Dual Design on Hierarchically Hollow MoTe2/C with Ion/Electron Channel Engineering for High-Performance Sodium Storage

Transition-metal tellurides have been investigated as novel anode materials for application in sodium-ion batteries (SIBs) due to their rich active sites and unique and controllable layered nanostructures. However, the weak structural strength and inferior intercalation/deintercalation kinetics inhibit the development of transition-metal tellurides. In this work, MoTe2/C composites with two different hollow nanostructures are designed and prepared. By adjustment of the precursor structure, MoTe2/C-2 exhibits superior sodium-storage performance because of its uniquely hollow nanostructure with self-assembled 2D flexible nanosheets grown on the external surface. MoTe2/C-2 delivers a higher specific capacity (276 mAh g-1 at 0.1 A g-1 after 300 cycles), much more than MoTe2/C-1 (201 mAh g-1 at 0.1 A g-1 after 300 cycles), and exhibits a long-time cycling performance (131 mAh g-1 at 1 A g-1 after 2000 cycles). The excellent sodium-storage performance derived from the rational structure design is beneficial for shortening the ion paths, facilitating the sodiation/desodiation process, and reinforcing the intrinsic structural stability, thus boosting the reaction kinetics and prolonging the cycling life. Meanwhile, the assembled full-cell maintains 101 mAh g-1 at 0.1 A g-1 after 50 cycles and lights an electric watch. The findings provide several new views for preparation of more transition-metal tellurides with multi-ion/electron migration channel engineering.

Efficacy of preventive interventions against ventilator-associated pneumonia in critically ill patients: an umbrella review of meta-analyses

Many meta-analyses have assessed the efficacy of preventive interventions against ventilator-associated pneumonia (VAP) in critically ill patients. However, there has been no comprehensive analysis of the strength and quality of evidence to date. Systematic reviews of randomized and quasi-randomized controlled trials, which evaluated the effect of preventive strategies on the incidence of VAP in critically ill patients receiving mechanical ventilation for at least 48 h, were included in this article. We identified a total of 34 interventions derived from 31 studies. Among these interventions, 19 resulted in a significantly reduced incidence of VAP. Among numerous strategies, only selective decontamination of the digestive tract (SDD) was supported by highly suggestive (Class II) evidence (risk ratio (RR)=0.439, 95% CI: 0.362-0.532). Based on data from the sensitivity analysis, the evidence for the efficacy of non-invasive ventilation in weaning from mechanical ventilation (NIV) was upgraded from weak (Class IV) to highly suggestive (Class II) (RR=0.32, 95% CI: 0.22-0.46). All preventive interventions were not supported by robust evidence for reducing mortality. Early mobilization exhibited suggestive (Class III) evidence in shortening both intensive length of stay (LOS) in the intensive care unit (ICU) (mean difference (MD)=-0.85, 95% CI: -1.21 to -0.49) and duration of mechanical ventilation (MD=-1.02, 95% CI: -1.41 to -0.63). In conclusion, SDD and NIV are supported by robust evidence for prevention against VAP, while early mobilization has been shown to significantly shorten the LOS in the ICU and the duration of mechanical ventilation. These three strategies are recommendable for inclusion in the ventilator bundle to lower the risk of VAP and improve the prognosis of critically ill patients.

Fluorine-Terminated Self-Assembled Monolayers Grafted Graphite Anode Inducing a LiF-Dominated SEI Inorganic Layer for Fast-Charging Lithium-Ion Batteries

The electrochemical kinetic processes of Li+ ions, including the desolvation of the Li+ ions from the electrolyte to the solid electrolyte interphase (SEI), the transportation of desolvated Li+ ions across the SEI, and the charge transfer at the interface between the SEI and graphite, determine the rate performance and cycling stability of the graphitic anode in lithium-ion batteries (LIBs). In this work, fluorine-terminated self-assembled monolayers were grafted on the surface of spherical graphite particles to regulate the chemical composition and structure of SEI formed on the graphite surface in the presence of conventional ester electrolytes. The comprehensive characterization and first-principles calculation results illustrate that a uniform LiF-dominated SEI film can be generated on the as-functionalized graphite anode due to the carbon-fluorine bonds' cleavage of fluorine-terminated self-assembled monolayers. The LiF-dominated SEI film is particularly beneficial for desolvated lithium-ion transport across the SEI, affording LiCoO2//graphite full cells with substantially enhanced fast-charging capability and cycle stability. This strategy should be potentially useful for modifying other anode materials to regulate the interfacial chemistry between the anode and electrolyte in lithium-ion batteries.

China's prevention and control experience of echinococcosis: A 19-year retrospective

Echinococcosis poses a significant threat to public health. The Chinese government has implemented prevention and control measures to mitigate the impact of the disease. By analyzing data from the Chinese Center for Disease Control and Prevention and the State Council of the People's Republic of China, we found that implementation of these measures has reduced the infection rate by nearly 50% between 2004 to 2022 (from 0.3975 to 0.1944 per 100,000 person-years). Nonetheless, some regions still bear a significant disease burden, and lack of detailed information limites further evaluation of the effects on both alveolar and cystic echinococcosis. Our analysis supports the continuing implementation of these measures and suggests that enhanced wildlife management, case-based strategies, and surveillance systems will facilitate disease control.

Entropy-Driven Morphology Regulation of MAX Phase Solid Solutions with Enhanced Microwave Absorption and Thermal Insulation Performance

Morphology regulation and composition design have proved to be effective strategies for the fabrication of desirable microwave absorbers. However, it is still challenging to precisely control the microstructure and components of MAX phases. Herein, an entropy-driven approach, a transition from irregular grains (low entropy) to sheet structure (high entropy), is proposed to modulate the morphology of MAX phases. The theoretical calculation indicates that the morphology evolution can be ascribed to the enlarged energy difference between (11_00) and (0001) facets. The enriched structural defects and optimized morphologies yield significant dipolar polarization, interfacial polarization, multiple reflections, and scattering, which all enhance the electromagnetic wave absorption performance of (V0.25 Ti0.25 Cr0.25 Mo0.25 )2 GaC. Specifically, its minimum reflection loss can reach up to -47.12 dB at 12.13 GHz, and the optimal effective absorption bandwidth is 4.56 GHz (2.03 mm). Meanwhile, (V0.25 Ti0.25 Cr0.25 Mo0.25 )2 GaC shows also pronounced thermal insulation properties affording it good reliability in the harsh working environment. This work offers a novel approach to designing and regulating the morphology of the high entropy MAX phase, and also presents an opportunity to elucidate the relationship between entropy and electromagnetic wave absorption performance.

