Objective To evaluate the effectiveness of schistosomiasis surveillance in Jiangsu Province during the stage moving from transmission control to transmission interruption, and to analyze the current risk and challenges, so as to provide the evidence for achieving the target of schistosomiasis elimination. Methods Schistosomiasis surveillance data were collected from Jiangsu Province from 2012 to 2024, and the endemic areas, Schistosoma japonicum infections in humans and livestock, Oncomelania hupensis snail distribution and implementation of integrated interventions were descriptively analyzed. In addition, the trends in areas with snails, seroprevalence of human S. japonicum infections and numbers of advanced schistosomiasis cases were assessed using a Joinpoint regression model. Results The endemic areas of schistosomiasis continued to shrink in Jiangsu Province from 2012 to 2024, with the number of schistosomiasis-eliminated counties (cities, districts) increasing from 53 (75.71%) to 63 (96.92%), and interruption of schistosomiasis transmission was achieved across the province. A total of 4 600 300 person-times were tested for serum antibodies against S. japonicum, with 28 719 person-times positive detected; and 616 500 person-times were tested S. japonicum infections among local residents in Jiangsu Province from 2012 to 2024, with only 3 egg-positives detected, and no egg-positives found since 2017. A total of 187 600 herd-times were tested for schistosomiasis in livestock, and no S. japonicum infections were found. O. hupensis snail survey was performed covering 1 018 408.97 hm², and a total of 35 556.35 hm² was found with snail-infested habitats, including 174.40 hm2 of emerging snail-infested habitats. A total of 1 102 800 O. hupensis snails were identified for S. japonicum infections, and no infections were found. The areas of snail-infested habitats appeared a tendency towards a rise in Jiangsu Province from 2019 to 2023 (APC = 23.67%, P < 0.05), and the actual areas of snail-infested habitats appeared a tendency towards a decline from 2012 to 2015 (APC = −22.77%, P < 0.05), and towards a rise from 2015 to 2023 (APC = 9.76%, P < 0.01). The seroprevalence of anti-S. japonicum antibodies appeared a tendency towards a decline among residents in Jiangsu Province from 2017 to 2023 (APC = −14.92%, P < 0.01). In addition, the number of newly diagnosed advanced schistosomiasis cases appeared a tendency towards a decline from 2012 to 2024 (APC = −12.02%, P < 0.01), and the numbers of advanced schistosomiasis patients requiring treatment showed a tendency towards a decline from 2012 to 2021 (APC = −10.56%, P < 0.01) and from 2021 to 2023 (APC = −20.06%, P < 0.01). Conclusions Great progresses had been achieved in schistosomiasis control in Jiangsu Province following transmission control, and transmission interruption had been achieved; however, there are still snail-infested habitats. High-intensity surveillance and integrated control are required to be maintained to advance the achievement of the target of schistosomiasis elimination in Jiangsu Province.

