In recent years, the incidence rate of pertussis in China has been steadily increasing, presenting an increasingly severe challenge for disease prevention and control. To strengthen the immune barrier in the population and effectively curb the spread of pertussis, National Disease Control and Prevention Administration of China and other relevant authorities optimized the immunization procedure for diphtheria-tetanus-pertussis vaccine, with the new procedure implemented in 2025. This adjustment includes three key measures: advancing the initial dose of the vaccine from 3 months to 2 months of age, extending the interval between primary immunization doses from 1 month to 2 months, and adding an extra dose of acellular diphtheria-tetanus-pertussis vaccine at 6 years of age. This article discusses potential changes in the epidemiology and clinical manifestations of pertussis following such adjustments for immunization procedure, and awareness of these changes will facilitate the accurate identification of pertussis cases, which is crucial for evaluating the impact of these adjustments and further optimizing immunization strategies.
Humans ; Whooping Cough/epidemiology* ; Diphtheria-Tetanus-Pertussis Vaccine/immunology* ; Infant ; Immunization Schedule ; Child

OBJECTIVES: To evaluate the clinical efficacy of hospital-prepared Chinese medicine Feigan granules for influenza patients. This study has been registered at the International Traditional Medicine Clinical Trial Registry platform (ITMCTR2025000162). METHODS: A prospective observational study was conducted on influenza patients who visited the Fever Clinic of the First Affiliated Hospital, Zhejiang University School of Medicine between February and March 2024. Patients were divided into the observation group (Feigan granules combined with conventional Western medicine) and the control group (conventional Western medicine). Main symptoms (including fever, cough and sore throat) and secondary symptoms (including chest tightness, poor appetite, muscle soreness and dry mouth) were evaluated with traditional Chinese medicine (TCM) symptom scale on the first day of the patient's visit and the third day after treatment. The degrees of improvement in the TCM symptom scores before and after treatment were compared using paired rank-sum test, and the differences in the overall symptom efficacy index between two groups were compared using the Wilcoxon test. RESULTS: A total of 217 influenza patients were included. After treatment, the TCM symptom scores of both groups were significantly improved compared with those before treatment (all P<0.01). The median differences in the main symptom score before and after treatment in the observation and the control groups were 7 points (95%CI: 6.0-8.0) and 6 points (95%CI: 6.0-8.0), respectively. The median difference in the secondary symptom score was 3 points (95%CI: 2.0-4.0) in both groups. The median differences in the total score were 9 points (95%CI: 8.0-10.5) and 8 points (95%CI: 7.0-10.0) in the observation and control groups, respectively. In the subgroup with an initial cough score >2, the improvement rates of total score (97.06% vs. 92.59%) and secondary symptoms (92.31% vs. 85.11%) in observation group were significantly higher than those in the control group (P<0.05); while there was no significant difference in the improvement rate of the main symptoms (95.59% vs. 90.74%, P>0.05). CONCLUSIONS Feigan granules can improve the TCM syndromes of influenza patients, especially for patients with more severe cough.
Humans ; Prospective Studies ; Influenza, Human/drug therapy* ; Medicine, Chinese Traditional/methods* ; Drugs, Chinese Herbal/therapeutic use* ; Female ; Male ; Middle Aged ; Adult ; Aged ; Adolescent ; Young Adult ; Treatment Outcome

