Objective:To investigate the current situation of knowledge, attitude and practice of medical personnel in areas with high incidence of fever with thrombocytopenia syndrome (SFTS) in Anhui Province, in order to provide a scientific basis for conducting systematic training for medical personnel.Methods:From July to August 2024, a multi-stage random sampling method was used to select medical personnel from village, township, county, and city level medical institutions in high incidence areas of SFTS in Anhui Province (Hefei City, Liu'an City, Chuzhou City, Xuancheng City) for an online questionnaire survey on their knowledge, attitude, and practice status. The survey included demographic data, knowledge, attitude, and practice related to SFTS, and a binary logistic regression model was used to analyze the influencing factors of SFTS knowledge qualification rate.Results:A total of 2 718 valid questionnaires were collected, with an effective response rate of 99.60% (2 718/2 729). Among them, 1 384 were males, accounting for 50.92%. The majority were medical personnel aged 41 to 50 years old, with undergraduate degrees, junior professional titles, working in township health centers or community health service centers, as clinical physicians, and with a working experience of no more than 10 years. They accounted for 31.97% (869/2 718), 50.48% (1 372/2 718), 35.54% (966/2 718), 38.52% (1 047/2 718), 62.33% (1 694/2 718), and 30.61% (832/2 718), respectively. The overall correct rates of medical personnel's relevant knowledge, attitude and practice were 77.52% (31 605/40 770), 94.53% (12 847/13 590) and 89.73% (12 194/13 590), respectively. There were statistically significant differences in the knowledge qualification of medical personnel of different genders, ages, education levels, professional titles, hospital levels, job positions, and years of work experience ( P < 0.05). The results of binary logistic regression analysis showed that professional title, hospital level, work position, and work experience were the influencing factors of knowledge qualification rate ( P < 0.05). Conclusions:Medical personnel have a relatively positive attitude and high level of practice towards SFTS, but their knowledge level still needs to be improved. It is recommended to provide targeted knowledge training for medical personnel in different positions to promote early detection, diagnosis, and treatment of SFTS.

The composition of the Gut Microbiome(GM)is regulated by numerous factors,including geography,ethnicity,diet,and genetics.This review systematically synthesizes studies on the GM across different geographic regions and ethnic minority groups in China.It focuses on elucidating the impact of geographical factors and ethnic backgrounds on GM composition and structure and provides an in-depth discussion on the association between ethnicity-specific microbial taxa,their metabolic functions,and susceptibility to diseases.By systematically comparing microbial compositional differences in microbiota-related diseases among different populations,this review aims to uncover the underlying patterns.The findings are expected to provide a theoretical foundation for ethnicity-specific GM research,the elucidation of disease mechanisms,and the development of targeted prevention and control strategies.

Based on the practice of National Diabetes Prevention and Control Center (DPCC) in Hunan Province for five years, this paper systematically reviewed the excellent experience and advanced practices of diabetes prevention and control in several demonstration areas.

Based on the practice of National Diabetes Prevention and Control Center (DPCC) in Hunan Province for five years, this paper systematically reviewed the excellent experience and advanced practices of diabetes prevention and control in several demonstration areas.

