Objective To analyze the epidemiological characteristics of norovirus outbreaks in Haidian District, Beijing, and to provide a reference for epidemic prevention and control. Methods Descriptive epidemiological methods were used to organize and statistically analyze the norovirus outbreak data reported from 2016 to 2022. Results A total of 26 outbreaks of norovirus were reported in Haidian District, with a total of 1595 cases and an attack rate M (Q_R) of 8.23 (16.33)%. There were 24 cases of norovirus type GII (92.31%), 1 case of type GI (3.85%), and 1 case of mixed infection of virus type GI/GII (3.85%). The highest number of reported outbreaks occurred in March and April, with 17 cases, accounting for 65.38%. The highest number of reported cases was in November and December, with 785 cases, accounting for 44.92%. The case age M (Q_R) was 18 (14) years old. The detection rate of positive samples in different age groups had statistical significance（χ²=12.021, P=0.007). The 26 outbreaks were mainly distributed in collective units such as schools, preschool institutions, and enterprises and institutions. There were a total of 11 outbreaks related to foodborne transmission, with 923 cases, accounting for 57.87%. Diarrhea was positively correlated with the age of the cases (r_s=0.572, P<0.001), while vomiting was negatively correlated with the age of the cases (r_s=-0187, P<0.001). The time interval between the onset of acute gastroenteritis symptoms in the first case and the reporting of the epidemic was positively correlated with the duration of the epidemic (r_s=0.586, P=0.002). Conclusion It is necessary to strengthen the prevention and control of norovirus in schools (primary and secondary schools and colleges), strictly implement health monitoring and regular screening for kitchen workers, carry out publicity and education, detect cases as early as possible, report the epidemic in a timely manner, and effectively reduce the scale of the epidemic and prevent its spread.

Objective: To understand the epidemiological characteristics of the norovirus epidemics in Haidian District, Beijing Municipality from 2015 to 2022, so as to provide insights into epidemic prevention and control. Methods: The epidemiological characteristics, case data, and laboratory testing of norovirus epidemics were collected in Haidian District from 2015 to 2022, and the temporal distribution, spatial distribution, population distribution, and norovirus detection were analyzed using a descriptive epidemiological method. Results: A total of 208 norovirus epidemics involving 3 530 cases were reported in Haidian District from 2015 to 2022, with a median attack rate of 25.00% (interquartile range, 18.35%). The main pathogens detected were type GⅡ, accounting for 87.98% (183 cases), and the main transmission mode was interpersonal transmission, accounting for 93.27% (194 cases). Norovirus epidemics peaked from March to June and October to December, accounting for 44.71% (93 epidemics) and 44.23% (92 epidemics), and predominantly occurred in schools and preschool institutions, accounting for 51.92% (108 epidemics) and 40.38% (84 epidemics). The median age of norovirus infected cases was 8 (interquartile range, 13) years. There were 1 920 males and 1 610 females, with a ratio of 1.19︰1. The positive rates of case specimens, key population specimens and environment smeared specimens in epidemic units were 74.32%, 13.91% and 5.86%, respectively. Conclusions The norovirus epidemics in Haidian District from 2015 to 2022 was mainly caused by type GⅡ and spread from person to person. The epidemics peaked in winter and spring, and schools and preschool institutions were the key units of prevention and control.

Acute-on-chronic liver failure(ACLF)is a complex clinical syndrome of acute liver function deterioration on the basis of chronic liver diseases,characterized by hepatic and/or extra-hepatic organ failure and a high short-term mortality rate.At present,there is still a lack of effective treatment methods,and the mortality rate of ACLF reaches 50%-90%after comprehensive medical treatment.A simple,rapid,and accurate prognostic prediction model for ACLF can help clinicians accurately judge the prognosis of ACLF patients in the early stage,identify the patients with poor prognosis,and provide early interventions,which can improve patient prognosis to some extent and help to reduce mortality rates.With the continuous development of computer science and increasingly powerful data processing capabilities,artificial intelligence is gaining more attention and has been applied in various aspects of liver diseases including diagnosis,treatment,and prognostic prediction.With reference to the current status of research in China and globally,this article reviews the common prognostic models for ACLF and machine learning-based prognostic prediction models and summarizes the latest research advances,in order to provide new perspectives for the future development of prognostic prediction models for ACLF.

