Objective To understand the epidemiological characteristics of a clustered outbreak of severe fever with thrombocytopenia syndrome(SFTS)as well as the ecological tick monitoring results for Zibo City, and to provide a scientific basis for formulating prevention and control strategies. Methods A case definition was cited before epidemic investigations were performed. Epidemiological investigations were performed on the index cases and their close contacts. Blood samples were collected from cases and close contacts, and quantitative real-time RT-PCR was used to detect SFTS virus(SFTSV)nucleic acid sequences. A retrospective cohort study was conducted to analyze risk factors and develop prevention and control strategies. Results This clustered outbreak involved two index cases and six close contacts with no deaths. Case A exhibited symptom onset on July 26. SFTS was confirmed on August 2. Case B exhibited symptom onset on August 1, and SFTS was confirmed on August 3. Patient B reported a recent history of tick bites. In both index cases, the incubation period for SFTS was inferred to be 7-12 days. The time interval from symptom onset to clinical diagnosis in the two cases ranged from 2-8 days, with an average period of 5 days. SFTSV nucleic acid test result were positive for both patients, whereas all six close contacts tested negative. All captured ticks tested negative for SFTSV using quantitative real-time RT-PCR. The densities of parasitic and free-living ticks in the emergency monitoring area around the cases were 12.60 and 4.65 ticks/(flag·100 m). In 2024, the average parasitic tick index and free-living tick density index were 4.21 and 2.43 ticks/(flag ·100 m)in Yiyuan County, respectively. Conclusions No evidence of human-to-human transmission was found in the assessed SFTS clusters. The infections were likely acquired through tick bites during fieldwork, and the risk of a subsequent outbreak spreading was low.

Under the background of carbon peaking and carbon neutrality goals, the Ministry of Ecology and Environment, together with 15 national ministries and commissions, has formulated the Implementation Plan on Establishing a Carbon Footprint Management System, and it is urgent for traditional Chinese medicine(TCM) pharmaceutical enterprises to carry out research on carbon footprint accounting methods of related products. Based on the life cycle assessment(LCA) theory, taking mulberry leaf extract produced by a certain enterprise as an example, this study analyzed the carbon footprint of TCM extracts during the life cycle. The results show that for every 1 kg of product produced, the carbon emissions from the stages of raw material acquisition, transportation, and extract production are-20.569, 1.205, and 173.577 kgCO_2eq(CO_2 equivalent), respectively. The carbon footprint of the product is 154.213 kgCO_2eq·kg~(-1). In addition, the carbon emission is the highest in the production stage, in which the consumption of ethanol solvents makes the greatest contribution to the carbon footprint, accounting for 25.71%, more than one-fourth of the total carbon footprint. The second contribution was from the treatment process of TCM residues, accounting for 19.67%, closely followed by wastewater treatment(17.71%), the consumption of hot steam(17.43%), and drinking water(16.90%). The consumption of electric power and packaging materials has a smaller carbon emission of 2.58%. In particular, the carbon emission caused by the consumption of packaging materials is only 0.04%, which is negligible. The results of the study are expected to provide a reference for TCM enterprises to carry out research on the carbon footprint of products, offer ideas for collaborative innovation in reducing pollution and carbon emissions throughout the entire industry chain of TCM, and develop new quality productivity of modern TCM industry based on green and low-carbon manufacturing.
Morus/chemistry* ; Plant Leaves/chemistry* ; Carbon Footprint ; Drugs, Chinese Herbal/chemistry* ; Plant Extracts/analysis* ; Medicine, Chinese Traditional

Objective To explore the potential central mechanisms of functional electrical stimulation(FES)hand cycling in promot-ing upper limb motor recovery after stroke.Methods A total of 35 stroke patients hospitalized in the Rehabilitation Center of Changzhou De'an Hospital from May,2023 to December,2024 were enrolled.They sequentially completed 10-minute FES hand cycling and 10-minute sham stimulation(simple hand cycling)tasks.The task order was randomized via dice rolling.Functional near-in-frared spectroscopy(fNIRS)was used to monitor real-time cerebral hemodynamic changes during both tasks to calculate the overall functional connectivity(FC)strength and the FC strength within regions of interest.Results The overall FC strength was higher during the FES hand cycling task than during the sham task(t=2.591,P<0.05),as well as FC between the ipsilateral primary motor cortex(iM1)and ipsilateral somatosensory association cortex(iSAC),iM1 and contralateral somatosensory association cortex(cSAC),ipsilateral pre-motor and supple-mentary motor cortex(iPMC)and iSAC,iPMC and cSAC,iPMC and ipsilateral primary somatosensory cortex(iS1),iPMC and iM1,and contralateral pre-motor and supplementary motor cortex(cPMC)and iSAC(PFDR<0.05).Conclusion FES hand cycling can promote the cortical function remodeling between cerebral hemispheres and the af-fected hemisphere,to integrate sensory-motor function.

