Progress of early warning indicators on infectious diseases / 上海预防医学

In recent years， with frequent outbreaks of infectious diseases around the world， the global public health is faced with many threats and challenges. An infectious diseases early warning system is an important means for prevention and control of infectious diseases. As an important part of the early warning system， the warning indicators is crucial for understanding the occurrence and development trend of infectious diseases， detecting abnormal situations timely and effectively， and issuing early warning and initiating emergency response. Based on the occurrence and development process of infectious diseases， this paper summarizes the research status of early warning indicators on infectious diseases， in order to provide reference for the development and improvement of the infectious diseases early warning system.

Epidemiological characteristics of the notifiable infectious diseases reported in Shanghai in 2020 / 上海预防医学

ObjectiveTo understand the epidemic characteristics of notifiable infectious diseases （NIDs） other than coronavirus disease 2019 （COVID-19） in Shanghai in 2020， and to provide evidence for formulating infectious disease prevention and control strategies. MethodsData of NIDs reported in Shanghai from 2015 to 2020 were collected through the National Information System for Disease Control and Prevention. Descriptive epidemiological methods were used to analyze the incidence and prevalence characteristics of NIDs in Shanghai in 2020， and compared them with the average values of 2015 to 2019. ResultsA total of 45 574 cases of 23 kinds of NIDs were reported in Shanghai in 2020， except for COVID-19， with an incidence of 187.69/105， and a decrease rate of 50.58% compared with the average value of 2015 to 2019. The incidence of category B and C infectious diseases decreased by 38.07% and 57.47%， respectively （All P<0.001）. The top 3 reported infectious diseases with the highest incidence rate were influenza （64.58/105）， syphilis （39.09/105） and tuberculosis （24.90/105）. The incidence of most infectious diseases decreased compared with the average of 2015 to 2019， among which measles （97.15%）， rubella （88.81%）， pertussis （87.43%）， hand foot mouth disease （85.99%） and scarlet fever （79.84%） decreased significantly （all P<0.001）. In general， compared with the average from 2015 to 2019， respiratory infectious diseases declined most， followed by intestinal infectious diseases， insect-borne and natural focal infectious diseases， blood-borne and sexually transmitted diseases. Districts with higher incidence in 2020 were Fengxian District （310.23/105）， Xuhui District （271.93/105） and Hongkou District （254.38/105）. Respiratory infectious diseases in Fengxian District， intestinal infectious diseases in Jinshan District， blood-borne and sexually transmitted infectious diseases in Changning District， and insect-borne and natural focal infectious diseases in Yangpu District showed the highest incidence rate. Incidence of infectious diseases in 16 districts of Shanghai decreased with different degrees （all P<0.001）. Incidence of infectious diseases in males （209.44/105） was higher than that in females （164.89/105） （χ2=624.864， P<0.001）. Children aged 0-9 years had the highest incidence of respiratory and intestinal infectious diseases. People aged 70‒79 years and 20‒29 years had higher incidence of blood-borne and sexually transmitted infectious diseases， and people aged 20‒29 years had the highest incidence of insect-borne and natural focal infectious diseases. Majority of the patients were students （8 327 cases， 18.27%）， retired people （6 393 cases， 14.03%） and unemployed household workers （5 988 cases， 13.14%）. ConclusionUnder the COVID-19 prevention and control policies， the incidence of most NIDs in Shanghai decreased significantly in 2020.

Analysis of media information monitoring results of COVID-19 in Shanghai in 2022 based on an internet surveillance system / 上海预防医学

ObjectiveTo understand the internet media information of COVID-19 in Shanghai in 2022， to provide evidence for health administration departments to respond to public health emergencies， and to establish a comprehensive public health media surveillance system. MethodsData on internet media information and the local COVID-19 epidemic data in Shanghai from January 1 to June 30， 2022 were collected and analyzed. ResultsA total of 90.197 3 million pieces of internet media information were monitored. The top four sources of the information were Weibo （36.84%）， short videos （26.19%）， internet media （14.47%）， and forums （13.31%）. The variation trend of daily internet media surveillance information was identified with the number of newly reported cases per day， and a correlation was found （r＝0.770. After the seven-day moving average，r＝0.796）. Frequent keywords included Shanghai， cheer up， nucleic acid， new cases， local， asymptomatic， prevention and control， gratitude， isolation， epidemic prevention， supplies， pandemic response， patient， seeking help， and clearing the cases. Within the information on Weibo， in addition to netizens in Shanghai （7 823 100） who were highly concerned about the pandemic， netizens from Beijing （2 749 100）， Guangdong Province （2 352 300）， Jiangsu Province （2 189 100） and Zhejiang Province（1 532 100） also posted a relatively high amount of information related to COVID-19 in Shanghai. ConclusionThe outbreak of major infectious diseases triggers significant online activity， and platforms such as Weibo and short video platforms play crucial roles in disseminating internet media information. Weibo， short videos etc. are important platforms for current internet media information. Strengthening media information monitoring and analysis， paying close attention to hot events， taking timely response measures and actively engaging in risk communication contribute to the response and management of public health emergencies.

