Objective:To analyze the surveillance results of brucellosis in Shanxi Province, to gain a understanding of the epidemic characteristics and changing trend of brucellosis in Shanxi Province, and to provide scientific basis for formulating prevention and control strategies and measures for brucellosis.Methods:The surveillance data of brucellosis in Shanxi Province from Infectious Disease Reporting Information Management System of China Disease Prevention and Control Information System, and the active surveillance results of 5 national brucellosis surveillance sites from 2018 to 2023 were collected for descriptive analysis.Results:From 2018 to 2023, a total of 24 041 cases of human brucellosis were reported in Shanxi Province, with the number of cases increased from 2 800 in 2018 to 5 131 in 2023. The annual reported incidence was 11.22/100 000, ranging from 7.56/100 000 to 14.74/100 000, showing an overall upward trend (χ 2trend = 1 377.43, P < 0.001). The epidemic had affected all counties (cities and districts) in the province, mainly concentrated in Linfen City, Jinzhong City, Datong City, and Shuozhou City, with a total of 13 489 cases of human brucellosis reported, accounting for 56.11%. The population distribution was mainly composed of individuals aged 40 - 69 (17 682 cases), males (18 513 cases), farmers (20 295 cases), and household and unemployed individuals (1 017 cases). The onset of the disease showed obvious seasonality, with the peak time from March to August, accounting for 66.39% (15 961/24 041). A total of 14 130 occupational individuals were investigated at the surveillance sites, and 11 141 underwent serological tests, with a positive rate of 5.25% (585/11 141), including 299 new cases. The positive rate of serological tests was relatively high in Qinyuan County, at 8.51% (241/2 832). Etiological culture was conducted on 338 human blood samples, and 43 strains of Brucella were isolated, with a detection rate of 12.72%. All strains were Brucella melitensis, including 42 strains of Brucella melitensis biovar 3. Conclusions:The overall trend of human brucellosis epidemic in Shanxi Province from 2018 to 2023 is on the rise, and it is still at a high level. It is suggested to continue strengthening monitoring, study the epidemic situation in a timely manner, take comprehensive prevention and control measures, and effectively control the spread of brucellosis.

Objective To investigate the efficacy and safety of transcutaneous electrical acupoint stimulation(TEAS)in reducing the consumption of analgesics after total knee arthroplasty(TKA).Methods Totally 124 patients undergoing unilateral TKA were included and divided into an intervention group and a control group according to random number table method,with 62 cases in each group.Both groups received routine postoperative analgesic protocols,with the intervention group additionally receiving TEAS treatment,30 min per time,twice a day.The additional doses of intravenous patient-controlled analgesia pumps and opioid analgesic consumption in two groups of patients after surgery were analyzed,as well as the adverse events and laboratory test results(WBC,PLT,SCr,BUN,ALT and AST)in both groups.Results The number of additional doses in the intervention group with the patient-controlled analgesia pump and the consumption of opioid analgesic were both lower than those in the control group(P<0.05);the incidence of postoperative nausea symptoms in the intervention group was lower than that in the control group,while other adverse reactions showed no significant difference(P>0.05).There was no significant difference in laboratory test results(WBC,PLT,SCr,BUN,ALT and AST)between the two groups on the day before surgery and on the 1st and 7th days after surgery(P>0.05).Conclusion TEAS can reduce the consumption of analgesics after TKA,decrease some adverse reactions associated with the use of analgesics,and has good safety.

