Objective:To analyze the spatial-temporal distribution of etiologically positive pulmonary tuberculosis (PTB) at the county (city, district) unit in Jiangsu Province from 2011 to 2021 to provide evidence for the implementation and adjustment of prevention and control strategies of PTB in Jiangsu Province.Methods:The registration data of etiologically positive PTB patients in Jiangsu Province from 2011 to 2021 were collected from the Tuberculosis Management Information System in the China Information System of Disease Control and Prevention. Data on the permanent population were from the statistical yearbook of each county (city, district) in Jiangsu Province. Geoda 1.18.0 software was used to analyze the global and local spatial autocorrelation and explore the spatial clustering. SaTScan 10.1 software was used to analyze the spatial-temporal clusters, and ArcGIS 10.7 software was used to visualize the spatial-temporal clusters.Results:A total of 128 240 etiological positive PTB cases were registered in Jiangsu Province from 2011 to 2021, with an average annual registration rate of 13.99/100 000. The registration rate showed an overall upward trend (trend χ2=63.49, P<0.001) after 2017, and the etiologically positive rate showed an overall upward trend (trend χ2=3 710.86, P<0.001). The annual Moran's I values ranged from 0.107 to 0.343, which showed a spatial clustering distribution. The results of local spatial autocorrelation analysis showed that there were "high-high" clustering areas in Jiangsu Province each year, showing a dynamic distribution, and most of the areas were distributed in the central and southern regions of Jiangsu Province, with the largest number (7) in 2015 and the smallest number (1) in 2011. A total of 4 spatial-temporal clustering areas were explored by spatial-temporal scanning analysis (all P<0.001), among which the first-level clustering area covered 3 counties (cities, districts), namely Changshu, Taicang, and Xiangcheng District of Suzhou, and the clustering time was from 2011 to 2015. The secondary clustering areas covered 24 counties (cities, districts), mainly covering Jiangsu's central and northern regions, such as Huai'an, Suqian, and Yancheng. The third-level clustering areas covered 26 counties (cities, districts); the fourth-level clustering area was the Gaochun District of Nanjing, with the clustering period from 2017 to 2021. Conclusions:From 2011 to 2021, the etiologically positive PTB registration rate at the county (city, district) level in Jiangsu Province had obvious spatial-temporal clustering characteristics. The clustering areas included the northern areas with relatively backward economies and the southern areas with better economic development. Multiple measures should be taken to prevent and control PTB according to the specific situation in different regions.

Objective To investigate the clinical significance of serum S100 calcium binding protein(S100 A4)and S100A12 in patients with severe traumatic brain injury(sTBI).Methods A total of 147 sTBI pa-tients admitted to Handan Central Hospital from March 2021 to March 2023 were selected as the sTBI group,and 50 healthy subjects who underwent physical examination in Handan Central Hospital during the same pe-riod were selected as the control group.The correlation between S100A4,S100A12 levels and brain injury markers and the influencing factors of early death in sTBI patients were analyzed,and the predictive value of serum S100A4 and S100A12 for early death in sTBI patients was studied.Results The serum levels of S100A4,S100A12,myelin basic protein(MBP),S100B and neuron specific enolase(NSE)in sTBI group were significantly higher than those in control group(P＜0.05).The serum levels of S100A4 and S100A12 were positively correlated with MBP,NSE and S100B in sTBI patients(P＜0.05).Multivariate Logistic regression analysis showed that decreased Glasgow coma scale(GCS)score on admission and increased serum levels of S100A4,S100A12,MBP,NSE and S100B were risk factors for early death in sTBI patients(P＜0.05).Receiv-er operating characteristic curve showed that the combination of serum S100A4 and S100A12 with GCS score,MBP,NSE and S100B was superior to any single detection in predicting early death in sTBI patients.Conclu-sion The serum levels of S100A4 and S100A12 are increased in sTBI patients,which are related to the aggra-vations of brain injury and early death.The combined detection of S100A4 and S100A12 has a good predictive value for early death in sTBI patients.

