Objective:To understand the epidemic characteristics and risk factors of severe fever with thrombocytopenia syndrome (SFTS) in Zhaoyuan City, and to provide basis for the improvement of prevention and control strategies.Methods:Retrospective analysis was performed to collect the SFTS surveillance data and epidemiological investigation results of confirmed cases in Zhaoyuan City from 2011 to 2018 from the "Infectious Disease Report Information Management System of the China Disease Prevention and Control Information System", and the general situation and epidemiological characteristics, onset and treatment, clinical manifestations and contact history of SFTS cases were analyzed by descriptive epidemiology method; 60 cases of SFTS confirmed cases and 120 healthy people in the same village, same sex, and same age group as the confirmed case were selected by case-control study to analyze the risk factors of SFTS.Results:A total of 140 confirmed SFTS cases were reported in Zhaoyuan City from 2011 to 2018, with a fatality rate of 18.57% (27/140); the onset time was mainly from May to August, accounting for 83.57% (117/140); the age of onset was mainly 50 - 80 years old, accounting for 90.00%(126/140); the sex ratio of men to women was 1.06 ∶ 1.00 (72 ∶ 68); the occupation distribution was dominated by farmers, accounting for 92.14% (129/140). In 140 cases of SFTS, the average time intervals from onset to first visit and from first visit to confirmation of diagnosis were 4 and 6 days, respectively; and the average medical visit history from onset to diagnosis was 2 times, 60.71% (85/140) of the cases were first diagnosed by township medical institutions, 86.43% (121/140) of the cases were diagnosed by municipal hospitals; the first symptom was fever, which accounted for 92.86% (130/140). The logistic regression analysis showed that domestic animals [odds ratio ( OR)=9.209, 95% confidence interval ( CI): 2.064-41.083] and tick bites ( OR = 16.818, 95% CI: 1.553 - 182.164) were risk factors for SFTS. Conclusions:The onset time of SFTS is mainly from May to August in Zhaoyuan City, and farmers over 50 years old are the key population; domestic animals and tick bites are the risk factors for the onset of SFTS. The publicity and health education of SFTS prevention and control knowledge for key populations should be strengthened.

Objective To evaluate the clinical value of bronchial artery infusion(BAI)combined with percutaneous intratumor alcohol injection(PAI)in the treatment of advanced lung cancer.Methods Thirty-two lesions confirmed by pathology,including 13 cases of primary bronchogenic carcinoma and 5 cases of pulmonary multi-metastasis tumor from hepatocellular carcinoma,were treated by 52 times of BAI and 78 times of PAI guided by fluoroscopy or CT .One cases of lung tumor was operated after the interventional therapy,and the specimen was studied with pathologic histology.Results The pathologic finding showed there was a large area necrosis in the tumor.The total effective rate of treatment was 83.8%.The 6,12 and 18 months suivival rates were 100%,77.7% and 61% respectively.Conclusion The combined interventional therapy of BAI and PAI is a more effective synthetical method for treatment only for primary tumor,but also metastasis lesions.It have better cooperative effect on the bigger lesions of lung carcinoma.

Objective To investigate the mechanism of Smad ubiquitination-related factor 2 (Smurf2)neddylation. Methods The Smurf2 protein level was tested by overexpression of Nedd8,while the method of immunoprecipitation(IP) and Western blotting were used to analyz Smurf2-Nedd8 modification.The GST-pulldown experiment was conducted to prove protein interactions.The protein was obtained by grinding mouse tissue and Western blotting was used to test the protein expression level.Results Over expression of Nedd8 could lead to the down regulation of the Smurf2′s protein level.Smurf1 and Smurf2 could interact in the GST-pulldown experiment. Smurf1 could enhance Smurf2-Nedd8 modification.The Smurf2′s protein level was up-regulated in mouse tissue of Smurf1 C426A.Conclusion There is some relationship and also difference between Smurf1 and Smurf2.Smurf1 can enhance Smurf2-Nedd8 modification.