Objective:To investigate the current situation of knowledge, attitude and practice of medical personnel in areas with high incidence of fever with thrombocytopenia syndrome (SFTS) in Anhui Province, in order to provide a scientific basis for conducting systematic training for medical personnel.Methods:From July to August 2024, a multi-stage random sampling method was used to select medical personnel from village, township, county, and city level medical institutions in high incidence areas of SFTS in Anhui Province (Hefei City, Liu'an City, Chuzhou City, Xuancheng City) for an online questionnaire survey on their knowledge, attitude, and practice status. The survey included demographic data, knowledge, attitude, and practice related to SFTS, and a binary logistic regression model was used to analyze the influencing factors of SFTS knowledge qualification rate.Results:A total of 2 718 valid questionnaires were collected, with an effective response rate of 99.60% (2 718/2 729). Among them, 1 384 were males, accounting for 50.92%. The majority were medical personnel aged 41 to 50 years old, with undergraduate degrees, junior professional titles, working in township health centers or community health service centers, as clinical physicians, and with a working experience of no more than 10 years. They accounted for 31.97% (869/2 718), 50.48% (1 372/2 718), 35.54% (966/2 718), 38.52% (1 047/2 718), 62.33% (1 694/2 718), and 30.61% (832/2 718), respectively. The overall correct rates of medical personnel's relevant knowledge, attitude and practice were 77.52% (31 605/40 770), 94.53% (12 847/13 590) and 89.73% (12 194/13 590), respectively. There were statistically significant differences in the knowledge qualification of medical personnel of different genders, ages, education levels, professional titles, hospital levels, job positions, and years of work experience ( P < 0.05). The results of binary logistic regression analysis showed that professional title, hospital level, work position, and work experience were the influencing factors of knowledge qualification rate ( P < 0.05). Conclusions:Medical personnel have a relatively positive attitude and high level of practice towards SFTS, but their knowledge level still needs to be improved. It is recommended to provide targeted knowledge training for medical personnel in different positions to promote early detection, diagnosis, and treatment of SFTS.

Objective To investigate the anti-inflammatory action of Celastrol in the ocular tissues of mice with ex-perimental autoimmune uveitis(EAU)and its effect on microglia polarization.Methods A total of 36 healthy B10.RⅢmice at 6-8 weeks of age were selected and randomly divided into the normal control group,EAU solvent control group and Celastrol intervention group,with 12 mice in each group.The interphotoreceptor retinoid-binding protein(IRBP)161-180 and Freund's complete adjuvant were mixed by thorough emulsification and injected subcutaneously into the bilateral thighs and tails of mice in the EAU solvent control group and the Celastrol intervention group with a total volume of 200 μL and 50 μg IRBP 161-180 in each mouse.On 7-14 days after immunization,mice in the Celastrol intervention group received a daily intraperitoneal injection of 0.5 mg·kg-1 Celastrol,and mice in the EAU solvent control group were injected with an equivalent dose of sterile Phosphate Buffered Saline solution.On the 14th day after immunization,the anterior segment of mice in each group was observed by slit-lamp microscope and Hematoxylin and Eosin(HE)staining of tissue sections was performed;the clinical and histopathological scores of mice in each group were obtained by reference to the Caspi grading standards;immunofluorescence staining was used to observe the activation of microglia in the eyes of mice;Western blot was used to detect the protein expression levels of inducible nitric oxide synthase(iNOS)and arginase-1(Argl)in the reti-na;quantitative real-time PCR was used to detect the relative mRNA expression of inflammatory factors in the retina,such as tumor necrosis factor(TNF)-α,interleukin(IL)-1β and IL-6.GraphPad Prism 9.0 was used for data analysis.Results On the 14th day after immunization,it was observed by the slit-lamp microscope that the anterior segment of mice in the EAU solvent control group was markedly congested with dilated iris blood vessels,corneal edema,and anterior chamber exudation;the inflammation in the anterior segment of mice in the Celastrol intervention group was markedly at-tenuated,and the iris blood vessels were seen to be mildly congested.Compared with the normal control group,the clini-cal scores of mice in the EAU solvent control group and the Celastrol intervention group were significantly elevated(both P＜0.05);the clinical scores of mice in the Celastrol intervention group were lower than those in the EAU solvent control group(P＜0.05).HE staining results showed that on the 14th day after immunization,mice in the EAU solvent control group showed severe retinal folds and detachment with diffuse infiltration of inflammatory cells,while mice in the Celastrol intervention group showed slight structural damage to the retina and a small amount of inflammatory cell infiltration.Com-pared with the normal control group,the histopathological scores of mice in the EAU solvent control group and the Celas-trol intervention group were significantly elevated(both P＜0.05);the histopathological scores of mice in the Celastrol in-tervention group were lower than those in the EAU solvent control group(P＜0.05).The intraocular Iba1+cell densities of mice in the normal control,EAU solvent control and Celastrol intervention groups were(1.00±0.12)％,(36.07± 4.57)％,and(1.83±0.36)％,respectively.Compared with the normal control group,the number of Iba1+cells in the eyes of mice in the EAU solvent control group and the Celastrol intervention group significantly increased(both P＜0.05);compared with the EAU solvent control group,the number of Iba1+cells in the eyes of mice in the Celastrol intervention group was significantly reduced(P＜0.05).Compared with the normal control group,the expression levels of iNOS and Arg1 proteins in the retinas of mice in the EAU solvent control group were significantly elevated(both P＜0.01);compared with the EAU solvent control group,the expression of iNOS protein in the retinas of mice in the Celastrol intervention group was significantly reduced(P＜0.01).Compared with the normal control group,the relative mRNA expressions of TNF-α.IL-1β,and IL-6 in the retinas of mice in the EAU solvent control group was significantly elevated(all P＜0.05);compared with the EAU solvent control group,the relative mRNA expressions of TNF-α,IL-1 β,and IL-6 in the retinas of mice in the Celastrol intervention group significantly decreased(all P＜0.05).Conclusion Celastrol inhibits Ml microglia activation and reduces the production of retinal inflammatory factors TNF-α,IL-1 β and IL-6 in EAU mice,thereby attenuating the in-flammatory reaction.

