Objective:To learn about the epidemiological and clinical characteristics of human brucellosis in Shaanxi Province, and to provide reference for brucellosis prevention and control.Methods:Through the China Disease Control and Prevention Information System and the Shaanxi Provincial Brucellosis Prevention and Control Work System, report data and case investigation data on human brucellosis cases in Shaanxi Province from 2020 to 2022 were collected, respectively, and the epidemiological characteristics, exposure history and clinical manifestations of the cases were analyzed descriptively.Results:A total of 4 240 human cases of brucellosis were reported in Shaanxi Province from 2020 to 2022, with no death. The average annual incidence was 3.60/100 000, with an average growth rate of 22.33%. Cases of brucellosis were reported from January to December throughout the year, mainly from April to August, accounting for 63.40% (2 688/4 240). Cases of brucellosis were reported in 12 prefectures (including Yangling District and prefecture-level administrative divisions directly administered by the province) and 90 counties (districts and cities), accounting for 79.65% (90/113) of the total number of counties (districts and cities). The male to female ratio of the cases was 2.92 ∶ 1.00 (3 159 ∶ 1 081). The onset age was mainly from 30 to 74 years old, accounting for 89.81% (3 808/4 240). Farmer was the main occupation, accounting for 87.12% (3 694/4 240). A total of 4 223 cases were investigated in Shaanxi Province from 2020 to 2022, with the acute phase being the main stage of disease progression, accounting for 94.67% (3 998/4 223); hospitalized cases accounted for 59.79% (2 525/4 223); the main risk occupations of brucellosis were rearing and grazing, accounting for 78.43% (3 312/4 223). The main exposure routes were direct contact through skin and mucous membranes and respiratory infection, accounting for 95.07% (4 015/4 223). There were 4 015 cases with a history of contact with livestock and their products, with sheep being the main type of contact (accounting for 96.91%, 3 891/4 015), and the possible infection sites were mainly at home (58.53%, 2 350/4 015). The main clinical symptoms were fever, muscle and joint pain, fatigue and excessive sweating, accounting for 75.49% (3 188/4 223), 58.23% (2 463/4 223), 68.17% (2 879/4 223) and 63.65% (2 688/4 223), respectively. A total of 139 Brucella strains were isolated and cultured, with sheep type 3 being the main bacterial type, accounting for 75.54% (105/139). Conclusions:The epidemic of brucellosis in Shaanxi Province is showing a clear upward trend, and the scope of the epidemic is becoming wider and wider. The incidence of brucellosis is mainly in free-range households, and the course of the disease is mostly in the acute phase. Brucellosis is mainly caused through direct contact with the skin and mucous membranes and respiratory infections. The clinical manifestations are diverse but non-specific. It is necessary to effectively improve the personal protection awareness and level of high-risk groups to reduce the occurrence of brucellosis.

Objective:To investigate the pathogenic and epidemiological characteristics of human brucellosis in Shaanxi Province, and to provide a basis for scientific prevention and control of human brucellosis in Shaanxi Province.Methods:The pathogenic culture data of 507 reported cases of human brucellosis reported in Shaanxi Province from 2014 to 2021 were collected from the Shaanxi Provincial Center for Disease Control and Prevention. The epidemiological data of the cases were collected from the Infectious Disease Information Reporting Management System of China Disease Prevention and Control Information System. The data were summarized and analyzed using Excel 2016 software, and visualized using ArcGIS 10.6 software.Results:The 507 cases were concentrated from 2018 to 2021 (322 cases), with a peak incidence period from May to July (255 cases). Cases mainly distributed in Weinan City (129 cases), Yulin City (114 cases) and Yan'an City (97 cases). Farmers were the main occupation (415 cases). The cases were mainly aged 40 - 59 (272 cases). The male to female gender ratio was 3.22 ∶ 1.00 (387 ∶ 120). Totally 95.46% (484/507) of the cases had a history of close contact with cattle or sheep, mainly sheep (480 cases). The clinical symptoms included fever, fatigue, hyperhidrosis, joint and muscle pain, with rare liver, spleen and testicular enlargement. Totally 89.55% (454/507) of the cases were diagnosed during the acute phase. In vitro agglutination test, 1 ∶ 200 positive cases were the most common (139 cases). Totally 214 strains of Brucella were isolated and cultured, and the rate of bacterial production was 42.21%, all of which were Brucella melitensis, of which type 3 accounted for 79.91% (171/214). Conclusion:Human brucellosis cases in Shaanxi Province are mainly infected by contact with sheep, with the main source of infection being Brucella melitensis type 3.

