ObjectiveTo analyze the incidence and spatiotemporal distribution of typhus fever in Baoshan City, Yunnan Province from 2005 to 2023, to identify high-risk populations and regions, so as to provide a scientific basis for optimizing the allocation of local prevention and control resources and developing targeted intervention measures. MethodsData of typhus fever cases in Baoshan City from 2005 to 2023 were obtained from the Infectious Disease Information Management System of the Chinese Center for Disease Control and Prevention. Descriptive epidemiological methods were used to analyze the temporal, spatial and demographic distribution of typhus fever cases. Spatial clustering was assessed using spatial dynamic window scan statistics (circular and elliptical windows), flexible spatial scan statistics, and local spatial autocorrelation methods (including local Moran’s I, local Geary’s C, and Getis-Ord G_i*). Retrospective spatiotemporal scan statistics were employed to detect spatiotemporal clusters. ResultsA total of 1 099 typhus fever cases were reported in Baoshan City from 2005 to 2023. The incidence rate peaked at 6.31/ 100 000 in 2007, followed by a decline until reaching its lowest level at 0.21/100 000 in 2015 , and subsequently rebounded during 2016‒2023. The highest proportion of cases was among children under 10 years of age (31.12%), and the top three occupations of cases were farmers, students, and children, accounting for 88.62% of all cases. Cases occurred predominantly between June and September each year. The incidence was relatively high in Jiucheng Town (62.58/100 000), Yaoguan Town (57.15/100 000), and Dianyang Town (46.81/100 000) of Shidian County. Spatial clustering analyses indicated that high-risk areas were mainly located in the southern part of Baoshan City, showing a south-to-north trend. Spatiotemporal scan analyses identified five clusters, with the most likely cluster centered around Yaoguan Town, covering ten towns (subdistricts) during the period 2007‒2010. ConclusionThe incidence of typhus fever in Baoshan City exhibits a clear seasonal and spatial clustering pattern, with peak incidence occurring in summer and autumn. Spatially, cases are primarily distributed in the southern part of Baoshan City, and high-risk clusters exhibit a south-to-north trend. Farmers, students, and children are the high-risk groups.

Objective This study investigated the regulatory effect of high mobility group protein B1 (HMGB1) in the peripheral blood of patients with primary immune thrombocytopenia (ITP) on myeloid dendritic cells (mDC) and Th17/regulatory T cells (Treg) balance. Methods The study enrolled 30 newly diagnosed ITP patients and 30 healthy controls.Flow cytometry was used to measure the proportion of mDC, Th17, and Treg cells in the peripheral blood of ITP patients and healthy controls. ELISA was conducted to quantify the serum levels of HMGB1, interleukin 6 (IL-6), IL-23, IL-17, and transforming growth factor β(TGF-β). The mRNA levels of retinoic acid-related orphan receptor γt(RORγt) and forehead box P3(FOXP3) were detected by real-time PCR. The correlation between the abovementioned cells, cytokines, and platelet count was assessed using Pearson linear correlation analysis. Results The proportion of Th17 cells and the expression levels of HMGB1, IL-6, IL-23, IL-17 and the level of RORγt mRNA in the peripheral blood of ITP patients were higher than those in healthy controls. However, the Treg cell proportion and TGF-β level were lower in ITP patients than those in healthy controls. In patients with ITP, the proportion of mDC and the level of FOXP3 mRNA did not show significant changes. The proportion of mDC cells was significantly correlated with the expression of IL-6 and IL-23. Moreover, the expression of HMGB1 showed a significant correlation with the expression of mDC, IL-6, IL-23, RORγt mRNA, and IL-17. Notably, both the proportion of mDC cells and the expression of HMGB1 were negatively correlated with platelet count. Conclusion The high expression of HMGB1 in peripheral blood of ITP patients may induce Th17/Treg imbalance by promoting the maturation of mDC and affecting the secretion of cytokines, thereby potentially playing a role in the immunological mechanism of ITP.
Humans ; Th17 Cells/cytology* ; HMGB1 Protein/genetics* ; T-Lymphocytes, Regulatory/cytology* ; Female ; Male ; Dendritic Cells/metabolism* ; Adult ; Middle Aged ; Purpura, Thrombocytopenic, Idiopathic/genetics* ; Nuclear Receptor Subfamily 1, Group F, Member 3/genetics* ; Young Adult ; Interleukin-23/blood* ; Interleukin-17/blood* ; Interleukin-6/blood* ; Forkhead Transcription Factors/genetics* ; Myeloid Cells/cytology* ; Aged