Quenching modification of NiFe layered double hydroxides as efficient and highly stable electrocatalysts for the oxygen evolution reaction

Nickel- and iron-containing layered double hydroxides (NiFe-LDHs) are prospective electrocatalysts for the oxygen evolution reaction (OER), but they suffer from poor electrical conductivity and inaccessible active sites. Herein, we employ a facile and efficient quenching strategy to modify the morphology and surface characteristics of NiFe-LDHs by rapid cooling in a series of salt solutions. After quenching in a SnCl4 solution, the modified NiFe-LDHs exhibit a low overpotential of 204 mV at a current density of 10 mA·cm-2 and Tafel slope of 58.0 mV·dec-1 in a 1.0 M KOH solution. The improvement in the oxygen-evolution performance is ascribed to the morphology transformation from agglomerated NiFe-LDHs flowers into dispersed two-dimensional NiFe-LDHs nanosheets, which offers more active sites for the OER. Metal atoms are also introduced to the surface of NiFe-LDHs nanosheets during quenching, thereby changing the chemical coordination environment between Ni and Fe and improving their conductivity. Considering the diversity of LDHs and salt solutions, this quenching strategy may provide a sophisticated approach to preparing stable non-noble-metal electrocatalysts for the OER.

Integrative analysis reveals the recurrent genetic etiologies in idiopathic pulmonary fibrosis

BACKGROUND

Idiopathic pulmonary fibrosis (IPF) is increasingly recognized as a chronic, progressive and fatal lung disease with an unknown etiology. Current studies focus on revealing the genetic factors in the risk of IPF, making the integrative analysis of genetic variations and transcriptomic alterations of substantial value.

AIM

This study aimed to improve the understanding of the molecular basis of IPF through an integrative analysis of whole-exome sequencing (WES), bulk RNA sequencing (RNA-seq) and single-cell RNA sequencing (scRNA-seq) data.

METHODS

WES is a powerful tool for studying the genetic basis of IPF, allowing for the identification of genetic variants that may be associated with the development of the disease. RNA-seq data provide a comprehensive view of the transcriptional changes in IPF patients, while scRNA-seq data offer a more granule view of cell-type-specific alterations.

RESULTS

In this study, we identified a comprehensive mutational landscape of recurrent genomic and transcriptomic variations, including single-nucleotide polymorphisms, CNVs and differentially expressed genes, in IPF populations, which may play a significant role in the development and progression of IPF.

CONCLUSIONS

Our study provided valuable insights into the genetic and transcriptomic variations associated with IPF, revealing changes in gene expression that may contribute to disease development and progression. These findings highlight the importance of an integrative approach to understanding the molecular mechanisms underlying IPF and may pave the way for identifying potential therapeutic targets.

[Molluscicidal effect of spraying 5% niclosamide ethanolamine salt granules with drones against Oncomelania hupensis in hilly regions]

OBJECTIVE

To establish a snail control approach for spraying chemicals with drones against Oncomelania hupensis in complex snail habitats in hilly regions, and to evaluate its molluscicidal effect.

METHODS

The protocol for evaluating the activity of spraying chemical molluscicides with drones against O. hupensis snails was formulated based on expert consultation and literature review. In August 2022, a pretest was conducted in a hillside field environment (12 000 m2) north of Dafengji Village, Dacang Township, Weishan County, Yunnan Province, which was assigned into four groups, of no less than 3 000 m2 in each group. In Group A, environmental cleaning was not conducted and 5% niclosamide ethanolamine salt granules were sprayed with drones at a dose of 40 g/m2, and in Group B, environmental cleaning was performed, followed by 5% niclosamide ethanolamine salt granules sprayed with drones at a dose of 40 g/m2, while in Group C, environmental cleaning was not conducted and 5% niclosamide ethanolamine salt granules were sprayed with knapsack sprayers at a dose of 40 g/m2, and in Group D, environmental cleaning was performed, followed by 5% niclosamide ethanolamine salt granules sprayed with knapsack sprayers at a dose of 40 g/m2. Then, each group was equally divided into six sections according to land area, with Section 1 for baseline surveys and sections 2 to 6 for snail surveys after chemical treatment. Snail surveys were conducted prior to chemical treatment and 1, 3, 5, 7 days post-treatment, and the mortality and corrected mortality of snails, density of living snails and costs of molluscicidal treatment were calculated in each group.

RESULTS

The mortality and corrected mortality of snails were 69.49%, 69.09%, 53.57% and 83.48%, and 68.58%, 68.17%, 52.19% and 82.99% in groups A, B, C and D 14 days post-treatment, and the density of living snails reduced by 58.40%, 63.94%, 68.91% and 83.25% 14 days post-treatment relative to pre-treatment in four groups, respectively. The median concentrations of chemical molluscicides were 37.08, 35.42, 42.50 g/m2 and 56.25 g/m2 in groups A, B, C and D, and the gross costs of chemical treatment were 0.93, 1.50, 0.46 Yuan per m2 and 1.03 Yuan per m2 in groups A, B, C and D, respectively.

CONCLUSIONS

The molluscicidal effect of spraying 5% niclosamide ethanolamine salt granules with drones against O. hupensis snails is superior to manual chemical treatment without environmental cleaning, and chemical treatment with drones and manual chemical treatment show comparable molluscicidal effects following environmental cleaning in hilly regions. The cost of chemical treatment with drones is slightly higher than manual chemical treatment regardless of environmental cleaning. Spraying 5% niclosamide ethanolamine salt granules with drones is recommended in complex settings with difficulty in environmental cleaning to improve the molluscicidal activity and efficiency against O. hupensis snails.