ObjectiveTo investigate the mechanism by which Jianpi Xiao'ai prescription （JPXAP） inhibits colorectal cancer progression by regulating the inducible nitric oxide synthase-arginase 1 （iNOS-ARG1） metabolic axis and inducing mitochondrial reactive oxygen species （mito-ROS）-mediated mitochondrial structural and functional impairment. MethodsAn arginine metabolism disorder model of human colorectal cancer HCT116 cells was established by combined treatment with recombinant human interferon-γ （IFN-γ， 10 μg·L^-1） and N（ω）-hydroxy-L-arginine （Nor-NOHA， 200 μmol·L^-1） for 24 h， followed by intervention with 5%， 10%， or 20% JPXAP-containing serum. Cell proliferation was assessed using cell counting kit-8 （CCK-8）， 5-ethynyl-2′-deoxyuridine （EdU） staining， and colony formation assays. Cell invasion and migration were evaluated using Transwell chamber and wound healing assays. Mitochondrial membrane potential （MMP） and ROS levels were assessed by JC-1 and MitoSOX staining， respectively. Mitochondrial ultrastructure was observed by transmission electron microscopy （TEM）. The expression of iNOS， ARG1， and mitochondrial dynamics-related proteins， including mitofusin 2 （MFN2） and dynamin-related protein 1 （DRP1）， was analyzed by Western blot and immunofluorescence. The levels of L-arginine， citrulline， and urea were determined by colorimetric methods and enzyme-linked immunosorbent assay （ELISA）. ResultsCompared with the blank group， the model group exhibited significantly upregulated iNOS expression， downregulated ARG1 expression， a decreased ARG1/iNOS ratio， reduced L-arginine and urea levels， and increased citrulline levels （P<0.05）. Meanwhile， mito-ROS accumulation was significantly increased， the JC-1 red/green fluorescence ratio was decreased， and mitochondria showed swelling and cristae disruption， indicating that metabolic disorder induced mitochondrial injury. Compared with the model group， all JPXAP-treated groups further decreased the ARG1/iNOS ratio， enhanced nitric oxide （NO） and reactive nitrogen species accumulation， further reduced L-arginine and urea levels， and increased citrulline levels （P<0.01）. EdU-positive rate， colony formation rate， wound healing rate， and Transwell invasion number all decreased significantly with increasing serum concentration （P<0.01）. Mito-ROS levels were further elevated， and the JC-1 red/green ratio further decreased. TEM revealed aggravated mitochondrial swelling and vacuolization. MFN2 expression was downregulated and DRP1 expression was upregulated （P<0.01），in a dose-dependent manner. ConclusionJPXAP further activates NO-mediated oxidative/nitrosative stress under arginine metabolism imbalance， inducing mito-ROS accumulation， MMP collapse， and mitochondrial dynamics imbalance， thereby inhibiting colorectal cancer cell proliferation and migration. These findings reveal an antitumor mechanism of JPXAP based on coordinated targeting of the "metabolism-mitochondria" axis.

Objective To examine the association between epidemiological characteristics of hemorrhagic fever with renal syndrome (HFRS) and meteorological factors in Shenzhen City during the period from 2012 to 2019. Methods Average atmospheric pressure, average air temperature, average relative humidity, precipitation, wind speed, and sunshine duration were captured from Meteorological Bureau of Shenzhen City each month from 2012 to 2019. The average monthly rodent densities in Shenzhen City from 2012 to 2019 were acquired from the Vector Surveillance Management System of Guangdong Provincial Center for Disease Control and Prevention, and the monthly HFRS incidence was retrieved from Shenzhen Municipal Disease Surveillance System from 2012 to 2019. The correlation between meteorological factors and the monthly incidence of HFRS was examined us ing Spearman’s rank correlation in Shenzhen City, and the temporal trends in monthly HFRS incidence and the degrees of freedom for the rodent density were determined in Shenzhen City with a generalized additive model. The optimal lag time was identified using excess risk (ER) and its 95% confidence interval (CI), and univariate and multivariate models were fitted to evaluate the impact of meteorological factors on HFRS incidence in Shenzhen City. Results The median number of incident HFRS cases was 3.00 (interquartile range, 3.25) in Shenzhen City from 2012 to 2019, with an average air temperature of (23.44 ± 4.91) °C, average relative humidity of (76.05 ± 7.61)%, median precipitation of 4.10 (interquartile range, 6.83) mm, average wind speed of (1.97 ± 0.26) m/s, average sunshine duration of (5.17 ± 1.64) h, and median monthly rodent density