Objective To explore the potential central mechanisms of functional electrical stimulation(FES)hand cycling in promot-ing upper limb motor recovery after stroke.Methods A total of 35 stroke patients hospitalized in the Rehabilitation Center of Changzhou De'an Hospital from May,2023 to December,2024 were enrolled.They sequentially completed 10-minute FES hand cycling and 10-minute sham stimulation(simple hand cycling)tasks.The task order was randomized via dice rolling.Functional near-in-frared spectroscopy(fNIRS)was used to monitor real-time cerebral hemodynamic changes during both tasks to calculate the overall functional connectivity(FC)strength and the FC strength within regions of interest.Results The overall FC strength was higher during the FES hand cycling task than during the sham task(t=2.591,P<0.05),as well as FC between the ipsilateral primary motor cortex(iM1)and ipsilateral somatosensory association cortex(iSAC),iM1 and contralateral somatosensory association cortex(cSAC),ipsilateral pre-motor and supple-mentary motor cortex(iPMC)and iSAC,iPMC and cSAC,iPMC and ipsilateral primary somatosensory cortex(iS1),iPMC and iM1,and contralateral pre-motor and supplementary motor cortex(cPMC)and iSAC(PFDR<0.05).Conclusion FES hand cycling can promote the cortical function remodeling between cerebral hemispheres and the af-fected hemisphere,to integrate sensory-motor function.

Objective To study the effects of dual-hemispheric transcranial direct current stimulation(Dual-tDCS)on upper limb motor function in chronic-phase stroke patients to provide theoretical references for neural mechanisms-based treatment of upper limb dysfunction.Methods Totally 24 chronic-phase stroke patients with upper limb motor dysfunction were selected from some hospital and divided into an experimental group(n=13)and a control group(n=11)the random number table.The control group was treated with tDCS pseudo-stimulation combined with conventional rehabilitation,while the experimental group was given with Dual-tDCS combined with conventional rehabilitation.The patient activities were assessed before and after treatment with Fugl-Meyer assessment upper limb scale(FMA-UL)and activities of daily living(ADL)scale.The changes of primary motor cortex(M1 area)and whole brain functional connectivity(FC)were compared before and after treatment.SPSS 24.0 statistical software was used for data analysis.Results After treatment,the two groups both had the FAM-UL and ADL scores increased significantly,and the experimental group had the scores statistically higher than those of the control group,and the differences were all statistically significant(P＜0.05).In the control group,the analysis on M1 area and whole brain FC after treatment indicated the FC decreased from M1 area at the unaffected side to midoccipital gyrus at the affected side and lingual gyrus and healthy angular gyrus at the unaffected side;there were no brain areas with changed FC found(P＜0.01).In the experimental group,the FC was lowered from M1 area at the unaffected side to cerebellum and cerebellar vermis at the unaffected side,while raised to precentral gyrus at the affected side(P＜0.01);the FC ascended from M1 area at the affected side to cerebellum and middle temporal gyrus at the affected side,while declined to precentral gyrus at the unaffected side(P＜0.01).Conclusion The neuromodulatory effect of Dual-tDCS on the brain improves FC in motor and non-motor-related brain areas in chronic-phase stroke patients,and may contribute to rehabilitation of upper limb motor dysfunction in chronic-phase stroke.[Chinese Medical Equipment Journal,2024,45(2):67-73]

