To investigate and analyze the causes of a human brucellosis epidemic in Chengjiang City in 2023 through field epidemiological investigation, and to provide a reference for future surveillance and control. A field epidemiological investigation of the case was carried out, with an active search of cases in epidemic areas. Samples from high-risk individuals, sheep, and dogs in the epidemic area were collected for brucellosis testing and pathogen isolation and culture, and the data were statistically analyzed by descriptive epidemiological method. One case of human brucellosis was detected in the outbreak, with smooth Brucella glabrata (ovine biotype 3) isolated from the patient's blood. Smooth Brucella glabrata antibodies were detected in two samples from the patient's dogs, with a positive rate of 16.67%. Tests for brucellosis in high-risk individuals and goats were negative, leading to a determination that this was an outbreak of ovine brucellosis transmitted from dogs to humans. This outbreak represented a rare instance of Brucella glabrata (ovine biotype 3) co-infected by humans and dogs. In dealing with the epidemic of human brucellosis, it is necessary to expand ideas and methods, strengthen the prevention and control of canine brucellosis, pay attention to the infection of dogs, and raise the protection awareness of dog farmers.

Transcutaneous immunization(TCI),the topical application of antigen and adjuvant directly onto intact skin,which can safely and effectively elicit systemic and celluar immune responses in mice and humans against a variety of antigens,is a novel method of vaccine delivery.Not only the skin has evolved as a barrier to prevent external agents,including pathogens,from entering the body,but also it has a complex and efficient immune system,which includes Langerhans′ cells and dendritic cells.The skin is an attractive target for vaccine delivery.By targeting the body′s natural defense system,TCI attempts to produce an efficient immune response.All these results highlight the likelihood that TCI will play an important role in vaccine applications in the future.

Objective To observe the blood perfusion of optic nerve and macular areas and investigate its relationship with visual field defect in nonarteritic anterior ischemic optic neuropathy (NAION). Methods Twelve consecutive unilateral NAION patients (course of disease <3 months) and 12 healthy Chinese adults were enrolled in the study. The affected eyes and fellow eyes from 12 NAION patients were defined as group A and group B; 12 eyes from 12 healthy adults were defined as group C. Best corrected visual acuity (BCVA), intraocular pressure (IOP), indirect ophthalmoscope and computer optometry were performed on all of the three groups of patients. Visual field (VF) and optical coherence tomography (OCT) were performed on NAION patients. Logarithm of the minimum angle of resolution (logMAR) was used to calculate visual acuity. Compared to group B, logMAR BCVA, mean deviation (MD) and pattern standard deviation (PSD) in group A were significant decreased (t=3.278, -4.909, 4.130, P<0.05). There was no significant difference in spherical equivalent, IOP, peripapillary retinal nerve fibre layer (pRNFL) between group A and group B (t=0.000, 0.890, 1.215; P>0.05). OCT angiography (OCTA) was used to measure the flow area (FA) at optic disc, flow area at radial peripapillary capillaries (RCFA) and FA, non-perfusion area (NFA), parafoveal vessel density (PVD) and parafoveal vascular index (PVI) in macular area. Pearson correlations between the deficiency of optic blood flow and visual field were analyzed. Results The differences of FA at optic disc and peripapillary RCFA among 3 groups were significant (F=4.162, 3.357; P<0.050). Compared to group B (t=-5.822, -7.467; P<0.001) and C (t=9.435, 4.615, P<0.05), FA at optic disc and peripapillary RCFA in group A was significantly reduced. There is several NAION showed quadrantal FA decreased in optic nerve. However, there was no significant difference in optic disc FA and peripapillar RCFA between group B and C (F=0.004, 0.030; P>0.050). There was no differences of FA, NFA, PVD and PVI among 3 groups (F=0.488, 1.107, 0.493, 1.086, 1.098, 0.093, 1.093, 1.221; P>0.05). Positive correlation between optic disc FA, peripapillary RCFA and MD (r=0.542, 0.585;P<0.05) were observed. However, there was no significant correlation between optic disc FA, peripapillary RCFA and PSD (r=-0.404, -0.430; P>0.05), and negatively correlated to BCVA (r=-0.617, -0.596; P<0.05). PRNFL was negatively correlated to optic disc FA (r=-0.643, P<0.05), but not correlated to peripapillary RCFA (r=-0.377, P>0.05). Conclusions The optic disc blood flow reduced in affected eyes of unilateral NAION whose disease course was less than 3 months, while the macular perfusion was normal. There was a positive correlation between optic disc flow and visual field.