Pigeon circovirus(PiCV)is globally widespread and is considered a potential cause of young pigeon sickness syndrome(YPDS),which leads to severe immunosuppression and high mortality.Due to the inability of PiCV to be cultured in cells,the development of traditional vac-cines is severely limited,and no effective vaccines is currently available.To develop a novel PiCV DNA candidate vaccine,we cloned the △Cap gene lacking a nuclear localization signal(NLS),and fused it at its C-terminus with the transmembrane and cytoplasmic regions of the Newcastle dis-ease virus(NDV)F protein(△Cap-TMCT).Two DNA vaccine candidates were constructed:pCAGG-△Cap,targeting intracellular expression,and pCAGG-△Capt,for cell surface expression,respectively.The results of indirect immunofluorescence and Western blot analyses confirmed suc-cessful expression of both recombinant plasmids in DF1 cells.Immunization studies in mice re-vealed that pCAGG-△Capt induced significantly higher levels of specific IgG antibodies,T-cell re-sponses,and cytokine secretion compared to pCAGG-△Cap,as assessed by ELISA,flow cytome-try,and ELISpot assays.These findings suggest that targeting △Cap-TMCT fusion protein to the cell surface can effectively enhance its immunogenicity,highlighting its potential as a PiCV DNA vaccine candidate.This study provides new strategies and theoretical foundations for the design and development of PiCV DNA vaccines.

Pigeon circovirus(PiCV)is globally widespread and is considered a potential cause of young pigeon sickness syndrome(YPDS),which leads to severe immunosuppression and high mortality.Due to the inability of PiCV to be cultured in cells,the development of traditional vac-cines is severely limited,and no effective vaccines is currently available.To develop a novel PiCV DNA candidate vaccine,we cloned the △Cap gene lacking a nuclear localization signal(NLS),and fused it at its C-terminus with the transmembrane and cytoplasmic regions of the Newcastle dis-ease virus(NDV)F protein(△Cap-TMCT).Two DNA vaccine candidates were constructed:pCAGG-△Cap,targeting intracellular expression,and pCAGG-△Capt,for cell surface expression,respectively.The results of indirect immunofluorescence and Western blot analyses confirmed suc-cessful expression of both recombinant plasmids in DF1 cells.Immunization studies in mice re-vealed that pCAGG-△Capt induced significantly higher levels of specific IgG antibodies,T-cell re-sponses,and cytokine secretion compared to pCAGG-△Cap,as assessed by ELISA,flow cytome-try,and ELISpot assays.These findings suggest that targeting △Cap-TMCT fusion protein to the cell surface can effectively enhance its immunogenicity,highlighting its potential as a PiCV DNA vaccine candidate.This study provides new strategies and theoretical foundations for the design and development of PiCV DNA vaccines.

Objective:To study the application of 3D printing technology in multi-center fenestrated/branched endovascular repair (F/B-EVAR) for endovascular repair of abdominal aortic diseases.Methods:From Feb 2018 to Mar 2023, The clinical and followup data of 316 cases of abdominal aortic lesions undergoing repair with F/B-EVAR at 69 medical centers nationwide using 3D printing technology to guide physician-modified stent graft were retrospectively analyzed.Results:The mean follow-up time of the patients was 23 months (2-60 months), and 24 cases were lost to follow up, the follow-up rate was 92.4% (292/316), the mean postoperative hospitalization time was (8.2±4.9) days. A total of 944 main abdominal branch arteries were reconstructed. Intraoperative reconstruction of 11 branches failed, with a success rate of 98.8% (933/944). Within 30 days after surgery, 8 patients died (2.5%), and 6 patients died during follow-up, a total of 14 patients died (4.4%). There were 11 cases (3.5%) of spinal cord ischemia and no patient suffered from permanent paraplegia. There were 19 patients (6.0%) with postoperative renal function injury. Internal leakage was found in 26 patients, and the rate of internal leakage was 8.2%.Conclusion:3D printing technology can accurately locate the location of branch arteries, simplifing the surgical process, shortening the learning curve , and improving clinical efficacy.