T-piece resuscitator versus self-inflating bag for positive pressure ventilation during neonatal resuscitation / 中华围产医学杂志

To compare the performance of self-inflating bag (SIB) with T-piece resuscitator (TPR) in neonatal resuscitation.Methods:This study involved the trainees participating in a Neonatal Resuscitation Simulation Camp (NRSC) organized by Shanghai First Maternity and Infant Hospital in December 2019. They were trained to provide positive pressure ventilation with the two devices on artificial lungs. Ventilation parameters including peak inspiratory pressure (PIP), positive end-expiratory pressure (PEEP), PIP in pulmonary alveoli (PIP alv), mean airway pressure (MAP), frequency, inspiratory time (Ti), tidal volume and minute ventilation volume were recorded and analyzed by independent sample t-test or rank sum test. Results:The PIP alv, PIP, oxygen flow rate, tidal volume and minute ventilation volume delivered by TPR were significantly lower than those by SIB [(17.18±1.61) vs (24.05±4.29) cmH 2O (1 cmH 2O=0.098 kPa), t=－6.87; (17.91±1.35) vs (29.97±4.50) cmH 2O, t=－14.06; (3.65±0.25) vs (6.88±1.59) L/min, t=－11.33; (15.90±1.81) vs (24.02±4.29) ml/min, t=－10.99; (664.71±88.94) vs (1 069.49±205.68) ml/min, t=－9.89; all P<0.001]. However, compared with SIB, the PEEP in pulmonary alveoli, Ti, duration of ventilation, inspiratory to expiratory ratio were increased when using TPR [(4.76(4.69-5.57) vs 0.19(0.12-4.10) cmH 2O, T=1 190.00; (0.59±0.15) vs (0.43±0.09) s, t=5.01; (1.46±0.23) vs (1.36±0.11) s, t=2.15; 0.71±0.22 vs 0.47±0.13, t=5.14; all P<0.05]. Conclusion:TPR could deliver more stable and safer PIP, PEEP and tidal volume than SIB and keeping MAP at a stable level during positive pressure ventilation on artificial lungs.

Effect of coronavirus disease 2019 pandemic on the epidemiological characteristics of scarlet fever in Shanghai City / 中华传染病杂志

Objective:To analyze the changes in the epidemiological characteristics of scarlet fever cases in Shanghai City before and after the outbreak of coronavirus disease 2019 (COVID-19), and to provide a reference for scientific prevention and control of scarlet fever.Methods:The information of scarlet fever reported cases in Shanghai City from January 2016 to June 2021 in the information system of Chinese Disease Prevention and Control was collected, and the differences in time trend, regional distribution, age and gender distribution of cases before and after the outbreak of COVID-19 in Shanghai City were analyzed by descriptive epidemiologic method.Results:The incidence rate of scarlet fever reported in 2016-2019 was (0.22-4.02)/100 000 in each month, with a median of 1.13/100 000. During January 2020 (the outbreak began in Shanghai City) and June 2021, the incidence rate of scarlet fever was (0.01-1.64)/100 000, with a median of 0.14/100 000, which was 12.39% of that before the outbreak of COVID-19. During February and June 2020, the monthly reported incidence rate of scarlet fever was (0.18-0.58)/100 000, showing an upward trend compared with the same period in 2020 ((0.01-0.05)/100 000). From 2016 to 2019, the annual reported incidence rate of each district was (0.55-65.48)/100 000, with a median of 9.57/100 000; while in 2020, the annual reported incidence rate of each district was (0.29-9.85)/100 000, with a median of 2.18/100 000, which was 22.78% of that before the outbreak of COVID-19. The incidence of scarlet fever dropped significantly. The incidence rate in Minhang District was still the highest. The cases were mainly four to eight years old, and there was no substantial difference of the proportions before and after COVID-19 pandemic, with the incidence rate of six years old group the highest. The proportion of male was more than female in reported case, while the male ratio in reported cases was not significantly different before and after COVID-19 pandemic.Conclusions:The incidence rate of scarlet fever in Shanghai City has dropped sharply after COVID-19 pandemic. The main epidemiological characteristics of the regional and population distribution of cases remain unchanged.

Effect of Jiajian-Zhujing Decoction on the AKT/mTOR signaling pathway in ARPE-19 cells after AKT transfection / 国际中医中药杂志

