Objective To investigate the epidemiological trends,temporal and spatial distribution characteristics of pulmonary tuberculosis in Lanping County.Methods Based on tuberculosis management data and basic information systems from the"China Disease Prevention and Control Information System,"pulmonary tuberculosis data from Lanping County for 2018-2023 were obtained.Descriptive epidemiology,concentration method,circular distribution method,and spatial autocorrelation analysis were used to conduct epidemiological and spatial analyses of the pulmonary tuberculosis data.Results A total of 2836 TB cases were reported in Lanping County from 2018 to 2023,with an average annual incidence rate of 233.26 per 100000,showing a declining trend.The male-to-female ratio was 1.95∶1,with the highest incidence among individuals aged 60 and above(932 cases,32.86%).Cases were predominantly among farmers(91.01%)and the Lisu ethnic group(52.68%).TB incidence showed weak seasonality with a bimodal distribution,with primary peak occurring from October to March and secondary peak from June to August.Tu'e Township(324.74 per 100,000),Shideng Township(307.42 per 100000),and Jinding Town(260.98 per 100,000)had the highest incidence rates,accounting for 1,284 cases or 45.28%of the county's total cases.In 2020,the incidence of pulmonary tuberculosis in Lanping County showed a spatial clustering distribution(global Morans's I value<0,P value<0.05),with Shideng Township consistently showing high-low aggregation characteristics.Conclusion Between 2018-2023,while the tuberculosis incidence rate in Lanping County has declined,it still falls short of Yunnan Province's tuberculosis prevention and control targets,and the prevention and control work continues to face significant challenges.Strengthening screening of high-risk populations and providing medical support to remote areas will be key measures for future prevention and treatment.

Objective:To investigate the mechanism of IL-23/STAT3/Th17 axis in severe acute pancreatitis(SAP)and the in-terventional effect of the Qingjie Huagong decoction(QJHGD).Methods:A rat model of SAP was established by injecting sodium tau-rocholate into the retrograde pancreatic duct.The blank group,model group,different doses of QJHGD administration groups and posi-tive group were set up respectively.HE staining was used to observe the pathology of pancreatic tissue.ELISA was used to detect serum lipase,α-amylase and inflammatory markers.By combining RT-qPCR,IHC,Western blot,and IF techniques,we elucidated the mechanism of QJHGD in protecting pancreatic tissue in SAP rats.Results:The levels of amylase,lipase,IL-1β,IL-6,IL-17,IL-23,TNF-α and TGF-β in the serum of SAP model rats in all dose groups of QJHGD were significantly reduced,and the effect was the best in medium dose group(P<0.05).The results of IHC and RT-qPCR revealed that the medium-and high-dose groups of QJHGD sig-nificantly reduced the expression of IL-23,STAT3,IL-17 protein and mRNA in the pancreatic tissue of this model(P<0.05).More-over,the Western blot results demonstrated that the expression of IL-23,STAT3,p-STAT3,and IL-17 proteins in SAP rats were sig-nificantly decreased in the medium-dose group of QJHGD(P<0.05);the IF assay indicated that Th17 cell differentiation in SAP rats was inhibited by all dose groups of QJHGD,with the most significant inhibition effect in the middle dose(P<0.05).Conclusion:QJH-GD regulates the activation of IL-23/STAT3/Th17 axis,thereby inhibiting Th17 cell differentiation and exerting a protective effect on pancreatic tissue.

Objective:To investigate the mechanism of IL-23/STAT3/Th17 axis in severe acute pancreatitis(SAP)and the in-terventional effect of the Qingjie Huagong decoction(QJHGD).Methods:A rat model of SAP was established by injecting sodium tau-rocholate into the retrograde pancreatic duct.The blank group,model group,different doses of QJHGD administration groups and posi-tive group were set up respectively.HE staining was used to observe the pathology of pancreatic tissue.ELISA was used to detect serum lipase,α-amylase and inflammatory markers.By combining RT-qPCR,IHC,Western blot,and IF techniques,we elucidated the mechanism of QJHGD in protecting pancreatic tissue in SAP rats.Results:The levels of amylase,lipase,IL-1β,IL-6,IL-17,IL-23,TNF-α and TGF-β in the serum of SAP model rats in all dose groups of QJHGD were significantly reduced,and the effect was the best in medium dose group(P<0.05).The results of IHC and RT-qPCR revealed that the medium-and high-dose groups of QJHGD sig-nificantly reduced the expression of IL-23,STAT3,IL-17 protein and mRNA in the pancreatic tissue of this model(P<0.05).More-over,the Western blot results demonstrated that the expression of IL-23,STAT3,p-STAT3,and IL-17 proteins in SAP rats were sig-nificantly decreased in the medium-dose group of QJHGD(P<0.05);the IF assay indicated that Th17 cell differentiation in SAP rats was inhibited by all dose groups of QJHGD,with the most significant inhibition effect in the middle dose(P<0.05).Conclusion:QJH-GD regulates the activation of IL-23/STAT3/Th17 axis,thereby inhibiting Th17 cell differentiation and exerting a protective effect on pancreatic tissue.