Flexible Fluorinated Graphene/Poly(vinyl Alcohol) Films toward High Thermal Management Capability

Graphene is widely used in heat dissipation, owing to its inherently high in-plane thermal conductivity and excellent mechanical properties. However, its poor cross-plane thermal conductivity limits its use in some electronic applications. The electron distribution of graphene and the interaction with the base material can be greatly altered by introducing F, the most electronegative element, giving fluorinated graphene oxide (FG) with a high thermal conductivity. Herein, FG is prepared by grafting F atoms onto the surface of graphene oxide in a low-temperature solid-phase reaction with poly(vinylidene fluoride) as a fluorine source. This method can effectively avoid the use of dangerous substances such as HF and F2. The FG dispersion and aqueous poly(vinyl alcohol) (PVA) solution are sequentially vacuum-filtered to obtain the FG/PVA composite film. After natural drying and hot-pressing, the thermal conductivity of the N-FG/PVA film is enhanced by the hydrogen bond between F of FG and the hydroxyl group of PVA. The in-plane and cross-plane thermal conductivity of an N-FG/PVA film containing 10.4 wt % FG are 7.13 and 1.42 W m-1 k-1, respectively. The film has a tensile strength of 60 MPa and an elongation at a break of 28%, which is promising for the thermal management of flexible electronic devices.

[Research progress of optical coherence tomography and optical coherence tomography angiography in noninfectious uveitis: a review]

Non-infectious uveitis (NIU) is a challenging type of intraocular inflammatory disease that tends to recur and can be resistant to treatment. It can cause both transient and permanent pathological changes in the retina and choroid. Accurate diagnosis and monitoring of these changes rely heavily on ophthalmic imaging methods. In recent years, the enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT), swept-source optical coherence tomography (SS-OCT), and swept-source optical coherence tomography angiography (SS-OCTA) have emerged as rapidly evolving ophthalmic imaging techniques that offer significant advantages in evaluating choroidal thickness, displaying the whole choroid, and monitoring choroidal blood flow. This review provides an overview of the current research status of EDI-OCT, SS-OCT, and SS-OCTA in evaluating intraocular inflammation and other choroid-related complications in noninfectious intermediate uveitis, posterior uveitis, and panuveitis, and also highlights their future prospects.

Removal of organophosphorus agents via atomically dispersed Co on nitrogen-doped graphene: catalytic degradation and adsorption

In this work, we disperse Co atomically on three-dimensional networks of N-doped graphene (3DNG) through the impregnation of 3DNG with Co(Ac)₂·4H₂O solution followed by rapid pyrolysis. The structure, morphology and composition of the as-prepared composite, namely ACo/3DNG, are characterized. The atomically dispersed Co and enriched Co-N species afford the ACo/3DNG with unique catalytic activity for hydrolysis of organophosphorus agents (OPs), and the network structure and super-hydrophobic surface of 3DNG ensures excellent physical adsorption capacity. Thus, ACo/3DNG demonstrates good capability for removal of OPs pesticides from water.

[Progress of schistosomiasis control in People's Republic of China in 2022]

This report presented the endemic status of schistosomiasis and analyzed the data collected from the national schistosomiasis prevention and control system and national schistosomiasis surveillance program in the People's Republic of China in 2022. Among the 12 provinces (municipality and autonomous region) endemic for schistosomiasis, Shanghai Municipality, Zhejiang Province, Fujian Province, Guangdong Province and Guangxi Zhuang Autonomous Region continued to maintain the achievements of schistosomiasis elimination, and Sichuan and Jiangsu provinces maintained the criteria of transmission interruption, while Yunnan, Hubei, Anhui, Jiangxi and Hunan provinces maintained the criteria of transmission control by the end of 2022. A total of 452 counties (cites, districts) were found to be endemic for schistosomiasis in China in 2022, with 27 434 endemic villages covering 73 424 400 people at risk of infections. Among the 452 endemic counties (cities, districts), 75.89% (343/452), 23.45% (106/452) and 0.66% (3/452) achieved the criteria of elimination, transmission interruption and transmission control of schistosomiasis, respectively. In 2022, 4 317 356 individuals received serological tests for schistosomiasis, and 62 228 were sero-positive. A total of 208 646 individuals received stool examinations for schistosomiasis, with one positive and another two cases positive for urine microscopy, and these three 3 cases were imported schistosomiasis patients from Africa. There were 28 565 cases with advanced schistosomiasis documented in China by the end of 2022. Oncomelania hupensis snail survey was performed in 18 891 endemic villages in China in 2022 and O. hupensis snails were found in 6 917 villages (36.62% of all surveyed villages), with 8 villages identified with emerging snail habitats. Snail survey was performed at an area of 655 703.01 hm² and 183 888.60 hm² snail habitats were found, including 110.58 hm² emerging snail habitats and 844.35 hm² re-emerging snail habitats. There were 477 200 bovines raised in the schistosomiasis endemic areas of China in 2022, and 113 946 bovines received serological examinations for schistosomiasis, with 204 sero-positives detected. Among the 131 715 bovines received stool examinations, no positives were identified. In 2022, there were 19 726 schistosomiasis patients receiving praziquantel chemotherapy, and expanded chemotherapy was performed in 714 465 person-time for humans and 234 737 herd-time for bovines in China. In 2022, snail control with chemical treatment was performed at an area of 119 134.07 hm², and the actual area of chemical treatment was 65 825.27 hm², while environmental improvements were performed at an area of 1 163.96 hm². Data from the national schistosomiasis surveillance program of China showed that the mean prevalence of Schistosoma japonicum infections was both zero in humans and bovines in 2022, and no S. japonicum infection was detected in O. hupensis snails. These data demonstrated that the endemic status of schistosomiasis continued to decline in China in 2022, with 3 confirmed schistosomiasis patients that had a foreign nationality and all imported from Africa, and the areas of snail habitats remained high. Further improvements in the construction of the schistosomaisis surveillance and forecast system, and reinforcement of O. hupensis survey and control are required to prevent the re-emerging schistosomiasis.

Occupancy of orbitals and the quadrupole collectivity in 45Sc nucleus

In the present work, the Doppler Shift Attenuation method (DSAM) was used to analyze the observed lineshapes of transitions from excited states in ⁴⁵Sc, populated in the reaction ³⁶Ar + ¹²C at a beam energy of 145 MeV. The interpretation and comparison of the experimental results have been performed with large-scale shell model calculations, involving different interactions like: GX1A, GX1J, FPD6, KB3 and ZBM2. KB3 and FPD6 (present work) interactions in the negative parity states, and in positive parity states ZBM2 are most pre-eminent in reproducing the results, due to the large configuration space describing strong collective effects. Furthermore, the present work also looks at the details of the shell model helping in improving the understanding for the occupancy of orbitals. The present investigation suggests the observation of stronger collectivity for positive parity states over negative parity states with predicted enhanced collectivity of states in ⁴⁵Sc nucleus.