Objective To explore the clinical features,primary lesions and prognosis of optic nerve metastases.Methods Seven patients (11 eyes) with optic nerve metastatic tumor diagnosed by the examinations of ophthalmology,laboratory and pathology in Chinese PLA General Hospital from April 2015 to September 2017 were included in this study.All patients underwent BCVA,flash VEP,OCT,orbital MRI,serum tumor marker,cerebral spinal fluid detection and PET-CT.Histopathological examination of primary or near superficial metastases was performed.The follow-up period was ranged from 16 to 44 months,with the mean of 23.0 ± 10.9 months.The clinical characteristics,primary tumor,imaging features,treatment and clinical prognosis in the patients were analyzed.Results Among 7 patients,there were 5 males and 2 females,with the mean age of 53.90± 14.99 years;3 patients with unilateral optic nerve involvement,4 patients with bilateral optic nerve involvement;5 patients (71.4％) first diagnosed in ophthalmology.Five patients (45.5％) were misdiagnosed as optic neuritis,optic disc edema in 6 eyes (54.5％).All of them appear loss of visual acuity,including 8 eyes (72.7％) with BCVA＜ 0.1,2 eyes (18.2％) with BCVA 0.1-0.5,1 eye (9.1％) with BCVA ＞ 0.5.MRI results show that 1 patient with intraorbital segment,1 patient with internal segment of optic canal,4patients with intracranial segment,1 patient with intracranial segment and optic chiasma involved simultaneously,4 patients involving surrounding tissue.There were 4 patients (57.1％) with lung cancer,2 patients (28.6％) with kidney cancer,1 patient (14.3％) with gastric cance;6 patients (85.7％) with metastasis from other sites,2 patients with brain metastasis (1 patient with meningitis carcinomatosa).There were 2 patients (28.6％) with previous primary cancer surgery.After diagnosis,1 patient received chemotherapy,1 patient received radiotherapy,5 patients gave up treatment.At the end of follow-up,1 patient (1 eye) of chemotherapy with BCVA increased by 2 line;1 patient (2 eyes) of radiotherapy with no change in BCVA;of the 5 patients who gave up treatment,1 patient died of disease,1 patient lost follow-up,and 3 patients (4 eyes) had no change in BCVA.Conclusions With atypically clinical manifestations,the optic nerve metastases easily misdiagnosed as optic neuritis,and with poor therapeutic effect.Primary lesions are mostly found in lung cancer.

Objective To evaluate the efficacy and safety of repeated treatments with low-dose rituximab for relapsing neuromyelitis optica spectrum disorder (NMOSD).Methods A perspective study.21 patients who were diagnosed with NMOSD one year ago were recruited for rituximab treatment.Of 21 patients,one was male,20 were females.Onset age was 10-51 years,the mean onset age was (26.2± 12.0) years.Duration of disease was 2.3-25.8 years,the mean duration was (9.2 ± 5.9) years.Best corrected vision activity (BCVA),expanded disability status scale (EDSS),annualized relapsing rate (ARR) were valued to investigate the efficacy and safety of repeated treatments with low-dose rituximab.The BCVA was examined using Snellen chart,and converted to logMAR.The mean BCVA was 1.13 ± 1.09,the mean BCVA in better eyes was 0.4±0.68,the mean BCVA in latter eyes was 1.87±0.90.The mean EDSS was 3.09±0.70.The mean ARR was 1.04± 0.65.All patients underwent two cycles of RTX treatment.The annually induction treatment was RTX 100 mg per week for 4 weeks.Of 21 patients,12 patients had treatment within one month after attack.The mean follow-up period was (28.4±4.9) months.The side effects were recorded,BCVA,EDSS,ARR were valued to investigate the efficacy and safety of repeated treatments with low-dose rituximab.Paired t test,independent sample t test and Chi-squared test were used.Results The mean BCVA at last follow-up was 0.62 ± 0.91,the mean BCVA in better eye was 0.62±0.91,the BCVA in latter eye was 1.0± 1.01.The mean EDSS was 2.26± 1.07.The mean ARR was 0.21 ± 0.3.After the treatment,patient had significant improvement on BCVA in worst eye (t=4.256),ARR (t=2.900),EDSS (t=4.620) with the significant differences (P＜0.05).Thirteen relapses in 9 patients were observed.B lymph cells were more than 0.01％ in all relapses.There was no significant difference on the BCVA in better eye (t=1.840,P＞0.05).There were 9 patients had relapse,13 times in total.Of 13 relapses,B lymph cell count was performed in 12 relapses,and the counts were 0.01％-0.14％.There were no significant difference between relapsed patients and non-relapsed patients on onset age (t=0.67,P=0.51),whether underwent plasma exchange treatment (x2=1.61,P＞ 0.05),with/without auto-immune antibody ratio (x2=1.61,P＞ 0.05).Of 21 patients,8 patients had side effects,including 5 patients with infection,4 patients with chest congestion,3 patients with hair losing,2 patients with skin rashes,headache and short of breath,1 patient with tinnitus,palpitation and fatigue.Four patients had more than one symptom.Of all patients who had side effects,slowing down the infusion speed of RTX or infusing 5 mg of dexamethasone could relieve the discomfort.Conclusion Lose-dose rituximab reduces the frequency of NMOSD relapses and is well tolerated.