Huangqin Decoction is a classic formula published in the Catalogue of Ancient Classical Famous Prescriptions(the Sec-ond Batch).This paper systematically collates,researches and analyzes the ancient and modern clinical literature that records Huan-gqin Decoction,sorts out key issues such as the prescription origin,composition,medicine origin,processing method,usage and dos-age,efficacy and indications of Huangqin Decoction,and performs predictive analysis on its quality markers(Q-Marker)to provide lit-erature and theoretical support for the clinical application and preparation development of Huangqin Decoction from the entire process of textual research-preparation development-quality evaluation.After analysis and research,it is found that Huangqin Decoction is de-rived from Zhang Zhongjing's Treatise on Cold Damage.It consists of Scutellaria baicalensis,Radix Paeoniae Alba,and Glycyrrhiza,with Jujube serving as the guiding herb.The medicine origin follows the 2020 edition of the Chinese Pharmacopoeia.Scutellaria ba-icalensis and Radix Paeoniae Alba are taken in the raw form;Glycyrrhiza is lightly fried and Jujubes with sliced pieces.The doasge of medicine is 11.19 of Scutellaria baicalensis,7.46 g of Radix Paeoniae Alba and Glycyrrhiza,and jujubes are added or subtracted ac-cording to the situation.The method of preparation and administration is that all herbs are added with 2 000 mL of water,decocting to 600 mL.The decoction can be consumed warm 3 times a day at any suitable time.The formula was commonly used in ancient times for dysentery,but now it is also used for other digestive system diseases such as ulcerative colitis and chronic colitis,which are mainly characterized by diarrhea.The suggested Q-markers for Huangqin Decoction are baicalin,baicalein,wogonin,paeoniflorin,glycyrrhi-zin and glycyrrhizic acid.

Objective:To explore the symptoms in cervical cancer patients during concurrent chemoradiotherapy, identify symptom clusters, and analyze their influencing factors, so as to provide reference for developing precise symptom management strategies.Methods:From March 2022 to March 2023, convenience sampling was used to select 240 cervical cancer patients who underwent concurrent chemoradiotherapy at the Cancer Center of People's Hospital of Guangxi Zhuang Autonomous Region as the research subject. Patients were surveyed using a General Information Questionnaire and the Chinese version of the M.D. Anderson Symptom Inventory (MDASI-C). Symptom clusters were extracted through exploratory factor analysis, and multiple linear regression was used to explore the influencing factors of the severity of symptom clusters.Results:A total of 240 questionnaires were distributed, and 234 valid questionnaires were collected, with an effective recovery rate of 97.50% (234/240). The 5 symptoms with a high incidence in 234 patients with cervical cancer undergoing concurrent chemoradiotherapy were fatigue, restless sleep, nausea, decreased appetite, and vomiting. The 4 symptom clusters identified by exploratory factor analysis were fatigue related symptom cluster, gastrointestinal related symptom cluster, emotional related symptom cluster, and somatic related symptom cluster. Age, educational level, tumor staging, complications, medical insurance type, and pathological type were the influencing factors for the occurrence of symptom clusters ( P<0.05) . Conclusions:Cervical cancer patients experience multiple symptoms during concurrent chemoradiotherapy, which are interrelated and mutually influencing, often in the form of symptom clusters, with fatigue related symptom clusters being severe. Medical and nursing staff should focus on the core symptoms that play a leading role, develop targeted symptom cluster intervention plans based on the core symptoms of fatigue, improve symptom management efficiency and patient quality of life.

