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ObjectiveTo describe a COVID-19 outbreak due to SARS-CoV-2 Omicron variant in a school and provide suggestions for COVID-19 prevention and control.MethodsData on the COVID-19 outbreak in a school in Putuo District of Shanghai were collected from November 14 to December 20， 2022. Epidemiological characteristics， incidence rate of secondary cases and response measures were described and analyzed.ResultsA total of 27 COVID-19 cases were identified infected with SARS-CoV-2 Omicron BA.5.2 variant， including 14 students （51.9%） and 13 family members / teachers living with those students （48.1%）. The first case occurred on November 14， with peak incidence during November 16-18. The median generation interval of the second generation cases was 2 （2，3） days. The index case （case 1， a student） had a clear contact history outside the school， which was found through routine examination in key populations in the school. Immediate management was conducted after the notification. All the second generation cases were exposed students in the same class with case 1， which were identified during the quarantine， whereas the third generation cases were their family members/teachers living with the second generation cases. The incidence rate within the class and school were 36.8% and 3.0%， respectively. No further social transmission was found outside the school.ConclusionEarly detection， multi-sectoral collaboration， prompt control and quarantine measures are effective in containing SARS-CoV-2 transmission. Health promotion， surveillance， ventilation and prophylactic disinfection should be reinforced in schools， office buildings and other gathering places.

ObjectiveTo evaluate nPEP willingness and uptake among MSM in Shanghai.MethodsMSM were recruited through a NGO-based HIV voluntary counseling testing clinic and several virtual communities using snowball sampling.ResultsA total of 606 MSM were successfully recruited in which 82.8% （502/606） had heard of nPEP and 81.2% （492/606） were willing to use nPEP. MSM who had been diagnosed with sexually transmitted diseases （STD） were more likely to hold willingness in using nPEP. High cost was the most common reason for being unwilling to use nPEP. 9.9% （60/606） had used nPEP in which 51.7% （31/60） had used twice or more， and 50%（30/60） had missed medication in the last nPEP. MSM who were heterosexual or with other sex orientations except for being bisexuality （OR=2.943， 95%CI： 1.057‒8.191）， being receptor in anal intercourse （OR=3.361， 95%CI： 1.552‒7.282）， having 2 or more sexual partners in the last 30 days （OR=2.242， 95%CI： 1.225‒4.105）， having been diagnosed with STI （OR=2.317， 95%CI： 1.223‒4.389）， and using drugs （OR=2.177，95%CI： 1.052‒4.503） were more likely to use nPEP.ConclusionMSM in Shanghai have a relatively high willingness to use and uptake of nPEP. Comprehensive strategies need to be developed on improving adherence and reducing HIV-risk behaviors.

Neonatal hypoxic-ischemic encephalopathy (HIE) is a severe disease with a poor prognosis, whose clinical treatment is still limited to therapeutic hypothermia with limited efficacy. Perillyl alcohol (POH), a natural monoterpene found in various plant essential oils, has shown neuroprotective properties, though its effects on HIE are not well understood. This study investigates the neuroprotective effects of POH on HIE both in vitro and in vivo. We established an in vitro model using glucose deprivation and hypoxia/reperfusion (OGD/R) in PC12 cells, alongside an in vivo model via the modified Rice-Vannucci method. Results indicated that POH acted as an indirect antioxidant, reducing inducible nitric oxide synthase and malondialdehyde production, maintaining content of antioxidant molecules and enzymes in OGD/R-induced PC12 cells. In vivo, POH remarkably lessened infarct volume, reduced cerebral edema, accelerated tissue regeneration, and blocked reactive astrogliosis after hypoxic-ischemic brain injury. POH exerted antiapoptotic activities through both the intrinsic and extrinsic apoptotic pathways. Mechanistically, POH activated Nrf2 and inactivated its negative regulator Keap1. The use of ML385, a Nrf2 inhibitor, reversed these effects. Overall, POH mitigates neuronal damage in HIE by combating oxidative stress, reducing inflammation, and inhibiting apoptosis via the Nrf2/Keap1 pathway, suggesting its potential for HIE treatment. [ABSTRACT FROM AUTHOR]