of 1.74% (interquartile range, 2.52%). Spearman’s rank correlation analysis showed that the average air temperature positively correlated with average relative humidity (r_s = 0.420, P < 0.05), precipitation (r_s = 0.658, P < 0.05) and sunshine duration (r_s = 0.633, P < 0.05), and the atmospheric pressure negatively correlated with average air temperature (r_s = −0.925, P < 0.05), relative humidity (r_s = −0.614, P < 0.05), precipitation (r_s = −0.789, P < 0.05) and sunshine duration (r_s = −0.437, P < 0.05), while the average relative humidity correlated positively with precipitation (r_s = 0.724, P < 0.05) and negatively with sunshine duration (r_s = −0.218, P < 0.05). Univariate modeling analysis showed that the ERs and their 95% CI were 0.639% (0.540%, 0.737%) for average atmospheric pressure, −7.157% (−8.113%, −6.190%) for average air temperature, −3.603% (−4.219%, −2.985%) for average relative humidity, −5.889% (−7.085%, −4.669%) forprecipitation,21.881% (−5.149%, 56.612%) for average wind speed, and −13.877% (−16.641%, −11.022%) for sunshine duation (all P values < 0.05). Multivariate modeling analysis showed that in the ensemble model combining average atmospheric pressure and precipitation, the highest ER (6.686%) was caused by increased average atmospheric pressure, and the highest absolute ER values for average air temperature (6.615%), average relative humidity (3.107%) and precipitation (5.386%) were seen after adjustment only for sunshine duration (all P values < 0.05), while the highest absolute ER for sunshine duration (11.875%) was found after adjustment for precipitation (P < 0.05). Conclusions An increase in average air temperature, relative humidity, precipitation and sunshine duration resulted in a reduced incidence rate of HFRS in Shenzhen City from 2012 to 2019, and an increase in average atmospheric pressure increased the incidence of HFRS. Meteorological factors are important determinants affecting HFRS incidence in Shenzhen City.

Objective To explore the role of chloride intracellular channel 5 (CLIC5) in the development of lung adenocarcinoma (LUAD). Methods The expression levels of CLIC5 in LUAD samples were determined using bioinformatics and qRT-PCR. The correlation between CLIC5 expression and LUAD progression was revealed through survival analysis and clinicopathological feature analysis. After the knockdown or overexpression of CLIC5 in the LUAD cells, cell proliferation was assessed through colony formation assay, cell apoptosis rate by flow cytometry, and cell migration and invasion by scratch and Transwell invasion assay. The protein levels of vimentin and Snail were detected by Western blot. Results Bioinformatics analysis results showed low CLIC5 expression levels in the LUAD samples. This finding was associated with the aggressive progression of LUAD and the poor survival of patients with LUAD. The qRT-PCR results confirmed that CLIC5 was mainly expressed in the cytoplasm of the LUAD cells. CLIC5 overexpression inhibited cell activity and proliferation and promoted the apoptosis of LUAD cells. The knockdown of CLIC5 exhibited the opposite effect. CLIC5 overexpression inhibited the migration and invasion of LUAD cells, downregulated Bcl-2, vimentin, and Snail and upregulated Bax, cleaved caspase-3 and E-cadherin in the LUAD cells. CLIC5 knockdown exhibited opposite effects. Conclusion CLIC5 overexpression promotes cell apoptosis and inhibits cell proliferation and invasion, thereby inhibiting the development of LUAD. Hence, CLIC5 is a novel biomarker of prognosis and therapeutic target for LUAD.

OBJECTIVE To investigate the mechanism by which resveratrol improves renal injury in rats with uric acid nephropathy （UAN） through inhibition of the protein kinase R-like endoplasmic reticulum kinase （PERK）/eukaryotic translation initiation factor 2α （eIF2α） pathway.METHODS A UAN rat model was established via oral administration of adenine plus potassium oxonate， and the rats were divided into a UAN model group， a positive control group （allopurinol 10 mg/kg）， a resveratrol group （100 mg/kg）， and a resveratrol+tunicamycin group [resveratrol 100 mg/kg+tunicamycin （PERK activator） 1 mg/kg]. A control group （without modeling） was also established， with 6 rats in each group. Rats in each group were administered the corresponding drug solution and/or normal saline via gavage or intraperitoneal injection once daily for 28 consecutive days. The contents of renal function-related parameters （24-hour urinary total protein， and uric acid， creatinine and blood urea nitrogen in serum）， the levels of inflammation-related markers [interleukin-6 （IL-6）， IL-18， tumor necrosis factor-α （TNF-α）， IL-10， and nucleotide-binding domain leucine-rich repeat and pyrin domain-containing receptor 3 （NLRP3）]， and pathological changes in renal tissue were determined， and the score for tubular damage， the score for inflammatory infiltration， and the degree of mesangial proliferation were assessed. The mRNA expressions of neutrophil gelatinase-associated lipocalin （NGAL） and kidney injury molecule-1 （KIM-1）， as well as the expressions of proteins associated with the PERK/eIF2α pathway， were measured in renal tissue from each group.RESULTS Compared with the control group， rats in the UAN model group exhibited marked tubular damage， inflammatory cell infiltration， and mesangial proliferation. The contents of renal function-related parameters， levels of IL-6， IL-18， TNF-α and NLRP3， scores for tubular damage and inflammatory infiltration， degree of mesangial proliferation， mRNA expressions of NGAL and KIM-1， and phosphorylation levels of PERK and eIF2α， as well as the expressions of activating transcription factor 4 and C/EBP homologous protein， were all significantly increased or upregulated， while IL-10 levels were significantly decreased （ P ＜0.05）. Compared with the UAN model group， the resveratrol group and the positive control group showed significant improvements in all of the aforementioned parameters （ P ＜0.05）. Tunicamycin could significantly reverse the beneficial effects of resveratrol on all quantitative parameters （ P ＜0.05）.CONCLUSIONS Resveratrol can reduce inflammatory responses in renal tissue of UAN rats， and improve tubular damage and renal function. These effects may be related to the inhibition of endoplasmic reticulum stress mediated by the PERK/eIF2α pathway.

[Objective] To investigate the infection status and characteristics of HEV among voluntary blood donors in Ningbo, and to provide a basis for improving the blood screening strategy. [Methods] A total of 12 227 blood samples from voluntary blood donors in Ningbo from June 2022 to May 2023 were tested for HEV serology, enzymology, and nucleic acid testing. Furthermore, HEV gene sequencing was performed for genotyping analysis, and donors with reactive nucleic acid testing results were followed up to confirm their infection status. [Results] The reactivity rate of HEV Ag, anti-HEV IgM and anti-HEV IgG was 0.098%, 0.899% and 29.198%, respectively. There was no difference in the reactivity of anti-HEV IgM and anti-HEV IgG between genders, donation frequencies and donation types (P>0.05). The reactivity rate increased significantly with age (P<0.05). The rate of ALT disqualification (ALT>50U/L) was significantly higher than that in non-reactive samples (P<0.05). The HEV Ag reactivity rate (0.098%) was not correlated with gender, donation frequency, donation type or age. One HEV RNA positive case was found, with a positive rate of 0.008%(1/12 227). It was confirmed to be hepatitis E virus genotype 3 by sequencing analysis. Apart from HEV Ag reactivity, all other blood safety screening items were non-reactive, suggesting this case might be in the acute infection phase. The follow-up results showed that all indicators of the donor's previous blood donation were non-reactive. [Conclusion] Pre-donation ALT detection can reduce the risk of transfusion-transmitted HEV (TT-HEV) to a certain extent, and the effective way to prevent TT-HEV is to detect HEV RNA and serology of donor blood.

Endoscopic thoracic sympathicotomy/sympathotomy (ETS) is the first-line treatment for palmar hyperhidrosis with best minimally invasive effect. In recent years, with the widespread development of ETS in the treatment of palmar hyperhidrosis, many medical centers list ETS surgery as the day surgery. Nevertheless, there is no expert consensus on medical quality control of day surgery for ETS yet. Therefore, the Chinese Medical Doctor Association Thoracic Surgeons Branch Hyperhidrosis Subcommittee, Sympathetic Neurosurgery Expert Committee of WU Jieping Medical Foundation, and Fujian Provincial Strait Medical and Health Exchange Association Hyperhidrosis Special Committee organized domestic experts to conduct repeated consultations and sufficient discussions based on domestic and foreign literatures, to formulate the "Chinese expert consensus on ETS optimization and surgical quality control of day surgery for palmar hyperhidrosis". It aims to provide a reference for the clinical diagnosis and treatment of palmar hyperhidrosis for thoracic surgery colleagues in our country, to enhance their management level and work efficiency, and ultimately to achieve standardized quality control.