Objective:To investigate the application of critical flicker fusion frequency (CFF) in non-arteritic anterior ischemic optic neuropathy (NAION).Methods:A cross-sectional study. From January 2021 to September 2021, a total of 58 NAION patients (105 eyes) (NAION group) and 33 cases (63 eyes) in the healthy control (HC) group were included from Department of Ophthalmology of First Medical Center, PLA General Hospital. Patients underwent best-corrected visual acuity (BCVA), optical coherence tomography (OCT), visual field, CFF and flash visual evoked potential (F-VEP) examinations. BCVA examination was performed using a Snellen decimal visual acuity chart and was converted to logarithm of the minimum angle of resolution visual acuity. In the affected eyes group, there were 56 cases (72 eyes), 31 cases (43 eyes) male and 25 cases (29 eyes) female, with an average age of 49.28±11.42 years old. And the affected eyes were divided into 4 groups: <1, 1-<3, 3-<6 and >6 months according to the time interval from onset to CFF examination, which were 20(27.8%), 26 (36.1%), 17 (23.6%) and 9 (12.5%) eyes, respectively. According to the BCVA ≥0.5, 0.1-0.5, <0.1 in CFF examination, the affected eyes were divided into a mild, moderate, and severe degree, 33 (45.8%), 32(44.4%) and 7 (9.8%) eyes, respectively. Sixty-three eyes of 33 cases were in the HC group. There were 17 cases(31 eyes) males and 16 cases (32 eyes) females, with an average age of 35.18±10.96 years. Hand-held CFF detector type 2 (Japan, NEITZ company) was used for the CFF examination. The thickness of peripheral retinal nerve fiber layer (pRNFL), macular inner limiting membrane retinal pigment epithelium (mILM-RPE), F-VEP peak time and peak value and mean visual field defect (MD) values were recorded within 1 week of CFF examination. The CFF value of the above subgroups was analyzed in order using one-way ANOVA. Pearson correlation analysis was used for the correlation between CFF and F-VEP peak time, peak value, BCVA and MD. The correlations between BCVA, visual field, F-VEP, and CFF were analyzed.Results:The trichromatic values of red, green and yellow in NAION affected eyes were 22.56±10.30, 24.10±11.51, 24.81±11.41 Hz, respectively, which was significantly reduced compared with the HC group ( t=-10.53,-11.11,-11.36; P<0.05). There was no significant difference in CFF-red, green, and yellow values at different time points after the onset of the disease ( F=2.075, 1.893, 2.073; P>0.05). Compared CFF-red, green, and yellow values in NAION-affected eyes with different degrees, the difference was statistically significant ( F=31.579, 27.332, 32.055; P<0.05). The results of correlation analysis showed that the peak time of F-VEP ( r=-0.362, -0.379,-0.357; P<0.05), BCVA ( r=-0.705,-0.695,-0.714; P<0.05), and which was negatively correlated with CFF three color. MD and CFF were positively correlated ( r=0.486, 0.435, 0.450; P<0.05). Conclusion:The CFF value of the affected eye is decreased significantly in NAION-affected eyes, and CFF is more sensitive than F-VEP in reflecting visual impairment, and has a good correlation with visual function and latency of F-VEP.

