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ObjectiveTo evaluate the measles surveillance system （MSS） in Jiading District， Shanghai from 2020 to 2022， and to provide evidence for the elimination of measles.MethodsDescriptive methods were used to analyze the MSS data and confirmed measles cases from 2020 to 2022 and to evaluate MSS performance indicators.ResultsA total of 120 suspected cases were reported through the MSS from 2020 to 2022， of which 12 were classified as measles， 9 as rubella， and 99 as non-measles /rubella. The incidence of reported non-measles /rubella was 1.44 per 100 000 population in 2020， 2.01 per 100 000 population in 2021， and 1.99 per 100 000 population in 2022. The rates of complete investigation within 48 hours， blood samples and etiology collection， timely delivery， and timely reporting were all 100%. Among the 12 confirmed measles cases from 2020 to 2022， seven routine immunization subjects completed the required doses of measles vaccines， while two out five adult cases had a history of measles vaccine-related immunization. The confirmed cases comprised six with fever accompanied by rash， five with rash alone， and one with fever alone.ConclusionThe MSS results in Jiading District， Shanghai are overall satisfactory. However， there is a need to improve sensitivity， especially in detecting and reporting cases with atypical symptoms. It is imperative to maintain high vaccination coverage for age-appropriate children， promote supplementary immunization activities， and elevate the overall immunity of the entire population.

Background It is of great importance to standardize labor management for ensuring maternal and neonatal safety. Since the publication of the new stage of labor, the definition of prolonged labor has not been emphasized and it is recommended to minimize interventions during labor, therefore, the number of pregnant women with labor over 24 h is increased compared to the previous. Objective To analyze the risk factors and maternal and neonatal outcomes of pregnant women with labor over 24 h and discuss the labor management under the new stage of labor. Methods The clinical data of pregnant women received maternity examination and delivered at Department of Obstetrics, the First Affiliated Hospital with Nanjing Medical University from January to December 2022 were collected in the retrospective study. A total of 40 single birth pregnant women with normal fetal position and prolonged total labor (more than 24 h) were selected as the observational group, and 95 single birth pregnant women with normal fetal position and normal total labor (less than 24 h) were selected as the control group. The age, BMI, gestational age of delivery, gestational diabetes, gestational hypertension, neonatal body mass, labor condition, analgesic delivery rate and delivery intervention rate of the two groups were compared. Multivariate Logistic regression analysis was used to explore the risk factors for total labor over 24 h. The maternal and neonatal outcomes including intrapartum fever, amniotic fluid contamination, mediolateral episiotomy, vaginal instrumental delivery, cervical laceration, postpartum hemorrhage, manual removal of placenta, fetal distress, neonatal asphyxia and referral to neonatal intensive care unit (NICU) were compared to screen the risk factors and analyse the maternal and neonatal outcomes of pregnant women with labor over 24 h. Results There were no significant differences in age, BMI, gestational age of delivery, gestational hypertension, gestational diabetes mellitus and neonate body mass between the two groups (P>0.05). The first stage of labor, second stage of labor and total labor were longer and the rates of labor analgesia and labor intervention were higher in the observational group than the control group (P0.05). There were no significant differences in the incidence of postpartum hemorrhage, vaginal instrumental delivery and fetal distress between the two groups (P>0.05) ; the incidence of intrapartum fever, amniotic fluid contamination, mediolateral episiotomy, vaginal instrumental delivery, cervical laceration and referral to NICU in the observational group was higher than the control group (P

ObjectiveTo analyze the epidemiological characteristics of varicella in Minhang District， Shanghai from 2013 to 2022， and to evaluate the impact of adjusting the varicella vaccination program to a two-dose regimen and its inclusion in the Shanghai immunization program on the incidence of varicella.MethodsData on reported varicella cases from 2013 to 2022 in Minhang District were collected. Interrupted time series analysis and segmented regression models were used to analyze the changes in varicella incidence before and after the adjustment of varicella immunization strategies.ResultsFrom 2013 to 2022， the average annual incidence of varicella was 76.58/100 000， with the highest incidence in 2017 （119.21/100 000） and the lowest in 2022 （27.02/100 000）. The varicella incidence exhibited seasonal patterns with peaks occurring from March to June and October to January of the following year. Prior to the adjustment of varicella immunization strategies （2013‒2017）， the varicella incidence showed an upward trend （z=2.20， P=0.03）， while after the adjustment （2018‒2022）， a adownward trend was observed （2018‒2022） （z=-2.25， P=0.02）. Interrupted time series analysis showed that following the adjustment of varicella immunization strategies， an immediate change of -33.91/100 000 （t=-4.35， P

