Aim To evaluate the effect of Pien Tze Huang(PTH)on influenza virus susceptibility in re-straint stress-induced H1N1 influenza susceptibility model in mice with emotional disorders and internal heat,guided by the theory of emotional pathogenesis.Methods Mice were infected with H1N1 influenza vi-rus following 18 h of restraint stress.The signs and weight changes of mice were recorded,and the morbid-ity of mice were analyzed.On the fourth day post viral infection,the lung tissue was collected.The pathologi-cal changes and inflammatory factors in lungs were de-tected by HE staining.The expression of NP was as-sessed by immunohistochemistry and Western blot.The level of lipid peroxidation end products was detected u-sing a commercial kit and western blot.Redox phos-pholipidomics was analyzed in lung tissue by HPLC-MS/MS.Results PTH significantly reduced the mor-tality of influenza-susceptible mice induced by emotion-al stress,inhibited the expression of NP and the re-lease of inflammatory factors,improved inflammation in lung tissue,and alleviated the accumulation of lipid peroxidation end products.Phospholipid oxidation a-nalysis revealed the elevated levels of oxidized phos-pholipid choline and phosphatidylethanolamine in lung tissue of influenza-susceptible mice,which were signif-icantly reduced by PTH administration.Conclusions PTH exhibits promising efficacy in ameliorating influ-enza virus susceptibility induced by internal heat,and its mechanism of action may be related to the regulation of phospholipid peroxidation.

The distribution of Ixodes and Ana plasma carried by Ixodes ticks in Anhui Province was clarified as reference for prevention and control of anaplasmosis.In total,630 hard ticks were collected from Jinzhai County,Hanshan County,Jing-de County and Chaohu City in Anhui Province from April to August 2023.Ticks were identified by morphological analysis and 16S rRNA sequencing.Nested PCR with Anaplasma species-specific primers were used to detect 16S rRNA of Anaplasma spe-cies carried by ticks.A phylogenetic tree was constructed using MEGA11.0 software.Of the identified ticks,18.8％(18/96)were Rhipicephalus microplus and 81.2％(78/96)were Haemaphysalis longicorni in Jinzhai County of Anhui Province,all were H.longicorni in Hanshan County and Chaohu City,while the main species in Jingde County was R.microplus.The posi-tive rate of Anaplasma carried by H.longicornis was 30.9％(102/330),which included A.bovis at 1.8％(6/330),A.phagocytophilum at 21.8％(72/330)and uncultured Anaplasma species at 7.3％(24/330).R.microplus was positively cor-related to A.bovis(13.6％,18/132).The uncultured Anaplasma species was mainly detected in host-free ticks.A.phagocy-tophilum was detected in 24.4％of parasitic ticks and 15.8％of host-free ticks.The positive rates of host-free and parasitic ticks were 19.9％and 17.8％,respectively.These results show that H.longicornis and R.microplus were the dominant ticks in several counties of Anhui Province.H.longicornis and R.microplus as well as free and parasitic ticks all carried Anaplas-ma.

Objective:To investigate the effectiveness,safety,and related prognostic factors of the treatment of follicular lymphoma(FL)with a regimen containing Bendamustine.Methods:The clinical data of 129 FL patients who were treated with Bendamustine containing regimen were collected from January 1,2020 to October 30,2022 in the Hematology Department of Lianyungang Second People's Hospital and Jiangsu Provincial People's Hospital.The patients were divided into three groups:Bendamustine plus Rituximab(BR),Bendamustine plus Obinutuzumab(GB),Rituximab+Cyclophosphamide+Epirubicin/Doxorubicin+Vindesine+Prednisone(R-CHOP).The efficacy,safety and related prognostic factors of the treatment of FL with a regimen based on Bendamustine were retrospectively analyzed.Results:The ORR was 98％for the BR group,94％for the GB group,and 72.3％for the R-CHOP group,while the CR rate was 61.2％,70％and 40.4％,respectively.The ORR and CR rates of the R-CHOP group were statistically different from those of the BR group and GB group(P＜0.05).The 3-year PFS rate of the BR group,GB group,and R-CHOP group was 89.6％,90.9％,48.9％,respectively.There was a statistically significant difference in 3-year PFS between the R-CHOP group,BR group,and GB group(P＜0.05),while there was no statistically significant difference in 3-year OS(P＞0.05).Hematological adverse reactions were mainly bone marrow suppression.Lymphocytes and CD4+T lymphocytes decreased to the lowest level about 6 months after treatment,and the incidence of lymphopenia in BR group and GB group was higher than that in R-CHOP group,with a statistical difference(P＜0.05).The higher incidence of non-Hematological adverse reactions were pulmonary infection,EB virus infection,hepatitis B virus reactivation,and gastrointestinal reactions without statistical difference in 3 groups(P＞0.05),and were all controllable.The Receiver operating characteristic of CD4+T lymphocyte count showed that AUC of BR group was 0.802,and the critical value was 258/uL;AUC of GB group was 0.754 with a critical value of 322/uL.Conclusion:The treatment of FL with the Bendamustine containing regimen has good efficacy and controllable adverse reactions,but lymphocytopenia was significant after treatment,and the curative efficacy in combination with various CD20 monoclonal antibodies was different.The lowest CD4+T lymphocyte count can be used as a predictive factor for the occurrence of infection and efficacy of the Bendamustine containing regimen for FL.