Objective:To investigate the genetic distribution of pathogenic genes of Charcot-Marie-Tooth diseases (CMT) in Chinese Han population, and compare the similarity and difference with the data in Peking University Third Hospital in 2013.Methods:Five hundred and twenty families with CMT and related diseases in Peking University Third Hospital and China-Japan Friendship Hospital from January 2007 to March 2021 were collected. After peripheral myelin protein 22 (PMP22) gene duplication and deletion mutations were initially detected by multiple ligation probe amplification, the probands of these families were sequenced by next-generation sequencing (NGS) gene panel or whole exome sequencing, and validated by Sanger sequencing.Results:Among the 520 families, 336 CMT families were genetically confirmed, and the mutation detection rate increased from 48.6% (51/105) in 2013 to 64.6% (336/520) in 2021 (χ 2=9.54, P=0.003). Among them, 139 families had PMP22 gene duplication mutation (139/520, 26.7%), 46 families had gap junction beta-1 (GJB1) gene mutation (46/520, 8.8%), 26 families had mitofusin-2 (MFN2) gene mutation (26/520, 5.0%), 12 families had myelin protein zero (MPZ) gene mutation (12/520, 2.3%), 11 families had PMP22 gene point mutation (11/520, 2.1%), and 10 families had heat shock protein B1 gene mutation (10/520, 1.9%). There were 10 families with ganglioside induced differentiation associated protein 1 (GDAP1) gene mutation (10/520, 1.9%), 8 families with SH3 domain and tetratricopeptide repeats 2 (SH3TC2) gene mutation (8/520, 1.5%), 7 families with immunoglobulin mu DNA binding protein 2 (IGHMBP2) gene mutation (7/520, 1.3%), 6 families with MORC family CW-type zinc finger 2 (MORC2) gene mutation (6/520, 1.2%), 5 families with sorbitol dehydrogenase (SORD) gene mutation (5/520, 1.0%), 16 families with very rare gene mutation (16/520, 3.1%) and 184 families without genetic diagnosis (184/520, 35.4%). Conclusions:Compared with the results in 2013, the 3 most common genes affecting CMT were still PMP22, GJB1 and MFN2 genes, but the proportion difference of patients with MPZ gene mutation gradually decreased with other genes such as SH3TC2 and GDAP1 genes. The proportion of newly discovered CMT genes, such as MORC2 and SORD genes, was similar with IGHMBP2 gene, which should be paid more attention. NGS greatly improved the detection rate of CMT, especially for patients with autosomal recessive-CMT.

The gas chromatography method was developed for the determination of ethylene glycol, diethylene glycol and triethylene glycol in poloxamer 188 to provide scientific basis for the quality control. The samples was separated on column VF-17ms(30 m×0. 53 mm, 1. 0 μm)with temperature programming, inlet temperature was 270 °C, detector temperature was 290 °C and the split ratio was 10 ∶1. The method showed great linearity over the range of 6-15 μg/mL(r≥0. 999). The injection precision(n=8)of the three residual impurities were 3. 3%, 3. 0%, 2. 3% and the average recoveries were 99. 05%(RSD=2. 9%, n=9), 102. 20%(RSD=4. 0%, n=9), 101. 91%(RSD=3. 1%, n=9), respectively. The analytical method is specific, accurate and sensitive, which is suitable for the determination of ethylene glycol, diethylene glycol and triethylene glycol in poloxamer 188, providing reference and guidance for the production and quality control of poloxamer 188.

