Chigger mites are arthropods and are the sole vectors of scrub typhus, and rodents as well as other small mammals are the most common hosts of chigger mite larvae. Therefore, it is of great medical significance to study the ecology of chigger mites. In this study, a detailed analysis of chigger mites was conducted based on field survey data. A total of 4,941 chigger mites were collected from 86 hosts at 34 survey sites in Ruili, Yunnan Province, China. Among the 4,941 chiggers, five genera in one subfamily were identified; Schoengastiella ligula was the dominant chigger species with the highest infestation index, prevalence (Pm, 42.86%) and mean intensity (MI, 59.09%) (P<0.001). The association coefficient (V) between S. ligula and Gahrliepia radiopunctata was positively correlated (P<0.05), indicating the tendency of chiggers to select and coexist on the same host at the same time. The dominant species Leptotrombidium kunmingense, Ascoschoengastia indica, S. ligula and G. radiopunctata showed aggregation distribution patterns, indicating that the distribution of chiggers among different hosts was not uniform. Low altitudes and low latitudes appeared to be more favorable for the growth and reproduction of chigger mites (P<0.05). It is suggested to collect as many host samples as possible in future field investigations to better understand the dynamics of chigger mite populations and their primary hosts.

OBJECTIVE: To study the relationship between the expression of extracellular signal-regulated kinase (ERK) and the expression of urokinase-type plasminogen activator (uPA) as well as its effect on the development of laryngeal squamous cell carcinoma (ISCC). METHOD: Western blot was used to detect ERK1/2 protein expression, meanwhile, the change of ERK1/2 activity was examined to measure its efficiency of phosphate transferase in 40 LSCC. Immunohistochemistry was applied to detect uPA protein expression. The correlation of each factor with relevant clinical factor was statistically analyzed. RESULT: Expression of ERK1/2 showed a positive linear correlation (P < 0.05). Neither ERK1 nor ERK2 expression was significantly related to T-grades, histological classes and cervical lymph node status. Neither T-grades, nor histological classes was significantly related to ERK1/2 activity or uPA protein expression. There was significant correlation between ERK1/2 activity and cervical lymph node status and between uPA protein expression and cervical lymph node status (P < 0.05). ERK1/2 protein expression was correlated with neither ERK1/2 activity nor uPA protein expression, but there was a significant positive linear association between ERK1/2 activity and uPA protein expression (P < 0.05). CONCLUSION Abnormal activation of ERK may play an important role in cervical lymph node metastasis of LSCC by up-regulation of uPA expression.
Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; Laryngeal Neoplasms ; metabolism ; pathology ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Mitogen-Activated Protein Kinase 1 ; metabolism ; Mitogen-Activated Protein Kinase 3 ; metabolism ; Neoplasm Staging ; Up-Regulation ; Urokinase-Type Plasminogen Activator ; metabolism

Objective To study the therapeutic effects and prognosis of advanced pancreatic carcinoma treated with iodine-125 seeds implantation.Methods The records of 98 patients with unresectable advanced pancreatic carcinoma admitted from Mar.2004 to Oct.2008 were analyzed.There were 53 cases treated by supportive treatment,24 cases by palliative operation and 21cases by palliative operation combined with iodine-125 seed implantation.Results Pain partial and complete relief rate in palliative operation combined with iodine-125 seeds implantation radiotherapy group(84.21% and 15.79%,respectively) was better than other two treatment groups(P

OBJECTIVEPrevention of the misdiagnosis of acute appendicitis when it first manifested as acute intestinal obstruction, and to search proper way of diagnosis and treatment for such event to provide the reference.

METHODSClinical data of 33 acute appendicitis cases presented with acute intestinal obstruction in Beijing Tong Ren Hospital during January 2000 and December 2015 were analyzed retrospectively.

RESULTSAll 33 patients were admitted to the Emergency Department with symptoms of various degrees abdominal pain and abdominal distension. There was no passage of gas and feces. The mean time of onset was (62.2±25.0) hours. The imaging examination showedthat all patients had complete bowel obstruction. Twenty one patients(63.6%) had peritonitis, three of whom developed with septic shock. Abdominal CT was performed in 17 patients preoperatively, which showed retention of gas and fluid in the small intestine in all the patients and 13 were suggestive of acute appendicitis. All of these patients received surgical treatment, 12 patients underwent laparoscopic exploration, and the remaining 21 patients received exploratory laparotomy during which acute appendicitis was confirmed to be the cause of intestinal obstruction, of whom 14(42.4%) was identified as mechanical intestinal obstruction. Nine patients underwent appendectomy and lysis of adhesion, five appendectomy and partial excision of the greateromentum. Nineteenpatients(57.6%) were identified as paralytic ileus and underwent appendectomy only. Twelve patients required respiratory and circulatory support and were admitted to ICU postoperatively. The mean duration time in ICU was(8.8±5.2) days. Postoperative pathology showedgangrene accompanied with perforation in the appendix. All patients were discharged without any complication. The length of hospital stay was (15.4±4.6) days. All patients were followed up for 3 ~ 12 months. One patient with chronic obstructive pulmonary disease developed repeated pulmonary infection and died of respiratory failure at 185 days postoperatively. The remaining patients were followed up and there were no patients developed intra-abdominalsepsis, intestinal obstruction, surgery-related complications, or death.

