Objective: To investigate the epidemiological characteristics and spatial-temporal clustering of severe fever with thrombocytopenia syndrome (SFTS) in Huai'an City, Jiangsu Province from 2011 to 2024, so as to provide a basis for optimizing local SFTS prevention and control strategies, and identifying high-risk areas and key populations. Methods: Data on SFTS incidence and deaths in Huai'an City from 2011 to 2024 were collected from the Infectious Disease Reporting Information System of the Chinese Disease Prevention and Control Information System. The reported incidence, mortality, and fatality rates were calculated. Descriptive analysis was performed on temporal, population, and regional distribution. The average annual percent change (AAPC) was used to analyze the trend in the reported incidence of SFTS. Global and local spatial autocorrelation analyses were employed to examine the spatial distribution patterns and spatial association patterns of SFTS incidence while spatio-temporal scanning analyses was used to assess the spatial-temporal clustering of SFTS. Results: A total of 337 SFTS cases were reported in Huai'an City from 2011 to 2024, with the reported incidence rising from 0.17/100 000 to 1.88/100 000. There were 20 deaths, with an average annual mortality of 0.03/100 000, and a fatality rate of 5.93%. The incidence showed obvious seasonality, with a peak in May and June (148 cases, accounting for 43.92%). Spring and summer accounted for 107 cases (31.75%) and 159 cases (47.18%), respectively. The reported SFTS cases were mainly male, farmers, and individuals aged ≥41 years, accounting for 56.38%, 79.23%, and 96.74%, respectively. The population distribution of death cases was basically consistent with that of incident cases. Xuyi County was a high-incidence area, with a total of 332 reported cases, accounting for 98.52%. All death cases were reported in this county. Spatial autocorrelation analyses revealed a positive spatial correlation in SFTS incidence from 2019 to 2024, with Moran's I values ranging from 0.214 to 0.336 (all P<0.05). Heqiao Town, Tianquanhu Town, and Guiwu Town in Xuyi County were identified as high-high clustering areas. Spatio-temporal scanning analyses showed that cluster 1 was consistent with the high-high clustering areas, with an aggregation time from the second quarter of 2019 to the second quarter of 2022. Conclusions From 2011 to 2024, the reported incidence of SFTS in Huai'an City showed an upward trend, with a high incidence in spring and summer. Males, farmers, and the middle-aged and elderly population were the key populations for prevention and control. Xuyi County was the key area for prevention and control.

Objective To analyze the epidemiological characteristics of hepatitis E (HE) in Huai'an City from 2015 to 2024, and construct and validate the prediction effect of the Seasonal Autoregressive Integrated Moving Average (SARIMA) model, and to provide a scientific basis for HE prevention and control. Methods Data of reported HE cases in Huai'an City from January 2015 to December 2024 were extracted from the National Disease Control and Prevention Information System. Descriptive epidemiological methods were used to analyze the temporal, regional and population distribution characteristics of HE incidence. After data preprocessing, stationarity test and randomness test, the SARIMA model was constructed. The optimal model was selected by minimizing the Akaike Information Criterion (AIC). The model performance was evaluated by adjusted R-squared (Adj R²) and root mean square error (RMSE). The monthly incidence rate of HE in Huai'an City in 2025 was predicted and compared with the actual incidence data to validate the model. Results A total of 1 713 HE cases were reported in Huai'an City from 2015 to 2024, showing a fluctuating upward trend. Huaiyin District (339 cases) and Lianshui County (334 cases) were high-incidence areas. The cases were mainly concentrated in people aged 45 and above (83.3%), males (gender ratio 2.37:1) and farmers (70.8%). The optimal model was SARIMA (1,1,1)×(2,0,1)₁₂, with residual as white noise sequence. There was no statistical difference between the actual incidence and predicted value from January to August 2025 (P>0.05). Conclusion HE incidence in Huai'an has obvious aggregation and temporal fluctuation characteristics. The SARIMA model has a good prediction effect, which can provide reference for formulating targeted prevention and control strategies.