Humans ; Glycated Hemoglobin ; Diabetes Mellitus, Type 1 ; Blood Glucose ; Diabetes Mellitus, Type 2

Objective:To mine and analyze the signals of the adverse event (AE) of erenumab and provide reference for the safe application of the drug.Methods:The reports of AE from 2004 to the first quarter of 2023 were extracted from the US FDA Adverse Event Reporting System database, and the full data and data after 2018 were analyzed respectively. AEs were classified according to preferred term (PT) and the system organ class (SOC) of Medical Dictionary for Regulatory Activities (MedDRA) 23.0 version for statistical analysis. The reported odds ratio (ROR) method and Bayesian confidence progressive neural network (BCPNN) method were used to mine the AE risk signals.Results:A total of 38 348 AE reports with erenumab as the primary suspect drug were collected, involving 2 629 PTs. The number of risk signals screened by the ROR and BCPNN methods from the full data and data after 2018 was 99 and 115, respectively, involving 19 SOCs. Among them, the most frequently reported AEs were injection site reactions and constipation, which were consistent with the label. Among the top 30 PTs, 13 were not recorded in the label, including pineal cyst, postural tachycardia, positive histone antibody, spastic eye movements, fear of injection, post-concussion syndrome, Raynaud effect, psychogenic seizures, coronary artery dissection, premature menopause, trichorrhexis, collagen disease, and blepharospasm.Conclusion:In clinical application of erenumab, in addition to the adverse reactions recorded in the label, attention should also be paid to the adverse events mined in this study.

Objective:To mine and analyze the signals of the adverse event (AE) of erenumab and provide reference for the safe application of the drug.Methods:The reports of AE from 2004 to the first quarter of 2023 were extracted from the US FDA Adverse Event Reporting System database, and the full data and data after 2018 were analyzed respectively. AEs were classified according to preferred term (PT) and the system organ class (SOC) of Medical Dictionary for Regulatory Activities (MedDRA) 23.0 version for statistical analysis. The reported odds ratio (ROR) method and Bayesian confidence progressive neural network (BCPNN) method were used to mine the AE risk signals.Results:A total of 38 348 AE reports with erenumab as the primary suspect drug were collected, involving 2 629 PTs. The number of risk signals screened by the ROR and BCPNN methods from the full data and data after 2018 was 99 and 115, respectively, involving 19 SOCs. Among them, the most frequently reported AEs were injection site reactions and constipation, which were consistent with the label. Among the top 30 PTs, 13 were not recorded in the label, including pineal cyst, postural tachycardia, positive histone antibody, spastic eye movements, fear of injection, post-concussion syndrome, Raynaud effect, psychogenic seizures, coronary artery dissection, premature menopause, trichorrhexis, collagen disease, and blepharospasm.Conclusion:In clinical application of erenumab, in addition to the adverse reactions recorded in the label, attention should also be paid to the adverse events mined in this study.