OBJECTIVES: To investigate the effect of Shenge powder (SGP) on myocardial fibrosis in rats with heart failure after myocardial infarction and its relation with lysyl oxidase like protein 2 (LOXL2)/transforming growth factor-β1 (TGF-β1)/IL-11 signaling pathway. METHODS: Seventy-two SPF male SD rats were divided into blank control group, model control group, SGP small dose group, SGP large dose group, positive control group, SGP large dose+LOXL2 activator group, with 12 rats in each group. Except for the blank control group, post-myocardial infarction heart failure was induced by coronary constriction. Corresponding treatments were given immediately after successful modeling, once a day for 4 weeks. Left ventricular fractional shortening (LVFS) and left ventricular ejection fraction (LVEF) in rats were detected by color Doppler ultrasound imaging. Levels of IL-1β and IL-6 in serum were analyzed by ELISA method. Myocardial collagen volume fraction (CVF) was evaluated by Masson staining. Expressions of collagen Ⅰ and α-smooth muscle actin (α-SMA) in myocardial tissue were detected by immunohistochemical staining. The mRNA expressions of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase 1 (TIMP-1) in myocardial tissue were detected by qRT-PCR. Expression of LOXL2, TGF-β1, and IL-11 proteins in myocardial tissue were detected by Western blotting. RESULTS: Compared with the blank control group, the LVFS and LVEF of the model control group decreased, the levels of serum IL-6 and IL-1β elevated, and the CVF value, the expressions of collagen Ⅰ and α-SMA in myocardial tissue, MMP-9 and TIMP-1 mRNA, and LOXL2, TGF-β1, IL-11 proteins increased (all P<0.05). Compared with the model control group, the LVFS and LVEF of SGP small dose group, SGP large dose group and positive control group increased, the levels of serum IL-6 and IL-1β decreased, and the CVF value, the expressions of collagen Ⅰ and α-SMA in myocardial tissue, MMP-9 and TIMP-1 mRNA, and LOXL2, TGF-β1, IL-11 proteins decreased (all P<0.05); while LOXL2 activator reversed the improvement effect of high-dose SGP on myocardial fibrosis in heart failure rats after myocardial infarction. CONCLUSIONS Shenge powder may inhibit myocardial fibrosis in heart failure rats after myocardial infarction by inhibiting the LOXL2/TGF-β1/IL-11 pathway.
Animals ; Male ; Rats, Sprague-Dawley ; Myocardial Infarction/complications* ; Transforming Growth Factor beta1/metabolism* ; Signal Transduction/drug effects* ; Drugs, Chinese Herbal/therapeutic use* ; Rats ; Heart Failure/pathology* ; Myocardium/metabolism* ; Fibrosis ; Amino Acid Oxidoreductases/metabolism* ; Interleukin-11/metabolism* ; Tissue Inhibitor of Metalloproteinase-1/metabolism* ; Matrix Metalloproteinase 9/metabolism*

OBJECTIVES: To investigate the effect of a variety of kidney-tonifying Chinese medicines on thymus regeneration after acute degeneration in mice. METHODS: Forty-eight 8-week-old male BALB/c mice were randomly divided into normal control group, model control group, negative control group, positive control group, the fructus of Cnidium monnieri (L.) Cuss. group, the fructus of Psoralea corylifolia (L.) group, the fructus of Rubus chingii Hu group, and the tuber onion seed group, with 6 mice in each group. Except for the normal control group, mice in the other groups received intraperitoneal injections of rapamycin (1 mg·kg^－1·d^－1) for 5 consecutive days followed by 14 h of starvation to induce acute thymus degeneration. After successful modeling, in treatment groups ethanol extract of the fructus of Cnidium monnieri (L.) Cuss. (0.78 g·kg^－1·d^－1), fructus of Psoralea corylifolia (L.) (0.39 g·kg^－1·d^－1), fructus of Rubus chingii Hu (0.78 g·kg^－1·d^－1) or the tuber onion seed(0.39 g·kg^－1·d^－1) was intraperitoneally injected once a day for 5 days; while the negative control group was given equal volume of normal saline, and the positive control group was given metformin (300 mg·kg^－1·d^－1). The grip strength was measured with a grip tester 2 h after the last administration. The pathological changes of thymus were observed by hematoxylin and eosin (HE) staining. The structure and distribution of thymic epithelial cells were observed by multiple immunofluorescence method. The proportion of T cell subsets in thymus and peripheral blood was analyzed by flow cytometry. The level of T cell receptor excision circles (TREC) in the genomic DNA of mouse spleen mononuclear cells was detected by quantitative polymerase chain reaction (PCR) for evaluation of thymic output function. The expression of thymus aging- and function-related factors in the thymus tissue were detected by quantitative reverse transcription PCR. The expression of cyclin-dependent kinase inhibitor 1A (p21) and tumor protein 53 (p53) were verified by immunohistochemistry. RESULTS: Rapamycin induced thymic atrophy and significantly reduced limb grip strength in mice (P<0.01). Compared with the negative control group, the limb grip strength of mice in the fructus of Psoralea corylifolia (L.) group, the fructus of Rubus chingii Hu group and the tuber onion seed group was significantly enhanced (all P<0.05), and the level of TREC in spleen of the mice in each administration group was reduced (all P<0.05). Among Chinese herb medicine-treatment groups, the recovery of thymus function and tissue structure in the tuber onion seed group was most obvious. Further study showed that compared with the negative control group, the proportion of CD4 single positive cells (CD3⁺TCR-β⁺CD4⁺CD8^－) in the thymus of the tuber onion seed group was significantly increased (P<0.01), and the proportion of CD3⁺CD28⁺ T cell and CD3⁺CD8⁺CD28⁺ T cell in peripheral blood was significantly increased (all P<0.01). The mRNA levels of IL-1α, IL-6, p21 and p53 in thymocytes were decreased (all P<0.05). The results of immunohistochemistry further confirmed the decrease in p21 and p53 expression. In normal mice, tuber onion seed was observed to enhance limb grip strength (P<0.01), while suppressing thymus output and change the distribution of T cell subsets, and there was no significant effect on thymus weight and the expression of Foxn1, SIRT1, p21, CXCL2 and PTMα. CONCLUSIONS The tuber onion seed and other kidney-tonifying traditional Chinese medicines can accelerate the regeneration process of mouse thymus after acute degeneration induced by rapamycin in mice, and the tuber onion seed exhibits the most pronounced therapeutic effect.
Animals ; Mice ; Male ; Mice, Inbred BALB C ; Thymus Gland/physiology* ; Drugs, Chinese Herbal/pharmacology* ; Sirolimus/adverse effects* ; Regeneration/drug effects*