Objective:To construct a follow-up evaluation index system for "Diagnosis of Brucellosis" (WS 269-2019), and provide a reference basis for the next revision and improvement of the standard.Methods:The evaluation index system for "Diagnosis of Brucellosis" (WS 269-2019) was preliminarily established by consulting relevant references and materials. The experts in the field of diagnosis, treatment, prevention and control of brucellosis were selected, and two rounds of expert consultation were carried out in the form of questionnaires using the Delphi method. The necessity and availability of evaluation indicators were scored, and suggestions for modifying and adding indicators were put forward. Based on this, a standard follow-up evaluation index system was established. At the same time, a judgment matrix was constructed combined with the Saaty scale, and the analytic hierarchy process was used to calculate the weight of each index in the system.Results:After 2 rounds of expert ( n = 10) consultation, a standard follow-up evaluation index system for "Diagnosis of Brucellosis" (WS 269-2019) was constructed with 3 first-level indexes, 8 second-level indexes and 21 third-level indexes. The positive coefficients of experts in 2 rounds of questionnaires were both 100%; the coefficient of authority of experts was 0.82; the Kendall's coefficients of concordance of first-level, second-level and third-level indexes were 0.722, 0.260, and 0.181, respectively, with P < 0.05. Among the first-level indexes, the weight of standard quality evaluation was the highest (0.364), and the weight of standard implementation status was the lowest (0.278); among the second-level indexes, the combined weight of social benefits was the highest (0.186), and the combined weight of advanced nature was the lowest (0.043); among the third-level indexes, the combined weight of timely diagnosis rate was the highest (0.096), and the combined weight of consistency with technical data was the lowest (0.009). Conclusions:The constructed follow-up evaluation index system for "Diagnosis of Brucellosis" (WS 269-2019) is scientific and reliable, which evaluated qualitatively and quantitatively, reduces the defects of a single evaluation, and provides a basis for subsequent revision and improvement of the standard.

Objective:To investigate the effect of early intervention with electroacupuncture (EA) on the gut microbiota in a mouse model of post-traumatic stress disorder(PTSD).Methods:Totally 32 C57BL/6 mice were randomly assigned to the following 4 groups ( n=8 for each group): Control group, EA group, PTSD group and PTSD+ EA group.After 7 days acclimation, mice in the PTSD group and PTSD+ EA group were subjected to modified single prolonged stress (mSPS). Mice in the EA group and PTSD+ EA group received EA (2/15 Hz, 1 mA, dilatational wave, 30 min/d) on "Baihui" for 7 days. Mice in the Control group and PTSD group received false stimulation (stimulated the same acupiont without electricity) for 7 days. Seven days after the last stimulation, elevated plus maze test and fear conditioning test were conducted to observe the effect of EA on PTSD-like behavior of mice. At the same time, feces of the mice were collected for gut microbiota detection by 16S rRNA sequencing.SPSS 19.0 was used for statistical analysis.One-way ANOVA was used for multiple group comparison and Bonferrani test was done for further pairwise comparision. Results:(1) There were statistically differences in the open arm activity time of the elevated plus maze test and the immobility time in contextual and cued fear conditioning test among the four groups ( F=6.93, 5.26, 14.51, all P<0.01). In the elevated plus maze test, mice in PTSD group ((60.17±15.52) s) showed significant less time in the open arms than mice in Control group((96.37±14.62) s) and PTSD+ EA group ((86.89±15.02) s) (both P<0.05). In the fear conditioning test, mice in PTSD group ((121.99±29.67) s, (130.82±29.11) s) showed significant increased immobility time both in contextual and cued fear conditioning tests than mice in Control group((74.50±26.65) s, (39.50±23.52) s) and PTSD+ EA group ((76.77±22.60) s, (102.17±3.39) s)(both P<0.05). (2) There were no significant differences among the four groups in the alpha diversity of gut microbiota ( F=0.79-2.45, all P>0.05). (3)Correlation analysis showed that 13 gut microbiotas were negatively correlated with the immobility time in contextual fear conditioning test, 2 gut microbiotas were positively correlated with it; 7 gut microbiotas were negatively correlated with the immobility time in cued fear conditioning test, 1 gut microbiota was positively correlated with it; 3 gut microbiotas were positively correlated with time spent in open arms of elevated plus maze test. Conclusion:Early intervention with EA can improve anxiety-fear like behaviors and gut microflora disorder in PTSD model mice.