Objective:To study the mechanism of the effect of Jiajian-Zhujing Decoction on the expression of VEGF on ARPE-19 cells after AKT transfection. Methods:To prepare the serum and blank serum of Jiajian-Zhujing Decoction and divide ARPE-19 cells into the normal group, model group, blank serum group, medicated serum group, Conbercept group and combined group. Except normal group, this research established AKT transfected cell model. Then cultured the normal group and model group with conventional method, and the blank serum group was cultured with 10% blank serum, the medicated serum group was cultured with 10% medicated serum, the Conbercept group was cultured with 20 μg/ml Conbercept, the combined group was cultured with 10% medicated serum and 20 μg/m Conbercept. The proliferation of ARPE-19 cells in each group was detect by the CCK-8 method. The levels of AKT, mTOR and VEGF mRNA were detected by real-time quantitative PCR. Western blot was used to detect the expression of AKT, mTOR and VEGF. Results:After being cultured for 24, 48 and 72 hours, compared with the model group, the cell proliferation rate in blank serum group, medicated serum group, Conbercept group and combined group significantly decreased ( P<0.05). Compared with the model group, the expression of AKT mRNA (24 h: 3.10 ± 0.48, 1.97 ± 0.14, 1.26 ± 0.24 vs. 4.77 ± 0.68; 48 h: 3.52 ± 0.82, 2.62 ± 0.77, 1.10 ± 0.19 vs. 6.12 ± 1.21), mTOR mRNA (24 h: 3.02 ± 0.26, 2.45 ± 0.75, 1.13 ± 0.15 vs. 4.48 ± 0.80; 48 h: 1.29 ± 0.30, 1.30 ± 0.57, 0.65 ± 0.19 vs. 2.54 ± 0.62), VEGF mRNA (24 h: 3.33 ± 0.62, 2.18 ± 0.20, 1.55 ± 0.28 vs. 5.53 ± 1.02; 48 h: 2.35 ± 0.54, 1.23 ± 0.28, 0.93 ± 0.25 vs. 3.59 ± 0.40), AKT protion (24 h: 0.45 ± 0.09, 0.25 ± 0.05, 0.14 ± 0.04 vs. 0.62 ± 0.04; 48 h: 0.36 ± 0.06, 0.23 ± 0.04, 0.14 ± 0.03 vs. 0.54 ± 0.08), mTOR protion (24 h: 0.35 ± 0.05, 0.24 ± 0.02, 0.18 ± 0.02 vs. 0.52 ± 0.09; 48 h: 0.23 ± 0.04, 0.29 ± 0.04, 0.14 ± 0.03 vs. 0.40 ± 0.10), VEGF protion (24 h: 0.14 ± 0.03, 0.33 ± 0.04, 0.24 ± 0.03 vs. 0.54 ± 0.10; 48 h: 0.24 ± 0.03, 0.17 ± 0.02, 0.11 ± 0.02 vs. 0.42 ± 0.10) significantly decreased ( P<0.05), and the combined group was significantly lower than that of the Conbercept group ( P<0.05). Conclusions:AKT transfection can promote the proliferation of ARPE-19 cells, and Jiajian-Zhujing Decoction can significantly inhibit this proliferation. Jiajian-Zhujing Decoction may inhibit the activity of AKT/mTOR signaling pathway to reduce the expression of VEGF.

Meta analysis of continuous versus intermittent feeding in very low birth weight infants / 临床儿科杂志

Objective To compare the effects of continuous versus intermittent feedings on the growth of very low birth weight infants. Methods Databases of Pubmed,Embase,Ovid,the Cochrane library and CBM were searched through internet,and citations of relevant original studies were also searched manually by using keywords of 'ontinuous,intermittent,nasogastric,premature,very low birth weight' Meta analysis was done on the results of these studies. Results Seven eligible studies with 434 infants were identified,among them,217 were fed using continuous nasogastric gavage,and other 217 were fed by intermittent nasogastric gavage. The result of the Meta analysis revealed that there was no statistical difference in the growth of the infants between two feeding methods. Conclusions Feeding methods are associated with similar outcomes when calorie intake is guaranteed.

Epidemiological Study on Subtypes of ADHD of Children Aged 4-16 Years Old in Wuhan / 中国心理卫生杂志

Objective:To get the prevalence of attention-deficit hyperactivity disorder and in Children. Methods:The subjects were 2188 children who were 4~16 year-old in Wuhan. We had their parents filled the investigation forms. Diagnosis was made according to criterion of attention-deficit hyperactivity disorder in DSM-IV. Results:of behavior problems were got through Achenbach Behavior Questionnaires. Those who were diagnosed as ADHD were classified into three subtypes: predominantly inattentive type; predominantly hyperactive-impulsive type and com-bined type. All suspicious patient and their parents were invited to have the diagnostic talk. Results: (1) The rate of ADHD was 13.58%. ADHD-C, 2.63%; ADHD-I, 8.27%; ADHD-HI, 2.68%. The male, 18.57%; female,8.78%. The ratio of male: female was 2.24:1。(2) There was significantly difference of rate of ADHD between age groups. The rate of 4~5 years-old was 15.88%, that for 6~11 years-old was 15.85%; and for 12~16 yeas-old, 9.98%. The rate of ADHD decreased by aging, especially the group of ADHD-HI. But the rate of ADHD-I was still increased, especially the male group of 6~11 years-old, 12.19%. (3) There was significantly difference of sociality ability between ADHD children and the normal. (4) No matter which age and sex, the scales of behavior problem of ADHD children were higher than the normal children. And the number of factors of behavior problem of ADHD children increased by ag-ing.Conclusion: The rate of ADHD-I was the highest in the three subtypes defined by DSM-Ⅳ, especially among boys 6~11-years-old. The rate of ADHD is significantly associated with sex and age.