Warfarin is an anticoagulant commonly used as an oral drug in preventing and treating thromboembolic diseases. The international normalized ratio (INR) is a clinical monitoring anticoagulation intensity index that adjusts the dose based on important references. In particular, INR value must be strictly monitored when warfarin is used for anticoagulation therapy in infected patients. Herein, we report a 54-year-old female patient diagnosed with pulmonary embolism and venous thrombosis of the lower limbs. After the warfarin administration, the INR was always substandard. The patient did not take other warfarin-interacting drugs or foods during the hospital stay. Metagenome next-generation sequencing suggested a bloodstream infection caused by Escherichia coli, which was further confirmed by blood culture. After meropenem administration for anti-infective treatment, the INR value rose rapidly to a standard level. Considering the lack of relevant reports, this case is the first report of potential interaction between E. coli and warfarin. Further, in patients with thromboembolic diseases complicated by infection, antibiotics should be chosen reasonably with close monitoring of the INR to avoid the interaction of warfarin and antibiotics and to ensure the effectiveness and safety of warfarin treatment.

Hepatitis E virus (HEV) reinfection is prevalent among the population, posing a significant burden on prevention and control efforts. In this study, we conducted a comprehensive analysis of data from China's Disease Prevention and Control Information System's infectious disease surveillance system to identify the epidemiological characteristics, spatiotemporal clustering, and high-risk populations of HEV reinfection. From 2005 to 2023, HEV reinfection in Zhejiang Province exhibited a fluctuating trend, peaking in 2020, with a 3–5-year lag compared to the pattern of HEV incidence. The Cox model indicated that individuals aged 40–50 and females are at higher risk of reinfection. Spatial autocorrelation was observed in reinfection cases from 2011 to 2016, with high–high clustering areas concentrated in downtown Hangzhou. Additionally, spatiotemporal scanning revealed that the clustering of reinfection cases has shifted from Hangzhou to coastal areas in recent years. Our findings suggest that targeted prevention and control measures for HEV rein fection should be implemented based on the characteristics of high-risk populations and spatiotemporal clustering patterns. [ABSTRACT FROM AUTHOR]

Hepatitis E virus (HEV) is a leading cause of acute viral hepatitis worldwide, primarily transmitted through contaminated water and food. In patients with chronic liver disease (CLD), HEV infection might worsen the prognosis. This study aimed to evaluate the cost-effectiveness of hepatitis E vaccination strategies in CLD patients. A decision tree–Markov cohort model was used to assess the cost-effectiveness of universal-vaccination, vaccination-following-screening, and no-vaccination strategies in 100,000 CLD patients over their lifetimes, simulating cohorts aged ≥16 years, ≥40 years, and ≥60 years, based on the licensed vaccination ages and typical ages of CLD onset, from a societal perspective. Model parameters were retrieved and estimated from previous publications and government data. The outcomes included HEV-related cases, costs, and the incremental cost-effectiveness ratio (ICER). Compared to no-vaccination, universal-vaccination reduced HEV-related cases by 32.8% to 39.6%, while vaccination-following-screening reduced them by 38.1% to 49.3%. Furthermore, universal-vaccination showed ICERs of USD 6898.33, USD 6638.91, and USD 6582.69 per quality-adjusted life year (QALY) for cohorts aged ≥16, ≥40, and ≥60 years, respectively. Moreover, the vaccination-following-screening strategy significantly enhanced cost-effectiveness, with ICERs decreasing to USD 6201.55, USD 5199.46, and USD 4919.87 per QALY for the cohorts. Additionally, one-way sensitivity analysis identified the discount rate and utility for CLD patients as the key factors influencing ICER. Probabilistic sensitivity analysis indicated the vaccination-following-screening strategy was cost-effective with probabilities of 92.50%, 95.70%, and 95.90% for each cohort. Hepatitis E vaccination in CLD patients costs less than GDP per capita for each QALY gained in China. The vaccination-following-screening strategy may be the optimal option, especially in those over 60 years. [ABSTRACT FROM AUTHOR]

ObjectiveTo determine the epidemiological and etiological characteristics of hand，foot，and mouth disease （HFMD） in Pujiang County from 2008 through 2020， so as to provide scientific evidence for prevention and control measures.MethodsDescriptive epidemiological analysis was used to analyze HFMD cases retrieved in the Chinese Information System for Disease Control and Prevention in Pujiang County during 2008‒2020.ResultsFrom 2008 through 2020， a total of 9 393 cases were documented in Pujiang County， with an annual incidence of 182.3 per 100 000， showing a trend of alternating high-incidence and low-incidence years. The seasonal distribution was bimodal， and the incidence peaked in May-July and November-December. The incidence of HFMD in urban areas was significantly higher than that in rural areas， and the incidence was positively correlated with population density. Majority of cases （94.9%） were children under 5 years old， of which boys had higher incidence than girls. The number of documented cases was the highest among preschool children living in families and kindergartens， accounting for 97.3%. Totally， 558 cases were laboratory confirmed in Pujiang County in 2008-2020， of which severe cases were all caused by EV71 infection.ConclusionEnterovirus serotypes in HFMD have continually changed from 2008 through 2020 in Pujiang County. However， severe HFMD remains principally attributable to EV71 infection， suggesting that it is necessary to strengthen the surveillance on the etiology of HFMD. In addition， it warrants further promotion of EV71 vaccination.