Objective:To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) on the hippocampal lipidome in a rat model of chronic unpredictable stress(CUS).Methods:Twenty-four SD rats were randomly assigned to the following 3 groups ( n=8 for each group): sham group, CUS group and CUS+ rTMS group. The sham group received only sham stimulation and rats in the CUS and CUS+ rTMS group were subjected to CUS stimulation. Then, rats received 5 Hz rTMS (5 Hz, 1.26 Tesla) or sham rTMS for 7 days. After the last stimulation, all rats underwent sucrose preference test, open filed test and forced swimming test so as to observe the effect of rTMS on depressive behavior. Then, rats were sacrificed, and the levels of lipid composition in hippocampus were determined by high performance liquid chromatography mass spectrometry and analyzed by lipid search software version 4.1 and SIMCA-P 14.1.The software of SPSS 19.0 was used for statistical analysis. Univariate analysis of variance was used for comparison among groups, and Tukey test was used for multiple comparison. Results:(1)There were significant differences in open field test, sugar preference test and forced swimming test among the three groups( F=6.853-7.466, all P<0.05). In the open field experiment, the exploring time and percentage of movement distance in central area of rats in CUS group((50.72±6.38)s, (11.41±1.55)%) was significantly less than that of sham group ((86.06±7.31)s, (18.60±1.21)%) and CUS+ rTMS group((79.87±7.87)s, (16.74±1.27)%)(all P<0.05). The results of sucrose preference test showed that the percentage of sucrose intake of rats in CUS group ((37.63±6.06)%) was significantly lower than that in sham group ((68.30±6.39)%) and CUS+ rTMS group ((62.68±5.50)%)(both P<0.05) . In forced swimming test, the immobility time of rats in CUS group ((137.60±13.36)s) was significantly longer than that of sham group ((80.57±10.36)s)) and CUS+ rTMS group ((86.14±11.49)s) (both P<0.05). (2)The levels of lipid composition in hippocampus were significantly different in the three groups( F=3.826-15.440, all P<0.05). The contents of phosphatidylethanolamine (PE) ((20 850±956.56)×10 7, (24 133.33±1 242.04)×10 7), phosphatidylinositol (PI) ((788.78±136.11)×10 7, (953.65±131.26)×10 7), lysophosphatidylcholine (LPC) ((340.29±35.66)×10 7, (275.32±35.78)×10 7), creatine phosphate (CerP) ((239.65±18.14)×10 7, (293.82±38.28)×10 7), sphingosine (So) ((22.96±4.04)×10 7, (15.36±3.87)×10 7), diglyceride (DG) ((3.35±0.85)×10 7, (4.57±1.02)×10 7) and monoglyceride (MG) ((6.71±0.82)×10 7, (7.94±0.91)×10 7)in hippocampus of rats in CUS group were significantly higher than those of sham group(all P<0.05), while the phosphatidic acid(PA) ((424.52±33.38)×10 7, (509.22±42.09)×10 7) and acyl carnitine(AcCa) ((2.68±0.33)×10 7, (3.39±0.33)×10 7) decreased(both P<0.05). Compared with CUS group, the contents of PE(21 816.67±928.26)×10 7, PI(83.16±91.52)×10 7, LPC(323.59±33.91)×10 7, CerP(236.39±32.02)×10 7, So(23.35±4.46)×10 7, DG(3.16±0.85)×10 7 and MG(7.03±0.26)×10 7 in the hippocampus of CuS+ rTMS group decreased, while the contents of PA(421.55±44.28)×10 7 and ACCA(2.56±0.32)×10 7 in the hippocampus of CUS+ rTMS group increased (all P<0.05). Conclusion:The levels of glycerophospholipids, glyceroglycerides, sphingolipids, fatty acids and other lipids in the hippocampus of CUS model rats are abnormal. And the 5 Hz rTMS intervention can ameliorate the depression like behavior and the disturbances of lipid in hippocampus of CUS model rats.