OBJECTIVE: To systematically evaluate the effect and safety of the combination of Compound Xuanju Capsules (CXC) and Western medicine (WM) in the treatment of type Ш prostatitis complicated by ED. METHODS: We searched for randomized controlled trials (RCT) on the treatment of type Ш prostatitis complicated by ED with CXC+WM or WM in the Chinese and English databases CNKI, VIP, Wanfang Digital, Duxiu Academic Search and Chaoxing Electronic Book Information Retrieval, Fangzheng Apabi Electronic Book, Google Scholar Search, Web of Science, Scopus, PubMed, and others from their establishment to April 2024. According to the Cochrane Handbook requirement, we subjected the identified RCTs to meta-analysis using the RevMan 5.3 software. RESULTS: A total of 16 eligible studies were identified, involving 742 cases treated by combination therapy of CXC+WM and another 742 with WM alone. The results of meta-analysis showed that the rate of clinical effectiveness was dramatically higher in the CXC+WM than in the WM group (P<0.01, MD = 6.19, 95% CI: 4.63－8.28), and so were the IIEF-5 scores (P < 0.004, MD = 2.90, 95% CI: 0.90－4.89), while the quality of life (QOL) scores were significantly lower in the former group than in the latter (P<0.01, MD = －1.94, 95% CI: －2.47－－1.40), and so were the NIH-CPSI scores (P<0.01, MD = －3.92, 95% CI: －4.94－－2.91). No statistically significant difference was reported in the adverse reactions between the two groups (P = 0.12, MD = 0.03, 95% CI: －0.01－0.08). Publication bias analysis on the effectiveness rate of the results revealed an incomplete symmetry between the two sides of the funnel plot, indicating the possibility of publication biases. CONCLUSION The combination therapy of CXC+WM is superior to WM alone in the treatment of type Ш prostatitis complicated by ED for its high safety and effect of improving the patients' erectile function, but inferior to the latter in improving the QOL and NIH-CPSI scores of the patients.
Male ; Humans ; Prostatitis/complications* ; Erectile Dysfunction/complications* ; Drugs, Chinese Herbal/therapeutic use* ; Capsules ; Randomized Controlled Trials as Topic ; Drug Therapy, Combination ; Treatment Outcome ; Quality of Life ; Phytotherapy

Bisphenol A (BPA) is a kind of exogenous chemicals presenting in the human living environment widely which affects the action of endocrine hormones in the human body. Numerous studies have shown that BPA has reproductive toxicity in the spermatogenic function damage of the testes through a variety of mechanisms such as interfering with endocrine function, inducing oxidative stress, promoting spermatogonial cell apoptosis, destroying the integrity of the blood-testis barrier, and regulating epigenetic inheritance, thereby destroying male fertility. Relevant studies have shown that TCM can improve male fertility by reversing BPA-induced reproductive damage through multi-component, multi-target and multi-mechanisms. However, there is no systematic review on the mechanism of TCM to reduce the reproductive toxicity of BPA. Based on the existing studies, this article will systematically introduce the mechanisms of BPA-induced reproductive impairment in men and the progress of TCM interventions, with a view to providing reference targets and research directions for the development of new Chinese medicines.
Humans ; Benzhydryl Compounds/adverse effects* ; Male ; Phenols/adverse effects* ; Medicine, Chinese Traditional ; Infertility, Male/chemically induced* ; Testis/drug effects* ; Drugs, Chinese Herbal/therapeutic use* ; Bisphenol A Compounds

