Objective To investigate the influence of the variations of an epidemic focus on hemorrhagic fever with renal syndrome (HFRS) so as to provide a basis for effective control of HFRS.Methods HFRS epidemic data from the rapid development of urbanization of Huangdao District and the general development of Jiaonan City were collected and analyzed retrospectively from 1979 to 2014.And the HFRS cases,incidences,host animals and Hantavirus surveillances were compared.Results The three epidemic peaks occurred from 1979 to 2014 in Huangdao District and Jiaonan City,they were in the mid-1980s (1983-1987),the late 1990s (1995-1999) and around 2012 (2010-2014),and 954,80,37 and 2 506,614,432 cases were reported,respectively,in Huangdao District and Jiaonan City.The three peak years were 1986,1999 and 2012.And the annual incidences of Huangdao District were 385.73/100 000,15.64/100 000 and 2.51/100 000,respectively.The annual incidences of Jiaonan City were 67.07/100 000,28.68/100 000 and 14.68/100 000,respectively.The three peaks obviously appeared double peaks [the autumn and winter (from Oct.to Dec.) and the spring (from Jan.to Feb.)] in Jiaonan City.And the first peaks in Huangdao District was in the autumn and winter (from Oct.to Dec.) and the spring (from Jan.to Feb.),the second and the third were only in the autumn and winter (from Oct.to Dec.).Eight kinds of host animals were detected in Jiaonan City from 2005 to 2014.They were house mouse [27.53％ (1 108/4 024)],brown rat [25.50％ (1 026/ 4 024)],striped field mouse [14.84％ (597/4 024)],black rat [10.74％ (432/4 024)],hamsters [11.01％ (443/4 024)],shrew [8.72％ (351/4 024)],back grain hamster [1.02％ (41/4 024)] and club rat [0.65％ (26/4 024)].Two kinds of host animals were detected in Huangdao District.They were house mouse [57.14％ (16/28)] and brown rat [42.86％ (12/28)].The capture rates in Jiaonan City were higher than those of Huangdao District.The capture rate in 2012 was 8.04％ (855/10 638) and the capture rates in Huangdao District were all lower than 0.84％.The total detection rate in Jiaonan City was 2.81％ (113/4 024).And there was no positive detection for ten years in Huangdao District.Conclusions HFRS epidemic intensities have receded gradually in Huangdao District and Jiaonan City.The epidemic in Huangdao District obviously presents a low epidemic condition after the first peak.The few kinds and low densities of host animals are resulting in the sustainable condition.The evolution of epidemic patterns of HFRS is related to the change of epidemic sources by the differences in urbanization between the two places.

Objective:To investigate the clinical, neuropsychological, and neuroimage characteristics in patients with corticobasal syndrome (CBS), and to elucidate the exact diagnosis of CBS patients.Methods:Twelve CBS cases admitted to the Department of Neurology, Huashan Hosiptal,Fudan University from April 2019 to July 2021 were retrospectively enrolled in this study. Those data, including clinical features (demographic data and clinical characteristics of cortical dysfunction and movement disorder), neuropsychological assessment [Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scales score], brain magnetic resonance imaging (MRI) and multi-mode positron emission tomography (PET)/CT, were collected and carefully reviewed. Exact diagnosis of these patients was given according to the disease diagnosis criteria.Results:Cortical dysfunction and asymmetrical movement disorders were found in all cases, with poor response to levodopa. Patients suffered from cognitive impairment (MMSE score 16.16±9.82, MoCA score 13.44±7.35). The cranial MRI demonstrated significant asymmetric atrophy of frontal and parietal lobes, especially in the pre- and post-central gyrus. Fluorodeoxyglucose PET of 12 patients showed asymmetric frontal lobe and basal ganglia (especially caudate and putamen) hypometabolism (obviously on the contralateral side of the affected limb). Tau PET was implemented in 11 patients and displayed that abnormal tau protein deposition was positive in the cortex and/or subcortex in all patients. Of the 4 cases, who completed amyloid PET, amyloid protein deposition was positive in the cortex of 2 patients. As a result, 6 patients were diagnosed as progressive supranuclear palsy, 1 patient was diagnosed as corticobasal degeneration, and 5 patients were diagnosed as Alzheimer′s disease.Conclusions:The etiology of CBS is heterogeneous. The combination of clinical manifestation, cranial MRI and multi-mode PET/CT helps the differential diagnosis of CBS.

【Objective】 To investigate the predictive value of preoperative platelet/lymphocyte ratio (PLR) and neutrophil/lymphocyte ratio (NLR) (NLR-PLR) in peripheral blood for the prognosis of patients with upper urinary tract urothelial carcinoma (UTUC) undergoing radical surgery. 【Methods】 The clinical data of 104 UTUC patients who underwent radical nephroureterectomy plus bladder sleeve resection in our hospital during Jan.2015 and Dec.2020 were retrospectively analyzed. The receiver operating characteristic (ROC) curve was drawn according to NLR and PLR, the optimal cut-off values of NLR and PLR were calculated, and NLR-PLR was determined accordingly. The patients were divided into NLR-PLR group 1 (PLR ≥161.46 and NLR≥ 2.51) and NLR-PLR group 0 (remaining patients). Chi-square test was used for comparison between groups, and the Kaplan-Meier method was used to draw survival curves. According to the Cox univariate and multivariate risk regression models, the risk factors for decreased overall survival (OS) were determined. 【Results】 The optimal cut-off values of PLR and NLR were 161.46 and 2.51, respectively. There were 74 patients in the NLR-PLR group 0 and 30 in the NLR-PLR group 1. Cox multivariate regression analysis showed that T stage, maximum tumor diameter and NLR-PLR were independent risk factors for reduced OS (P<0.05). 【Conclusion】 Preoperative NLR-PLR is a potential predictor of the prognosis of UTUC patients. Higher NLR-PLR is associated with poorer prognosis.