OBJECTIVE To study the efficacy and safety of the combination therapy of vericiguat and metoprolol in the treatment of heart failure with reduced ejection fraction （HFrEF）. METHODS Prospective inclusion of 136 HFrEF patients admitted to the Handan First Hospital from January 2022 to January 2025， divided into a control group and an experimental group using a random number table method， 68 cases per group. At the same time as anti heart failure foundation， the control group was treated with metoprolol， while the experimental group was treated with metoprolol and vericiguat for 6 months. Compare the clinical efficacy and cardiac function indicators， serological related indicators， quality of life before and after treatment， and incidence of adverse reactions between the two groups. RESULTS Three cases were lost in the experimental group and four cases were lost in the control group. The total clinical effective rate of the experimental group was 95.38%， significantly higher than the control group’s 75.00% （P＜0.05）. Compared to before treatment， after treatment， the left ventricular end-systolic diameter， left ventricular end-diastolic diameter， homocysteine level， N-terminal pro-B-type natriuretic peptide level， C-reactive protein level， and Minnesota Living with Heart Failure Questionnaire scores of both groups of patients significantly decreased （P＜0.05）， while the left ventricular ejection fraction significantly increased （P＜0.05）， and the improvement effect of the experimental group was more significant than that of the control group （P＜0.05）. There was no statistically significant difference in the incidence of adverse reactions between the two groups of patients （P＞0.05）. CONCLUSIONS Compared to metoprolol alone， the combination of vericiguat and metoprolol can further improve heart function in HFrEF patients， better regulate serological related indicators， enhance quality of life and overall clinical efficacy， and has good safety.

Objective:To investigate the anti-fatigue effect of Dendrobium and Panax Quinquefolius Granules(DPQG)on the overtrained mice,and to clarify its possible mechanism.Methods:A total of 48 mice were randomly divided into control group(equal volume of distilled water),low dose of DPQG group(400 mg·kg-1 DPQG),medium dose of DPQG group(800 mg·kg-1 DPQG),and high dose of DPQG group(1 600 mg·kg-1 DPQG).The DPQG were administered by gavage for 35 d,and the rotarod test and swimming endurance test were performed 30 min after last administration.Serum,liver tissue,and muscle tissue were collected from the mice in various groups.ELISA method was used to detect the serum lacticacid(LAC)levels and lactate dehydrogenase(LDH)activities,and the malondialdehyde(MDA)levels,superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px)activities,and the liver glycogen and muscle glycogen levels in muscle tissue of the mice in various groups;HE staining was used to observe the pathomorphology of muscle tissue of the mice.Transcriptomics and metabolomics technologies were used to identify the key genes and metabolites in muscle tissue of the mice in control group and high dose of DPQG group and to analyze the correlations between differentially expressed genes(DEGs)and differentially expressed metabolites.Results:Compared with control group,the rod turning exhaustion time of the mice in different doses of DPQG groups were significantly increased(P＜0.05),and the swimming exhaution time of the mice in high dose of DPQG group was increased(P＜0.05).Compared with control group,the LDH,SOD,and GSH-Px activities of the mice in medium and high doses of DPQG groups were increased(P＜0.01).Compared with control group,the levels of MDA and liver glycogen of the mice in medium and high doses of DPQG groups were decreased(P＜0.05 or P＜0.01).The transcriptomics sequencing results showed that DPQG mainly acted on DEGs such as Trib3 and Olfr495;the Gene Ontology(GO)functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)signaling pathway enrichment analysis results showed that the DEGs were mainly enriched in olfactory-related processes and signaling pathways;the metabolomics KEGG analysis results showed that the differential metabolites were mainly enriched in the regulation pathway of inflammatory mediators on tryptophan(TRP);the combined analysis of transcriptomics and metabolomics results showed that the piezo1 gene had high correlations with the differential metabolites β1-solamarine(r=-1,P＜0.05)and tilidine(r=1,P＜0.05).Conclusion:DPQG can exert an anti-fatigue effect on the overtrained mice by modulating LAC metabolism and glycogen homeostasis,as well as maintaining the oxidative/antioxidant balance in the body;its anti-fatigue mechanism is related to the Olfr495 and piezo1 genes and the regulation pathway of inflammatory mediators on TRP channels.

