ObjectiveTo analyze the epidemiological and clinical characteristics of pertussis in Taizhou City, Zhejiang Province, 2024, and to provide a scientific basis for formulating local prevention and control strategies. MethodsCase data and population data were obtained from the China Disease Prevention and Control Information System. Epidemiological case investigation data were collected from the Zhejiang Vaccine Clinical Research and Application Effectiveness Evaluation System and the Immunization Service Information System. Descriptive epidemiological methods were used to analyze the temporal, spatial and demographic distributions, and SaTScan 9.7 software was applied for spatiotemporal cluster scanning. ResultsIn 2024, a total of 3 090 pertussis cases were reported in Taizhou City, with no deaths. The number of reported cases increased significantly compared with those in previous years, and the peak occurred in April. Spatiotemporal scanning identified three clusters: a most likely cluster centered around Tantou Town in Tiantai County, covering 16 streets/towns, a second most likely cluster centered around Taiping Subdistrict in Wenling City, covering 11 streets/towns, and a third most likely cluster centered around Ganjiang Town in Yuhuan City, covering 6 streets/towns. The three clusters together accounted for 31.04% of the total scanned cases.The majority of cases were in the 6‒10 years age group (55.02%), and students accounted for the highest proportion by occupation (44.17%). Among 2 929 epidemiological investigation cases, the most common clinical manifestations were cough (97.58%) and aggravated nocturnal cough (52.10%), while typical symptoms (including paroxysmal spasmodic cough and post-tussive vomiting, etc.) were less frequent. Among the cases, 82.49% had completed the full 4-dose vaccination schedule, and their complication rate (10.47%) was lower than that of the unvaccinated group (20.56%). ConclusionThe number of reported pertussis cases surged in Taizhou City in 2024, showing significant spatiotemporal clustering, with school‑aged children being the high‑risk group. Vaccination could reduce the risk of complications. It is recommended to further enhance surveillance sensitivity, with a focus on strengthening immunization strategies for high-risk groups such as school-aged children aged 6‒10 years, and to reinforce targeted protection for infants under 1 year old who have not completed primary vaccination, along with their families. In addition, prevention and control resources should be deployed in advance for the cluster areas identified through spatiotemporal analysis and for the spring peak season,to interrupt local transmission chains.

Fire twinkling is the common method in cupping therapy. In the teaching materials of acupuncture and moxibustion, and the national standard, Standardized Manipulations of Acupuncture and Moxibustion-Part 5: Cupping Therapy, this cupping technique is operated by igniting an alcohol-soaked cotton ball held with a forceps, placing it inside the cup, taking it out after "turning around in several circles", and placing the cup on the selected area. Based on the clinical experience of chief physician LI Yan, a high-efficient and safe fire twinkling was developed. Clamping the middle part of the cotton ball with a holder, dipping it in 95% ethanol, and squeezing the cotton ball to ensure no ethanol drops left; holding the cup with the dominant hand and covering the ignited cotton ball vertically, removing the cup immediately when the ball touching the cup bottom. Such manipulation mode, "flame going in and out directly", can avoid the potential safety hazards such as residual ethanol left on the cup opening, overheating of cup opening and accidentally falling-off of the ignited cotton ball.
Humans ; Cupping Therapy/instrumentation* ; Acupuncture Therapy/instrumentation* ; Fires

Lenvatinib, a second-generation multi-receptor tyrosine kinase inhibitor approved by the FDA for first-line treatment of advanced liver cancer, facing limitations due to drug resistance. Here, we applied a multidimensional, high-throughput screening platform comprising patient-derived resistant liver tumor cells (PDCs), organoids (PDOs), and xenografts (PDXs) to identify drug susceptibilities for conquering lenvatinib resistance in clinically relevant settings. Expansion and passaging of PDCs and PDOs from resistant patient liver tumors retained functional fidelity to lenvatinib treatment, expediting drug repurposing screens. Pharmacological screening identified romidepsin, YM155, apitolisib, NVP-TAE684 and dasatinib as potential antitumor agents in lenvatinib-resistant PDC and PDO models. Notably, romidepsin treatment enhanced antitumor response in syngeneic mouse models by triggering immunogenic tumor cell death and blocking the EGFR signaling pathway. A combination of romidepsin and immunotherapy achieved robust and synergistic antitumor effects against lenvatinib resistance in humanized immunocompetent PDX models. Collectively, our findings suggest that patient-derived liver cancer models effectively recapitulate lenvatinib resistance observed in clinical settings and expedite drug discovery for advanced liver cancer, providing a feasible multidimensional platform for personalized medicine.