[Activation of GABAergic neurons in the zona incerta accelerates anesthesia induction with sevoflurane and propofol without affecting anesthesia maintenance or awakening in mice]

OBJECTIVE

To explore the regulatory effects of GABAergic neurons in the zona incerta (ZI) on sevoflurane and propofol anesthesia.

METHODS

Forty-eight male C57BL/6J mice divided into 8 groups (n=6) were used in this study. In the study of sevoflurane anesthesia, chemogenetic experiment was performed in 2 groups of mice with injection of either adeno-associated virus carrying hM3Dq (hM3Dq group) or a virus carrying only mCherry (mCherry group). The optogenetic experiment was performed in another two groups of mice injected with an adeno-associated virus carrying ChR2 (ChR2 group) or GFP only (GFP group). The same experiments were also performed in mice for studying propofol anesthesia. Chemogenetics or optogenetics were used to induce the activation of GABAergic neurons in the ZI, and their regulatory effects on anesthesia induction and arousal with sevoflurane and propofol were observed; EEG monitoring was used to observe the changes in sevoflurane anesthesia maintenance after activation of the GABAergic neurons.

RESULTS

In sevoflurane anesthesia, the induction time of anesthesia was significantly shorter in hM3Dq group than in mCherry group (P < 0.05), and also shorter in ChR2 group than in GFP group (P < 0.01), but no significant difference was found in the awakening time between the two groups in either chemogenetic or optogenetic tests. Similar results were observed in chemogenetic and optogenetic experiments with propofol (P < 0.05 or 0.01). Photogenetic activation of the GABAergic neurons in the ZI did not cause significant changes in EEG spectrum during sevoflurane anesthesia maintenance.

CONCLUSION

Activation of the GABAergic neurons in the ZI promotes anesthesia induction of sevoflurane and propofol but does not affect anesthesia maintenance or awakening.

Vapor-phase derived ultra-fine Bismuth nanoparticles embedded in carbon nanotube networks as anodes for sodium and potassium ion batteries

Bismuth (Bi) is a promising material as the anode for sodium-ion batteries (SIBs) and potassium-ion batteries (PIBs) due to its characteristics such as reasonable price and high theoretical volumetric capacity (3800 mAh cm^-3). Nevertheless, considerable drawbacks have hindered the practical applications of Bi, including its relatively low electrical conductivity and inevitable volumetric change during the alloying/dealloying processes. To solve these problems, we proposed a novel design:Bi nanoparticles were synthesized via a single-step low-pressure vapor-phase reaction and embedded onto the surfaces of multi-walled carbon nanotubes (MWCNTs). After being vaporized at 650℃ and 10^-5 Pa, Bi nanoparticles less than 10 nm were uniformly distributed in the three-dimensional (3D) MWCNT networks to form a Bi/MWNTs composite. In this unique design, the nanostructured Bi can reduce the risk of structural rupture during cycling, and the structure of the MWCMT network is beneficial in shortening the electron/ion transport path. In addition, MWCNTs can improve the overall conductivity of the Bi/MWCNTs composite and prevent particle aggregation, thus improving the cycling stability and rate performance. As an anode material for SIB, the Bi/MWCNTs composite has demonstrated excellent fast charging performance with a reversible capacity of 254 mAh/g at 20 A/g. A capacity of 221mAhg^-1 after cycling at 10 A/g for 8000 cycles has also been achieved for SIB. As an anode material for PIB, the Bi/MWCNTs composite has delivered excellent rate performances with a reversible capacity of 251 mAh/g at 20 A/g. A specific capacity of 270mAhg^-1 after cycling at 1Ag^-1 for 5000 cycles has also been achieved for PIB.

Detection of haemodynamic obstruction in hypertrophic cardiomyopathy using the sub-aortic complex: a cardiac MRI and Doppler study

AIM

To investigate the "sub-aortic complex (SAC)", a new cardiac magnetic resonance imaging (CMRI)-derived parameter, for the evaluation of left ventricular (LV) outflow tract (LVOT) obstruction in patients with hypertrophic cardiomyopathy (HCM), compared with conventional CMRI parameters and Doppler echocardiography.

MATERIALS AND METHODS

A total of 157 consecutive patients with HCM were recruited retrospectively. The patients were divided into two groups, 87 with LVOT obstruction and 70 without obstruction. The SAC was defined as a specific anatomical SAC affecting the LVOT, which were measured on the LV three-chamber steady-state free precession (SSFP) cine image at the end-systolic phase. The relations between the existence and severity of obstruction and SAC index (SACi) were evaluated using Pearson's correlation coefficient, receiver operating characteristic (ROC) curves, and logistic regression.

RESULTS

The SACs were significantly different between the obstructive and non-obstructive groups. The ROC curves indicated that the SACi was able to discriminate obstructive and non-obstructive patients with the best predictive accuracy (AUC = 0.949, p<0.001). The SACi was an independent predictor of LVOT obstruction and there was a significant negative correlation between resting LVOT pressure gradient and SACi (r=0.72 p<0.001). In the subgroup of patients with or without severe basal septal hypertrophy, the SACi was still able to predict LVOT obstruction with excellent diagnostic accuracy (AUC = 0.944 and 0.948, p<0.001, respectively).

CONCLUSION

The SAC is a reliable and straightforward CMRI marker for assessing LVOT obstruction. It is more effective than CMRI two-dimensional flow in diagnosing the severity of obstruction in patients with HCM.

Oxidative Cleavage of β-O-4 Linkage in Lignin via Co Nanoparticles Embedded in 3DNG as Catalyst

The cleavage of β-O-4 linkage in lignin is one of the key steps for oxidative conversion of lignin to low-molecular-weight aromatics. Herein, Co nanoparticles embedded in three-dimensional network of nitrogen-doped graphene (Co/NG@3DNG-X) were prepared through an immersion-pyrolysis procedure, in which X denotes the pyrolysis temperature. The detailed characterization of Co/NG@3DNG-X shows that the Co nanoparticles are coated with a few layers of nitrogen-doped graphene (NG) sheets that are further embedded in 3DNG matrix. The catalytic activities of the Co/NG@3DNG-X for the oxidative cleavage of β-O-4 linkage in lignin model compounds with O₂ as oxidant are explored. It is demonstrated that catalytic activities of as-prepared Co/NG@3DNG-X can be tuned by varying the pyrolysis condition, and the Co/NG@3DNG-900 shows the highest catalytic activity, which is attributed to the enriched Co-N_x species, the strong surface basicity, the high specific surface and the mesoporous motif of 3DNG network. More pronouncedly, the Co/NG@3DNG-900 can also effectively catalyze the oxidative cleavage of organosolv lignin, generating certain monomeric aromatics. Additionally, the intrinsic magnetic property of Co nanoparticles makes the Co/NG@3DNG-X be easily recovered from the reaction mixture, and the as-coated thin NG layer can protect Co nanoparticle from oxidation condition, which putting together afford the Co/NG@3DNG-X with good reusability and stability.