The widespread application of next generation sequencing (NGS) in clinical settings has enabled testing, diagnosis, treatment and prevention of genetic diseases. However, many issues have arisen in the meanwhile. One of the most pressing issues is the lack of standards for reporting genetic test results across different service providers. The First Forum on Standards and Specifications for Clinical Genetic Testing was held to address the issue in Shenzhen, China, on October 28, 2017. Participants, including geneticists, clinicians, and representatives of genetic testing service providers, discussed problems of clinical genetic testing services across in China and shared opinions on principles, challenges, and standards for reporting clinical genetic test results. Here we summarize expert opinions presented at the seminar and report the consensus, which will serve as a basis for the development of standards and guidelines for reporting of clinical genetic testing results, in order to promote the standardization and regulation of genetic testing services in China.

Objective To investigate the relationship between lymph nodes count after selective neck lymph node dissection and the prognosis of patients with pathologically lymph node-negative (pN0) hypopharyngeal squamous cell carcinoma (HPSCC). Methods The clinical data of 96 patients with pN0 HPSCC undergoing selective neck dissection (bilateralⅡ-Ⅳregion) from October 1995 to October 2012 in Shanxi Provincial Cancer Hospital were analyzed retrospectively. The optimal lymph nodes count cutoff values were determined by using the X-tile program in different prognostic groups, and the univariate and multivariate survival analysis in different groups were analyzed by using SPSS 19.0 software. Results A total of 2116 lymph nodes were detected in this cohort, with a median number of 22 (3-52). Except for the tumor site (P= 0.011), there were no statistical differences in lymph nodes count of patients with different age, gender, history of smoking or drinking, T stage, and differentiation degree (all P> 0.05). Applying 9 and 23 nodes as the cutoff values determined by using X-tile program, all patients could be divided into the high-risk (13 cases, lymph nodes count 3-9), the middle-risk (37 cases, lymph nodes count 10-22) and the low-risk (46 cases, lymph nodes count 23-52) groups. And the 5-year overall survival (OS) rate was 23.1 ％, 55.9％and 86.0％in the high, middle, low risk groups respectively (χ2= 21.73, P< 0.001). Multiple-factor analysis showed that lymph nodes count, T stage and degree of tumor differentiation were independent prognostic factors in patients with pN0 HPSCC (all P< 0.05). Further analysis showed that when the cutoff value of lymph nodes count was 9, the patients could be divided into two groups with significantly differentprognosis. The 5-year OS rate was 23.1％ in the high-risk group and 73.2 ％ in the low-risk group, and the difference was statistically significant (χ2 = 17.87, P< 0.001). Conclusions Lymph nodes count after selective neck lymph node dissection can be used to predict the prognosis of patients with pN 0 HPSCC. It is likely that 9 is the minimum number of lymph nodes in pN0 HPSCC patients.

Objective To study the effect of target rehabilitation diary in elderly patients with total knee arthroplasty (TKA). Methods One hundred patients who received unilateral first TKA (no patella) were numbered according to the order of admission time, according to random digit table, 50 cases in the control group and the intervention group. Conventional treatment methods were given to both two groups, the control group received routine care measures and health education, the intervention group was given target rehabilitation diary for self- management based on the conventional health education. The differences in American Knee Society Knee Score (KSS), self- management and self- efficacy were compared between the two groups. Results The KSS was (75.50 ± 6.90) points in the intervention group and (71.90 ± 7.20) points in the control group on the first week after operation, the difference was statistically significant (t=2.553, P<0.05). On the twelfth week of intervention, KSS was (85.86 ± 2.80) points in the intervention group and (80.88 ± 2.20) points in the control group, the difference was statistically significant (t=9.880, P<0.01). Self-efficacy and self-management on the twelfth week were (47.22 ± 3.34) and (54.55 ± 2.66) points in the intervention group, which were significantly higher than those in the control group (34.24 ± 4.11) and (42.54 ± 3.76) points, the difference was statistically significant (t=17.33, 18.43, P<0.01). Conclusions The target rehabilitation diary plays a good role in the self-management of elderly patients with TKA.