Prostate cancer is one of the most common tumor, with the disease progressing from inert to aggressive tumors, and rapidly progressing to castration-resistant prostate cancer. Early-stage prostate cancer is usually asymptomatic. And by the time that symptoms appear, the disease has progressed to an incurable stage. Therefore, early diagnosis and treatment is especially important to control prostate cancer, which prolongs the survival period of patients. Digital rectal examination and prostate-specific antigen have been widely used in the diagnosis of prostate cancer. However, there are certain limitations that lead to overdiagnosis and overtreatment. Although prostate needle biopsy is still the gold standard for diagnosing prostate cancer, with the wide application of multiparametric magnetic resonance examination and PSMA-PET/CT and other technologies in recent years, as well as the emergence of new biomarkers with higher sensitivity and specificity, its status as the gold standard has been challenged. And the diagnostic mode of prostate cancer has also undergone great changes. On this basis, the radical prostatectomy without prostate needle biopsy has been attempted clinically to treat prostate cancer, which gains the good clinical results. This article provides a review of the latest research advances in early screening and diagnostic models for prostate cancer.
Humans ; Male ; Benzhydryl Compounds/adverse effects* ; Drugs, Chinese Herbal/therapeutic use* ; Infertility, Male/chemically induced* ; Medicine, Chinese Traditional ; Phenols/adverse effects* ; Testis/drug effects* ; Bisphenol A Compounds

BACKGROUND: It is inaccurate to reflect the level of dust exposure through working years. Furthermore, identifying a predictive indicator for lung function decline is significant for coal miners. The study aimed to explored whether club cell secretory protein (CC16) levels can reflect early lung function changes. METHODS: The cumulative respiratory dust exposure (CDE) levels of 1,461 coal miners were retrospectively assessed by constructed a job-exposure matrix to replace working years. Important factors affecting lung function and CC16 were selected by establishing random forest models. Subsequently, the potential of CC16 to reflect lung injury was explored from multiple perspectives. First, restricted cubic spline (RCS) models were used to compare the trends of changes in lung function indicators and plasma CC16 levels after dust exposure. Then mediating analysis was performed to investigate the role of CC16 in the association between dust exposure and lung function decline. Finally, the association between baseline CC16 levels and follow-up lung function was explored. RESULTS: The median CDE were 35.13 mg/m³-years. RCS models revealed a rapid decline in forced vital capacity (FVC), forced expiratory volume in the first second (FEV₁), and their percentages of predicted values when CDE exceeded 25 mg/m³-years. The dust exposure level (<5 mg/m³-years) causing significant changes in CC16 was much lower than the level (25 mg/m³-years) that caused changes in lung function indicators. CC16 mediated 11.1% to 26.0% of dust-related lung function decline. Additionally, workers with low baseline CC16 levels experienced greater reductions in lung function in the future. CONCLUSIONS CC16 levels are more sensitive than lung indicators in reflecting early lung function injury and plays mediating role in lung function decline induced by dust exposure. Low baseline CC16 levels predict poor future lung function.
Uteroglobin/blood* ; Humans ; Dust/analysis* ; Occupational Exposure/analysis* ; Male ; Middle Aged ; Adult ; Retrospective Studies ; Lung Injury/chemically induced* ; Coal Mining ; Biomarkers/blood* ; China/epidemiology* ; Air Pollutants, Occupational ; Female