Objective: To investigate the regional differences in the incidence of urothelial carcinoma among kidney transplant recipients between northern and southern China，so as to provide reference for early diagnosis of this disease. Methods: A comprehensive search was conducted across multiple databases，including CNKI，Wanfang，CBM，and PubMed，using the keywords “kidney transplantation” and “tumor” to collect clinical data from qualified kidney transplant centers.The latest and most complete literature data published by 17 transplant centers in northern China and 14 in southern China were included.Statistical analyses were performed to compare the incidence of post-transplant urothelial carcinoma and non-urothelial malignancies. Results: A total of 37 475 kidney transplant recipients were included，among whom 837 (2.23%) developed post-transplant malignancies，including urothelial carcinoma (366/837，43.73%)，non-urothelial carcinoma (444/837，53.05%)，and malignancies with unspecified pathology (27/837，3.23%).The incidence of malignancies was significantly higher in northern China than in southern China [(2.82±1.39)% vs. (1.67±0.83)%，P=0.011]，with a particularly pronounced difference in the incidence of urothelial carcinoma [(1.68±1.12)% vs. (0.32±0.32)%，P<0.001].No significant difference was observed in the incidence of non-urothelial carcinoma between the two regions [(1.11±0.56)% vs. (1.35±0.65)%，P=0.279].Additionally，female transplant recipients exhibited a higher incidence of malignancies than males in both regions (southern China：2.38% vs. 1.80%; northern China：8.93% vs. 2.52%). Conclusion: The incidence of urothelial carcinoma following kidney transplantation is significantly higher in northern China than in southern China，underscoring the importance of implementing regular tumor screening for kidney transplant recipients，particularly for female patients in northern China，to facilitate early diagnosis and timely intervention.

Objective:To investigate the relationship between serum progranulin(PGRN),pentraxin 3(PTX3),krebs von den lungen-6(KL-6)and the prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)combined with type Ⅱ respiratory failure(RF)after nasal high-flow humidified oxygen therapy.Methods:160 patients with AECOPD combined with type Ⅱ RF who were treated in Zigong First People's Hospital from June 2022 to June 2024 were retrospectively selected,all patients received nasal high-flow humidified oxygen therapy,and they were divided into death group(38 cases)and survival group(122 cases)according to the prognosis of patients after treatment.The differences of serum PGRN,PTX3 and KL-6 levels and clinical data between two groups before treatment were compared.Logistic regression was applied to analyze the influencing factors of the poor prognosis of patients,and the receiver operating characteristic(ROC)curve was used to analyze the predictive efficacy of related risk factors for the poor prognosis of patients.Results:According to the prognosis evaluation,122 cases(76.25％)were in survival group,and 38 cases(23.75％)were in death group.Compared with survival group,serum PGRN,PTX3,KL-6,C-reactive protein(CRP),arterial partial pressure of carbon dioxide(PaCO2)and the number of AECOPD episodes in the past 1 year before treatment in death group were significantly increased,while the arterial partial pressure of oxygen(PaO2)was significantly decreased,the differences were statistically significant(P＜0.05).Logistic multivariate regression analysis showed that,elevated PGRN(OR=1.138),elevated PTX3(OR=1.182)and elevated KL-6(OR=1.162)were risk factors for death in patients with AECOPD combined with type Ⅱ RF after nasal high-flow humidified oxygen therapy(P＜0.05),and elevated PaO2(OR=0.758)was protective factor(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of serum PGRN,PTX3 and KL-6 in predicting the death of patients with AECOPD combined with type Ⅱ RF after nasal high-flow humidified oxygen therapy was 0.816,0.731 and 0.695 respectively,the AUC of the combined prediction of the three was 0.893,which was significantly higher than that of the single prediction.Conclusion:The levels of serum PGRN,PTX3 and KL-6 in patients with AECOPD combined with type Ⅱ RF are increased,which have high predictive value for the poor prognosis of patients with AECOPD combined with type Ⅱ RF after nasal high-flow humidified oxygen therapy.