Aim To explore the mechanism of the syn-ergistic effect of the ferroptosis inducer erastin com-bined with shikonin in promoting ferroptosis in human hypertrophic scar fibroblasts(HSFBs).Methods Hypertrophic scar tissues provided by the General Hos-pital of Ningxia Medical University were collected,and HSFBs were extracted.HSFBs were identified by HE staining and immunofluorescence.The inhibitory rates of Era and SHK on HSFBs at different concentrations were detected by CCK-8 assay,and the IC50 value was calculated.CompuSyn software was used to calculate the co-use index(CI).Control group,Erastin(Era)group,shikonin(SHK)group and Era+SHK group were set up,and the number and morphological chan-ges of cells were observed after 24 hours of interven-tion.The ability of cell migration and invasion was de-tected by scratch test and Transwell test.The changes of malondialdehyde(MDA),total iron ion and reactive oxygen species(ROS)were detected by corresponding biochemical kits.The expressions of collagen I,α-SMA and GOT1,SLC7A11,GPX4 and FTH1 were detected by Western blot.Results The IC50 value of Era and SHK of primary HSFBs was 2.22 μmol·L-1 and 3.94μmol·L-1 respectively,which was used as the single drug concentration for subsequent experiments.The CompuSyn software was employed to calculate the CI value when the two drugs were used in combination,and the concentrations corresponding to CI=0.39597(Era:1.2 μmol·L-1+SHK:1.5 μmol·L-1)were selected as subsequent combination concentrations(Because when CI was equal to 0.395 97,the concen-tration of each drug was lower than the concentration of single drug,and the inhibition rate of combined drug was greater than 50％).Compared with the monother-apy group,the number of HSFBs in the SHK+Era group was significantly reduced,cell membrane showed breakage and vesiculation,cell wrinkling became smal-ler,and cytoplasm was concentrated.The migration and invasion ability of HSFBs in the SHK+Era group were obviously weakened(P＜0.05),and the expres-sion of fibrosis-related proteins collagen Ⅰ and α-SMA was reduced(P＜0.05);the contents of MDA,total i-ron ions,and ROS in HSFBs of the SHK+Era group increased(P＜0.05),and the protein expression lev-els of SLC7A11,GOT1,GPX4,and FTH1 further de-creased(P＜0.05).Conclusions Erastin in combi-nation with shikonin can synergistically inhibit the pro-liferation,migration and fibrosis levels of HSFBs.The mechanism may be that erastin enhances the inhibition of shikotin on GOT1,increases the levels of cellular i-ron ions,ROS,and lipid peroxides,thereby promoting ferroptosis in HSFBs.

Objective To evaluate the clinical effectiveness and safety of different traditional Chinese medicine(TCM)prescriptions combined with conventional western drugs to improve idiopathic membranous nephropathy(IMN)based on the Chinese medicine evidence system.Methods A computerized search of databases was conducted to collect randomized controlled trials(RCTs)of TCM compound formulas combined with conventional western medicines for the treatment of IMN,with a search timeframe from the establishment of the database to October 2023.Thirty-five RCTs involving six interventions and containing 2518 IMN patients were finally included.The quality of the included literature was evaluated.Reticulated Meta-analysis was performed,and surface under the cumulative ranking(SUCRA)curve was used to rank the clinical efficacy and safety of the six interventions,aiming to provide an evidence-based basis for the rational clinical selection of prescriptions for treating patients with IMN.Results The formula of tonifying deficiency and eliminating stasis combined with conventional western medicine showed significant effects in lowering 24-hour urine protein quantification(SUCRA=95.3％)and total cholesterol level(SUCRA=98.2％).The formula of tonifying deficiency,eliminating stasis,purging heat,and dispelling dampness combined with conventional western medicine was effective in lowering blood creatinine(SUCRA=80.4％)and increasing serum albumin level(SUCRA=72.9％).The formula of tonifying deficiency and clearing heat and dampness combined with conventional western medicine was more effective in lowering M-type phospholipase A2 receptor antibody titer(SUCRA=86.0％).Conclusion In terms of safety,the adverse effects of the TCM compound formula combined with conventional western drugs were overall less than those of conventional western drugs alone.