Cornus officinalis,a medicinal and edible plant known for its liver-nourishing properties,has shown promise in inhibiting the activation of hepatic stellate cells(HSCs),crucial indicators of hepatic fibrosis,especially when processed by high pressure wine steaming(HPWS).Herein,this study aims to investigate the regulatory effects of cornus officinalis,both in its raw and HPWS forms,on inflammation and apoptosis in liver fibrosis and their underlying mechanisms.In vivo liver fibrosis models were established by subcutaneous injection of CCl4,while in vitro HSCs were exposed to transforming growth factor-β(TGF-β).These findings demonstrated that cornus officinalis with HPWS conspicuously ameliorated his-topathological injury,reduced the release of proinflammatory factors,and decreased collagen deposition in CCl4-induced rats compared to its raw form.Utilizing ultra-high-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometer(UHPLC-QTOF-MS)combined with network analysis,we identified that the pharmacological effects of the changed components of cornus officinalis before and after HPWS,primarily centered on the adenosine phosphate(AMP)-activated protein kinase(AMPK)pathway.Of note,cornus officinalis activated AMPK and sirtuin 3(SIRT3),promoting the apoptosis of activated HSCs through the caspase cascade by regulating caspase3,caspase6 and caspase9.small interfering RNA(siRNA)experiments showed that cornus officinalis could regulate AMPK activity and its mediated-apoptosis through SIRT3.In conclusion,cornus officinalis exhibited the ability to reduce inflammation and apoptosis,with the SIRT3-AMPK signaling pathway identified as a potential mecha-nism underlying the synergistic effect of cornus officinalis with HPWS on anti-liver fibrosis.

Objective To understand the current situation of human brain donation in Hebei Province by analyzing the basic information of Human Brain Bank samples of Hebei Medical University in order to provide basic data support for subsequent scientific research.Methods The samples collected from the Human Brain Bank of Hebei Medical University were analyzed(from December 2019 to February 2024),including gender,age,cause of death,as well as quality control data such as postmortem delay time,pH value of cerebrospinal fluid and and RNA integrity number and result of neuropathological diagnosis.Results Until February 2024,30 human brain samples were collected and stored in the Human Brain Bank of Hebei Medical University,with a male to female ratio of 9∶1.Donors over 70 years old accounted for 53％.Cardiovascular and cerebrovascular diseases(36.67％)and nervous system diseases(23.33％)accounted for a high proportion of the death causes.The location of brain tissue donors in Shijiazhuang accounted for 90％donations,and the others were from outside the city.The postmortem delay time was relatively short,90％within 12 hours and 10％more than 12 hours.69.23％of the brain samples had RNA integrity values greater than 6.Cerebrospinal fluid pH values ranged from 5.8 to 7.5,with an average value of 6.60±0.45.Brain weights ranged from 906-1496 g,with an average value of(1210.78±197.84)g.Three apolipoprotein E(APOE)alleles were detected including five genotypes(ε2/ε3,ε2/ε4,ε3/ε3,ε3/ε4,ε4/ε4).Eleven staining methods related to neuropathological diagnosis had been established and used.A total of 12 cases were diagnosed as neurodegenerative diseases(including Alzheimer's disease,Parkinson's disease,multiple system atrophy,corticobasal degeneration and progressive supranuclear palsy,etc.),accounting for 40％donated brains.The comorbidity rate of samples over 80 years old was 100％.Conclusion The summary and analyses of the data of brain donors in the Human Brain Bank of Hebei Medical University can reflect the current situation of the construction and operation of the brain bank in Hebei Province,and it can also be more targeted to understand and identify potential donors.Our information can provide reference for the construction of brain bank and provides more reliable materials and data support for scientific research.

Objective To study the pharmacokinetic(PK)characteristics,bioequivalence and safety of two kinds of vildagliptin tablets in Chinese healthy subjects in postprandial state.Methods A single-center,open,balanced,randomized,single-dose,two-period,two-sequence,crossover design was adopted.Each period,subjects orally took 50 mg of the test formulation or reference formulation after a high-fat meal.Blood samples were collected at preset time points and the plasma concentration of vildagliptin was measured by liquid chromatography/mass spectrometry(LC-MS/MS).The PK parameters were calculated using Phoenix WinNonlin 8.2 software;and the bioequivalence of the two formulations was evaluated.Demographic and baseline characteristics,as well as safety analysis of the subjects,were performed using SAS 9.4 software.Results Out of 24 subjects,one subject withdrew from the trial before administration in the first period,and another withdrew before administration in the second period.Under postprandial conditions,the main pharmacokinetic parameters of vildagliptin tablets for the test and reference formulations were Cmax were(230±73.9)and(203±44.0)ng·mL-1,AUC0-t were(1 065.93±215.46)and(1 029.30±185.78)ng·h·mL-1,AUC0-∞ were(1 078.74±217.93)and(1 041.59±190.66)ng·h·mL-1.The 90％confidence intervals for the geometric mean ratios of Cmax,AUC0-t and AUC0-∞ were within the requirements of the equivalent range of bioequivalence(80.00％-125.00％).During the trial,five subjects experienced mild adverse events,with no serious adverse events occurring.Conclusion Two kinds of vildagliptin tablets have bioequivalence in postprandial state,and have good safety and tolerability in healthy subjects.