Objective Meta-analysis was used to summarize the current status of medication adherence in patients with type 2 diabetes mellitus and to clarify the characteristics of people with low medication adherence.Methods Relevant literatures were searched in Pubmed,Cochrane Library,Web of Science,Embase,CINAHL,CBM,China National Knowledge Infrastructure,Wanfang Data,and VIP.Two researchers conducted literature screening,data extraction and quality evaluation.Stata 16.0 software was used for subgroup analysis,sensitivity analysis,offset analysis.Results A total of 42 papers were included,and the overall medication adherence of middle-aged and elderly type 2 diabetes patients ranged from 18.37%-96.53%.The medication adherence was higher among those with high education level(63%),married(61%),not living alone(50%),monthly income>3000 RMB/month(64%),having medical insurance(49%),good psychological status(61%),no chronic co-morbidities(66%),having knowledge about the disease(53%),taking≤3 types of medication(58%),convenient access to medical care(58%),and good doctor-patient relationship(50%).Conclusion The medication adherence of patients with type 2 diabetes mellitus varies greatly among different subgroups.In the future,the specific influencing factors should be further explored to formulate targeted policies and intervention measures to improve patients'medication adherence and improve their health and quality of life.

Objective To systematically evaluate the efficacy and acceptability of non-pharmaceutical intervention(NPI)for depression in patients with mild cognitive impairment(MCI).Methods Randomized controlled trials of NPI in treatment of depression patients with MCI published in PubMed,Embase,Web of Science,CINAHL,Cochrane Library,CNKI,Wanfang Data,VIP and CBM databases were searched from self-built databases to January 6,2024,and performed a network Meta-analysis using Stata 14.0 software.Results A total of 55 literatures were included,involving 10 NPIs.According to the surface under the cumulative ranking curve(SUCRA),the top 3 curative effects were cognitive behavioral therapy(CBT),Chinese traditional sport(CTS)and art therapy,the top 3 acceptability were CBT,CTS,and health education.Conclusion CBT and CTS may be effective and acceptable NPI for improving depression in patients with MCI,and individualized interventions can be tailored to the patient's situation to achieve the best results.

Objective To investigate the geographical distribution and seasonal fluctuations of visceral leishmaniasis vectors sandflies in Henan Province in 2023, so as to provide insights into the prevention and control of visceral leishmaniasis vectors. Methods A total of 23 counties (districts) were sampled from 18 cities of Henan Province from May to September, 2023 as sandfly surveillance sites, and sandflies were captured using human capture and light trapping methods. Following morphological identification, the changes in the sandfly density were calculated at different months and in different breeding habitats. Results A total of 406 light traps were set at sandfly surveillance sites in Henan Province from May to September, 2023, and a total of 3 137 female sandlies were captured, with an average density of 7.73 sandlies/(light·night). A total of 1 494 Phlebotomus chinensis sandflies were captured, including 1 222 female sandflies, with an average density of 3.01 sandflies/(light·night), and the highest density of P. chinensis was found in Gongyi City [17.00 sandflies/(light·night)]. A total of 5 544 sandflies were captured using the human capture method, including 230 P. chinensis, and the density of P. chinensis appeared a unimodal distribution, with a peak in early July [5.81 sandflies/(light·night)]. Among different breeding habitats, the highest P. chinensis density was detected in pigpens [4.50 sandflies/(light·night)]. Conclusions P. chinensis was predominantly distributed in hilly areas of northern and central-western Henan Province in 2023, and the sandfly density appeared a unimodal distribution. Intensified monitoring of visceral leishmaniasis vectors is recommended.

