ⅱ was the predominant genotype .Conclusions The recent epidemic of norovirus infection in diarrheal patients in Pudong new district has an apparent seasonality peaked from October to next March .Adult ,patients with vomiting and more severe diarrhea symptoms are at risk of norovirus infection .The long-term surveillance is critical for the norovirus infection control .

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.