Objective: To investigate the epidemiological characteristics of pulmonary tuberculosis (PTB) among the elderly at ages of 65 years and older in Yangzhou City, Jiangsu Province from 2017 to 2021, so as to provide the evidence for the development of PTB prevention and control measures in the elderly. Methods: Data of PTB cases at ages of 65 years and older in Yangzhou City from 2017 to 2021 were collected from the Tuberculosis Management Information System of the Chinese Disease Control and Prevention Information System, including age, gender, current address, population classification and diagnosis classification. Descriptive epidemiological methods were used to analyze the temporal distribution, regional distribution, population distribution and delay in healthcare-seeking of PTB cases. Results: A total of 3 283 PTB patients at ages of 65 years and older were registered in Yangzhou City from 2017 to 2021, accounting for 41.12% of the total number of PTB cases. The incidence decreased from 112.10/105 to 66.03/105 (P<0.05), with an average annual incidence of 80.43/105. There were 1 236 cases of PTB cases from April to July, accounting for 37.65%. Guangling District had the highest annual incidence of 96.45/105, followed by Hanjiang District (89.29/105) and Jiangdu district (87.05/105). The average annual incidence of PTB in males was 134.07/105, which was higher than that in females (30.55/105, P<0.05). There were 1 070 cases of PTB cases at ages of 65-69 years, accounting for 32.59%. The highest incidence was seen in men at ages of 85 years and older (200.39/105) and in women at ages of 80-84 years (38.34/105). Farmers were the predominant occupation of PTB cases (2 488 cases, 75.78%). There were 2 365 cases of PTB with delay in healthcare-seeking, accounting for 72.04%. Conclusions The incidence of PTB in the elderly at ages of 65 years and older in Yangzhou City showed an overall downward trend from 2017 to 2021, peaked from April to July, and was higher in Guangling District, Hanjiang District and Jiangdu District. Males and farmers had higher risks of PTB.

Objective: To summarize the measures and experience of treatment in mass extremely severe burn patients. Methods: The clinical data and treatment of 8 extremely severe burn patients in August 2 Kunshan factory aluminum dust explosion accident who were admitted in the 100th Hospital of PLA on August 2nd, 2014, were retrospectively analyzed. There were 4 males and 4 females, aging 22-45 (34±7) years, with total burn area of 55%-98% [(89±15)%] total body surface area (TBSA) and full-thickness burn area of 45%-97% [(80±21)%] TBSA. All the 8 patients were accompanied with severe shock, inhalation injury, and blast injury. According to the requirements of former PLA General Logistics Department and Nanjing Military Command, a treatment team was set up including a special medical unit and a special care unit, with Chai Jiake from the First Affiliated Hospital of PLA General Hospital as the team leader, Zheng Qingyi from the 175th Hospital of PLA (the Affiliated Dongnan Hospital of Xiamen University) as the deputy leader, the 100th Hospital of PLA as the treatment base, and burn care, respiratory, nephrology, nursing specialists from the First Affiliated Hospital of PLA General Hospital, and the burn care experts and nursing staff from the 180th Hospital of PLA, 118th Hospital of PLA, 98th Hospital of PLA, and 175th Hospital of PLA, and nurses from the 85th Hospital of PLA, 455th Hospital of PLA, 101th Hospital of PLA, 113th Hospital of PLA as team members. Treatment strategies were adopted as unified coordination by the superior, unified responsibility of team leader, division of labor and cooperation between team members, and multidisciplinary cooperation led by department of burns. With exception of one patient who received deep vein catheterization before admission, the other 7 patients were treated with deep vein catheterization 0.5 to 3.0 hours after admission to correct hypovolemic shock as soon as possible. Eight patients received tracheotomy, and 7 patients were treated with mechanical ventilation by ventilator in protective ventilation strategy with low tide volume and low volume pressure to assist breathing. Fiberoptic bronchoscopy was done one to three times for all the 8 patients to confirm airway injuries and healing status. Escharectomy and Meek dermatoplasty in the extremities of all the 8 patients were performed 3 to 6 days after injury for the first time. Escharectomy, microskin grafting, and covering of large pieces of allogeneic skin on the trunks of 4 patients were performed 11 to 16 days after injury for the second time. The broad-spectrum antibiotics were uniformly used at first time of anti-infective therapy, and then the antibiotics species were adjusted in time. The balance of internal environment was maintained and the visceral functions were protected. One special care unit was on responsibility of only one patient. Psychological intervention was performed on admission. The rehabilitative treatment was started at early stage and in company with the whole treatment. Results: Acute renal injury occurred in 5 patients within 36 hours after injury and their renal function was restored to normal 4 days after injury due to active adjustment of fluid resuscitation program. No pulmonary complications, such as severe pulmonary infection and ventilator-associated pneumonia, occurred in the survived patients. One of the 8 patients died, and the other 7 patients were cured successfully. The wounds were basically healed in 2 patients in 26 or 27 days by 2 or 3 times of operation, and in 5 patients by 4 or 5 times of operation. The basic wound healing time was 26-64 (48±15) days for all the 7 patients. Conclusions Treatment strategies of unified coordination by the superior, unified responsibility of team leader, division of labor and cooperation between team members, and multidisciplinary cooperation led by department of burns are the bases to successful treatment. Correcting shock as soon as possible is the prerequisite and closing wound as soon as possible is the key to successful treatment. Comprehensive treatment measures, such as maintaining and regulating the function of viscera, improving the body immunity, and preventing and treating the complications, are the important components to successful treatment. It is emphasized that in the treatment of mass extremely severe burn patients, specialist burn treatment should always be in the dominant position, and other related disciplines may play a part in auxiliary function.