Objective To characterize the species of common sandflies in Henan Province using DNA barcoding with cytochrome c oxidase subunit I (COI) gene as the molecular marker, and to analyze the genetic polymorphisms of sandflies, so as to provide insights into visceral leishmaniasis prevention and control in Henan Province. Methods Sandfly specimens were sampled from 13 sandflies surveillance sites from 2021 to 2023 in Anyang City, Zhengzhou, Luoyang and Xuchang cities (Zhengzhou-Luoyang-Xuchang areas) where visceral leishmaniasis cases were reported and in Jiaozuo and Xinxiang cities (Jiaozuo-Xinxiang areas) without visceral leishmaniasis cases reported. Genomic DNA was extracted from a single sandfly, and COI gene was amplified. The amplification product was subjected to bidirectional sequencing. Following sequence assembly, the species of sandflies was characterized through sequence alignment using the BLAST tool. The intra-specific and inter-specific genetic distances of sandflies were estimated among different areas using the software Mega 11, and phylogenetic trees were created. The polymorphisms of nucleotide sequences in the sandflies COI gene were estimated using the software DnaSP. The fixation index (F_ST) of different geographical isolates of sandflies was calculated using the Arlequin software, and the gene flow value (Nm) was used to measure the gene flow in the sandflies populations. In addition, the population genetic structure of different geographical populations of Phlebotomus chinensis was analyzed using the STRUCTURE software. Results A total of 978 sandflies were collected from 13 sandflies surveillance sites in Zhengzhou-Luoyang-Xuchang areas, Jiaozuo-Xinxiang areas and Anyang City of Henan Province from 2021 to 2023, and 475 sandflies were randomly sampled for subsequent detections. A total of 304 Ph. chinensis, 162 Se. squamirostris and 9 Se. bailyi were identified based on molecular biological detection of the COI gene, and Se. bailyi was reported for the first time in Henan Province. The intraspecific genetic distances of sandflies were 0.000 to 0.040, and the inter-specific genetic distances ranged from 0.133 to 0.161. Phylogenetic analysis revealed that each of the three sandfly species was clustered into a clade. The genetic polymorphisms of Ph. chinensis populations varied among different areas, with the highest haplotype diversity (0.966 ± 0.007) and the greatest nucleotide diversity (0.011) in Zhengzhou-Luoyang-Xuchang areas, and the lowest haplotype diversity (0.720 ± 0.091) and nucleotide diversity (0.004) in Anyang City. The dominant haplotype of Ph. chinensis populations was Pch_Hap_2 in Anyang City and Jiaozuo-Xinxiang areas, with moderate genetic differentiation (0.05 < F_ST < 0.15) and frequent gene exchange (Nm value > 1) between Ph. chinensis populations sampled from Anyang City, and Jiaozuo-Xinxiang areas. Population genetic structure analysis showed that the dominant component of Ph. chinensis populations was K5 in Anyang City and Jiaozuo-Xinxiang areas. No obvious dominant haplotype was observed in Ph. chinensis populations sampled from Zhengzhou-Luoyang-Xuchang areas, which had very high genetic differentiation (F_ST > 0.25) and little gene exchange (Nm value < 1) with Ph. chinensis populations from Anyang City, and Jiaozuo-Xinxiang areas, with K3 as the dominant component. In addition, there was no significant difference in the genetic polymorphism level among Se. squamirostris populations from the three areas. Conclusions There are Ph. chinensis, Se. squamirostris and Se. bailyi in Henan Province, and S. bailyi is recorded for the first time in Henan Province by molecular biological assays. There are different levels of genetic differentiation and gene exchange among P. chinensis populations in different areas of Henan Province.

Objective To analyze the characteristics of visceral leishmaniasis cases in Henan Province, so as to provide insights into formulation of the visceral leishmaniasis control srtrategy. Methods All epidemiological data of reported visceral leishmaniasis cases in Henan Province from 2021 to 2023 were retrieved from the National Notifiable Disease Report Information Management System of Chinese Center for Disease Control and Prevention, and the epidemiological features and diagnosis of visceral leishmaniasis cases were descriptively analyzed. Results A total of 93 visceral leishmaniasis cases were reported in Henan Province from 2021 to 2023, with a male to female ratio of 2.58∶1, and including 2 imported cases from other provinces and 91 local cases. The number of visceral leishmaniasis cases peaked during the period between March and May, and between July and October. The reported visceral leishmaniasis cases had ages of 7 months to 74 years, with the largest number of cases found at ages of 0 to 9 years (26 cases, 27.96%), followed by at ages of 60 to 70 years (24 cases, 25.81%). Farmer (47 cases, 50.54%) and diaspora children (19 cases, 20.43%) were predominant occupations, and 91 local visceral leishmaniasis cases were found in 6 cities of Zhengzhou, Luoyang, Anyang, Hebi, Sanmenxia and Xuchang. The median duration from onset of visceral leishmaniasis to diagnosis was 20 days, and there were 25.81% (24/93) cases with 10 days and less duration from onset to diagnosis, 38.71% (36/93) cases receiving diagnosis at 11 to 30 days following onset, and 35.48% (33/93) cases receiving diagnosis for more than 30 days following onset. All cases were predominantly diagnosed in province- (60.00%) and city-level (28.89%) medical institutions. Conclusions The number of visceral leishmaniasis is on the rise in Henan Province, with a gradually expanding coverage. Intensified monitoring of visceral leishmaniasis cases, dogs, and vectors, dog management, sandflies control and improved individual protection are recommended to prevent the spread of visceral leishmaniasis.