Objective:To establish a morphologic classification system for characterizing blast cells in patients with acute promyelocytic leukemia(APL)and analyze the correlation of different APL morphologic characteristics with conventional tests and genetic variants.Methods:Based on the morphological characteristics of APL blast cells,a classification system of 14 categories was established to characterize the inter-and intra-individual cellular morphological heterogeneity of patients.The classification system was used for the morphological analysis of 40 APL patients,and the classification results were statistically analyzed with the patients'conventional test indexes and gene variant characteristics to analyze the correlation of different APL blast cell morphological features with conventional test indexes and gene variants.Results:In the FLT3-ITD mutation-positive group,there were significantly fewer cells with regular nuclear shape,hyper granularity,and missing Auer rods(category 1)than in the FLT3 mutation-negative group(P＜0.05).The activated partial thromboplastin(APTT)was significantly longer in the group with regular nucleus compared to the group with irregular nucleus(P＜0.05).In the hypo-granular group,the APTT was also significantly longer compared to the hyper-granular group(P＜0.01),and the proportion of myeloid blast cells was relatively lower(P＜0.05).The peripheral blood white blood cell counts,D-dimer,lactate dehydrogenase and proportion of bone marrow blast cells were significantly higher in the Auer rods(-)group than Auer rods increasing group(all P＜0.05).Conclusion:The newly established morphologic classification system in this study can objectively characterize different types of APL blast cells,which helps to better assess the intra-and inter-individual heterogeneity of APL blast cells,and further use in accurately analyzing the correlation of morphological phenotypes with biological properties of APL.

Objective:To explore the association between insulin resistance (IR) and new-onset hyperuricemia (HUA) in nurses.Methods:A retrospective cohort study was conducted on 3 792 nurses from Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, who were surveyed from January to July in 2021. A total of 2 995 nurses who were successfully followed up in 2023 and met the inclusion criteria were selected for the study. The nurses were divided into four groups based on their quantiles (Q1 to Q4)for each indicator of insulin resistance (IR), including the triglyceride glucose (TyG), the triglyceride glucose-body mass index (TyG-BMI), the triglyceride/high-density lipoprotein-cholesterol index (TG/HDL-C), and the metabolic score for insulin resistance (METS-IR): groups. The impact of each IR indicator on the risk of HUA was assessed by using Cox regression analysis, while the receiver operating characteristic (ROC) curve was employed to evaluate and compare the predictive power of each indicator.Results:Of the 2 995 nurses, there were 65 males and 2 930 females, with a mean age of (33.19±6.67) years. During the follow-up period of 1.95 (1.87, 2.03) years, 152 new-onset HUA cases were identified, resulting in an incidence density of 26.02 per 1 000 person-years. After adjusting for various confounding factors, the Cox risk regression model analysis indicated that the hazard ratios (95% CI) for the risk of HUA in the highest quartile (Q4) compared to the lowest quartile (Q1) were as follows: 2.20(1.34, 3.63) for TyG, 4.95 (2.76, 8.90) for TyG-BMI, 3.24 (1.92, 5.45) for TG/HDL-C, and 6.15 (3.34, 11.33) for METS-IR. The areas under the ROC curves for TyG, TyG-BMI, TG/HDL-C, and METS-IR levels in predicting the risk of HUA in nurses was 0.71, 0.73, 0.72, and 0.74, respectively. Conclusion:The IR is positively correlated with new-onset HUA in nurses, and each IR index demonstrates a certain predictive efficacy for risk of HUA.