BACKGROUND: Japan lacks comprehensive reports on the nationwide voluntary vaccine coverage. The effectiveness of public subsidies in promoting vaccination has not been fully investigated. Therefore, we aimed to estimate the nationwide coverage of voluntary vaccines, compare it with that of national immunization program (NIP)-included vaccines, and investigate the effectiveness of public subsidies. METHODS: We obtained nationwide monthly vaccine market data for rotavirus, Haemophilus influenzae type b (Hib), diphtheria, tetanus toxoid, acellular pertussis, inactivated poliovirus (DTaP-IPV), and mumps vaccines; estimated recipient numbers; and calculated coverage as the proportion of children from October 2011 to March 2022. Regarding the NIP-included vaccine, we compared vaccine coverage calculated from nationwide annual market data with that estimated by World Health Organization (WHO)/United Nations Children's Fund (UNICEF), using Bland-Altman analysis. RESULTS: The estimates of Hib and DTaP-IPV vaccine coverage derived from market data were slightly higher than the WHO/UNICEF estimates, with mean differences of 0.05 (95% CI: 0.02-0.07) for Hib and 0.03 (95% CI: 0.01-0.05) for DTaP-IPV. The coverage of the rotavirus vaccine gradually increased long before the implementation of national subsidies, reaching 0.9 in 2020. Hib vaccine coverage had already achieved 1.0 by January 2012. The coverage of the DTaP-IPV vaccine was approximately 0.6-0.8 in 2013, reaching 1.0 in 2014. The coverage of mumps vaccine increased gradually from 2011 to 2021. CONCLUSIONS Despite the possibility of overestimation, our estimates may serve as a valuable surrogate for actual vaccine coverage in Japan. An increasing trend in rotavirus and mumps vaccine coverage was observed when these vaccines were categorized as voluntary. Although vaccination policies differ from country to country, it would be beneficial to share findings on the impact of subsidies in Japan with other countries.
Japan ; Humans ; Vaccination Coverage/statistics & numerical data* ; Infant ; Immunization Programs/statistics & numerical data* ; Rotavirus Vaccines ; Haemophilus Vaccines ; Child, Preschool ; Poliovirus Vaccine, Inactivated ; Vaccines

OBJECTIVE: To investigate the hepatotoxicity of alkaloids from Euodiae Fructus combined with berberine (BBR) in Zuojin Pill, and to preliminarily explore the possible detoxification mechanism of the combination components. METHODS: The combination ratio of components was determined by the maximum concentration (Cmax) of the chemical components in Zuojin Pill. HepG2 cell model was used to investigate the combined toxicity of the hepatotoxic components from Euodiae Fructus, such as evodiamine (EVO) or dehydroevodiamine (DHED), with BBR for 48 h. The experimental groups were set as follows: the vehicle control group, the EVO group, the DHED group, the BBR group, and the combination group of EVO or DHED with BBR. The cell counting kit-8 (CCK-8) method was used to determine the cell viability, and the combination index (CI) was used to determine the combined toxicity of the components. The alanine transaminase (ALT), aspartate aminotransferase (AST), lactate dehydroge-nase (LDH), and alkaline phosphatase (ALP) activities as well as total bilirubin (TBIL) content in the cell culture supernatant were detected. The protein expression levels of bile acid transporters, such as bile salt export pump (BSEP) and multidrug resistance-associated protein 2 (MRP2), were detected by Western blot. The intracellular malondialdehyde (MDA) content and superoxide dismutase (SOD) activity in HepG2 cells were detected. RESULTS: Compared with EVO or DHED group, the combination of EVO 1 μmol/L with BBR 10 μmol/L or DHED 50 μmol/L with BBR 35 μmol/L significantly increased cell viability of HepG2 cells (P < 0.01), with CI values of 77.89 or 4.49, respectively, much greater than 1. Significant decreases in the activities of ALT, AST, LDH, ALP, and TBIL content in the cell culture supernatant were found in both combination groups (P < 0.05, P < 0.01). Compared with the EVO group, the combination of EVO with BBR upregulated the protein expression levels of BSEP and MRP2. Compared with the DHED group, the combination of DHED with BBR significantly downregulated the protein expression levels of BSEP and MRP2 (P < 0.01). Compared with EVO or DHED group, the combination of EVO or DHED with BBR significantly reduced the MDA content in HepG2 cells (P < 0.05, P < 0.01). CONCLUSION A certain ratio of BBR combined with EVO or DHED had an antagonistic effect on HepG2 cytotoxicity, which might be related to regulating the expression of bile acid transpor-ters, and reducing lipid peroxidation damage.
Humans ; Hep G2 Cells ; Berberine/pharmacology* ; Drugs, Chinese Herbal/toxicity* ; Evodia/chemistry* ; Alkaloids/pharmacology* ; Cell Survival/drug effects* ; Multidrug Resistance-Associated Proteins/metabolism* ; Multidrug Resistance-Associated Protein 2 ; Quinazolines