CRISPR-Associated Protein 9 ; Gene Editing ; CRISPR-Cas Systems/genetics*

Objective:To compare the early effect of water sac blocking and Heartstring for proximal anastomosis of the calcific ascending aorta.Methods:The data of 400 consecutive patients undergoing elective off-pump coronary artery bypass grafting(OPCABG) in Beijing Anzhen Hospital from January 2022 to June 2022 were retrospectively analyzed. 46 patients with calcific ascending aorta including 40 males and 6 females, with the age ranged from 53 to 73 years and an average of(65.2±5.1) years, who were revealed by preoperative chest CT scan and intraoperative palpation. According to the method of proximal anastomosis, the patients were divided into 2 groups: water sac blocking group(n=19) and Heartstring group(n=27). The effect of preventing postoperative stroke was compared by counting the incidence of postoperative stroke. The efficacy of the 2 methods was compared by detecting the flow and pulsatility fraction of the saphenous vein trunk during surgery, observing the dynamic changes of the electrocardiogram and cTnI level within 48h after the surgery, and reviewing the coronary CTA 3 months after discharge.Results:There was no perioperative death, and all the patients were discharged 4-13 days postoperatively. No adverse events such as stroke and malignant ventricular arrhythmia occurred during perioperative period. 1 patient in each group developed low cardiac output syndrome postoperatively, and both improved after IABP placement. 1 patient in Heartstring group developed acute inferior myocardial infarction, which was improved after IABP placement. Coronary CTA 3 months after operation showed that there was no proximal anastomotic stenosis in both groups.Conclusion:There is no significant difference between the 2 proximal anastomosis methods in preventing stroke after OPCABG in patients with ascending aortic calcification. Compared with Heartstring, water sac blocking does not increase the risk of proximal anastomotic stenosis. In addition, water sac blocking does not require expensive consumables, which is especially suitable for patients with limited funds and can be generalized.

Objective:To explore the clinical value of aspirin combined with atorvastatin in the prevention of new onset atrial fibrillation after off-pump coronary artery bypass grafting (OPCABG).Methods:208 patients with coronary artery bypass grafting in our hospital from June 2019 to June 2021 were selected as the research subjects and divided by a random number table method into groups. The control group (104 cases) was treated with aspirin before operation, and the observation group (104 cases) was treated with aspirin and atorvastatin before operation. ECG monitoring was carried out continuously for 7 days of patients in the two groups, and the occurrence and duration of AF were recorded. The clinical therapeutic efficacy, incidence and adverse reactions of AF, left atrial diameter and high-sensitivity C-reactive protein (hs-CRP) level were observed before and after treatment.Results:The incidence of AF in the observation group was significantly lower than that in the control group, the difference was statistically significant ( P<0.05). There was no statistical significant difference in the starting time of AF between the two groups after operation ( P>0.05). The duration of AF in the observation group was better than that in the control group, the difference was statistically significant ( P<0.05). Before treatment, there was no statistical significant difference in left atrial diameter and hs-CRP level between the two groups ( P>0.05). After treatment, the left atrial diameter in the observation group returned to that before treatment, and there was no statistical significant difference in the same group ( P>0.05). The left atrial diameter in the control group was higher than that before treatment, and there was statistical significant difference in the same group ( P<0.05). The level of hs-CRP was lower than that in the control group, the difference was statistically significant ( P<0.05). There were no adverse reactions in both groups. Conclusion:Aspirin combined with atorvastatin has a significant effect in preventing new onset AF after OPCABG. It can reduce the incidence of postoperative AF, shorten the duration of AF, effectively control the inner diameter of left atrium, reduce the degree of postoperative inflammatory reaction, and has no adverse effects. It is worthy of clinical application.

Objective:To investigate the early effect of different antithrombotic therapy in patients with coronary endarterectomy(CE) combined with off-pump coronary artery bypass grafting(OPCABG).Methods:Between January and December 2021, 154 consecutive patients including 120 males and 34 females with the age ranged from 39 to 78 years and an average of(62.6±7.2) years who underwent CE+ OPCABG were evaluated retrospectively. According to the postoperative anticoagulant therapy, patients were divided into two groups: Aspirin+ low molecular weight heparin group(n=81, LMWH group) and Aspirin+ ticagrelor group(n=73, ticagrelor group). The data of both preoperative and postoperative hemoglobin level and blood transfusion after the surgery were collected. The dynamic changes of electrocardiogram and cTnI level were observed within 48 h after the surgery.Results:There was no perioperative death, and all the patients were discharged 5-13 days postoperatively. After the initiation of anticoagulant therapy, the lowest hemoglobin value in the LMWH group and ticagrelor group was(88.3±14.6)g/L vs.(89.5±11.6)g/L( P>0.05), blood transfusion was performed in 8 vs. 5 patients with hemoglobin below 70g/L( P>0.05), peak cTnI within 48 h of surgery was 850.55(410.63, 1 662.63)pg/ml vs. 1 184.60(667.50, 3 169.63)pg/ml( P<0.05), the number of patients with perioperative myocardial infraction within 48h after the surgery confirmed by electrocardiogram was 2(2.5%) vs.2(2.5%), P>0.05. Conclusion:There was no significant difference between the two anticoagulant treatments in preventing perioperative myocardial infarction after CE+ OPCABG surgery. LMWH did not increase the risk of postoperative bleeding compared with ticagrelor. In addition, aspirin+ LMWH reduced the levels of peak TnI within 48 h of surgery, which may be associated with better long-term postoperative outcomes, but further research is needed to confirm this.