Objective:To explore the cerebral cortical mechanism of intravesical electrical stimulation (IVES) on neurogenic underactive bladder (UAB).Methods:A prospective study was conducted on healthy subjects (HS) recruited in our center and patients with neurogenic UAB treated with IVES from March 2022 to June 2023 were included. HS inclusion criteria: females aged 18-60 years; the 72-hour voiding diary was normal; the urine volume was 200-400 ml, and the free urine flow rate > 20 ml/s. HS exclusion criteria: urinary and neurological related disorders; major diseases of all systems of the body; cognitive dysfunction. Inclusion criteria for UAB patients: females aged 18-60 years; neurogenic UAB due to incomplete spinal cord injury (grade D or E) with a duration of > 3 months; previous routine use of intermittent catheterization, or indication of intermittent catheterization (residual urine accounts for > 40% of functional bladder capacity). Exclusion criteria for UAB patients: decreased bladder compliance on urodynamic examination; symptomatic urinary tract infection; concomitant hydronephrosis, vesicoureteral reflux or renal insufficiency (serum creatinine greater than 1.5 times of the normal upper limit); bladder tumors; neurological related diseases; pregnant or trying to conceive; a pacemaker or defibrillator has been implanted in the body. At baseline, the 24-hour voiding diary, residual urine, voiding efficiency, first sensation of bladder filling volume and American Urological Association Symptom Index Quality of Life scores(AUA-SI-QOL)were recorded, and the resting state-functional near-infrared spectroscopy scans of the prefrontal cortex was completed in the bladder emptying state and the strong desire to void stage. The UAB group was re-evaluated after completing 20 IVES treatments. Improvement in residual urine > 50% was defined as success of IVES treatment. The differences in functional connectivity in the prefrontal lobe between the successful UAB group before and after IVES and between the successful UAB group and the HS group were compared.Results:A total of 16 HS and 18 UAB patients were included. Eleven UAB patients were successfully treated by IVES, and 7 UAB patients were failed. Compared with pre-treatment, the post-treatment residual urine volume [90.0(50.0, 120.0) ml vs. 210.0(110.0, 300.0) ml], 24-h intermittent catheterization [3.0(2.0, 4.0) times vs. 4.0(3.0, 4.0) times], first sensation of bladder filling volume [275.0(245.0, 280.0) ml vs. 295.0 (290.0, 315.0) ml] and AUA-SI-QOL score [2.0 (2.0, 3.0) vs. 4.0 (4.0, 4.0)] of the successful UAB group were significantly lower ( P<0.05), and the voiding efficiency [75.0% (69.0%, 85.0%) vs. 42.0% (35.0%, 77.0%)] was significantly higher ( P< 0.05). Before IVES, the successful UAB group compared with the HS group, internal prefrontal functional connectivity was significantly attenuated in the bladder emptying state involving 5 brain regions: bilateral dorsolateral prefrontal cortex (DLPFC), bilateral frontopolar area, and left pars triangularis. And in the strong desire to void stage significantly attenuated involving 4 brain regions: bilateral DLPFC and bilateral frontopolar area. In the successful UAB group after IVES compared with the HS group, internal prefrontal functional connectivity was significantly attenuated in the bladder emptying state involving 2 brain regions: left pars triangularis and left DLPFC. And in the strong desire to void stage involving 4 brain regions: left DLPFC, right frontopolar area, the left pars opercularis Broca's area, and the left pars triangularis. After IVES in the successful UAB group compared with pretreatment, prefrontal internal functional connectivity was significantly enhanced in the bladder emptying state involving 4 brain regions: bilateral DLPFC and bilateral frontopolar area, and in the strong desire to void stage involving 4 brain regions: bilateral DLPFC, bilateral frontopolar area. Conclusions:Significant enhancement of functional connectivity within the prefrontal lobes (bilateral DLPFC and bilateral frontopolar area) may be the cortical mechanism of IVES for neurogenic UAB.

Objective:To explore the influence of environment temperature on the incidence of testicular torsion.Methods:We collected the clinical data on 172 cases of testicular torsion diagnosed in the Second Hospital of Hebei Medical University from De-cember 2013 to December 2020.According to the local environment temperature on the day of onset,we divided the patients into groups A(below 0℃),B(0-10℃),C(10-20℃)and D(above 20℃),and compared the incidence rates of testicular torsion among the four groups,followed by correlation analysis.Results:The incidence rate of testicular torsion was 12.8％(n=22)in group A,35.5％(n=61)in B,34.9％(n=60)in C and 16.9％(n=29)in D,the highest at 0-10℃ in group B,with sta-tistically significant difference among the four groups(x2=29.07,P＜0.001).Spearman correlation analysis indicated that the inci-dence of testicular torsion was negatively correlated with the environment temperature(r=-0.261,P＜0.01),with no statistically significant difference among different seasons(x2=5.349,P＞0.05),but higher in autumn and winter than in the other two sea-sons.Conclusion:The incidence of testicular torsion is negatively correlated with the environment temperature,elevated when the temperature decreases,but has no statistically significant difference among different seasons,though relatively higher in autumn and winter.