Objective:To investigate the characteristics of obesity in adolescents with major depressive disorder (MDD) and its association with the depressed severity.Methods:A total of 278 adolescents with MDD were recruited according to the inclusion and exclusion criteria. Their demographic data were collected and 24-item Hamilton depression scale (HAMD-24) was used to evaluate their severity of depression. According to the body mass index (BMI) classification standard of adolescents in China, all subjects were classified into four groups(wasting group, normal BMI group, overweight group and obesity group). SPSS 26.0 statistical software was used for data analysis. The Kruskal-Wallis test and the Chi-square test were separately used for the comparison of the four groups.Spearman correlation was used to explore the relationship between BMI and HAMD-24 scores and severity.Results:Among 278 adolescents with MDD, the prevalence of body abnormality was 32.4% (90/278), among which wasting, overweight and obesity were 9.0% (25/278), 14.4% (40/278) and 9.0% (25/278) respectively. There were statistically differences in gender ( χ2=17.018, P<0.001), HAMD-24 scores ( H=9.427, P=0.024) and depressed severity( H=8.508, P=0.037) among the four groups. Multiple comparisons showed that there were only statistically differences between obesity group and normal BMI group, that was the prevalence of obesity in males was higher than that in females ( χ2=13.631, P<0.001), and the level in HAMD-24 scores ( Z=2.956, P=0.003) and depressed severity ( Z=2.832, P=0.005) was lower in obesity group than that in normal BMI group.Spearman correlation analysis showed that BMI was negatively correlated with HAMD-24 scores ( r=-0.162, P=0.007). Conclusion:There is gender difference in obesity rates among the adolescent patients with first-episode untreated MDD. And the obese patients are less depressed than those with normal BMI.

Objective To analyze the efficacy and effects of balloon dilation combined with iliac vein balloon dilatation on complications and coagulation function of acute deep venous thrombosis of lower limbs(DVT)complicated with Cockett syndrome.Methods Data of 102 patients with acute DVT combined with Cockett syndrome admitted to the hospital from March 2018 to September 2022 were retrospectively analyzed,including 53 patients treated with catheter thrombolytic balloon dilation of iliac vein(recorded as the study group)and 49 patients treated with catheter thrombolytic therapy(recorded as the control group).Both groups were followed up for 1 year.Thrombosis clearance,edema reduction of affected limb,lower limb hemodynamics,coagulation function,peripheral blood inflammatory factors,complications and thrombosis recurrence were compared between the two groups.Results The thrombus removal grade of the study group was better than that of the control group(P＜0.05).Before and 1 year after surgery,In the control group,the leg circumference diameter difference above the knee between the affected side and the healthy side was(8.02±1.41)cm and(2.89±0.32)cm,respectively.In the study group,the data were(8.19±1.38)cm and(2.57±0.29)cm,respectively.Before and 1 year after surgery,in the control group,the leg circumference diameter difference below the knee between the affected side and the healthy side was(6.84±1.18)cm and(2.13±0.38)cm,respectively.In the study group,the data were(6.63±1.09)cm and(1.76±0.32)cm,respectively.The difference was statistically significant(P＜0.05),and the study group was lower 1 year after surgery(P＜0.05).The average blood flow velocity of femoral vein in control group was(24.75±4.03)cm/s and(28.82±4.29)cm/s before and 3 days after surgery,respectively.In the study group,the data were(24.02±3.86)cm/s and(30.94±4.37)cm/s,respectively.The femoral vein blood flow before and 3 days after surgery in the control group was(13.02±2.12)ml/s and(15.05±2.29)ml/s,respectively,while that in the study group was(13.36±2.09)ml/s and(16.26±2.34)ml/s,with statistical significance(P＜0.05).The study group was higher 3 days after surgery(P＜0.05).The prothrombin time before and 3 days after operation were(22.93±2.04)s and(18.13±1.34)s in the control group,and(23.24±1.99)s and(17.29±1.21)s in the study group,respectively.The thrombin time before and 3 days after operation were(24.86±2.31)s and(21.04±1.75)s in the control group,and(24.13±2.16)s and(19.89±1.53)s in the observation group,respectively.The activated partial thromboplastin time before and 3 days after surgery was(59.21±3.92)s and(49.13±3.02)s in control group,and(60.17±3.85)s and(47.09±2.98)s in observation group,respectively,and the difference was statistically significant(P＜0.05).It was lower 3 days after surgery in study group(P＜0.05).In the study group,preoperative tumor necrosis factor(TNF)-α,platelet activating factor(PAF)and thromboxen B2(TXB2)were(31.91±4.89)ng/L,(14.59±2.36)pg/ml,and(213.12±30.98)pg/ml,respectively.Three days after surgery,the levels were(36.24±4.29)ng/L,(16.12±2.59)pg/ml,and(239.86±32.85)pg/ml,respectively,with statistical significance(P＜0.05).TNF-α,PAF and TXB2 were higher in the study group 3 days after surgery(P＜0.05).There was no significant difference in the incidence of total complications between the two groups(P＞0.05).The recurrence rate of thrombosis in study group was lower than that in control group(3.77％vs 16.33％,P＜0.05).Conclusion Catheter thrombolytic balloon dilation of iliac vein for acute DVT complicated with Cockett syndrome can enhance the thrombolysis effect,improve the swelling of the affected limb,lower limb hemodynamics and coagulation function,and reduce the risk of thrombosis recurrence,which is safe and reliable.However,this treatment plan can mediate the occurrence of inflammation,and reasonable anti-inflammatory therapy should be actively implemented after surgery.

