Objective　To study the relationship between atherosclerotic plaques in carotid artery and ischemic cerebrovascular diseases. Methods　The extracranial carotid arteries (ECA) and middle cerebral artery (MCA) of 54 patients with transient ischemic attack (TIA) or cerebral infarction (CI) were examined with doppler ultrasound. The distribution of atherosclerotic plaque, degree of stenosis and ultrasounic classification of ECA and the mean velocity of blood flow in MCA were examined. Results　①Stenosis over middle-grade on asymptomatic side in extracranial internal carotid artery (EICA) in group of patients with TIA was significantly higher than symptomatic side(P<0.01). Stenosis over high-grade on asymptomatic side in ELCA in group of patients with CI was significantly higher than symptomatic side (P<0.01). ②Flat and soft plaque are most common in group of patients with TIA or CI, then are hard and ulcerative plaques. Incidence of soft plaques on asymptomatic side in group of patients with TIA or CI are significantly higher than symptomatic side (P<0.01); ③Among the group of patients with CI, mean velocity of MCA decreased on asymptomatic side in 31 cases (68.9%), and significantly higher than symptomatic side (P<0.01). Conclusion　Atheroclerotic plaques in carotid artery and intracranial hemodynamic characteristics are the important risk factors for ischemic cerebrovascular diseases. These findings have important values in predicting subsequent TIA or CI in asymptomatic subjects.

Objective To investigate clinicopathological features、diagnosis and surgical treatment of duodenal stromal tumors. Methods A retrospective clinical analysis was made in 23 cases of duodenal stromal tumors admitted from 1995 to 2004. Results Melena and abdominal pain was the most common presenting symptom. Complete resection was achieved in all cases, including pancreatoduodenectomy in 13 cases, by pylorus-preserving pancreatoduodenectomy in 3 cases, and tumor enucleation in 7 cases. The mean size of the tumor was 6. 6 cm (2 - 21 cm) , among them 10 cm in 6. Pathologically tumors less than 5 cm were all of potential malignancy, whereas those larger than 5 cm were malignant. Follow-up of 2 months to 9 years found all cases alive and healthy except for one who died of liver metastasis one year postoperatively. Conclusion Duodenal stromal tumors were low malignancy tumors. Aggressive surgery is the choice of treatment. Favorable prognosis is expected after complete surgical excision.

Objective To type Streptococcus pneumoniae(S.pneumoniae) isolated from children, and provide scientific basis for the correct selection of S.pneumoniae vaccine.Methods 182 strains of S.pneumoniae were collected from Children's Hospital of Hebei Province in 2014, species of strains were identified by polymerase chain reaction (PCR), types of strains were analyzed with multiplex PCR.Results PCR detection showed that cpsA gene amplification of 182 strains were all positive;multiplex PCR detection revealed that except 8 strains were not typed, the main types of the remaining 174 strains were 19 F (n=68, 37.36%), 19A(n=33, 18.13%), and 6A/6B (n=26,14.28%), the other types were 35B, 14, 6C/6D, 23F, 15B/15C, and so on.Conclusion The main types of 182 strains of S.pneumoniae are 19 F, 19A, and 6A/6B, which provide scientific basis for the correct selection of S.pneumoniae vaccine for this province.