ObjectiveTo investigate the therapeutic effect of Qingjie Huagong decoction （QJHGD） on a mouse model of severe acute pancreatitis （SAP） and the mechanism of action of QJHGD against inflammatory response. MethodsA total of 36 male C57BL/6J mice were randomly divided into blank group， model group， Western medicine group （ulinastatin）， and low-， middle-， and high-dose QJHGD groups， with 6 mice in each group. All mice except those in the blank group were given 5% sodium taurocholate by retrograde pancreaticobiliary injection to establish a model of SAP. After modeling， the mice in the low-， middle-， and high-dose groups were given QJHGD （1， 2， and 4 g/kg， respectively） by gavage， and those in the Western medicine group were given intraperitoneal injection of ulinastatin （5×10⁴ U/kg）， for 7 days in total. HE staining was used to observe the histopathological changes of the pancreas； ELISA was used to measure the levels of α-amylase， lipase， interleukin-1β （IL-1β）， interleukin-6 （IL-6）， interleukin-8 （IL-8）， interleukin-18 （IL-18）， and tumor necrosis factor-α （TNF-α） in mice； RT-qPCR was used to measure the mRNA expression levels of NOD-like receptor protein3 （NLRP3）， Toll-like receptor 4 （TLR4）， and nuclear factor-kappa B （NF-κB） in pancreatic tissue； immunohistochemistry was used to measure the positive expression rates of NLRP3， TLR4， and NF-κB in pancreatic tissue； Western blot was used to measure the protein expression levels of NLRP3， TLR4， NF-κB， IL-1β， and IL-6. An analysis of variance was used for comparison of continuous data between multiple groups， and the least significant difference t-test was used for further comparison between two groups. ResultsCompared with the blank group， the model group had diffuse destruction of pancreatic tissue structure， focal dilatation of pancreatic lobular septum， pancreatic acinar atrophy， and massive inflammatory cell infiltration， as well as significant increases in the content of α-amylase， lipase， IL-1β， IL-6， IL-8， IL-18， and TNF-α （all P<0.05）， the mRNA expression levels and positive expression rates of NLRP3， TLR4， and NF-κB （all P<0.05）， and the protein expression levels of NLRP3， TLR4， NF-κB， IL-1β， and IL-6 （all P<0.05）. Compared with the model group， the low-， middle-， and high-dose QJHGD groups and the Western medicine group had slightly tighter and more intact structure of pancreatic tissue， ordered arrangement of pancreatic acinar cells， a small amount of inflammatory cell infiltration， and hemorrhagic foci of pancreatic lobules， as well as significant reductions in the content of α-amylase， lipase， IL-1β， IL-6， IL-8， IL-18， and TNF-α （all P<0.05）， the mRNA expression levels and positive expression rates of NLRP3， TLR4， and NF-κB （all P<0.05）， and the protein expression levels of NLRP3， TLR4， NF-κB， IL-1β， and IL-6 （all P<0.05）. ConclusionQJHGD may exert a protective effect on the pancreatic tissue of SAP mice by inhibiting the activation of NLRP3/TLR4/NF-κB signaling pathway-related proteins， reducing the release of inflammatory mediators， and preventing the enhancement of inflammatory cascade response.