Objective To observe the clinical therapeutic effect of oral solution of Huaixue Shenshu for treatment of patients with IgA nephropathy and explore its mechanism. Methods A prospective study was conducted. Forty patients with IgA nephropathy diagnosed by pathology were selected, and they were randomly divided into treatment group and control group, 20 cases in each group. The two groups were subjected to the routine treatment, and on this base, the control group also received cozaar 50-100 mg, while the treatment group additionally received oral solution of Huaixue Shenshu decoction (drug composition:Centellae herba 15 g, Sophorae Flos 20 g, Ecliptae Herba 20 g, Ligustri Lucidi Fructus 15 g, Cicadae Periostracum 15 g, Pyrolae Herba 20 g, Saposhnikoviae Radix 10 g, Astragali Radix 15 g, the above ingredients were immersed in water and boiled to form 200 mL decoction, as a dose, and then divided into two parts to take orally one of them each time, twice a day). Both groups took two therapeutic courses in total, 3 months constituting one course. After treatment, the integral changes of clinical symptoms and clinical efficacy were observed, and before treatment and 3 months and 6 months after treatment, the 24-hour urine protein, serum creatinine (SCr), and albumin (Alb) were measured in the two groups. Results Before treatment, there was no significant difference in integral of clinical symptoms between treatment group and control group (score: 18.42±5.41 vs. 19.95±6.25, P>0.05);after treatment, the integrals of two groups were significantly lower than those before treatment, and the degree of decrease in treatment group was more obvious (score: 6.35±2.11 vs. 9.45±3.55, P < 0.05). After treatment the total effective rate in treatment group was significantly higher than that in control group [75.0% (15/20) vs. 40.0% (8/20), P<0.05]. Before treatment, the differences in 24-hour urinary protein, SCr and Alb were not significant between the two groups (all P > 0.05); with the prolongation of treatment, the 24-hour urinary protein was decreased gradually, and Alb was increased gradually, reaching its peak after 6 months of treatment, and the changes were more obvious in treatment group [24-hour urinary protein (g):0.71±0.58 vs. 1.31±0.55, Alb (g/L):37.8±6.1 vs. 35.5±5.2, both P<0.01]. No significant difference in SCr was found before and after treatment between the two groups (both P > 0.05). Conclusion The effect of oral solution of Huaixue Shenshu in treatment of IgA nephropathy is good.

Objective To study the clinical,pathological and genetic features of myofibrillar myopathy caused by BAG3 gene mutation.Methods The clinical features and pathological findings of a patient with myofibrillar myopathy were analyzed.Genomic DNA of the patient was extracted from peripheral blood and the next generation sequencing was performed to explore the mutation of genes about myopathies.Results The patient presented with nine-year-old onset myopathy characterized by progressive difficulty for squatting,rigid spine and muscle atrophy in the limbs symmetrically.Peripheral neurogenic damages were found on electromyography.On muscle biopsy,myogenic and neurogenic damages with rimmed vacuoles appeared,and the deposited materials were positive for sarcoglycan,dystrophin-R and dystrophin-C.There was a reported heterozygous mutation in the exons of the BAG3 gene (c.626C ＞ T).Conclusion There is no specificity of clinical manifestation in myofibrillar myopathy,and the diagnosis of this disease mainly depends on muscle biopsy and genetic screening.