[Prevalence and related factors of visual disability, hearing disability and comorbidity of visual and hearing disability among the elderly in China]

Objective: To estimate the prevalence of visual disability, hearing disability and comorbidity of visual and hearing disability among the elderly in China, and explore the related factors of comorbidity of visual and hearing disability in the elderly. Methods: This was a cross-sectional study. Based on the Second China National Sample Survey on Disability in 2006, the data of the elderly with visual and hearing disability were extracted and combined for descriptive analysis. Meanwhile, multivariate logistic regression model was used to analyze the related factors of comorbidity of visual and hearing disability among the elderly. Results: A total of 250 752 cases were in the final analysis (119 120 males and 131 632 females), and there were 164 003, 74 156 and 12 593 cases with the age of 65-<75, 75-<85 and ≥ 85 years, respectively. The prevalence of visual disability and hearing disability of the elderly in China was 8.10% (95%CI: 8.00%-8.21%), 13.41% (95%CI: 13.29%-13.54%), respectively, while the prevalence of comorbidity of visual and hearing disability was 1.97% (95%CI: 1.92%-2.02%). The severity of disability of the elderly with comorbidity of visual and hearing disability was higher, and the percentage of mild disabilities (18.31%, 966/5 277) was lower than those with visual (53.06%, 11 208/21 123) or hearing disabilities (32.96%, 11 536/34 995). Moreover, 19.40% (1 024/5 277) of visual or hearing disability occurred in the same year. Multivariate logistic regression analysis showed that education level below primary school (OR=0.65, 95%CI: 0.61-0.70, P<0.001), having a spouse (OR=0.68, 95%CI: 0.64-0.72, P<0.001), living in an urban area (OR=0.77, 95%CI: 0.71-0.82, P<0.001) and having a per capita household income higher than the national average (OR=0.73, 95%CI: 0.68-0.78, P<0.001) were protective factors for comorbidity of visual and hearing disability among the elderly. Conclusions: Visual disability is correlated with hearing disability in the elderly. Attention should be paid to the prevention and control of associated disabilities such as visual and hearing co-disabilities in the elderly population, with emphasis on strengthening publicity and education on prevention and control of visual and hearing disabilities for the elderly who are economically disadvantaged, have no spouse and live in remote areas.

A Case of ALECT2 Renal Amyloidosis Associated with IgG4 Related Kidney Disease, Membranous Nephropathy and Early Diabetic Kidney Injury

Introduction/Objective

ALECT-2 amyloidosis is a rare type of amyloidosis that mostly involves kidneys with other organs rarely affected. It has a high prevalence among patients of Hispanic descent. Membranous nephropathy is one of the most common causes of proteinuria in adults. IgG4-related disease is a systemic disease, which commonly involves the pancreas, but occasionally affects the kidney and manifests as chronic renal insufficiency. Here we describe a very unusual case of concurrence of membranous nephropathy, IgG4 disease involving the kidney, ALECT2 amyloidosis, and early diabetic kidney injury.

Methods/Case Report

A 49-year-old Hispanic male patient with a history of diabetes and IgG4-related autoimmune pancreatitis and primary sclerosing cholangitis presented with abrupt onset of proteinuria and hypoalbuminemia. A kidney biopsy was performed and showed severe interstitial plasma cell-rich inflammatory infiltrates and interstitial fibrosis which had a storiform pattern. The glomerular basement membranes (GBM) showed focal pinpoint holes but no spikes by silver stain. Immunofluorescence microscopy (IF) showed diffuse and finely granular capillary loop staining for IgG, with Kappa and lambda light chains of equal intensity. IF for Anti-phospholipase A2 receptor (PLA2R) was negative. Immunohistochemical (IHC) stain showed IgG4 positivity in about 60% of IgG-positive plasma cells. Congo red was positive for birefringent deposits predominantly in the interstitium and arteriolar walls with focal deposits in the glomerular mesangium and capillary wall. IHC stain for Amyloid AA and DNAJB9 were negative. Electron microscopy showed scattered subepithelial immune complex-type electron dense deposits consistent with membranous nephropathy, randomly oriented fibrils in interstitium, mesangium and GBM, consistent with amyloidosis, and thickening of GBM (average 559 nm), consistent with early diabetic kidney change. The tissue was sent for mass spectrometry which showed a peptide profile consistent with ALECT-2 (Leukocyte chemotactic factor 2) type amyloidosis.

Results (if a Case Study enter NA)

NA

Conclusion

In up to a third of cases reported in the literature, a concomitant renal pathology was present. Diabetic nephropathy was the most common concurrent pathology, to be followed by IgA nephropathy and membranous nephropathy. However, the concurrence of membranous nephropathy, IgG4 disease involving the kidney, ALECT2 amyloidosis, and early diabetic kidney injury has never been described before.

[Clinical features and risk factors for early relapse of pediatric ulcerative colitis]