Purpose: Neonatal bacterial meningitis (NBM) is a serious disease with high morbidity and mortality. This study aimed to establish a foundation for the selection of empirical antibiotics for NBM through an analysis of pathogen distribution and shift in antimicrobial resistant pattern. Patients and Methods: A retrospective cohort study on culture confirmed NBM from 2005 to 2022. Results: A total of 191 cases were enrolled, 48 for premature infants and 70 for early-onset meningitis. The incidence of NBM in first half and last half period was 0.2‰ and 0.24‰, while the mortality was 12.0% and 5.6% respectively. The top two pathogens were Escherichia coli (E. coli) (40.3%) and Group B Streptococcus (GBS) (29.8%). E. coli was the most common pathogen in both periods, Enterococcus (13.3% vs 0.9%, P < 0.05) and Staphylococcus aureus (8.4% vs 1.9%, P < 0.05) decreased, while GBS increased significantly in the periods [16.9% vs 39.8%, P < 0.001]. Gram-positive bacteria were more common in full term infants (53.8% vs 27.1%, P = 0.001), while gram-negative bacteria were more common in preterm infants (72.9% vs 46.2%, P = 0.001). All isolated GBS strains were susceptible to penicillin. On the other hand, less than 60% of E. coli were susceptible to third generation of cephalosporins, and were only susceptible to carbapenem or amikacin. This was mainly due to production of extended-spectrum beta-lactamase (ESBLs) which was higher in late-onset group than that in early-onset group (45.1% vs 19.2%, P = 0.026). Conclusion: Incidence of NBM has not changed significantly over the last 2 decades. E. coli remains as the most common pathogen of NBM despite that GBS has increased in recent 9 years, especially in full-term infants. While all isolated GBS are susceptible to penicillin, over a third of E. coli strains are multidrug resistant due to production of ESBLs. [ABSTRACT FROM AUTHOR]