AIM:To observe the effect of Wnt/β-catenin signaling pathway on diabetic ulcer.METHODS:Diabetic animal model was established in the female Wistar rats by intraperitoneal injection of low-dose streptozotocin fol-lowing high-fat diet feeding.A circular wound was made on the dorsum of the rats in both control group and diabetic group. The condition of wound healing was recorded and the structures of the wound tissues were observed by HE staining in the 2 groups at 3, 7 and 14 d after wounding.The expression ofβ-catenin, GSK-3βand Rspo-3 at mRNA and protein levels in the wound tissues was detected by RT-PCR and ELISA.RESULTS:In diabetic group, the wound healing rate was lower (P<0.05), and the inflammatory cells, fibroblast cells and new capillaries in the wound tissues were fewer than those in control group.The expression of β-catenin and Rspo-3 at mRNA and protein levels in the wound tissues in control group was significantly higher than those in diabetic group, and the expression of GSK-3βwas exactly the opposite (P<0.05). CONCLUSION:The down-regulation of Wnt/β-catenin probably resultes from the decreased level of Rspo-3, which may be one of the reasons for delaying the diabetic ulcer healing.

Objective To investigate the effect of Bcl-2 gene expression on the proliferation and apoptosis of human pancreatic cancer SW1990 cells.Methods Bcl-2 short guide RNA (Bcl-2-sgRNA) was designed and synthesized,and it was combined with CRISPR-Cas 9.After confirmation by gene sequencing,it was transfected into human pancreatic cancer cell line SW1990,then the cells with stable Bcl-2 gene knock-out were selected,and wild type SW1990 cells were used as control.The cell growth curve was determined by CCK-8 method.The number of clone formation was measured.Flow cytometry was used to measure cell cycle and apoptosis.Results Human pancreatic cancer cell line SW1990 with Bcl-2 gene knock-out was successful constructed.Compared with wild type SW1990 cells,the growth of SW1990 cells with Bcl-2 gene knock-out was inhibited,the number of clone formation was significantly decreased [(160.7 ± 10.0) vs (285.3 ± 14.2)],the proportion of G1 cells was significandy increased [(84.51 ± 0.97) ％ vs (57.49 ± 1.08) ％],the proportion of S phase cells significantly decreased [(12.82 ± 0.99) ％ vs (27.56 ± 1.65) ％],and apoptosis rate was remarkably increased [(12.67 ± 0.59) ％ vs (0.37 ± 0.35) ％],and the difference between the two groups was statistically significant (P ＜ 0.01).Conclusions Knock-out of Bcl-2 gene can inhibit the growth of human pancreatic cancer cell line SW1990,decrease the ability of clone formation,block the cell in G1 phase and greatly increase cell apoptosis rate.

Objective:To investigate the effect and prognostic factors of rituximab-containing chemotherapy regimen in treatment of patients with mantle cell lymphoma (MCL).Methods:The clinical data of 56 patients aged ≤65 years in the First Affiliated Hospital of Soochow University from June 2007 to November 2018 were retrospectively analyzed. Rituximab-containing chemotherapy regimen was used, and the effects of clinical features, treatment regimen and biological indexes on overall survival (OS) and progression-free survival (PFS) were observed.Results:The median age of 56 patients was 57 years old, including 43 males and 13 females. Among these cases, 24 patients received R-CHOP chemotherapy regimen; 29 patients received cytarabine-containing chemotherapy regimen, including R-hyper CVAD/R-MA regimen used in 15 patients and R-CHOP alternating with R-DAHP regimen used in 14 patients; and 3 patients received other treatment regimens. Among 56 patients, 19 patients received autologous hematopoietic stem cell transplantation (ASCT) consolidation therapy. The median OS time was 74 months, 2-year OS rate was 83.8%, 3-year OS rate was 70.9%, 2-year PFS rate was 72.0% and 3-year PFS rate was 49.7%. International prognostic index (IPI) high-risk and receiving ASCT or not during the treatment were independent influencing factors of OS and PFS in MCL patients. The overall response rate (ORR) in cytarabine-containing regimen group was higher compared with that in R-CHOP regimen group (93.1% vs. 83.3%), and there was no statistically significant difference ( χ2=0.465, P=0.495). In addition, there were no significant differences between two groups in both OS ( χ2=0.291, P=0.590) and PFS ( χ2=0.912, P=0.339). ASCT consolidation prolonged the median OS time (72 months vs.124 months, χ2=3.973, P=0.040) and the median PFS time (34 months vs. 90 months, χ2=3.984, P=0.046) in MCL patients achieving remission after induction therapy. Among patients in simplified MCL IPI (sMIPI) score middle-high risk group, compared with those not receiving ASCT, patients receiving ASCT therapy could obtain better OS and PFS (OS: χ2=5.037, P=0.025; PFS: χ2=6.787, P=0.009); among patients of sMIPI score low risk, there were no statistically significant differences in OS and PFS between the group receiving ASCT and not (all P > 0.05). Conclusions:Cytarabine-containing chemotherapy regimen has no predicatively satisfactory value in improving the prognosis and survival for MCL patients. For MCL patients who have achieved remission after reduction therapy and those in sMIPI score middle-high risk group, ASCT consolidation therapy can improve the prognosis and can be taken as the first-line consolidation treatment in young patients.