CONCLUSIONPatients with acute appendicitis presenting with acute intestinal obstruction are mostly in severe condition. Clinical diagnosis for this patients is difficult and surgery should be performed as soon as possible.

Abdominal Pain ; Acute Disease ; Appendectomy ; Appendicitis ; diagnosis ; pathology ; surgery ; Diagnostic Errors ; Humans ; Intestinal Obstruction ; diagnosis ; Intestine, Small ; Laparoscopy ; Laparotomy ; Length of Stay ; Physical Examination ; Postoperative Period ; Retrospective Studies

Based on the field investigations in 91 investigation sites (counties) in southwest China between 2001 and 2019, the present paper reported the chigger mites on A. agrarius mice in southwest China for the first time by using a series of statistical methods. From 715 striped field mice captured in 28 of 91 investigated sites, only 255 chiggers were collected, and they were identified as 14 species, 6 genera in 3 subfamilies under 2 families. Of 715 A. agrarius mice, only 24 of them were infested with chigger mites with low overall prevalence (PM=3.4%), overall mean abundance (MA=0.36 mites/host) and overall mean intensity (MI=10.63 mites/host). The species diversity and infestation of chiggers on A. agrarius were much lower than those previously reported on some other rodents in southwest China. On a certain species of rodent, A. agrarius mouse in southwest China seems to have a very low susceptibility to chigger infestations than in other geographical regions. Of 14 chigger species, there were 3 dominant species, Leptotrombidium sialkotense, L. rupestre and Schoengastiella novoconfuciana, which were of aggregated distribution among different individuals of A. agrarius hosts. L. sialkotense, one of 6 main vectors of scrub typhus in China, was the first dominant on A. agrarius. The species similarity of chigger mites on male and female hosts was low with CSS=0.25, and this reflects the sex-bias of different genders of A. agrarius mice in harboring different chigger species.

Objective:To explore the safety of inactivating coronavirus disease 2019(covid-19)vaccine in liver transplantation(LT)recipients.Methods:Retrospective analysis was performed for clinical data of 151 LT recipients from March 2003 to October 2019.They had stable conditions and completed the course of covid-19 vaccine.Frequencies of pain at injection site, fatigue, headache and pruritus after vaccination were recorded.The safety profiles were compared between recipients with and without local and general adverse reactions after vaccination.At the same time, recipients completing two doses of covid-19 vaccines were grouped.According to vaccine companies, they were classified into Sinovac Biotech Ltd and Beijing Biological.Based upon more than or less than 60 years, they were grouped into <60 years and ≥60 years.The safety profiles of inactivating COVID-19 vaccine were compared in subgroups.Results:Among 151 eligible LT recipients, 98 of them were in group of age <60 years and 53 in group of age >60 years.The median period between vaccination and LT was 8.44(4.37, 12.39)years and the median concentration of tacrolimus 2.5(1.8, 3.9)ng/L.Eighty-three cases completed two doses of Sinovac Biotech Ltd(Sinovac Biotech Ltd group)and 40 cases Beijing Biological(Beijing Biological group); 14 cases had combined course of Sinovac Biotech Ltd and Beijing Biological, four recipients were vaccinated with inactivated vaccine from other companies and ten recipients did not know their inactivated vaccine' companies.After immunization, 24/151(15.9%)recipients had a local and general adverse reaction.The prevalence of pain at injection site, fatigue, headache and pruritus was 9.9%( n=15), 5.2%( n=8), 1.3%( n=2)and 0.7%( n=1)respectively.No significant differences existed in age( P=0.602), gender( P=0.752), period after LT( P=0.890), trough concentration of tacrolimus( P=0.377)or versions of covid-19 vaccine( P=0.582)between 24 cases with general adverse reaction and 127 without.Local and general reactions occurred in 16/83(19.3%)in Sinovac group and 5/40(12.5%)in Beijing Biological.There was no significant inter-group difference( P=0.769). There were 98 cases(64.9%)in <60 years group, 17 cases(17.3%)had local and general reaction, 53 cases(35.1%)in ≥60 years group and 7 cases(13.2%)had a local and systemic reaction.There was no significant inter-group difference( P=0.507). Conclusions:Covid-19 vaccine is safe for long-term survival LT recipients with normal liver function.Few participants present with mild fatigue and pain at injection site.