Objective To investigate the value of predicting the pathological results of labial gland biopsy in Sj?gren's syndrome(SS)based on the labial gland MRI radiomics machine learning models.Methods The labial gland MRI data of 178 suspected SS patients were analyzed retrospectively,and the labial gland biopsy pathology results were positive in 97 cases and negative in 81 cases.The samples were divided into training set(143 cases)and test set(35 cases)using a randomized stratified sampling according to the ratio of 4:1.The region of interest(ROI)was manually outlined at the maximal level of the lower labial gland in T2WI water phase and radiomics features(104)were extracted.Feature screening was performed using the least absolute shrinkage and selection operator(LASSO),and the selected features set was used to construct Extra Trees,LightGBM,and Gradient Boosting classifier models.The predictive efficacy of the models was evaluated using the receiver operating characteristic(ROC)curve,and the DeLong test was used to compare the differences in the area under the curve(AUC)between the models.Decision curve analysis(DCA)was used to evaluate the clinical application value of the models in guiding biopsy.Results After LASSO screening,five optimal radiomics features were obtained.The AUC of Extra Trees,LightGBM,and Gradient Boosting models on the training and test sets were as follows 1.000,0.807,0.960 and 0.655,0.779,0.639,respectively.The DeLong test showed no statistically significant difference in AUC among the three models in the test set.DCA showed that the LightGBM model of guided biopsy had a higher clinical net benefit over a wider range of risk thresholds than other models.Conclusion Based on the radiomics features of the labial gland T2WI water phase,the LightGBM model has a high accuracy in predicting the pathological results of labial gland biopsy in SS,and guiding biopsy can obtain high clinical benefits,which has potential clinical application value.

Objective To investigate the mechanism of Nlrp6 for regulating hepatocellular carcinoma(HCC)progression in light of lipid synthesis regulation.Methods Nlrp6 expression level in HCC tissues of different pathological grades was investigated using RNA-seq data from The Cancer Genome Atlas(TCGA)database,and its correlation with the patients'survival was analyzed with Kaplan-Meier survival analysis.HepG2 cells with adenovirus-mediated Nlrp6 overexpression or knockdown were treated with palmitic acid(PA),and the changes in lipid deposition and cell proliferation were evaluated using Oil Red O staining,CCK-8 assay,EdU staining,and colony formation assay.RT-qPCR and Western blotting were used to detect the changes in expression of lipid synthesis-related genes and the proteins in the AMPK-Srebp1c axis.In a mouse model of hepatic steatosis established in liver-specific Nlrp6 knockout mice by high-fat diet feeding for 24 weeks,liver fibrosis was examined with histological staining,and the changes in expressions of HCC markers and the AMPK-Srebp1c signaling pathway were detected.Results Nlrp6 expression was significantly reduced in HCC tissues with negative correlations with the pathological grades and the patients'survival(P<0.0001).In HepG2 cells,Nlrp6 overexpression significantly inhibited lipid deposition and cell proliferation,whereas Nlrp6 knockdown produced the opposite effects.Nlrp6 overexpression strongly suppressed the expression of lipid synthesis-related genes,promoted AMPK phosphorylation,and inhibited Srebp1c expression.The mice with liver-specific Nlrp6 knockout and high-fat feeding showed increased hepatic steatosis,collagen deposition,and AFP expression with reduced AMPK phosphorylation and increased Srebp1c expression.Conclusion Nlrp6 overexpression inhibits lipid synthesis in HCC cells by regulating the AMPK-Srebp1c axis,which might be a key pathway for suppressing HCC cell proliferation.