Objective To determine the surgical approaches and evaluate the clinical efficacy of skin defects of the emergency thumb, finger reconstruction.Methods Emergency in 11 cases complicated skin defect of the thumb and the hand, fingers missing injured patients by using the method of combined of toenail flap of biped dorsalis pedis flap or the second toe.The implantation of thumbnail flap of dorsalis pedis flap combined with the second toenail flap was applied on 5 cases.3 cases had received the implantation of thumbnail flap of dorsalis pedis flap combined with the second toe and 3 cases with combined repair of the second toe of biped dorsal flap.Of all the cases, reconstruction of 3 fingers in 1 case, reconstruction of 2 fingers in 10 cases,5 cases with reconstruction by means of implantation of toenail flap of same pediele splitting flap or the second toe, 6 cases with repair of toenail flap of dorsalis pedis flap or second toe.Results Except for 1 necrosis occurred in 1 finger in 1 case of 3 fingers reconstruction, the rest of tissue flaps and fingers all survived.The primary healing was achieved postoperatively.The patients were followed up for 5-24 months.The functions such as grabbing, grasping, nipping were basically restored after the repair.The appearance of hand was also restored to a certain degree.Sensory recovery S2-S4 of reconstruction finger and flap was achieved.Healing was satisfying in the donor area, no obvious cicatricial contracture was seen, while the walk function was not affected.Conclusion The application of combined implantation of toenail flap of biped dorsalis pedis flap or the second toe in the repair of overall hand skin degloving injury could restore the function and appearance of the injured hands to a certain degree.It is proved to be an effective treatment method.

Objective To observe the effect of Weipixiao, a compound recipe which has the actions of strengthening spleen, resolving stasis and removing toxins, on the histopathological changes of gastric mucosal tissue in rats with gastric precancerous lesions ( GPL) . Methods SD rats were randomly divided into normal group, model group, Vitacoenzyme group (0.2 g·kg-1·d-1), and high-, middle-, and low-dose Weipixiao groups ( in the dose of 15, 7.5, 3.75 g·kg-1·d-1, respectively) . Except for the normal control group, the rats in other groups received spontaneous intake of N-methyl-N’-nitro-nitrosoguanidine ( MNNG) solution combined with irregular diet and oral use of purgative herbs for 18 weeks to induce GPL. From the 9th week, the mediation groups were simultaneously given corresponding medicine for 10 weeks. At the end of the experiment, the histopathological changes of gastric mucosal tissue in all groups were observed. Results Pathological scores of intestinal metaplasia and epithelial dysplasia in rat gastric mucosa of the model group were significantly increased ( P<0.01 compared with those of the normal group) , but were decreased in three Weipixiao groups to various degrees, particularly in low-dose Weipixiao group ( P<0.05 or P<0.01) . Conclusion Weipixiao can block and reverse gastric intestinal metaplasia and dysplasia in GPL rats to certain degrees, and low-dose Weipixiao may have better long-term effect for the prevention and treatment of GPL.