Objective To investigate the predictive value of changes in various indicators of routine blood tests for the severity of brain damage in patients with acute cerebral hemorrhage(ACH)in high-altitude regions.Methods A retrospective analysis was conducted using data from 249 inpatients diagnosed with ACH at a hospital in Xizang.Patient data,including demographic information and results of routine blood tests,were collected.Based on their Glasgow Coma Scale(GCS)scores,the patients were divided into 2 groups,a mild brain damage group(GCS≥13 points)and a moderate-to-severe brain damage group(GCS≤12 points).Demographic information and laboratory test results were compared between the two groups.Binary logistic regression analysis was performed to examine the relationship between indicators of routine blood tests and the severity of brain damage,and key indicators were identified.The receiver operating characteristic(ROC)curve analysis was used to evaluate the predictive performance of key indicators in various combinations for the severity of brain injury in ACH patients.Results The moderate-to-severe group had a higher proportion of high-altitude residents,as well as elevated levels of white blood cells(WBC),neutrophils(N),neutrophil-to-lymphocyte ratio(NLR),systemic inflammatory index(SII),neutrophil-to-platelet ratio(NPR),and C-reactive protein(CRP)-to-lymphocyte ratio(CLR),compared to the mild group.On the other hand,the levels of lymphocytes(L),platelets(PLT),and platelet-to-albumin ratio(PAR)in the moderate-to-severe group were lower than those in the mild group.Binary logistic regression analysis showed that WBC(OR=1.221,95%CI:1.127-1.322),CRP(OR=1.019,95%CI:1.004-1.033),CRP-to-albumin ratio(CAR)(OR=1.845,95%CI:1.137-2.996),and CLR(OR=1.018,95%CI:1.005-1.030)were positively associated with moderate-to-severe brain damage,and that their elevated levels were associated with an increase in risk by the corresponding folds.PAR(OR=0.845,95%CI:0.721-0.990)was negatively correlated with moderate-to-severe brain damage,with an increase resulting in a reduction of risk by 0.845 times.ROC curve analysis showed that,in the mild group,the combined AUC for WBC+CRP was 0.689(optimal cutoff value 0.19,specificity 0.776,95%CI:0.624-0.755);the PAR+CAR+CLR combination(CAR was not significant,P>0.05)had an AUC of 0.675(optimal cutoff value 0.19,specificity 0.760,95%CI:0.609-0.741);the key indicator combination of WBC+PAR+CLR(CRP was not significant,P>0.05)demonstrating the strong predictive performance moderate-to-severe brain damage,yielding an AUC of 0.737(optimal cutoff value 0.08,specificity 0.624,95%CI:0.676-0.798).Conclusion The indicator combinations of WBC+CRP,PAR+CLR,and WBC+PAR+CLR exhibit significant value for predicting the severity of brain injury in ACH patients and may serve as potential predictive tools for the severity of brain damage in patients with acute cerebral hemorrhage in high-altitude regions.