Objective: To investigate the clinical features of pediatric ulcerative colitis (UC) and analyze the risk factors of disease relapse. Methods: The clinical data of 79 children with UC diagnosed in Beijing Children's Hospital, Capital Medical University from January 2016 to February 2021 were retrospectively analyzed. They were divided into early relapse group and non-early relapse group according to the clinical relapse within 12 months after diagnosis. T-test, rank sum test, χ² test or Fisher's exact test were used to compare the variables between the 2 groups, including the clinical features, laboratory examination results and treatments. The Logistic regression was used to analyze the risk factors of early relapse. The cumulative relapse rate during follow-up was calculated by Kaplan-Meier method. Results: Among the 79 UC children, 46 were males and 33 were females, and the age of onset was 10.6 (6.4, 12.7) years. The children were mainly characterized by extensive disease (E3) and pancolitis (E4) (51/79, 65%), moderate to severe activity (48/79, 61%) and moderate to severe inflammation of colonic mucosa (71/79, 90%). Thirty-eight (48%) patients had atypical phenotype and 17 (22%) had extraintestinal manifestations. The follow-up period was 43.9 (22.8, 61.3) months, and of the 41 patients rechecked with colonoscopy, 7 (17%) had disease progression. According to Kaplan-Meier analysis, the cumulative relapse rate of the 79 cases at 3 months, 6 months, 1 year and 2 years after diagnosis were 27% (21/79), 47% (37/79), 57% (45/79) and 73% (53/73), respectively. There were 45 children (57%) in early relapse group and 34 (43%) in non-early relapse group. In early relapse group, hemoglobin and mucosal healing rate were both significantly lower (105 (87, 122) vs. 120 (104, 131) g/L, 28% (7/25) vs. 7/9, Z=-2.38, χ²=4.87, both P<0.05). The rate of steroid-dependent, E3 and step-up therapy during the induction period were all significantly higher than those in non-early relapse group (11/19 vs. 1/12, 24% (11/45) vs. 6% (2/34), 29% (13/45) vs. 6% (2/34), χ²=5.67, 4.85, 6.66, all P<0.05). Multivariate Logistic regression analysis showed that extraintestinal manifestations (OR=4.33, 95%CI 1.05-17.83), E3 (OR=8.27, 95%CI 1.47-46.46) and step-up therapy during the induction period (OR=5.58, 95%CI 1.01-30.77) were independent risk factors for early relapse. Conclusions: Pediatric UC is usually extensive and severe, with atypical phenotype, a high rate of relapse and a risk of disease progression. Extraintestinal manifestations, E3 and step-up therapy during the induction period are independent risk factors for early relapse.

Probing ^{93m}Mo Isomer Depletion with an Isomer Beam

The isomer depletion of ^{93m}Mo was recently reported [Chiara et al., Nature (London) 554, 216 (2018)NATUAS0028-083610.1038/nature25483] as the first direct observation of nuclear excitation by electron capture (NEEC). However, the measured excitation probability of 1.0(3)% is far beyond the theoretical expectation. In order to understand the inconsistency between theory and experiment, we produce the ^{93m}Mo nuclei using the ^{12}C(^{86}Kr,5n) reaction at a beam energy of 559 MeV and transport the reaction residues to a detection station far away from the target area employing a secondary beam line. The isomer depletion is expected to occur during the slowdown process of the ions in the stopping material. In such a low γ-ray background environment, the signature of isomer depletion is not observed, and an upper limit of 2×10^{-5} is estimated for the excitation probability. This is consistent with the theoretical expectation. Our findings shed doubt on the previously reported NEEC phenomenon and highlight the necessity and feasibility of further experimental investigations for reexamining the isomer depletion under low γ-ray background.

MicroRNA-29a-3p regulates chemosensitivity in hypopharyngeal carcinoma via targeting Cdc42

INTRODUCTION

Hypopharyngeal carcinoma is one kind of high malignant tumour followed by poor prognosis in head and neck carcinomas. This study aimed to detect miR-29a-3p and Cdc42 in patients with hypopharyngeal carcinoma.

MATERIALS AND METHODS

The expression of miR-29a-3p and Cdc42 mRNA were detected, and the correlation between miR-29a-3p/Cdc42 and clinical stages was investigated.

RESULTS

The relative expression of miR-29a-3p in stage II, III and IV hypopharyngeal carcinoma tissues was significantly lower than that of stage I (P< 0.05). The relative expression of Cdc42 mRNA in stage I, III and IV tissues was significantly higher than that of stage I (P< 0.05). The expression of miR-29a-3p in hypopharyngeal carcinoma with lymph node metastasis was significantly lower than that without lymph node metastasis (P = 0.045).

CONCLUSION

MiR-29a-3p and Cdc42 mRNA could be potential diagnostic biomarkers of hypopharyngeal carcinoma.

The effect of neuropilin-1 silencing on the transforming growth factor-β1-mediated epithelial-mesenchymal transition of colon cancer SW480 cells and its effect on the proliferation and migration of colon cancer cells

This study aimed to investigate the effect of neuropilin-1 (NRP-1) silencing on epithelial-mesenchymal transformation (EMT) mediated by transforming growth factor-β1 (TGF-β1) and on the proliferation and migration of colon cancer SW480 cells. After transfection of small interfering ribonucleic acid (siRNA)-NRP-1 into colon cancer SW480 cells, the messenger RNA (mRNA) and protein expression levels of NRP-1 were detected using quantitative real-time polymerase chain reaction (qRT-PCR) and Western blot. Four EMT models were induced using 0, 2, 5, and 10 ng/mL TGF-β1, respectively. Cell proliferation was detected using Cell Counting Kit-8, and the protein levels of EMT markers E-cadherin and vimentin were detected using Western blot. EMT was induced in the transfected SW480 cells using TGF-β1, after which four groups were created: a negative control group (siRNA-Ncontrol), a transfection group (siRNA-NRP-1), an induction group (TGF-β1), and a transfection + induction group (siRNA-NRP-1+TGF-β1). Western blot was then used to detect the expression of E-cadherin and vimentin, and cell proliferation and migration were detected using cell counting kit-8 (CCK-8) and scratch assay. After transfection with siRNA-NRP-1, the mRNA and protein expression levels of SW480 cells were significantly decreased (P<0.05). After 48 hours of induction with 10 ng/mL TGF-β1, cell proliferation was obvious, E-cadherin expression decreased, and vimentin expression significantly increased (P<0.05), indicating that EMT had been successfully induced compared with the induction group, the transfection + induction group had significantly increased E-cadherin expression after corresponding treatments (including transfection and induction alone) (P<0.05), and the proliferation and migration of colon cancer cells decreased (P<0.05). In conclusion: silencing, NRP-1 in colon cancer SW480 cells can partially reverse TGF-β1-mediated EMT, reduce the proliferation activity of colon cancer cells, and slow their migration ability. Therefore, NRP-1 may become a new target for the treatment of colon cancer.