Objective To study the pharmacokinetic(PK)characteristics,bioequivalence and safety of two kinds of vildagliptin tablets in Chinese healthy subjects in postprandial state.Methods A single-center,open,balanced,randomized,single-dose,two-period,two-sequence,crossover design was adopted.Each period,subjects orally took 50 mg of the test formulation or reference formulation after a high-fat meal.Blood samples were collected at preset time points and the plasma concentration of vildagliptin was measured by liquid chromatography/mass spectrometry(LC-MS/MS).The PK parameters were calculated using Phoenix WinNonlin 8.2 software;and the bioequivalence of the two formulations was evaluated.Demographic and baseline characteristics,as well as safety analysis of the subjects,were performed using SAS 9.4 software.Results Out of 24 subjects,one subject withdrew from the trial before administration in the first period,and another withdrew before administration in the second period.Under postprandial conditions,the main pharmacokinetic parameters of vildagliptin tablets for the test and reference formulations were Cmax were(230±73.9)and(203±44.0)ng·mL-1,AUC0-t were(1 065.93±215.46)and(1 029.30±185.78)ng·h·mL-1,AUC0-∞ were(1 078.74±217.93)and(1 041.59±190.66)ng·h·mL-1.The 90％confidence intervals for the geometric mean ratios of Cmax,AUC0-t and AUC0-∞ were within the requirements of the equivalent range of bioequivalence(80.00％-125.00％).During the trial,five subjects experienced mild adverse events,with no serious adverse events occurring.Conclusion Two kinds of vildagliptin tablets have bioequivalence in postprandial state,and have good safety and tolerability in healthy subjects.

Objective:To investigate the diagnostic accuracy of serological indicators and evaluate the diagnostic value of a new established combined serological model on identifying the minimal hepatic encephalopathy (MHE) in patients with compensated cirrhosis.Methods:This prospective multicenter study enrolled 263 compensated cirrhotic patients from 23 hospitals in 15 provinces, autonomous regions and municipalities of China between October 2021 and August 2022. Clinical data and laboratory test results were collected, and the model for end-stage liver disease (MELD) score was calculated. Ammonia level was corrected to the upper limit of normal (AMM-ULN) by the baseline blood ammonia measurements/upper limit of the normal reference value. MHE was diagnosed by combined abnormal number connection test-A and abnormal digit symbol test as suggested by Guidelines on the management of hepatic encephalopathy in cirrhosis. The patients were randomly divided (7∶3) into training set ( n=185) and validation set ( n=78) based on caret package of R language. Logistic regression was used to establish a combined model of MHE diagnosis. The diagnostic performance was evaluated by the area under the curve (AUC) of receiver operating characteristic curve, Hosmer-Lemeshow test and calibration curve. The internal verification was carried out by the Bootstrap method ( n=200). AUC comparisons were achieved using the Delong test. Results:In the training set, prevalence of MHE was 37.8% (70/185). There were statistically significant differences in AMM-ULN, albumin, platelet, alkaline phosphatase, international normalized ratio, MELD score and education between non-MHE group and MHE group (all P<0.05). Multivariate Logistic regression analysis showed that AMM-ULN [odds ratio ( OR)=1.78, 95% confidence interval ( CI) 1.05-3.14, P=0.038] and MELD score ( OR=1.11, 95% CI 1.04-1.20, P=0.002) were independent risk factors for MHE, and the AUC for predicting MHE were 0.663, 0.625, respectively. Compared with the use of blood AMM-ULN and MELD score alone, the AUC of the combined model of AMM-ULN, MELD score and education exhibited better predictive performance in determining the presence of MHE was 0.755, the specificity and sensitivity was 85.2% and 55.7%, respectively. Hosmer-Lemeshow test and calibration curve showed that the model had good calibration ( P=0.733). The AUC for internal validation of the combined model for diagnosing MHE was 0.752. In the validation set, the AUC of the combined model for diagnosing MHE was 0.794, and Hosmer-Lemeshow test showed good calibration ( P=0.841). Conclusion:Use of the combined model including AMM-ULN, MELD score and education could improve the predictive efficiency of MHE among patients with compensated cirrhosis.