Objective:To discuss the clinical efficacy of Xuesusheng granule for cancer related fatigue （CRF） deficiency of both Qi and blood in clinical practice， and to investigate its effect on immune function and quality of life. Method:According to random number table method， 118 patients were divided into observation group （59 cases） and control group （59 cases）. Patients in control group got Ejiao Huangqi oral liquid， 10-20 mL/time， 2 times/day. Patients in observation group got Xuesusheng granule， 10 g/time， 3 times/day. The treatment was continued for 8 weeks in both groups. Before and after treatment， scores of cancer fatigue scale （CFS）， functional assessment of cancer therapy （FACT） and Qi and blood deficiency syndrome were graded， and degree of fatigue was discussed with brief fatigue inventory scale-Chinese （BFI-C）. Levels of white blood cell count （WBC）， neutrophil count （NEU）， platelet count （PLT）， red blood cell count （RBC）， and hemoglobin （Hb） were compared before and after treatment.T lymphocyte subsets of （CD3⁺， CD4⁺， CD8⁺） levels， natural killer （NK） cells， interleukin-1（IL-1）， IL-6， IL-8 and tumor necrosis factor -α （TNF -α） were also detected， and the safety was evaluated. Result:After treatment the scores of each factor in CFS scale and the total score of CFS in the observation group were lower than those in the control group （P<0.01）， and the degree of fatigue was lower than that in control group （Z=2.101， P<0.05）. The total score of FACT and the scores of four dimensions of physiology， society/family， emotion and function in the observation group were lower than those in the control group （P<0.01）. Levels of WBC， NEU， RBC and Hb in the observation group were higher than those in the control group （P<0.01）. Scores of BFI-C， deficiency of Qi and blood were lower than those in control group （P<0.01）. Levels of NK， CD3⁺， CD4⁺ and CD4⁺/CD8⁺ in the observation group were all higher than those in the control group （P<0.01）， while the IL-1， CD8⁺， IL-6， IL-8 and TNF-α levels in observation group were lower than those in the control group （P<0.01）. Not observed， there was no adverse reaction related to Xususheng granule. Conclusion:Xuesusheng granule can improve the symptoms of fatigue， reduce the degree of fatigue， improve the quality of life， reduce the degree of bone marrow suppression， improve immune function， and regulate immune inflammatory factors with high clinical efficacy in the use for patients with CRF and deficiency of Qi and blood.

With the appearance of the disadvantages of traditional tumor treatment, immunotherapy has entered people′s horizons as modern emerging treatment strategies, among which plant polysaccharides have received much more attention due to their antitumor activity and significant immunomodulatory effects. Tumor-associated macrophages (TAMs), as a component of tumor microenvironment, are important factors affecting tumors, and the regulation of TAMs by plant polysaccharides is one of the effective immunotherapy to treat tumor. In this review, we mainly described the regulation of TAMs by plant polysaccharides and the underlying mechanisms, and then gave an outlook on the research interests and the development of plant polysaccharides as immune adjuvants, aiming to provide reference for the study of plant polysaccharides in the immunotherapy for tumors.

Objective:To describe a distal anastomosis support (DAS) technique, and retrospectively investigate the effect of DAS on the mid-term graft patency of patient with small posterior descending artery.Methods:Between January and December 2016, 100 patients with triple-vessel disease and small PDA who continuously underwent off-pump coronary artery bypass grafting (OPCABG) (OPCABG group, n=50) and OPCABG with DAS for anastomosis of PDA grafted by saphenous vein (SVG) (OPCABG+ DAS group, n=50) were evaluated retrospectively. The dynamic changes of electrocardiogram and TnI level were observed within 48h after the surgery. All patients came back to follow-up visit 6th, 12th, 24th and 36th postoperative month. The primary endpoint was the graft failure (FitzGibbon B or O) of SVG-PDA on the follow-up CTA.Results:There was no death during the operation. There was no acute inferior wall myocardial infarction confirmed by electrocardiogram. Peak TnI within 48h of surgery was 0.74(0.98)ng/ml vs. 0.92(1.29)ng/ml, P>0.05, and the number of patients with peak TnI≥70×ULN was 3(6%, 3/50) vs.5(10%, 5/50), P>0.05. There was no postoperative death, and all the patients were discharged 5-15 days postoperatively. We found significantly improved cumulative graft patency in OPCABG+ DAS group at 36 months after operation [85.7%(42/49) vs. 68.0%(34/50), P<0.05). In multivariate logistic regression analysis, PDA with atherosclerotic lesions ( OR=6.513, 95% CI: 1.279-33.180, P=0.024), and peak TnI≥70×ULN within 48 h of surgery ( OR=5.948, 95% CI: 1.128-31.368, P=0.036) were independent predictors of graft failure, whereas concomitant DAS ( OR=0.222, 95% CI: 0.069-0.713, P=0.011) was significant protective factor. Conclusion:Concomitant DAS conferred superior mid-term patency of SVG-PDA in patients with small PDA. Adding the DAS procedure to OPCABG may be a promising surgical option for small PDA with atherosclerotic lesions.