OBJECTIVE: To analyze the results of prenatal diagnosis for fetuses with a high risk for sex chromosome aneuploidies (SCAs) indicated by non-invasive prenatal testing (NIPT), and to assess the influence of maternal chromosomal factors on the results of NIPT. METHODS: A retrospective analysis was conducted on the clinical data of 454 pregnant women with a high risk for SCAs indicated by NIPT undergoing invasive prenatal diagnosis at the Medical Genetics Center of Northwest Women's and Children's Hospital from January 2022 to September 2024. The data has included prenatal diagnosis indications, results, pregnancy outcomes, and the chromosomal results of pregnant women. RESULTS: Among the 454 women (including 10 with twin pregnancy) with a high risk for SCAs indicated by NIPT, 149 (including 4 twin cases) were diagnosed with SCAs through invasive prenatal diagnosis. These had included 47,XXX (37 cases), 47,XXY (56 cases), 47,XYY (29 cases), 45,X (1 case), 48,XXYY (1 case), mosaicism (20 cases), sex chromosome structural abnormalities (6 cases), and small-scale pathogenic copy number variations (3 cases). 383 pregnant women (including 7 with twin pregnancy) had accepted chromosomal karyotyping analysis. In total 49 cases of SCAs abnormalities were detected. Among them, 41 cases were pregnant women with SCAs but normal fetal chromosomes, which yielded a false positive rate for NIPT caused by maternal factors by 10.7%. In addition, 8 cases (including 1 twin case) had SCAs abnormalities in both the pregnant woman and the fetus. Among the 383 pregnant women, 129 cases (including 3 twin cases) of fetal SCAs were diagnosed, which yielded an overall positive predictive value (PPV) of NIPT for SCAs by 33.7% (129/383). With the 41 false positive cases caused by maternal SCAs abnormalities excluded, the PPV of NIPT for SCAs will be increased to 37.7% (129/342). Among the 454 pregnant women, twin pregnancies have accounted for 2.2% (10/454). Among the confirmed cases of SCAs abnormalities, twin cases accounted for 2.7% (4/149). Among the 383 pregnant women undergoing chromosomal karyotyping, twin cases accounted for 1.8% (7/383). Among the detected cases of chromosomal abnormalities, twin cases accounted for 2.0% (1/49). By calculation, the proportion of singleton pregnant women with a high risk for SCAs indicated by NIPT was approximately 32.1%, and the proportion of twin pregnant women was approximately 38.6%, indicating that twin pregnancies could increase the positive rate of NIPT. CONCLUSION NIPT can improve the screening efficiency for SCAs, but its PPV is limited. Therefore, pregnant women with a high risk for SCAs indicated by NIPT need to undergo invasive prenatal diagnosis for a definite diagnosis, and twin pregnancies can increase the positive rate of NIPT. The study confirmed that chromosomal abnormalities in pregnant women can significantly affect the accuracy of NIPT in detecting fetal SCAs. Therefore, when NIPT indicates SCAs abnormalities, it is recommended to simultaneously conduct chromosomal testing on the pregnant women. The combined application of chromosomal karyotyping analysis, fluorescence in situ hybridization, and copy number variation detection techniques can significantly improve the diagnostic accuracy for SCAs, especially for the detection of mosaicisms.
Humans ; Female ; Pregnancy ; Sex Chromosome Aberrations ; Adult ; Retrospective Studies ; False Positive Reactions ; Prenatal Diagnosis/methods* ; Noninvasive Prenatal Testing/methods* ; Aneuploidy ; Male ; Sex Chromosome Disorders/genetics*

Objective To investigate the efficacy and safety of transcutaneous electrical acupoint stimulation(TEAS)in reducing the consumption of analgesics after total knee arthroplasty(TKA).Methods Totally 124 patients undergoing unilateral TKA were included and divided into an intervention group and a control group according to random number table method,with 62 cases in each group.Both groups received routine postoperative analgesic protocols,with the intervention group additionally receiving TEAS treatment,30 min per time,twice a day.The additional doses of intravenous patient-controlled analgesia pumps and opioid analgesic consumption in two groups of patients after surgery were analyzed,as well as the adverse events and laboratory test results(WBC,PLT,SCr,BUN,ALT and AST)in both groups.Results The number of additional doses in the intervention group with the patient-controlled analgesia pump and the consumption of opioid analgesic were both lower than those in the control group(P<0.05);the incidence of postoperative nausea symptoms in the intervention group was lower than that in the control group,while other adverse reactions showed no significant difference(P>0.05).There was no significant difference in laboratory test results(WBC,PLT,SCr,BUN,ALT and AST)between the two groups on the day before surgery and on the 1st and 7th days after surgery(P>0.05).Conclusion TEAS can reduce the consumption of analgesics after TKA,decrease some adverse reactions associated with the use of analgesics,and has good safety.