[Analysis of failure causes and countermeasures of automatic coagulation analyzer detection of thrombin time]

To study the failure alarm information displayed on the automatic coagulation analyzer (coagulation method) of thrombin time (TT), and formulate the coping strategies combined with clinical information. Methods: A total of 233 failed TT blood samples [132 males, 101 females, with a median age of 73 (66, 79) years] were selected from 21 359 inpatients in Peking University First Hospital from January to June 2021. The statistical analysis was made and the failure causes and solutions were summarized according to the coagulation curve and the error codes displayed on the coagulation instrument, in combination with the clinical information, sample characteristics, medication status and other reasons. Meanwhile, a total of 96 TT detection failed lipid blood samples [56 males, 40 females, with a median age of 72 (65, 79) years] were analyzed from the inpatients in Peking University First Hospital from July to November 2021. TT results were obtained by artificial coagulation curve interpretation method, magnetic bead method and high-speed centrifugal re-detection method, respectively. The TT results of the three methods were compared. Results: The proportion of 233 failed TT tests from the total number of samples was 1.1% (233/21 359). There were 41.2% (96/233) samples with lipids, 23.2% (54/233) samples with heparin interference, 22.3% (52/233) samples with oral anticoagulant, and 13.3% (31/233) samples with micro-coagulation or insufficient plasma volume among these test failure samples. The classifications for these alarm information of coagulation curves showed on the instrument were as follows: 32.6% (76/233) of samples with higher changes in absorbance at baseline (SD>2 mAbs), 30.5% (71/233) of samples without peak values of second derivative, 25.8% (60/233) of samples with absorbance difference<35 mAbs between baseline and plateau period, 8.6% (20/233) samples with too low starting point or no starting point, and 2.6% (6/233) samples without coagulation curves. Among these 233 samples, there were 55.8% (130/233) samples that could be manually judged according to the reaction principle and standard coagulation curve pattern. Among the 96 samples that failed in coagulation method due to lipemia, there were 78 samples with sufficient blood volume tested by magnetic bead method. The TT results of the high-speed centrifugal redetection method, artificial coagulation curve interpretation method and magnetic bead method were 14.10 (14.80, 13.38) s, 14.30 (14.99, 13.60) s, and 15.65 (17.25, 14.65) s, respectively, but the difference was not statistically significant (P=0.055). For 78 lipid samples, there was a correlation between the results of the artificial coagulation curve interpretation method and the results of magnetic bead method (r=0.99,P=0.001). Conclusions: For those samples failed in TT detection by coagulation method on automatic coagulation instrument, the cause of failure can be analyzed through coagulation curve and alarm information. For the lipid samples, TT results can be obtained by manual interpretation method, high-speed centrifugation method and magnetic bead method.

[Preliminary study on differentially expressed proteins in a mouse model of secondary cystic echinococcosis based on data independent acquisition proteomics]

OBJECTIVE

To identify the differentially expressed proteins in different liver tissues in the mouse model of cystic echinococcosis (CE), so as to provide insights into the research and development of therapeutic drugs targeting CE.

METHODS

Female Kunming mice at ages of 6 to 8 weeks were randomly assigned into the CE group and the control group. Mice in the CE group were intraperitoneally infected with 2 000 Echinococcus multilocularis protoscoleces, while mice in the control group were injected with the same volume of physiological saline. All mice in both groups were sacrificed after breeding for 350 d, and the lesions (the lesion group) and peri-lesion specimens (the peri-lesion group) were sampled from the liver of mice in the CE group and the normal liver specimens (the normal group) were sampled from mice in the control group for data independent acquisition (DIA) proteomics analysis, and the differentially expressed proteins were subjected to Gene Ontology (GO) term enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis.

RESULTS

A total of 26 differentially expressed proteins were identified between the lesion group and the normal group and between the peri-lesion group and the normal group, including 8 up-regulated proteins and 18 down-regulated proteins. GO term enrichment analysis showed that these differentially expressed proteins were predominantly enriched in endoplasmic reticulum membrane (biological components), oxidoreductase activity (molecular function) and oxoacid metabolic process and monocarboxylic acid metabolic process (biological processes). KEGG pathway enrichment analysis revealed that the differentially expressed protein Acyl-CoA oxidase 1 (Acox1), which contributed to primary bile acid biosynthesis during the fatty acid oxidation, was involved in peroxisome signaling pathway, and the differentially expressed protein fatty acid binding protein 1 (Fabp1), which contributed to fatty acid transport, was involved in the peroxisome proliferator-activated receptor (PPAR) signaling pathway.

CONCLUSIONS

Differentially expressed proteins are identified in the liver specimens between mouse models of CE and normal mice, and some differentially expressed proteins may serve as potential drug targets for CE.

[Preliminary study on differentially expressed proteins in a mouse model of secondary alveolar echinococcosis based on data independent acquisition proteomics]

OBJECTIVE

To identify the differentially expressed proteins in different liver tissues in the mouse model of alveolar echinococcosis using high-resolution mass spectrometry with data independent acquisition (DIA), and to identify the key proteins contributing to the pathogenesis of alveolar echinococcosis.

METHODS

Protoscoleces were isolated from Microtus fuscus with alveolar echinococcosis and the experimental model of alveolar echinococcosis was established in female Kunming mice aged 6 to 8 weeks by infection with Echinococcus multilocularis protoscoleces. Mice were divided into the experimental and control groups, and animals in the experimental group was injected with approximately 3 000 protoscoleces, while mice in the control group were injected with the same volume of physiological saline. Mouse liver specimens were sampled from both groups one year post-infection and subjected to pathological examinations. In addition, the lesions (the lesion group) and peri-lesion specimens (the peri-lesion group) were sampled from the liver of mice in the experimental group and the normal liver specimens (the normal group) were sampled from mice in the control group for DIA proteomics analysis, and the differentially expressed proteins were subjected to bioinformatics analysis.

RESULTS

A total of 1 020 differentially expressed proteins were identified between the lesion group and the normal group, including 671 up-regulated proteins and 349 down-regulated proteins, and 495 differentially expressed proteins were identified between the peri-lesion group and the normal group, including 327 up-regulated proteins and 168 down-regulated proteins. The Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis revealed that these differentially expressed proteins were involved in peroxisome, peroxisome proliferator-activated receptor (PPAR) and fatty acid degradation pathways, and the peroxisome and PPAR signaling pathways were found to correlate with liver injury. Several differentially expressed proteins that may contribute to the pathogenesis of alveolar echinococcosis were identified in these two pathways, including fatty acid binding protein 1 (Fabp1), Acyl-CoA synthetase long chain family member 1 (Acsl1), Acyl-CoA oxidase 1 (Acox1), Enoyl-CoA hydratase and 3-hydroxyacyl CoA dehydrogenase (Ehhadh) and Acetyl-Coenzyme A acyltransferase 1B (Acaa1b), which were down-regulated in mice in the experimental group.