Objective To evaluate the accuracy of simple anthropometric parameters in diagnosing obesity in children in Guangzhou. Methods A cross-sectional study, including 465 children aged 6-9 years, was carried out in Guangzhou. Their body height and weight, waist circumference (WC) and hip circumference were measured according to standard procedure. Body mass index (BMI), waist to hip ratio (WHR) and waist-to-height ratio (WHtR) were calculated. Body fat percentage (BF%)was determined by dual-energy X-ray absorptiometry. Multiple regression analysis was applied to evaluate the correlations between age-adjusted physical indicators and BF%, after the adjustment for age. Obesity was defined by BF%. Receiver operating characteristic (ROC) curve analyses were performed to assess the diagnostic accuracy of the indicators for childhood obesity. Area under-ROC curves (AUCs) were calculated and the best cut-off point that maximizing'sensitivity+specificity-1'was determined. Results BMI showed the strongest association with BF% through multiple regression analysis. For'per-standard deviation increase' of BMI, BF%increased by 5.3%(t=23.1, P<0.01) in boys and 4.6%(t=17.5, P<0.01) in girls, respectively. The ROC curve analysis indicated that BMI exhibited the largest AUC in both boys (AUC=0.908) and girls (AUC=0.895). The sensitivity was 80.8% in boys and 81.8% in girls, and the specificity was 88.2%in boys and 87.1%in girls. Both the AUCs for WHtR and WC were less than 0.8 in boys and girls. WHR had the smallest AUCs (<0.8) in both boys and girls. Conclusion BMI appeared to be a good predicator for BF%in children aged 6-9 years in Guangzhou.