Objective:To investigate the effects of fluoxetine (Flx) on lipidomics of hippocampal tissue in chronic unpredictable stress (CUS) model rats.Methods:A total of 30 Sprague-Dawley rats were randomly divided into Sham group, CUS group and CUS+ Flx group, with 10 rats in each group. Rats in the CUS group and CUS+ Flx group were received one or two random stimuli every day for 28 days, and then they were received intraperitoneal injection of normal saline(1 ml/kg) and fluoxetine(10 mg/kg) respectively once a day for 14 days. Rats in the Sham group were maintained in their home cages for 28 days, and then received intraperitoneal injection of saline (1 ml/kg) once a day for 14 days. The sugar water preference experiment was carried out 24 hours after the last injection, and then the rats were killed to separate the rat hippocampus. The levels of lipid composition in hippocampus were detected by high performance liquid chromatography-mass spectrometry. The relative content of lipid was analyzed by Simca-p 14.1 and LipidSearch software version 4.1. SPSS 19.0 was used for statistical analysis. One-way ANOVA or Kruskal-Wallis test was used for comparison among groups, and Bonferroni test was used for post-hoc test. Pearson correlation or Spearman correlation was used to analyze the correlation between behavioral indexes and lipid molecular level in hippocampus.Results:There was significant difference in sugar preference test among the three groups ( F=12.830, P<0.001). The percentage of sucrose intake of rats in CUS group ((43.57±12.38)%) was significantly lower than those in Sham group ((67.09±11.81)%) and CUS+ Flx group ((62.74±8.58)%) (both P<0.05). Ninety five differential lipid molecules were screened among the three groups by lipidomic analysis, mainly distributed in glycerophospholipids and sphingolipids. Among them, levels of PE (34∶1e)+ H( r=-0.477), PE(18∶1p/20∶1)+ H( r=-0.433), PE(18∶1/18∶1)+ Na( r=-0.603), PE(36∶2p)-H( r=-0.382), PE(16∶0/20∶4)-H( r=-0.464), PE(18∶0/18.2)-H( r=-0.482), PE(16∶0e/22∶6)-H( r=-0.514), PE(18∶1/20∶4)-H( r=-0.511) and CerG1 (d18∶2/24∶0+ O)+ H( r=-0.490) were negatively correlated with sucrose preference rate (all P<0.05), whereas levels of PE (42∶6p)+ Na( r=0.379), PE(34∶0p)-H( r=0.397) and SM (d22∶1/16.0)+ HCOO( r=0.388) were positively correlated with sucrose preference rate (all P<0.05). Conclusion:Flx improves the depressive-like behavior of CUS model rats, which may be related to the regulation of hippocampal glycerophospholipid and sphingolipid metabolism.

Unroofed coronary sinus syndrome (UCSS), also named coronary sinus septal defect, is a rare type of atrial septal defect with the incidence less than 1% of the total number of atrial septal defects. It is caused by incomplete formation of left atrial venous folds during embryonic development. Here we reported a patient with UCSS, who was treated in the Second Xiangya Hospital of Central South University. The patient was 50 years old and the main clinical manifestations were fatigue and shortness of breath after repeated exercise. Color Doppler echocardiography showed coronary sinus dilatation (17 mm×14 mm), indicating the possibility of permanent left superior vena cava. Pulmonary angiography showed that the left ventricle and coronary sinus were developed at the same time while the atrial septum was intact after the development of the left atrium, followed by the right atrium and right ventricle, indicating a partial anomalous pulmonary venous drainage (intracardiac type). Finally, the cardiac computed tomograhic angiography showed that 4 pulmonary veins and permanent left superior vena cava (PLSVC) went into the left atrium and the coronary sinus, respectively, while the coronary sinus septum was absent and the PLSVC was connected with the left atrium. The patient was later treated with the correction of non-parietal sinus syndrome in the Cardiovascular Surgery Department of our hospital.