Objective To evaluate the clinical effectiveness and safety of different traditional Chinese medicine(TCM)prescriptions combined with conventional western drugs to improve idiopathic membranous nephropathy(IMN)based on the Chinese medicine evidence system.Methods A computerized search of databases was conducted to collect randomized controlled trials(RCTs)of TCM compound formulas combined with conventional western medicines for the treatment of IMN,with a search timeframe from the establishment of the database to October 2023.Thirty-five RCTs involving six interventions and containing 2518 IMN patients were finally included.The quality of the included literature was evaluated.Reticulated Meta-analysis was performed,and surface under the cumulative ranking(SUCRA)curve was used to rank the clinical efficacy and safety of the six interventions,aiming to provide an evidence-based basis for the rational clinical selection of prescriptions for treating patients with IMN.Results The formula of tonifying deficiency and eliminating stasis combined with conventional western medicine showed significant effects in lowering 24-hour urine protein quantification(SUCRA=95.3％)and total cholesterol level(SUCRA=98.2％).The formula of tonifying deficiency,eliminating stasis,purging heat,and dispelling dampness combined with conventional western medicine was effective in lowering blood creatinine(SUCRA=80.4％)and increasing serum albumin level(SUCRA=72.9％).The formula of tonifying deficiency and clearing heat and dampness combined with conventional western medicine was more effective in lowering M-type phospholipase A2 receptor antibody titer(SUCRA=86.0％).Conclusion In terms of safety,the adverse effects of the TCM compound formula combined with conventional western drugs were overall less than those of conventional western drugs alone.

Objective To develop a task prompt card for critical care records,providing standardized guidance for nurses on record-keeping tasks,reducing record deficiencies caused by forgetfulness,and improving the quality of critical care records.Methods Relevant literature on critical care record was retrieved from the official website of the Chinese government,the official website of the National Health Commission,Wanfang Database,China National Knowledge Infrastructure(CNKI),VIP database,PubMed,Embase,Web of Science,Clinical Key for nursing,Cochrane Library database,and the International Guideline Network.The Joanna Briggs Institute(JBI)literature evaluation tool was used to evaluate the literature.Information related to the construction of critical care record task prompt cards in the literature was extracted to form the expert consultation letter for the Delphi method.According to the research topic and the requirements of the Delphi consultation letter,relevant experts were selected by purposive sampling.The consultation letters were sent to the experts,and after the letters were collected and statistically analyzed,the research team added,modified or deleted the items of the plan according to the experts'opinions and the results of data analysis.The Delphi method was conducted in multiple rounds until the experts'opinions were consistent.Results A total of 14 articles were ultimately included to form the expert consultation letter of the Delphi method.The first round of the Delphi method expert consultation letter contained 5 first-level indicators and 28 second-level indicators.The average score of the first-level indicators in the first round of expert consultation ranged from 4.78-5.00,with a coefficient of variation ranging from 0.00-0.09 and a full score ratio ranging from 77.8%-100.0%.The average score of the second-level indicators in the first round of expert consultation ranged from 3.44-4.89,with a coefficient of variation ranging from 0.00-0.44 and a full score ratio ranging from 33.3%-88.9%.According to the item retention criteria,4 second-level indicators were deleted,8 second-level indicators were modified and 1 second-level indicator was added.The average score of the first-level indicators in the second round of expert consultation ranged from 4.78-5.00,with a coefficient of variation ranging from 0.00-0.09 and a full score ratio ranging from 77.8%-100.0%.The average score of the second-level indicators in the second round of expert consultation ranged from 4.33-5.00,with a coefficient of variation ranging from 0.00-0.16 and a full score ratio ranging from 44.4%-100.0%.After two rounds of the Delphi method,the research team finalised a critical-care record task-reminder card that comprised 5 first-level and 25 second-level indicators.Conclusions The critical-care record task reminder card is an effective tool for preventing critical care nurses from forgetting due to interruption in record tasks,which can lead to errors or omissions in the record content.It can also improve the quality of nursing management.