Introduction China has approximately 1 million new cases of tuberculosis per year, (1-3) resulting in a substantial burden of premature mortality. (2) Several factors are known to increase the risk [...], Objective To determine excess mortality in a cohort of people with tuberculosis in Shanghai. Methods Participants were local residents in 4 (of 19) districts in Shanghai, registered In one of four tuberculosis clinics between January 1, 2004 and December 31, 2008. Baseline data were collected at the most recent diagnosis of tuberculosis and mortality was assessed between March and May of 2014. We calculated standardized mortality ratios (SMR) and case-fatality rates for all participants and for subgroups. Univariate and multivariate Cox regression models were used to quantify associations between co-morbidities and mortality from all causes and from tuberculosis. Findings We registered 4569 subjects in the cohort. Overall, the cohort had an SMR for deaths from all causes of 5.2 (95% confidence interval, CI: 4.8-5.6). Males had a higher SMR than females (6.1 versus 3.0). After adjustment for age and sex, hazard ratios (HR) for deaths from all causes were significantly greater in previously treated people (HR: 1.26; 95% CI: 1.08-1.49) and sputum smear-test positive people (HR: 1.55; 95% CI: 1.35-1.78). The risk of death from tuberculosis was. also significantly greater for previously treated people (HR: 1.88; 95% CI: 1.24-2.86) and smear positive people (HR: 3.16; 95% CI: 2.06-4.87). Conclusion People with tuberculosis in Shanghai have an increased risk of mortality. Earlier diagnosis and more vigilant follow-up may help to reduce mortality In this group. Objectif Determiner la surmortalite dans une cohorte de personnes atteintes de tuberculose a Shanghai. Methodes Les participants etaient des habitants de 4 districts (sur 19) de Shanghai, enregistres dans une des quatre cliniques de la tuberculose entre le 1er janvier 2004 et le 31 decembre 2008. Des donnees de reference ont ete recueillies lors du diagnostic le plus recent de tuberculose et la mortalite a ete evaluee entre mars et mai 2014. Nous avons calcule les rapports standardises de mortalite (RSM) et les taux de letalite pour tous les participants ainsi que pourdes sous-groupes. Des modeles de regression univariee et multivariee de Cox ont ete utilises pour quantifier les associations entre les comorbidites et la mortalite, toutes causes confondues et due a la tuberculose. Resultats Nous avons enregistre 4569 sujets dans la cohorte. Globalement, la cohorte avait un RSM pour les deces toutes causes confondues de 5,2 (intervalle de confiance (IC) de 95%: 4,8-5,6). Les hommes affichaient un RSM plus eleve que les femmes (6,1 contre 3,0). Apres ajustement en fonction de l'age et du sexe, les ratios de risque (RR) de deces toutes causes confondues etaient nettement plus eleves chez les personnes ayant precedemment recu un traitement (RR: 1,26; IC 95%: 1,08-1,49) et les personnes a frottis d'expectoration positif (RR: 1,55; IC 95%: 1,35-1,78). Le risque de deces du a la tuberculose etait egalement beaucoup plus important pour les personnes ayant precedemment recu un traitement (RR: 1,88; IC 95%: 1,24-2,86) et les personnes a frottis positif (RR: 3,16; IC 95%: 2,06-4,87). Conclusion Les personnes atteintes de tuberculose a Shanghai presentent un risque accru de mortalite. Un diagnostic plus precoce et un suivi plus attentif pourraient permettre de reduire la mortalite dans ce groupe. Objetivo Determinar el exceso de mortalidad en una cohorte de personas con tuberculosis en Shanghai. Metodos Los participantes eran residentes locales de 4 (de 19) distritos de Shanghai, registrados en uno de los cuatro consultorios antituberculosos entre el 1 de enero de 2004 y el 31 de diciembre de 2008. Se recogieron datos de referencia de los diagnosticos de tuberculosis mas recientes y se evaluo la mortalidad entre marzo y mayo de 2014. Se calcularon las tasas de mortalidad estandarizadas (SMR) y la tasa de letalidad de todos los participantes y por subgrupos. Se utilizaron modelos de regresion de Cox univariables y multivariables para cuantificar las asociaciones entre la comorbilidad y la mortalidad de todas las causas de tuberculosis. Resultados Se registraron 4.569 sujetos en la cohorte. En general, la cohorte tenia una SMR para muertes de todas las causas de 5,2 (intervalo de confianza del 95%, IC: 4,8-5,6). Los hombres tenian una SMR mayor que las mujeres (6,1 frente a 3,0). Tras ajustarlos de acuerdo a edad y sexo, los cocientes de riesgo (HR) para las muertes de todas las causas eran significantemente mayores en personas tratadas con anterioridad (HR: 1,26 (IC del 95%: 1,08-1,49) y personas con pruebas de esputo positivas (H R: 1,55 (IC del 95%: 1,35-1,78). El riesgo de muerte por tuberculosis tambien era significativamente mayor en personas tratadas con anterioridad (HR: 1,88 (IC del 95%: 1,24-2,86) y personas con pruebas de esputo positivas (HR: 3,16 (IC del 95%: 2,06-4,87). Conclusion Las personas con tuberculosis en Shanghai tienen un mayor riesgo de mortalidad. Unos diagnosticos mas tempranos y un seguimiento mas atento podrian ayudar a reducir la mortalidad de este grupo.

The cellular characteristics of intestinal cells involved in the therapeutic effects of astragaloside IV (AS-IV) for treating slow transit constipation (STC) remain unclear. This study aimed to determine the dynamics of colon tissue cells in the STC model and investigate the effects of AS-IV treatment by single-cell RNA sequencing (scRNA-seq). STC mouse models were developed using loperamide, with subsequent treatment using AS-IV. Colon tissues and feces were collected for scRNA-seq and targeted short-chain fatty acid quantification. We integrated scRNA-seq data with network pharmacology to analyze the effect of AS-IV on constipation. AS-IV showed improvement in defecation for STC mice induced by loperamide. Notably, in STC mice, epithelial cells, T cells, B cells, and fibroblasts demonstrated alterations in cell proportions and aberrant functions, which AS-IV partially rectified. AS-IV has the potential to modulate the metabolic pathway of epithelial cells through its interaction with peroxisome proliferator-activated receptor gamma (PPARγ). AS-IV reinstated fecal butyrate levels and improved energy metabolism in epithelial cells. The proportion of naïve CD4+T cells is elevated in STC, and the differentiation of these cells into regulatory T cells (Treg) is regulated by B cells and fibroblasts through the interaction of ligand-receptor pairs. AS-IV treatment can partially alleviate this trend. The status of fibroblasts in STC undergoes alterations, and the FB&#95;C4&#95;Adamdec1 subset, associated with angiogenesis and the Wingless-related integration (Wnt) pathway, emerges. Our comprehensive analysis identifies perturbations of epithelial cells and tissue microenvironment cells in STC and elucidates mechanisms underlying the therapeutic efficacy of AS-IV.