ObjectiveTo investigate the status of carcinogenic infection in people infected with HIV and those with negative HIV test results in VCT clinics. To analyze the epidemiological characteristics and provide scientific basis for more targeted disease prevention and control strategies.MethodsThe serum levels of Epstein-Barr virus （EBV）， human herpesvirus type 8 （HHV-8） and human T-lymphotropic virus type Ⅰ （HTLV-Ⅰ） antibodies were detected by ELISA method in 224 HIV-infected patients and 480 HIV-negative visitors treated in VCT clinics during the same period from 2014 to 2017， to compare the differences in the infection rates of this virus between HIV-infected and HIV-negative individuals and to systematically analyze the correlation between viral infections and high-risk sexual behavior.ResultsAmong the 224 HIV-infected patients， 79 were positive for EBV antibody， with the infection rate of 35.27%； 151 were positive for HHV-8 antibody， with the infection rate of 67.41%； and 95 were positive for HTLV-Ⅰ， with the infection rate of 42.41%. A total of 480 HIV negative visitors were tested. 7 patients were positive for EBV antibody， with the infection rate of 1.46%. 26 patients were infected with positive HHV-8 antibody， with the infection rate of 5.41%. 9 patients had positive HTIV-Ⅰ antibody， with the infection rate of 1.86%. The infection rates of the three carcinogenic viruses in HIV-infected patients were all higher than those in HIV-negative groups， and the differences were statistically significant （P

Introduction: Pulmonary embolism (PE), the most serious presentation of venous thromboembolism (VTE), is associated with a high rate of mortality and expense. Clinical studies on pregnant women with PE are scarce. The aim of this study was to analyze the clinical impact of fibrinolytic enzyme activation inhibitor-1 (PAI-1) 4G/5G genetic polymorphisms, methylenetetrahydrofolate reductase (MTHFR) rs1801131 (A1298C) and rs1801133 (C677T) genetic polymorphisms, and establish a predictive model for pregnant women. Material and Methods: Between September 2022 and August 2023, 53 pregnant women with PE were enrolled. Using the propensity score matching method, 106 consecutive pregnant women without VTE were 1:2 matched. The relevant patient data were collected, and the susceptibility genes for PE were detected to determine genetic polymorphisms, and PE susceptibility in pregnant women, as well as to develop predictive models. Results: Our study showed that 4G/4G homozygous mutations increased the risk of pregnant PE fourfold (OR = 4.46, 95% CI = 1.59– 12.50, P = 0.004), whereas the 4G allele mutation increased the risk twofold (OR = 2.33, 95% CI = 1.35– 4.04, P = 0.002). A nomogram was established to predict the risk of pregnant women with PE by four predictive features including PAI-1 genetic polymorphisms, international normalized ratio (INR), antithrombin-III (AT-III) activity, and platelet count (PLT). The area under the curve (AUC) of the nomogram was 0.821 (0.744– 0.898). The AUC of the internal validation group was 0.822 (0.674– 0.971). Decision curve analysis revealed that the nomogram has a higher net benefit in the following threshold: probability interval of ≥ 15%. Conclusion: The PAI-1 4G/4G genotype is an independent risk factor for pregnant women with PE; furthermore, the presence of the 4G allele can increase the risk of PE. The study established a nomogram to predict the risk of PE in pregnant women. [ABSTRACT FROM AUTHOR]

Efficient thermal management is essential for low-temperature optoelectronic devices. Traditional liquid nitrogen (LN2) cooling presents challenges such as frequent replenishment needs and limited operational duration. This study introduces micromachined Joule–Thomson (MJT) cooling as a superior alternative for temperature regulation in optoelectronic devices. We evaluated the thermal and optical performance of MJT cooling for a CdSe/ZnS quantum dot (QD) sample within a temperature range of 120–300 K. Thermal analysis showed that with a single 50 l nitrogen refill, the MJT system can operate continuously for over one week, surpassing the LN2 system by 11 times. The temperature stability was affected little by laser irradiation, with a <0.2 K rise at 5 mW of laser power. In addition, the MJT cooling led to an average blueshift of 1–3 meV in the emission peak of QDs and 0.3–2.3 meV reduced spectral broadening compared to LN2, attributed to a smaller sample-to-cold-stage temperature gap of about 8–9 K in the MJT setup. The standard deviations of peak energy and FWHM are in the order of E − 1 meV magnitude, demonstrating a comparable thermal uniformity compared to LN2. The vibration spectra obtained for both vertical and horizontal directions reveal the superior low-vibration characteristics of MJT cooling. These findings validate MJT cooling as a superior and reliable strategy for the thermal management of optoelectronics, ensuring prolonged operational durations, reliable temperature stability, enhanced temperature precision, high thermal homogeneity, and low vibrations. [ABSTRACT FROM AUTHOR]