CONCLUSIONS

A large number of differentially expressed proteins are identified in the liver of the mouse model of alveolar echinococcosis, and Fabp1, Acsl1, Acox1, Ehhadh and Acaa1b may contribute to the pathogenesis of alveolar echinococcosis.

The rational design of nickel-cobalt selenides@selenium nanostructures by adjusting the synthesis environment for high-performance sodium-ion batteries

Different selenization products (from the perspectives of micromorphology and sodium storage performance) can be obtained via regulating the selenization environment.

[Microscopic observation of the enamel microstructures of SD rats with different degrees of fluorosis]

Objective: To establish a dental fluorosis model of SD rats with various degrees, to observe the microstructures of enamel samples under scanning electron microscope and to clarify the changes of enamel microstructures with various degrees of dental fluorosis, so as to provide clinical reference for the treatment of patients with moderate and severe dental fluorosis. Methods: Thirty male SD rats (6 weeks of age) were randomly divided into 3 groups with 10 rats in each group. The control group was fed with deionized water without fluoride, the low fluoride group was fed with 50 mg/L NaF deionized water and the high fluoride group was fed with 100 mg/L NaF deionized water in order to establish the dental fluorosis model of rats. After feeding for 6 weeks, the rats were sacrificed and the mandibular incisor teeth were collected and recorded. The surface and sagittal plane of each tooth were observed by scanning electron microscopy and the enamel thickness was measured. Results: In the control group, the enamel color was brown yellow. Enamel color discoloration occurred both in low-fluoride group and high-fluoride group. The enamel color in low-fluoride group was mostly yellow and white striped while in high-fluoride group was mostly chalky white. Under electronic microscope, the enamel rods were alternately arranged and their structure was clear and plump in the control group. The enamel rods of moderate fluorosis were arranged in a straight orientation like tips of bamboo shoots. The enamel rods of severe fluorosis, however, became thinner and the tips of rods were broken. In the control group, sagittal images of enamel turned out to be a dense outer structure with clear boundaries among the inner. The structure of the middle layer was reticulated showing a clear boundary with middle and outer layers. The structure of enamel rods in the inner layers was arranged vertically and horizontally. In the moderate fluorosis group, the outer layer of the enamel became thinner and the middle layer disappeared although the boundary between the outer and middle layers was still clear. In the inner layer, the vertically arranged enamel rods seemed still clear, however the horizontal enamel rods disappeared. In the severe fluorosis group, the outer layer could not be traced. The middle layer was exposed to the air and the inner enamel rods contracted. The inner layers of the enamel had gradually become thinner with the development of the dental fluorosis. The thicknesses of inner layers in control, moderate and the severe groups were (180.71±7.01), (157.10±11.04) and (121.10±12.56) μm respectively. As for the thicknesses of the full layers in the above mentioned three groups, the same trend was observed. The thicknesses, in order of the severity of dental fluorosis, were (241.54±7.76), (207.42±14.36) and (143.79±14.60) μm. Conclusions: With the development of dental fluorosis, the outer enamel layers became thinner or disappeared and the inner enamel layers became thinner or lost its normal structure as well. It is highly recommended that the resin penetration could be used for the proper treatment of moderate and severe dental fluorosis and the strong bleaching and the micro-grinding should be used cautiously.

Hydrolysis of Organophosphorus Agents Catalyzed by Cobalt Nanoparticles Supported on Three-Dimensional Nitrogen-Doped Graphene

Catalytic chemical degradations and many other methodologies have been explored for the removal and/or degradation of organophosphorus agents (OPs) that are often used as pesticides, nerve agents, and plasticizers. To explore more efficient and recyclable catalysts for the removal and/or degradation of OPs, we fabricate the composites of cobalt nanoparticles and three-dimensional nitrogen-doped graphene (Co/3DNG). We demonstrate that OPs can be hydrolyzed efficiently at ambient temperature by the Co/3DNG. Because of the unique structural and chemical properties of the supporting matrix 3DNG and active species Co-N, the catalytic activities of Co/3DNG composites are much higher than those of bare 3DNG, Co nanoparticles, or the Co nanoparticles physically mixed with 3DNG. We conclude that in the Co/3DNG composites, the interaction between 3DNG and Co stabilizes and distributes well the Co nanoparticles and affords the active catalytic species Co-N.

[Study on epidemic trend of hemorrhagic fever with renal syndrome in Zhejiang province, 2005-2020]

Objective: To analyze the epidemiological characteristics and spatiotemporal distribution of hemorrhagic fever with renal syndrome (HFRS) in Zhejiang province from 2005 to 2020, and provide scientific information for the precise prevention and control of HFRS. Methods: Data on HFRS cases in Zhejiang province during 2005-2020 were collected from the China National Notifiable Infectious Disease Reporting Information System (NNDS) for a descriptive analysis, and software ArcGIS 10.2 was used for global autocorrelation and local autocorrelation analyses. Spatiotemporal clusters were scanned with SaTScan 9.4.4 and visualized with ArcGIS 10.2. Results: A total of 7 724 HFRS cases were reported in Zhejiang province from 2005 to 2020, including 25 deaths. There were two incidence peaks each year, in late spring and early summer (May-June) and in winter (November-January). The top three areas with high cumulative cases were Ningbo (1 875, 24.27%), Taizhou (1 642, 21.25%), and Shaoxing (1 123, 14.54%). Among the reported cases, with a male to female ratio of 2.73∶1(5 656∶2 068). The majority of HFRS cases were middle-aged and elderly people, with cases aged 41-70 years accounting for 60.95%. Most HFRS cases were farmers, accounting for 69.89% (5 398/7 724). The spatial distribution of HFRS in most years was correlated. SaTScan was used for retrospective spatiotemporal scanning and three clusters were detected: the first type clusters were in 21 counties in eastern Zhejiang province and central Zhejiang province, among which 4 were in Ningbo, Shaoxing and Jinhua, 8 were in Taizhou, and 1 was in Lishui (RR=13.69, LLR=5 522.60, P<0.001); the second type clusters were in Longquan and Qingyuan counties (RR=31.20, LLR=1 232.46, P<0.001); the third types of clusters were in Changxing and Anji counties of Huzhou in northern Zhejiang province (RR=3.42, LLR=23.93, P<0.001). Conclusions: HFRS mainly occurred in middle-aged,elderly and male farmers in Zhejiang province. The incidence was high in late spring, early summer and winter in eastern Zhejiang province. Precise prevention and control measures are needed for populations at high risk before the epidemic season.