Objective:To explore the effects of depressive symptoms on sleep quality in adolescents with depressive disorder, and the mediating roles of cognitive fusion and sleep belief.Methods:A sample of 210 adolescents with first episode depressive disorder aged 12-18 years were recruited to complete 17-item Hamilton depression scale (HAMD-17), Pittsburgh sleep quality index (PSQI), cognitive fusion questionnaire (CFQ), and dysfunctional beliefs and attitudes about sleep scale (DBAS-16) from November 2021 to July 2022. SPSS 26.0 software was used to perform descriptive analysis and correlation analysis. The mediating effect was tested by Bootstrap analysis using PROCESS V 3.4 Macro program.Results:The incidence of low sleep quality in adolescents with depressive disorder was 69.0%(145/210). HAMD-17 score was (22.4±7.9), PSQI score was (9.7±3.7), CFQ score was (51.6±7.8), DBAS-16 score was (43.5±8.4).PSQI was positively correlated with the scores of HAMD-17 and CFQ( r=0.613, 0.463, both P<0.001).HAMD-17 was positively correlated with CFQ score ( r=0.488, P<0.001).DBAS-16 was negatively correlated with scores of PSQI, HAMD-17 and CFQ( r=-0.326, -0.284, -0.354, all P<0.001). The direct effect of depression on sleep quality was 0.230(95% CI=0.169-0.293). The indirect effect of depression on sleep quality through two pathways, the separate mediating effect value of cognitive fusion was 0.041 (95% CI=0.011-0.074), and the chain mediating effect value of cognitive fusion and sleep beliefs was 0.008(95% CI=0.001-0.020). Conclusion:Depressive symptoms can directly affect sleep quality of depressive disorder adolescents and indirectly through cognitive fusion and sleep beliefs.

Objective To understand the situation of knowledge,attitude and practice (KAP) of sheep farmers and field veterinarians towards brucellosis prevention,and find out the potentially influential factors.Methods From March to September in 2017,1 067 sheep farmers and 401 field veterinarians were selected as participates,and questionnaire survey was carried out.Percentage rate was used to describe the situation of KAP.Nonparametric test was used to compare the KAP score difference.Results The overall awareness in sheep farmers and field veterinarians was 64.2％ and 80.1％,respectively.In addition,there were 17.3％ (185/1067) sheep farmers and 12.2％ (49/401) field veterinarians had never heard of brucellosis.The knowledge awareness in sheep farmers and field veterinarians was 62.6％ and 79.0％,respectively,75.8％ and 83.8％ of them had positive attitude to brucellosis prevention,54.1％ and 77.6％ of them had good practice habit.They hoped in the future,more information could be received through TVs,and then was internet or broadcasting.Sheep farmers who from first class region,age less than 45 years,education higher than junior high school,feeding time less than 5 years and sheep ever infected with brucellosis (U =4.85,3.08,3.29,2.20,6.62,P ＜ 0.05 or ＜ 0.01),had higher KAP scores than others.Field veterinarians,who had lower education,had lower KAP scores (U =4.29,P ＜ 0.01).Conclusions The awareness of sheep farmers and field veterinarians still need to improve and strengthen.Some suggestions are put forward:improve intervention pattern,optimize content and method,pay attention to use new media.