Coronary Sinus ; Heart Atria ; Heart Septal Defects, Atrial ; Humans ; Middle Aged ; Vena Cava, Superior

Objective: To study the distribution and pharmacokinetics of cefuroxime in rabbit eyes after intravenous administration. Methods: Thirty-five rabbits were randomly divided into 7 groups by random number table method, with 5 rabbits in each group.The rabbits in blank control group were feed without any treatment, the rest rabbits were injected with 40.63 mg/kg cefuroxime intravenously.The rabbits were sacrificed at 0.5 hour, 1.0 hour, 1.5, 2.0, 2.5 and 3.0 hours after injection, and the eyeballs were immediately dissected.The concentration of drug in different ocular tissues was detected by high performance liquid chromatography, and the pharmacokinetic parameters in eyes were computed by the DAS software.This study was approved by the Experimental Animal Ethics Committee of Shanxi Provincial Eye Hospital (201802b). Results: The peak concentrations (Cmax) of cefuroxime were (11.63±0.20), (1.59±0.05), (1.51±0.08), (0.99±0.07), (1.55±0.08) and (8.57±0.17)μg/ml in aqueous humor, iris-ciliary body, vitreous body, retinal-choroid, cornea and sclera, respectively.The times to peak (Tmax) were 1.5 hours, 1.0, 1.0, 0.5, 1.0 and 0.5 hour in aqueous humor, iris-ciliary body, vitreous body, retinal-choroid, cornea and sclera, respectively.The areas under drug time curve (AUC_0-t) were (26.60±0.62), (6.22±0.84), (5.86±0.16), (3.75±0.45), (5.50±0.15) and (26.48±0.73)(μg·h)/ml in aqueous humor, iris-ciliary body, vitreous body, retinal-choroid, cornea and sclera, respectively.Cefuroxime was not detected in the lens at different time points after injection.The parameters of pharmacokinetics were fitted to two compartment model. Conclusions Cefuroxime shows good penetration in aqueous humor, iris-ciliary body, vitreous body, retinal-choroid, cornea and sclera when administrated by intravenous injection in rabbits and cefuroxime has no distribution in lens.Cefuroxime can reach an effective concentration in ocular tissues 0.5 to 1.5 hours after intravenous injection.

Objective To investigate the antidepressive?like effect of repetitive transcranial magnetic stimulation (rTMS) on the rats model exposing chronic unpredictable stress (CUS) and their nuclearfactor?E2?related factor2 (Nrf2) gene expression in hippocampus. Methods (1) SD rats were randomly assigned to the following 3 groups (n=8 for each group):Sham, CUS, CUS+rTMS. The Sham group received only Sham stimulation. The rats in the CUS and CUMS+ rTMS group were subjected to CUS stimulus, followed by 5Hz rTMS or Sham rTMS for 7 days. 24 h after the last stimulation, rats were given a sucrose preference test, an open filed test and a forced swim test. Finally the gene expression of Nrf2, HO?1 and SOD?1 in the hippocampus were determined by real?time PCR and western blot. (2) SD rats were randomly assigned to another 3 groups (n=8 for each group): scramble+CUS, scramble+ CUS+ rTMS and shNrf2+CUS+rTMS. Rats were injected with scramble or shNf2 lentivirus into the dentate gyrus. Two weeks later, all rats were subjected to CUS followed by rTMS or Sham rTMS stimulus for 7 days. Finally rats were given the series behavior tests, and the gene expression of hippocampal Nrf2, HO?1 and SOD?1 were then determined after being sacrificed. Results (1) In comparison with Sham, the rat in CUS group showed significant lower sucrose preference ((77.31 ± 4.69)％vs. (39.33 ± 11.85)％;F2, 21=8.32, P<0.01) and shorter centre time ((52.49±1.07) s vs. (14.70±4.27) s;F2, 