[Objective]To excavate and analyze the prescription and medication rules of Dr.XU Xiancha in treating children with external heat dampness.[Methods]Select Dr.XU Xiancha's medical records of pediatric external heat and dampness,and enter data according to items such as"name""gender""age""disease name""main symptom""tongue pulse""pathogenesis""treatment""drug composition"to establish a database of external heat and dampness medical records.By using application software such as Excel 2021,SPSS Modeler 18.0,Cytoscape,SPSS Statistics 25.0,and using frequency statistics,association rules and cluster analysis techniques,the frequency of drug use,drug meridians,four Qis and five flavors,and commonly used drug equivalence in the prescription were analyzed.A complex network analysis was conducted on all drugs to obtain the core prescription.[Results]A total of 995 prescriptions and 145 drugs were included.Among them,the top 10 high-frequency drugs ranked included Artemisiae Annuae Herba,Eupatorii Herba,Gardeniae Fructus Praeparatus,Trichosanthis Radix,Curcumae Radix,Crataegi Fructus,Galli Gigerii Endothelium Corneum,Liuyi Powder,Citri Reticulatae Pericarpium and Amomi Fructus Rotundus.The five flavors of high-frequency drug were mainly pungent,bitter and sweet,while the four Qis were mainly cold and warm.The meridians mainly belonged to the lung meridian,spleen meridian and stomach meridian.The top three in the combination of prescriptions were mainly Qi regulating drugs,heat clearing drugs and phlegm resolving drugs.Association rule analysis revealed 373 highly correlated drug pairs,including Artemisiae Annuae Herba-Eupatorii Herba,Artemisiae Annuae Herba-Gardeniae Fructus Praeparatus,and Eupatorii Herba-Gardeniae Fructus Praeparatus.Through cluster analysis,two types of drugs were obtained,among which type 1 had Artemisiae Annuae Herba,Eupatorii Herba,Gardeniae Fructus Praeparatus,Curcumae Radix,Galli Gigerii Endothelium Corneum,Trichosanthis Radix and Crataegi Fructus;Type 2 Citri Exocarpium Rubrum,Peucedani Radix.Type 1 was frequently used.The core prescription obtained from the complex network analysis results consisted of 10 drugs,including Artemisiae Annuae Herba,Eupatorii Herba,Gardeniae Fructus Praeparatus,Curcumae Radix,Galli Gigerii Endothelium Corneum,Trichosanthis Radix,Crataegi Fructus,Chrysanthemi Flos,Amomi Fructus Rotundus and Forsythiae Fructus.[Conclusion]Combined with the special physiological and pathological characteristics of children and the condition of dampness and heat in the Shao region,the clinical manifestation of summer-dampness in children is mainly caused by evil of lung,spleen and stomach.Dr.XU Xiancha's treatment of summer-damp external sensation is mainly based on the method of clearing heat and drying dampness and regulating Qi,supplemented by nourishing Yin and promoting fluid,strengthening the spleen and relieving food.

Objective To analyze the brucellosis epidemic and genotyping characteristics of Brucella strains isolated from Hebei Province,and to provide scientific basis for brucellosis control and prevention.Methods Descriptive epidemiological analysis (including region,population,and time distribution characteristics) was performed using individual data of human brucellosis in Hebei Province from the National Notifiable Infectious Disease Reporting Information System of China Information System for Disease Control and Prevention in 2016,Brucella strains were isolated by phase culture bottles in Brucellosis Lab from Hebei Provincial Center for Disease Control and Prevention.Multiple-locus variable-number tandem-repeat analysis (MLVA) was used to identify the genotyping characteristics of the isolates.Results There were 3 774 reported cases in 2016,and 11 cities in the province had reported the cases.The cases were found mainly in Zhangjiakou,Chengde and Tangshan.And 95.98％ (167/174) of all counties were reported brucellosis cases.Vocational high risk population was farmers and herdsmen engaged in livestock and processing of animal products,accounting for 90.22％ (3 405/3 774).Male had the highest incidence,accounting for 74.38％ (2 807/3 774).The onset time was concentrated in January-August,accounting for 83.67％ (3 161/3 774).Twenty-one strains of Brucella were isolated,twenty isolates were Brucella melitensis biovar 3,and one isolate was Brucella abortus biovar 3.Panel 1 (MLVA-8) identified three genotypes 42,43,and 114,with genotype 42 representing 85.00％ (17/20);Panel 1 + Panel 2A (MLVA-11) identified three genotypes 116,122,291,with genotype 116 representing 85.00％ (17/20),which were identified as belonging to the East Mediterranean group.Panel 1 (MLVA-8) identified the genotype 36,Panel 1 + Panel 2A (MLVA-11) identified the genotype 72 of one Brucella abortus strain.It was identified as belonging to abortus C.Conclusions The brucellosis epidemic in Hebei is relatively severe,the pathogenic bacteria is mainly Brucella melitensis.The MLVA assay is a very practical and important molecular genotyping tool,it provides a basis for tracing the source of brucellosis infection.