Objective To investigate the mechanism of Nlrp6 for regulating hepatocellular carcinoma(HCC)progression in light of lipid synthesis regulation.Methods Nlrp6 expression level in HCC tissues of different pathological grades was investigated using RNA-seq data from The Cancer Genome Atlas(TCGA)database,and its correlation with the patients'survival was analyzed with Kaplan-Meier survival analysis.HepG2 cells with adenovirus-mediated Nlrp6 overexpression or knockdown were treated with palmitic acid(PA),and the changes in lipid deposition and cell proliferation were evaluated using Oil Red O staining,CCK-8 assay,EdU staining,and colony formation assay.RT-qPCR and Western blotting were used to detect the changes in expression of lipid synthesis-related genes and the proteins in the AMPK-Srebp1c axis.In a mouse model of hepatic steatosis established in liver-specific Nlrp6 knockout mice by high-fat diet feeding for 24 weeks,liver fibrosis was examined with histological staining,and the changes in expressions of HCC markers and the AMPK-Srebp1c signaling pathway were detected.Results Nlrp6 expression was significantly reduced in HCC tissues with negative correlations with the pathological grades and the patients'survival(P<0.0001).In HepG2 cells,Nlrp6 overexpression significantly inhibited lipid deposition and cell proliferation,whereas Nlrp6 knockdown produced the opposite effects.Nlrp6 overexpression strongly suppressed the expression of lipid synthesis-related genes,promoted AMPK phosphorylation,and inhibited Srebp1c expression.The mice with liver-specific Nlrp6 knockout and high-fat feeding showed increased hepatic steatosis,collagen deposition,and AFP expression with reduced AMPK phosphorylation and increased Srebp1c expression.Conclusion Nlrp6 overexpression inhibits lipid synthesis in HCC cells by regulating the AMPK-Srebp1c axis,which might be a key pathway for suppressing HCC cell proliferation.

Effective budget management is crucial for the internal control of procurements in public hospitals.This paper investigates challenges such as unscientific budget preparation,insufficient market analysis,and inadequate procurement internal control in a tertiary hospital in Shenzhen.In addition,based on a budget inquiry mechanism,the study explores strategies to en-hance internal control management within procurements in public hospitals,focusing on the pilot implementation of budget price review mechanisms in the hospital.The paper proposes such rules as"whoever applies is responsible and conducts research,"departmental checks and balances,continuous feedback,and pre-budget inquiry.These measures are used to improve procure-ment cost control,enhance hospital operational efficiency,and increase economic benefits.

Artificial blood vessels, serving as crucial vascular substitutes, have been widely utilized in vascular interventional therapies and revascularization surgeries. Small-diameter artificial blood vessels (diameter < 6 mm) pose challenges for long-term implantation due to their small diameter, slow flow velocity, low blood pressure, and complex blood flow environment. Bacterial nanocellulose (BNC), a natural polymer material, enhances the regenerative and repair effects of small-diameter artificial blood vessels through composite modification and surface modification. This article reviewed the research progress in the preparation of small-diameter artificial blood vessels using BNC and discussed the advantages and potential application prospects of BNC artificial blood vessels.