Background Bacteria are the most diverse and widely sourced microorganisms in the indoor air of subway stations, where pathogenic bacteria can spread through the air, leading to increased health risks. Objective To understand the status and distribution characteristics of indoor air bacterial pollution in subway stations and compartments in a city of Central South China, and to provide a scientific basis for formulating intervention measures to address indoor air bacteria pollution in subways. Methods Three subway stations and the compartments of trains parking there in a city in Central South China were selected according to passenger flow for synchronous air sampling and monitoring. Temperature, humidity, wind speed, carbon dioxide (CO₂), fine particulate matter (PM_2.5), and inhalable particulate matter (PM₁₀) were measured by direct reading method. In accordance with the requirements of Examination methods for public places-Part 3: Airborne microorganisms (GB/T 18204.3-2013), air samples were collected at a flow rate of 28.3 L·min⁻¹, and total bacterial count was estimated. Bacterial microbial species were identified with a mass spectrometer and pathogenic bacteria were distinguished from non-pathogenic bacteria according to the Catalogue of pathogenic microorganisms transmitted to human beings issued by National Health Commission. Kruskal-Wallis H test was used to compare the subway hygiene indicators in different regions and time periods, and Bonferroni test was used for pairwise comparison. Spearman correlation test was used to evaluate the correlation between CO₂ concentration and total bacterial count. Results The pass rates were 100.0% for airborne total bacteria count, PM_2.5, and PM₁₀ in the subway stations and train compartments, 94.4% for temperature and wind speed, 98.6% for CO₂, but 0% for humidity. The overall median (P₂₅, P₇₅) total bacteria count was 177 (138,262) CFU·m⁻³. Specifically, the total bacteria count was higher in station halls than in platforms, and higher during morning peak hours than during evening peak hours (P<0.05). A total of 874 strains and 82 species were identified by automatic microbial mass spectrometry. The results of identification were all over 9 points, and the predominant bacteria in the air were Micrococcus luteus (52.2%) and Staphylococcus hominis (9.8%). Three pathogens, Acinetobacter baumannii (0.3%), Corynebacterium striatum (0.1%), and Staphylococcus epidermidis bacilli (2.2%) were detected in 23 samples (2.6%), and the associated locations were mainly distributed in train compartments during evening rush hours. Conclusion The total bacteria count in indoor air varies by monitoring sites of subway stations and time periods, and there is a risk of opportunistic bacterial infection. Attention should be paid to cleaning and disinfection during peak passenger flow hours in all areas.

Objective To evaluate the effect of ambroxol on p38 mitogen-activated protein kinase pathway in mice with sepsis-induced lung injury.Methods Sixty male C57BL/6 mice were equally and randomly divided into 3 groups (n=20 each) using a random number table:sham operation group (group S),sepsis-induced lung injury group (group CLP),and sepsis-induced lung injury + ambroxol group (group AMB).Sespsis was produced by cecal ligation and puncture(CLP).Ambroxol 50 mg/kg preconditioning was injected intraperitoneally for 3 days in group AMB,while the equal volume of normal saline instead was given in S and VILI groups.The arterial blood gas was detected 24 h after CLP.Then the mice were sacrificed and broncho-alveolar lavage fluid (BALF) was collected for determination of the concentrations of total protein,interleukin-1β (IL-1β),tumor necrosis factor-α (TNF-α),IL-6 and intercellular adhesion molecule-1 (ICAM-1).The lung tissues were taken for determination of wet to dry lung weight ratio (W/D ratio),expression of p-p38 MAPK,IL-1β mRNA,TNF-α mRNA,IL-6 mRNA and ICAM-1 mRNA,and for examination of the pathological changes which were scored.Results Compared with group S,partial pressure of oxygen in arterial blood(PaO2) was decreased (P＜0.05),and W/D ratio,lung injury score,concentrations of total protein,IL-1β,TNF-α,IL-6 and ICAM-1 in BALF,and expression of p-p38 MAPK,IL-1β,TNF-α,IL-6 and ICAM-1 mRNA were significantly increased in CLP group (P＜0.05).Compared with group CLP,PaO2 was increased (P＜0.05),W/D ratio,lung injury score,concentrations of total protein,IL-1β,TNF-α,IL-6 and ICAM-1 in BALF,and expression of p-p38 MAPK,IL-1β,TNF-α,IL-6 and ICAM-1 mRNA were decreased in group AMB (P＜0.05).Conclusion Ambroxol can attenuate sepsis-induced lung injury probably through inhibiting p38 mitogen-activated protein kinase pathway in mice.