Objective To explore the effect and mechanism of long non-coding RNA (LncRNA) nuclear enriched abundant transcript 1 (NEAT1) on proliferation and metastasis of myeloma through miR-195-5p/CCAAT enhancer binding protein α (CEBPA) axis. Methods ① From March 2021 to February 2023,bone marrow mononuclear cells (BMNC) from 40 patients with multiple myeloma (MM) and 10 healthy bone marrow donors who were hospitalized in the Department of Hematology the Second People's Hospital of Liaocheng City,Shandong First Medical University and MM cell lines U266,RPMI 8226,NCI-H929 and MM.1S were collected. RT-qPCR and Western blot were used to detect NEAT1,miR-195-5p,CEBPA mRNA and protein levels in cells. ② U266 cells were divided into overexpressing NEAT1 group (NEAT1 group) and its control group (NC group),knockdown NEAT1 expression group (sh-NEAT1 group) and its control group (sh-NC group),overexpressing NEAT1 and miR-195-5p group (NEAT1+miR-195-5p group) and its control group (NEAT1+miR-NC group),and overexpressing miR-195-5p and CEBPA group (miR-195-5p+CEBPA group) and its control group (miR-195-5p+NC group). CCK-8 and EdU staining were used to detect cell proliferation ability. Transwell assay was used to detect cell migration and invasion ability. RT-qPCR was used to detect NEAT1,miR-195-5p,and CEBPA mRNA levels in cells. Western blot was used to detect CEBPA,Ki67,proliferating cell nuclear antigen (PCNA),matrix metalloproteinase (MMP)-2,MMP-9,phosphoinositide 3 kinase (PI3K),p-PI3K,protein kinase B (AKT),p-AKT,mechanistic target of rapamycin (mTOR),and p-mTOR protein levels. ③ Twenty nude mice were divided into knockdown NEAT1 expression group (sh-NEAT1 group) and its control group (sh-NC group),with ten mice in each group. Nude mice were subcutaneously injected with corresponding transfected U266 cell suspension,and the differences in various indicators of transplanted tumor were measured after 4 weeks. Results ① Compared with normal BMNC,NEAT1,CEBPA mRNA and protein levels in MM patients and MM cell lines were increased,while miR-195-5p level was decreased,and the differences were significant (t=11.697,9.272,4.352,11.639,all P<0.05). ② After overexpression of NEAT1,NEAT1,CEBPA mRNA and protein levels in cells were increased (t=12.825,5.874,13.893),while miR-195-5p level was decreased (t=4.797),the A value and EdU positive rate after 72 hours of cell culture were increased (t=9.425,5.632),the number of migration/invasion cells were increased (t=8.841,5.364),and Ki67,PCNA,MMP-2,MMP-9,p-PI3K/PI3K,p-AKT/AKT and p-mTOR/mTOR protein levels were increased (t=14.227,7.743,7.348,7.803,8.714,8.629,7.359),with significant differences (all P<0.05). After knockdown the expression of NEAT1,NEAT1,CEBPA mRNA and protein levels in cells were decreased (t=5.776,5.001,4.503),while miR-195-5p level was increased (t=4.456),the ability of cell proliferation,invasion and metastasis was decreased (t=6.204,8.792),with significant differences (all P<0.05). Overexpression of miR-195-5p could partially reverse the effects of overexpression of NEAT1 on the aforementioned cellular indicators,and the differences were significant (t=4.356～10.809,all P<0.05). Meanwhile,overexpression of CEBPA could partially reverse the effects of overexpression of miR-195-5p on the aforementioned cellular indicators,and the differences were significant (t=4.329～14.452,all P<0.05). ③ Knockdown NEAT1 expression could inhibit the growth of transplanted tumors in nude mice,and the differences were significant (t=5.175～18.190,all P<0.05). Conclusion LncRNA NEAT1 promotes proliferation,invasion and metastasis of MM cells by targeting miR-195-5p/CEBPA expression,which may act by activating the PI3K/AKT/mTOR pathway.

Objective:To investigate the effect of nursing measures based on the Rockall scoring system combined with the SBAR communication model in patients with acute upper gastrointestinal bleeding.Methods:A convenience sampling method was used to select 140 patients with acute upper gastrointestinal bleeding admitted to the First Affiliated Hospital of Zhengzhou University from June 2022 to January 2024. The patients were divided into a control group and an observation group, with 70 cases in each. The control group received nursing measures based on the Rockall scoring system, while the observation group received nursing measures based on the Rockall scoring system combined with the SBAR communication model. Treatment compliance, bleeding status, length of hospital stay, psychological state, and self-management behavior scores were compared between the two groups.Results:After intervention, the treatment compliance of the observation group was significantly higher than that of the control group ( P<0.05) . The bleeding cessation time and hospital stay time were shorter in the observation group than in the control group ( P<0.05) . Eight weeks after intervention, the scores of Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) in the observation group were lower than those in the control group ( P<0.05) . Six months after intervention, the scores of all dimensions and the total score of self-management behaviors in the observation group were significantly higher than those in the control group ( P<0.05) . Conclusions:Nursing interventions based on the Rockall scoring system combined with the SBAR communication model can improve treatment compliance, reduce negative emotions, and enhance self-management ability in patients with acute upper gastrointestinal bleeding.