OBJECTIVE: To evaluate the effectiveness of tibial nerve transection with epineurial suture and division of the common plantar digital nerve branches in the treatment of congenital macrodactyly in children. METHODS: A retrospective analysis was conducted on clinical data from 9 children with congenital macrodactyly who met the selection criteria and were admitted between January 2018 and December 2024. The cohort included 4 boys and 5 girls, aged 1-6 years (median, 3 years). Syndactyly of the second and third toes was present in 2 patients. Hypertrophy distribution was as follows: 1 case of single-ray involvement, 4 of double-ray, 1 of triple-ray, 1 of quadruple-ray, and 2 of quintuple-ray. Preoperatively, 7 cases exhibited limitations in both active and passive flexion and extension of the affected toes; in 2 cases, active movement was restricted while passive motion remained intact. All 9 children were unable to wear standard-sized footwear for the unaffected foot. Six presented with a limp, and 3 had difficulty walking. All 9 cases were moderate to severe progressive macrodactyly, and the growth rate of the affected foot was significantly faster than that of the healthy side. Six cases had undergone prior surgical interventions at other institutions, but disease progression continued postoperatively. All 9 patients underwent tibial nerve transection with epineurial suture and selective division of the common plantar digital nerve branches. At last follow-up, the foot growth rate was calculated (compared with that immediately after operation), and the changes of plantar pain sensation in the affected foot were detected before operation, immediately after operation, and at last follow-up, and the surgical efficacy was evaluated based on improvements in shoe fit and gait function. RESULTS: All 9 children were followed up 6-36 months, with an average of 18 months. All the incisions healed by first intention, and no infection or plantar ulceration occurred. At last follow-up, the growth rate of the affected foot was 0.10 (0.04, 0.14) cm/month, which was significantly slower than that of the healthy foot [0.14 (0.08, 0.18) cm/month] ( Z=3.951, P<0.001). Preoperatively, plantar pain sensation was absent in all cases; it was restored immediately after operation. At last follow-up, 6 patients had absent pain sensation, 2 had partial preservation (involving certain toes and central plantar regions), and 1 patient (with 3-year follow-up) exhibited regained sensation in multiple plantar areas. Gait improved in most cases, in which 8 children achieved normal ambulation, while 1 continued to limp due to leg-length discrepancy. Surgical efficacy were rated as excellent in 1 case, good in 7, and fair in 1. CONCLUSION Tibial nerve transection with epineurial suture combined with selective division of the common plantar digital nerve branches effectively reduces the growth rate of congenital macrodactyly in children, has minimal impact on plantar sensory function, and does not result in plantar ulcers or impaired ambulation.
Humans ; Male ; Female ; Child, Preschool ; Child ; Retrospective Studies ; Infant ; Tibial Nerve/surgery* ; Toes/surgery* ; Treatment Outcome ; Suture Techniques ; Fingers/surgery* ; Foot/innervation* ; Limb Deformities, Congenital

Objective To investigate the regulatory mechanism of the central nervous system in patients with refractory overactive bladder (rOAB) using diffusion tensor imaging (DTI) and graph theory analysis. Methods A total of 43 rOAB patients (rOAB group) and 46 matched healthy controls (HC group) were recruited during May and Nov.2024. All participants were scanned with DTI, and surveyed with the overactive bladder symptom score (OABSS), and overactive bladder questionnaire (OAB-q). Their age, gender, height, weight, and educational years were collected.DTI plus graph theory analysis was employed to explore the alterations in global and local topological properties of the brain structural network in rOAB patients. Brain regions showing significant group differences in structural metrics [specifically, the right paracentral lobule (PCL.R) ]were further used as seed points for functional connectivity (FC) analysis. Correlations between the nodal clustering coefficient (NCp) of the identified region, FC strength, OABSS, and OAB-q score were investigated. Results The OABSS [8 (6,10) vs.0 (0,1) ]and OAB-q [71 (53,80) vs.20 (19,24) ]were higher in the rOAB group than the HC group (P<0.001). Graph theory analysis revealed no statistically significant differences in global network metrics between the two groups (P>0.05). However, the NCp was significantly higher in the PCL.R of rOAB group compared to HC group (P<0.05, FDR-corrected).FC analysis using the PCL.R as a seed region demonstrated significantly reduced FC value in the left cerebellar crus Ⅱ (Cerebelum_Crus2_L) of the rOAB group (P<0.05, FDR-corrected). Partial correlation analysis showed that the NCp of PCL.R was positively correlated with both OABSS (r=0.255, P=0.018) and OAB-q score (r=0.257, P=0.017). Conversely, the FC of Cerebelum_Crus2_L was significantly negatively correlated with OABSS (r=-0.545, P<0.001) and OAB-q score (r=-0.535, P<0.001). Conclusion Patients with rOAB exhibit distinct brain structural network alterations compared to healthy individuals, primarily manifestation in the NCp value of PCL.R increased, and the FC intensity of Cerebelum_Crus2_L is significantly weakened. These alterations in the topological properties of the structural network may be implicated in the pathogenesis of rOAB.