Objective:To compare the efficacy and safety of radium-223 in the treatment of metastatic castration-resistant prostate cancer (mCRPC) patients with and without homologous recombination repair (HRR) gene mutation.Methods:The clinical data of 27 patients with mCRPC bone metastases who received radium-223 therapy from April 2021 to November 2022 in Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine were retrospectively analyzed. Among the 27 mCRPC patients, 18 patients carrying HRR gene mutations belonged to the HRD(+ ) group, and 9 patients without HRR gene mutation belonged to the HRD(-) group. The age of patients in HRD(+ ) group was 69.5 (63.8, 77.0) years old, alkaline phosphatase (ALP) was 243.0 (82.8, 301.3) U/L, prostate specific antigen (PSA) was 71.6 (7.3, 329.8) ng/ml, pain score was 3.0 (1.0, 5.0) points. Eastern Cooperative Oncology Group (ECOG) score ranged from 0 to 1 points in 7 cases, and 2 points in 11 cases. In the HRD(-) group, the median age was 72.0 (64.5, 76.5) years old, ALP was 88.0 (67.5, 260.6) U/L, PSA was 19.1 (1.1, 117.8) ng/ml, and pain score was 2.0 (0, 4.5) points. The ECOG score ranged from 0 to 1 in 4 cases, and 2 in 5 cases in the HRD(-) group. There was no significant difference in the above general data between the two groups ( P>0.05). All patients received radium-223 treatment every 4 weeks, no more than 6 times. The changes of ALP, PSA, pain score and hematological adverse reactions were compared between the two groups. Results:In the HRD(+ ) group, the median number of radium-223 treatment was 4.5 (3.0, 5.3) couses, 4 patients (22.2%) completed 6 courses, and 6 patients died of prostate cancer during follow-up. In the HRD(-) group, the median number of radium treatment was 4.0 (2.5, 6.0) couses, 3 patients (33.3%) completed 6 courses, and 1 patient died of prostate cancer during follow-up. There was no significant difference in the number of radium treatment courses between the two groups ( P=0.320). ALP in HRD(+ ) group was 101.8 (61.3, 147.0) U/L after radium-223 treatment, which was significantly lower than that before treatment ( P=0.002). ALP in HRD(-) group was 73.0 (64.0, 113.5) U/L after radium-223 treatment, and it was not significantly different from that before treatment ( P=0.327). The rate of ALP response (ALP decrease >10%) in HRD(+ ) group was significantly higher than that in HRD(-) group [83.3% (15/18) vs. 44.4% (4/9), P=0.037]. PSA was 105.9(5.2, 798.4) ng/ml in HRD (+ ) group after radium-223 treatment, and was 25.6(0.8, 1 031.0) ng/ml in HRD(-) group, and they were not significantly different from that before treatment ( P=0.145, P=0.386). There were no significant differences in the rate of PSA response (PSA decrease>10%) between HRD(+ ) group and HRD(-) group [38.9% (7/18) vs. 22.2% (2/9), P=0.386]. The median pain score of HRD(+ ) group was 3.0 (0, 4.0) points after treatment, which was significantly lower than that before treatment ( P=0.028). The pain score of HRD(-) group was 1.0(0, 3.0) points after treatment, and it was not significantly different from that before treatment ( P=0.129). There was no significant difference in pain relief rate between HRD(+ ) group and HRD(-) group [66.7% (12/18) vs. 44.4% (4/9), P=0.411]. The incidence of at least one hematological adverse event during radium-223 treatment in the HRD(+ ) group was higher than that in the HRD(-) group [77.8% (14/18) vs. 33.3% (3/9), P=0.039]. There was no significant difference in the incidence of grade 1-2 hematological adverse events between the two groups [72.2%(13/18) vs. 33.3%(3/9), P=0.097]. Only 1 patient in the HRD(+ ) group experienced grade 3 anemia during treatment which was recovered after blood transfusion. Conclusions:Compared to mCRPC patients without HRR gene mutation, patients with HRR gene mutations had better ALP response and bone pain relief after radium-223 treatment. The overall incidence of adverse events in the HRD(+ ) group is higher than that in HRD(-) group, and there was no significant difference in grade 1-2 hematological adverse events between the two goups. It is necessary to expand the sample size to further verify the conclusion.