Objectives:To evaluate the feasibility and clinical efficacy of eccentric occluder for the treatment of ventricular septal defect(VSD)without distance from the aortic valve.Methods:This analysis included 16 patients(9 males and 7 females)with VSD without distance from the aortic valve,who were treated at Fuwai Central China Cardiovascular Hospital from February 2022 to June 2024.Ten cases had mild right coronary sinus prolapse,and 2 had mild aortic valve regurgitation.All patients were diagnosed with VSD located zero-distance from aortic valve through transthoracic echocardiography(TTE)and left ventricular angiography.Eccentric occluder was used for interventional closure.TTE and 12-lead electrocardiography(ECG)were performed at 1 month,3 months,and 6 months after surgery to observe the presence of residual shunt,aortic valve regurgitation,and cardiac electrical conduction abnormalities.Results:Transcatheter closure was successful in 15 patients,procedure failed in one patient due to the unstable fixation of the occluder.Average diameter of the defect is(4.37±1.53)mm,and the diameter of the occluder is 6.5(6.0,8.0)mm.Postoperative left ventricular angiography showed minimal residual shunt in 3 cases,and no complications such as pericardial tamponade,hemolysis,thromboembolism,or infection,were observed.At one month after occlusion,TTE results showed that residual shunt disappeared in 3 patients with residual shunt.During 3-month and 6-month follow-up,all the occluders were well-positioned with no new aortic valve regurgitation or worsening of the original regurgitation,and no atrioventricular block or bundle branch block and other electrocardiographic conduction abnormalities.Conclusions:The use of eccentric occluder for intervention of ventricular septal defect patients without distance from the aortic valve is safe and effective.

Objective:This study aims to develop a laboratory-based predictive model for early neurological deterioration (END) in patients with acute cerebral infarction (ACI) using baseline data collected at hospital admission.Methods:This study was a retrospective cohort study. Clinical and baseline laboratory test data from 502 patients with ACI admitted to the Department of Neurology at our hospital between January 1, 2022 and May 31, 2025. Of these patients, 313 were male and 189 were female, with a median age of 67 years (interquartile range: 58-73). Patients were classified into an END group and a non-END group according to the occurrence of END within 7 days of admission. Subsequently, using the caret package in R (version 4.4.2), the dataset was randomly divided into a training set ( n=351) and a validation set ( n=151) at a 7∶3 ratio, with END status as the stratification variable and a fixed random seed to ensure reproducibility. Following baseline characteristic comparisons between groups, these datasets were used for model development and validation, respectively. The differences in clinical indicators between the two patients groups were assessed using the chi-square test and the Wilcoxon rank sum test. In the training group, Lasso regression was utilized to identify variables significantly associated with END. Seven machine learning algorithms-decision tree (DT), random forest (RF), light gradient boosting machine (LGBM), extreme gradient boosting (XGB), K-nearest neighbors (KNN), support vector machine (SVM), and logistic regression (LR)-were employed to develop predictive models. The optimal hyperparameters were determined via grid search integrated with 5-fold cross-validation. The final algorithm was selected based on comprehensive model performance evaluation. Additionally, clinical data of 79 patients with ACI, collected between June 1 to August 31, 2025, were compiled as an independent test set for external validation. The cohort comprised 49 males and 30 females, with a median age of 68 years (interquartile range: 57-72). The SHapley Additive exPlanations (SHAP) method was employed to access feature importance and model interpretability. SHAP dependence plots and interaction plots were utilized to emplore the nonlinear relationships and interaction effects among the featurevariables. Results:Among the 502 patients, 166 experienced END during 7 days of hospitalization. Lasso regression identified nine significant predictors: history of hyperlipidemia, admission NIHSS score, lymphocyte-to-monocyte ratio (LMR), hemoglobin, D-dimer, albumin, neuron-specific enolase (NSE), homocysteine (HCY), and vitamin B12. The area under the receiver operating characteristic curve (AUC) for the seven machine learning models ranged from 0.709 to 0.946. The XGB model achieved the highest predictive performance, with an AUC of 0.946 (95% CI 0.924-0.960) in the training cohort and 0.867 (95% CI 0.902-0.933) in the validation cohort. SHAP analysis revealed that the top five variables contributing to END prediction were admission NIHSS score, HCY, D-dimer, history of hyperlipidemia, and vitamin B12. Conclusion:This study successfully developed a laboratory-based prediction model for END using the XGB machine learning algorithm, which demonstrated strong predictive performance.