Objective:To analyze the spatial-temporal epidemiological characteristics of pertussis from 2013 to 2022 in Hebei Province and to provide a reference for improving prevention and control measures.Methods:Based on the data of pertussis reported in Hebei Province during 2013-2022 to analyze the popular characteristic, the ArcGIS 10.8 software was used to construct a ring map and to perform spatial autocorrelation analysis; the SaTScan 10.1 software was used for spatial-temporal scan statistics.Results:There were 6 715 cases of the cumulative report in Hebei Province from 2013 to 2022 without death. The annual report incidence was 0.90/100 000. The overall incidence rate showed an upward trend from 2013 to 2019, and during 2020-2021, it showed a sharp decline, but in 2022, it showed a sharp increase. Summer and autumn are the peak seasons of the epidemic. The incidence was highest in age group <1 year (48.67%), and the lowest age group in age group ≥15 years (0.45%) and mainly scattered children (78.03%); the incidence about men is higher than women. Spatial autocorrelation analysis showed that the onset of pertussis has spatial clustering, and high-high clusters were found in Langfang, Baoding, and Cangzhou, the top three countries with reported incidence. The area covered by a low-low cluster was consistent with the distribution of the corresponding low-incidence areas in this study. Space-time scan detects five statistically significant areas, and three zones were concentrated in 2022.Conclusions:The incidence of pertussis in Hebei had obvious season, population, and area-specific differences. There was obvious spatiotemporal and clustering, so the control of key areas should target the characteristics of time and space.

Objective To analyze the relationship between the fat content of supraspinatus muscle measured by spectral CT fat-muscle material decomposition technology and the tendon tear severity(TTS)of supraspinatus,as well as shoulder joint function.Methods A total of 108 patients were prospectively selected to undergo routine MRI and spectral CT imaging of the shoulder joints.The patients were divided into normal,degenerative,partial tear,and full-thickness tear groups based on MRI findings.A fat-muscle material decomposition image was generated through spectral analysis to measure the fat content of supraspinatus muscle.The differences in fat content of supraspinatus muscle between the groups were compared,and correlation analyses were performed between the fat content of supraspinatus muscle and the clinical baseline characteristics,symptom duration,and Constant-Murley scores in patients with supraspinatus tendon tears.Results Comparison of supraspinatus muscle fat content among the four groups:the full-thickness tear group＞the partial tear group＞the degenerative group＞the normal group(P＜0.05).There was a strong positive cor-relation between the supraspinatus muscle fat content and the supraspinatus TTS(r=0.654,P＜0.05).Among patients with partial and full-thickness tears of the supraspinatus tendon,there was a moderate positive correlation between supraspinatus muscle fat content and patient age(r=0.393,P＜0.05),a weak positive correlation with gender(r=0.199,P＜0.05),with higher fat content observed in females compared to males,no significant correlation with symptom duration(r=0.037,P＞0.05),a moderate positive correla-tion with body mass index(BMI)(r=0.463,P＜0.05),and a moderate negative correlation with Constant-Murley score(r=-0.316,P＜0.05).Conclusion In patients with rotator cuff tears,the quantitative fat content of supraspinatus muscle based on spectral CT fat-muscle material decomposition technology is strongly positively correlated with rotator cuff injury degree,and is also correlated with patient age,gender,BMI,and the strength of the shoulder joint muscles and range of the motion.

Objective:To investigate the carriage status of Neisseria meningitidis ( Nm) among the healthy population in Hebei Province for the prevention and control of meningitis. Methods:From 2015 to 2022, throat swabs were collected from health people, which were selected by cluster random sampling in 11 cities of Hebei.The positive rate of Nm was detected by bacterial culture. The serogroups of isolated strains were identified.The laboratory detection results of Nm strains, combined with epidemiological survey data, were synthetically analyzed. Results:A total of 20 245 people were investigated; 249 strains of Nm were isolated; the overall Nm carriage rate was 1.23%. The carriage rate was significantly higher in men than in women(χ 2=28.831, P<0.05). The positive rates of Nm in different age groups were significantly different(χ 2=428.018, P<0.05), with the highest rates in the 15-19 year-old group(4.90%, 149/3 042). The positive rates of Nm were significantly different in different regions(χ 2=177.512, P<0.05), with the highest positive rate of Nm in Xingtai, Shijiazhuang, Chengde and Baoding city in sequence. Among the isolated Nm strains, ungroupable serogroups, serogroup B, serogroup C, and serogroup W accounted for 71.49%(178/249), 13.65%(34/249), 6.83%(17/249) and 4.42%(11/249), respectively. Conclusions:The carriage rate of Nm among healthy population is generally low in Hebei Province. It is recommended to continue to strengthen monitoring, pay attention to the changes and distribution characteristics of Nm, and formulate scientific and targeted prevention and control measures of meningococcal disease.