Objective: To evaluate the safety and efficacy of ombitasvir/paritaprevir/ritonavir (OBV/PTV/r) 25/150/100 mg once daily combined with dasabuvir 250mg, twice daily in non-cirrhotic Chinese adult patients with newly diagnosed and treated chronic HCV genotype 1b infection. Methods: A randomized, double-blind, placebo-controlled, multicenter phase 3 clinical trial was conducted in mainland China, Korea, and Taiwan.Safety and efficacy of OBV/PTV/r plus DSV administered for 12 weeks were evaluated in a newly diagnosed and treated (interferon alpha /pegylated interferon alpha) and ribavirin non-cirrhotic adults with chronic HCVgenotype 1b infection. Patients randomly received OBV/PTV/r plus DSV for 12 weeks (Group A), or placebo for 12 weeks (Group B) followed by an open-label phase of OBV/PTV/r plus DSV for 12 weeks. Sustained response (SVR12) rate obtained at 12 weeks and (SVR24) 24 weeks after discontinuation of treatment, and the incidence of adverse events and laboratory abnormalities after double-blind and open-label phase treatment were assessed. Results: A total of 410 cases of Chinese patients were included and randomly assigned to group A and B (with 205 cases in each group) in a 1:1 ratio. The rates of SVR12 and SVR24 were 99% (95% CI: 94.8% - 99.8%) in the newly diagnosed patients in group A (205 patients) and the rates of SVR12 and SVR24 were 100% in treated patients (95% CI: 96.3% - 100%). Different baseline characteristics had no effect on SVR12 and SVR24 rates. Most of the adverse events occurred were mild, asymptomatic, and≥ 3 laboratory abnormalities during treatment were rare, including elevation of alanine aminotransferase (2 cases in double-blind stage A group), aspartate aminotransferase (Double-blind stage A (3 cases) and total bilirubin (1 case in open-label phase B group); however, those mild adverse events could be recovered after drug withdrawal or discontinuation. only1 person discontinued drugs due to adverse events (Group B, open-label phase). Conclusion The 12 weeks treatment course of OBV/PTV/r combined with DSV produced 99% ~ 100% rates of SVR12 and SVR24 in non-cirrhotic Asian adult patients with newly diagnosed and treated chronic HCV genotype 1b infection, and the tolerance and safety were good.

Objective To improve the diagnostic and therapeutic ability of Brucellosis by analyzing the epidemic and clinical characteristics.Methods A retrospective analysis was done on the data of Brucellosis patients treated in our hospital from 2007 to 2016.Results Since the first case was diagnosed in 2012,27 patients [19 male and 8 female,mean age (44.4 ± 16.9) years] were confirmed by clinical manifestations and positive bacterial cultures results.The annual number of cases from 2012 to 2016 was 1,1,6,4 and 15.Among them,10 cases (37.0％) had a history of close contact with goat,7 cases (25.9％)with raw mutton,1 case (3.7％) with raw beef and 1 case (3.7％) with suspicious laboratory contamination while 8 cases (29.6％) had no evident risk factors for Brucellosis.The common clinical manifestation included fever (81.5％),lumbago/joint pain (55.6％),fatigue (33.3％) and hyperhidrosis (22.2％).The white blood cell count was normal among 20 cases (74.1％) while 6 cases (22.2％) with leukopenia.Mild to moderate anemia in 20 cases (74.1％) and decreased platelet number in 4 case (14.8％).The percentage of elevated alanine aminotransferase,aspartate aminotransferase and lactate dehydrogenase was 32.0％,48.0％ and 100％,respectively.Decreased albumin level was found in 23 cases (92.0％).The percentage of elevated erythrocyte sedimentation rate (ESR),C-reactive protein and serum ferritin 75.0％,82.3％ and 77.8％,respectively,while 12 cases (85.7％) with procalcitonin level below 0.5 ng/L.According to follow-up for at least half year,all the cases were cured by active medical management.Conclusions The number of Brucellosis cases is rapidly increasing in our hospital.It's of great significance to know the epidemic and clinical characteristics of Brucellosis.