OBJECTIVE: Xuebijing injection has been recommended as a therapeutic approach for individuals with severe and critical COVID-19. This study aims to explore the correlation of neutrophil to lymphocyte platelet ratio (NLPR) with the severity and prognosis of COVID-19, and the effect of XBJ on the prognosis of patients with COVID-19 in different inflammatory states. METHODS: This was a retrospective study conducted at Wuhan Union Hospital in China. COVID-19 patients admitted between November 1, 2022 and February 1, 2023 were included. In predicting prognosis for individuals with COVID-19, new inflammatory indicators were used, and their prognostic value was assessed by using Cox regression models and receiver operating characteristic curves. Furthermore, a calculation was made to determine the cutoff value for NLPR. Relative risk and Cox regression models were used to examine the effects of Xuebijing injection on prognosis in patient cohorts that had been stratified by the NLPR cutoff. RESULTS: This research included 455 participants with COVID-19, with a mean age of 72 years. Several inflammatory indicators were found to be strongly correlated with prognosis, and NLPR shows the greatest predictive power. Patients with NLPR > 3.29 exhibited a mortality rate of 17.3%, which was 6.2 times higher than in patients with NLPR ≤ 3.29. Importantly, providing Xuebijing injection to patients with NLPR > 3.29 was associated with a lower risk of 60-day all-cause mortality. However, there was no discernible improvement in survival among patients with NLPR ≤ 3.29 who received Xuebijing injection. CONCLUSION NLPR is the most reliable inflammatory marker for predicting prognosis among individuals with COVID-19, and can accurately identify individuals who may benefit from Xuebijing injection. Please cite this article as: Liao M, Zhang LT, Bai LJ, Wang RY, Liu Y, Han J, Liu LH, Qi BL. Xuebijing injection reduces COVID-19 patients mortality as influenced by the neutrophil to lymphocyte platelet ratio. J Integr Med. 2025; 23(3): 282-288.
Humans ; Drugs, Chinese Herbal/administration & dosage* ; Male ; Female ; Retrospective Studies ; Aged ; Neutrophils ; COVID-19 Drug Treatment ; COVID-19/blood* ; Middle Aged ; Prognosis ; Lymphocytes ; Blood Platelets ; Platelet Count ; SARS-CoV-2 ; Aged, 80 and over ; Adult

Nigella sativa L. seeds have been traditionally utilized in Chinese folk medicine for centuries to treat vitiligo. This study revealed that the ethanolic extract of Nigella sativa L. (HZC) enhances melanogenesis and mitigates oxidative stress-induced cellular senescence and dysfunction in melanocytes. In accordance with established protocols, the ethanol fraction from Nigella sativa L. seeds was extracted, concentrated, and lyophilized to evaluate its herbal effects via 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assays, tyrosinase activity evaluation, measurement of cellular melanin contents, scratch assays, senescence-associated β-galactosidase (SA-β-gal) staining, enzyme-linked immunosorbent assay (ELISA), and Western blot analysis for expression profiling of experimentally relevant proteins. The results indicated that HZC significantly enhanced tyrosinase activity and melanin content while notably increasing the protein expression levels of Tyr, Mitf, and gp100 in B16F10 cells. Furthermore, HZC effectively mitigated oxidative stress-induced cellular senescence, improved melanocyte condition, and rectified various functional impairments associated with melanocyte dysfunction. These findings suggest that HZC increases melanin synthesis in melanocytes through the activation of the MAPK, PKA, and Wnt signaling pathways. In addition, HZC attenuates oxidative damage induced by H₂O₂ therapy by activating the nuclear factor E2-related factor 2-antioxidant response element (Nrf2-ARE) pathway and enhancing the activity of downstream antioxidant enzymes, thus preventing premature senescence and dysfunction in melanocytes.
Oxidative Stress/drug effects* ; Melanocytes/cytology* ; Cellular Senescence/drug effects* ; Nigella sativa/chemistry* ; Plant Extracts/pharmacology* ; Seeds/chemistry* ; Mice ; Animals ; Melanins/metabolism* ; Monophenol Monooxygenase/metabolism* ; Humans