Objective:To investigate the effects of types of ulnar styloid process fracture on the treatment of distal radius fracture.Methods:The 80 patients were analyzed retrospectively who had been treated at The First Department of Hand Surgery, Honghui Hospital from January 2019 to January 2020 for fracture of distal radius complicated with fracture of ulnar styloid process. They were 25 males and 55 females, aged from 30 to 85 years (average, 58.6 years). According to the types of ulnar styloid process fracture, 40 patients were assigned into a Hauck type Ⅰ group and the other 40 into a Hauck type Ⅱ group. The 2 groups were compared in terms of operation, postoperative complications, hospital stay, bone union, visual analogue scale (VAS) on postoperative 1 to 3 days, and modified Mayo wrist function score, wrist range of motion and quality of life by WHOQOL-BREF at the last follow-up.Results:The 2 groups were comparable because there was no significant difference in age, gender, American Society of Anesthesiologists (ASA) rating, or time from injury to operation between them ( P>0.05). All the patients were followed up for 12 to 24 months (average, 17 months). There was no significant difference between Hauck type Ⅰ group and Hauck type Ⅱ group in operation time, intraoperative blood loss, hospital stay, rate of postoperative complications, fracture union, modified Mayo wrist function score or VAS on postoperative 1 to 3 days ( P>0.05). At the last follow-up, the palm tilt and ulnar inclination angles were 13.8°±1.9° and 21.6°±2.8° in Hauck type Ⅰ group, significantly larger than those in Hauck type Ⅱ group (11.9°±1.6° and 18.8°±2.3°) ( P<0.05). At the last follow-up, Hauck Ⅰ group scored 85.3±6.4,85.6±6.5, 84.7±6.3 and 85.0±6.7 respectively in the domains of physical health, psychology, environment and social relationships, significantly higher than those Hauck type Ⅱ group did (78.5±6.5, 78.9±6.5, 77.8±6.1 and 77.9±6.3) ( P<0.05). Conclusions:In open reduction and internal fixation for distal radius fracture, Hauck Type Ⅰ fracture of ulnar styloid process has no significant effect on the functional recovery of the wrist but Hauck Type Ⅱ fracture of ulnar styloid process may. Therefore, surgical fixation needs to be strengthened if Hauck Type Ⅱ fracture of ulnar styloid process is complicated.

Objective:To compare the performance of the severity-of-illness score for toxic epidermal necrolysis (SCORTEN) and ABCD-10 (age, bicarbonate, cancer, dialysis, 10% body surface area) scoring systems in predicting death in patients with Stevens-Johnson syndrome (SJS) /toxic epidermal necrolysis (TEN) .Methods:Clinical data were collected from 85 patients with SJS/TEN who were hospitalized in Sichuan Provincial People′s Hospital from January 2010 to April 2021, and retrospectively analyzed. The predicted mortality and actual mortality were compared at each score level of SCORTEN and ABCD-10. The receiver operating characteristic (ROC) curve and Hosmer-Lemeshow goodness-of-fit test were used to evaluate the predictive power and calibration of SCORTEN and ABCD-10 on mortality.Results:Among the 85 patients, 37 were males and 48 were females, and their ages were 52.36 ± 19.31 years (range, 14 - 88 years) . There were 61 cases of SJS, 6 of SJS/TEN overlap, and 18 of TEN. Ten patients died in hospital and the fatality rate was 11.76%. Among the SCORTEN and ABCD-10 components, age > 40 years or ≥ 50 years, epidermal exfoliation > 10% body surface area on the 1st day after admission, heart rate > 120 beats per minute, serum urea nitrogen level > 10 mmol/L and serum bicarbonate level < 20 mmol/L were significantly correlated with death ( χ2 = 4.46, 6.18, 25.50, 15.13, 7.59, 8.38, respectively, all P < 0.05) , while malignancies, serum glucose level > 14 mmol/L, and pre-hospital dialysis were not significantly correlated with death ( χ2 = 0.35, 0.10, 1.38, respectively, all P > 0.05) . There were no significant differences between the predicted mortality and actual mortality at every score level of SCORTEN and ABCD-10 (all P > 0.05) . The ROC curve showed that both SCORTEN and ABCD-10 had good predictive power for death (areas under the curve: 0.874 and 0.867, 95% CI: 0.758 - 0.990, 0.773 - 0.962, respectively) , but the model goodness-of-fit of SCORTEN was superior to that of ABCD-10 ( P = 0.944, 0.048, respectively) . Conclusion:Both SCORTEN and ABCD-10 scoring systems could accurately predict mortality of SJS/TEN patients at early stage, but SCORTEN showed more favourable predictive power and calibration.