Objective To investigate the safety,feasibility,and efficacy of highly selective protective vagotomy in laparoscopic fundoplication.Methods Clinical data of 78 patients who underwent laparoscopic hiatal hernia repair plus fundoplication(short floppy Nissen procedure)for gastroesophageal reflux disease and hiatus hernia from January 2014 to December 2019 in our hospital were retrospectively analyzed.The patients were divided into two groups:the traditional operation group and the vagus nerve protection group.The operation time,blood loss during operation,hospital stay after operation and the incidence of postoperative complications were compared between the two groups.The GERD Q score,DeMeester score,lower esophageal sphincter pressure(LESP),and control of reflux symptoms at 6 months after operation in the two groups were analyzed.Results Both groups of surgeries were successfully completed,and there were no serious intraoperative side injuries.There was no significant difference between the traditionaloperationgroupandthevagusnerveprotectiongroupinoperationtime[(85.5±13.9)minvs.(88.3±18.6)min,t =0.729,P =0.468],intraoperative blood loss[(18.6±8.6)ml vs.(18.1±8.5)ml,t =-0.221,P =0.825],and postoperative transanal exhaust time[(2.0±0.7)d vs.(1.8±1.0)d,t =-1.227,P =0.224].The postoperative hospital stay in the traditional surgical group was significantly longer than that in the vagus nerve protection group[(9.4±3.0)d vs.(8.2±2.1)d,t =-2.172,P = 0.033].The incidence of surgical complications within 30 d after surgery in the traditional surgical group was 36.8%(14/38),which was significantly higher than that in the vagus nerve protection group[12.5%(5/40),χ2 = 6.267,P = 0.012].The traditional surgical group had a cure rate of 86.8%(33/48)at 6 months after surgery,which was not significantly different from the vagus nerve protection group[85.0%(34/40),Z =-0.232,P =0.816].There were no significant differences in GERDQscore,DeMeester score,LESP between the two groups at 6 months after surgery[(5.6±0.9)points vs.(5.8±0.8)points,t =1.232,P =0.222;(4.1±2.2)points vs.(4.2±2.2)points,t =0.261,P =0.795;(23.2±3.5)mm Hg vs.(23.5±3.8)mm Hg,t = 0.412,P = 0.681].Conclusion It is safe,feasible,and effective to apply the highly selective protective vagotomy in laparoscopic short floppy Nissen fundoplication to protect the vagus nerve.

Objective To characterize a species of the genus Tricula and parasitized trematodes in schistosomiasis-endemic areas of Yunnan Province using a molecular analysis, so as to understand their taxonomic positions. Methods Tricula spp. and Oncomelania snails were collected from Xiangyun County, Yunnan Province, and cercaria parasitizing snails were observed using crushing followed by microscopy. Cercaria parasitizing Tricula snails at various morphologies were sampled using a shedding method. Genomic DNA was extracted from snail soft tissues and cercariae, and the 16S rRNA, COI, 28S rDNA genes in snails and the ND1 and 28S rDNA genes in cercariae were amplified using a PCR assay and sequenced. The species of Tricula snails and their parasitized trematodes was characterized using sequence alignment and phylogenetic analysis. Results Among 382 Tricula snails detected, there were three types of trematode cercariae found, including the non-forked (20.94%, 80/382), double-forked (3.40%, 13/382) and swallow shapes (7.07%, 27/382). Sequence and phylogenetic analyses showed that the 16S rRNA, COI and 28S rDNA gene sequences of this species of Tricula had high homology to those in Delavaya dianchiensis, and were clustered in a branch. Sequencing analysis of the ND1 and 28S rDNA genes revealed that the non-forked cercariae belonged to the family Pleu- rogenidae, the swallow-shaped cercariae belonged to the family Opecoelidae, and the double-forked cercariae belonged to another species of the genus Schistosoma that was different from S. sinensium and S. ovuncatum. Conclusion The species and taxonomy of Triculla spp. and their parasitized trematodes are preliminarily determined in schistosomiasis-endemic areas of Yunnan Province; however, further studies are required to investigate the more definite taxonomy and pathogenicity.