OBJECTIVETo explore the efficacy and safety of deferasirox in aplastic anemia (AA)patients with iron overload.

METHODSA single arm, multi- center, prospective, open- label study was conducted to evaluate absolute change in serum ferritin (SF)from baseline to 12 months of deferasirox administration, initially at a dose of 20 mg·kg(-1)·d(-1), and the safety in 64 AA patients with iron overload.

RESULTSAll patients started their deferasirox treatment with a daily dose of 20 mg · kg(-1) ·d(-1). The mean actual dose was (18.6±3.60) mg · kg(-1)·d(-1). The median SF decreased from 4 924 (2 718- 6 765)μg/L at baseline (n=64) to 3 036 (1 474- 5 551)μg/L at 12 months (n=23) with the percentage change from baseline as 38%. A median SF decrease of 651 (126-2 125)μg/L was observed at the end of study in 23 patients who completed 12 months' treatment, the median SF level decreased by 1 167(580-4 806)μg/L [5 271(3 420-8 278)μg/L at baseline; 3 036(1 474-5 551)μg/L after 12 months' treatment; the percentage change from baseline as 42% ] after 12 months of deferasirox treatment. The most common adverse events (AEs) were increased serum creatinine levels (40.98%), gastrointestinal discomfort (40.98%), elevated liver transaminase (ALT: 21.31%; AST: 13.11%)and proteinuria (24.59%). The increased serum creatinine levels were reversible and non-progressive. Of 38 patients with concomitant cyclosporine use, 12(31.8%)patients had two consecutive values >ULN, 10(26.3%)patients had two consecutive values >1.33 baseline values, but only 1(2.6%)patient's serum creatinine increased more than 1.33 baseline values and exceeded ULN. For both AST and ALT, no patients experienced two post- baseline values >5 ×ULN or >10 × ULN during the whole study. In AA patients with low baseline PLT count (less than 50 × 10(9)/L), there was no decrease for median PLT level during 12 months' treatment period.

CONCLUSIONSAA patients with iron overload could achieve satisfactory efficacy of iron chelation by deferasirox treatment. The drug was well tolerated with a clinically manageable safety profile and no major adverse events.

Anemia, Aplastic ; drug therapy ; Benzoates ; therapeutic use ; Blood Transfusion ; China ; Ferritins ; blood ; Humans ; Iron ; blood ; Iron Chelating Agents ; therapeutic use ; Iron Overload ; drug therapy ; Liver ; Prospective Studies ; Triazoles ; therapeutic use

Acute cerebral infarction （ACI）， also known as ischemic stroke， is a disease with a high disability rate， which brings heavy burdens to society and families. Its pathogenesis is related to many factors， of which the inflammatory theory is one of the important mechanisms. In the early stage of ACI， microglia are activated， and the inflammatory mediators， such as interleukins and tumor necrosis factor-α （TNF-α）， released by them induce vascular endothelial cells to express adhesion molecules. The circulating leukocytes （neutrophils， monocyte-macrophages， etc.） are promoted to roll and adhere to the injured vascular endothelium， migrate and cross the blood-brain barrier， penetrate and infiltrate the brain parenchyma， and further expand the local inflammatory response by releasing a variety of proinflammatory mediators， thus exacerbating the tissue injury at the injury site and ischemic penumbra. Traditional Chinese medicine （TCM） has advantages in treating the disease. TCM believes that the occurrence of stroke is related to blood stasis caused by various reasons， which block the brain vessel. This article reviewed the research progress on the effect of activating blood therapy on inflammatory factors in patients with ACI in recent years and discussed its regulation of inflammatory factors in ACI such as interleukin-1 （IL-1）， interleukin-6 （IL-6）， interleukin-8 （IL-8）， interleukin-10 （IL-10）， TNF-α， C reactive protein （CRP）， and monocyte chemotactic protein-1 （MCP-1）， hoping to elucidate the scientific connotation of TCM treatment of ACI and lay the foundation for further research.