Objective To observe the clinical efficacy of lumbar disc resection under unilateral biportal endoscopy(UBE)for calcified lumbar disc herniation(CLDH).Methods A retrospective analysis was conducted on 25 patients with single-segment CLDH who underwent lumbar disc resection under UBE from January 2020 to January 2022.The operation time,postoperative hospital stay,and postoperative complications were recorded.The visual analogue scale(VAS)score for low back and leg pain,Japanese Orthopaedic Association(JOA)score for the lumbar spine,and Oswestry disability index(ODI)were used to evaluate the efficacy before surgery,3 d after surgery,1 month after surgery,and at the last follow-up.At the last follow-up,the modified Macnab standard was used to assess the excellent and good rate.Results The patients were followed up for 12～24 months,with an average of(15.60±2.60)months.The average operation time was(58.67±10.73)min,and the postoperative hospital stay was(4.65±0.63)d.The VAS score,and ODI were lower,and JOA score was higher at 3 d after surgery,1 month after surgery,and the last follow-up compared with those before surgery,and the differences were statistically significant(P<0.05).At the last follow-up,according to the modified Macnab criteria,15 cases were rated as excellent,9 cases as good,and 1 case as fair.The excellent and good rate was 96.00%(24/25).Postoperative complications included a tear of the ventral dural sac of the nerve root,about 5 mm in length,without dural sac repair.The patient was instructed to stay in bed for 5 d after surgery and was given fluid replacement.The patient did not complain of discomfort such as headache when he got out of bed,and the postoperative MRI showed no massive epidural effusion.One patient had lower limb sensory disturbance and was treated with neurotrophic drugs,and recovered at the 1-month follow-up after surgery.Postoperative imaging examinations showed that the free calcified tissues were basically completely resected and the nerve roots were adequately decompressed.At the last follow-up,no recurrent cases were found.Conclusion Lumbar disc resection under UBE for CLDH is an effective and safe minimally invasive technique.

Objectives:To evaluate the feasibility and clinical efficacy of eccentric occluder for the treatment of ventricular septal defect(VSD)without distance from the aortic valve.Methods:This analysis included 16 patients(9 males and 7 females)with VSD without distance from the aortic valve,who were treated at Fuwai Central China Cardiovascular Hospital from February 2022 to June 2024.Ten cases had mild right coronary sinus prolapse,and 2 had mild aortic valve regurgitation.All patients were diagnosed with VSD located zero-distance from aortic valve through transthoracic echocardiography(TTE)and left ventricular angiography.Eccentric occluder was used for interventional closure.TTE and 12-lead electrocardiography(ECG)were performed at 1 month,3 months,and 6 months after surgery to observe the presence of residual shunt,aortic valve regurgitation,and cardiac electrical conduction abnormalities.Results:Transcatheter closure was successful in 15 patients,procedure failed in one patient due to the unstable fixation of the occluder.Average diameter of the defect is(4.37±1.53)mm,and the diameter of the occluder is 6.5(6.0,8.0)mm.Postoperative left ventricular angiography showed minimal residual shunt in 3 cases,and no complications such as pericardial tamponade,hemolysis,thromboembolism,or infection,were observed.At one month after occlusion,TTE results showed that residual shunt disappeared in 3 patients with residual shunt.During 3-month and 6-month follow-up,all the occluders were well-positioned with no new aortic valve regurgitation or worsening of the original regurgitation,and no atrioventricular block or bundle branch block and other electrocardiographic conduction abnormalities.Conclusions:The use of eccentric occluder for intervention of ventricular septal defect patients without distance from the aortic valve is safe and effective.