ObjectiveTo investigate the correlation of polymorphism and loci interaction of nucleic acid binding oligomeric domain-like receptor heat protein domain associated protein 3 (NLRP3) gene and susceptibility to coal workers' pneumoconiosis (CWP) in Xinjiang Region. Methods A total of 109 CWP were selected as the case group, and 69 coal miners with similar age, years of dust exposure and work types were selected as the control group by convenient sampling method. Blood samples of individuals in workers in these two groups were collected, and the genotypes of single nucleotide polymorphism loci, rs1539019, rs4612666, rs4925650 and rs7525979, in the NLRP3 gene were detected using an improved multiplex ligation detection reaction. The optimal genetic model was selected based on the Akaike information criterion. Results The results of unconditional logistic regression analysis showed that individuals with the C allele of rs1539019 or rs4612666 had a higher risk of CWP than those with the A or T allele (all P<0.05), and individuals with the AA genotype of rs1539019 or the TT genotype of rs4612666 had a lower risk of CWP than those with the CC genotype (all P<0.05), after adjusting for age, years of work, alcohol, and smoking. The optimal genetic models for rs1539019 and rs4612666 were the recessive model and the additive model, respectively, and these differences were associated with the susceptibility to CWP at the Bonferroni-corrected level (all P<0.05). No correlation was found between rs4925650 and rs7525979 and the susceptibility to CWP (all P>0.05). In the smoking population, the rs1539019 co-dominant model, recessive model, and additive model were associated with a decreased risk of CWP (all P<0.05). The rs4612666 co-dominant model, dominant model and additive model were associated with an increased risk of CWP (all P<0.05), with the optimal genetic models being the recessive model and the additive model among smokers. The rs1539019 and rs4612666 were not found to be associated with the increased risk of CWP in non-smokers (all P>0.05). The rs4612666 dominant model and additive model were associated with an increased risk of CWP (all P<0.05), and the rs4925650 recessive model and over-dominant model were associated with a decreased and increased risk of developing CWP (all P<0.05), with the optimal genetic models being the dominant model and the over-dominant model in drinkers. The rs1539019 co-dominant model, dominant model, recessive model, and additive model were associated with a decreased risk of developing CWP (all P<0.05), and the rs4612666 co-dominant model, recessive model, and additive model were associated with an increased risk of developing CWP (all P<0.05), with the optimal genetic models being the additive model and the recessive model in non-drinkers. The result of haplotype analysis showed that the ACAC and ACGC haplotypes were associated with a reduced risk of CWP (all P<0.05). Conclusion The rs1539019 and rs4612666 loci of the NLRP3 gene are associated with susceptibility to CWP. This study provides clues for further research on the risk of CWP in coal workers.

The present study shows the case of a patient with acetabular protrusions secondary to rheumatoid arthritis progressing to femoral neck fracture.The patient,a 64 years female,had a history of rheumatoid arthtitis for 38 years.The left hip pain and abnormal sound occurred when hip flexion for picking up.She was diagnosed with rheumatoid arthritis secordary to acetabular pelvic retraction and left femoral neck fracture by medical history,physical examination and imaging.Total hip arthroplasty was performed after preoperative examination.Hip dislocation,femoral head removal,acetabular reconstruction;cup fixation,and bone mass assessment are technical challenges during surgery.Based on literature review,this case is belonging to secondary acetabular pelvic retraction,which may be related to acetabular softening caused by rheumatoid arthritis.Whenthe stress from the femoral head exceeds the endurance of the softened acetabulum,the acetabulum protrudes into the pelvis and gradually wraps around the femoral head.Based on the pathological characteristics,itis speculated that the cause of femoral neck fracture is the direct hit of the femoral neck-acetabular rim during hip flexion.In this case,spiral cup prosthesis was used to achieve both the initial stability of the prosthesis and saving bone mass around the acetabulum.The patient was followed up for 3 months with satisfactory position of prosthesis and joint function.

Chigger mites are parasites of rodents and other vertebrates, invertebrates, and other arthropods, and are the only vectors of scrub typhus, in addition to other zoonoses. Therefore, investigating their distribution, diversity, and seasonal abundance is important for public health. Rodent surveillance was conducted at 6 districts in Shandong Province, northern China (114–112°E, 34–38°N), from January to December 2011. Overall, 225/286 (78.7%) rodents captured were infested with chigger mites. A total of 451 chigger mites were identified as belonging to 5 most commonly collected species and 3 genera in 1 family. Leptotrombidium scutellare and Leptotrombidium intermedia were the most commonly collected chigger mites. L. scutellare (66.2%, 36.7%, and 49.0%) was the most frequently collected chigger mite from Apodemus agrarius, Rattus norvegicus, and Microtus fortis, respectively, whereas L. intermedia (61.5% and 63.2%) was the most frequently collected chigger mite from Cricetulus triton and Mus musculus, respectively. This study demonstrated a relatively high prevalence of chigger mites that varied seasonally in Shandong Province, China.
Animals ; Arthropods ; Arvicolinae ; China* ; Cricetinae ; Cricetulus ; Humans ; Invertebrates ; Mice ; Mites* ; Murinae ; Neptune ; Parasites ; Prevalence ; Public Health ; Rats ; Rodentia* ; Scrub Typhus ; Seasons ; Trombiculidae* ; Vertebrates ; Zoonoses