21=3.84, P<0.01)) in the open filed test, but longer freezing time in the forced swim test ((24.19 ± 1.07 s vs. (38.70 ± 4.27);F2, 21=10.31, P<0.05);the expression of Nrf2, HO?1 and SOD?1 in the hippocampus was inhibited in the CUS rats. (2) Compared with CUS group, the rat in CUS+rTMS group showed significant better sucrose preference (P<0.05), longer centre time (P<0.05 in open filed test), while shorter freezing time in the forced swim test (P<0.05); the expression of Nrf2, HO?1 and SOD?1 in the hippocampus in CUS+rTMS rats was up?regulated (P<0.05);(3) Rats in shNrf2+CUS+rTMS group showed lower sucrose preference (P<0.05), shorter centre time (P<0.05) in the open filed test and longer freezing time in the forced swim test (P<0.05) and their expression of Nrf2, HO?1 and SOD?1 in the hippocampus (P<0.05) was down?regulated than rats in scramble+CUS+rTMS group. Conclusion rTMS administration may reverse depressive?like behaviors in rats under CUS paradigm and may restore the gene expression of Nrf2, HO?1 and SOD?1 in the hippocampus.

Objective To investigate the antidepressive?like effect of repetitive transcranial magnetic stimulation (rTMS) on the rats model exposing chronic unpredictable stress (CUS) and their nuclearfactor?E2?related factor2 (Nrf2) gene expression in hippocampus. Methods (1) SD rats were randomly assigned to the following 3 groups (n=8 for each group):Sham, CUS, CUS+rTMS. The Sham group received only Sham stimulation. The rats in the CUS and CUMS+ rTMS group were subjected to CUS stimulus, followed by 5Hz rTMS or Sham rTMS for 7 days. 24 h after the last stimulation, rats were given a sucrose preference test, an open filed test and a forced swim test. Finally the gene expression of Nrf2, HO?1 and SOD?1 in the hippocampus were determined by real?time PCR and western blot. (2) SD rats were randomly assigned to another 3 groups (n=8 for each group): scramble+CUS, scramble+ CUS+ rTMS and shNrf2+CUS+rTMS. Rats were injected with scramble or shNf2 lentivirus into the dentate gyrus. Two weeks later, all rats were subjected to CUS followed by rTMS or Sham rTMS stimulus for 7 days. Finally rats were given the series behavior tests, and the gene expression of hippocampal Nrf2, HO?1 and SOD?1 were then determined after being sacrificed. Results (1) In comparison with Sham, the rat in CUS group showed significant lower sucrose preference ((77.31 ± 4.69)％vs. (39.33 ± 11.85)％;F2, 21=8.32, P<0.01) and shorter centre time ((52.49±1.07) s vs. (14.70±4.27) s;F2, 21=3.84, P<0.01)) in the open filed test, but longer freezing time in the forced swim test ((24.19 ± 1.07 s vs. (38.70 ± 4.27);F2, 21=10.31, P<0.05);the expression of Nrf2, HO?1 and SOD?1 in the hippocampus was inhibited in the CUS rats. (2) Compared with CUS group, the rat in CUS+rTMS group showed significant better sucrose preference (P<0.05), longer centre time (P<0.05 in open filed test), while shorter freezing time in the forced swim test (P<0.05); the expression of Nrf2, HO?1 and SOD?1 in the hippocampus in CUS+rTMS rats was up?regulated (P<0.05);(3) Rats in shNrf2+CUS+rTMS group showed lower sucrose preference (P<0.05), shorter centre time (P<0.05) in the open filed test and longer freezing time in the forced swim test (P<0.05) and their expression of Nrf2, HO?1 and SOD?1 in the hippocampus (P<0.05) was down?regulated than rats in scramble+CUS+rTMS group. Conclusion rTMS administration may reverse depressive?like behaviors in rats under CUS paradigm and may restore the gene expression of Nrf2, HO?1 and SOD?1 in the hippocampus.