Objective To investigate the effect of vitamin D supplementation on biochemical imdexes and compliations in patients with type 2 diabetes(T2DM).Methods Two hundred and ten patients with type 2 diabetes of the People's Hospital of Chongli County were selected from January 2001 to January 2002.According to the envelope sampling method they were divided into vitamin D supplementation group of 105 people and not supplemented group of 105 people,and 105 healthy people at the same period as control group.Compared the biochemical baseline indicators differences.After 10 years of follow-up,the biochemical indexes and the complications were detected and compared again.Results After ten years follow-up,82 cases of supplementation group were followed up,78 cases of not supplemented group were followed up.The level of FPG and HbA1c of supplementation group and not supplementation group were higher than that of control group,the differernce was significant(P＜0.05).In supplement group,TG levels,25(OH) D3 concentrations and BMD values were (2.11±0.41) mmol/L,(16.88±5.02) μg/L and-1.15±(-0.25) respectively,and equal to the control group ((2.12 ± 0.38) mmol/L,(44.83 ± 21.25) mmol/L,-0.94 ± (-0.21)),and TG levels were lower than not supplemented group,25 (OH) D3 concentrations and high bone density higher than not supplemented group((24.53±15.61) mmol/L,-3.15±(-0.33),P＜0.05).FPG,Cr,BUN,UA,FIB,and BNP in supplement group were(10.00±2.32) mmol/L,(64.77±9.31) μmol/L,(6.41± 1.24) mmol/L,(339.83±43.74) mmol/L,(2.41±0.46) g/L and (588.92±73.69) ng/L,in not supplemented group were (15.60±2.51) mmol/L,(92.69±11.68).μmol/L,(8.70±2.35) mmol/L,(398.94±49.13) mmol/L,(2.89±0.54) g/L and (761.09±91.52) ng/L,all higher than those in control group ((5.01 ±0.59) mmol/L,(57.81±6.61) μmol/L,(4.52±1.11) mmol/L,(311.83±49.51) mmol/L,(2.00±0.31) g/L,(434.31 ± ±71.03) ng/L),and those indexes in supplement group all higher than in not supplemented group(P＜0.05).The level of HbA1c of supplement group and not supplemented group both higher than control group((11.32 ± ±2.03) ％,(13.22±4.17) ％ and (5.34±1.99) ％,P＜0.05).There were 45 cases in supplement group occurred diabetic nephropathy and cardiovascular complications,and 65 cases of not supplemented group (x2 =15.07,P＜0.05).Conclusion The relationship of Vitamin D and various complications of diabetes mellitus are closely,and supplementing vitamin D can reduce the complications of diabetes.

Objective To study the expression of GRHL-3 in diffuse large B-cell lymphoma (DLBCL) tissues and its clinical significance.Methods One hundred and sixty-eight pathology paraffin-embedded diffuse large B-cell lymphomas tissues were collected from January 2006 to September 2011.Immunohistochemistry was used to detect the expression of GRHL-3 protein in the above tissues.Results The positive expression rate of GRHL-3 protein in the GCB type tissues was higher than that in the non-GCB type tissues [84.87 ％(101/119) vs 14.29 ％ (7/49), P ＜ 0.01].Further analysis indicated that in the non-GCB type tissues,the positive expression rate of GRHL-3 in the latter stage group was significantly higher than that in the early stage group [90.00 ％ (63/70) vs 77.56 ％ (38/49), P ＜ 0.01].The positive expression rate of GRHL-3 in the lactatede hydrogenase increased group was significantly higher than that in the normal lactated hydrogenase [91.67 ％ (77/84) vs 68.57 ％ (24/35), P ＜ 0.01].The positive expression rate of GRHL-3 in the extranodal involvement status ≥ 2 group was significantly higher than that in the extranodal involvement status 0-1 group [96.29 ％ (26/27) vs 81.52 ％ (75/92), P ＜ 0.05].The positive expression rate of GRHL-3 in the IPI score 4-5 group was significantly higher than that in the IPI score 0-1 group [91.30 ％ (65/69) vs 66.67 ％ (18/27), P ＜ 0.01] and IPI score 2-3 group [91.30 ％ (65/69) vs 79.96 ％ (18/23), P ＜ 0.05].However, the expression of GRHL-3 had no correlation with the gender, age, and performance status of DLBCL.Conclusion The positive expression rate of GRHL-3 protein in the GCB type tissues is higher than that in the non-GCB type tissues.The positive expression rate of GRHL-3 in the DLBCL is correlated with the Ann Arbor stage, lactate dehydrogenase, extranodal involvement status and IPI score.

People wearing positive pressure biological protective suits might face some potential safety risks when work -ing in a high-risk biological contamination environment .These risks could be effectively prevented by simulation experi-ments.This paper elaborates on the progress in risk studys on positive pressure biological protective suits in terms of dynam -ic detection methods and risk assessment , and points out the problems to be solved and the direction of future development .