AIM:To establish a severe pneumonia mouse model induced by bacterial infection.METHODS:A total of 102 male SPF C57BL/6J mice were randomly divided into a control group and a model group.Klebsiella pneu-moniae was administered via tracheal instillation at a concentration of 5×109 CFU.Mice were euthanized on days 1,2,4,8,and 14 post-infection to assess general condition,body weight,mortality,white blood cell and neutrophil counts,in-flammatory markers,and pathological changes in lung,heart,liver,spleen,kidney,and intestinal tissues.RESULTS:Mice in the model group exhibited symptoms such as dyspnea and huddling from 6 hours to 4 days post-infection,which progressively worsened,accompanied by continuous weight loss(P<0.01).These symptoms gradually resolved between days 5 and 14.Arterial oxygen saturation in the model group dropped to 80.7%from days 1 to 8(P<0.01)but returned to normal from days 9 to 14.A total of 23 model mice died between days 1 and 9,with no deaths thereafter,resulting in a mortality rate of 31.9%(P<0.01).Pathological examination revealed inflammatory cell infiltration,congestion,and ede-ma in lung tissue from days 1 to 2,with continued inflammatory cell infiltration,alveolar structural disorganization from days 4 to 8,and alveolar rupture and fusion by day 14(P<0.05 or P<0.01).Additionally,model mice showed significant increases in neutrophil count,white blood cell count,protein content in bronchoalveolar lavage fluid,total cell count,neutrophil ratio,and levels of inflammatory factors tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β)and IL-6 in peripheral blood from days 1 to 8(P<0.05 or P<0.01).No significant pathological changes were observed in heart and liver tissues,while spleen,kidney,and intestinal tissues exhibited notable pathological changes:indistinct boundaries be-tween red and white pulp in the spleen,significant congestion and edema around renal glomeruli,renal tubules,and col-lecting ducts,and extensive inflammatory cell infiltration in the colonic mucosa.CONCLUSION:Tracheal instillation of 5×109 CFU Klebsiella pneumoniae induces severe pathological changes in the lungs of mice,offering a robust model for studying the pathogenesis and treatment of severe pneumonia.

Objective To investigate the incidence rate,clinical characteristics,and prognosis of neonatal stroke in Shenzhen,China.Methods Led by Shenzhen Children's Hospital,the Shenzhen Neonatal Data Collaboration Network organized 21 institutions to collect 36 cases of neonatal stroke from January 2020 to December 2022.The incidence,clinical characteristics,treatment,and prognosis of neonatal stroke in Shenzhen were analyzed.Results The incidence rate of neonatal stroke in 21 hospitals from 2020 to 2022 was 1/15 137,1/6 060,and 1/7 704,respectively.Ischemic stroke accounted for 75％(27/36);boys accounted for 64％(23/36).Among the 36 neonates,31(86％)had disease onset within 3 days after birth,and 19(53％)had convulsion as the initial presentation.Cerebral MRI showed that 22 neonates(61％)had left cerebral infarction and 13(36％)had basal ganglia infarction.Magnetic resonance angiography was performed for 12 neonates,among whom 9(75％)had involvement of the middle cerebral artery.Electroencephalography was performed for 29 neonates,with sharp waves in 21 neonates(72％)and seizures in 10 neonates(34％).Symptomatic/supportive treatment varied across different hospitals.Neonatal Behavioral Neurological Assessment was performed for 12 neonates(33％,12/36),with a mean score of(32±4)points.The prognosis of 27 neonates was followed up to around 12 months of age,with 44％(12/27)of the neonates having a good prognosis.Conclusions Ischemic stroke is the main type of neonatal stroke,often with convulsions as the initial presentation,involvement of the middle cerebral artery,sharp waves on electroencephalography,and a relatively low neurodevelopment score.Symptomatic/supportive treatment is the main treatment method,and some neonates tend to have a poor prognosis.

Clinical data of 3 patients with linezolid-induced lactic acidosis treated in 2 hospitals in Beijing and Shandong were retrospectively analyzed,and relevant literatures at home and abroad were retrieved.The pathogene-sis,risk factors,clinical manifestations,and treatment scheme were valuated.Three patients received linezolid anti-infection treatment due to their disease condition.At different phases of treatment,they developed lactic acidosis that was difficult to be explained with septic shock.After discontinuing linezolid and receiving bedside continuous veno-venous hemofiltration(CVVH)treatment,patient's blood lactate levels decreased significantly.It is clinically diagnosed linezolid-induced lactic acidosis finally,but the initial diagnosis was septic shock by all doctors.After ac-tive treatment,2 patients recovered and 1 patient died.Linezolid-induced lactic acidosis is easily to be misdiagnosed as septic shock.Clinicians should enhance their understanding and recognition of the early diagnosis of the adverse reactions,take effective measures,so as to improve patient prognosis.