Objective : To investigate the epidemiological and clinical characteristics of cases with pertussis in Yiwu City, Zhejiang Province, so as to provide insights into pertussis diagnosis and control. Methods: A total of 186 patients with definitive diagnosis of pertussis in medical institutions in Yiwu City from November 1, 2020 to August 31, 2022 were recruited, and subjects' demographic, clinical symptoms and history of pertussis vaccination were collected using questionnaire surveys. The temporal, population, and spatial distribution and clinical symptoms of pertussis were analyzed using a descriptive epidemiological method, and the clinical characteristics of pertussis patients with different doses of pertussis vaccination were compared. Results: Pertussis was found to predominantly occur during the period between July and November (101 cases, 54.30%), and the three highest-incidence regions included Jiangdong Street, Beiyuan Street and Choujiang Street (87 cases, 46.77%). The 186 pertussis cases included 105 males (56.45%) and 81 females (43.55%), and included 144 cases with age of onset under 7 year (77.42%). Preschool and diaspora children were predominant among all pertussis cases, and the main clinical symptoms included spasmodic cough (97 cases, 52.15%), post-tussive vomiting (82 cases, 44.09%) and aggravated cough at night (77 cases, 41.40%). Routine blood tests measured 119 cases with abnormal white blood cell counts (63.98%), 137 cases with abnormal lymphocyte counts (73.66%), 39 cases with abnormal neutrophil counts (20.97%), 21 cases with abnormal platelet counts (11.29%) and 111 cases with abnormal hemoglobin concentrations (59.68%). There were 55 cases that were unvaccinated (29.57%), 23 cases that were not fully vaccinated (12.37%), and 108 cases that were fully vaccinated (58.06%). There were significant differences among pertussis cases with different doses of vaccination in terms of age, incidence of post-tussive vomiting, percentage of abnormal platelet counts and percentage of hemoglobin concentrations (all P<0.05). Conclusions The majority of pertussis cases are preschool and diaspora children in Yiwu City from November 1, 2020 to August 31, 2022, and the clinical symptoms mainly include spasmodic cough, post-tussive vomiting and aggravated cough at night, with atypical symptoms. The capability for differential diagnosis of pertussis is required to be improved in medical institutions.

Abstract OBJECTIVE To explore the potential targets and mechanisms of Rhodiolae Crenulatae Radix et Rhizoma in regulating autophagy in granulosa cells based on network pharmacology and experimental verification. METHODS With the help of the database, the active components, effect targets and autophagy-related targets of Rhodiolae Crenulatae Radix et Rhizoma were obtained, and a component-target network diagram and a protein-protein interaction network diagram were established. Enrichment analysis of genes and signaling pathways was conducted on key targets and the active ingredients and core targets were docked to explore the possible mechanism of Rhodiolae Crenulatae Radix et Rhizoma in regulating autophagy in granulosa cells. Western blotting, RT-PCR, transmission electron microscopy and double-labeled adenovirus were used to detect the effect of important active ingredients of Rhodiolae Crenulatae Radix et Rhizoma on autophagy in granulosa cells. RESULTS There were 7 active ingredients of Rhodiolae Crenulatae Radix et Rhizoma obtained, with 441 targets, 796 autophagy-related targets, and there were 834 biological processes, 60 cellular components, 69 molecular functions, and 150 signaling pathways obtained by enrichment analysis. Molecular docking results showed that the active components of Rhodiolae Crenulatae Radix et Rhizoma and the core targets AKT1, ERBB2, PIK3CA, PIK3R1 could form a stable target binding effect. The experimental results showed that salidroside, an important active component of Rhodiolae Crenulatae Radix et Rhizoma, could promote the formation of autophagosomes and autophagolysosomes, and inhibit the activity of the Pl3K/AKT signaling pathway. CONCLUSION The results show that the regulation of autophagy in granulosa cells by Rhodiolae Crenulatae Radix et Rhizoma has the characteristics of multi-component-multi-target-multi-pathway, and its mechanism is related to the regulation of PI3K/AKT signaling pathway by salidroside.