Objective: To investigate the efficacy and safety of the new investigational drug pegylated interferon α-2b (Peg-IFN-α-2b) (Y shape, 40 kD) injection (180 µg/week) combined with ribavirin in the treatment of patients with genotype 1/6 chronic hepatitis C (CHC), with standard-dose Peg-IFN-α-2a combined with ribavirin as a positive control. Methods: A multicenter, randomized, open-label, and positive-controlled phase III clinical trial was performed. Eligible patients with genotype 1/6 CHC were screened out and randomly divided into Peg-IFN-α-2b(Y shape, 40kD) group and Peg-IFN-α-2a group at a ratio of 2:1. The patients in both groups were given oral ribavirin for 48 weeks in addition and then followed up for 24 weeks after drug withdrawal. Abbott Real Time HCV Genotype II was used to determine HCV genotype, and Cobas TaqMan quantitative real-time PCR was used to measure HCV RNA level at 0, 4, 12, 24, 48, and 72 weeks. Adverse events were recorded in detail. The primary efficacy endpoint was sustained virological response (SVR), and a non-inferiority test was also performed. Results: A total of 561 patients with genotype 1/6 CHC were enrolled, among whom 529 received treatment; 90.9% of these patients had genotype 1 CHC. The data of the full analysis set showed that SVR rate was 69.80% (95% CI 65.00%-74.60%) in the trial group and 74.16% (95% CI 67.73%-80.59%) in the control group (P = 0.297 0). The data of the per protocol set (PPS) showed that SVR rate was 80.63% (95% CI 76.04%-85.23%) in the trial group and 81.33% (95% CI 75.10%-87.57%) in the control group (P = 0.849 8), and the 95% CI of rate difference conformed to the non-inferiority standard. The analysis of the PPS population showed that of all subjects, 47.9% achieved rapid virologic response, with a positive predictive value of 93.8%. The incidence rate of adverse events was 96.30% in the trial group and 94.94% in the control group, and the incidence rate of serious adverse events was 5.13% in the trail group and 5.06% in the control group. Conclusion In the regimen of Peg-IFN-α combined with ribavirin for the treatment of genotype 1/6 CHC, the new investigational drug Peg-IFN-α-2b(Y shape, 40 kD) has comparable clinical effect and safety to the control drug Peg-IFN-α-2a.

Objective: To investigate the clinical effect and safety of long-acting pegylated interferon-α-2b (Peg-IFN-α-2b) (Y shape, 40 kD) injection (180 μg/week) in the treatment of HBeAg-positive chronic hepatitis B (CHB) patients, with standard-dose Peg-IFN-α-2a as positive control. Methods: This study was a multicenter, randomized, open-label, and positive-controlled phase III clinical trial. Eligible HBeAg-positive CHB patients were screened out and randomized to Peg-IFN-α-2b (Y shape, 40 kD) trial group and Peg-IFN-α-2a control group at a ratio of 2:1. The course of treatment was 48 weeks and the patients were followed up for 24 weeks after drug withdrawal. Plasma samples were collected at screening, baseline, and 12, 24, 36, 48, 60, and 72 weeks for centralized detection. COBAS® Ampliprep/COBAS® TaqMan® HBV Test was used to measure HBV DNA level by quantitative real-time PCR. Electrochemiluminescence immunoassay with Elecsys kit was used to measure HBV markers (HBsAg, anti-HBs, HBeAg, anti-HBe). Adverse events were recorded in detail. The primary outcome measure was HBeAg seroconversion rate after the 24-week follow-up, and non-inferiority was also tested. The difference in HBeAg seroconversion rate after treatment between the trial group and the control group and two-sided confidence interval (CI) were calculated, and non-inferiority was demonstrated if the lower limit of 95% CI was > -10%. The t-test, chi-square test, or rank sum test was used according to the types and features of data. Results: A total of 855 HBeAg-positive CHB patients were enrolled and 820 of them received treatment (538 in the trial group and 282 in the control group). The data of the full analysis set showed that HBeAg seroconversion rate at week 72 was 27.32% in the trial group and 22.70% in the control group with a rate difference of 4.63% (95% CI -1.54% to 10.80%, P = 0.1493). The data of the per-protocol set showed that HBeAg seroconversion rate at week 72 was 30.75% in the trial group and 27.14% in the control group with a rate difference of 3.61% (95% CI -3.87% to 11.09%, P = 0.3436). 95% CI met the non-inferiority criteria, and the trial group was non-inferior to the control group. The two groups had similar incidence rates of adverse events, serious adverse events, and common adverse events. Conclusion In Peg-IFN-α regimen for HBeAg-positive CHB patients, the new drug Peg-IFN-α-2b (Y shape, 40 kD) has comparable effect and safety to the control drug Peg-IFN-α-2a.